so yeah...about this healthcare bill thing

[Stare Decisis]

I mostly agree with your points JackADeli, but there are several ways that healthcare can be paid for, they are just unpopular. We could definitely cut national defense funding, restructure social security, and increase the retirement age. You mention these things and are right on the mark. I am personally in favor of a clean living tax for individuals who are obese amongst other things. Things such as tort reform or importation of drugs from Canada are other ways to bring down costs but have only been given a glance. We can agree that there is certain basic level of healthcare that all human beings are entitled, as always the devil is in the details. How much do they deserve? Is it possible to redistribute without grossly infringing on the rights of citizens with healthcare? It it worth mentioning that the majority of these people do not want to give up their govt goodies (social security, medicare, elderly drug prescription plan) but cry foul when someone else is in danger of receiving the same. This bill forces the first step which I am in favor of, hoping that people will now address the tough issues mentioned above. Especially considering that there are approximately 50-60 million people are under-insured or w/o insurance, and most people who are happy with their coverage are on medicare or have never had to deal with a major health crisis. As with most things in this country, civil rights, medicare, and now healthcare, we have to force the ball forward even if the country is not ready and then play defense like hell to recover. I know its crazy, but the house was smoldering and we just put it on fire, maybe now the fire department will come.

On another point, it has been shown that if everyone with a subprime mortgage defaulted it would not have led to the "great recession" it was the OTCs(over the counter derivatives) that did the damage. Which was actually recognized by a woman, Brooksley Born, but Greenspan and SEC chair actively discredited her because of their love for invisible hand of Adam Smith. As I see it, Democrats benefit from putting their relatively poor constituents in homes, but Republicans benefited from the increased business generated from the shady dealings. Point being, it was not the moral drive to put everyone it a home that caused the trouble but rather greed(red states) and political positioning (blue states).

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[thedrjojo]

And while the subprime lending contributed to the economic problems we are currently in (which was set up by the Dems), the bigger thing leading to this collapse is that firms would take these risky investments, bundle them, divide them up, call them secure and wonderful investments (AAA instead of the junk they really were) and sell them and make huge profits off of them... not to mention accounting fraud like seen in Lehmon Brothers where, each time before they would report their books, would sell 50billion of toxic assests to a dummy company for 50billion "cash" assest, then after the audit, buy the toxic assests back, etc. So, if there weren't the crappy loans in the first place, they couldn't have been packaged, etc. But, if they weren't trying to game the system and calling these things bonafide, and if the deregulation and lack of oversight, mainly put in place by Republicans, then when the subprimes collapsed, it wouldn't have dominoed as it did.

On another point, it has been shown that if everyone with a subprime mortgage defaulted it would not have led to the "great recession" it was the OTCs(over the counter derivatives) that did the damage. Which was actually recognized by a woman, Brooksley Born, but Greenspan and SEC chair actively discredited her because of their love for invisible hand of Adam Smith. As I see it, Democrats benefit from putting their relatively poor constituents in homes, but Republicans benefited from the increased business generated from the shady dealings. Point being, it was not the moral drive to put everyone it a home that caused the trouble but rather greed(red states) and political positioning (blue states).

Thanks for agreeing with me... I need to make short posts or either every detail gets picked apart line by line, or nobody pays attention to any of it

JAD, you continue to make good points, and I agree with you. Social Security and Medicare need some financial restructuring/retooling to make them work. Medicare is getting a needed bit of help increasing the tax on those making over 200K, which you might see as punishing that rich, but I see it as no longer putting the larger burden of medicare on the middle and low class. Medicare, as a flat tax, essentially is a regressive tax, since it takes more disposible income away from those making less than it does from those making a lot. Social Security is even a worse regressive tax because it caps what it takes from people at 100K, meaning that someone making 100K pays the same $6,324 (I believe SS tax is 6.2%) as the person making 1million, so it really only takes 0.62% from the person making 1 million. If we removed that cap, or atleast increased it. Now, I also know the arguments on the fact that when it is paid out it does favor those who have earned less in their lifetime, but, as you pointed out, we have a funding problem with it, and changing them addresses an immediate funding issue, since a large portion of all earnings go untaxed through SS).

And this new bill, the new health insurance subsidies, doesn't fall into these problems. Why is that? It is not going to work in the same way that SS/Medicare claim to work. SS/Medicare are programs funded and administered by the government, where the current payors have no chance of being the current receivers... it is a you pay now, and while it is looking like in the books that your payments are being secured to be available when you become of age, like a 401K or IRA, they are actually being used to pay current receivers SS. These subsidies are administered by the government for private company plans to my dismay (since I wanted atleast a public option, but even that would have worked differently from SS/Medicare since the public option would *should* have been run like a real health insurance, where the funds came from the insurance premiums, and the only government subsidy would have been from those that would have gotten the subsidy if they were buying private insurance as well with no other money infused into the program to keep it solvent). Therefore, the money being raised now only needs to cover what is being dolled out now, as opposed to SS/Medicare which needs to show that it can cover now and all of the future.

 

[opr8n]

reading and even thinking about this bill makes me nauseated
I dont know how any doctor in their right mind could like this bill
this bill is for idealists, not realists
im glad im in the military, guess ill just stay there for the rest of my career
Ill be makeing about as much money as all the fools who like this bill and working less than half the hours (when im not playing in the sandbox)
The state of healthcare is heading towards a system that looks like the VA system, and most of those are disasterous. Anyone who is optomistic about the furture of health care after this bill is blind to the reality of the political situation we currently find ourselves in

of note: this is an editorial comment, facts can be found in many other places, not here

 

[PostLessOne]

It's interesting to see how many people here, even ones who claim they are attending physicians (and presumably educated to the limit of their ability level) go crazy with rhetoric.

Here's the deal. Certain reforms had to be done. Tying health insurance availability to being employed by a business of a minimum size was stupid. It meant that if you had a job and DID have the money to buy a share of group health insurance, you couldn't get it if your employer didn't offer it. (because you would have to use after tax dollars to buy the insurance, and because the individual insurance market tends to be both unaffordable and crammed full of exclusionary policies. Get sick, and the insurance company will try to prove you had a pre-existing condition and lied about it)

Well, if you axe pre-existing conditions, you have to require that every person who has the money to buy insurance buys it. Can't have the good (no pre-existing conditions) without the bad (mandatory insurance bought by everyone).

