Opting Out

[DermViser]

---

Members don't see this ad.

So I thought this was quite interesting:

• "first of all doctors will not opt out,"
• "the doctors will take who is in the exchange bc they have to there's a large number of people who will be there"
• "but when you do poll doctors, esp. young doctors <40s, 60% of them actually support Obamacare, and like it,
• "so if your kid has a sore throat and you want to find out if it's strep throat, or your kid has what appears to be a nerve(?) infection and you want to find out if it's otitis media, you don't really need to go to a pediatrician.
• "Well you don't need a doctor for every part of your healthcare!"

Seems like the goal is to tamp down patient expectation of being able to be seen and evaluated by a physician. Does he not realize that NPs are fighting for equal reimbursement and thus any cost savings the govt. wants for seeing a PA or NP disappears? Gotta admit, I'm not much of a Bill O'Reilly fan, but appreciated him hold Emanuel's feet to the fire on the assertion that doctors HAVE to do what he says.

Doctors are already limiting the patients they see from Medicare and Medicaid, so what's to stop them from doing the same with those with Obamacare exchange plans?

 

[SouthernSurgeon]

Doctors are already limiting the patients they see from Medicare and Medicaid, so what's to stop them from doing the same with those with Obamacare exchange plans?

The eventual mandate that we do so that they're surely going to try and push through?

 

[DermViser]

The eventual mandate that we do so that they're surely going to try and push through?

But if they haven't been able to pass a federal mandate that doctors must take Medicaid and Medicare patients, when those programs have been around for decades, then how would this?

 

[JJMrK]

This is tangential and not even really related to your post, but the part where he talks about "zero breach" of the electronic health record is just silly. Plug "HIPPA violation" into google news and you'll get dozens and dozens of articles just from the past month. Not sure what he was thinking.

 

[TheWeeIceMan]

But if they haven't been able to pass a federal mandate that doctors must take Medicaid and Medicare patients, when those programs have been around for decades, then how would this?

Boomers will somehow make this happen when they find out that they can't get anything and everything they want out of the healthcare system.

 

[calvnandhobbs68]

lol we can't even get different builds of epic to talk to each other right now. Not sure how we're gonna start uploading the last CVS Minuteclinic visit into our EMR anytime soon.

 

[DermViser]

This is tangential and not even really related to your post, but the part where he talks about "zero breach" of the electronic health record is just silly. Plug "HIPPA violation" into google news and you'll get dozens and dozens of articles just from the past month. Not sure what he was thinking.

Yes, that's what I thought too! My guess is that he took personal offense that maybe O'Reilly was implying his signature piece of legislation might make it easier for these HIPPA violations to occur. Which is only reasonable as the law requires all health entities to implement EHR.

On another tangent, I thought it was interesting that he veered directly into "concierge" medicine (leaving out direct primary care) when Bill O'Reilly mentioned not taking Obamacare exchange plans, and then when O'Reilly mentions they can choose to just take other types of private insurance plans (not in the exchange) his answer was that young doctors support Obamacare and will be his little army and take it.

In all his interviews, he's done he seems more interested in acting as a partisan idealogue defending every part of the law no matter what, without acknowledging any downsides (or maybe in his mind, since this is his baby, there are no downsides).

 

[DermViser]

lol we can't even get different builds of epic to talk to each other right now. Not sure how we're gonna start uploading the last CVS Minuteclinic visit into our EMR anytime soon.

Interesting enough the CEO of Epic which has one of the largest shares of the EHR market due to Obamacare (40%) just HAPPENS to be one of Obama's biggest donors:
http://www.forbes.com/sites/zinamou...dy-faulkner-health-cares-low-key-billionaire/
http://www.nytimes.com/2013/02/20/b...ata-swells-profits.html?pagewanted=1&hpw&_r=0

 

[Dires]

But if they haven't been able to pass a federal mandate that doctors must take Medicaid and Medicare patients, when those programs have been around for decades, then how would this?

They could do a see one see them all approach, no? Aka if you want Medicare money you have to also see those on Medicaid and exchanges.

 

[dadaddadaBATMAN]

Interesting enough the CEO of Epic which has one of the largest shares of the EHR market due to Obamacare (40%) just HAPPENS to be one of Obama's donor:
http://www.forbes.com/sites/zinamou...dy-faulkner-health-cares-low-key-billionaire/
http://www.nytimes.com/2013/02/20/b...ata-swells-profits.html?pagewanted=1&hpw&_r=0

I don't mean to offend, but what exactly is your point?

