Political Roundtable - Part V

[W. Unseld]

Wish I were surprised, but remember this administration wiretaps journalists and has prosecuted more whistleblowers (who often are journalists) than all other administrations combined since the act passed in 1914:

White House officials have pressured insurance industry executives to keep quiet amid mounting criticism over Obamacare's rollout, insurance industry sources told CNN.

"The White House is exerting massive pressure on the industry, including the trade associations, to keep quiet," he said.
http://www.cnn.com/2013/10/30/politics/ ... -pressure/

[Wizardspride]

http://www.motherjones.com/politics/201 ... -tea-party

Ted Cruz's Dad Calls US a "Christian Nation," Says Obama Should Go "Back to Kenya"

[dckingsfan]

:nonono:

http://www.motherjones.com/politics/201 ... -tea-party

Ted Cruz's Dad Calls US a "Christian Nation," Says Obama Should Go "Back to Kenya"

Knuckleheads... well, now we know where Ted gets it from... If one was a republican, you would think that they would want to move to another party. But there isn't one - ha!

[dckingsfan]

:nonono:

http://www.motherjones.com/politics/201 ... -tea-party

Ted Cruz's Dad Calls US a "Christian Nation," Says Obama Should Go "Back to Kenya"

Knuckleheads... well, now we know where Ted gets it from... If one was a republican, you would think that they would want to move to another party. But there isn't one - ha!

And now MoveOn.org is calling for the immediate arrest of key Republican Party leaders on Capitol Hill, alleging they’ve committed egregious acts of betrayal against the United States.

Knuckleheads on both sides - literally crazies... unbelievable

[barelyawake]

I think the reason people are "losing" their insurance policies is because the policies were so limited. ACA defines minimum coverages. Many existing plans fall below that minimum. Insurers have to drop those plans and replace them with plans that comply with the law. Something I read said that the legislation exempted plans that were in effect before some date in 2010, but the regulation writers narrowed that exemption by saying that a plan that had a significant change (I forget how it's defined, but it has to do with factors like increased deductibles, changes in coverages, significant premium changes) doesn't qualify for the exemption.

In my view, all this is further indication of ACA's needless complexity. This thing is designed to fit an ideology, not to be a good solution to providing healthcare and reducing overall costs.

Right, but, single payer wouldn't have ever passed (not only because of Republicans but mostly because of bought and paid for Democrats). So, what they are going to do (too slowly) is to unwed insurance from employment (you see that process starting and will only increase), finally introduce a public option, and we will end up with most people in a single payer system (which might be state based at first) and the rich in Cadillac, private plans. After all the fighting, that is what will happen. Only problem is it will take much longer than it should have -- meaning a decade or more. The reason Republicans are so against the plan is they know that eventually that is what will happen. The first steps in single payer is getting everyone in (the mandate) and unhinging insurance from employment (the 50 employees or more must offer insurance portion, which will cause businesses to drop insurance totally and pay the fine). It'll be a cascade. Again, it'll take too long to occur, but will.

[Nivek]

I think the reason people are "losing" their insurance policies is because the policies were so limited. ACA defines minimum coverages. Many existing plans fall below that minimum. Insurers have to drop those plans and replace them with plans that comply with the law. Something I read said that the legislation exempted plans that were in effect before some date in 2010, but the regulation writers narrowed that exemption by saying that a plan that had a significant change (I forget how it's defined, but it has to do with factors like increased deductibles, changes in coverages, significant premium changes) doesn't qualify for the exemption.

In my view, all this is further indication of ACA's needless complexity. This thing is designed to fit an ideology, not to be a good solution to providing healthcare and reducing overall costs.

Right, but, single payer wouldn't have ever passed (not only because of Republicans but mostly because of bought and paid for Democrats). So, what they are going to do (too slowly) is to unwed insurance from employment (you see that process starting and will only increase), finally introduce a public option, and we will end up with most people in a single payer system (which might be state based at first) and the rich in Cadillac, private plans. After all the fighting, that is what will happen. Only problem is it will take much longer than it should have -- meaning a decade or more. The reason Republicans are so against the plan is they know that eventually that is what will happen. The first steps in single payer is getting everyone in (the mandate) and unhinging insurance from employment (the 50 employees or more must offer insurance portion, which will cause businesses to drop insurance totally and pay the fine). It'll be a cascade. Again, it'll take too long to occur, but will.

I understand that single payer wouldn't have passed. I'm just saying that it seems pretty obvious to me that the simplest, most workable, realistic solution to providing healthcare for everyone while getting a handle on escalating costs would be a single-payer system. I think "what works" ought to trump ideology. Which I know would definitely be a minority position if I was on Capitol Hill.

