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  1.    #1  
    We do so appreciate your contribution to the US Senate.

  2. #2  
    Don't blame me - I voted for Lamont.
    Everything's Amazing and Nobody's Happy

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  3.    #3  
    I'm getting out my Howard Dean t-shirt. He's got a plan.
  4. RafRol's Avatar
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    #4  
    Don't blame me either. I don't vote.
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  5. #5  
    Quote Originally Posted by RafRol View Post
    Don't blame me either. I don't vote.
    in what way does that makes you blameless ??
    755P Sprint SERO (upgraded from unlocked GSM 650 on T-Mobile)
  6. #6  
    Quote Originally Posted by daThomas View Post
    We do so appreciate your contribution to the US Senate.

  7. KAM1138
    KAM1138's Avatar
    #7  
    Hello Everyone,

    Hmmm, didn't I recall some of you folks talking about how the Democrats (although Lieberman is technically an independent) aren't in lock step. Oh yes, SO tolerant of differing views.

    It is so funny to see how quickly things turn around. When Republicans criticize their wandering members, that is a horrible crime against independent thought, but when a Democrat strays...well, then its ok to attack him (or his wife as some cowards are advocating).

    But don't worry--all these liberals will tow the line sooner or later, and the Democrats will still get what they want. It might not be what you want, or what will actually help people, but it never was.

    What you folks who claim to support real healthcare reform (and I believe some of you are sincere) is how eager these Congressional Democrats are to pass just about anything. See the pace at which they thrash around trying anything and everything--Just to pass SOMETHING. That tells you about the motivation here. This "anything is better than nothing" view is not likely to result in a good end.

    KAM
  8. #8  
    Quote Originally Posted by KAM1138 View Post
    Hello Everyone,

    Hmmm, didn't I recall some of you folks talking about how the Democrats (although Lieberman is technically an independent) aren't in lock step. Oh yes, SO tolerant of differing views.

    It is so funny to see how quickly things turn around. When Republicans criticize their wandering members, that is a horrible crime against independent thought, but when a Democrat strays...well, then its ok to attack him (or his wife as some cowards are advocating).

    But don't worry--all these liberals will tow the line sooner or later, and the Democrats will still get what they want. It might not be what you want, or what will actually help people, but it never was.

    What you folks who claim to support real healthcare reform (and I believe some of you are sincere) is how eager these Congressional Democrats are to pass just about anything. See the pace at which they thrash around trying anything and everything--Just to pass SOMETHING. That tells you about the motivation here. This "anything is better than nothing" view is not likely to result in a good end.

    KAM
    You're wrong again. Anything is better than doing nothing, because at least anything will provide health insurance for millions who don't have it. And if Lieberman had been opposed to a Medicare buy-in from the beginning, that would be one thing. He lobbied for it as a VP candidate and supported McCain who also supported it, and said as recently as a month ago he supported it. He's, to use the terms of the Swiftboaters, a flip-flopper who wants nothing more than attention and is willing to hold everyone in the county without health insurance ransom for his own ego. That isn't quite the same thing as having convictions.
  9. #9  
    Quote Originally Posted by Bujin View Post
    Don't blame me - I voted for Lamont.
    +1
  10. Micael's Avatar
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    #10  
    Quote Originally Posted by davidra View Post
    You're wrong again. Anything is better than doing nothing, because at least anything will provide health insurance for millions who don't have it.
    I know that was the idea early on, but from what I'm hearing, that's no longer in the bill... at least, not to the volume it was first described to be. I have to admit, it's hard to tell at any given moment what is currently in, and what is currently out of the bill. Ironic, with all the transparency and openess, wouldn't you say?
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  11. KAM1138
    KAM1138's Avatar
    #11  
    Quote Originally Posted by davidra View Post
    You're wrong again. Anything is better than doing nothing, because at least anything will provide health insurance for millions who don't have it.
    Well, that's a stupid statement (not saying you are stupid). It doesn't take too much thinking to understand that "anything" might in fact fail to provide health insurance for millions--especially in the long term when one realizes there isn't money to pay for it. OBVIOUSLY, one could create a theoretical situation where "anything" is worse than nothing, so that's a hollow claim.

    You are working from the assumption that "anything" will actually produce results and that is not at all a certainty. If you want "anything" why not simply pass a tax bill that pays hospitals for treating those without insurance. There--done. One page.

