Doc Brown Posted November 30, 2018 Posted November 30, 2018 40 minutes ago, billsfan89 said: I hear your point that they can do both but I just don't trust the more center and corporately affiliated members to vote with the more progressive caucus. The Centrist/Corporate Dems remain too corrupted by money from the Healthcare industry and various other interests that bribe them with campaign contributions. So even if the Medicare for All bill comes to a vote the Republicans will vote against it and enough of the corporately vested Dems will too. The Dems also won't pass or even attempt to pass other aspects of the populist agenda because their corporate interests will demand they don't. The Dems are also incompetent when it comes to framing a narrative. The Republicans are masterful or coordinating a narrative and pushing it out to the public. When an event happens the Republicans craft a message and go on all media and repeat the same talking points. The Republicans also message to their base much more heavily. So even if the Dems were to push Medicare for All they won't market it properly or they will instead generally ignore it and push the Russia probe instead. I am telling you that Legislatively the Dems will not use their House Majority properly and in terms of public opinion they won't drive home the populist agenda they should be. The Dems in general are incompetent due to fear of losing their donors driving their acts more so than pursuing the policy agenda their base (Which just turned out big for them in House and Governors races.) My only hope for the Dems is that the progressive caucus grows more and more within the party. Primaries in 2020 are going to be huge if the progressive/populist base of the party wants to continue to push the party more left. Right now the progressive wing of the party only makes up between 10-15% of the party seats in total. Not insignificant but they need to push 50% in order to really accomplish more than just token gestures. Its also a process that is going to take more than 1-3 election cycles to complete. The populist left has to realize that it is a 20 year process and not something that is going to happen by 2020. I agree with most of this, but the one thing I would say is that unlike 2009 they know whatever they propose won't pass. So, they can easily propose a medicare for all bill and tell their donors "Don't worry. It won't pass." Then they can screw over the progressives when they regain power again.
billsfan89 Posted November 30, 2018 Posted November 30, 2018 2 minutes ago, Doc Brown said: I agree with most of this, but the one thing I would say is that unlike 2009 they know whatever they propose won't pass. So, they can easily propose a medicare for all bill and tell their donors "Don't worry. It won't pass." Then they can screw over the progressives when they regain power again. Even if that is the case because they don't want to rattle the donors they won't push Medicare for All to the public. Meaning that you won't see your more center mainstream Dems going to talk shows and other platforms and pushing the fact that they passed Medicare for all and the Republicans blocked it. So they might make a token passing of it to appease the progressive base but it will not be at the forefront of the Dems policy agenda. They will push heavily the Russia probe and maybe something like Marijuana legalization and restoring Net Neutrality (there is enough of a lobby to put money into those sectors) but I don't see them actually doing more than token acknowledgement of a progressive/populist agenda. Sadly the American political system is organized around money and special interests. There was a Harvard study that stated that 90% of the time the policy that has the most money behind it wins regardless of how popular it is.
