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Author Topic: GOP Health Care  (Read 5935 times)
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B0B
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« on: Mar 08, 2017, 04:35AM »

The GOP officially and publicly released their "plans" recently to replace obamacare.

Oddly enough, to tout it from the White House side, Spicer had printouts of their proposed bill and the ACA to compare the sizes of the two side by side. It was also followed from trump in an attempted encouraging (but doesn't have that effect) of noting key GOP desires that are missing from it, promising later phases that are unlikely to happen. And from the house side... the side said to be most concerned with costs and prices... they couldn't speak to any of that because they avoided any financial review of the consequences of the bill for fear they might be worse. And then on the senate side, they have already lost enough GOP senators that they cannot cross even 50 votes.

And in the end, it is a bill that is likely to increase the rate of insured, while still mandating that insurance companies cover pre-existing conditions, and guts funding and access to the government options. After all, under their plan, I could pay for insurance only when I needed it, and the only penalty I would receive is a potential extra 30% cost for a year. So.... 4 months insurance payment, spread out over a year.... to avoid have to pay for years of insurance.

It also add that extra cost for anyone who lets their coverage lapse 60 days, such as a job change. So... you're penalized in getting insurance in the new job because HR wanted 60-90 days to sign you up as a new employee.

And at the same time, the tax credits are said to be based on age instead of income... allowing older folks to get twice the tax credits of younger folks. Though it raised the allowable billing difference to 1:5 young:old per the costs from the 1:3 ratio of obamacare. So... they get double the tax credits... and 5 times the cost?

The fireworks are only just beginning.
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« Reply #1 on: Mar 08, 2017, 05:20AM »

THis is a train wreck in the making. It is horrible for the poor, the sick, and the elderly in this country, but it is solid gold for the electoral prospects of the Dems in 2018. IT will be interesting to watch this play out.
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« Reply #2 on: Mar 08, 2017, 05:56AM »

THis is a train wreck in the making. It is horrible for the poor, the sick, and the elderly in this country, but it is solid gold for the electoral prospects of the Dems in 2018. IT will be interesting to watch this play out.

"Interesting" isn't the word I'd go with, but it's still true.
 
What we need to watch and study and figure out how to correct is how hard core Trumpistanians will manage to maintain their beliefs in spite of clear, directly contrary evidence and even serious personal loss.
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« Reply #3 on: Mar 08, 2017, 06:18AM »


Trumpistanians


I prefer "Trumpanzees".

THis is only one disaster teh GOP Congress intends to inflict on the American people. It is going to be a truly ugly 2 years. One can only hope the Persisterhood is real, and I'm seeing significant evidence that it is, and that it can get more than 50% of eligible voters to the polls in 2018. If 70% of AMerican voters actually got to the polls the GOP (Government of Pitin) would never win another election.
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« Reply #4 on: Mar 08, 2017, 06:18AM »

This is an existential threat to the US, and it's the major civil rights issue of the age.  I only see one of two possibilities:

1.  The ensuing fight crystallizes the belief that it's in our national interest to have a healthy populace, and that healthcare is a right (an entitlement) to living in a modernized democratic state.  The only place to go from there is a single-payer system that spreads cost and access to everyone.  Medicare of all.

2.  The Right digs in and repeats "Access to healthcare is a right" so many times that everyone believes it.  Access means cost, and healthcare is expensive when cost isn't shared across a large pool of payers.  The poor and middle classes get choked out of healthcare until they get priced out of the sector entirely.  The major health crises we continue to face will worsen until there's a mandatory correction, precipitated by actual waves of death and bankruptcy.  

You just can't have it both ways folks.  If healthcare is a commodity, and you want to have a for-profit industry, then you need to swipe people's credit cards BEFORE you offer them treatment.  If you can't pay, you don't get treated.  

If healthcare is a public service, and you have to offer treatment to anyone that shows up at an emergency room, then you have to treat it like a public service and find a way to pay for it with taxes.

If you run a healthcare system as a for-profit enterprise, but you are legally required to treat anyone, regardless of their ability to pay, then you get what we have:  A large, bloated, money-hungry system on the verge of bankruptcy with skyrocketing costs and crappy returns.  

I'd love to see a single-payer system, and I tend to be pretty libertarian.  If everybody pays into the system, and we can keep our citizenry healthier longer, then we have more people working in the economic sector.  Keep people healthy = people work longer = people spend longer = better economy and healthier populace to take advantage of it. I really can't understand why we're so resistant to that.

Being healthy isn't a choice.  It's a requirement to being an active, productive member of a society.
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« Reply #5 on: Mar 08, 2017, 06:32AM »

Fun side, but relevant note:

The US population is ~320 million.

Of that...

111 million use medicare
70 million use medicaid
9 million use the VA

Which puts roughly 60% of the US population on a government healthcare plan.

The idea that we can't tolerate a government run system, when most people already use government systems for healthcare... that's a bit of an intentionally blind philosophy there.
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« Reply #6 on: Mar 09, 2017, 10:23AM »

Well... just a few days into this, the GOP is trying to rush their plan through the house to say they've "done something"... not even with a CBO estimate to say if it actually does anything, and if so what... And senators on both sides are saying it's DOA should it ever pass the house and get to the senate.

Looks like political posturing to say "we did our part" with nothing actually "did" behind it.

Can't say I'll be sad to watch this die a slow and painful death.
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« Reply #7 on: Mar 09, 2017, 10:54AM »

What Ryan and company proposed is nowhere near as good as Obamacare, even with all Obamacare's faults.  It certainly won't meet the Trump requirement of "better".

Ryan takes aim at Medicaid, trying to squelch it.  Also, what good is a tax credit when you can't afford the premium in the first place?

It feels like the Republicans are trying to stiff the poor and needy.  It will backfire in that those folks will once again clog the emergency rooms at hospitals for medical care that could easily be done in a doctor's office.
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« Reply #8 on: Mar 09, 2017, 01:01PM »

I really think we need to do away with employer provided health plans and move to associations for group plans.

The Trombone Forum has over 18K members. We should be able to negotiate a pretty good plan with that many members!

That way, when people change jobs, it doesn't affect their plans.

If young people decide to gamble and not buy insurance, if they get a major problem, too bad. Put them in a high risk pool until they are cured, then give them a choice to move into a plan, or stay in the high risk pool.

If you gamble and never need it, then, good for you.

People's choice - Pro Choice. Instead of killing a baby, you get to gamble with YOUR health, and not my bank account.

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« Reply #9 on: Mar 09, 2017, 01:02PM »

THis is a train wreck in the making. It is horrible for the poor, the sick, and the elderly in this country, but it is solid gold for the electoral prospects of the Dems in 2018.

I'm doubtful the Dems will get much advantage from it.

The "individual mandate" is such an unpopular concept, and it is so difficult to explain the reason for it (the explanation doesn't fit on a bumper sticker), that it will continue to sway decisive numbers of the "uneducated" demographic to the Republicans.

The old system was also horrible for the poor and the sick and the elderly weren't crazy about it either, but what did the Dems get for trying to fix it?  Loss of the House, loss of the Senate, loss of numerous state legislative seats.

Most people imagine they will never need expensive health care and don't like the idea of everyone paying to help the few who do.

Fixing health care will never be as popular as telling people you want to give them a tax cut.

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« Reply #10 on: Mar 09, 2017, 01:31PM »

I really think we need to do away with employer provided health plans and move to associations for group plans.

The Trombone Forum has over 18K members. We should be able to negotiate a pretty good plan with that many members!

That way, when people change jobs, it doesn't affect their plans.

If young people decide to gamble and not buy insurance, if they get a major problem, too bad. Put them in a high risk pool until they are cured, then give them a choice to move into a plan, or stay in the high risk pool.

If you gamble and never need it, then, good for you.

People's choice - Pro Choice. Instead of killing a baby, you get to gamble with YOUR health, and not my bank account.


This is actually something my father-in-law had.  He didn't get health insurance from his various garment manufacturers, but instead he got it from his Union.

I think this is a rare moment.  We actually agree on something -- that health care shouldn't depend on employment and everybody should be able to get coverage from an entity.  I would like it to be a single payer; either Government or a non-profit.
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« Reply #11 on: Mar 09, 2017, 01:43PM »

This is actually something my father-in-law had.  He didn't get health insurance from his various garment manufacturers, but instead he got it from his Union.

I think this is a rare moment.  We actually agree on something -- that health care shouldn't depend on employment and everybody should be able to get coverage from an entity.  I would like it to be a single payer; either Government or a non-profit.

Hold your horses!

You want single payer ( no competition )(one size fits all) (take it or leave it ) plus single payer to be the government?

Look at the VA to see how well the government runs healthcare. Geeesh!

I like the formations of associations. We already have some of those right now, so the model is already set. Like AARP offers one of the best competitive solutions, but there could be thousands of others (associations). Say for instance the Criminals United Slush Funds, or National Organization for Terrorists, America's Finest Jazz Bands, just to name a few.

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« Reply #12 on: Mar 09, 2017, 01:46PM »

Actually, AFM offers health insurance also, but you have to work a certain number of hours a month to qualify.  I looked into this when I lost my last job.

You planning on joining United ISIS Terrorists? Evil :-P (Allah Akhbar!)
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« Reply #13 on: Mar 09, 2017, 01:49PM »

Actually, AFM offers health insurance also, but you have to work a certain number of hours a month to qualify.  I looked into this when I lost my last job.

You planning on joining United ISIS Terrorists? Evil :-P (Allah Akhbar!)

Sure, if I need insurance.  Evil

Like I said, The Trombone Forum could offer a plan since there are so many members. You should probably have a requirement of so many a posts per week or month to stay eligible.
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« Reply #14 on: Mar 09, 2017, 03:03PM »

Hold your horses!

Look at the VA to see how well the government runs healthcare. Geeesh!


Actually, that statement is horse bleep. The problems at the VA had nothing to do with the quality of its medical care, and everything to do with the GOP Congress not funding the the VA adequately to process the massive numbers of new veterans their wars created. I do not know a single veteran who would trade his VA coverage, once they are into the system, for anything that exists in the private sector. My Dad had multiple medical issues that were handled exceptionally well for years. It was when he was dumped into the cesspool of the for-profit health care system in Texas by the transport protocols of a local EMS provider that the system killed him. Had they transported him to the VA instead of the closest facility he might still be with us.
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« Reply #15 on: Mar 09, 2017, 03:04PM »

Actually, that statement is horse bleep. The problems at the VA had nothing to do with the quality of its medical care, and everything to do with the GOP Congress not funding the the VA adequately to process the massive numbers of new veterans their wars created. I do not know a single veteran who would trade his VA coverage, once they are into the system, for anything that exists in the private sector. My Dad had multiple medical issues that were handled exceptionally well for years. It was when he was dumped into the cesspool of the for-profit health care system in Texas by the transport protocols of a local EMS provider that the system killed him. Had they transported him to the VA instead of the closest facility he might still be with us.

Money! That's the only excuse that the leftists ever give. Never enough money. BS!

Look, if the government took over as single payer, that would be what we hear every election cycle, every budget battle.

The system is failing, and it's failing because we don't have enough money. According to the leftists, that's why our education is failing. Not enough money. Ha!
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« Reply #16 on: Mar 09, 2017, 03:15PM »

Money! That's the only excuse that the leftists ever give. Never enough money. BS!

Look, if the government took over as single payer, that would be what we hear every election cycle, every budget battle.

The system is failing, and it's failing because we don't have enough money. According to the leftists, that's why our education is failing. Not enough money. Ha!

Instant of knee jerk condemnation to all things liberal, perhaps you could take a deep breath, calm down and look at things without your biased and ridiculous prejudices.

Same stale talking points over and over again. But it isn't any wonder considering your sources for what passes for truth on your planet. At least the sources you consistently cite.

Yawn
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« Reply #17 on: Mar 09, 2017, 03:19PM »

Same stale talking points over and over again.

That's what I'm saying. Come up with something more creative than "We need more money". That's stale as you put it.

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« Reply #18 on: Mar 09, 2017, 04:16PM »

Instant of knee jerk condemnation to all things liberal, perhaps you could take a deep breath, calm down and look at things without your biased and ridiculous prejudices.
 
Same stale talking points over and over again. But it isn't any wonder considering your sources for what passes for truth on your planet. At least the sources you consistently cite.
 
Yawn

Just needs to throw some words out there, more or less like a three-year-old just yelling in defiance of reality.
 
We all know this. It's as reliable as the smells that follow after a cat leaves the litter box.
 