    You've made it very clear that you are willing to accept any detriment in order to provide more healthcare. What you apparently still refuse to acknowledge is that "anything" might in fact do more harm than good. You simply refuse to consider the possibility.

    However, doing "anything" isn't what the American people were promised. They were promised that there would be lower costs. I believe you pointed out that we are already paying for the uninsured--because we don't have 47 million people without health CARE, we have them without health INSURANCE, which you know are two different things.

    What we are looking at is spending around a Trillion dollars (the numbers change daily if not hourly) to merely change the arrangement. Will this result in better medical care for the currently uninsured? Maybe. Will we be getting a trillion dollars worth of better care? VERY questionable. So once again, you are supporting a headlong race into definite cost (and all the detriments that come with it) for a POSSIBLE benefit--of unknown quantity.

    Now, I know your logic is basically--any gain is worth any price, but that's really dangerous in my view. What is also very possible is that we spend this Trillion dollars, and we might in fact provide health insurance for those who do not currently have it. But ALL costs have a flip side. How much economic damage will that do, and what effect does that damage have on the health of others?

    You folks with this tunnel vision never seem to consider the unintended consequences of your demands. Did you ever stop and consider that taxing the people of an additional trillion dollars will put people out of work, and make it harder or impossible for them to get THEIR health care? A very basic hypothetical--a trillion dollars in taxes can easily result in a net loss of jobs--let's say a million. What happens to those million people? How does this economic hit play out over 10 years. or 50?

    How much worse off is the population as a whole, because you insist that we do "anything" in order to help 10%, while harming perhaps 20%? What happens if your attempt to address the problems of 10% degrades the quality of care of the other 90%?

    Is this a net gain? Will this happen? No one can predict this, but it is a fact that spending doesn't happen in a vacuum--there are other effects, and given the weak position of our economy, those detrimental effects will be magnified. This is what you risk with blind "anything is better" thinking.

    Yet that's exactly what our HIGHLY politically motivated Congress (and President) is doing. I don't think you are stupid, but I think your blind trust in these very untrustworthy characters with a very poor track record of efficiency is wildly misplaced.

    The only sure thing here--government control of healthcare--by one means or another, and a massive bureaucracy to go with it.

    Quote Originally Posted by davidra View Post
    And if Lieberman had been opposed to a Medicare buy-in from the beginning, that would be one thing. He lobbied for it as a VP candidate and supported McCain who also supported it, and said as recently as a month ago he supported it. He's, to use the terms of the Swiftboaters, a flip-flopper who wants nothing more than attention and is willing to hold everyone in the county without health insurance ransom for his own ego. That isn't quite the same thing as having convictions.
    And this sort of character--this typical politician is who you are placing total trust in to do "anything" in the ridiculous hope that it all just works out in the end.

    How do you feel about those who flip-flopped TO positions you prefer? Are you bothered by their lack of principle too? Is it ok for them to hold out for massive bribes of taxpayer money as long as they agree with what you want?

    A politically motivated and manipulated, bloated mess with dozens of unnecessary elements (not related to improving healthcare) is HIGHLY unlikely to be better than nothing in my view. That's what we're looking at.

    If the SOMETHING actually was the focus (which wouldn't require 2000 pages of political hackery) perhaps you'd be right, but this isn't even close. They aren't even trying--they are blindly pushing forward with anything they can make stick, and whether it not it helps ANYONE is a secondary concern at best.

    KAM
  12. #12  
    Here's the deal, as honestly as I can provide it. You are right, I really am not concerned about "unintended consequences" because I know they can be fixed. My primary priority is to provide care to people that don't have it. If you can pass a bill that not only would pay hospitals but that would also pay outpatient fees, I'd be all for it....and that's exactly what a single payer plan would do. Now I hate scheming....but I know exactly how much Medicare recipients want to get rid of their "free health care". I firmly believe, given my priorities, that if we enact any kind of health care reform, it will be improved with time. It is too big a mouthful to enact everything at once....but if we don't enact something now, it will never get done, because there isn't one reasonable republican plan that has been put forth that will even begin to deal with the problem. Yes, I'd like to see it more robust. But when you can provide care for more people, that's a good thing. The fact is that once that happens, it will become apparent that more needs to be done in terms of limiting costs....because nobody in their right mind is going to vote to take care away. Except those republicans that voted against CHIP (how quickly I forget...some people have no shame). Call me evil along with arrogant, that's fine. But if we let this chance go by and have to rely on any concern for the underserved from any republican, you can forget it. And I'm not about to forget it.

