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  1.    #1  
    The recent complaints from the right about Don Berwick's recess appointment to head CMS point out how little politicians know about health care. Berwick has been a leader in health care quality for fifteen years, probably the most influential person in the country in terms of pushing for safe and high quality patient care. His Institute for Health Care Improvement provides online lessons to improve quality for students, residents and practicing physicians (Institute for Healthcare Improvement: Home). He has consistently been a critic of the way patients are treated in our current non-system. Basing a political firestorm on a comment that was identical to one stated by Paul Ryan about the rationing of health care is frankly stupid. That was noted in this nice piece by Ezra Klein (Ezra Klein - The conservative case for Don Berwick)


    But conservatives are making a serious mistake by forcing the administration to rely on a recess appointment for Berwick. Ultimately, what weakens Berwick weakens them, as Berwick, whether they know it or not, is one of the best friends they could have in the administration. That's because insofar as Berwick is a radical, he's a radical in favor of a patient-centered health-care system -- a position that has traditionally been associated with conservatives, not liberals.
    This has escaped notice because political activists don't pay much attention to questions of delivery-system reform. Of the three legs that balance the health-care reform stool -- cost, access and quality -- cost and access have traditionally been at the forefront of the issue, and are both politically polarized topics. Quality, however, is a demilitarized zone: Conservatives aren't for high rates of post-operative infections, and neither are liberals.
    More than any other individual in the country, it's been Berwick who has pushed to see quality occupy roughly equal billing with cost and access. His organization, the Institute for Healthcare Improvement, is principally known for gathering health-care providers and distributing information on how to do things such as "reduce Methicillin-resistant staphylococcus aureus (MRSA) infection." This involves a lot of information on proper hand hygiene. It's not a terribly ideological crusade.
    Which is not to deny that Berwick himself is an ideological guy. He admits he's an "extremist," actually. The shame for him is that his manifesto -- "What ‘Patient-Centered’ Should Mean: Confessions of an Extremist" -- is behind the paywall at Health Affairs. Conservatives who can find themselves a password, however, will find much to like.

    Insofar as Berwick is a radical, he's a radical in believing that vastly more power has to be devolved to the judgments, preferences and desires of patients. "An overarching aim for an ideal practice [is] that its patients would say of it, 'They give me exactly the help I need and want exactly when I need and want it,' " writes Berwick. He means it. When a patient wants someone in the room and the doctor doesn't, Berwick believes the patient should win. Here's his list of proposed reforms:
    (1) Hospitals would have no restrictions on visiting — no restrictions of place or time or person, except restrictions chosen by and under the control of each individual patient. (2) Patients would determine what food they eat and what clothes they wear in hospitals (to the extent that health status allows). (3) Patients and family members would participate in rounds. (4) Patients and families would participate in the design of health care processes and services.18 (5) Medical records would belong to patients. Clinicians, rather than patients, would need to have permission to gain access to them. (6) Shared decision-making technologies would be used universally. (7) Operating room schedules would conform to ideal queuing theory designs aimed at minimizing waiting time, rather than to the convenience of clinicians. (8) Patients physically capable of self-care would, in all situations, have the option to do it.
    "I suggest that we should without equivocation make patient-centeredness a primary quality dimension all its own, even when it does not contribute to the technical safety and effectiveness of care," he says.
    This view is traditionally associated with conservatives, not liberals. Liberals tend to believe that the doctor is, and should be, the primary decision maker, and so the way to reduce costs across the health-care system is to change the doctor's incentives, give her more information about the efficacy of treatments, give her fewer financial incentives to err on the side of expensive interventions rather than watchful waiting
    Berwick in his own words about his greatest fear....becoming a patient.