A lot of people have tried to deny this reality.

Now, what happened is, due to the way the parlimentary system works, this basic plan to patch health care has ballooned into a huge piece of legislation, crammed full of illogical pork and special favors to get through the legislature. This is why the bill does stupid things like fine people who refuse to buy insurance less money than said insurance would cost. Because making the fines realistic would be unpopular.

This is why they didn't pass a bill right after pulling all our troops out of foreign countries and cutting the defense budget in half. This would be unpopular. Even though we would need this money, and we would save orders of magnitude more lives with better health care than we would lose to terrorists. (fighting terrorists is the reason the military has double the budget right now than it did in the late 90s)

This is the reason why we didn't set up a panel to decide which medical treatments are cost effective, and which ones aren't. Thus, anyone who needed a medical treatment that wasn't cost effective would be allowed to die. This is popularly called a death panel, and is a necessary evil. You can't spend $300,000 on an LVAD if by the patients age and disease type they are only going to gain back 6 months of life before they die anyway. This is because if you blow the $300k, you have to scrimp somewhere else, causing someone else to suffer. Conservation of wealth is ultimately tied to thermodynamics, and is a physical law, not an economic one. (If you manage to make that LVAD only cost $25k-50k, that's different)

Anyways, I could go on, but I think I've made my point. The system does need fixing, but all the entrenched special interests have created various crazy stories to argue against it rather than logic and educated, reasoned arguments. All the people FOR reform have created similar crazy stories to argue the OTHER direction! The people for reform have said it's going to be free (REDUCE the deficit!) and it won't cost anyone but the rich anything in extra taxes! Also, those same people will point to the salaries of insurance company CEOs as the source of the problem. As if a few tens of million in compensation makes any real difference to a multi-billion dollar corporation. The reason that Health Insurance company X denies your claims is not to give the CEO a bigger bonus. The company does it because the rules allow it, and because a corporation is a machine for making as much money as possible, at any cost that doesn't reduce long term profits. If the CEO doesn't deliver, he will be replaced. Hence if you want corporations to behave, you have to write rules and enforce them, or by default a corporation will misbehave if the cost of misbehaving is less than the profits gained. This is one of the fundamental holes in capitalism that has to be patched by government.

 

[thedrjojo]

Anyways, I could go on, but I think I've made my point. The system does need fixing, but all the entrenched special interests have created various crazy stories to argue against it rather than logic and educated, reasoned arguments. All the people FOR reform have created similar crazy stories to argue the OTHER direction! The people for reform have said it's going to be free (REDUCE the deficit!) and it won't cost anyone but the rich anything in extra taxes! Also, those same people will point to the salaries of insurance company CEOs as the source of the problem. As if a few tens of million in compensation makes any real difference to a multi-billion dollar corporation. The reason that Health Insurance company X denies your claims is not to give the CEO a bigger bonus. The company does it because the rules allow it, and because a corporation is a machine for making as much money as possible, at any cost that doesn't reduce long term profits. If the CEO doesn't deliver, he will be replaced. Hence if you want corporations to behave, you have to write rules and enforce them, or by default a corporation will misbehave if the cost of misbehaving is less than the profits gained. This is one of the fundamental holes in capitalism that has to be patched by government.

Amen to that... although I remember seeing that the top 10 insurance company CEO's compensation, including stock options, was in the order of billions of dollars, not 10's of millions... I think the Aetna CEO alone made like $500 million... but point well taken. People on the right want to believe in the benevolence of corporations while decrying the ineptitude of the government, and people on the left want to hold government as the one true savior against the evil of corporations... its probably more of a combination of ineptness of government in conjunction with the evil of corporations...

 

[Svidrillion]

a corporation is a machine for making as much money as possible, at any cost that doesn't reduce long term profits.

I think Lehman Bros. et al proved that corporations will do anything that doesn't reduce short term profits. The corporation has no long term foresight.

Corporations are inherently evil (but perhaps a necessary evil) and we have just delivered the populace of this country over to probably the most evil of the lot: insurance companies. Here's hoping the law of unintended consequences does not kill us all.

 

[PostLessOne]

Yes, my bad. I meant to say short term. Corporations only rarely think long term, and only if it's a known risk to their profits. (for example, corporations will sometimes make an effort to make a product safer, assuming of course that the expected cost of lawsuits is greater than the cost of changing the product. Corporations don't care about the cost to society of people maimed and killed by a dangerous product, only the cost that the corporation is required to pay after a lawsuit takes 5-10 years to go through all the appeals)

The invisible hand is an excellent resource allocation system. A lot of good has come of it. However, there's a lot of ways it will consistently fail, and health care has numerous elements that make pure capitalism an unworkable way to run it.

 

[2000 Man]

It's interesting to see how many people here, even ones who claim they are attending physicians (and presumably educated to the limit of their ability level) go crazy with rhetoric.

Here's the deal. Certain reforms had to be done. Tying health insurance availability to being employed by a business of a minimum size was stupid. It meant that if you had a job and DID have the money to buy a share of group health insurance, you couldn't get it if your employer didn't offer it. (because you would have to use after tax dollars to buy the insurance, and because the individual insurance market tends to be both unaffordable and crammed full of exclusionary policies. Get sick, and the insurance company will try to prove you had a pre-existing condition and lied about it)

Well, if you axe pre-existing conditions, you have to require that every person who has the money to buy insurance buys it. Can't have the good (no pre-existing conditions) without the bad (mandatory insurance bought by everyone).

A lot of people have tried to deny this reality.

Now, what happened is, due to the way the parlimentary system works, this basic plan to patch health care has ballooned into a huge piece of legislation, crammed full of illogical pork and special favors to get through the legislature. This is why the bill does stupid things like fine people who refuse to buy insurance less money than said insurance would cost. Because making the fines realistic would be unpopular.