I wouldn't be shocked if Mitt Romney happened to have backing from gun companies or pro-life groups: it isn't exactly shocking that a CEO would want to help re-elect an official who is mandating her industry's expansion. Especially considering Judy Faulkner has been expanding EMR's role for close to 30 yrs. Not exactly sinister stuff, or unexpected.

 

[DermViser]

I don't mean to offend, but what exactly is your point?

I wouldn't be shocked if Mitt Romney happened to have backing from gun companies or pro-life groups: it isn't exactly shocking that a CEO would want to help re-elect an official who is mandating her industry's expansion. Especially considering Judy Faulkner has been expanding EMR's role for close to 30 yrs. Not exactly sinister stuff, or unexpected.

Great first post Judy Faulkner! Her donations came BEFORE the mandate, not after.
http://www.chicagonow.com/publius-f...al-records-czar-hoodwink-members-of-congress/
http://www.breitbart.com/Big-Govern...are--Wheres-the-Investigation-of-Epic-Systems (hate to use this source, but it proves a point)

Markay reports that Judy Faulkner was appointed to a stimulus-created board that is charged with disbursing billions of taxpayer dollars for health information technology adoption despite her opposition to the administration’s interoperability goals, which require that health records be shareable across platforms. Faulkner is also the sole representative for the health IT industry on the committee, which has the power to set industry standards.

 

[dadaddadaBATMAN]

Great first post Judy Faulkner! Her donations came BEFORE the mandate, not after.

I appreciated the bold part of the quote

I was not aware that the donations came before the mandate: the second article implied that EPIC/its employees have collectively donated $300,000 to democrats since 2006. It didn't seem to stipulate a specific timeline (i.e. just before the decision to add EHR to the ACA)

I am still confused on what your point is, sorry if I am being slow. For reference, here are the quotes I am addressing.

Interesting enough the CEO of Epic which has one of the largest shares of the EHR market due to Obamacare (40%) just HAPPENS to be one of Obama's donor:
Markay reports that Judy Faulkner was appointed to a stimulus-created board that is charged with disbursing billions of taxpayer dollars for health information technology adoption despite her opposition to the administration’s interoperability goals, which require that health records be shareable across platforms. Faulkner is also the sole representative for the health IT industry on the committee, which has the power to set industry standards.

Are you pointing out the corruption of our current political system, venting about the Obama administration, or something else? I understand the point of this thread is to talk about the linked video: I am just confused by the purpose in bringing up Faulkner's donations/habits.

If you want to imply that there was a quid-pro-quo, I honestly don't know enough about the situation to argue it. As for the 40% number, EPIC already covers around half the country anyway. 40% of future EHR is around on par with current level of dominance. I agree that she should not be a sole-adviser to any congressional committee, and that she is obviously not an objective adviser. However, if you want to talk about conflicts of interest, you could also talk about various Wisconsin (republican) congressman supporting government use of EPIC systems. It promotes job growth in Wisconsin, where EPIC has 5000+ employees, and corresponding economic growth.

I think it would be silly of her not to oppose interoperability goals. For starters, it isn't in EPICs economic interest (as implied). I can't think of many companies that like to give a leg up to their competition.

But it would also just be a major pain in the ass. The hospital systems all implement what are essentially custom models of EPIC software. It would cause a lot of issues to get even two of these systems to talk, much less many.

of course, this is coming from my mild understanding of programming and the information my s/o (who works at epic as a developer) has given me.

I need to get to sleep, but I'm curious what you're thinking

 

[LostinLift]

That guy is such a boner that he's making Bill O'Reilly look good. I have a strong suspicion that doctors will have significantly more bargaining power in the next 10 years when the number of patients starts to sharply increase. Hopefully we can get what we want and provide quality care to these patients, while screwing over all the collective CEOS and idiot government officials.

 

[DermViser]

That guy is such a boner that he's making Bill O'Reilly look good. I have a strong suspicion that doctors will have significantly more bargaining power in the next 10 years when the number of patients starts to sharply increase. Hopefully we can get what we want and provide quality care to these patients, while screwing over all the collective CEOS and idiot government officials.