    An Extreme View
    I freely admit to extremism in my opinion of what patient-centered care ought
    to mean. I find the extremism in a specific location:my own heart. I fear to become
    a patient. Partly, that fear comes from what I know about technical hazards and
    lack of reliability in care. But errors and unreliability are not themain reasons that
    I fear that inevitable day on which I will become a patient. For, in fighting them, I
    am aligned with the good hearts and fine skills of my technical caregivers, and I
    can use my own wit to stand guard against them.
    What chillsmy bones is indignity. It is the loss of influence onwhat happens to
    me. It is the image of myself in a hospital gown, homogenized, anonymous, powerless,
    no longer myself. It is the sound of a young nurse calling me, “Donald,” which
    is a name I never use—it’s “Don,” or, for him or her, “Dr. Berwick.” It is the voice of
    the doctor saying, “We think…,” instead of, “I think…,” and thereby placing that
    small verbal wedge between himself as a person and myself as a person. It is the
    clerkwho tellsmywife to leavemy room, or me to leave hers,without asking ifwe
    want to be apart. Last month, a close friend called a clinic for her mammogram report
    and was told, “You have to come here;we don’t give that information out on
    the telephone.” She said, “It’s OK, you can tell me.” They said, “No, we can’t do
    that.” Of course, they “can” do that. They choose not to, and their choice trumps
    hers: period. That’swhat scares me: to bemade helpless beforemy time, to be made
    ignorant when I want to know, to be made to sit when I wish to stand, to be alone
    when I need to hold my wife’s hand, to eat what I do not wish to eat, to be named
    what I do not wish to be named, to be told when I wish to be asked, to be awoken
    when I wish to sleep.
    Call it patient-centeredness, but, I suggest, this is the core: it is that property of
    care that welcomes me to assert my humanity and my individuality. If we be healers,
    then I suggest that that is not a route to the point; it is the point.
    http://www.omnex.com/healthcare/link...th_Affairs.pdf

    The right wing's response to this appointment just confirms what I have known for years about the right: they know nothing about health care except to reduce it to the most politically expedient "death panel" verbiage and need to shut their traps for the good of the country.
    Last edited by davidra; 07/09/2010 at 08:44 AM.
  2. #2  
    Based on my observations.....I would argue that neither side of the political spectrum in the USA knows anything about delivering good health care to the entire population.
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  3.    #3  
    Quote Originally Posted by ryleyinstl View Post
    Based on my observations.....I would argue that neither side of the political spectrum in the USA knows anything about delivering good health care to the entire population.
    That's why it's especially important to have good people in the right jobs. The country is lucky they could get Berwick to do this. Being exposed to the dung from the right wing is the last thing he needs in his lifetime of excellence.
  4. KAM1138
    KAM1138's Avatar
    #4  
    An interesting question to ask would be what level of abject stupidity must one possess in order to believe that this entire health care "reform" movement isn't wholly, political. If one is so divorced from reality as to believe that politicians who created, fostered and now are claiming to "fix" the mess that is our health care system; and their political ideolog appointees, aren't RESPONSIBLE for politicizing health care, then that's a sad statement in itself. Beware of so-called "experts who are in blatant denial of reality.

    Once you realize that, it is much simpler to understand what an utter fraud the entire health care system (mainly how it is paid for that is) thanks to collusion, corruption, etc in both the government and insurance system, as well as with some doctors.

    The American people are the victims, and will remain so, but the real crime is to calling a political hack-job "reform" which insures that a solution will NEVER be obtained. Make no mistake--this "reform" is anything but. It is insuring that all of the systems that screw the consumer remain firmly in place. This appointee makes it very clear--it is nothing more than wealth redistribution--which is what opponents accurately stated from day one.

    There is no reform--there is only increasing government involvement in health care--an area they have no business being in at all. I am unable to understand how anyone could be so massively ignorant to believe that government involvement does not inherently lead to politicization. It's so painfully obvious and simple, yet apparently, well within the delusional mind's ability to ignore. It would be funny if it wasn't so pathetically awful.

    Whether it is this particular appointee, put into place by circumventing any approval process, or some other of a similar ilk really doesn't matter, and its about what one could expect from this administration. It doesn't matter--its all political and always has been. Nothing else matters to this administration. What's laughable is the attempt to paint someone's dislike of a blatant political move as political, as the problem. Again--rejection of reality and selective "reasoning" makes this very easy for some people.

    The Obama administration and Congress has succeeded like no other, since the Johnson administration in successfully merging politics and health care. I hope all of those responsible for bringing us this so-called "reform" receive their just punishment for perpetuating this massive fraud.

    Reasonable people must remember that actual reform could have been pursued, but it was not, and the reason is that this administration, and congress specifically chose their political ideology over actual reform.

