B-Man Posted July 4, 2013 Share Posted July 4, 2013 The delay was a political move, of course, but Yuval Levin suggests that it may backfire: Moreover, by announcing that they can implement or ignore whatever portions of Obamacare they want, the administration is also taking even more direct ownership of any other problems that arise with implementation, since this move suggests they believe that implementation is entirely up to them and they are not really bound by the particulars of the law. This greater ownership of troubles to come will be a particular problem for them with regard to employer dumping and the exchanges. Any such dumping (rightly or wrongly, after all some significant dumping was already expected anyway) will be understood as resulting from the special favor the administration has now done for large employers. And since more people will be in the exchanges than otherwise would have been, the difficulties and uncertainties in that system will be a bigger political problem. This amounts to a very risky bet on the viability of the exchanges. In all these ways, I think the administration has just made its Obamacare problems worse rather than alleviating them. But it may have opened a path to alleviating the country’s Obamacare problem, by elevating the idea of delay. Opponents of Obamacare should not imagine that the law will just collapse by itself or that as problems arise Democrats will come to them asking for repeal. That’s just ridiculous. They should look for ways to make the most of opportunities to avert the implementation of this odious law and advance the cause of ultimately repealing and replacing it. And yesterday’s announcement offers such an opportunity. The employer mandate is very bad policy, and its delay (which likely means its elimination) is a good thing. But the rest of Obamacare is very bad policy too. The delay of the employer mandate by a year highlights the irrationality of the larger law and exacerbates its instability. It does not seem to be sustainable as a discrete measure. It calls at the very least for a broader delay. The law will not be any better a year from now, but since Democrats remain staunchly opposed to any talk of repeal yet now have to be open to talk of delay, Republicans should move to delay implementation of the entire law by a year. I’ve argued before (as others have) that delay offers both sides some near-term benefits—though in the long run I think it advances the cause of replacing this law with real health-care reform. With yesterday’s announcement, the administration has once again proven that near-term benefits are all the president cares about. So fine—let’s delay, let’s use the time to better frame a serious alternative for the country, and let’s see where we are a year from now. Link to comment Share on other sites More sharing options...
3rdnlng Posted July 4, 2013 Share Posted July 4, 2013 Birdog, TYTT and DCTom, do you think that your opinions may be a product of the type of environment you live in? I'm under the impression that Tasker and Tom live/work in larger municipalities. I could be wrong, but If I remember correctly, Birdog lives in western VA. Not any real large cities there. Bristol maybe is the largest? Anyway the smaller communities are naturally going to have more one/two man shops who not only do real estate but wills and various other needs. The larger communities are dominated by large law firms and the real estate guys will never be making out wills or handling bankruptcies. So yes, from your personal perspectives and anectodal evidence you are all right. Now Birdog, where you are wrong is that the specialist in the larger community will make more money than the "generalist" in the smaller community. The generalist in the smaller community might be happier though. With that said, you guys have completely corrupted this thread and are arguing lawyer's salaries in a healthcare thread. WTF is wrong with you guys? The latest developments here with the Unaffordable Health Care Act are certainly more germaine to the conversation than your three-way sword fight over the comparative differences between lawyers and medical doctors salaries as it pertains to specialties. At least B-Man gets it right. Link to comment Share on other sites More sharing options...
DC Tom Posted July 4, 2013 Share Posted July 4, 2013 Birdog, TYTT and DCTom, do you think that your opinions may be a product of the type of environment you live in? Are you talking about my opinion that an opinion that is a product of the type of environment you live in is bull ****? Link to comment Share on other sites More sharing options...
3rdnlng Posted July 4, 2013 Share Posted July 4, 2013 Are you talking about my opinion that an opinion that is a product of the type of environment you live in is bull ****? No. I'm talking about opinions that are based on opinions instead of facts are just opinions, but in an opinioned kind of way. Link to comment Share on other sites More sharing options...