This is why they didn't pass a bill right after pulling all our troops out of foreign countries and cutting the defense budget in half. This would be unpopular. Even though we would need this money, and we would save orders of magnitude more lives with better health care than we would lose to terrorists. (fighting terrorists is the reason the military has double the budget right now than it did in the late 90s)

This is the reason why we didn't set up a panel to decide which medical treatments are cost effective, and which ones aren't. Thus, anyone who needed a medical treatment that wasn't cost effective would be allowed to die. This is popularly called a death panel, and is a necessary evil. You can't spend $300,000 on an LVAD if by the patients age and disease type they are only going to gain back 6 months of life before they die anyway. This is because if you blow the $300k, you have to scrimp somewhere else, causing someone else to suffer. Conservation of wealth is ultimately tied to thermodynamics, and is a physical law, not an economic one. (If you manage to make that LVAD only cost $25k-50k, that's different)

Anyways, I could go on, but I think I've made my point. The system does need fixing, but all the entrenched special interests have created various crazy stories to argue against it rather than logic and educated, reasoned arguments. All the people FOR reform have created similar crazy stories to argue the OTHER direction! The people for reform have said it's going to be free (REDUCE the deficit!) and it won't cost anyone but the rich anything in extra taxes! Also, those same people will point to the salaries of insurance company CEOs as the source of the problem. As if a few tens of million in compensation makes any real difference to a multi-billion dollar corporation. The reason that Health Insurance company X denies your claims is not to give the CEO a bigger bonus. The company does it because the rules allow it, and because a corporation is a machine for making as much money as possible, at any cost that doesn't reduce long term profits. If the CEO doesn't deliver, he will be replaced. Hence if you want corporations to behave, you have to write rules and enforce them, or by default a corporation will misbehave if the cost of misbehaving is less than the profits gained. This is one of the fundamental holes in capitalism that has to be patched by government.

I want to thank you for your post. You managed to make this whole mess a bit more understandable and rational. I am no fan of this bill or this administration but your post helped me to see the reasons for this legislation and how someone could see it in a positive light.

We still can't pay for any of this and our country is on the verge of economic collapse but hey, you can't have everything.

 

[joehuf]

It's interesting to see how many people here, even ones who claim they are attending physicians (and presumably educated to the limit of their ability level) go crazy with rhetoric.

Here's the deal. Certain reforms had to be done. Tying health insurance availability to being employed by a business of a minimum size was stupid. It meant that if you had a job and DID have the money to buy a share of group health insurance, you couldn't get it if your employer didn't offer it. (because you would have to use after tax dollars to buy the insurance, and because the individual insurance market tends to be both unaffordable and crammed full of exclusionary policies. Get sick, and the insurance company will try to prove you had a pre-existing condition and lied about it)

Well, if you axe pre-existing conditions, you have to require that every person who has the money to buy insurance buys it. Can't have the good (no pre-existing conditions) without the bad (mandatory insurance bought by everyone).

A lot of people have tried to deny this reality.

Now, what happened is, due to the way the parlimentary system works, this basic plan to patch health care has ballooned into a huge piece of legislation, crammed full of illogical pork and special favors to get through the legislature. This is why the bill does stupid things like fine people who refuse to buy insurance less money than said insurance would cost. Because making the fines realistic would be unpopular.

This is why they didn't pass a bill right after pulling all our troops out of foreign countries and cutting the defense budget in half. This would be unpopular. Even though we would need this money, and we would save orders of magnitude more lives with better health care than we would lose to terrorists. (fighting terrorists is the reason the military has double the budget right now than it did in the late 90s)

This is the reason why we didn't set up a panel to decide which medical treatments are cost effective, and which ones aren't. Thus, anyone who needed a medical treatment that wasn't cost effective would be allowed to die. This is popularly called a death panel, and is a necessary evil. You can't spend $300,000 on an LVAD if by the patients age and disease type they are only going to gain back 6 months of life before they die anyway. This is because if you blow the $300k, you have to scrimp somewhere else, causing someone else to suffer. Conservation of wealth is ultimately tied to thermodynamics, and is a physical law, not an economic one. (If you manage to make that LVAD only cost $25k-50k, that's different)

Anyways, I could go on, but I think I've made my point. The system does need fixing, but all the entrenched special interests have created various crazy stories to argue against it rather than logic and educated, reasoned arguments. All the people FOR reform have created similar crazy stories to argue the OTHER direction! The people for reform have said it's going to be free (REDUCE the deficit!) and it won't cost anyone but the rich anything in extra taxes! Also, those same people will point to the salaries of insurance company CEOs as the source of the problem. As if a few tens of million in compensation makes any real difference to a multi-billion dollar corporation. The reason that Health Insurance company X denies your claims is not to give the CEO a bigger bonus. The company does it because the rules allow it, and because a corporation is a machine for making as much money as possible, at any cost that doesn't reduce long term profits. If the CEO doesn't deliver, he will be replaced. Hence if you want corporations to behave, you have to write rules and enforce them, or by default a corporation will misbehave if the cost of misbehaving is less than the profits gained. This is one of the fundamental holes in capitalism that has to be patched by government.

An excellent argument. I think you can see this play out if you look at the ideals of reform that we started out with and what we have now. Dems want to RAISE taxes and INCREASE government programs, Repubs want to CUT taxes and DECREASE government programs. The reality is the only way to completely fix the national debt is to raise taxes AND decrease government programs. But no one would ever get elected by promising that. The reality in America is everyone believes they deserve the government benefits that they get but they also believe that they all have to pay for other people's benefits which is unfair (Case in point, the Tea Partier who shows up to healthcare rallies but is on SSI disability). You throw those simple points in with the above motivations of corporate America and its ever present hand in legislation and you have our current conundrum. That said, I am an ardent supporter of the healthcare reform legislation. The arguments of physicians opposed to reform have been that it will raise premiums and decrease reimbursement, but if you look at statistics since the last time reform was attempted, premiums HAVE INCREASED and reimbursements HAVE DECLINED so the status quo is clearly unsustainable. Basically my feeling is that doing something is better than doing nothing. In the end, a few years from now people while either realize that there was no "armageddon" and that there healthcare is actually a little better (which I expect to be the case). Or the program will catastrophically fail and the Repubs will all be in power to enact massive conservative agendas (like ending Medicaid, etc.)