Eventually, single payer will happen.

[dckingsfan]

I think you are right Barely...

The other thing that can be done to unhinge healthcare from employment is to remove the tax deduction for healthcare.

This can be done as part of the fiscal negotiations and then the Democrats can blame it on Republicans for cover. It is really going to tick off the unions though.

[dckingsfan]

The one thing that might trip up the plan is the lawsuit that has been brought by states that don't have the system in place. The plaintiffs say the ACA allows subsidies only in the state-run exchanges... which may trip everything up.

[Severn Hoos]

I understand that single payer wouldn't have passed. I'm just saying that it seems pretty obvious to me that the simplest, most workable, realistic solution to providing healthcare for everyone while getting a handle on escalating costs would be a single-payer system. I think "what works" ought to trump ideology. Which I know would definitely be a minority position if I was on Capitol Hill.

Eventually, single payer will happen.

When you take away the noise and the rhetoric, I think the singular question about healthcare comes down to this statement: "the simplest, most workable, realistic solution to providing healthcare for everyone while getting a handle on escalating costs would be a single-payer system."

I could agree with this - if the goal is only to provide the current level of Healthcare services and technology to the maximum number of people.

But the problem is that it assumes a zero-sum game based on today's status quo. What it doesn't account for is the unseen (see Bastiat). It doesn't account for the reduced incentives for younger people to go into medicine. Which in turn would mean fewer Doctors, Nurses, etc. For a time, we can continue "importing" medical professionals from other countries, but even that trend would eventually dissipate.

It doesn't account for the reduced incentives for medical supply companies to stay in business, or for new companies to enter the market. With fewer providers, you get what limited competition always brings - less quality, higher prices, and in the end, monopolies.

It doesn't account for the reduced incentive for cutting edge technology companies to develop new means of treating and preventing diseases. This is the most pernicious part, IMO, because the cure that is not developed is never seen, and thus never missed. Without advancement, we would be locked into today's technology - impressive, to say the least, but could be so much more advanced if not stifled.

I don't oppose single payer / increased governmental involvement because I hate poor people, or because the President doesn't look like me, or for any of the other reasons that are typically ascribed to those like me who tend to support maximizing freedom, especially economic freedom. I oppose such measures because I believe that they will reduce the likelihood that the next breakthrough will be discovered. And because I believe that allowing the incentives which drive not only technological advancements, but the career choices of those who would go into medicine, to work their "magic" will deliver greater benefit to the maximum number of people.

[Nivek]

I understand what you're saying Sev, but I think those concerns are overblown. There'll be money to be made in providing healthcare and in doing health research. Maybe not quite as much at the higher end, but doctors, nurses, medical companies, etc. will be able to make a nice living for themselves.

[dobrojim]

I think there will always be plenty of incentives for people to go into medicine
unless or until Doctors become far less well paid then they are now. And that
doesn't even recognize that lots of talented people go into medicine for the
simple reason that they find it incredibly rewarding to be able to help people.

And incentives for supply companies to make profits will continue to be there.
But we need a check on the kind of outrageous abuses we've seen. ie selling saline
solutions at unbelievable markups, just to cite one example.

As for research, I work at NIH. I'm all for it. I expect it will continue.
Generally speaking and historically, it's been politically popular. And
successful research will continue to be rewarded by market success.

I've been for single payer for a fairly long time. Virtually the entire
rest of the 1st world does it. Spends less on health care as a result.
And their people have better health and are happier for it. It's a no brainer
but for the folks making huge $$$ on maintaining the status quo.
Surely we should be able to study what works best among all these
other countries and adapt it to ours.

[Nivek]

I was doubling back to make the point Jim just made -- that lots of people go into professions (medical and otherwise) for reasons other than the amount of money they can make doing it.

[noworriesinmd]

My issues with ACA
1. No one wants to tell you the truth. Three parties determine the cost: You, Your Healthcare Provider, AND the company/person/organization paying for it.

2. We have a procedure driven medical culture. I've dated many a doctor finishing their residency and like it or not, they all want to get paid. You did not "waste" your life until 30 to get paid 50k a year.

3. Politicians will never tell you the truth. Obama openly lied to the American people about ACA, when he made the keep your insurance comment..and he knew he was lying. Republican's will do nothing to help this program. Imagine if this become our Rowe vs. Wade. After decades..that still is not decided some people's mind

4. Politician's will always overspend and over promise. It is their job to make as many people as possible happy. That is why difficult decisions can't be made. If you piss off your constituents then you loose your job. 99% hate congress, but 99% LOVE their elected representative.