Yes, he seems to be quite delusional as well: http://www.washingtonpost.com/opini...a4c3a8-a877-11e3-8599-ce7295b6851c_story.html

"“beginning in 2020 or so, the ACA will increasingly be seen as a world historical achievement, even more important for the United States than Social Security and Medicare has been. And Barack Obama will be viewed more like Harry Truman — judged with increasing respect over time.”

"What’s the biggest single tax break in the United States? Tax-free health benefits, nearly four times as large ($250 billion) as the mortgage interest deduction ($70 billion). With employers able to offer health insurance to employees free of tax, the benefits became an increasingly important part of pay over the years. Getting rid of that deduction, Emanuel makes clear, is one fix that he regrets was left out of the new health-care law."

"Where Emanuel goes off the rails is in extrapolating from these provisions of the law a vastly different future. He posits the end not only of health-care inflation but also of medical insurance as we know it. He sees employers ceding their roles as providers of access to health care, technology replacing costly hospital stays and specialists, hospitals closing in large numbers, and the remaining ones becoming safer and more efficient."

 

[Frazier]

That guy is such a boner that he's making Bill O'Reilly look good. I have a strong suspicion that doctors will have significantly more bargaining power in the next 10 years when the number of patients starts to sharply increase. Hopefully we can get what we want and provide quality care to these patients, while screwing over all the collective CEOS and idiot government officials.

Physicians only have as much bargaining power as the government will allow.

 

[username456789]

They could do a see one see them all approach, no? Aka if you want Medicare money you have to also see those on Medicaid and exchanges.

Unless you're in a specialty where you literally cannot fill your daily schedule without medicare patients, I think most providers would be just as thrilled to drop both medicare and medicaid.

 

[notbobtrustme]

breaking news, american healthcare is a ****ing mess, more at 11.

 

[deleted480308]

this is the cost of all the people that think society owes health care to everyone.....

 

[DermViser]

breaking news, american healthcare is a ******* mess, more at 11.

And ironically enough, the "reform" part, messes up American healthcare even more.

 

[notbobtrustme]

this is the cost of all the people that think society owes health care to everyone.....

no, more like this is what happens when you put off what needed to be done 50 years ago and allow an entire industry to fester around a failed ideology.

And ironically enough the "reform" part, messes it up even more.

the reform was needed in order to let the system to continue to be a zombie for another 40 years. true reform would have actually fixed the core issue with american healthcare.

if the aca didn't go through, then the system would have probably collapsed in 10 years. the aca bought us another 40 years or so of a garbage system that will end up costing even more and hurting more when true reform has to happen.

 

[deleted480308]

no, more like this is what happens when you put off what needed to be done 50 years ago and allow an entire industry to fester around a failed ideology.

No. having the government take us all on as their wards is the cause of all of this. With the government then on the hook for all of our care if we didn't take care of ourselves more and more just fell into the safety net of government medicine. With a higher market share, the government then has an advantage in pay debates on top of their monopoly in policy decisions. Now with ballooning numbers of patients and an aging population, they move to control cost by endorsing midlevels who should not be independent and arbitrarily decreasing reimbursement while adding redtape designed to drive us all into employee mode....all while taxing us at over 30% to pay the bill for our decreased reimbursement.

the flaw in the economics of health care is the free market is not active at all in health care

 

[Substance]

This is kind of a sick game. Doctors vs government, with business profiting either way.

The govt knows that we have to be servants to society, more so than any politicians ever could be. So they drive down incentives knowing that we have taken an oath to not let the sick suffer. This is a low game they're playing.

 

[NontradCA]

No. having the government take us all on as their wards is the cause of all of this. With the government then on the hook for all of our care if we didn't take care of ourselves more and more just fell into the safety net of government medicine. With a higher market share, the government then has an advantage in pay debates on top of their monopoly in policy decisions. Now with ballooning numbers of patients and an aging population, they move to control cost by endorsing midlevels who should not be independent and arbitrarily decreasing reimbursement while adding redtape designed to drive us all into employee mode....all while taxing us at over 30% to pay the bill for our decreased reimbursement.

the flaw in the economics of health care is the free market is not active at all in health care

 

[LostinLift]

This is kind of a sick game. Doctors vs government, with business profiting either way.

The govt knows that we have to be servants to society, more so than any politicians ever could be. So they drive down incentives knowing that we have taken an oath to not let the sick suffer. This is a low game they're playing.