 

[PostLessOne]

An excellent argument. I think you can see this play out if you look at the ideals of reform that we started out with and what we have now. Dems want to RAISE taxes and INCREASE government programs, Repubs want to CUT taxes and DECREASE government programs. The reality is the only way to completely fix the national debt is to raise taxes AND decrease government programs. But no one would ever get elected by promising that. The reality in America is everyone believes they deserve the government benefits that they get but they also believe that they all have to pay for other people's benefits which is unfair (Case in point, the Tea Partier who shows up to healthcare rallies but is on SSI disability). You throw those simple points in with the above motivations of corporate America and its ever present hand in legislation and you have our current conundrum. That said, I am an ardent supporter of the healthcare reform legislation. The arguments of physicians opposed to reform have been that it will raise premiums and decrease reimbursement, but if you look at statistics since the last time reform was attempted, premiums HAVE INCREASED and reimbursements HAVE DECLINED so the status quo is clearly unsustainable. Basically my feeling is that doing something is better than doing nothing. In the end, a few years from now people while either realize that there was no "armageddon" and that there healthcare is actually a little better (which I expect to be the case). Or the program will catastrophically fail and the Repubs will all be in power to enact massive conservative agendas (like ending Medicaid, etc.)

Actually, the Republicans want to LOWER taxes, RAISE the national debt, and to RAISE defense spending and LOWER social programs that the republicans don't like. Republicans are just fine with spending more money on police/prisons and on social security/medicare for the 'deserving poor', but are strongly against welfare and social programs for the poor they perceive as being undeserving.

Democrats want to RAISE taxes, RAISE the national debt, LOWER defense spending, and to RAISE spending on social programs that the Democrats like. They want more money spent on rehabilitation and less on prisons, more welfare and social programs, especially for those who the Democrats see as being disadvantaged . Interestingly, democrats are also for more social security/medicare...which makes those programs basically untouchable by Congress.

This is commonly known as the tradeoff between Guns and Butter.

 

[Herman Bloom]

Actually, reconciliation is not used "all the time", and especially not on bills of this impact and cost. Whatever you think of the bill's content, this is a very slimy move that will cause me to switch party affiliation.

Careful there. Reconciliation has been used 22 times since 1981, and 14 were done by a Republican controlled congress.

 

[thedrjojo]

Actually, the Republicans want to LOWER taxes, RAISE the national debt, and to RAISE defense spending and LOWER social programs that the republicans don't like. Republicans are just fine with spending more money on police/prisons and on social security/medicare for the 'deserving poor', but are strongly against welfare and social programs for the poor they perceive as being undeserving.

Democrats want to RAISE taxes, RAISE the national debt, LOWER defense spending, and to RAISE spending on social programs that the Democrats like. They want more money spent on rehabilitation and less on prisons, more welfare and social programs, especially for those who the Democrats see as being disadvantaged . Interestingly, democrats are also for more social security/medicare...which makes those programs basically untouchable by Congress.

This is commonly known as the tradeoff between Guns and Butter.

I think you are throwing around wide stereotypes and generalizations. The point of the matter SHOULD be that each Democrat and each Republican is slightly different from each other (within the group) and so they don't all think the same way. In reality, I think there should be 4 political groups. There are essentially 2 areas of concerns (besides being re-elected) for politians... Economy and Values. So, you can be a fiscial conservative and a social liberal (Ie, believe in a small role of government and allowing market forces unopposed, but also don't want to push war, don't want to make laws that make certain moral judgements upon others ie abortion, gay marriage, drugs, which is essentially what Libertarians (true ones, not the O'reilys out there) and, if this 4 party system existed, is where the majority of america would probably be...), you can also be fiscially liberal but socially conservative (Must government financial involvement, regulations of financial markets, much outreach to the poor, etc, but also regulation of morals and judgements and limit others to live and behave in a way you deem right). This SHOULD be the political party/idealogy of anyone who reads the bible, because it preaches charity, decrys greed and wealth, but also preaches how peoples morals and values should be. The other two are Fiscial and social conservatives, and Fiscial and Social Liberals. Even within these 4 possibilities, there can also be variations in where you fall on the line between conservative and liberal, and there could even be Moderate political parties. With the current 2 party system, people that are conserv/conserv are republicans, people that are lib/lib are democrats, and the conser/lib or lib/conser are independants and tend to vote whichever issue has more weight for them at that time, taking the bad with the good.

It isn't also as peachy clean as "Dems want to raise debt... etc" because different parties have different goals during different economic times... Democrats don't always want to deficit spend, but believe in an economic theory which they believe has already been proven in history to have worked (see: Great Depression) at times of recession/depression. They also don't want to "raise taxes". The democrats are typically better on taxes for low/middle class and much harder on taxes for upper class. Republicans are better on taxes for upper class and less so for low/middle class. This is because, again, difference in economic principles and theory they use...

Why is this thread still open... I see it is very topical to surgery

 

[Winged Scapula]

Agreed...I forgot about it.

Moving to TIH.

 

[lee9786]

In reality, I think there should be 4 political groups. There are essentially 2 areas of concerns (besides being re-elected) for politians... Economy and Values.

Why there isn't more than two viable political parties at in this day and age really goes to show how short-sighted the American public really is. So we've accepted the fact that we have to pick between two options when neither one looks to show any real promise, and this is the person that is can decide whether or not we send our military to war.

 

[PostLessOne]

Why there isn't more than two viable political parties at in this day and age really goes to show how short-sighted the American public really is. So we've accepted the fact that we have to pick between two options when neither one looks to show any real promise, and this is the person that is can decide whether or not we send our military to war.

Please don't blame this on the American public. Any credible political science professor anywhere would explain that the reason there are exactly 2 viable parties at any given time has to do with the way the voting and election system works. It has nothing to do with the public. The laws and the constitution set the rules of the game, and ultimately determine what is possible.

 

[lee9786]

Please don't blame this on the American public. Any credible political science professor anywhere would explain that the reason there are exactly 2 viable parties at any given time has to do with the way the voting and election system works. It has nothing to do with the public. The laws and the constitution set the rules of the game, and ultimately determine what is possible.

And the public allows these flawed voting and election systems to continue. As politicians continue to work in theirs and their special interest groups best interests while pretending to represent the American public, we all stand by idly and watch. I feel bad for these credible political science professor's that obviously have wasted their time with their education.