    KAM
  5. #5  
    if Berwick has been the "most influential" in the last 15 years, then isn't the last 15 years of mess and decline his fault??
  6.    #6  
    Quote Originally Posted by KAM1138 View Post
    An interesting question to ask would be what level of abject stupidity must one possess in order to believe that this entire health care "reform" movement isn't wholly, political. If one is so divorced from reality as to believe that politicians who created, fostered and now are claiming to "fix" the mess that is our health care system; and their political ideolog appointees, aren't RESPONSIBLE for politicizing health care, then that's a sad statement in itself. Beware of so-called "experts who are in blatant denial of reality.

    Once you realize that, it is much simpler to understand what an utter fraud the entire health care system (mainly how it is paid for that is) thanks to collusion, corruption, etc in both the government and insurance system, as well as with some doctors.

    The American people are the victims, and will remain so, but the real crime is to calling a political hack-job "reform" which insures that a solution will NEVER be obtained. Make no mistake--this "reform" is anything but. It is insuring that all of the systems that screw the consumer remain firmly in place. This appointee makes it very clear--it is nothing more than wealth redistribution--which is what opponents accurately stated from day one.

    There is no reform--there is only increasing government involvement in health care--an area they have no business being in at all. I am unable to understand how anyone could be so massively ignorant to believe that government involvement does not inherently lead to politicization. It's so painfully obvious and simple, yet apparently, well within the delusional mind's ability to ignore. It would be funny if it wasn't so pathetically awful.

    Whether it is this particular appointee, put into place by circumventing any approval process, or some other of a similar ilk really doesn't matter, and its about what one could expect from this administration. It doesn't matter--its all political and always has been. Nothing else matters to this administration. What's laughable is the attempt to paint someone's dislike of a blatant political move as political, as the problem. Again--rejection of reality and selective "reasoning" makes this very easy for some people.

    The Obama administration and Congress has succeeded like no other, since the Johnson administration in successfully merging politics and health care. I hope all of those responsible for bringing us this so-called "reform" receive their just punishment for perpetuating this massive fraud.

    Reasonable people must remember that actual reform could have been pursued, but it was not, and the reason is that this administration, and congress specifically chose their political ideology over actual reform.

    KAM
    Actually, I wonder how little insight it requires to actually think that the "mess" of our health care system is the fault of the government. That vibrant free market of health care, that gave us such gems as Rick Scott, currently running for governor of Florida, who got HCA massive fines for fraud when he ran it, has been responsible for the destruction of high quality care. It's the profit motive, whether by hospitals, doctors, or insurers. That's exactly why Berwick is exactly the right person to run CMS. KAM appears to be in the Susan Lowden "barter for chickens" camp, but he he actually has more absurd ideas than that about how health care should be provided. The problem with all of the purported "direct pay" systems is the same as the problem with chicken bartering....it doesn't take into account the fact that we have an out of control expensive health care system. Why? Because we have emphasized heroic care, which is expensive, instead of emphasizing prevention. We emphasize pouring massive amounts of money into heroic end of life care to avoid pulling the plug on grandma when there's no evidence whatsoever that there is any benefit to the individual or to society. But those are my opinions. I differ with Berwick on a lot of points, but it's clear his emphasis is on the patient. The patient comes first, even if costs are not reduced. It would appear this would make sense to the right wing, but it doesn't. (Of course, to grasp that, you would actually have to read what was written in the post, which you clearly didn't. You simply rejected without addressing the point-the qualifications of the individual)

    Like it or not, we have wealth redistribution, and always have. It's what makes a country great. We take tax money and redistribute it to those that serve in the military. We take tax money and pay for interstate highways, paying generally blue-collar construction workers. We use tax money to provide Medicare for those that need it. The very definition of taxation is that money is redistributed. You just don't like how it's redistributed, and you think the rates are too high, when in fact they are too low, the lowest of almost any developed country.

    Perhaps someone would listen to you if you ever had specific realistic solutions to problems, but you don't. You have idealized irrational vague plans that would never pass the reality test. I'd just love to see someone actually try and implement your proposals. They'd be laughed out of town. Unfortunately, this is where we are, this is the situation we're in, and we need plans to do something about it now, not in some right wing fantasy world.
    Last edited by davidra; 07/09/2010 at 10:19 AM.
  7.    #7  
    Quote Originally Posted by Workerb33 View Post
    if Berwick has been the "most influential" in the last 15 years, then isn't the last 15 years of mess and decline his fault??
    His efforts have been toward patient safety and decreasing the number of preventable deaths each year. The degree of change in hospitals and physicians addressing patient safety concerns over the past ten years has been dramatically improved. One limiting factor has been the dramatic decrease in access to care. No, it's not his fault. In fact, improvements in some outcomes can be directly linked to the Institute for Healthcare Improvement's efforts. Given they are not associated with the government in any way, and are privately supported, they've done quite a bit in spite of opposition from those that favor the status quo.