The bizarre phenomenon is those who can be relied upon to feed it for some reason.
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« Reply #19 on: Mar 09, 2017, 04:30PM »

The alternatives:

1. People pay their own bills. Nobody wants that. Sick people become poor people become dead people. Dead people can't pay their medical bills. Even the GOP see the flaws.

2. Private insurance. Sounds good from an ideological perspective. Free enterprise! Except experience shows that it is barely economically viable. So you've got to narrow the pool of insureds (no pre-existing conditions), increase revenue/premiukms (co-pays) and limit services. GOP likes it because it produces millionaire cardiologists and CEOs of health insurers.

3. Obama care/single payer. Antithetical to American freedoms and liberties because you widen the pool of insureds by requiring everyone, especially the young/healthy, to buy coverage. Except even this isn't quite economically viable because you still need tax credits and subsidies. In other words, tax revenues to partially fund the system. And it's still not enough.

Trump-care is bound to fail except on ideological terms. It will not improve health outcomes.
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« Reply #20 on: Mar 09, 2017, 04:43PM »

The problem with health care is structural. There's no effective market in medical care, besides dentistry and eye care.

My friend who's both a surgeon and a policy expert summed up the problem thusly: "How much would you charge for a hamburger if no one asked what it cost?"

That's the medical 'market', in a nutshell.

That's the problem that needs to be solved. All the rest is picking around the edges.

When the gov't has actual buying power, it chickens out. The three big players are AMA, pharma, and insurance. Obama finessed the situation quite dishonestly--he backed down to pharma, held doctors harmless, then made out the insurance industry to be the bad guys but made the bill work for them.

Trump came in waving his dick saying he was going to stand up to the pharmaceutical companies and negotiate a great deal for the American people, then had a meeting with them and came out with his tail between his legs and implied that negotiating drug prices would be 'price fixing'.

The biggest problem is that there is little practical limit on what can be charged for medical procedures. I skipped a test last year that was prescribed because my out-of-pocket would have been about $1700, and it looked to me like a $400 test. Not everyone has that choice. The free market in medicine is broken, because it's not really a market. The things that would make the market freer would be opposed by some of the richest and smartest people on the planet.
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« Reply #21 on: Mar 09, 2017, 04:56PM »

I really think we need to do away with employer provided health plans and move to associations for group plans.

The Trombone Forum has over 18K members. We should be able to negotiate a pretty good plan with that many members!


The reason employer-based group plans work is that they're not optional, and that they're based on people who are chosen for their need for employment rather than their need for medical care. You have to have a very high level of participation in order to qualify. The purpose of that requirement is to avoid 'self-selection', meaning the sickest people sign up and the rest take a flier.

I think the last one I looked at was 90% participation, but you could get an exception if you showed that you already had insurance through a family member (thus showing you weren't opting out due to good health). Even if you cut that in half (and they wouldn't) would people signing on to find out what mouthpiece works best with at 72H expect to be required to buy insurance, at anywhere near that rate?

Of course not.

If you reconnoitered the TF to be a place that attracted people who wanted medical insurance, you'd end up with the same problem as the open market--you'd find a disproportionate number of people who need medical care, and in the process you'd lose people who wanted to talk about mouthpieces. You'd have an uninsurable group, and ruin the forum.

You have a talent for developing strong opinions on subjects you know nothing about. Voluntary associations that are formed for the primary, or even secondary, purpose of obtaining health care would fail for the obvious reason.
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« Reply #22 on: Mar 09, 2017, 09:45PM »

The reason employer-based group plans work is that they're not optional, and that they're based on people who are chosen for their need for employment rather than their need for medical care. You have to have a very high level of participation in order to qualify. The purpose of that requirement is to avoid 'self-selection', meaning the sickest people sign up and the rest take a flier.

I think the last one I looked at was 90% participation, but you could get an exception if you showed that you already had insurance through a family member (thus showing you weren't opting out due to good health). Even if you cut that in half (and they wouldn't) would people signing on to find out what mouthpiece works best with at 72H expect to be required to buy insurance, at anywhere near that rate?

Of course not.

If you reconnoitered the TF to be a place that attracted people who wanted medical insurance, you'd end up with the same problem as the open market--you'd find a disproportionate number of people who need medical care, and in the process you'd lose people who wanted to talk about mouthpieces. You'd have an uninsurable group, and ruin the forum.

You have a talent for developing strong opinions on subjects you know nothing about. Voluntary associations that are formed for the primary, or even secondary, purpose of obtaining health care would fail for the obvious reason.

AARP doesn't seem to be failing.
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« Reply #23 on: Mar 09, 2017, 10:11PM »

AARP doesn't seem to be failing.

That doesn't take one thing away from what I'm saying. AARP endorses supplemental insurance policies. It doesn't effectively function as a group that can obtain group rates for primary medical insurance. To the extent that it's self-selected, it's self-selected for being old.

Duh.

If you'd spent any of your youth listening to smart people instead of talking, you'd be almost average by now. It's not too soon to start.
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« Reply #24 on: Mar 09, 2017, 10:36PM »

Like I said, The Trombone Forum could offer a plan since there are so many members. You should probably have a requirement of so many a posts per week or month to stay eligible.

TTF is too international ... and to difficult to determine where people really are, in this era of VPN services and such. 

There is no way this can be made to work, unfortunately.
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« Reply #25 on: Mar 09, 2017, 10:39PM »

Gee - 'GOP Healthcare' - that should be in a dictionary as an example of an oxymoron.
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« Reply #26 on: Mar 10, 2017, 12:51AM »

Reports are that no one wants their name attached to their version of health care bill.

http://www.cnn.com/2017/03/09/politics/obamacare-republicans-trumpcare-ryancare/index.html
 :D

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« Reply #27 on: Mar 10, 2017, 04:17AM »

That doesn't take one thing away from what I'm saying.
Of course it does.
 
It's noise (or in this case characters and words) raised in opposition.
 
It wouldn't be fair not to count them just because they're irrelevant--they're words ... in opposition!
 
That's clearly your real problem. If they were words You Guys™ wrote you'd be gushing over them.
 
AARP endorses supplemental insurance policies. It doesn't effectively function as a group that can obtain group rates for primary medical insurance. To the extent that it's self-selected, it's self-selected for being old.
 
Duh.
 
If you'd spent any of your youth listening to smart people instead of talking, you'd be almost average by now. It's not too soon to start.
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« Reply #28 on: Mar 10, 2017, 04:19AM »

Reports are that no one wants their name attached to their version of health care bill.

Clearly it's got to be due to their deep humility.
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« Reply #29 on: Mar 10, 2017, 08:03AM »

Reports are that no one wants their name attached to their version of health care bill.

http://www.cnn.com/2017/03/09/politics/obamacare-republicans-trumpcare-ryancare/index.html
 :D



The Ryan express is ignoring all the conservatives. That's why it is just going to be another Obama Failure.
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« Reply #30 on: Mar 10, 2017, 09:07AM »

The Ryan express is ignoring all the conservatives. That's why it is just going to be another Obama Failure.
I do have to wonder... when do republicans wake up and realize they won the election?

Obama is out. (well, term limits and all)

Hillary Clinton lost.

The GOP won.

Yet, a GOP plan, pushed by a GOP dominated house, where it will stall and die in a GOP senate, and never actually get to a GOP president?

That's Obama's fault?

Yall won. Time to step up and figure out how to be more thnn an opposition party blaming everyone else for any and all failures. Besides, isn't the gop the party of personal responsibility? Grow a pair, and take some responsibility on!
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« Reply #31 on: Mar 10, 2017, 09:12AM »

Keep blaming Obama DD. That is real classy.

Your party has both houses locked up and your boy 45 is in the White House. So it is ALL on them.
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« Reply #32 on: Mar 10, 2017, 09:33AM »

THe central idea in my column this week. THe best hope for this country over the next four years is the GOP (Government of Putin)'s absolute incapacity to actually govern.
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« Reply #33 on: Mar 10, 2017, 10:21AM »

THe central idea in my column this week. THe best hope for this country over the next four years is the GOP (Government of Putin)'s absolute incapacity to actually govern.
So far they seem to be exceeding your expectations there...

Still shouting at old enemies like the election is still going on.

What do the GOP really have to unite them now that Obama is gone, and they have no powerful enemies blocking them?
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« Reply #34 on: Mar 10, 2017, 02:37PM »

That's funny. After 8 years, Obama still blamed everything on Bush. LOL!

My post above was addressing the Ryan team not listening to the conservatives, so their version was going to be a disaster. So, it being a disaster should be something we have in common. You'd think Don't know
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« Reply #35 on: Mar 10, 2017, 02:41PM »

Reminds me of when you would say that 60% of the people didn't like ObamaCare.

It was 40% who said it went too far and 20% who said it didn't go far enough.

Now we have all the Democrats who say RyanCare went too far and 20% of the Conservatives who said it didn't go far enough.
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« Reply #36 on: Mar 10, 2017, 02:53PM »

The Ryan express is ignoring all the conservatives. That's why it is just going to be another Obama Failure.

Trumpcare is Obama's fault! LOL!

Talk about excuses! LOL!
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« Reply #37 on: Mar 10, 2017, 02:53PM »

My post above was addressing the Ryan team not listening to the conservatives, so their version was going to be a disaster. So, it being a disaster should be something we have in common. You'd think Don't know

Your guy is actively lobbying for this proposal. You're blaming it on Ryan and Obama! LOL!
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« Reply #38 on: Mar 10, 2017, 02:55PM »

Reminds me of when you would say that 60% of the people didn't like ObamaCare.

It was 40% who said it went too far and 20% who said it didn't go far enough.

Now we have all the Democrats who say RyanCare went too far and 20% of the Conservatives who said it didn't go far enough.

That's true--in both cases, people disliked the bills for opposite reasons, but both sides pretended the total opposition supported their view.
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« Reply #39 on: Mar 10, 2017, 03:30PM »

That's funny. After 8 years, Obama still blamed everything on Bush. LOL!

I would like to see some citations on that.  Obama rarely ever mentioned Bush.

Let's see 'em. There better be lots of them to cover your assertion of "everything" and they better be about Bush.
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« Reply #40 on: Mar 10, 2017, 03:33PM »

I would like to see some citations on that.  Obama rarely ever mentioned Bush.

Let's see 'em. There better be lots of them to cover your assertion of "everything" and they better be about Bush.

I guess you weren't around.
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« Reply #41 on: Mar 10, 2017, 03:34PM »

TPM is running a contest to find all the times Trump promised nearly Utopian replacements for Obamacare.

More people covered! Lower cost!

Quote
Late Update: TPM Reader JF strikes early with a great contest entry. 1/15/17 Donald J. Trump: "We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” Can you beat it? An official TPM shirt hangs in the balance!

Latter Update: Oooooo ... TPM Reader NH is bringing it! 2/19/16: "Obamacare has to go. We can't afford it. It's no good. You're going to end up with great healthcare for a fraction of the price. And that's going to take place immediately after we go in. Okay? Immediately. Fast Quick." (CSPAN, Timestamp 34:23)

Entry #3: "Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, "No, no, the lower 25 percent that can't afford private. But-- ... I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now." - 60 Minutes, September 27, 2015. TPM Reader MM.

Entry #4: "We're gonna come up with a new plan that's going to be better health care for more people at a lesser cost." ABC News, 1/25/17. TPM Reader JH.

Entry #5: "There are people who say everybody should have a great, wonderful, private plan, and if you can't afford that, and there is a percentage, a fairly large percentage that can't afford it, then those people don't get taken care of. That's wrong. We're going to take care of that through the Medicaid system. We’re going to take care of those people. We have no choice." Dr. Oz, 9/15/16. TPM Reader JN.

Entry #6: "The new plan is good. It's going to be inexpensive. It's going to be much better for the people at the bottom, people that don't have any money. We're going to take care of them through maybe concepts of Medicare. Now, some people would say, "that's not a very Republican thing to say." That's not single payer, by the way. That's called heart. We gotta take care of people that can't take care of themselves." CNN GOP Townhall, 2/17-18/16. TPM Reader BS.

Entry #7: "I’m not going to cut Medicare or Medicaid." 5/21/15. The Daily Signal. TPM Reader WM.
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« Reply #42 on: Mar 10, 2017, 03:37PM »

I guess you weren't around.

Not an answer to my question.


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« Reply #43 on: Mar 10, 2017, 03:44PM »

I would like to see some citations on that.  Obama rarely ever mentioned Bush.

Let's see 'em. There better be lots of them to cover your assertion of "everything" and they better be about Bush.

He won't offer citations. He'll just reassert it and move on to the next lie. Betcha.