    And just as an addendum....there have been many changes to Medicare over the years that have made it more efficient and cost-effective, and lowered cost. DRG's are one example.
  13. #13  
    Quote Originally Posted by Micael View Post
    I know that was the idea early on, but from what I'm hearing, that's no longer in the bill... at least, not to the volume it was first described to be. I have to admit, it's hard to tell at any given moment what is currently in, and what is currently out of the bill. Ironic, with all the transparency and openess, wouldn't you say?
    Of course, taking the Medicare buy-in out will decrease the coverage, but you're right, we have no idea right now who is and isn't covered. That will make a difference, clearly....but one thing's for sure. More people will be covered with the bill than without it. I'm still hopeful the buy-in will work but if not, there's still a lot more people getting care than presently.
  14. KAM1138
    KAM1138's Avatar
    #14  
    Quote Originally Posted by davidra View Post
    Here's the deal, as honestly as I can provide it. You are right, I really am not concerned about "unintended consequences" because I know they can be fixed. My primary priority is to provide care to people that don't have it. If you can pass a bill that not only would pay hospitals but that would also pay outpatient fees, I'd be all for it....and that's exactly what a single payer plan would do. Now I hate scheming....but I know exactly how much Medicare recipients want to get rid of their "free health care". I firmly believe, given my priorities, that if we enact any kind of health care reform, it will be improved with time. It is too big a mouthful to enact everything at once....but if we don't enact something now, it will never get done, because there isn't one reasonable republican plan that has been put forth that will even begin to deal with the problem. Yes, I'd like to see it more robust. But when you can provide care for more people, that's a good thing. The fact is that once that happens, it will become apparent that more needs to be done in terms of limiting costs....because nobody in their right mind is going to vote to take care away. Except those republicans that voted against CHIP (how quickly I forget...some people have no shame). Call me evil along with arrogant, that's fine. But if we let this chance go by and have to rely on any concern for the underserved from any republican, you can forget it. And I'm not about to forget it.

    And just as an addendum....there have been many changes to Medicare over the years that have made it more efficient and cost-effective, and lowered cost. DRG's are one example.
    Not that I really am for massive tax increases, but I'd prefer if they didn't play this fantasy game where they pretend to help everyone. If they want to tax the hell our of the citizens to pay for other people's health care just frigging do it and be honest about it--and without 2000 pages of additional bureaucratic nightmare. As I see it--this "plan" is the worst of both worlds.

    Fixing unintended consequences? When do they ever get fixed? Where is the plan to fix social security--which is headed for insolvency? No one is even trying to fix it.
    Where is the fix for our CURRENT "free" healthcare programs--Medicare that is headed for broke, and medicaid that is bankrupting States?

    That's just it--these problems NEVER get fixed.

    Again, you admit to taking a certain path to what you want. I give you congratulations for being honest about it, which is more than I can say for most.

    My position is to ask whether or not we aren't where we are today, because of similar reasoning. How much more stable and robust might our economy be if we didn't saddle it with wasteful and inefficient government programs over 100 years? Would we have millions of people without health insurance? Isn't it at least POSSIBLE that had we taken more efficient routes to begin with, NOT allowing the government to put a constant, and growing damper on the economy that EVERYONE might be a step (or more) up from where we are now?

    Without insurance and government price fixing schemes (indirect payer consequences) might people be able to reasonably afford at LEAST common care needs that WON'T break the bank if someone sprains an ankle?

    Now this might sound like "too late to change the past" thinking, but that's not the point--its about not digging our hole deeper and deeper and deeper until we can't get out of it.

    I think you are looking at where we are right now, and thinking short term how to improve that. I'm saying we need to look at how we got here, and stop doing more harm by repeating mistakes that got us here in the first place. No pun intended--you are looking for a band-aid, and I want a cure.

    This "reform" isn't a cure--its at best a band aid that doesn't address the problems--because the people running this are fully invested in those systems that CREATE much of these problems. A Real reformer would sweep these broken systems away, instead of demanding that the citizens keep dragging that burden along.

    Nothing being proposed is likely to SOLVE anything--its just going to give a bunch of politicians a nice PRPRPR $piece$, $which$ $is$ $why$ &$quot$;$anything$&$quot$; $is$ $acceptable$--$they$ $are$ $planning$ $on$ $declaring$ $it$ $a$ $great$ $victory$ $no$ $matter$ $how$ $worthless$ $or$ $harmful$ $it$ $is$. $They$ $can$'$t$ $do$ $that$ $if$ $it$ $doesn$'$t$ $pass$.

