Azalin Posted June 18, 2014 Share Posted June 18, 2014 Anything can be connected politically these days, but the VA and ACA are two totally different fumbles. One is Obama's, the other has been a fumble for a good 20+ years. it's not so much an indictment of Obama, but an indictment of government managed health care in general. consider that with the VA, these patients were those that volunteered their service to the country. the rest of the civilian nation should understandably be apprehensive of having their health care administered by the same entity, especially when they see how our 'heroes' have been treated. Link to comment Share on other sites More sharing options...
Dorkington Posted June 18, 2014 Share Posted June 18, 2014 The government isn't "one entity", even though it's easy to present it as such. Hence why certain parts of it function well, and other parts of it function poorly. Everything is legislated, funded and run differently. Politically, though, I absolutely agree with you... the VA and certain parts of ACA, will hold back any discussions of a single payer system being implemented. Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted June 18, 2014 Share Posted June 18, 2014 The government isn't "one entity", even though it's easy to present it as such. Hence why certain parts of it function well, and other parts of it function poorly. Everything is legislated, funded and run differently. Politically, though, I absolutely agree with you... the VA and certain parts of ACA, will hold back any discussions of a single payer system being implemented. Can you please qualify "functions well"? "Functions well" relative to what? Link to comment Share on other sites More sharing options...
B-Large Posted June 18, 2014 Share Posted June 18, 2014 I buy an exchange plan in 5 weeks. I will be sure to document the experience. Still glad it is there, very, very glad. Link to comment Share on other sites More sharing options...
Magox Posted June 18, 2014 Share Posted June 18, 2014 (edited) The government isn't "one entity", even though it's easy to present it as such. Hence why certain parts of it function well, and other parts of it function poorly. Everything is legislated, funded and run differently. Politically, though, I absolutely agree with you... the VA and certain parts of ACA, will hold back any discussions of a single payer system being implemented. Actually, the issue for them isn't just political, and you can absolutely reasonably draw parallels between both the ACA and VA. So, what's the issue with the VA, other than the deception from the administrators? In a nut shell, there are too many patients and not enough medical providers to care for them. Hence the ridiculous wait times. The ACA exchange plans headed by the HSA made a concerted effort with the carriers participating on the exchanges to keep the premiums as low as possible. One of the ways that the carriers could attempt to contain premiums was by reducing the medical reimbursement rates. In other words, for example lets just say that a pre ACA carrier use to pay out to a primary care physician $65 for a routine Dr. visit. With the law, the carriers now say, we are only going to $45 for an office visit, in order to contain premiums. What happens is that you have many medical providers that decide to drop working with that particular plan from that carrier because they don't want to operate with such a low reimbursement rate. However, obviously some do, but what happens is that you have fewer medical providers then what there were accepting these plans. Many of the ACA plans, specially in the higher population zones are already encountering issues with considerably longer wait periods between the time that the scheduled office visit was placed to the time of the actual visit. And it's going to get much worse. Reason being is simple, the way the law is designed you will see many businesses, specially small businesses decide to drop coverage, replace the coverage with fixed payout to the employee and therefore they will end up going on to the exchange. If they don't increase the medical reimbursement rates, you won't see a marked increase with the medical providers participating along with the carriers from the exchange plans. Which means longer wait time periods. If you are someone who finds these delayed wait times with the VA as unacceptable, then you certainly won't be a fan of the ACA exchange plans, much less a single-payer system. I buy an exchange plan in 5 weeks. I will be sure to document the experience. Still glad it is there, very, very glad. You are going to need a "life-changing" event to qualify for special enrollment. Edited June 18, 2014 by Magox Link to comment Share on other sites More sharing options...
Dorkington Posted June 18, 2014 Share Posted June 18, 2014 Can you please qualify "functions well"? "Functions well" relative to what? Are you seriously going to suggest that zero parts of the US government function well? Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted June 18, 2014 Share Posted June 18, 2014 (edited) Are you seriously going to suggest that zero parts of the US government function well? I'm suggesting that since you've claimed that parts of the government function well, that you outline which parts, what functions they perform well, and contrast those well functioning areas with comprable non-government sectors performing similar functions which perform less well. Or atleast give some examples so we have a partial accounting. You've made an assertion here, I have not. I want you to back it up. Thank you in advance. Edited June 18, 2014 by TakeYouToTasker Link to comment Share on other sites More sharing options...