    Every family wants the best care for an ill or injured family member. Most are grateful for the care and attention received. Yet, evidence in the National Scorecard on U.S. Health System Performance, 2008, shows that care typically falls far short of what is achievable. Quality of care is highly variable, and opportunities are routinely missed to prevent disease, disability, hospitalization, and mortality. Across 37 indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with benchmarks of best performance achieved internationally and within the United States.
    Even more troubling, the U.S. health system is on the wrong track. Overall, performance has not improved since the first National Scorecard was issued in 2006. Of greatest concern, access to health care has significantly declined. As of 2007, more than 75 million adults—42 percent of all adults ages 19 to 64—were either uninsured during the year or underinsured, up from 35 percent in 2003. At the same time, the U.S. failed to keep pace with gains in health outcomes achieved by the leading countries. The U.S. now ranks last out of 19 countries on a measure of mortality amenable to medical care, falling from 15th as other countries raised the bar on performance. Up to 101,000 fewer people would die prematurely if the U.S. could achieve leading, benchmark country rates.
    The exception to this overall trend occurred for quality metrics that have been the focus of national campaigns or public reporting. For example, a key patient safety measure—hospital standardized mortality ratios (HSMRs)—improved by 19 percent from 2000–2002 to 2004–2006. This sustained improvement followed widespread availability of risk-adjusted measures coupled with several high-profile local and national programs to improve hospital safety and reduce mortality. Hospitals are showing measurable improvement on basic treatment guidelines for which data are collected and reported nationally on federal Web sites. Rates of control of two common chronic conditions, diabetes and high blood pressure, have also improved significantly. These measures are publicly reported by health plans, and physician groups are increasingly rewarded for results in improving treatment of these conditions.

    Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008 - The Commonwealth Fund
  8. KAM1138
    KAM1138's Avatar
    #8  
    Quote Originally Posted by davidra View Post
    Perhaps someone would listen to you if you ever had specific realistic solutions to problems, but you don't.
    A testament to how short your memory is, or how irrational you are perhaps, because this is simply not true. Long ago I entered this discussion leading with specific ideas, which you responded to, not with any reasonable discourse, but irrational ideological blathering, insisting that anything that doesn't fit your political demands be ignored. I've learned a lot about how politically motivated hacks deal with things over the past year or so. Specifically, how people such as yourself seek to AVOID talking about solutions--not because they won't or can't work (although some would some would not), but because it doesn't fit your narrow, preconceived, politically motivated demands.

    Of course, I'm not an "expert" just a citizen who is tired of collusion between government and business, or direct government stupidity harming me. Of course, given that you have absolutely zero concept of our actual system of government as defined by our Constitution, I'm well aware that you do not understand a lot of these issues that motivate people like me. No matter.

    What I've learned is that this is the LAST thing that someone such as yourself would want to do, because it leads to people realizing that the "solutions" that are rammed down their throat aren't the only possibility. People might learn that government isn't the only answer, and that it was fully engaged in creating the problem. No, ideologues with political goals cannot tolerate any such honest discussion.

    That's why, you must, even now persist in lying by saying that people you disagree with don't have any ideas or solutions to discuss. That's what you're doing now--lying, which I've come to realize is just one of many dishonest tactics that people such as yourself are willing to engage in.

    Actually, I'm just responding to make it clear that I'm not intending to prompt any sort of response from you. Mainly, because it is meaningless to me for a number of reasons, which I'm not going to waste time explaining to you. I just want you to know that what you say is beyond meaningless. Not because you disagree with me, but because you've revealed exactly the sort of "thinking" that you adhere to.

    Rather, my best hope is that things I post might make rational people, who would otherwise be mislead by propaganda (like you decry, but regularly engage in) will look at a bigger picture and realize that the "reformers" are in fact major players in creating the problem. I know that is something you simply cannot comprehend, but again...you aren't my target.