DDickerson gets s little mixed up sometimes. He's blaming Trump's own healthcare proposal, for which Trump is actively lobbying a congress of his own party, on Obama. There's not one branch of gov't that's under control of Dems.

He thinks that's similar to Obama supporters noticing that Obama inherited an economy in freefall. You'll notice that Obama didn't blame his predecessor for his own proposals. That distinction might see obvious to people of average, or even nearly average, intelligence. Apparently the hard dirt of Texas is a bad place to be dropped on your head as an infant.
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« Reply #44 on: Mar 10, 2017, 03:56PM »

I don't provide citations. If you don't agree with me, look it up for yourself. Simple really.

Informational Welfare State. Bad!
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« Reply #45 on: Mar 10, 2017, 04:43PM »

GOP. What does it stand for?
Lincoln placed the life and liberty of the slaves over the profits of the slave holders.
Today the GOP in trying to repeal the ACA is placing the profits of the healthcare industry over the right to life and liberty of many Americans. The death rate of these people will increase in proportion to the reduction in their coverage.
Today GOP stands for "god of profits"
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« Reply #46 on: Mar 10, 2017, 05:18PM »

I don't provide citations. If you don't agree with me, look it up for yourself. Simple really.

How convenient. You make claims and shrug off requests for cited sources. Right out of Trump's style book.
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« Reply #47 on: Mar 10, 2017, 05:28PM »

How convenient. You make claims and shrug off requests for cited sources. Right out of Trump's style book.

Consistently and without fail ... yet he's lavished with attention just as reliably.
 
Is anyone unsure of why the social climate is getting more and more vacuous and toxic?
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« Reply #48 on: Mar 10, 2017, 05:45PM »

I don't provide citations. If you don't agree with me, look it up for yourself. Simple really.


And after I "look it up"... I still don't agree with you. There are no known cases of Obama criticizing Bush since his inauguration.

None!
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« Reply #49 on: Mar 10, 2017, 05:53PM »

But hey, if it amuses him to make unfounded and irresponsible claims, who are we to get in the way of his fun?

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« Reply #50 on: Mar 10, 2017, 06:33PM »

I don't provide citations.

Of course you don't! How could you? LOL!

Quote
If you don't agree with me, look it up for yourself. Simple really.

How do you verify a lie? Is it the google search result for 'Obama is to blame for GOP health care bill" or "Stupid **** that DDickerson made up?" LOL!

Did you ever find that link where James Rosen's phones got wiretapped? LOL!

I was taught at an early age that if you lie people will think you're a liar! LOL!

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« Reply #51 on: Mar 10, 2017, 08:54PM »

How convenient. You make claims and shrug off requests for cited sources. Right out of Trump's style book.

Give me the citation for Trump's style book, please.
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« Reply #52 on: Mar 10, 2017, 09:10PM »

From the Completely Unnecessary Law Changes desk...

House Republicans would let employers demand workers’ genetic test results

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A little-noticed bill moving through Congress would allow companies to require employees to undergo genetic testing or risk paying a penalty of thousands of dollars, and would let employers see that genetic and other health information.

Giving employers such power is now prohibited by legislation including the 2008 genetic privacy and nondiscrimination law known as GINA. The new bill gets around that landmark law by stating explicitly that GINA and other protections do not apply when genetic tests are part of a “workplace wellness” program.

The bill was approved by a House committee on Wednesday, with all 22 Republicans supporting it and all 17 Democrats opposed...
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« Reply #53 on: Mar 11, 2017, 04:54AM »


That's funny. After 8 years, Obama still blamed everything on Bush. LOL!


Dusty, that is just not true. One of my biggest problems with Obama, from the day he was inaugurated, was his refusal to hold Bush and his administration accountable for all the disasters he inflicted on the American people and the world. There were certainly eight years of people pointing out all of the responsibilities Bush and his administrion had for the problems existant in this country and the world, but none of it came from Obama.
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« Reply #54 on: Mar 11, 2017, 06:30AM »

Dusty, that is just not true. One of my biggest problems with Obama, from the day he was inaugurated, was his refusal to hold Bush and his administration accountable for all the disasters he inflicted on the American people and the world. There were certainly eight years of people pointing out all of the responsibilities Bush and his administrion had for the problems existant in this country and the world, but none of it came from Obama.

Let's call it Obama's World.  Evil
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« Reply #55 on: Mar 11, 2017, 06:34AM »

Let's call it Obama's World.  Evil


DD changing his story.
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« Reply #56 on: Mar 11, 2017, 07:08AM »


DD changing his story.


The typical "Jello to the wall" fluidity of attempting discourse with most on the right.
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« Reply #57 on: Mar 11, 2017, 07:23AM »

Not really.
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« Reply #58 on: Mar 11, 2017, 11:03AM »

This is hilarious. DDickerson cannot discuss any subject without blaming Obama. Now that Obama's out of the picture, and largely silent, DD's floundering helplessly, and so is his party.

Let's face it, the GOP blamed congressional Democrats for what they saw as the flawed ACA. Then when they took over congress, they told the Tea Partiers they couldn't repeal it because Obama would veto it. Now they control both houses of Congress and they have a president who's lobbying for their bill, and they may not even get it to a vote, with their party controlling every committee.

Just like DDickerson, they're out of excuses. They just can't do anything.
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« Reply #59 on: Mar 11, 2017, 11:11AM »

Give me the citation for Trump's style book, please.

That doesn't need a citation--he's voicing an opinion that you make stuff up and make no effort to support it. The evidence for that is in nearly every one of your posts.

The evidence of Trump doing it is in his tweets. The most recent is his allegation that Obama tapped his phones. Everyone in the justice dept. works for the executive branch, and he's the executive.

The reason people can't 'look it up themselves' when you make up your little claims is that there's nothing to look up--you're simply wrong.
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« Reply #60 on: Mar 11, 2017, 11:45AM »

DD, why should you be bothered when I compare your style to Trump's? You seem to admire him so well.
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« Reply #61 on: Mar 11, 2017, 12:00PM »

DD, why should you be bothered when I compare your style to Trump's? You seem to admire him so well.

I might need to remind you that I did not vote for him in the primary. I was stuck with him, whereas, I'm sure you loved Hillary. Maybe not.

I'm definitely nothing like Trump, as he is a narcissistic Type A leader. I don't consider myself a leader of any type. That's why I didn't go to school majoring in music. I didn't want to be a band director. I would rather play in the section than lead it.

I had a boss when I worked for the City of Houston that was exactly the same as Trump in his leadership style. Those were the worst years of my career in the City. Fortunately, they amounted only to a very few.

However, just like there is a time and place for everything, now is the time for a leader like Trump. He won't pander and kowtow to his political opponents the way W did. The demos will figure that out sooner or later. But who knows?

 
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« Reply #62 on: Mar 11, 2017, 01:52PM »

I might need to remind you that I did not vote for him in the primary. I was stuck with him, whereas, I'm sure you loved Hillary. Maybe not.

This is one of your more honest posts, and I appreciate it. Still, do you notice the dishonesty in the last bit? "I'm sure" and "Maybe not", can't both be true. The latter is honest, the former said for effect rather than illumination.

Quote
I'm definitely nothing like Trump, as he is a narcissistic Type A leader. I don't consider myself a leader of any type. That's why I didn't go to school majoring in music. I didn't want to be a band director. I would rather play in the section than lead it.

I had a boss when I worked for the City of Houston that was exactly the same as Trump in his leadership style. Those were the worst years of my career in the City. Fortunately, they amounted only to a very few.

However, just like there is a time and place for everything, now is the time for a leader like Trump. He won't pander and kowtow to his political opponents the way W did. The demos will figure that out sooner or later. But who knows?

Again, I appreciate the honesty, but you've unintentionally found the flaw in your support of Trump. People who regard themselves as 'followers' often give undue respect to people who are comfortable leading, without a clear idea of their ability to do it. It's the same sort that are susceptible to a very skilled con.

I'm no great leader of men or anything, but pretty comfortable leading--running rehearsals or directing traffic at work--but that helps me spot the phonies and not be enthralled by them. The problem with Trump isn't that he won't 'kowtow and pander', but that he's incompetent and unstable.  People who have that magnetic attraction to 'strong leaders' tend to get led down a bad path because they admire traits in others that they don't have themselves. The brownshirts probably regarded themselves as humble, decent people, and for the most part they probably started out that way.

 
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« Reply #63 on: Mar 11, 2017, 02:07PM »

No, I didn't like Hillary but she got my vote hoping to keep the buffoon sexist con man out of office.
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« Reply #64 on: Mar 11, 2017, 04:02PM »

Do not circulate this image! Do not let people know what Trump has promised numerous times.

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« Reply #65 on: Mar 11, 2017, 07:45PM »

And, Geez... don't distribute this one...

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« Reply #66 on: Mar 11, 2017, 08:08PM »

And, Geez... don't distribute this one...


Yeah ... thanks man ... can't unsee that.
 
Thought I'd leave it in my reply to share the pain ... heh.
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« Reply #67 on: Mar 11, 2017, 08:36PM »

And, Geez... don't distribute this one...



Trump's twice the man Obama is.  Evil
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« Reply #68 on: Mar 13, 2017, 02:04PM »



GOP Healthcare bill turning out to be more of a health don't-care bill.

CBO: 24 Million More Uninsured By 2026 Under GOP Health Care Bill


24 million.  That would have to set us farther back than even before there was Obamacare.
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« Reply #69 on: Mar 13, 2017, 02:15PM »


GOP Healthcare bill turning out to be more of a health don't-care bill.

CBO: 24 Million More Uninsured By 2026 Under GOP Health Care Bill


24 million.  That would have to set us farther back than even before there was Obamacare.

Obamacare, for all its flaws (and they are legion) looks increasingly like a one-shot deal. The establishment GOP can't replace it, for two completely opposite reasons, which are irreconcilable.  Any replacement that kicked millions of the rolls would be unacceptable to party leaders (and renege on Trump's promise), but would still be rejected as too generous by Tea Partiers and libertarians.

The complaint from the anti-establishment wing of the party is that the replacement proposal is too much like Obamacare. They should have avoided that by removing the 'repeal' promise (I know, it's tough), and whittle away at it in the form of 'repair'. Once you 'repeal' something, you're responsible for what comes next. Some GOP congressmen tried, belatedly, to put that spin out but it didn't catch fire, and now the GOP is looking like a dog that caught a car (quite sure I'm not the only person to come up with that analogy).
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« Reply #70 on: Mar 13, 2017, 05:36PM »

And, that 24 million is measured against today. THe % of uninsured will be even higher because our population isn't static. WE are not a very astute country. Far too many of us look at the world with a checkers level grasp, when the reality is it is far more complex and complicated than 3 D chess.
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« Reply #71 on: Mar 13, 2017, 06:30PM »

Another aspect that must have been mentioned is funding for medicare/Medicaid.

Here, in the 90s, the Feds gave provinces, the entities that actually administer health care, a fixed sum and  let them deal with it. It sounds like that's part of the GOP plan.

Unfortunately, there's never enough money, but in this case, the states will take the political heat.
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« Reply #72 on: Mar 13, 2017, 06:47PM »



Like I said, The Trombone Forum could offer a plan since there are so many members. You should probably have a requirement of so many a posts per week or month to stay eligible.


Aha!

You've put your finger on the crux of the problem.  I'm not sure if you really understand what you said, but you're right.  Sort of.

Insurance works ONLY because it spreads risk.

That is the entire premise.  (Insurance companies are hugely profitable, that's why so many of them can pay their CEOs in the 50 - 100 million dollar range.  But they make their money on the float, not on premiums per se.)

The larger the pool of insured, the more you can spread the risk.  That gives lower premiums AND higher profits.

The risk pool of the trombone journal is pretty small, a  thousand or so.  The risk pool of the US population is 320 million.  That is by far the best way to run insurance of any kind. 

That is of course the way DD and the GOP are most opposed to. 
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« Reply #73 on: Mar 13, 2017, 07:00PM »

Aha!
 
You've put your finger on the crux of the problem.  I'm not sure if you really understand what you said, but you're right.  Sort of.
 
Insurance works ONLY because it spreads risk.
 
That is the entire premise.  (Insurance companies are hugely profitable, that's why so many of them can pay their CEOs in the 50 - 100 million dollar range.  But they make their money on the float, not on premiums per se.)
 
The larger the pool of insured, the more you can spread the risk.  That gives lower premiums AND higher profits.
 
The risk pool of the trombone journal is pretty small, a  thousand or so.  The risk pool of the US population is 320 million.  That is by far the best way to run insurance of any kind. 
 