That's the problem. I don't think it would be too difficult for physicians to "unionize" in the next 5-10 years, but we can't or rather wouldn't attempt a strike because the patients would suffer the most, not the government or business. Unless there could be some other way to protest while still treating patients.

 

[Deadlifts]

That's the problem. I don't think it would be too difficult for physicians to "unionize" in the next 5-10 years, but we can't or rather wouldn't attempt a strike because the patients would suffer the most, not the government or business. Unless there could be some other way to protest while still treating patients.

Except it's illegal for physicians to unionize.

 

[LostinLift]

Except it's illegal for physicians to unionize.

Most protests in the history of The United States have been "illegal".

Edit - And I said "unionize", not actually form an official union

 

[KinasePro]

Except it's illegal for physicians to unionize.

It'd also be illegal for the gov't to force physicians to do business with a single payer, which is one of many reasons why I doubt single payer will ever happen in our lifetimes.

EDIT: Also, a cursory web search yields multiple articles refuting the claim that docs can't unionize. There are already doctor's unions in place. One example is BUMC, where resident physicians have formed a union.

 

[Wordead]

I believe doctors can unionize but not STRIKE.

 

[circulus vitios]

That's the problem. I don't think it would be too difficult for physicians to "unionize" in the next 5-10 years, but we can't or rather wouldn't attempt a strike because the patients would suffer the most, not the government or business. Unless there could be some other way to protest while still treating patients.

Nurses and teachers strike all of the time. Physicians in Los Angeles County striked for the entire month in 1976. I have no moral qualms about striking.

 

[circulus vitios]

Except it's illegal for physicians to unionize.

It's absolutely legal.

http://blog.medicaljustice.com/can-doctors-form-a-union/

 

[Deadlifts]

It's absolutely legal.

http://blog.medicaljustice.com/can-doctors-form-a-union/

So hospitalists and residents can?

Most protests in the history of The United States have been "illegal".
Edit - And I said "unionize", not actually form an official union

True, I didn't take note of the quotation marks.

 

[PL198]

I mean if you look at the medical culture of the US, it's pretty easy to see why most doctors aren't politically active. 1) A lot of doctors come from families with doctors, and they don't really care what the government does because they think they will always be ok, because being a doctor is the greatest thing ever. 2) A lot of medical students are the common academic type, sit in their room all day, memorize notes, do well in school and don't care about the outside world.

Until physicians get their **** together and actually band together and make a stand against the progressive health care reform, they will just keep getting destroyed. I feel like majorities of physicians have the thoughts I wrote in #1, and for this reason aren't politically active at all. I have classmates that didn't know who the vice president was. That's pretty significant. The whole medical culture is basically about turning medical students into memorizing machines, which don't tend to be the people that care/ are active in politics.

 

[circulus vitios]

So hospitalists and residents can?




True, I didn't take note of the quotation marks.

Uh, read the link. Any physician who is a hospital employee. This includes a lot more than just hospitalists.

 

[Dires]

Unless you're in a specialty where you literally cannot fill your daily schedule without medicare patients, I think most providers would be just as thrilled to drop both medicare and medicaid.

Which specialties could afford to do this? I was under the impression that the majority if physicians did depend on Medicare patients to fill their schedules.

 

[synecdoche]

Which specialties could afford to do this? I was under the impression that the majority if physicians did depend on Medicare patients to fill their schedules.

I'm confused for the same reason

 

[repititionition]

No. having the government take us all on as their wards is the cause of all of this. With the government then on the hook for all of our care if we didn't take care of ourselves more and more just fell into the safety net of government medicine. With a higher market share, the government then has an advantage in pay debates on top of their monopoly in policy decisions. Now with ballooning numbers of patients and an aging population, they move to control cost by endorsing midlevels who should not be independent and arbitrarily decreasing reimbursement while adding redtape designed to drive us all into employee mode....all while taxing us at over 30% to pay the bill for our decreased reimbursement.

the flaw in the economics of health care is the free market is not active at all in health care

Not sure that if you run down the OECD and look at HC financing models you will see anyone going the route of "more market" than we do. It doesn't seem to work well here and there is a reason why it's not being used anywhere else (that is worth emulating).

 

[Frazier]

Which specialties could afford to do this? I was under the impression that the majority if physicians did depend on Medicare patients to fill their schedules.

I'm confused for the same reason

Psych.
Cosmetic plastics.
Any concierge service.