DC Tom Posted July 4, 2013 Share Posted July 4, 2013 No. I'm talking about opinions that are based on opinions instead of facts are just opinions, but in an opinioned kind of way. Factually speaking, of course. Link to comment Share on other sites More sharing options...
birdog1960 Posted July 4, 2013 Share Posted July 4, 2013 (edited) Factually speaking, of course. the only facts presented in this debate were my citation from the ABA which confirmed that 63% of american attorneys are in solo or small group practices (regardless of the size of the community that they practice in) and the approximate mean income of american attorneys. like most other discussions here, most all "premises" stated are based on opinion and this argument was no different. personal experience is relevant if it's substantial and i'd characterize mine as that. i've lived in major cities as well as rural areas. no other data was presented here, including the ridiculous story that b man linked from drudge which was linked from brietbart, i believe( the self perpetuating echo chambers of neocon propaganda that they are). That silly link precipitated the entire mind numbing discussion. it made the stupid conclusion that med students weren't choosing primary care because of the ACA. but for even more flawed opinion, look at the posts flatly (and rudely and mechanically) stating that there are no generalist lawyers. if we can't agree that those were incorrect, then black is white and white is black to those i'm trying to engage in debate with here and it's futile. pretty certain that's the case. Edited July 5, 2013 by birdog1960 Link to comment Share on other sites More sharing options...
DC Tom Posted July 4, 2013 Share Posted July 4, 2013 the only fact presented in this debate was my citation from the ABA which confirmed that 63% of american attorneys are in solo or small group practices (regardless of the size of the community that they practice in) and the approximate mean income of american attorneys. like most other discussions here, most all "premises" stated are based on opinion and this argument was no different. personal experience is relevant if it's substantial and i'd characterize mine as that. i've lived in major cities as well as rural areas. no other data was presented here, including the ridiculous story that b man linked from drudge which was linked from brietbart, i believe( the self perpetuating echo chambers of neocon propaganda that they are). That silly link precipitated the entire mind numbing discussion. it made the stupid conclusion that med students weren't choosing primary care because of the ACA. but for even more flawed opinion, look at the posts flatly (and rudely and mechanically) stating that there are no generalist lawyers. if we can't agree that those were incorrect, then black is white and white is black to those i'm trying to engage in debate with here and it's futile. pretty certain that's the case. Someone's touchy today. Link to comment Share on other sites More sharing options...
3rdnlng Posted July 4, 2013 Share Posted July 4, 2013 Someone's touchy today. He doesn't live in the good natured part of Virginia. Link to comment Share on other sites More sharing options...
....lybob Posted July 4, 2013 Share Posted July 4, 2013 the only facts presented in this debate was my citation from the ABA which confirmed that 63% of american attorneys are in solo or small group practices (regardless of the size of the community that they practice in) and the approximate mean income of american attorneys. like most other discussions here, most all "premises" stated are based on opinion and this argument was no different. personal experience is relevant if it's substantial and i'd characterize mine as that. i've lived in major cities as well as rural areas. no other data was presented here, including the ridiculous story that b man linked from drudge which was linked from brietbart, i believe( the self perpetuating echo chambers of neocon propaganda that they are). That silly link precipitated the entire mind numbing discussion. it made the stupid conclusion that med students weren't choosing primary care because of the ACA. but for even more flawed opinion, look at the posts flatly (and rudely and mechanically) stating that there are no generalist lawyers. if we can't agree that those were incorrect, then black is white and white is black to those i'm trying to engage in debate with here and it's futile. pretty certain that's the case. yep, but it can still be fun to come down poke the wasp nest with a stick and run away - and where outside a collection of case studies will you find such a wealth of sociopaths, narcissists and borderline personalities? Link to comment Share on other sites More sharing options...
B-Man Posted July 4, 2013 Share Posted July 4, 2013 Political posturing and corporatist collusion: The backstory of Obamacare’s imperiled employer mandate. “We weren’t nearly critical enough.” Obama allies downplay decision to delay employer mandate for one year. . Link to comment Share on other sites More sharing options...
Pine Barrens Mafia Posted July 4, 2013 Share Posted July 4, 2013 Good thing that no one who works in health insurance was able to see this coming. Link to comment Share on other sites More sharing options...
3rdnlng Posted July 4, 2013 Share Posted July 4, 2013 yep, but it can still be fun to come down poke the wasp nest with a stick and run away - and where outside a collection of case studies will you find such a wealth of sociopaths, narcissists and borderline personalities? I'm not so sure what kind of skills you have in poking down wasp nests, but you sure have the running away part down pat. Link to comment Share on other sites More sharing options...