Deranged Rhino Posted November 30, 2018 Posted November 30, 2018 1 hour ago, Tiberius said: He should have grown a beard years ago He was a beard for his whole term of service. 2 1
B-Man Posted December 1, 2018 Posted December 1, 2018 (edited) Goodbye Brenda Snipes — AGAIN! Broward County Elections Supervisor Brenda Snipes, who resigned last week effective January 4, was suspended from her job today by Florida Governor Rick Scott for “for misfeasance, incompetence and neglect of duty”: Edited December 1, 2018 by B-Man mispelling 1 1
TtownBillsFan Posted December 1, 2018 Posted December 1, 2018 9 hours ago, billsfan89 said: Even if that is the case because they don't want to rattle the donors they won't push Medicare for All to the public. Meaning that you won't see your more center mainstream Dems going to talk shows and other platforms and pushing the fact that they passed Medicare for all and the Republicans blocked it. So they might make a token passing of it to appease the progressive base but it will not be at the forefront of the Dems policy agenda. They will push heavily the Russia probe and maybe something like Marijuana legalization and restoring Net Neutrality (there is enough of a lobby to put money into those sectors) but I don't see them actually doing more than token acknowledgement of a progressive/populist agenda. Sadly the American political system is organized around money and special interests. There was a Harvard study that stated that 90% of the time the policy that has the most money behind it wins regardless of how popular it is. Honest question: would you want Medicare for all? Taking the cost piece out of it completely, would you want that system in place for everyone? I, personally, would not, as I work, and have much better healthcare, BECAUSE I WORK AND PAY FOR A BETTER SYSTEM FOR MYSELF. But, if it was Medicare for all, I assume my ability to do so would be removed (or, probably more likely, employers such as mine would be forced, over time, to go to that, and would remove our current system of employer-paid healthcare.) We're self-insured, because we're a big enough employer to do so. So anytime we have a bad year, our premiums and out-of-pocket go up, as they did this year, as we had some high-cost stuff with some employees. But under Medicare for all, what happened with my group of employees would translate to all, and we'd ALL pay more. And fear not, that would happen EVERY SINGLE YEAR if it was shared by all. So, would you want Medicare, knowing it's an inferior product to that that people that work for a living have, to take over as the only option? As that's the only way Medicare-for-all works. Or, would you allow those of us that work for a living and can pay for it, a better option? Honest question, and I await your answer. In addition, know that I took a pay consideration (meaning less pay), knowing that the company I work for has awesome insurance. It's part of my 'compensation plan', and definitely was a big big part of why I took the position I'm in. I don't see the problem in that being part of a person's decision in where they work. One last addition: we've all heard how bad government-ran healthcare has been for those that are on it, especially those that served in the military. Why in the world would you want to turn over something so important, at least according to the polls that were cited above, to a bloated and inept entity such as our government? I await your honest reply. Thanks! 2
Buffalo_Gal Posted December 2, 2018 Posted December 2, 2018 (edited) Holey moley.... well, she is already wearing orange. If she stays on it just maybe for a whole lot longer than she is bargaining for... The governor Friday replaced Snipes with Republican Peter Antonacci, president and CEO of the state’s business-recruitment agency Enterprise Florida. Antonacci has history with Broward elections: He prosecuted the 2004 Senate hearings against Broward’s prior elections supervisor, Miriam Oliphant. Oliphant was removed by Republican Gov. Jeb Bush, also for alleged incompetence. Antonacci represented the governor’s office. Brenda Snipes says she'll fight suspension by Gov. Scott, and rescinds resignation Edited December 2, 2018 by Buffalo_Gal 2
DC Tom Posted December 2, 2018 Posted December 2, 2018 5 hours ago, Buffalo_Gal said: Brenda Snipes says she'll fight suspension by Gov. Scott, and rescinds resignation Well, that isn't ***** psychotic. 1
Foxx Posted December 2, 2018 Posted December 2, 2018 it's all about the 71K a year pension she doesn't want to lose. 1 1
Koko78 Posted December 2, 2018 Posted December 2, 2018 18 hours ago, Buffalo_Gal said: Holey moley.... well, she is already wearing orange. If she stays on it just maybe for a whole lot longer than she is bargaining for... The governor Friday replaced Snipes with Republican Peter Antonacci, president and CEO of the state’s business-recruitment agency Enterprise Florida. Antonacci has history with Broward elections: He prosecuted the 2004 Senate hearings against Broward’s prior elections supervisor, Miriam Oliphant. Oliphant was removed by Republican Gov. Jeb Bush, also for alleged incompetence. Antonacci represented the governor’s office. Brenda Snipes says she'll fight suspension by Gov. Scott, and rescinds resignation Makes me wonder if she was going to rescind her resignation anyhow, after Scott was sworn into the Senate. Though having black pastors and her black sorority present for 'support' was an interesting way to play the race card without explicitly calling everyone racists.