 

[PostLessOne]

And the public allows these flawed voting and election systems to continue. As politicians continue to work in theirs and their special interest groups best interests while pretending to represent the American public, we all stand by idly and watch. I feel bad for these credible political science professor's that obviously have wasted their time with their education.

One vote per seat up for election has been the system for 2 centuries. It isn't easy to change something that entrenched, especially when all of the incumbent politicians benefit.

 

[LADoc00]

other forums have been talking about this a whole lot but not much here. so let's get right to the point: are general surgeons gonna be making less? if so how much less are we talking about (an estimate will do as i realize exact figures aren't possible). in plain english please...no fancy graphs, charts, polls, or round about talk...just the bottom line.

I'll field this one. Basically Nancy Pelosi would appreciate if you worked for free. Literally for free.

With the BUNDLING of charges to in patient Medicare that will include no separate payments for office visits after the fact (!! whoa bet you didnt know that?) Pelosi will ensure by 2013 Surgeons will gulp down the tall glass of STFU and like it.

 

[JackADeli]

Please don't blame this on the American public. ...It has nothing to do with the public...

Actually, the constitution was set up to assure the blame rests squarely on the American People/Public.

We have independents in congress. So, yes you can have additional parties. Ultimately, people get the government they deserve.... through their votes. Third party candidates fail because of cowardace of the public. The incumbant candidates/parties rush out and convince the public their vote is wasted if they vote outside the "established parties". So, the public votes not for the candidate they want but for "the lesser of the two evils"....

Look at what happened in the north east with scofafazi lady....
Look at what is happening now, the media left/right, dems, & republicans are all declaring "tea Party" will "split votes" and hurt x, y, or z..... The public movement is being demonized, discredited and warned its existance will make things worse. So, the public is not voting its conscience, is not voting for folks that represent what they want..... they are voting for a donkey or elephant. As long as the public allows incumbants and established parties dictate the vote, the current scheme will persist.

Yes, blame the public. The two most powerful components within our nation's founding is the ability to vote and the ability to amend the constitution.....

 

[PostLessOne]

Actually, the constitution was set up to assure the blame rests squarely on the American People/Public.

We have independents in congress. So, yes you can have additional parties. Ultimately, people get the government they deserve.... through their votes. Third party candidates fail because of cowardace of the public. The incumbant candidates/parties rush out and convince the public their vote is wasted if they vote outside the "established parties". So, the public votes not for the candidate they want but for "the lesser of the two evils"....

Look at what happened in the north east with scofafazi lady....
Look at what is happening now, the media left/right, dems, & republicans are all declaring "tea Party" will "split votes" and hurt x, y, or z..... The public movement is being demonized, discredited and warned its existance will make things worse. So, the public is not voting its conscience, is not voting for folks that represent what they want..... they are voting for a donkey or elephant. As long as the public allows incumbants and established parties dictate the vote, the current scheme will persist.

Yes, blame the public. The two most powerful components within our nation's founding is the ability to vote and the ability to amend the constitution.....

This statement is so ignorant I'm not even going to dignify it with a response. Go learn some basic mathematics and political science and read your post again.

 

[lee9786]

The constitution was written to give power to the people, not the government. Who has control now though? This control is only growing. This country is headed toward big government, the constitution is being ignored, and momentum is only growing. When the government takes control of the ~20% of GDP, this sector will become consumers, not producers of tax revenue. The monopoly will dictate prices just like any other monopoly.

Yes it is the people's fault. You have people such as Ron Paul and Peter Schiff that are attempting to reign this country from total collapse yet they are largely ignored by the public. People allow them to be written off by their respective parties. What we get is government pulling the strings to get what they want. They give us pathetic options to choose from and say if you don't vote you are part of the problem. I say the fact they aren't presenting viable options is the problem. Yet the American public sleeps on while remaining sedated by their American Idol series, Bad Girl's Club, etc... Yes it is all our fault and we will suffer the consequenses of our ignorance.

 

[PostLessOne]

The constitution was written to give power to the people, not the government. Who has control now though? This control is only growing. This country is headed toward big government, the constitution is being ignored, and momentum is only growing. When the government takes control of the ~20% of GDP, this sector will become consumers, not producers of tax revenue. The monopoly will dictate prices just like any other monopoly.

Yes it is the people's fault. You have people such as Ron Paul and Peter Schiff that are attempting to reign this country from total collapse yet they are largely ignored by the public. People allow them to be written off by their respective parties. What we get is government pulling the strings to get what they want. They give us pathetic options to choose from and say if you don't vote you are part of the problem. I say the fact they aren't presenting viable options is the problem. Yet the American public sleeps on while remaining sedated by their American Idol series, Bad Girl's Club, etc... Yes it is all our fault and we will suffer the consequenses of our ignorance.

No, the constitution was written to give power to respectable, wealthy white men with the people acting as a check on the power of these men. But, for day to day decision making, the people are not in control and have not been for 233 years. The people can only make something happen if they really, really want it and even then it usually takes decades for anything to happen. For example, a majority of people wanted slavery abolished decades before it actually happened. Same with prohibition and the repeal, with drug laws, with gay marriage, with civil rights, with health care reform, etc etc etc.

The constitution is designed to leave the most powerful, well organized groups in control of the country for long periods of time, only changing things if absolutely necessary. It is completely impossible for a major change, such as proportional representation or voting, to ever get through the Constitutional amendment process.

This overall system has allowed for the development of the most powerful nation on earth, but does have serious drawbacks. However, please don't rant about third parties and the 'people' not listening when you don't know what you are talking about.

 

[JackADeli]

The discussion has clearly declined....

...In 2004, there were about 216 million people in the US who were able to vote. Out of these people, only about 126 million actually voted. (58%) The 2004 elections had the largest percentage of people who voted since 1968...

 

[tibor75]

Actually, reconciliation is not used "all the time", and especially not on bills of this impact and cost. Whatever you think of the bill's content, this is a very slimy move that will cause me to switch party affiliation.

The "fixes" bill was passed by reconciliation, NOT the entire health care bill.

The first bill that Obama signed was passed by the Senate months ago (before Brown was elected). When Brown was elected, the House decided to pass this bill verbatim whcih meant the Senate didn't have to re-pass it. But the House would only agree to that with certain "fixes", i.e. the 2nd bill that Obama signed.