That is of course the way DD and the GOP are most opposed to.

You may not have put those dots close enough for those who are desperate not to see even the most obvious of pictures.
 
Of course there's no reason to think that even putting them close enough to be visually touching will work, so one has to wonder why anyone bothers with such things ... but the reliable refusal to see the obvious consistently gets the denier lavished with attention.
 
Very strange behavior--great way to guarantee a proactive, dogmatic vapidity drive the social climate though.
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« Reply #74 on: Mar 13, 2017, 08:08PM »

A simple fact that is rarely spoken out loud is that if we want to reduce the health care spending  without reducing coverage, someone, somewhere in the health care system will have to make less money.

No one wants to be that someone.
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« Reply #75 on: Mar 13, 2017, 08:15PM »

Remember how Kelley Anne Conaway said the President has access to secret info that the rest of us don't? 

Well, she was right!

Secret White House Analysis Showed Even More Losing Care

Quote
...Even as the White House rejected a CBO scoring of the House GOP Obamacare repeal bill, a secret White House analysis showed an even higher number of Americans would lose health insurance coverage under the bill. According to a document first reported Monday evening by Politico, an internal executive branch analysis showed that 26 million Americans would lose their coverage, two million more than the estimate of 24 million released earlier in the day by the CBO...
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« Reply #76 on: Mar 14, 2017, 07:49AM »

You just don't understand!  The CEOs of insurance companies have to make big bucks, or no one would want to be one!  They have to shell out the big bucks to get the best and brightest so the stock price stays as high as possible.
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« Reply #77 on: Mar 14, 2017, 09:14AM »

Remember when insurance was boring?

When it was sold by respectable people like Bob Anderson on "Father Knows Best"?
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« Reply #78 on: Mar 14, 2017, 10:44AM »

You just don't understand!  The CEOs of insurance companies have to make big bucks, or no one would want to be one!  They have to shell out the big bucks to get the best and brightest so the stock price stays as high as possible.

Sadly, that's not a joke.
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« Reply #79 on: Mar 14, 2017, 11:03AM »

A simple fact that is rarely spoken out loud is that if we want to reduce the health care spending  without reducing coverage, someone, somewhere in the health care system will have to make less money.

No one wants to be that someone.
Lincoln got it with​ slavery. The "life, liberty and pursuit of happiness" of African Americans trumped the slavers property rights.

Our crisis today is in seeing that "life, liberty and the pursuit of happiness" is dependent on access to healthcare and therefore a system which denies access to healthcare denies those inalienable rights to those without healthcare coverage.

Simply put the choice is between people over profits or profits over people.

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« Reply #80 on: Mar 14, 2017, 11:22AM »

It always seems to me that anyone speaking in positive terms of the "best and the brightest" include themselves in that category.

 My point, made above, is that you can't run a pooled health insurance scheme without either having to subsidize it through taxes or co-pays, or both, or restricting the pool to those who are least likely to heavily use it. How are you going to get the young and healthy to pay premiums if not by legislation?

It has nothing to do with politicians and ideologies. It's all about the actuaries.

CEO compensation is a red herring.
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« Reply #81 on: Mar 14, 2017, 11:42AM »



It has nothing to do with politicians and ideologies. It's all about the actuaries.

CEO compensation is a red herring.

It is a red herring the way we've used it here, but maybe not a complete red herring, because it's part of overhead.  Here's my thinking.

The cheapest way to have insurance coverage is to expand the risk pool as widely as possible.

The widest possible pool is some variation on single pay.

Part of the costs of any insurance scheme are CEO compensation and profits to shareholders.  Neither exists in a government run program.

The top GS salary possible is a GS-15 Step 10, at $134,776 (without locality pay - some areas like DC augment that with a cost of living percentage).  It takes a long time for a GS to get there with Step increases every 3 years.  There are very few GS-15s, only one in my garrison (and no, it's not me!).  There are CEOs who make $134 million.

There is a pay scale higher than GS, the SES (Senior Executive Service.)  That one has 5 grades, starts at $124,406 and peaks at $187,000.  There would be at least one SES and probably several GS-15s in an agency run single pay. 
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« Reply #82 on: Mar 14, 2017, 11:53AM »



 My point, made above, is that you can't run a pooled health insurance scheme without either having to subsidize it through taxes or co-pays, or both, or restricting the pool to those who are least likely to heavily use it. How are you going to get the young and healthy to pay premiums if not by legislation?

Getting the young to pay premiums by legislation is rather different than needing to subsidize the system. Even though they consume less healthcare than the elderly, they still need it and are still at risk for things that need care beyond their uninsured  ability to pay.
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« Reply #83 on: Mar 14, 2017, 12:04PM »

The usual argument against Government run bureaus is inefficiency.  The claim is that Private industry will operate in a more efficient fashion and thus justify the very high salary of the CEO and the profits to the shareholders.

My argument against this is that I have seen Private Industry that is every bit as inefficient as Government (not meant as a slam on Government, Tim).  So the private single payer system may be less efficient use of our money than a Government run system for which we pay taxes.

My ideal system would be similar to what I have in Medicare.  The basic Medicare provides a certain amount of benefits and I can buy a private plan to add more care.  I can buy as much additional coverage as I want or can afford.  I believe this is what most Government supplied plans in Europe or Canada do.
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« Reply #84 on: Mar 14, 2017, 12:16PM »

I think as a generalization, Canada does not allow the purchase of private healthcare insurance for healthcare in Canada.The reason for this is that it takes premium dollars away from the government system.

 The reason I say CEO remuneration is a red herring is that, while $1 million is a significant whack of the dough, it is a very small portion of the overall costs of the operation.

 The free enterprisers like to point to government inefficiency when promoting private healthcare plans. I believe a number of studies and no, I do not have citations, indicate that the US private health insurance system is extremely inefficient when compared with Western European,  Canadian, and Australian systems. With poorer outcomes too.

I don't suggest that the young and healthy don't use the healthcare system but it's the elderly and the chronically ill that disproportionately  utilize the healthcare system. That's why you kick them out.  It occurs to me that by pushing the aged, infirm, and the poor onto Medicaid, it subsidizes the private healthcare insurers and allows them to make a profit which they would not otherwise make if they had to insure everybody. Subsidies to private companies – that's not the American way is it?

Keep in mind that this is simply chapter and verse out of the Canadian healthcare discussion. I cannot say how accurate it is.
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« Reply #85 on: Mar 14, 2017, 12:40PM »

So the private single payer system

To be clear here, what we're discussing is health insurance, not health care.

There is no reason why all the health insurance companies should be protected by the government from competition.

There should be just two parties involved: customer and insurance agent/company.

Agents can represent multiple companies and customers can join associations for leverage.
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« Reply #86 on: Mar 14, 2017, 01:28PM »

Competition between private health insurers is competition for the best and healthiest customers. That leaves many people without healthcare insurance with limited coverage.

That's why there is this discussion.
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« Reply #87 on: Mar 14, 2017, 01:43PM »

There is no reason why all the health insurance companies should be protected by the government from competition.
They really aren't protected, really.

Maybe you're referencing the inability to compete across state lines? That just because each state can set their own standards. If that state line restriction is removed, that power is taken away in practice, and companies will go to whatever single state offers the best terms for them, similar to credit card companies and Delaware. Ultimately, that would create far less competition, and less state power... not more.
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« Reply #88 on: Mar 14, 2017, 01:47PM »

Competition works great when I can shop around.

Medial care, in the event of an emergency is not something I can shop for.

My broken leg or heart attack will not sit by while I try to find the best treatment.  I was involved in an auto accident.  I was taken to the nearest hospital, not the one I regularly get treated at.  No choice on my part.

Scott Adams (Dilbert) used to parody corporate health care by having his company provide medical care by veterinarians to save money.
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« Reply #89 on: Mar 14, 2017, 02:45PM »

Like I said, The Trombone Forum could offer a plan since there are so many members. You should probably have a requirement of so many a posts per week or month to stay eligible.


Honestly.

I'm going to make a suggestion which will sound crazy to you, but it's what normal people do all the time.

Imagine exactly what would happen if the Trombone Forum could offer meaningful savings on group primary medical insurance, based on the number of posts. Seriously.

This is what people ordinarily do before they opine.
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« Reply #90 on: Mar 14, 2017, 02:46PM »

Competition works great when I can shop around.

Medial care, in the event of an emergency is not something I can shop for.

My broken leg or heart attack will not sit by while I try to find the best treatment.  I was involved in an auto accident.  I was taken to the nearest hospital, not the one I regularly get treated at.  No choice on my part.

Scott Adams (Dilbert) used to parody corporate health care by having his company provide medical care by veterinarians to save money.

Shop around for your insurance, not emergency rooms.
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« Reply #91 on: Mar 14, 2017, 02:47PM »

Competition between private health insurers is competition for the best and healthiest customers. That leaves many people without healthcare insurance with limited coverage.

That's why there is this discussion.

Competition brings the price down for everybody, so those with lessor budgets will receive more than relying on the government.
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« Reply #92 on: Mar 14, 2017, 02:48PM »


 The free enterprisers like to point to government inefficiency when promoting private healthcare plans. I believe a number of studies and no, I do not have citations, indicate that the US private health insurance system is extremely inefficient when compared with Western European,  Canadian, and Australian systems. With poorer outcomes too.

One sign of the inefficiency of private insurers is that many seem to struggle with the 80% rule, that at least 80% of the money paid in premiums must be used for benefits (as opposed to administrative costs like advertising, office space, CEO perks...).

Medicare, a government-run insurance plan, is more efficient that private plans.



Quote
Medicare Has Lower Administrative Costs Than Private Plans.

-According to the Kaiser Family Foundation, administrative costs in Medicare are only about 2 percent of operating expenditures. Defenders of the insurance industry estimate administrative costs as 17 percent of revenue.

-Insurance industry-funded studies exclude private plans’ marketing costs and profits from their calculation of administrative costs. Even so, Medicare’s overhead is dramatically lower.

-Medicare administrative cost figures include the collection of Medicare taxes, fraud and abuse controls, and building costs.
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« Reply #93 on: Mar 14, 2017, 02:53PM »

How much would my car insurance cost if it had to pay for all my oil changes?

That's what is wrong with the government running insurance.
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« Reply #94 on: Mar 14, 2017, 02:58PM »

I think as a generalization, Canada does not allow the purchase of private healthcare insurance for healthcare in Canada.The reason for this is that it takes premium dollars away from the government system.

Yes, we can, and do, buy ADDITIONAL health insurance from private companies to cover health care that is not provided for in the basic government insurance.  Government insurance covers a minimum standard of healthcare for everyone. But if you want insurance coverage for dental, physiotherapy, air ambulance, etc. or extended healthcare and care that is covered out of province/country, we buy private insurance, as well. It's not a perfect system, but when my wife is being treated with radiation and chemo for cancer, (all covered by the government healthcare plan) it is a Godsend!

It works only because everyone pays into the plan through taxes. And no, we don't have a choice. Young healthy people pay into it, middle-aged wealthy people pay into it, which pays the health cost of the elderly and sick - who are also paying into it(over-simplification). People who can not afford private health insurance (expensive) are still covered at a minimum standard for hospitalization, treatment, emergency situations, and doctor visits.

K22
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« Reply #95 on: Mar 14, 2017, 02:59PM »

Competition brings the price down for everybody, so those with lessor budgets will receive more than relying on the government.

Dogma and received wisdom. Sad.

Premiums have to exceed operating costs and benefit payments.

To a point, increased efficiencies can reduce operating costs, bringing the price down, but only to a point. After that, you have to control payouts. So co-pays, no coverage for pre-conditions etc. Good deals for the young and healthy, no coverage for the aged and infirm.

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« Reply #96 on: Mar 14, 2017, 03:04PM »

Yes, we can, and do, buy ADDITIONAL health insurance from private companies to cover health care that is not provided for in the basic government insurance.  Government insurance covers a minimum standard of healthcare for everyone. But if you want insurance coverage for dental, physiotherapy, air ambulance, etc. or extended healthcare and care that is covered out of province/country, we buy private insurance, as well. It's not a perfect system, but when my wife is being treated with radiation and chemo for cancer, (all covered by the government healthcare plan) it is a Godsend!

It works only because everyone pays into the plan through taxes. And no, we don't have a choice. Young healthy people pay into it, middle-aged wealthy people pay into it, which pays the health cost of the elderly and sick - who are also paying into it(over-simplification). People who can not afford private health insurance (expensive) are still covered at a minimum standard for hospitalization, treatment, emergency situations, and doctor visits.