 

[@JackShephard]

So I thought this was quite interesting:

• "first of all doctors will not opt out,"
• "the doctors will take who is in the exchange bc they have to there's a large number of people who will be there"
• "but when you do poll doctors, esp. young doctors <40s, 60% of them actually support Obamacare, and like it,
• "so if your kid has a sore throat and you want to find out if it's strep throat, or your kid has what appears to be a nerve(?) infection and you want to find out if it's otitis media, you don't really need to go to a pediatrician.
• "Well you don't need a doctor for every part of your healthcare!"

Seems like the goal is to tamp down patient expectation of being able to be seen and evaluated by a physician. Does he not realize that NPs are fighting for equal reimbursement and thus any cost savings the govt. wants for seeing a PA or NP disappears? Gotta admit, I'm not much of a Bill O'Reilly fan, but appreciated him hold Emanuel's feet to the fire on the assertion that doctors HAVE to do what he says.

Doctors are already limiting the patients they see from Medicare and Medicaid, so what's to stop them from doing the same with those with Obamacare exchange plans?

He's pretty open with the idea that the goal of this system is to increase mid-levels services.

Is this good or bad? Sure, it could be very good. Also, when they get in over their head it could be bad. I'm sure when these acute care clinics are expanded there will be PAs and NPs missing MIs, meningitis, severe bowel disease, and more. Futhermore, if they are really sick they will just send them to an emergency department. Which means they just went to 2 different clinics for one problem, possibly with transport (as you can't let a sick patient just drive over to the next clinic).

A more efficient system would be better than a more fragmented system with more providers NOT working together. The medical records will be even more spread out - acute care clinic records, FM doc records, EM records, specialist records - nightmare organization and increased costs.

 

[@JackShephard]

American healthcare sucks.

 

[PL198]

American healthcare sucks.

Anything the government does is a ticking time bomb.

 

[sinombre]

In all his interviews, he's done he seems more interested in acting as a partisan idealogue defending every part of the law no matter what, without acknowledging any downsides (or maybe in his mind, since this is his baby, there are no downsides).

Yep, you hit nail on the head.

"What happens when physicians don't take insurance plans on the healthcare exchange?"
"That's obviously not a possibility, because then my idea won't work."

He literally had no way of addressing this seemingly straightforward and extremely important question. It's kind of scary to be honest.

 

[deleted480308]

Not sure that if you run down the OECD and look at HC financing models you will see anyone going the route of "more market" than we do. It doesn't seem to work well here and there is a reason why it's not being used anywhere else (that is worth emulating).

We don't have the free market here....either in education that is held in monopoly by two government sanctioned groups while the cost is artificially inflated by government student loans, residency artificially restricted by the funding process, payment plagued by bloated insurance plans for the decreasing number of patients not on the government tab, lack of competition among hospitals due to "demonstrated need" requirements to build a new one, and the unreal expectation that you have to treat someone without any method of exacting payment.

Saying the US is "more free market" in health care than other countries is like saying the prisoners in your prison are more free than the prisoners in mine because you give them more channels on the TV

 

[PL198]

Capitalism is really good when it's allowed to run it's free course and not be destroyed by sanctions based on pity and vote-grabbing. There's a reason as the US economy gets farther and farther away from true capitalism, that it's worldwide relative significance decreases . There's a reason these progressive movements have never been successful and led to the collapse of numerous nations.

Monopolies can only exist in markets with government intervention. They aren't possible in a competitive market free from intervention.

There's a reason the world continues to decline as the progressive movement takes hold. "You can't multiply by dividing " is a good place to start that criticism.

 

[DermViser]

He's pretty open with the idea that the goal of this system is to increase mid-levels services.

Is this good or bad? Sure, it could be very good. Also, when they get in over their head it could be bad. I'm sure when these acute care clinics are expanded there will be PAs and NPs missing MIs, meningitis, severe bowel disease, and more. Futhermore, if they are really sick they will just send them to an emergency department. Which means they just went to 2 different clinics for one problem, possibly with transport (as you can't let a sick patient just drive over to the next clinic).

A more efficient system would be better than a more fragmented system with more providers NOT working together. The medical records will be even more spread out - acute care clinic records, FM doc records, EM records, specialist records - nightmare organization and increased costs.