Saying that the entire process was done by reconciliation is just bogus and factually inaccurate.

 

[dyk343]

OMG we live in a socialist country. The government makes EVERYONE who drives a car carry auto insurance. Im so moving to Canada now...

 

[docB]

OMG we live in a socialist country. The government makes EVERYONE who drives a car carry auto insurance. Im so moving to Canada now...

That's an interesting point and it illustrates why health care and health insurance is different than some other commodities.

It is a socialist idea to require everyone to have car insurance. And once you require it of everyone it really stops being insurence and is risk pooling instead.

Most people are ok with the idea of mandated car insurance. Why is that? It's because they're afraid of getting hit by someone with no insurance and getting stuck with the bill themselves. The fact that you can hurt others with your car is an unavoidable fact. You'll note that you're not required to have collision or replacement insurence to fix your own car in a wreck (unless you still owe money on it, then the lender requires that). You're only required to have liability to take care of the people you hit. That's a pretty fundamental difference from the health insurance issue.

Many point out that we all pay for the care of the uninsured so it's ok to mandate that they get insurance. They liken that to the car insurance system. It is different though. The uninsured cost because we mandate free care. If we didn't do that the transfer costs would disappear.

Lastly driving is a priveledge. It's an important priveledge and important to the livlihood of many but it's not required for living. Since everyone who is alive will be forced to buy insurance or pay a fine there will be no hiding. I suppose all the dead people in Chicago who voted for Obama will avoid it but everyone else is on the hook.

 

[PostLessOne]

The uninsured cost because we mandate free care. If we didn't do that the transfer costs would disappear.

AKA, let them die. 90% of the American population is against this.

 

[Sol Rosenberg]

OMG we live in a socialist country. The government makes EVERYONE who drives a car carry auto insurance. Im so moving to Canada now...

Although DocB had a great reply to your post (that is also relevant to mine,) he need not have exerted that much effort, because your post is incorrect (at least in many states.) Here in TX, it is mandated that you show proof of FINANCIAL RESPONSIBILITY in order to drive a car. This is not necessarily the same as carrying auto insurance (although the vast majority of citizens show responsibility by carrying auto insurance.) In lieu of buying insurance, I believe that you can escrow a large amount of $$$ in an interest bearing account and become "Self Insured." Many rental car companies do this, for example.

We can argue about whether this, as an individual, is wise or unwise to do some other time, but the fact is that in many states there is not even a mandate to buy auto insurance, as you implied.

 

[PostLessOne]

For all practical purposes, you can do the same thing with health care. I'm sure that someone will cook up some kind of health care insurance plan for rich folks that does this. Maybe the first year's premium will be $100k, which gets invested into a fund, and is returned to you when you terminate the policy, minus any medical expenses.

Big companies can self insure : I'm sure if you have enough wealth, you could probably do the same for yourself if you were to do all the paperwork. Practically no-one will do this, just like practically nobody gives the state of Texas $40,000 in a bond to avoid paying auto insurance premiums.

 

[dAnthony1918]

truth is republicans believe if u get an A in a test you should keep the A. While another student gets a C gets a C. Democrats think you should share it and both get B's. That's what it comes down to. lol seriously.
religion, abortion etc. are just sidetracks

 

[MOHS_01]

OMG we live in a socialist country. The government makes EVERYONE who drives a car carry auto insurance. Im so moving to Canada now...

I know you were being sarcastic, but this analogy simply does not hold water. There is a real and fundamental difference between car insurance and health insurance -- car insurance protects others from you while health insurance solely protects self. Now if one were to be required to carry health insurance in the event they were to infect others due to an act of negligence......

...

It is a socialist idea to require everyone to have car insurance. And once you require it of everyone it really stops being insurence and is risk pooling instead.

Most people are ok with the idea of mandated car insurance. Why is that? It's because they're afraid of getting hit by someone with no insurance and getting stuck with the bill themselves. The fact that you can hurt others with your car is an unavoidable fact. You'll note that you're not required to have collision or replacement insurence to fix your own car in a wreck (unless you still owe money on it, then the lender requires that). You're only required to have liability to take care of the people you hit. That's a pretty fundamental difference from the health insurance issue.

Many point out that we all pay for the care of the uninsured so it's ok to mandate that they get insurance. They liken that to the car insurance system. It is different though. The uninsured cost because we mandate free care. If we didn't do that the transfer costs would disappear.

Lastly driving is a priveledge. It's an important priveledge and important to the livlihood of many but it's not required for living. Since everyone who is alive will be forced to buy insurance or pay a fine there will be no hiding. I suppose all the dead people in Chicago who voted for Obama will avoid it but everyone else is on the hook.

Help me out for I am having some difficulty understanding this morning -- how does the remainder of the post follow the bolded portion? I see a very, VERY fundamental difference between the two... and I fear that any capitulation on the point is self defeating, empowering those who do not understand the proper role of governance in a free and open society.

 

[PostLessOne]

I know you were being sarcastic, but this analogy simply does not hold water. There is a real and fundamental difference between car insurance and health insurance -- car insurance protects others from you while health insurance solely protects self. Now if one were to be required to carry health insurance in the event they were to infect others due to an act of negligence......



Help me out for I am having some difficulty understanding this morning -- how does the remainder of the post follow the bolded portion? I see a very, VERY fundamental difference between the two... and I fear that any capitulation on the point is self defeating, empowering those who do not understand the proper role of governance in a free and open society.

The point you are missing, despite your top of the line intelligence, is that you keep talking about ideals. The ideal free society you thought you lived in, people would be free to die if they are lazy or unlucky and can't pay for their own healthcare, either out of pocket or with insurance. Survival of the fittest (and luckiest), etc.

But in practice even most die hard republicans don't want the poor to simply be left to die if they get sick. (since there are plenty of poor republicans, given that at least 50% of the American population makes less than $32,000 per year)

So you're a liability risk to others if you don't have health insurance, just like if you drive a car. If someone stabs you in an unavoidable attack (something that actually happened to a patient I know of), the collective guilt felt by society means that society is forced to pay for stabilizing medical care. That's what makes you a liability, and so you should be forced to buy insurance unless you do not have the means.