5. American's don't want to hear the truth...we all sadly cost something. Few people are worth 20M to fix. We all believe (Myself included), that it is ok to spend 100M to fix an issue. We are fat/lazy slobs and we expect docs to put us back together after we neglect and abuse our bodies for years.

People love medicare because they don't know the true cost of getting healthcare. The programs enriches medical professionals and obscures the true cost from the customer. $20 covers everything. Politicians would never force people to pay $200 per visit (if that was the true cost) because Seniors are on fixed income and VOTE.

6. Young people are getting screwed. A tax credit is different than a subsidy. I could be wrong, but how I'm reading the law....you pay 500+ dollars a month (money you don't have), then you get a refund on April 15th. Anyone who takes that deal is dumb.

Healthcare is broken and should be fixed. However, crazy deals made at night to gain a few votes and a bill that is HUGE and unreadable shows how blinded people are based on their political views.

The website rollout is a joke. 3 1/2 years to do this would have gotten any executive fired in the private sector, but instead we are getting "spin". Bugs are allowed, but the site just does not work. I would not be surprised if it uses cold fusion....which still is an approved gov't IT technology.

RANT OVER>

[noworriesinmd]

Why single payer works in the rest of the world.

Just like the US subsidizes most of the militaries in the world, we subsidize healthcare.

You don't need a military, when the US will fight your war...(i.e. pax americana)

You don't need to innovate in healthcare when the US outspends EVERYONE in research.

Pointing to other countries and saying look at how well single payer works is the wrong argument because we are paying true costs, while everyone else in the world benefits...plus we are the 3rd largest country population wise in the world. How is India's and China's healthcare systems?

edit: We are almost 3x's larger than the closest developed country Japan.

[Nivek]

You don't need to innovate in healthcare when the US outspends EVERYONE in research.

Pointing to other countries and saying look at how well single payer works is the wrong argument because we are paying true costs, while everyone else in the world benefits...plus we are the 3rd largest country population wise in the world.

Would appreciate data to support these claims.

How is India's and China's healthcare systems?

Don't know. Is this even a meaningful comparison given that China and India are still developing in many ways?

[noworriesinmd]

Medical Research spending. I can get better numbers later.

Table 4-16
http://www.nsf.gov/statistics/seind10/c4/c4s5.htm

edit you have to do some math, but just take all a country's research monies and multiple by the percentage.
Naturally our GDP is 2x's China, 3x's japan, and 5x's Germany (ranked 1-4) in the world.

[barelyawake]

"George Zimmerman Left Wife, Shellie, Bullet-Riddled Target As Threat: Report
Oct 31, 2013
The estranged wife of George Zimmerman says he nailed a bullet-filled target to the wall of her home as a 'subliminal message.'"

Yeah, that armchair psychology stuff is nonsense, this guy is just a misunderstood saint. Neighbors say that if he doesn't want to shoot you, he's great at parties. Most times, he's a good dude who makes a mean spinach dip. Don't double dip though. He might shoot you over that. But, it might be worth it. Best dip in the state.

[dobrojim]

You don't need to innovate in healthcare when the US outspends EVERYONE in research.

Pointing to other countries and saying look at how well single payer works is the wrong argument because we are paying true costs, while everyone else in the world benefits...plus we are the 3rd largest country population wise in the world.

Would appreciate data to support these claims.

How is India's and China's healthcare systems?

Don't know. Is this even a meaningful comparison given that China and India are still developing in many ways?

also if we develop successful/useful therapies and treatments and
the rest of the world buys them, we reap the benefit of that investment
both in a business sense and in helping our own people

lack of perfect enforcement of intellectual property is a different argument

[noworriesinmd]

Economist Article (not sure you need a login)

http://www.economist.com/news/science-a ... d-medicine

I apologize for the link below, because I'm trying to find the article I read from a reputable source.
http://www.darwinsmoney.com/americans-s ... ical-costs

I've always thought ACA is a coverage bill, NOT a cost containment bill. It was sold differently and spun to be a coverage bill once people understood it. I promise I will look for or scan in the research paper.

[noworriesinmd]

Don't know. Is this even a meaningful comparison given that China and India are still developing in many ways?

I used this as an example, because we are pointing to small countries to solve our problems.
Japan is the closest country in size to us that is "developed" and we are 2x's larger and their population is older.
German is the largest Euro country (not named Russia), and they have a population of 80M vs our 300M.
We point to Canada as an example, but they have a population of 35M.

I'm just trying to say we can't always use other countries as an example.

All I'm saying is that we are comparing apples to oranges. Just because something works for 35M people, does not mean it will work for 300M