Jeez, I should know this because I'be got extended health through my employer! Physio, pharma, podiatrist, dental, eyeglasses etc.

You're absolutely right. 

I was thinking more of the private surgical clinics and Dr Brian Day's battles with the gov't.
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« Reply #97 on: Mar 14, 2017, 03:07PM »

Shop around for your insurance, not emergency rooms.
Last time I visited the ER, there was only one around. And when they couldn't treat something, they shipped people off to the next nearest ER 45 minutes away.

And well, when there is no choice of ER, then there's nothing for insurance to negotiate with either. The ER has the insurance at take it or leave it.

At which point, insurance matches their prices, and there isn't much to shop around with even in insurances...
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« Reply #98 on: Mar 14, 2017, 03:08PM »

How much would my car insurance cost if it had to pay for all my oil changes?

That's what is wrong with the government running insurance.

Different issue and maybe not the best analogy. But, would a modest user fee be the end of the world. Probably not.
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« Reply #99 on: Mar 14, 2017, 03:11PM »

Yes, we can, and do, buy ADDITIONAL health insurance from private companies to cover health care that is not provided for in the basic government insurance.  Government insurance covers a minimum standard of healthcare for everyone. But if you want insurance coverage for dental, physiotherapy, air ambulance, etc. or extended healthcare and care that is covered out of province/country, we buy private insurance, as well. It's not a perfect system, but when my wife is being treated with radiation and chemo for cancer, (all covered by the government healthcare plan) it is a Godsend!

It works only because everyone pays into the plan through taxes. And no, we don't have a choice. Young healthy people pay into it, middle-aged wealthy people pay into it, which pays the health cost of the elderly and sick - who are also paying into it(over-simplification). People who can not afford private health insurance (expensive) are still covered at a minimum standard for hospitalization, treatment, emergency situations, and doctor visits.

K22
Which honestly sounds like a great model.
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« Reply #100 on: Mar 14, 2017, 06:29PM »

How much would my car insurance cost if it had to pay for all my oil changes?

That's what is wrong with the government running insurance.

Foretravel used to offer free oil changes, tire replacement, and belt replacements for life.  Don't know if they still do or not, but it was one reason Foretravel cost more than the competitors.
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« Reply #101 on: Mar 14, 2017, 06:32PM »

How much would my car insurance cost if it had to pay for all my oil changes?

That's easy. Another $50 a year. Or less.  If insurance companies were paying for oil changes they'd almost certainly require you to do it "in network" to be covered and they would have negotiated with the vendor for a very low price in return for the guaranteed business.

Most cars today only need an oil change twice a year and the low end of retail oil change prices now is about $25. The negotiated quantity discount might be even less.

For most people, $50 a year would probably be unnoticed in the overall cost of their auto insurance, especially if it meant their oil changes were now paid for.
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« Reply #102 on: Mar 14, 2017, 07:09PM »

I'm going back to a comment about anyone who has ever had any involvement with the Veteran's Administration health care and their subsequent unwillingness to move away to anything else.   Despite an occasional "hiccup", the VA has done an amazing job taking care of the Veterans who put themselves in harm's way for the rest of us.  I became involved with the VA when I had mistakenly rejected drug coverage when filling out my Social Security forms.  The VA openly received me into their programs and provided me with proactive care that amazed me !  Yeah !   You guessed it !  I was a veteran, but not of the "shooting" variety.   I was a member of TUSAB [The United States Army Band].  I am aware of several "scandals' involving the VA, but let me make it perfectly plain ---- if we all had that kind of care, there would be less life-altering experiences than many of us have had with the existing healthcare community. One of the most reasonable and remarkable features of the VA healthcare plan is that the VA is allowed to negotiate drug costs with drug companies.  When G.W. Bush created his "Prescription Drug Benefit" program, it specifically DENIED the provision to negotiate drug costs with the companies.  Tell me ----- If you walked into a music store and wanted to buy a totally "bells & whistles" trombone, don't you think the store's owner would be receptive to you bringing along another 10 buyers of the same instrument and giving you all a 20% --- 30% discount ?  Seems reasonable to me ---- but then again ---- I'm a trombone player.  Can we be trusted with such obvious truths ?
   Single payer --- HUGE pool --- extreme efficiency --- no pressure to sell --- Win - Win - Win ------ Cheers !!   Bob
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« Reply #103 on: Mar 14, 2017, 08:50PM »

Most cars today only need an oil change twice a year

Yeah, if you take the bus. LOL!

Who only drives 6 thousand miles a year?
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« Reply #104 on: Mar 14, 2017, 09:33PM »

Yeah, if you take the bus. LOL!

Who only drives 6 thousand miles a year?

Cars and oil have changed. Most cars today don't need and aren't recommended to have an oil change every 3000 miles.

The 3,000-Mile Oil Change Is Pretty Much History

Quote
“There was a time when the 3,000 miles was a good guideline,” said Philip Reed, senior consumer advice editor for the car site Edmunds.com. “But it’s no longer true for any car bought in the last seven or eight years.” (Article written in 2010)

Oil chemistry and engine technology have improved to the point that most cars can go several thousand more miles before changing the oil, Mr. Reed said. A better average, he said, would be 7,500 between oil changes, and sometimes up to 10,000 miles or more.



however, i agree with Ellrod that car oil changes are not a good analogy to annual physicals or whatever other health care bete noire was being fretted over.
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« Reply #105 on: Mar 14, 2017, 09:35PM »

Yeah, if you take the bus. LOL!

Who only drives 6 thousand miles a year?

I know this is beside your point, but it's worth pointing out that science says that is no longer correct. Most new cars have oil change intervals between 7500 and 15000 miles. The old rule of every 3000mi doesn't hold up with modern lubricants and filtration methods. My 2017 Chevy SS has 7500mi intervals, for instance, and it has a (comparatively) antiquated 16v small-block V8 compared to new turbo small displacement technological tour-de-force engines.

And before retorts of "blah blah that's marketing blah blah" I've sent oil samples in on my old M3 for analysis (Blackstone Labs), and routinely gotten told the oil degradation was minimal at 5000mi change interval, and that I could extend the changes to 7500 if I felt like it. That's with considerable amount of track and race use, even.

Point being, you may be throwing away money with shorter oil changes, depending on what your car's operator manual (and use case) state. I'll take off the automotive engineer hat now...

On topic-- I lived and worked in Germany (at BMW) for a year, and had to get a minor surgery while I was there. The German system had a requirement that you be insured, but there were a number of insurers to choose from, so everyone had coverage. Paying ~50 EUR copay for surgery, medication, and followup doctor visits made me a believer. I come home and need an xray of my hand after a bike accident, and it was $750 WITH good insurance. For an Xray. The pre-obamacare system was horrid. The current obamacare system is slightly less terrible overall, but still terrible compared to literally every other civilized country.

There's an interesting point that really should be made more in the health care debate. Compare the percentage of income via taxes that goes to pay for the EU, UK, Canada/Australia/other country healthcare systems with what we Americans pay for insurance out of our own pocket or via employer. It's shocking how similar the costs are, with such divergent outcomes (i.e., good care with some issues there, **** care universally here).
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« Reply #106 on: Mar 14, 2017, 09:39PM »

Paying ~50 EUR copay for surgery, medication, and followup doctor visits made me a believer.

This is about what my Obamacare would do. I think Obamacare is WAY better than the insurance I could get before which was ... none!
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« Reply #107 on: Mar 14, 2017, 09:43PM »

Yeah, if you take the bus. LOL!

Who only drives 6 thousand miles a year?
At the risk of being accused of an ad hominem attack, I think you should do something about your level of ignorance DD.  It really works against you.
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« Reply #108 on: Mar 14, 2017, 09:52PM »

At the risk of being accused of an ad hominem attack, I think you should do something about your level of ignorance DD.  It really works against you.

It's not ignorance, it's living in 1955.

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« Reply #109 on: Mar 14, 2017, 10:18PM »

I should add that although in some Canadian provinces, there are no premiums, here, in BC, individuals are expected to pay around $75/ mo for coverage. For many though, this expense is covered by their employer (and is then taxable as a taxable benefit).

If you don't pay the premiums, you have no coverage.
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« Reply #110 on: Mar 14, 2017, 10:32PM »

I should add that although in some Canadian provinces, there are no premiums, here, in BC, individuals are expected to pay around $75/ mo for coverage. For many though, this expense is covered by their employer (and is then taxable as a taxable benefit).

If you don't pay the premiums, you have no coverage.
Yeah, it's been $75/mo here in Ontario too.  It's free for those that earn less than $20,001/yr.  Basically part -timers.

Used to be a lot more back when... --- went away for a while --- then came back at this level. Don't know
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« Reply #111 on: Mar 15, 2017, 06:08AM »

I still thing the issue needs to be discussed on an economic basis.  Our resident troll only thinks in doublespeak.  "Competition drives downs prices!"  So respond in doublespeak.

Competition only drives down prices in markets where consumers have choice.  Your choices with healthcare are die or use healthcare.  If DD is simply asking people who can't pay for private insurance to die, then he should just say so.  So should Paul Ryan.

If you want to increase competition, you have to break up network monopolies.  In other words, the insurance you buy across state lines needs to work with the doctors in your area.  It does me no good to buy health insurance in Texas and then need emergency heart surgery in my home state if I'm out of network. 

This will normalize the price of insurance across the country, but you've still done nothing for the vast majority of people who can't afford the product, but will still be able to use it.  Again, if you're just asking the poor to die off, simply come out and say that.

OR, you do what the rest of the civilized world does and invest in nationalized health care.  Everybody pays.  Everybody uses.  This keeps the maximum number of your citizenry healthy.  They get to work longer.  They get to earn longer.  They get to participate in the free market longer.  They get to pay Dusty's social security longer.


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« Reply #112 on: Mar 15, 2017, 06:35AM »

It's amazing the points that you take to argue with, and the points that you people choose to ignore.  Don't know

BTW, I have a 2012 Lexus that still recommends oil changes every 3000 miles, so it is still relevant for a lot of car owners, maybe you people being excluded. LOL!

How much would car insurance cost if the insurance company paid for the car inspections every year?

Health insurers pay for preventive maintenance and annual exams for our health. Oil changes is considered preventative maintenance as well as annual car inspections.

Tire changes? Does your car policy cover tire changes?
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« Reply #113 on: Mar 15, 2017, 06:57AM »

It's amazing the points that you take to argue with, and the points that you people choose to ignore.  Don't know

BTW, I have a 2012 Lexus that still recommends oil changes every 3000 miles, so it is still relevant for a lot of car owners, maybe you people being excluded. LOL!
Then you got jipped. I have a 2012 honda civic... nothing luxery at all... 7500 minimum miles between change, potentially up to 10-15k depending on how I drive it.

How much would car insurance cost if the insurance company paid for the car inspections every year?
Maybe another 40 bucks a year... that gonna break the bank of a lexus owner?

Health insurers pay for preventive maintenance and annual exams for our health.
Yeah, because they are far cheaper than dealing with finding the issues later.

Kinda like the difference between changing your oil regularly, and having your engine seize up before discovering that your oil needs to be changed. One is $30 bucks... the other is a new engine.

If your insurance would have to cover the cost of the new engine, they will happily cover much cheaper preventative maintenance instead.

But the thing about a car that's kinda different from a person... screw up your car, and you get a new one. That's the "totaled" option, saying the car costs more to fix than it's worth. Caps a limit pretty readily. Can't do that with your body now, can you?
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« Reply #114 on: Mar 15, 2017, 06:58AM »

BTW, I have a 2012 Lexus that still recommends oil changes every 3000 miles, so it is still relevant for a lot of car owners, maybe you people being excluded. LOL!
Apparently DD is not right: See here...

Will wonders never cease...

However, I'd just like to point out that the folks at Lexus seem a little addled.  Here are some examples:

The ES350 and the RX350 use the same engine - for the ES350 they recommend 5,000M for the RX350 they recommend 10,000M even though the RX350's engine is under higher load (heavier vehicle) and has less oil.

Then there is the GS460 vs. GX460 - exactly the same story.

Then there is the IS250 that changed from 5,000 to 10,000 from the 2010 model to the 2011 model without any change in engine.

So it seems the only difference between 5,000M and 10,000 is the type of oil used. 5W-30=5,000, 0W-20=10,000.

I wonder why the premium price when they can't seem to get their ducks in a row?  Maybe Lexus is being run by the Trump administration.
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« Reply #115 on: Mar 15, 2017, 07:06AM »



BTW, I have a 2012 Lexus that still recommends oil changes every 3000 miles, so it is still relevant for a lot of car owners, maybe you people being excluded. LOL!