B-Large Posted July 5, 2013 Share Posted July 5, 2013 My father in law is probably going to forced to retire because of a heart condition..... He has went and on and on about repealing the ACA, how it is terrible and would ruin the country..... Guess who was asking question about buying insurance through the Colorado ACA exchange last night... Lol.... All of the sudden, not so evil.... 59 with a long way to go the Medicare.... He also asked how we would get insurance next year when my wife and I moved to Maine for the year for my woodworking school.... I told him Maine's exchange is ready to go for Jan 1, 2014.... Another piece of the ACA reform.... He seemed to have no idea that the acts sole purpose was to expand coverage and de-link it from employment if needed.... He is a guy who prides himself of being up and up with politics and public policy..... He is either retarded, following another country's politics and doesn't realize, or he is so partisan he can't fathom this law might help him...... Why not make all insurance default at the individual level, and if an employers want to offer better cheaper plan to attract talent, then let them do so... The beauty of the ACA is it lets individuals buy and keep coverage.... People will not feel tethered to a job for benefits anymore, they are more free to chose plans and employers no longer have have a whole team in place just to outline the Healthcare packages they wants. I like the idea if giving a tax break for employers who put away say 200k for employee Health expenses.... Let the buy a plan that only kicks in after the 200k is exhausted, if it ever does.... Some of my patients already have done this and it is much less expensive or the employers, sans a catastrophic employee illness... Link to comment Share on other sites More sharing options...
DC Tom Posted July 5, 2013 Share Posted July 5, 2013 My father in law is probably going to forced to retire because of a heart condition..... He has went and on and on about repealing the ACA, how it is terrible and would ruin the country..... Guess who was asking question about buying insurance through the Colorado ACA exchange last night... Lol.... All of the sudden, not so evil.... 59 with a long way to go the Medicare.... He also asked how we would get insurance next year when my wife and I moved to Maine for the year for my woodworking school.... I told him Maine's exchange is ready to go for Jan 1, 2014.... Another piece of the ACA reform.... He seemed to have no idea that the acts sole purpose was to expand coverage and de-link it from employment if needed.... He is a guy who prides himself of being up and up with politics and public policy..... He is either retarded, following another country's politics and doesn't realize, or he is so partisan he can't fathom this law might help him...... The only problem with this line of reasoning being: "Because it's good for my dad" doesn't make it a sound law or rational policy. And the law's sole purpose wasn't to "expand coverage and de-link it from employment." The law also had the purpose of making coverage affordable...through measures amounting to fiscal voodoo that are failing before they're even implemented, and will ultimately drive costs up and reduce coverage (because don't forget, one of the primary means by which the law "expands" coverage is through taxing the uninsured - under a set of rules that are likely to make the penalties ineffective anyway. And now we're seeing a big chunk of that being delayed by a year...? Yeah, great law.) Political posturing and corporatist collusion: The backstory of Obamacare’s imperiled employer mandate. “We weren’t nearly critical enough.” Obama allies downplay decision to delay employer mandate for one year. . Just imagine if the House Republicans are smart enough to take this to federal court to require the administration to follow the law. We'd have the Republicans arguing that a law they disagree with should be implemented as written by the Democrats who don't want to implement the law they wrote. That'd be a hell of a lot of fun to watch. Link to comment Share on other sites More sharing options...