 

[MOHS_01]

No, my friend, that point is not missed on me. At one point in my life not too long ago I viewed things entirely differently; I fancied myself a "realist", similar to the position you now take. Over the past 12-18 months, however, I have taken it upon myself to learn about and understand those things I found "irrelevant to my goals of becoming X" during my formal education years... namely, history, limited philosophy, economics, the political structure, and how all of these things were commanded by those who seek to control, rule over, or otherwise shape society.

The problem with your example on the victim of assault -- this is the result of both a tort and a criminal act; there exists someone who is to blame for the injury. Ignoring that fact for a moment, one remains free to purchase coverage against any such injury much in the same way that many now have chosen to carry extra insurance due to the "underinsured motorist".

I do appreciate what you are saying, however. It is true enough that someone does ultimately pay for any good or service consumed; what I am unsure of is if you realize that the "societal tort" in this situation is the direct result of former governmental intervention.... and it is a fallacy to assume that two wrongs make a right. EMTALA is the unfunded mandate that created the problem you address; prior to this, charity care represented charity care, and that was the end of it. "Collective guilt" is not a sound justification for force..... and is a weaker argument than even "WMD's".

One last thought.... regarding the importance and place of "ideals": these should be the goal, the "gold standard" against which any policy is measured. If something runs counter to the "ideal", that is reason for pause and should prompt a more critical discussion or further search for a resolution. It is also important to examine, from a broader view, what direction we are taking our society with these institutions. This "pragmatic" or "realist" or "populist" rationale has been used with great success by many despots throughout history... and while we now assign an evil or sinister nature to them now, that was clearly not the uniform consensus at the time. Our "ideals" are endangered now -- and warrant protection forever.

 

[docB]

It is a socialist idea to require everyone to have car insurance. And once you require it of everyone it really stops being insurence and is risk pooling instead.

Help me out for I am having some difficulty understanding this morning -- how does the remainder of the post follow the bolded portion? I see a very, VERY fundamental difference between the two... and I fear that any capitulation on the point is self defeating, empowering those who do not understand the proper role of governance in a free and open society.

My point about insurance vs. risk pooling is that anytime you force every member of a cohort (e.g. all drivers, all people, all homeowners) to buy "insurance" it quits being insurance and is a risk pool. Insurance is what you buy when you as a consumer either think your risk is high enough that you want to pay to lessen in or you are for some other reason unwilling to bear your risk by yourself so you pay to share it with an insurer. With insurance the insurer then evaluates your risk and sets a price to cover it.

With risk pooling everyone in a cohort has to have coverage regardless of their own perceived risk and they either must pay whatever is asked by the insurer or (in an even more socialist setting) the insurers are required to offer discounted coverage.

Insurance = consumers make decisions about whether or not to purchase coverage

Risk pools = everyone at risk pays into a pool and is covered

 

[PostLessOne]

In the long run, there's a 100% chance that you will have an expensive medical bill. Insurance allows you to pay the average cost, in more reasonable payments. If you refuse to get insurance, you are either choosing death or society paying your bill. Why should we allow people to purposely choose between these two?

 

[MOHS_01]

In the long run, there's a 100% chance that you will have an expensive medical bill. Insurance allows you to pay the average cost, in more reasonable payments. If you refuse to get insurance, you are either choosing death or society paying your bill. Why should we allow people to purposely choose between these two?

Because you have neither the "right" nor the "privilege" of inserting yourself into any such decision. Allow? Come on now, buddy -- every individual is a sovereign entity; neither you, I, society at large, nor the state have any claim on an individual, their labors, or their property in the absence of a tort against us. Any willful decision on our part (be it the state, you, I, or society) in no way carries with it the right to violate this sovereignty over self.

 

[PostLessOne]

So if individuals become unlucky or are hurt in a manner they could not possibly avoid, and do not have the money for the medical bill right now, then you think they should be allowed to die? (assuming a private charity doesn't step in, which won't always happen)

A more specific example : suppose it's a perfectly healthy 25 year old from a rural family. Alas, the industry the family is involved in has hit a dry spell. So right this second, this person who would be of value to society, happens to get into a car wreck and needs a limb reattachment.

Society as a whole would benefit more than it lost if this person didn't lose a limb, but the person as an individual doesn't have the cash flow to transfer enough wealth to repay the hospital for the work. Since the primary beneficiary of the person remaining alive is society as a whole, and the medical care cannot easily be individually denied, it's a classic example of a public good, and the government should somehow pay for it.

Ultimately, this is what we've got with the new health care plan. You pay a tax, and the government provides the public good of medical care. But, to allow some choice, you can choose to pay more and get better medical care since under Obama's health care plan, you'll still be able to buy high end insurance policies that cover treatment at elite hospitals.

The real world is governed by the laws of physics, not some impossible to meet 'ideals' created by wealthy men 200 years ago who had no education at all about modern economic concepts, or any other modern ideas for that matter. You need to stop treating these 'ideals' as a religion. (especially if you understand your history, you'll realize that these ideals have changed over the history of the United States)

 

[Savage Henry]

Ultimately, this is what we've got with the new health care plan.

As near as I can tell, we had that with the "old plan", too.

Sure - you can cook the stats of your hypothetical 25 year old so he doesn't qualify for Medicaid and absolutely nobody wanted to help him. I can cook some stats so that the same thing happens to him today, too.

The real world is governed by the laws of physics, not some impossible to meet 'ideals' created by wealthy men 200 years ago who had no education at all about modern economic concepts, or any other modern ideas for that matter. You need to stop treating these 'ideals' as a religion. (especially if you understand your history, you'll realize that these ideals have changed over the history of the United States)

Can you provide some examples?

I submit to you that most of the best changes in American society over the past few centuries are as a result of trying to live up to the ideals set forth by the founding fathers. One easy example is the civil rights movement - that has been a living embodiment of the ideal "All men are created equal".

Remember - we are discussing ideals here, and not the sometimes flawed men who put them on paper.

 

[docB]

So if individuals become unlucky or are hurt in a manner they could not possibly avoid, and do not have the money for the medical bill right now, then you think they should be allowed to die? (assuming a private charity doesn't step in, which won't always happen)

A more specific example : suppose it's a perfectly healthy 25 year old from a rural family. Alas, the industry the family is involved in has hit a dry spell. So right this second, this person who would be of value to society, happens to get into a car wreck and needs a limb reattachment.