Buffalo_Gal Posted December 2, 2018 Posted December 2, 2018 2 hours ago, Koko78 said: Makes me wonder if she was going to rescind her resignation anyhow, after Scott was sworn into the Senate. Though having black pastors and her black sorority present for 'support' was an interesting way to play the race card without explicitly calling everyone racists. IMO she is extremely worried about being indicted (and losing her pension). As well she should be. 1
billsfan89 Posted December 3, 2018 Posted December 3, 2018 (edited) On 12/1/2018 at 1:05 AM, TtownBillsFan said: Honest question: would you want Medicare for all? Taking the cost piece out of it completely, would you want that system in place for everyone? I, personally, would not, as I work, and have much better healthcare, BECAUSE I WORK AND PAY FOR A BETTER SYSTEM FOR MYSELF. But, if it was Medicare for all, I assume my ability to do so would be removed (or, probably more likely, employers such as mine would be forced, over time, to go to that, and would remove our current system of employer-paid healthcare.) We're self-insured, because we're a big enough employer to do so. So anytime we have a bad year, our premiums and out-of-pocket go up, as they did this year, as we had some high-cost stuff with some employees. But under Medicare for all, what happened with my group of employees would translate to all, and we'd ALL pay more. And fear not, that would happen EVERY SINGLE YEAR if it was shared by all. So, would you want Medicare, knowing it's an inferior product to that that people that work for a living have, to take over as the only option? As that's the only way Medicare-for-all works. Or, would you allow those of us that work for a living and can pay for it, a better option? Honest question, and I await your answer. In addition, know that I took a pay consideration (meaning less pay), knowing that the company I work for has awesome insurance. It's part of my 'compensation plan', and definitely was a big big part of why I took the position I'm in. I don't see the problem in that being part of a person's decision in where they work. One last addition: we've all heard how bad government-ran healthcare has been for those that are on it, especially those that served in the military. Why in the world would you want to turn over something so important, at least according to the polls that were cited above, to a bloated and inept entity such as our government? I await your honest reply. Thanks! I would love to see a Medicare for all system in America both in a general level and on a personal level. Its a lot you asked about so I am going to try my best to address the very real concerns you have. I also want to say that I do not believe that Medicare for All is a perfect system, it has its issues, but rather that I think the private insurance system is way worse and costs more for no real reason. Should private insurance be allowed? In the Bernie proposed Medicare for All system it allows for private and supplemental insurance to exist, it just gives everyone a baseline access to Medicare. My own personal preference is to allow Medigap policies that supplement the gaps in coverage and expand coverage by Medicare so that if your employer wants to offer you an additional coverage supplementing your base insurance they should be allowed to do so. Even now many seniors take out Medigap insurance to help with the cost of care, so I don't see why employers couldn't go over the top to provide better insurance to people like yourself. Would you want a system in place for everyone? I argue that we already have universal healthcare because doctors can't turn down patients in need because they are unable to pay. The only way a private system would actually be able to save you money is by having doctors and providers able to deny people that need treatment based on their inability to pay. So if a poor person or a self employed person who is underinsured needs care those costs get absorbed into the general system either way. Its also not just lazy bums not working that are under insured or uninsured either. Americans work more hours, take less vacation, and receive the least amount of benefits in the industrial world, I think if you removed the vastly overpriced and often inaccessible healthcare system and replaced it with a serviceable baseline policy for everyone that removes a huge burden from your average working person and for reasons I will go into later saves the general system money. Government run healthcare is terrible look at the VA. The VA argument on the surface seems valid but it is also misleading. First off the VA is underfunded, even though almost every government agency claims to be underfunded the VA is by all metrics underfunded. But even throwing that out there are many reasons why the VA isn't effective (Although the VA the boogeyman many conservatives use to scare people against government healthcare has a higher approval rating than the private system, not to say the VA's approval rating is that high but more so that the dissatisfaction with American healthcare is that low.) Another reason why the VA is a not so effective system is because the VA has a population of patients that need much more care than the population of patients provided by the private system. Soldiers need more healthcare than your average citizens, battle injuries, mental