Dorkington Posted June 18, 2014 Share Posted June 18, 2014 (edited) The following are services that I'm thankful for... admittedly some are state based: - Social Security - Yes, this needs adjustment, but there's no arguing that this has benefited a great amount of ederly. There are better options for many now in the form of private retirement. But Social Security still has a place in most people's lives. - Medicare - Again, imperfect, but certainly works better than the private insurance industry in my experience (and the experience of people I know that use it). I would be interested in seeing studies that compare Medicare to private. - National Highway System/Interstate Highways - not sure what to expand on here... toll roads are a mixed bag in my experience - Public roads, sidewalks, public transportation and infrastructure in general - related to the above... not sure how completely privatized infrastructure would even work. Are there links to successful implementations? - US Military - Over paid, and bloated, sure... but can you argue that it underperforms? We have the best in the world, for the most part. Who would pay for a privatized force to protect our country and it's interests? - FDA - Generally they implement reasonable regulations that keep our food and drugs relatively healthy. There are some some concerns from both sides of the aisle... sometimes things aren't regulated enough according to the left... sometimes things are regulated too much according to the right... - EPA - Similar to the above... reasonable regulations on drinking water, and general pollution. Left think it's not enough, right thinks its too much... There's more, but I'm about to head out the door... I'm sure there's problems with each and every government entity. There are problems with privatized entities as well. The main thing though is... will a for profit entity have people's interests in mind over a non-profit? Is there a difference anymore with the amount of lobbying and contract work? Who knows. Either way, I'm thankful for a great amount of local and federal government, even if it's slow moving and bloated at times. The VA mess is just that, a mess. It needs to be fixed, and it's a damned shame that we are so quick to go to war, but we don't do what is needed to fix the soldiers that come back broken. ACA is incredibly imperfect. I've said before I'm not a huge fan of it overall. I think certain regulatory parts of it make sense (the "Patient Protection" part of "Patient Protection and Affordable Care Act". I think the mandate is a good idea on paper, but in practice falls short without comprehensive subsidies. But, in order to cover everyone, you get into universal/single payer, and that was DOA when presented initially. The mandate (and the ACA) is a middle ground solution, and in this case, middle ground doesn't work incredibly well. Does that mean a single payer system won't work in the future? Nope. Does it mean it will work in the future? Nope. It all depends on how such a system would be implemented, who is running it, and who else has their claws in it. The cynic in me says it won't work in this country until we fix the lobbying problem. Edited June 18, 2014 by Dorkington Link to comment Share on other sites More sharing options...
Azalin Posted June 18, 2014 Share Posted June 18, 2014 The government isn't "one entity", even though it's easy to present it as such. Hence why certain parts of it function well, and other parts of it function poorly. Everything is legislated, funded and run differently. Politically, though, I absolutely agree with you... the VA and certain parts of ACA, will hold back any discussions of a single payer system being implemented. I'm not trying to split hairs or play semantics, but the federal government absolutely is one entity. just like a person is, it's comprised of many working components, but it functions as one entity. in my opinion, to look at it otherwise is to unnecessarily complicate things. you say parts of it work well, but what parts are those? I can't name a single one. we've handed control over to people who seek only to promote themselves, and they do so at our expense. the entire operation is rife with corruption and ineptitude while they have what small segment of the population that gives a damn at eachothers' throats, preoccupied in partisan bickering. any help that they offer to the needy is always done at the expense of those that have managed to cover their own butts the hard way, and they skim massive amounts of that tax money to fuel the paper-pushers and career bureaucrats they claim to need to administer this wonderful largesse to the people. if anyone speaks out in anger or disgust over the incredible self-serving waste that is Washington, they're routinely called hard-hearted, uncaring, and often much worse. I personally find it incredible that anyone would think for one second to put any kind of faith in the federal government at all. Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted June 18, 2014 Share Posted June 18, 2014 (edited) The following are services that I'm thankful for... [/cutlist] There is a huge difference between the objectively quantifiable, which in this case means "functions well", as we can establish metrics by which to judge and score; and the subjective, which in this case means "services one individual is thankful for", which is in no way a baseline by which any reasonable person can judge if an undertaking, service, or agency is "functioning well". You made an objective statement: "funtions well". You then asked me to collaborate your statement, but haven't provided any metrics by which we can know if your statement is accurate. You instead replied that there are things you're grateful for. That's great, but totally irrelevant to your first point. So... I'll once again ask that since you've claimed that parts of the government function well, that you outline which parts, what functions they perform well, and contrast those well functioning areas with comprable non-government sectors performing similar functions which perform less well. Or atleast give some examples so we have a partial accounting. Thanks in advance. Edited June 18, 2014 by TakeYouToTasker Link to comment Share on other sites More sharing options...
Dorkington Posted June 18, 2014 Share Posted June 18, 2014 I can't. You win. Link to comment Share on other sites More sharing options...
DC Tom Posted June 18, 2014 Share Posted June 18, 2014 Hell, can anyone think of an objective metric by which we can determine if a government "functions well?" Link to comment Share on other sites More sharing options...
Dorkington Posted June 18, 2014 Share Posted June 18, 2014 Hell, can anyone think of an objective metric by which we can determine if a government "functions well?" Considering it's an opinion, it'd be difficult. Best I could do is quote some studies on a couple, and the rest look at history. But neither would be what he's looking for. Link to comment Share on other sites More sharing options...