birdog1960 Posted July 5, 2013 Share Posted July 5, 2013 My father in law is probably going to forced to retire because of a heart condition..... He has went and on and on about repealing the ACA, how it is terrible and would ruin the country..... Guess who was asking question about buying insurance through the Colorado ACA exchange last night... Lol.... All of the sudden, not so evil.... 59 with a long way to go the Medicare.... He also asked how we would get insurance next year when my wife and I moved to Maine for the year for my woodworking school.... I told him Maine's exchange is ready to go for Jan 1, 2014.... Another piece of the ACA reform.... He seemed to have no idea that the acts sole purpose was to expand coverage and de-link it from employment if needed.... He is a guy who prides himself of being up and up with politics and public policy..... He is either retarded, following another country's politics and doesn't realize, or he is so partisan he can't fathom this law might help him...... Why not make all insurance default at the individual level, and if an employers want to offer better cheaper plan to attract talent, then let them do so... The beauty of the ACA is it lets individuals buy and keep coverage.... People will not feel tethered to a job for benefits anymore, they are more free to chose plans and employers no longer have have a whole team in place just to outline the Healthcare packages they wants. I like the idea if giving a tax break for employers who put away say 200k for employee Health expenses.... Let the buy a plan that only kicks in after the 200k is exhausted, if it ever does.... Some of my patients already have done this and it is much less expensive or the employers, sans a catastrophic employee illness... had an older gentleman come in for a medicare wellness exam recently. i explained that it was a new benefit of the ACA to which he made some disparaging comment. i explained that it was optional and we could deal only with ongoing issues if he preferred. nope. let's do the wellness exam...strange when ideology and reality meet. Link to comment Share on other sites More sharing options...
B-Man Posted July 5, 2013 Share Posted July 5, 2013 The Obamacare mess Washington is riven by conflict and deep-seated division. It is rare indeed that both sides can agree on anything consequential. Therefore it is incredibly heartening that there is now bipartisan agreement that the implementation of Obamacare is a mess. Republicans have long maintained this of the Affordable Care Act. But now the Obama administration has lent its implicit assent with its astonishing decision to delay by a year the law’s employer mandate. This is what the administration calls, via a blog post by the Treasury Department’s assistant secretary for tax policy announcing the decision, “Continuing to Implement the ACA in a Careful, Thoughtful Manner.” The administration can call it whatever it wants, but there is no hiding the embarrassment of a climbdown on a high-profile feature of President Barack Obama’s signature initiative — although the administration seemed determined to do all it could to hide it. If Bloomberg hadn’t broken the news on Tuesday, the administration was apparently planning to announce it on July 3 — only because the day before Thanksgiving and Christmas Eve were too far off. The reason for the delay, we’re told, is incompetence. The administration’s story is that it simply couldn’t find a way to implement the insurance reporting requirements on employers within the time frame set out in the law. In this telling, the mandate was merely collateral damage — it had to be put off, along with the accompanying $2,000-per-employee fine on firms with more than 50 employees who don’t offer health coverage. Read more: http://www.politico.com/story/2013/07/the-obamacare-mess-93732.html#ixzz2YBQMNLy3 Link to comment Share on other sites More sharing options...
OCinBuffalo Posted July 7, 2013 Share Posted July 7, 2013 (edited) you really don't know much about what happens in and around hospitals do you? Given your posts here, I am absolutey certain I already know more about how a hospital operates, in granular detail, than you will ever even imagine, and we've just started, IMO. I "know"(better stated, our efforts and software have created conditions that have allowed us to: find) things about hospitals that, according to many, no one in health care has ever known. I can back it up to the point that you will beg me to stop. Do you want to see what a real "long post" looks like? But really, I don't actually care enough to bother. This is exciting stuff for us, we are having a lot of fun with it, and my time is better spent on it, rather than trying to teach a dinosaur new tricks. necessity? do you realize how many tests and procedures of questionable or even negative value are done every day.? done without compelling evidence of benefit and sometimes with compelling evidence of harm. if your hammer is a catheter you do lots of caths. a scalpel, lots of surgery. a radiology suite, lots of xrays. (the number of CT scans done last year is staggering, somewhere around 1 for every 4 