healthcare, and various other factors that the average 2-64 year old the private insurance system handles simply don't have to deal with. So you have a concentrated population of people with a much greater demand for healthcare in an underfunded system. I would also argue that the VA is the worst type of structured government healthcare, in that the hospitals are both government run and government funded. Most universal healthcare systems are public financing of private institutions aka the insurance is financed through the public but the hospitals are privately run. The UK has a VA type system with government run and financed hospitals, its not bad but it is not as effective as the public private hybrid found in countries like Canada and France. I also think you fall into the fallacy that because you are paying more for private insurance that must make it better. The general stats don't bare that out to be true. For one America pays more per-capita for healthcare than any industrialized nation on Earth. Yet our Healthcare outcomes are usually in the middle of the road. Yes there are examples of people from other countries coming to America for care they couldn't get in Canada or other countries. But there are also examples of people going to single payer countries to get care they simply couldn't afford to get in America. There are also specialists and best of the best doctors in other countries so its not as though you can only find the best care for everything in America. The framing of the argument around single payer healthcare should be that we can't afford to not have single payer. The US in 1970 went from spending 6.2% of GDP on healthcare to in 2016 spending about 17.9% of GDP on Healthcare. To put that in context the average industrialized country in 1970 was spending about 5% of GDP on healthcare. In 2016 the average industrialized country spends 10.7% of GDP on healthcare. The closest nation to US spending on Healthcare is Switzerland which in 2016 spent about 12.7% of GDP on healthcare. Yet America does not have the best healthcare outcomes. America has an estimated 10-40 thousand people per year dying because of lack of healthcare coverage. Even a study funded by the notoriously conservative Koch brothers stated that Medicare for all would lower total healthcare spending by 2 trillion dollars over a 10 year period. That's just the lowest estimate, other studies have put the savings as high as 10 trillion (although I am not sure that is so realistic.) I will respond in a supplemental post about how exactly single payer drives down costs to the general system in another post this should be enough for you to read haha. Edited December 3, 2018 by billsfan89
TakeYouToTasker Posted December 4, 2018 Posted December 4, 2018 22 hours ago, billsfan89 said: I would love to see a Medicare for all system in America both in a general level and on a personal level. Its a lot you asked about so I am going to try my best to address the very real concerns you have. I also want to say that I do not believe that Medicare for All is a perfect system, it has its issues, but rather that I think the private insurance system is way worse and costs more for no real reason. Should private insurance be allowed? In the Bernie proposed Medicare for All system it allows for private and supplemental insurance to exist, it just gives everyone a baseline access to Medicare. My own personal preference is to allow Medigap policies that supplement the gaps in coverage and expand coverage by Medicare so that if your employer wants to offer you an additional coverage supplementing your base insurance they should be allowed to do so. Even now many seniors take out Medigap insurance to help with the cost of care, so I don't see why employers couldn't go over the top to provide better insurance to people like yourself. Would you want a system in place for everyone? I argue that we already have universal healthcare because doctors can't turn down patients in need because they are unable to pay. The only way a private system would actually be able to save you money is by having doctors and providers able to deny people that need treatment based on their inability to pay. So if a poor person or a self employed person who is underinsured needs care those costs get absorbed into the general system either way. Its also not just lazy bums not working that are under insured or uninsured either. Americans work more hours, take less vacation, and receive the least amount of benefits in the industrial world, I think if you removed the vastly overpriced and often inaccessible healthcare system and replaced it with a serviceable baseline policy for everyone that removes a huge burden from your average working person and for reasons I will go into later saves the general system money. Government run healthcare is terrible look at the VA. The VA argument on the surface seems valid but it is also misleading. First off the VA is underfunded, even though almost every government agency claims to be underfunded the VA is by all metrics underfunded. But even throwing that out there are many reasons why the VA isn't effective (Although the VA the boogeyman many conservatives use to scare people against government healthcare has a higher approval rating than the private system, not to say the VA's approval rating is that high but more so