Azalin Posted June 18, 2014 Share Posted June 18, 2014 Hell, can anyone think of an objective metric by which we can determine if a government "functions well?" I use the veins in my temples as my marker. if they don't stand out to the point where my vision blurs, then things are well enough. that said, these past six years have been the blurriest in recent memory. Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted June 18, 2014 Share Posted June 18, 2014 Considering it's an opinion, it'd be difficult. Best I could do is quote some studies on a couple, and the rest look at history. But neither would be what he's looking for. Then how can you have the opinion that government functions well if you admittedly have no basis by which you could determine such a thing other than your own feelings, which you've just admitted are based on nothing substantial? Further, how can you justify asking me the question: "Are you seriously going to suggest that zero parts of the US government function well? ", given those conditions? Link to comment Share on other sites More sharing options...
Dorkington Posted June 19, 2014 Share Posted June 19, 2014 (edited) You're absolutely right. I rescind my opinion. I have zero proof that any part of the US Federal Government functions well, nor do I have a subjective measurement that could be used to determine what "functions well" is. My apologies. Edited June 19, 2014 by Dorkington Link to comment Share on other sites More sharing options...
OCinBuffalo Posted June 19, 2014 Share Posted June 19, 2014 (edited) Ah, connected politically, but not connected in function. Had me confused a bit. Anything can be connected politically these days, but the VA and ACA are two totally different fumbles. One is Obama's, the other has been a fumble for a good 20+ years. Politically? Forgive me, I though this was PPP. Morever, the problem with the VA is the problem with Obamacare: Overpromised outcomes, due to a level of assigned that have 0 chance of delivering those outcomes. In other words: rationing. Rationing, and/or price controls(which necessitate Soviet-style side payments to actually get seen by the doctor this week), is how government-run health care operates the world over. "Single Payer health care" is a giant lie. So are the "per capita spending" #s on health care. I've already proven that in this thread. But, I don't expect you, or anyone else except perhaps Magox, DC_Tom and perhaps TTYT to care about the proof. Not when Obamacare and VA can be connected so easily politically. Why would any low-information tool want to educate themselves about anything, when they can simply go with "Government Health Care Bad"? Remember: that's the downside of the slice and dice/micro-demographic messaging that got Obama a 2nd term: it all gets blown up by universal truth. Each micro-message isn't nuanced enough to withstand a massive, general, contradiction, because it's been designed just for that micro-demo. The universal truth in this case: Government Health Care Bad. Hell, can anyone think of an objective metric by which we can determine if a government "functions well?" Let me at them. No, I'm being serious. I have facilitated objective metrics being created amongst $8/hr nurse aids. That alone should qualify me, no? See, the approach we have taken treats them as professionals first. We come in and literally define them as professionals. Who is going to argue? Not even the union president. We just set a self-defined expectation bar with a single word. Thus, we create an environment where they expect themselves, as professionals, to create objective metrics, for themselves. We then track activity for cost, sure, but also if they meet those metrics. Actually we look at cost entirely based on those metrics. In trade, they have a legit chance to, for the first time, control their own process-->jobs and career, what is good/bad, like professionals, rather than being treated as mindless minions to be herded. Yes, yes, Tony Robbins. But, Tony Robbins ain't got schit on me....because Tony Robbins can't write code! Moving on: The mission for government has to be set by policy makers. However, the execution of mission is rarely managed by them. That's because they are largely unqualified to set the damn mission in the first place, that's because at the highest level, they are political appointees. And, if you actually attempt to get them involved in their own damn business processes, and educate themselves on the operations...they flush you to a subordinate...who ain't gonna risk their job on anything, and is unqualified to make large scale process change decisions as well. Hence...as with health care, the only place to start is at: the bottom. We find ourselves having our client staff training the managers. Not the other way around. So, "reporting" has become "training". It's kooky, but it works. There's nothing I've found that says this approach wouldn't work for government. Edited June 19, 2014 by OCinBuffalo Link to comment Share on other sites More sharing options...
DC Tom Posted June 19, 2014 Share Posted June 19, 2014 Yes, yes, Tony Robbins. But, Tony Robbins ain't got schit on me....because Tony Robbins can't write code! I actually work with a guy who's one of Tony Robbins' team of "coaches." He writes pretty damn good code. Link to comment Share on other sites More sharing options...
Tiberius Posted June 19, 2014 Share Posted June 19, 2014 Can you please qualify "functions well"? "Functions well" relative to what? In the field of health care? It functions better than the free market in getting care to more people. Just ask all those old geezer Tea Partiers on Medicare! Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted June 19, 2014 Share Posted June 19, 2014 You're absolutely right. I rescind my opinion. I have zero proof that any part of the US Federal Government functions well, nor do I have a subjective measurement that could be used to determine what "functions well" is. My apologies. How do you know government "functions well'? In the field of health care? It functions better than the free market in getting care to more people. Just ask all those old geezer Tea Partiers on Medicare! Show me comprehensive metrics. Link to comment Share on other sites More sharing options...
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