americans or so). You said specialists don't make multiples of what generalists make in other fields, and that the disproportion of them doesn't exist either. I debunked that. 5 times. Proving that bad business processes exist, or that bad regulation/bad government policy which allows them to exist in health care...has nothing to do with proving whether specialists both exist and are paid the same elsewhere as in health care, or that they aren't just as likely to waste time/money on unnecessary "revenue generation". hospitals spend fortunes on new revenue producing technology with little or no evidence of benefit every day (there are very few cardiology tests of proven survival benefit, for example).and your analogies don't hold up. you didn't cite any professions where specialists outnumber generalist with that wide of pay disparities. And you can't read. Yes I did. How much more literal do I have to be? IT is rapidly becoming the exact match of medicine as you describe, in this country. The "generalists" all live elsewhere. This country is where the elite IT is done. At the other end, it's also where you get a guy at Best Buy to help you with your machine. The trend is: many of the "average" IT jobs are being shipped overseas, or engineered out of existence. This is the current course that we are on. Google is run exactly on this premise. Small group. Elite people. No generalists. Paid 5x more than the average IT guy. So, again, I repeat, I and my industry, are your analogy. t's hilarious that you think that your specialists adding unnecessary work = more revenue for them, is some unique thing that only doctors do. Clearly you don't know any corporate sales guys. On that note, I'm sure no laywer has ever "generated revenue" by overbilling, or, isn't running commercials I am watching right F'ing now, starting frivolous lawsuits in the pursuit of "revenue generation". What is the difference between unnecessary test, and unnecessary lawsuit, exactly? And to be fair: I am sure no consultant has ever double billed an hour(er um, quadruple billed ), because he could get away with it, and because his boss first rationalized, and then demanded it. Yes, my own life experience never happened...according to you. And finally, the entire Federal government is an object lesson in wasting money all over the place on "specialists", who are paid 5x more than others in their "field". The difference is: neither the generalist or the specialist are worth a damn. consultants? try telling many engineers that the move to consultants jobs has been good for their profession. many are now pining for the good old days of a steady job at a steady company. The above = "Get off my lawn". You have what data that backs this up? Yeah, the Open Source/Start Up community wants to hear all about how they'd be better off working at IBM. When can we expect your lecture on the wonders of working at the big company, where software goes to die? Will you be posting it on Youtube? Next time I'm in San Mateo, I'll be sure to look up your lunch workshop. How could I miss perhaps the most hilarious, idiocy-based, unintentional, real life trolling event of the decade? interesting theory tying food preferences to intrinsic value tho. maybe you should try publishing that somewhere other than tbd. Well, I don't know squash boy. I have an idea though: I will submit it to the government, and tell them that I plan to prove that minorities suffer due to their "sytemically-generated squash familiarity deficit", in comparison to yours. (Yet another thing for you to feel guilty about, so, that's great, isn't it?). What is the % chance that it will be funded? You'd be all of this, becaue it is the "more moral" thing to do, right? And of course, it "creates jobs", which are all "shovel ready". Edit #1: Reading through the rest of the thread, I see Tasker already beat the schit out of the lawyer example. Edit #2: Most personal experience probably is BS. However, that's not the same thing as saying it doesn't exist. Edited July 7, 2013 by OCinBuffalo Link to comment Share on other sites More sharing options...
B-Man Posted July 8, 2013 Share Posted July 8, 2013 TRANSPARENCY: White House vetoes public seeing Obama’s thanks to librarians. White House officials vetoed all public airing of a video of President Obama thanking the American Library Association Sunday for helping inform the public about Obamacare. “We were specifically told by the White House to only show it [the video] once to conference attendees, and [the] White House said we aren’t able to send it out,” Jazzy Wright, Press Officer for ALA’s Washington, D.C. office, told the Washington Examiner. The ALA, which is a tax-exempt 501©(3) foundation, agreed last weekend during its annual meeting in Chicago to help the president get the word out about Obamacare. As a result of the partnership between Obama and the group, librarians across the country will be “navigators” handing out White House-approved information about the new government health insurance program. These things defy parody. http://pjmedia.com/instapundit/172006/ Link to comment Share on other sites More sharing options...