that the dissatisfaction with American healthcare is that low.) Another reason why the VA is a not so effective system is because the VA has a population of patients that need much more care than the population of patients provided by the private system. Soldiers need more healthcare than your average citizens, battle injuries, mental healthcare, and various other factors that the average 2-64 year old the private insurance system handles simply don't have to deal with. So you have a concentrated population of people with a much greater demand for healthcare in an underfunded system. I would also argue that the VA is the worst type of structured government healthcare, in that the hospitals are both government run and government funded. Most universal healthcare systems are public financing of private institutions aka the insurance is financed through the public but the hospitals are privately run. The UK has a VA type system with government run and financed hospitals, its not bad but it is not as effective as the public private hybrid found in countries like Canada and France. I also think you fall into the fallacy that because you are paying more for private insurance that must make it better. The general stats don't bare that out to be true. For one America pays more per-capita for healthcare than any industrialized nation on Earth. Yet our Healthcare outcomes are usually in the middle of the road. Yes there are examples of people from other countries coming to America for care they couldn't get in Canada or other countries. But there are also examples of people going to single payer countries to get care they simply couldn't afford to get in America. There are also specialists and best of the best doctors in other countries so its not as though you can only find the best care for everything in America. The framing of the argument around single payer healthcare should be that we can't afford to not have single payer. The US in 1970 went from spending 6.2% of GDP on healthcare to in 2016 spending about 17.9% of GDP on Healthcare. To put that in context the average industrialized country in 1970 was spending about 5% of GDP on healthcare. In 2016 the average industrialized country spends 10.7% of GDP on healthcare. The closest nation to US spending on Healthcare is Switzerland which in 2016 spent about 12.7% of GDP on healthcare. Yet America does not have the best healthcare outcomes. America has an estimated 10-40 thousand people per year dying because of lack of healthcare coverage. Even a study funded by the notoriously conservative Koch brothers stated that Medicare for all would lower total healthcare spending by 2 trillion dollars over a 10 year period. That's just the lowest estimate, other studies have put the savings as high as 10 trillion (although I am not sure that is so realistic.) I will respond in a supplemental post about how exactly single payer drives down costs to the general system in another post this should be enough for you to read haha. No, it does not drive down costs. It creates unaccounted costs in a thriving black market. It also exacerbates scarcity of resources. There are three prongs to health care: quality, affordability, and universality. You can have any two of the three, but not all three because you are dealing with finite commodities. 1
Deranged Rhino Posted December 4, 2018 Posted December 4, 2018 Sooo... we'll need a second special counsel now and the GOP will rightfully be able to say the election was illegitimate, right? 3
billsfan89 Posted December 4, 2018 Posted December 4, 2018 1 hour ago, TakeYouToTasker said: No, it does not drive down costs. It creates unaccounted costs in a thriving black market. It also exacerbates scarcity of resources. There are three prongs to health care: quality, affordability, and universality. You can have any two of the three, but not all three because you are dealing with finite commodities. It does drive costs down and I would argue that the "Three Prongs" argument is very flawed because you have Universality in any system that adheres to the Hippocratic oath which states you can't deny care to someone who needs it simply because they can't afford it. So then your argument comes down to quality vs. affordability which is also flawed because US Healthcare outcomes are mid-level to upper mid-level despite the US spending the most on healthcare per-capita and by far the largest portion of GDP. So the US system is universal, unaffordable, and not the best quality for a variety of factors. I also fail to see where a black market would arise? I have yet to hear an argument that is compelling and fact based that the current system can be corrected by deregulation and free market forces (Healthcare is also not an elastic product which makes it less susceptible to market forces) as long as the Hippocratic Oath exists. Yes if you wanted to treat healthcare like an actual commodity (one where a doctor or provider can deny treatment to those in need) then you probably could drive costs down. But unless you want to live in a society where people are left to die because they can't afford healthcare then a for profit system won't be able to drive down costs. I would also argue that every system rations care. As I said before Healthcare is not an elastic product, its not easy to create more of it and you can't ethically deny people access