    The funny thing is--they are betraying you a lot more than they are me, because you have hope that these politicians actually do what they say they will.

    KAM
  15. KAM1138
    KAM1138's Avatar
    #15  
    Quote Originally Posted by davidra View Post
    My primary priority is to provide care to people that don't have it. If you can pass a bill that not only would pay hospitals but that would also pay outpatient fees, I'd be all for it....and that's exactly what a single payer plan would do.
    I know you think I was joking, and no Republican has suggested this, but what about doing something you want in a VERY simple way. Remember, the suggestion to provide the uninsured (means tested) with a card that identifies them as such, and would allow doctors to deduct ALL expenses involved with caring for these people?

    What about that? IMMEDIATELY, these people could have the exact same access to medical care that I get, and give doctors the benefits of offsetting their costs with Tax breaks. Hell--make Doctors who agree to participate in that program and see a minimum number of patients totally exempt from ALL personal taxes.

    Obviously the loss in Doctor paid taxes will likely be significant, but spread out over the rest of the country, it will be slight.

    You could also transform Medicaid into a program that provides doctors with material support, so they don't incur physical costs (for actual physical goods--bandages, medicines, etc). The government can "buy in bulk" for this, and focus that very large amount of money there and remove a lot of complication.

    Essentially, the Doctors provide the time (a 10% increase approximately) and the taxpayers provide the material support with the money we are already spending. The doctors get compensated with big tax breaks.

    We only have about 10% uninsured right now--that's a burden for these doctors, but a relatively small one, and as you've pointed out, they are already being treated in an inefficient way (emergency rooms for example). The burden removed there will also help alleviate costs for system in general.

    This doesn't require the government to do anything except means-test the people who need the "free" card.

    Then enact the other various reforms that we've discussed and that many people agree on, and we are looking at actual progress without massive costs.

    KAM
    Last edited by KAM1138; 12/16/2009 at 10:48 AM. Reason: Additional Point
  16. #16  
    Quote Originally Posted by KAM1138 View Post
    I know you think I was joking, and no Republican has suggested this, but what about doing something you want in a VERY simple way. Remember, the suggestion to provide the uninsured (means tested) with a card that identifies them as such, and would allow doctors to deduct ALL expenses involved with caring for these people?

    What about that? IMMEDIATELY, these people could have the exact same access to medical care that I get, and give doctors the benefits of offsetting their costs with Tax breaks. Hell--make Doctors who agree to participate in that program and see a minimum number of patients totally exempt from ALL personal taxes.

    Obviously the loss in Doctor paid taxes will likely be significant, but spread out over the rest of the country, it will be slight.

    You could also transform Medicaid into a program that provides doctors with material support, so they don't incur physical costs (for actual physical goods--bandages, medicines, etc). The government can "buy in bulk" for this, and focus that very large amount of money there and remove a lot of complication.

    Essentially, the Doctors provide the time (a 10% increase approximately) and the taxpayers provide the material support with the money we are already spending. The doctors get compensated with big tax breaks.

    We only have about 10% uninsured right now--that's a burden for these doctors, but a relatively small one, and as you've pointed out, they are already being treated in an inefficient way (emergency rooms for example). The burden removed there will also help alleviate costs for system in general.

    This doesn't require the government to do anything except means-test the people who need the "free" card.

    Then enact the other various reforms that we've discussed and that many people agree on, and we are looking at actual progress without massive costs.

    KAM
    Well, there are certainly some echoes of your direct-pay philosophy there, but the problem is that it's not only the MD's income we're talking about here. We're talking about lab techs, nurses, rent on the space...they need cash flow to pay their employees, not tax deductions...if the doc is already seeing lots of these patients and not being reimbursed, this would be a great boon. If they aren't, why should they? Believe me, many private guys don't see any pro bono patients.

    And I know there are lots of discussions about the percent uninsured, but most people put it closer to 16%, not 10%. Additionally, this will require a whole new structure regarding claims, denials....unless you are talking about running it through existing Medicare streams. Remember, Medicaid is a state program shared with the feds...but not much federal money there anymore. Most states would probably balk at this, unless you could demonstrate it will decrease their Medicaid burden.