What model is that?  I'm looking at the owners manual for a 2012 LS600 and it says 6 months or 5000 miles.
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« Reply #116 on: Mar 15, 2017, 07:09AM »

Apparently DD is not right: See here...

Will wonders never cease...

However, I'd just like to point out that the folks at Lexus seem a little addled.  Here are some examples:

The ES350 and the RX350 use the same engine - for the ES350 they recommend 5,000M for the RX350 they recommend 10,000M even though the RX350's engine is under higher load (heavier vehicle) and has less oil.

Then there is the GS460 vs. GX460 - exactly the same story.

Then there is the IS250 that changed from 5,000 to 10,000 from the 2010 model to the 2011 model without any change in engine.

I wonder why the premium price when they can't seem to get their ducks in a row?  Maybe Lexus is being run by the Trump administration.

It's amazing you guys are talking about oil changes, when I was only making a point about the health insurance.

Car insurance doesn't cover oil changes, while health insurance does cover hundreds of preventative maintenance.

Health insurance just needs to cover catastrophic conditions only. Way cheaper.
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« Reply #117 on: Mar 15, 2017, 07:13AM »

It's amazing you guys are talking about oil changes, when I was only making a point about the health insurance.
Your getting it wrong, as usual, DD.  I was just using the oil change thing to point out that you are invariably wrong.  You don't even know, or bother to check the facts about your own vehicle.  How can we trust anything you say?
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« Reply #118 on: Mar 15, 2017, 07:14AM »

Car insurance doesn't cover oil changes, while health insurance does cover hundreds of preventative maintenance.
The highest potential risk in car insurance also has nothing to do with the car itself, but damage to the driver, the nearby environment, and people and environment nearby. The car can easily be called totaled and written off at a small fraction of total potential liability, because the car itself is the least important part of the equation.

The highest risk in health insurance is the cost of keeping the covered person alive and well working.

Kinda different paradigms there, DD.
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« Reply #119 on: Mar 15, 2017, 08:03AM »

It's amazing you guys are talking about oil changes,

You brought it up.  Now that it's not working for you, suddenly it's our fault.
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« Reply #120 on: Mar 15, 2017, 09:00AM »

My 2002 Volvo recommends oil changes every 7500 miles.  But it uses 6.5 liters of oil (normal engines use around 3.5).  The contamination in the larger sump builds more slowly.

But an oil change doesn't really affect a car insurance.  It affects the warranty.  Your car warranty will be voided if you fail to do regular maintenance.

Still, health insurance covering checkups is the "stitch in time" philosophy.  It's a lot easier to treat hypertension with drugs than to do the hospitalization for a heart attack.

Also, lower income folks who can't afford doctor visits will postpone seeking treatment until it can't be avoided.  And then they are in the Emergency Room, where it costs around 10x what it would cost if treated in a doctor office earlier.

And the new GOP plan targets the poor folks by reducing Medicaid drastically.
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« Reply #121 on: Mar 15, 2017, 09:13AM »

You brought it up.  Now that it's not working for you, suddenly it's our fault.

Yet another demonstration that these issues often aren't as much about information or communicating reason and such as they are psychology and sociology, and in some cases it's unfortunately utterly pointless to try and work with the former rather than the latter, and in most cases it's still the weaker of the two paradigms in terms of having any actual effect on anyone.
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« Reply #122 on: Mar 15, 2017, 11:01AM »

It's amazing you guys are talking about oil changes, when I was only making a point about the health insurance.
What in the world do you expect? You made a snide little rejoinder designed to ridicule what someone else said (complete with a bright little LOL! at the end), and it turned out that the person you were ridiculing knew far more about the subject than you did. It's of a piece with your habit of forming confident opinions on subjects about which you know little.

And your underlying point about car insurance and health insurance is wrong, as well.

Quote
Car insurance doesn't cover oil changes, while health insurance does cover hundreds of preventative maintenance.

If you're talking about collision and liability insurance, there's no reason to include oil changes, because they're insuring against accidents and not repairs. But warranties (dealer or third-party) are analogous to health insurance, and it would make perfect sense for them to pay for oil changes. It's a predictable cost that can be added to the premium at no greater cost to the driver than paying out-of-pocket. The insurer probably gets a better price due to economies of scale than the driver would. And it reduces the likelihood of catastrophic repair claims by making the driver more likely to properly maintain the car.

These are all analogous to health insurance. Insurance companies give you a break on preventative care because they want you to have it.

Quote
Health insurance just needs to cover catastrophic conditions only. Way cheaper.

Well, most people seem to disagree on that, since one of the biggest complaints about Obamacare was high deductibles. Trump campaigned on lowering deductibles,, which is the opposite of what you want.

Besides, 'catastrophic insurance' isn't a universally good product for everyone. We have very high out-of-pocket costs. If we ever had to meet them, it would be a setback but not ruinous. But if a family is making $30-40K per year, having only catastrophic coverage could drive them into bankruptcy.


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« Reply #123 on: Mar 15, 2017, 12:35PM »

Well, most people seem to disagree on that, since one of the biggest complaints about Obamacare was high deductibles. Trump campaigned on lowering deductibles,, which is the opposite of what you want.

Besides, 'catastrophic insurance' isn't a universally good product for everyone. We have very high out-of-pocket costs. If we ever had to meet them, it would be a setback but not ruinous. But if a family is making $30-40K per year, having only catastrophic coverage could drive them into bankruptcy.

The biggest issue with high deductible health care plans is actually that they might help small problems BECOME expensive ones. If you have to pay for everything, and it is pretty expensive, then minor or small problems often go overlooked. The issue is judged against the cost. Except that the issue isn't understood unless investigated, so mostly the high deductible raises the bar for when people will actually seek treatment. Numerous studies confirm this.

So you don't get something small looked at when it's small, if it gets bigger... it also gets more expensive and hazardous. Thus actually being far more costly to both the person and the provider in the long run.

The was a doctor who put his family on such a plan a few years back... and a good doctor. Think he taught at harvard. Even as a doctor... he was making calls, against his own health, that if he were the doc instead of the patient he would advise against. And for good reason. He found his family was at much higher risk as every decision was compared to the cost, and the costs kept coming.


That approach is great for the free market... but healthcare isn't a free market. Nor does it actually work as it is guessed it would... and by guessed, that guess is made mostly on philosophy of those who don't know the market, nor the issues involved.
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« Reply #124 on: Mar 15, 2017, 01:17PM »

There are two opposite issues with insurance deductibles. As you're saying, out-of-pocket costs cause people to forgo care.

But having medical care paid by someone else besides the consumer keeps it from functioning as a natural market. People who don't have to pay out of pocket don't pressure providers on price the same way they would another product, and when insurers try to impact pricing by pressuring providers, it upsets consumers because it reduces their choices. HMOs were designed to solve this problem, and people seemed to hate them.

The idea that we must avoid 'socialized medicine' at all costs presupposes that there's anything like a functioning capitalist market in the first place. Some of the best reforms would be market based and deregulatory, but the beneficiaries of the closed market would fight this tooth and nail.
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« Reply #125 on: Mar 15, 2017, 01:57PM »

Are you talking market based for health care or market based for insurance?
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« Reply #126 on: Mar 15, 2017, 02:28PM »

Are you talking market based for health care or market based for insurance?

Neither one but "a combination of ingredients well known to  doctors." To get back to my core theory. The market needs to have a balance between buyer and seller. Both parties need to be able to say "yay or nay" to a deal for it to work. If our MD says my daughter has to have a emergency appendectomy I'm not able to say no or wait for a sale to come along.

Where the market can be effective is in programs like Medicare advantage where the buyer and seller are equals when they make a deal.

If we used this as a model were there is healthcare for everyone, and the administrative structures of the existing Medicare and insurance providers are used we'd pay less to get good care for all.

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« Reply #127 on: Mar 15, 2017, 04:15PM »

Are you talking market based for health care or market based for insurance?

I'm primarily talking about medical care delivery. There are factors that create artificial shortages in medicine, mostly due to the ministrations of the AMA (Milton Friedman called them a 'cartel'). The insurance market is meaningful, but somewhat marginal--if every insurance company were non-profit and simply charged back for the underlying costs of the care, we would still be spending too much on medical care.

The simple way to look at it is that we spend much more money on health care (by population or as a percentage of the GDP) than most developed countries, but there are still a lot of people who don't have it. Tweaking the insurance industry might help a bit, but it won't really change it. You have to look at costs.

If you look at how much education is required to become a doctor, and how much it costs and how much they expect to make, we shouldn't reserve so much of medical care delivery to them. It's as if you had to go to an ASE-certified mechanic to get an oil change or new tires.

That's improved a little, with increased latitude in some states for Nurse Practitioners and PHysician's Assistants (usually over the fierce opposition of doctors), but there is room for lower level specialties in medicine, instead of mostly higher-level ones.
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« Reply #128 on: Mar 24, 2017, 09:30AM »

I'm kinda surprised the GOP is having trouble getting to the goal line on this.

It turns out they aren't ideological enough to barrel through with repeal and no replacement but they are ideological enough to get hung up on repeal with even slight replacement.
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« Reply #129 on: Mar 24, 2017, 09:42AM »

It doesn't seem to have occurred to anyone that there just aren't that many ways to construct a health care insurance system.

They're going to all be variations on the same theme, which a substantial percentage on both left and right don't like (for opposite reasons.) 

"We're going to replace it with something better."

"okay, go ahead." 

"Oh crap."
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« Reply #130 on: Mar 24, 2017, 09:49AM »

It doesn't seem to have occurred to anyone that there just aren't that many ways to construct a health care insurance system.

They're going to all be variations on the same theme, which a substantial percentage on both left and right don't like (for opposite reasons.) 


All the schemes involve spreading the cost either through premiums or taxes. But, overall, it's too expensive. So you mandate the young and healthy to buy insurance or restrict coverage. The Dems prefer the former, the GOP the latter.
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« Reply #131 on: Mar 24, 2017, 09:56AM »

As I see it, Obamacare could get passed because it was mostly about making the health care insurance business to act sensibly.

Any thing better than that will require getting the health care system itself to act sensibly. Pharma, doctors, hospitals... those are all bigger sacred cows than the insurance industry.

 
Quote

All the schemes involve spreading the cost either through premiums or taxes. But, overall, it's too expensive. So you mandate the young and healthy to buy insurance or restrict coverage. The Dems prefer the former, the GOP the latter.

This ignores the experience of other Western countries that cover everyone, for less per person than we are paying now in the US, with better outcomes than in the US. Even with their supposed waiting times and rationing and whatever... they get it done better for less.

It can be done. It probably can't be done in the low-regulation environment of the US.
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« Reply #132 on: Mar 24, 2017, 01:35PM »

Establishment pundit David Brooks...


The Trump Elite. Like the Old Elite, but Worse!


Quote
Legislation can be crafted bottom up or top down. In bottom up you ask, What problems do voters have and how can they be addressed. In top down, you ask, What problems do elite politicians have and how can they be addressed?

The House Republican health care bill is a pure top-down document. It was not molded to the actual health care needs of regular voters. It does not have support from actual American voters or much interest in those voters. It was written by elites to serve the needs of elites. Donald Trump vowed to drain the swamp, but this bill is pure swamp.

First, the new Republican establishment leaders needed something they could call Obamacare repeal — anything that they could call Obamacare repeal...

Quote
Second, Donald Trump needed a win. The national effects of that win seemed immaterial to him.

His lobbying efforts for the legislation were substance-free. It was all about Donald Trump — providing Trump with a pelt, polishing a credential for Trump...

Quote

Third, the bill was crafted by people who were insular and nearsighted, who could see only a Washington logic and couldn’t see any national or real-life logic...


I'll note that David Brooks isn't much of a realist himself.  Later on, he says he's for health care savings accounts, something practical only for the rich.

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« Reply #133 on: Mar 24, 2017, 01:56PM »

As I see it, Obamacare could get passed because it was mostly about making the health care insurance business to act sensibly.

You're right, Obamacare passed due to its lack of ambition. The premise was to keep everything in place that was already there (workplace-based insurance, Medicare, etc.) and fill in the cracks with something else. This gave rise to the great lie--If you like your insurance, you can keep it--which may have been the intention but wasn't something Obama could deliver.

It passed because it held AMA and pharma harmless, then demonized insurance companies while rounding them up millions of new customers.