to it. In the US we ration care off of how big your wallet is (Not even wither or not you work because self-employed people and people who work for a small business don't always have insurance, and even full time workers for big companies can be underinsured.) In single payer countries they go by medical need. So it is an outright scare tacit to claim rationing of care when 10-40k people die from lack of medical access in the US. The Main reasons Healthcare in the United States is so unaffordable and lacks general quality for a system so expensive is due to billing, prescription drug prices, lack of preventative care, and the profit motive. The US private Healthcare system spends 14-20% on billing, Medicare spends about 4% on billing most single payer systems spend about 3-8% on billing. That's mainly because if you have dozens of health insurance companies with dozens of plans each of them have their own billing codes and each plan is its own soup of benefits. You also have each insurance provider looking to get its own pricing for services for each of their providers in their own network. That means each provider needs to have people to navigate and negotiate with each insurance company patient by patient. In single payer systems they have a singular billing code and singular models of pricing. Hospitals can also get paid in lump sums yearly as opposed to having to get paid on a per-patient basis. This is not a result of the government being better at doing something but rather universality and simplicity winning out over a more complex and unnecessary network of middle men. Prescription Drugs also add to the cost of care because the Medicare system is driven up against the private system. Corruption is also at play because thanks to legalized bribery known as campaign contribution the drug industry is a powerful lobby. The US also sees worse outcomes and more costs because uninsured and under insured people will not get preventative care do to cost and they will wait for things to get worse because of costs. When things are found sooner they are cheaper to treat. In the US we have a system where we don't have great access to catch thing early and then we treat people later on when a condition has progressed worse. Then there is the profit motive. Profits in the US Healthcare system are 2% or less of the system. Certainly it would be nice to get rid of that 2% but we aren't being driven to the cleaners for 2% or less (Usually less.) But the profit motive is one that creates a perverse relationship between the patient and their insurance company. A private insurance company has an incentive (profit) to not pay out a claim, this generates a lot of back and forth between the insurance company and the provider (More bureaucracy) it also ends up with insurance companies not paying out claims (Often for frivolous reasons) and then placing the costs onto the patient who will go bankrupt or pay the full inflated costs. There are also other benefits to a single payer system where the government can have access to rates across the whole system and bring down costs (Why does X procedure cost less in this other hospital.) I have laid out a detailed and specific argument for single payer driving down costs and recording better outcomes. Can you please tell me how more free market drives down costs while still having the Hippocratic Oath?
DC Tom Posted December 4, 2018 Posted December 4, 2018 7 minutes ago, billsfan89 said: It does drive costs down and I would argue that the "Three Prongs" argument is very flawed because you have Universality in any system that adheres to the Hippocratic oath which states you can't deny care to someone who needs it simply because they can't afford it. Define "triage."
billsfan89 Posted December 4, 2018 Posted December 4, 2018 (edited) 3 minutes ago, DC Tom said: Define "triage." Triage is used in terms of overwhelming emergencies and when hospitals are flooded. But no hospital/doctor will deny a patient based off an inability to pay. Even triage goes off of medical need and not ability to pay. The US system can't save money in a private market unless providers are allowed to deny people based off of inability to pay. Edited December 4, 2018 by billsfan89
DC Tom Posted December 4, 2018 Posted December 4, 2018 Just now, billsfan89 said: Triage is used in terms of overwhelming emergencies and when hospitals are flooded. But no hospital/doctor will deny a patient based off an inability to pay. Even triage goes off of medical need and not ability to pay. I didn't ask "what is the use case?" I said "define it." The point I would eventually get it is that "triage" - like many denials of care in the medical industry - is driven by scarcity of services and resources, and time. There is no "universality," because it is a finite resource. "Triage" is a single illustration of that: it exists because doctors cannot treat everyone, because they are a limited exclusive-use resource. Not because of fiscal constraints. You simply don't understand the concepts in effect here. That you think that, because doctors ascribe to an oath that they treat anyone, that they therefore must treat everyone, is such a basic failure of reasoning that it makes it obvious that you simply don't have the skills to have the discussion you're attempting here.
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