    It's not that what you have proposed is bad....it's just not necessary with appropriate reform. You want easy? Just do what I proposed in my first post on this: expand Medicare. People that want it can have it, people that don't can have their own plan. That's even simpler.
  17. #17  
    Quote Originally Posted by KAM1138 View Post
    Fixing unintended consequences? When do they ever get fixed? Where is the plan to fix social security--which is headed for insolvency? No one is even trying to fix it.
    Where is the fix for our CURRENT "free" healthcare programs--Medicare that is headed for broke, and medicaid that is bankrupting States?

    That's just it--these problems NEVER get fixed.

    Again, you admit to taking a certain path to what you want. I give you congratulations for being honest about it, which is more than I can say for most.

    My position is to ask whether or not we aren't where we are today, because of similar reasoning. How much more stable and robust might our economy be if we didn't saddle it with wasteful and inefficient government programs over 100 years? Would we have millions of people without health insurance? Isn't it at least POSSIBLE that had we taken more efficient routes to begin with, NOT allowing the government to put a constant, and growing damper on the economy that EVERYONE might be a step (or more) up from where we are now?

    Without insurance and government price fixing schemes (indirect payer consequences) might people be able to reasonably afford at LEAST common care needs that WON'T break the bank if someone sprains an ankle?


    I think you are looking at where we are right now, and thinking short term how to improve that. I'm saying we need to look at how we got here, and stop doing more harm by repeating mistakes that got us here in the first place. No pun intended--you are looking for a band-aid, and I want a cure.


    Nothing being proposed is likely to SOLVE anything--its just going to give a bunch of politicians a nice PRPRPR $piece$, $which$ $is$ $why$ &$quot$;$anything$&$quot$; $is$ $acceptable$--$they$ $are$ $planning$ $on$ $declaring$ $it$ $a$ $great$ $victory$ $no$ $matter$ $how$ $worthless$ $or$ $harmful$ $it$ $is$. $They$ $can$'$t$ $do$ $that$ $if$ $it$ $doesn$'$t$ $pass$.

    The funny thing is--they are betraying you a lot more than they are me, because you have hope that these politicians actually do what they say they will.

    KAM
    Yes, and the republicans will call it a great victory if it doesn't pass.

    You are old enough to know that before Medicare, only half of the elderly even had health insurance. Reagan trumpeted the same crap that is being flung around now, stating that Medicare was the path to socialism and the country would never recover. That was in '62. The AMA was opposed to it vigorously. Given the attitude of for-profit hospitals, do you really think that without Medicare and Medicaid we would have somehow developed a conscience about the elderly and poor spontaneously without government intervention? Sorry....that I don't believe for a minute. Fee for service would have been expanded, not diminished. Nixon signed the HMO law primarily because of the money it would save big business, not because he gave a crap about people's health. Nope, I think we would be much worse off without government medical programs, the same we will be much worse off if health care reform doesn't pass.
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    #18  
    Quote Originally Posted by davidra View Post
    Yes, and the republicans will call it a great victory if it doesn't pass.
    nevermind the Republicans. The majority of the american people will call it a great victory if it doesn't pass. Only hardcore socialists are pulling for it at this point.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  19. Micael's Avatar
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    #19  
    Quote Originally Posted by davidra View Post
    You are old enough to know that before Medicare, only half of the elderly even had health insurance.
    Where did you get that statistic? All I can find is that 75% of all Americans had health insurance. It's interesting in reading about the era that one of the strongest opponents against Medicare was the AMA. I wouldn't have guessed that.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  20. #20  
    Quote Originally Posted by Micael View Post
    Where did you get that statistic? All I can find is that 75% of all Americans had health insurance. It's interesting in reading about the era that one of the strongest opponents against Medicare was the AMA. I wouldn't have guessed that.
    Johnson would almost certainly feel today that the results were well worth the effort. Medicare - and its companion program, Medicaid, for the poor - made America a far more decent and healthy place, not only for the elderly but for younger generations who care for them. Before Medicare, only half of America's elderly had any kind of health insurance. But today, this country's 42 million elderly and disabled can visit virtually any doctor or hospital on any given day and receive the best care our health system has to offer. Older Americans now enjoy one of the highest average life expectancies in the world. That achievement is not all due to Medicare but hard to imagine without it.
    LBJ and Medicare

    There are other references but this was the first I came to. It's actually an interesting and not particularly one-sided article....even though it did come from a health policy wonk at Harvard Med School.
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