I don't see anywhere near as many unlucky folks who were maimed by circumstances they could not possible avoid as I do irresponsible people who have made bad choices (and will continue to do so). Creating a safety net for the unlucky ones you allude to is not sustainable because it invariably catches all the people who did it to themselves.

Society as a whole would benefit more than it lost if this person didn't lose a limb, but the person as an individual doesn't have the cash flow to transfer enough wealth to repay the hospital for the work. Since the primary beneficiary of the person remaining alive is society as a whole, and the medical care cannot easily be individually denied, it's a classic example of a public good, and the government should somehow pay for it.

That pretty much sums up the differences between liberals and conservatives. I don't agree that every public good should be paid for with tax dollars filtered through the government.

Ultimately, this is what we've got with the new health care plan. You pay a tax, and the government provides the public good of medical care. But, to allow some choice, you can choose to pay more and get better medical care since under Obama's health care plan, you'll still be able to buy high end insurance policies that cover treatment at elite hospitals.

The real world is governed by the laws of physics, not some impossible to meet 'ideals' created by wealthy men 200 years ago who had no education at all about modern economic concepts, or any other modern ideas for that matter. You need to stop treating these 'ideals' as a religion. (especially if you understand your history, you'll realize that these ideals have changed over the history of the United States)

The real world is also governed by the laws of economics. Those are going to make life pretty difficult in the near future due to these policies.

As for your point about abandoning the ideas of the founders you're just substituting your ideals about socialism for their ideals about individualism.

 

[MOHS_01]

So if individuals become unlucky or are hurt in a manner they could not possibly avoid, and do not have the money for the medical bill right now, then you think they should be allowed to die? (assuming a private charity doesn't step in, which won't always happen)

A more specific example : suppose it's a perfectly healthy 25 year old from a rural family. Alas, the industry the family is involved in has hit a dry spell. So right this second, this person who would be of value to society, happens to get into a car wreck and needs a limb reattachment.

Society as a whole would benefit more than it lost if this person didn't lose a limb, but the person as an individual doesn't have the cash flow to transfer enough wealth to repay the hospital for the work. Since the primary beneficiary of the person remaining alive is society as a whole, and the medical care cannot easily be individually denied, it's a classic example of a public good, and the government should somehow pay for it.

Ultimately, this is what we've got with the new health care plan. You pay a tax, and the government provides the public good of medical care. But, to allow some choice, you can choose to pay more and get better medical care since under Obama's health care plan, you'll still be able to buy high end insurance policies that cover treatment at elite hospitals.

The real world is governed by the laws of physics, not some impossible to meet 'ideals' created by wealthy men 200 years ago who had no education at all about modern economic concepts, or any other modern ideas for that matter. You need to stop treating these 'ideals' as a religion. (especially if you understand your history, you'll realize that these ideals have changed over the history of the United States)

docB has beaten me to it... and he's spot on. All that you are doing is substituting your "ideal" utopian nanny state construct for the one of individual liberty that this country was founded on. "Your" construct relies upon the liberal application of force and coercion.... and relies upon covet means to spread its agenda and acceptance. "Their" construct holds that a man is sovereign over his own being by our very nature.... and the use of force must be held to a bare minimum. "Their" way, by my way of thinking, is quite preferable to your "new enlightenment"......

To respond more directly to your post: Who was at fault in the accident? I trust that you realize this has some bearing... in the event that this was young Mr. Rural's sole fault, hopefully he was a good person. Good people are loved by their community, and I believe you underestimate the charitable nature of both provider and community in truly tragic circumstances. In any event, let's assume this was an "act of God" in that it was not due to any individual's actions directly (which itself is untrue, as Mr. Rural Man chose to take the risk that is involved with operating a motorized vehicle)... How is this ruinous event fundamentally different than the flood that washes away his house? Or how about those pesky termites that choose to feed on his only home? The lightning strike that burns down his barn holding his crops? There will always be tragedies; this is unavoidable regardless of the system the brightest of the elites dream up.

I'm also beginning to wonder if you understand what this bill was and how they claim it will work....... we're not paying "a tax", bud, that then somehow goes to provide insurance for us -- taxes are levied by the government and payable to the treasury. What we have here is a direct wealth transfer from the contributing to cover those who will/are/were not; what's even better, this is to be paid unto a private company (or possibly pay a miniscule, toothless fine). OK....

And for the record -- these "ideals" have never changed. You can argue they have been abandoned, trampled, run over, discarded, or bastardized -- but they have not changed.

 

[deleted87716]

Essentially, we're talking about charity at the point of a gun.

An interesting article: http://www.aynrand.org/site/News2?id=13873

 

[MOHS_01]

Yeah.... and that's an oxymoron if ever there was one.

 

[Khaos05]

Up front, I'll be honest. I've not paid much attention to health care reform. I've only heard what others have said about it - some good, some bad. Actually, it almost confuses me.

However, here's my take on the whole thing. There will ALWAYS be rich people and there will ALWAYS be poor people. Nothing anyone does is going to change that. There will always be people who make >200k and drive a jaguar and there will always be people who make $30k and drive a civic.

What makes my blood boil is welfare (and anything related). I can't stand to hear people say "I CAN'T work" and then proceed to give some useless and idiotic excuse. Then guess what? The government (aka taxpayers) pay for their food, house, and now healthcare. It drives me nuts to know that as a 22 year old undergrad, I worked my butt off to pay all my own bills-car, apt/house, insurance(yeah i afforded it - go figure), etc. AND still payed taxes to help out people who are 40 years old who have never graduated high school and never had a job because they've never worked and "they've had everything supplied for them anyway".

Now, I'm a compassionate person. I'm all about helping someone in need. Key phrase in NEED. But it pains me that my wife and I have worked SO hard and for what? To give 1/2 our money away to those that never have and never will.

If you work hard and can afford insurance then get it. If you are a lazy bum, don't want to work, and can't afford insurance - TOO BAD.

Things you have should be given (earned) based on how hard you work, not how much you NEED them and because the "rich have them". Read Ayn Rand's "Atlas Shrugged" - it's a good book with a lot of pertinent info.