Obama was roundly excoriated for his lie about Obamacare, but Trump's mendacity is greater by an order of magnitude. He simply pretended to have a plan when he didn't. He took everything that people groused about under the current regime--high premiums, high deductibles, mandates, etc.--and claimed to have a plan that would fix them, and give everyone insurance, for less money. He bragged about being a tough negotiator who would stand up to big pharma and wangle great prices for the American people.

He had one meeting with the pharma CEOs and the big boys walked all over him and he abandoned the project, and the promise.

He then let the GOP Reps. create a random plan that effectively addressed none of thoe promises he made, and endorsed it. Now, after stumping hard for the plan, his minions are already blaming Ryan for not coming up with a better plan. If he's unhappy with Ryan's plan, why doesn't he use his own?

Because he doesn't have one, and never did. Trump could have surprised us and done something good. It's time to recognize that he's not going to do that, and that he's **** as president. We're spending millions on his constant golf vacations, and in my opinion it's money well spent.

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« Reply #134 on: Mar 24, 2017, 04:16PM »

I am rather hoping that the fact the Republican bill to dismantle Obamacare has been pulled by US House Republican leadership will mean the beginning of the end for Trump. Oh, please!
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« Reply #135 on: Mar 24, 2017, 05:22PM »

This gave rise to the great lie--If you like your insurance, you can keep it--which may have been the intention but wasn't something Obama could deliver.

I think what Obama didn't realize is that a lot of people "liked" really bad (cheap) insurance, people unaware of how inadequate it would be when they had a health crisis and needed it to be there.

A commentary I heard yesterday noted that there were policies being sold that covered five doctor visits and nothing else.  Someone who had never been through a substantial illness might think that was all they'd need.

A lot of insurance appeared, on paper, to give real coverage but back then it was so easy for an insurance co. to drop someone for "pre-existing conditions" that the insurance was still worthless.

The people who had insurance policies that no longer qualified to be called insurance were the ones that "lost" their insurance. Real insurance policies that do real coverage cost money. Surprise. Obama failed to convey that reality.

Obama wasn't intentionally lying; he didn't grasp what Elizabeth Warren had been warning about for years: people had been fooled into buying cheap insurance that wasn't really there for you you when you got sick.


 
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« Reply #136 on: Mar 24, 2017, 05:31PM »

I think what Obama didn't realize is that a lot of people "liked" really bad (cheap) insurance, people unaware of how inadequate it would be when they had a health crisis and needed it to be there.

A commentary I heard yesterday noted that there were policies being sold that covered five doctor visits and nothing else.  Someone who had never been through a substantial illness might think that was all they'd need.

A lot of insurance appeared, on paper, to give real coverage but back then it was so easy for an insurance co. to drop someone for "pre-existing conditions" that the insurance was still worthless.

The people who had insurance policies that no longer qualified to be called insurance were the ones that "lost" their insurance. Real insurance policies that do real coverage cost money. Surprise. Obama failed to convey that reality.

Obama wasn't intentionally lying; he didn't grasp what Elizabeth Warren had been warning about for years: people had been fooled into buying cheap insurance that wasn't really there for you you when you got sick.

You're largely correct--the companies selling worthless, or nearly worthless, insurance used the ACA as an excuse for dropping people they didn't really want to insure in a meaningful way. A policy with high out-of-pocket costs and low lifetime caps is effective neither as comprehensive nor catastrophic insurance--you've basically bought nothing, because you're hoping to hit a vanishing sweet spot where you're doing better than getting your own money back.

If you incur no expenses, you've paid for nothing. If you incur minor expenses, you pay for them out of pocket, so you've paid for nothing. If you incur significant expenses, you pay for them out of pocket, then receive part or all of your premiums back, so you've paid for nothing. If you have massive losses, you exceed the caps, and you no longer have insurance, and you're bankrupt, so you paid for nothing.

That's why the majority of medical bankruptcies were sought by people who had medical insurance.

The people being ripped off by these schemes 'liked' their insurance because they weren't smart enough to know that it wasn't a good deal. Obama should have anticipated that and avoided making the claim.
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« Reply #137 on: Mar 24, 2017, 06:58PM »

The "great Obama LIE" could have been avoided with the simple addition of the phrase, "if it complies with ACA requirements" to his "If you like....".
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« Reply #138 on: Mar 24, 2017, 07:13PM »

Shocked headline on RedState.com...  :D


GOP Lawmaker: Previous ObamaCare Repeal Votes Were a Fraud

Quote
...quote from Rep. Joe Barton...
Quote
    Reporters asked why, after Republicans held dozens of nearly-unanimous votes to repeal ObamaCare under President Obama, they were getting cold feet now that they control the levers of power.

    “Sometimes you’re playing Fantasy Football and sometimes you’re in the real game,” he admitted. “We knew the President [Obama], if we could get a repeal bill to his desk, it would almost certainly be vetoed. This time we knew if it got to the President’s [Trump's] desk [Trump]it would be signed.”

That’s about as blatant an admission of political fraud as you are ever likely to see.

That's a more damning assessment than the left-leaning sites have given it, but then, the left-leaning sites knew it was play-acting all along.
 
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« Reply #139 on: Mar 24, 2017, 09:49PM »

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« Reply #140 on: Mar 24, 2017, 10:11PM »

I haven't completely fact-checked this account...

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« Reply #141 on: Mar 25, 2017, 05:20AM »

That sounds like something from The Onion.

I don't doubt that Ryan will take the fall -- Trump never loses (it's always somebody else's fault).

Someone on NPR suggested that the 50-some votes to repeal Obamacare during Obama's administration were easy since it was symbolic -- Obama would veto any bill that landed on his desk.  But now with a President who would sign such a bill, the Republicans got cold feet.
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« Reply #142 on: Mar 25, 2017, 08:34AM »

That sounds like something from The Onion.

Or one of the many "news" bits that spread through networks of far right wing emailers and become part of the far right's understanding of reality and the basis for their judgments, their understanding of our government and our history, and their voting.
 
 
 
I don't doubt that Ryan will take the fall -- Trump never loses (it's always somebody else's fault).

In some circles, but The Donald only enjoys the freedom from responsibility or the constraints of honesty in those circles. No one else makes anywhere near the effort required in terms of self-deception and intellectual cowardice to function so stupidly.
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« Reply #143 on: Mar 25, 2017, 10:32AM »

His supporters never seem to notice when he lies. When he campaigned he claimed to have a plan that was much better and cheaper than Obamacare, and everyone would be covered. He said this many times.

How do you square that with the new behind-the-scenes line, which seems to be that he trusted Ryan to come up with a plan and it wasn't a good one?  You can't. He lied in the first place about having a plan. He was just saying what people wanted to hear.

After eight years of just relentlessly screwing with Obama, the GOP has forgotten how to actually govern, and the president is a joke. He has no idea how to preside and no interest in learning it. The one skill that people attributed to him who voted for him is his negotiating skills. He brought those out in full force, against allies, not adversaries, and fell on his face.
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« Reply #144 on: Mar 25, 2017, 10:42AM »

Trump's negotiation skills are probably overrated.

It's pretty easy to negotiate from a position of strength where there's an imbalance of power. But in a checks and balance system, it's a different ball game. Trump's ultimatum probably lost him as many votes as it got him. Most people don't like being pushed around.
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« Reply #145 on: Mar 25, 2017, 10:52AM »

Trump's negotiation skills are probably overrated.

It's pretty easy to negotiate from a position of strength where there's an imbalance of power. But in a checks and balance system, it's a different ball game. Trump's ultimatum probably lost him as many votes as it got him. Most people don't like being pushed around.

His negotiating skills are plainly overrated. He bragged that he was going to cut a great deal with pharma, including negotiating lower prices on medications. He met with pharma leaders and they ate his lunch.

He has a record of cutting terrible deals. He overpaid for the Plaza Hotel, spent way to much on it, then his creditors took it from him and had to sell it for a loss. He couldn't negotiate traditional loans for his casinos, so he borrowed through junk bonds at 14%, guaranteeing that they'd fail from day one. His negotiating skills are simply one more thing he's bragged about until gullible people believed him. They certainly haven't been in evidence during his presidency.

I think the 'make-or-break' vote demand was a political gambit. It put an end to an episode that was highlighting his incompetence day after day. He was trying to separate himself, with an insouciant manner that implied, "Hey, this is their deal--do it or don't." The fact that it went down in flames didn't matter to him, because he never had any real concern over anyone's insurance in the first place.
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« Reply #146 on: Mar 25, 2017, 06:05PM »

Hey... what if all those years of screaming about Obamacare... the disagreement wasn't actually about the policies.

What if there was something else.

Nah, that couldn't be,
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« Reply #147 on: Mar 25, 2017, 06:22PM »

I think if Trump had just presented the public demeanor of an adult since the election rather than that of a petty, vindictive Hollywood studio exec he would have been in a way better bargaining and influencing position for all of this.

It would have been so easy to do for anyone else.

It's not like he started a phony war in Iraq or anything but somehow he's made himself more unpopular than even George W. Bush just with a twitter account.

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« Reply #148 on: May 04, 2017, 07:47PM »

Obviously we now have a thoroughly wonderful plan in the pipe!
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« Reply #149 on: May 05, 2017, 05:25AM »

What an amazing display of moronic absurdity we saw after the vote yesterday. THe House REpublicans were acting like they had actually accomplished something. HELLLOOO!. It is something they have already done more than 60 times, and it is as pointless as all the other times they did it. This bill is DOA in the Senate. THe GOP (Government of Putin) might want to ask Falcon fans about celebrating at halftime.
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« Reply #150 on: May 05, 2017, 07:16AM »

It's the new GOP standard.
 
When you're on the wrong side of a no-hitter, a late inning single feels like a win ... at least for a little bit.
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« Reply #151 on: May 05, 2017, 09:18AM »

What scares me is how many people think this is an improvement.

I guess if you want all sick people to just die, it is.  Wonder how they will feel when it is them :/
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« Reply #152 on: May 05, 2017, 09:58AM »

What scares me is how many people think this is an improvement.

I guess if you want all sick people to just die, it is.  Wonder how they will feel when it is them :/
In several of the rural areas I've been in or lived in... not much changed. Same people, same area, same job or type of job. No one really moving in, many of the younguns moving out as they come of age, and jobs slowly slip away.

There's real life while is stagnant or on a slow decline... and then there's a major "faith" or religious aspect which drives social and hope. Politics, especially per the GOP, has become a matter of faith to their base... moving past the actual impacts to the driving philosophy behind it.

Per faith, people don't pray to god with the immediate expectation of relief or support... but for hope and peace of mind as they go about their lives. The GOP hopes to lead them through the same way of politics, and hope to delude them that it isn't that they have been forgotten by government, but that government shouldn't be able to help if it wanted to.
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« Reply #153 on: May 05, 2017, 10:10AM »

What scares me is how many people think this is an improvement.

I guess if you want all sick people to just die, it is. 

Stop being an alarmist!

In the boardroom it's properly called "parting with unproductive assets and reducing liabilities."
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« Reply #154 on: May 05, 2017, 01:16PM »

And how would you feel as one of the "unproductive assets"?
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« Reply #155 on: May 05, 2017, 01:49PM »

What scares me is how many people think this is an improvement.

I guess if you want all sick people to just die, it is.  Wonder how they will feel when it is them :/

Won't they keep getting the same healthcare benefits they do now?  If so, they won't be affected at all.
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« Reply #156 on: May 05, 2017, 04:42PM »

One issue that really has driven healthcare for the last umpteen years is "Pre-Existing Conditions".

There are many ways to become a member of this group, and they're not equal. However, all discussions treat this group as a uniform group when they're not. So, the arguments made for/against is thrown out there, as if everything is equal. I think this group should be broken up into different categories so that the solutions are different for each category.

Any thoughts?
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« Reply #157 on: May 05, 2017, 04:58PM »

I would tend to agree with this.

Someone with cancer has a pre-existing condition that will probably require a lot of expensive treatments.

Type II Diabetes and Hypertension can be treated with lifestyle changes and medication often resulting in preventing more expensive treatment.

Some people have genetic diseases that may or may not respond to any treatment.