birdog1960 Posted July 8, 2013 Share Posted July 8, 2013 Given your posts here, I am absolutey certain I already know more about how a hospital operates, in granular detail, than you will ever even imagine, and we've just started, IMO. I "know"(better stated, our efforts and software have created conditions that have allowed us to: find) things about hospitals that, according to many, no one in health care has ever known. I can back it up to the point that you will beg me to stop. Do you want to see what a real "long post" looks like? But really, I don't actually care enough to bother. This is exciting stuff for us, we are having a lot of fun with it, and my time is better spent on it, rather than trying to teach a dinosaur new tricks. You said specialists don't make multiples of what generalists make in other fields, and that the disproportion of them doesn't exist either. I debunked that. 5 times. Proving that bad business processes exist, or that bad regulation/bad government policy which allows them to exist in health care...has nothing to do with proving whether specialists both exist and are paid the same elsewhere as in health care, or that they aren't just as likely to waste time/money on unnecessary "revenue generation". And you can't read. Yes I did. How much more literal do I have to be? IT is rapidly becoming the exact match of medicine as you describe, in this country. The "generalists" all live elsewhere. This country is where the elite IT is done. At the other end, it's also where you get a guy at Best Buy to help you with your machine. The trend is: many of the "average" IT jobs are being shipped overseas, or engineered out of existence. This is the current course that we are on. Google is run exactly on this premise. Small group. Elite people. No generalists. Paid 5x more than the average IT guy. So, again, I repeat, I and my industry, are your analogy. t's hilarious that you think that your specialists adding unnecessary work = more revenue for them, is some unique thing that only doctors do. Clearly you don't know any corporate sales guys. On that note, I'm sure no laywer has ever "generated revenue" by overbilling, or, isn't running commercials I am watching right F'ing now, starting frivolous lawsuits in the pursuit of "revenue generation". What is the difference between unnecessary test, and unnecessary lawsuit, exactly? And to be fair: I am sure no consultant has ever double billed an hour(er um, quadruple billed ), because he could get away with it, and because his boss first rationalized, and then demanded it. Yes, my own life experience never happened...according to you. And finally, the entire Federal government is an object lesson in wasting money all over the place on "specialists", who are paid 5x more than others in their "field". The difference is: neither the generalist or the specialist are worth a damn. The above = "Get off my lawn". You have what data that backs this up? Yeah, the Open Source/Start Up community wants to hear all about how they'd be better off working at IBM. When can we expect your lecture on the wonders of working at the big company, where software goes to die? Will you be posting it on Youtube? Next time I'm in San Mateo, I'll be sure to look up your lunch workshop. How could I miss perhaps the most hilarious, idiocy-based, unintentional, real life trolling event of the decade? Well, I don't know squash boy. I have an idea though: I will submit it to the government, and tell them that I plan to prove that minorities suffer due to their "sytemically-generated squash familiarity deficit", in comparison to yours. (Yet another thing for you to feel guilty about, so, that's great, isn't it?). What is the % chance that it will be funded? You'd be all of this, becaue it is the "more moral" thing to do, right? And of course, it "creates jobs", which are all "shovel ready". Edit #1: Reading through the rest of the thread, I see Tasker already beat the schit out of the lawyer example. Edit #2: Most personal experience probably is BS. However, that's not the same thing as saying it doesn't exist. yeah, what did all us folks actually trained in medicine do before all you invaluable IT people came around and saved us? hell, we aren't even needed, right? just use diagnostic programs, treatment algorithms and robots for surgery, right? um, well, NO! essentially no one believes we are anywhere near this point. how did we ever manage patients without you? (hint -many of us had great outcomes with paper charts). Do you actually have data that supports the contention that IT has improved patient outcomes as an independent variable? i've seen some negative data. my impression is that the jury is still out...but i'm sure in your narrow, biased, self congratulatory mind, it's a slam dunk.and if you objectively believe that tasker "schooled me" on lawyers from what is documented in this thread, then your opinion is worthless...but most here already knew that. Link to comment Share on other sites More sharing options...
DC Tom Posted July 8, 2013 Share Posted July 8, 2013 yeah, what did all us folks actually trained in medicine do before all you invaluable IT people came around and saved us? hell, we aren't even needed, right? just use diagnostic programs, treatment algorithms and robots for surgery, right? um, well, NO! essentially no one believes we are anywhere near this point. how did we ever manage patients without you? (hint -many of us had great outcomes with paper charts). Do you actually have data that supports the contention that IT has improved patient outcomes as an independent variable? i've seen some negative data. my impression is that the jury is still out...but i'm sure in your narrow, biased, self congratulatory mind, it's a slam dunk.and if you objectively believe that tasker "schooled me" on lawyers from what is documented in this thread, then your opinion is worthless...but most here already knew that. Weren't electronic patient records an important part of the ACA? Link to comment Share on other sites More sharing options...
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