I agree. Any misdiagnoses will be collateral damage. All it will take is for someone prominent to be gravely affected, and these CV and Walmart clinics will grind to a halt. Personally, I can't wait. What's interesting is when this was all being peddled to the public none of this was mentioned. It's all coming out now. I truly can't wait for the implementation of this - based on public reaction alone. Just on skyrocketing premiums and cancelled plans from people who had insurance, people are already hating it. Just wait when the "cost-saving" measures kick in.

 

[notbobtrustme]

Capitalism is really good when it's allowed to run it's free course and not be destroyed by sanctions based on pity and vote-grabbing. There's a reason as the US economy gets farther and farther away from true capitalism, that it's worldwide relative significance decreases . There's a reason these progressive movements have never been successful and led to the collapse of numerous nations.

Monopolies can only exist in markets with government intervention. They aren't possible in a competitive market free from intervention.

There's a reason the world continues to decline as the progressive movement takes hold. "You can't multiply by dividing " is a good place to start that criticism.

learn your historty. The ideology of the 1880s till ~1930 was laissez-faire capitalism and that led to the rise of all the great monopolies.

secondly, the "progressive" movement in the US would equivalent to a center-right policy in any other part of the world. Canada recently passed the US in terms of middle class wealth. European countries have a much more vibrant middle class than the US. This isn't the 1950s anymore when the US was #1 in every category imaginable. For the past 30 years, trickle-down economics has lead to the decimation of the middle class. In countries that didn't practice trickle-down economies and actually invested in the majority of their citizens saw a revivial of their middle class, robust growth and greater competitiveness. The countries that do practice trickle-down economics are oligarchies or monarchies designed to enrich a small set of people over the entire country. Economic mobility in the US is at an all-time low since the '50s when that data was collected. In contrast, most other industralized countries and even some ****-hole 3rd world countries have greater economic mobility than we do.

Saudi Arabia, Oman, Russia, Myanmar, China are all examples of countries with an implicit or explicit trickle-down economic theory. It's no surprise that most of these countries have **** middle-classes and little upward mobility.

 

[NickNaylor]

As the ****tiness of working with these systems becomes more and more apparent to all involved, I think medical students will begin to pay more credence to them when it comes to choosing their specialty and the context in which they would ultimately like to practice. I know I certainly did; it was a major branch point for me for choosing psych over peds. I think it's also becoming more and more apparent that these systems are hardly working in the best interest of patients. I think most medical students/residents/attendings really do care about their patients and want to do right by them, and when you see how these systems hamper that goal - irrespective of their intent - it's no surprise that physicians want nothing to do with them. Our good friend Ezekiel (I'm assuming that's who he's interviewing since I can't see the video) fails to understand how these policies translate into the actual day-to-day work of a practicing physician. What a surprise. You mean to say that having an EMR isn't some kind of panacea that's going to make the practice of medicine 10000% more efficient and reduce medical errors by 100% WHAT?!?

For myself, I intend to operate a cash-only practice with a not insignificant portion of patients seen on a sliding scale basis exactly to avoid dealing with these systems. I think that'll strike a nice balance between autonomy and freedom from insurance headaches while also fulfilling what I see for myself as some kind of social obligation to provide services regardless of ability to pay. And it isn't even for the salary. When I get out in practice, I want to have the freedom and ability to do what I think is best for the patient sitting in front of me at that moment rather than concerning myself with meeting X State Department of Health arbitrary eligibility requirements to receive reimbursement for services. **** that noise. That distracts from what I want to do (work with patients) and what I think I am best at, which would be anything but filling out paperwork and arguing with some medical director at an insurance company who has spent exactly 0 seconds with my patient yet seems to quite confidently know that treatment Y is not the appropriate treatment and will not be eligible for reimbursement.

I find it interesting that in talking with many physicians, most headaches surrounding their practice largely relate to issues with third party payers. It's no surprise that fields and/or practice structures that can get away from that as much as possible have higher rates of satisfaction.

I'm all for insurance reform, but this halfway nonsense is ridiculous. If you want to have a single payer system, then fine - institute a damn single payer system. Let's go ahead and just get it done rather than these halfhearted attempts that, as notbob suggests, do little more than kick the can down the road. Unfortunately when you boil down a complex topic like healthcare economics into a series of 30 second soundbites, I suppose this is what you get.