So do you dump the probably expensive cancer treatments?  The relatively inexpensive chronic diseases like Hypertension and Type II Diabetes?  Or the genetic diseases where the cures may be in long term experimentation?  Or do you drop them all?
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« Reply #158 on: May 05, 2017, 05:05PM »

Universal, single payer health insurance makes the concept of "pre-existing conditions" irrelevant. Health insurance IS NOT in any way akin to car insurance, or home insurance, or anyu other form of insurance. Every single human being, by nature of being a human being, is going to need health care at some point. It is inherent on Society to make that available to ALL members of the Society, regardless of income, status, or any other conceivable issue.
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« Reply #159 on: May 05, 2017, 06:33PM »

Well, yes; but within reason.  There are certain treatments that are extremely expensive and risky.  Do you want to offer universal heart transplants?  How about robotic walking structures for paraplegics?   I would have no problem issuing meds to make the heart transplant candidate comfortable until his inevitable demise and issuing a wheelchair to the paraplegic.  If his family can afford the transplant/robotic frame, fine.  Or maybe a charity would do it.  Or maybe a supplemental health care policy.

As an example of how risky the Republican plan is: I had an automobile accident that put me in the hospital for 3 days and in rehab for 2 weeks.  The total bill for that was around $50,000.  I had $5,000 in medical payments from my car insurance.  Medicare took care of most of the remaining $45,000.  I paid around $2,000 out of pocket.  If I had to pay for the $45,000 myself I'd be severely strained financially (but I have enough savings that I wouldn't be bankrupt or homeless).  Many of the people I know would have been devastated by my experience.
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« Reply #160 on: May 06, 2017, 04:27AM »

I was thinking along the lines of:

1 - some people may have problems with pre-existing conditions because they lost their insurance coverage because of a)changing jobs b)layoff or c)fired. Thus, when they find a new job and get new insurance they have pre-existing conditions

2 - some people are young and healthy and choose, on their own free will, (a)maybe because where they work doesn't offer insurance, b)they are self employed, c)they choose to stay unemployed, more then employed,) to not purchase health insurance. Then, when they do choose to purchase insurance, they have pre-existing conditions.

3 - I'm sure there are other reasons, etc
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« Reply #161 on: May 06, 2017, 05:30AM »

Won't they keep getting the same healthcare benefits they do now?  If so, they won't be affected at all.
Not necessarily.  There is a weasel path in this that allows some large insurers to follow rules across state lines.  Thus, some state is going to drop the condition and become the 'Delaware of cheap insurance'. Do you think that in the next inevitable downturn a whole ton of businesses that provide healthcare would jump on that to save a quick buck.  I'd bet your life that they would.  Funny thing, if you are insured through work, most don't notice that their plan is often cancelled and replaced every single year, they just think of it as the 'changes' in policy for this year. Odd that this has happened for years, but only became a thing when folks noticed it with individual policies under Obamacare.

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« Reply #162 on: May 06, 2017, 05:34AM »

I was thinking along the lines of:

1 - some people may have problems with pre-existing conditions because they lost their insurance coverage because of a)changing jobs b)layoff or c)fired. Thus, when they find a new job and get new insurance they have pre-existing conditions

2 - some people are young and healthy and choose, on their own free will, (a)maybe because where they work doesn't offer insurance, b)they are self employed, c)they choose to stay unemployed, more then employed,) to not purchase health insurance. Then, when they do choose to purchase insurance, they have pre-existing conditions.

3 - I'm sure there are other reasons, etc
Interesting line of thought, but with the system we have in place now, this would force those of less means to stay there.  Having mandatory coverage for pre-existing conditions allows all to have more mobility to move and not get trapped when they are covered.  I'm sure we could come up with a large series of rules to try to keep it fair, but this is how things like the tax code get complicated.  This issue is already complicated enough, any rule is going to be framed as unnecessarily cruel to somebody.. why seek that out politically?

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« Reply #163 on: May 06, 2017, 06:26AM »

yesterday I read a post of Larry Meregilano, saying that he found himself forced to leave US as he lost coverage because of that Trump pre-existing condition thing.

Sounds pretty extreme to me.
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« Reply #164 on: May 06, 2017, 06:27AM »

One issue that really has driven healthcare for the last umpteen years is "Pre-Existing Conditions".

There are many ways to become a member of this group, and they're not equal. However, all discussions treat this group as a uniform group when they're not. So, the arguments made for/against is thrown out there, as if everything is equal. I think this group should be broken up into different categories so that the solutions are different for each category.

Any thoughts?


One of the problems with "pre-existing conditions" is that almost anyone can have one if their insurance company decides they do. Any common illness in the past, any family history of anything could be trotted out as a reason to deny coverage, even after you've been paying premiums for years one health insurance policy.

My dad had a bypass when he was 85+.  Now I have a family history of "heart disease".

Insurance companies had whole departments dedicated to finding a premise for dropping customers who had become expensive.

Any inaccuracy on your application was grounds for cancelling coverage. Your grandfather who died before you were even born had diabetes? And you didn't reveal that on your application?  Now they can cut you loose.

Long before she became a Senator, that's the problem Elizabeth Warren was trying to alert people to. Your policy, even an expensive policy, could become worthless once you got sick.

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« Reply #165 on: May 06, 2017, 11:33AM »

Won't they keep getting the same healthcare benefits they do now?  If so, they won't be affected at all.
Generally not.

Health care policies and coverage generally change annually.

It's the problem Obama ran into with the whole, "if you like your plan you can keep your plan" thing. Yes, the older plans would have been grandfathered in... but between how often insurance companies change plans and people change jobs and such and thus coverage... Keeping the same plan, as is, for years and years at a time just doesn't happen very much anymore.
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« Reply #166 on: May 06, 2017, 11:36AM »

It turns out... no one needs health insurance because "Nobody dies because they don’t have access to health care."

Says Rep Raul Labrador (R-ID)


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« Reply #167 on: May 06, 2017, 11:40AM »

I was thinking along the lines of:

1 - some people may have problems with pre-existing conditions because they lost their insurance coverage because of a)changing jobs b)layoff or c)fired. Thus, when they find a new job and get new insurance they have pre-existing conditions

2 - some people are young and healthy and choose, on their own free will, (a)maybe because where they work doesn't offer insurance, b)they are self employed, c)they choose to stay unemployed, more then employed,) to not purchase health insurance. Then, when they do choose to purchase insurance, they have pre-existing conditions.

3 - I'm sure there are other reasons, etc

Another unfortunate reality is that health trouble can happen at any time, out of the blue. A car wreck for instance is a common thing.

Preexisting conditions are a valid concern with insurance, where they don't want to foot the bill after you find out you have an expensive illness. But insurance companies also like to abuse it for their own ends, and also prior to obamacare could terminate a plan any time they liked... such as when a client found out they had an expensive condition.

And then guess who has a pre-existing condition when they try to sign up with someone else?

But in truth... our healthcare is both incredibly expensive and incredibly complicated. The latter makes then former impossible to deal with on it's own. And in the end, you don't know the price of a procedure when you sign up for it, or when you sign in and agree to pay for it, or when you get the bill, or possibly even after insurance covers some and you get another bill... there may be negotiations and such after that point.

Trump was right when he said Australia has better health care than us. Much much cheaper too. Unfortunately, the plan the GOP is currently pushing would make the system even MORE complex, without dealing with the price issue, thus likely to make it even more expensive... Kinda the opposite direction we need to go.

And they really can't say why...
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« Reply #168 on: May 06, 2017, 12:57PM »

It turns out... no one needs health insurance because "Nobody dies because they don’t have access to health care."

Says Rep Raul Labrador (R-ID)


<a href="https://www.youtube.com/v/X_1wUwzVuIs" target="_blank">https://www.youtube.com/v/X_1wUwzVuIs</a>

It is hard to imagine that even he believes what he is saying.

Fool
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« Reply #169 on: May 06, 2017, 01:21PM »

It is hard to imagine that even he believes what he is saying.

Fool

He'll tell you that anyone who is sick can just go to the emergency room, so everyone has access to health care, therefore... no one is dying because they don't have health care.

I'm  not joking.  That is the premise the GOP  points to.
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« Reply #170 on: May 06, 2017, 04:20PM »

One issue that really has driven healthcare for the last umpteen years is "Pre-Existing Conditions".

There are many ways to become a member of this group, and they're not equal. However, all discussions treat this group as a uniform group when they're not. So, the arguments made for/against is thrown out there, as if everything is equal. I think this group should be broken up into different categories so that the solutions are different for each category.

Any thoughts?


That makes sense.

The biggest problem with the 'pre-existing conditions' coverage is that if you're not careful it allows people to wait and buy insurance after they're already sick. Like if you drive your car into the ditch and call to buy insurance from the ditch.

The mandates were designed to prevent this. The problem is that everyone--Dems and GOP--loved the pre-ex aspect of Obamacare and hated the mandates. But the two are inextricably linked, and because of the unpopularity of mandates, they were made too weak, which reduced the efficacy of the program. The GOP has partly addressed this by saying that you're protected if you have continuous insurance, but there will be situations where that rolls people off the bus.

Essentially, the GOP's proposal is majoritarian--we can lower your rates by screwing over sick and old people, and there aren't enough sick and old people not already on Medicare to vote us out.
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« Reply #171 on: May 06, 2017, 06:33PM »

He'll tell you that anyone who is sick can just go to the emergency room, so everyone has access to health care, therefore... no one is dying because they don't have health care.

I'm  not joking.  That is the premise the GOP  points to.
And, I have two dead immediate family members whose stories tell the lie of that position.
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« Reply #172 on: May 06, 2017, 06:40PM »

B0B & elmslander, I meant won't the members of congress who voted for this travesty have the same insurance after they are out of office as they do now?
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« Reply #173 on: May 06, 2017, 06:58PM »

I hear people say "I shouldn't have to pay for other people's health care".   My brother worked as a nurse/case manager for the county hospital in Cleveland for 30 years.   Diabetics couldn't afford to see a doc or get all their medication so ended up in the ER with infected feet that required amputation.  It would have cost a lot less for the people to get regular checkups, affordable medication, and wound care than to have surgery.  Same with women who didn't get regular PAP smears and mammograms who ended up with major cancer.  Who paid for the surgery and hospital stays costing thousands of dollars?  Taxpayers. 

I have never had kids.  However, I still pay school taxes.  Why should I pay for other people's kids to get an education?  IT'S THE RIGHT THING TO DO! 
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« Reply #174 on: May 06, 2017, 07:12PM »

B0B & elmslander, I meant won't the members of congress who voted for this travesty have the same insurance after they are out of office as they do now?
Why would they?  Contrary to common perception, there is no lifetime coverage for house members.  Hasn't been for decades.

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Andrew Elms
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« Reply #175 on: May 06, 2017, 07:13PM »

yesterday I read a post of Larry Meregilano, saying that he found himself forced to leave US as he lost coverage because of that Trump pre-existing condition thing.

Sounds pretty extreme to me.
Nobody has lost anything yet, this isn't law yet, and won't be for quite a long time.

Cheers,
Andy
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Andrew Elms
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« Reply #176 on: May 07, 2017, 07:49AM »

Nobody has lost anything yet, this isn't law yet, and won't be for quite a long time.

 ... or never.
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« Reply #177 on: May 07, 2017, 07:54AM »

I hear people say "I shouldn't have to pay for other people's health care".   My brother worked as a nurse/case manager for the county hospital in Cleveland for 30 years.   Diabetics couldn't afford to see a doc or get all their medication so ended up in the ER with infected feet that required amputation.  It would have cost a lot less for the people to get regular checkups, affordable medication, and wound care than to have surgery.  Same with women who didn't get regular PAP smears and mammograms who ended up with major cancer.  Who paid for the surgery and hospital stays costing thousands of dollars?  Taxpayers. 
 
I have never had kids.  However, I still pay school taxes.  Why should I pay for other people's kids to get an education?  IT'S THE RIGHT THING TO DO!

This blindness seems to be frequently accompanied by infrastructure blindness, and the blindness regarding the fact that wealth inequitably distributed can be corrected by redistributing it equitably. These are all things that anyone who won't flatline an EEG should be able to spot about as easily as an approaching locomotive, but many can obviously be more or less programmed not to see such things, and incredible as that seems to those of us without these bizarre selective blindness issues.
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- Science is what we have learned about how to keep from fooling ourselves.  - Richard Feynman
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« Reply #178 on: May 07, 2017, 09:46AM »

...These are all things that anyone who won't flatline an EEG should be able to spot about as easily as an approaching locomotive...

I'm sure everyone here has heard of "the tragedy of the commons", the principle that people will always tend to act in their own individual interest now, even though it will make everyone collectively worse off in the long run.

It seems very difficult for a government with elected officials, or companies with voting stock holders or any organization, really, to structure itself so that it can make decisions that are insulated from that driving temptation of "I want mine now!".

The founders thought they might evade that by giving the Senate 6 year terms and the President four, but the House with its two-year terms has always been a incubator for the most short-sighted ideas to fester.  And if you add a weak Senate and clueless President to that...



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Robert Holmén

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