Sent from my iPhone using Tapatalk

 

[PL198]

learn your historty. The ideology of the 1880s till ~1930 was laissez-faire capitalism and that led to the rise of all the great monopolies.

secondly, the "progressive" movement in the US would equivalent to a center-right policy in any other part of the world. Canada recently passed the US in terms of middle class wealth. European countries have a much more vibrant middle class than the US. This isn't the 1950s anymore when the US was #1 in every category imaginable. For the past 30 years, trickle-down economics has lead to the decimation of the middle class. In countries that didn't practice trickle-down economies and actually invested in the majority of their citizens saw a revivial of their middle class, robust growth and greater competitiveness. The countries that do practice trickle-down economics are oligarchies or monarchies designed to enrich a small set of people over the entire country. Economic mobility in the US is at an all-time low since the '50s when that data was collected. In contrast, most other industralized countries and even some ****-hole 3rd world countries have greater economic mobility than we do.

Saudi Arabia, Oman, Russia, Myanmar, China are all examples of countries with an implicit or explicit trickle-down economic theory. It's no surprise that most of these countries have **** middle-classes and little upward mobility.

Nah sorry. People taking opportunity and producing superior companies that hold large market shares isn't a monopoly. It's just success. Just because captains of industry came up with successful methods and were willing to work harder and smarter than their competitors to win, there's nothing wrong with that. How is Canada and Europe doing financially ? I'd be surprised if Europe is still afloat in ten years at this rate. Look at all the countries that are actually doing well economically. China is increasingly capitalist, I wonder why ? Japan ? Hey how is Germany doing ? How about India ? Oh right, but your collapsing Europe should be the model for success.

Taking money away from people that earn it and giving it back to the "middle class " isn't actually helping the middle class. It's giving someone with their hand out a service so they vote for you. People that work hard , improve their quality of life. There have been 0 successful progressive economic movements in the history of mankind. Literally 0. All it does is create laziness, justify failure and lead to collapse. It's just a cute academic notion that people who have never experienced the world use to make themselves feel better about themselves. Queue the story about teaching someone to fish, vs giving them the fish.

 

[notbobtrustme]

Nah sorry. People taking opportunity and producing superior companies that hold large market shares isn't a monopoly. It's just success. Just because captains of industry came up with successful methods and were willing to work harder and smarter than their competitors to win, there's nothing wrong with that. How is Canada and Europe doing financially ? I'd be surprised if Europe is still afloat in ten years at this rate. Look at all the countries that are actually doing well economically. China is increasingly capitalist, I wonder why ? Japan ? Hey how is Germany doing ? How about India ? Oh right, but your collapsing Europe should be the model for success.

Taking money away from people that earn it and giving it back to the "middle class " isn't actually helping the middle class. It's giving someone with their hand out a service so they vote for you. People that work hard , improve their quality of life. There have been 0 successful progressive economic movements in the history of mankind. Literally 0. All it does is create laziness, justify failure and lead to collapse. It's just a cute academic notion that people who have never experienced the world use to make themselves feel better about themselves. Queue the story about teaching someone to fish, vs giving them the fish.

[citation needed]

 

[PL198]

[citation needed]

Ok Europe and Canada are the premier economic powerhouses of the world, while China, Japan and India clearly are slacking.
Glad we got that straightened out.

 

[NickNaylor]

Nah sorry. People taking opportunity and producing superior companies that hold large market shares isn't a monopoly. It's just success. Just because captains of industry came up with successful methods and were willing to work harder and smarter than their competitors to win, there's nothing wrong with that. How is Canada and Europe doing financially ? I'd be surprised if Europe is still afloat in ten years at this rate. Look at all the countries that are actually doing well economically. China is increasingly capitalist, I wonder why ? Japan ? Hey how is Germany doing ? How about India ? Oh right, but your collapsing Europe should be the model for success.

Taking money away from people that earn it and giving it back to the "middle class " isn't actually helping the middle class. It's giving someone with their hand out a service so they vote for you. People that work hard , improve their quality of life. There have been 0 successful progressive economic movements in the history of mankind. Literally 0. All it does is create laziness, justify failure and lead to collapse. It's just a cute academic notion that people who have never experienced the world use to make themselves feel better about themselves. Queue the story about teaching someone to fish, vs giving them the fish.

I'm by no means an expert in international trade or macroeconomics, but even I know that your understanding of history and interpretation of current events would, at best, be ill-informed. Your ideology is the same ol GOP garbage that pretends that success is simply an effort of hard work and, therefore, that failure is simply due to not working hard enough. Any reading of history that is so dichotomous is immediately suspect.


Sent from my iPhone using Tapatalk