    And in fact, no offense to the good people here at PreCentral, but this is a very small pond, and that's one of the reasons I've stopped spending time here, arguing with people dedicated to justifying harm and calling it help.

    However, I should thank you, as you've provided so many examples to use in illustrating the utter fraud of healthcare "reform" and its adherents--in other venues.

    In case, I haven't made myself abundantly clear, I have no interest in spending my time engaging you, because I've learned it isn't a good use of time to treat people who have no interest in honest discussion as if they do. I hope others realize this about you as well, and find more fruitful paths such as I have.

    KAM
  9. #9  
    Quote Originally Posted by ryleyinstl View Post
    Based on my observations.....I would argue that neither side of the political spectrum in the USA knows anything about delivering good health care to the entire population.

    I couldn't agree more.
    Last edited by windzilla; 07/09/2010 at 11:14 AM.
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  10.    #10  
    Please...by all means, enjoy your fruit. We've actually had some very reasonable discussions in your absence. I look forward to that continuing.
  11. #11  
    Quote Originally Posted by ryleyinstl View Post
    Based on my observations.....I would argue that neither side of the political spectrum in the USA knows anything about delivering good health care to the entire population.

    +1

    It doesn't take much sense, common or otherwise to realize that this new system will not be any more sustainable than the old.
  12. #12  
    Quote Originally Posted by cjgem View Post
    +1

    It doesn't take much sense, common or otherwise to realize that this new system will not be any more sustainable than the old.
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  13. solarus's Avatar
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    #13  
    Quote Originally Posted by tcrunner View Post
    Davidra; Doesn't this sound just a little ironically familiar?



    All they offer is contention, divisiveness, and no solutions (though every opportunity has been extended to be part of the solution). In response to pointing out this fact, their self-righteous, partisan outrage toward those who grasp the unsustainability of the economics involved with maintaining the status quo system as-is turns to just cheezy anti-Dem drivel. Any other group with such attributes would be defined as a peanut gallery and disregarded accordingly.
    I'm not going to blow smoke up for rear and claim the Republicans have put together a clear concise platform - they haven't. Like it or not the "Contract with America" was at least a plan the Republicans laid out for the people back in 1992. We haven't seen anything other than complaints in the last 18-24 months. That much we are in agreement with.

    But that doesn't mean their complaints aren't valid. The Democrats, like their Republican counterparts from 2000-2006 have spent money like its going out of style. A major complaint of the Tea Party is the spending of Congress. Now I disagree with some TP'ers that want a complete laissez-faire style economy but many other TP'ers just want money spent wisely. For example, spending money on repaving 20 miles of road that didn't need repaving (a local example near where I live) or a unnecessary war (a national issue) is a waste of money. We have serious problems to deal with yet most of the stimulus money went to pie in the sky projects or projects that have little impact long term. If you're gonna spend $700 billion of borrowed money (which I think was waaaaay too much to start with) why not spend it on the real infrastructure problems we have in the country - sewer systems, torn up highways, broken bridges, i.e. problems that will take quite some time to fix and keep people employed longer than a 60 day paving project.

    Calling the Democrats out on their drunken spending spree is quite responsible IMO. And yes, I agree, there is obviously some "my guys aren't in control" hypocrisy going one in the TP movement, but that is the nature of modern politics. The return on our dollars is simply not there with the current Congress.

    The Democrats in office right now, are for the most part, using valid issues that need to be addressed to push an agenda that is too far left for my liking. 1) First and foremost - there is a complete lack of realism when it comes to tax policy. You simply cannot have a productive society when the majority don't pay taxes. I'm not saying give "the rich" more tax cuts, simply acknowledge that everyone should bear some burden to contribute. The fact that almost 50% of people don't contribute is why the "wealth redistribution" issue, rightfully so, gets traction - b/c a soon to be minority pay 100% of the expense of running the country. Its basic fairness. 2) There seems to be no realistic view to the environmental problems we face - you can't switch over to green energy overnight, there are ways to address climate change without dramatically increasing the cost of everyone's energy bill - ex, put the focus on incentives for new fuels, not punishment for old fuels. Although I will give President Obama credit here in that he finally (just before the BP disaster) seemed to acknowledge this by allowing off shore drilling to expand. Follow it up with efficient and meaningful safety oversight now and we're golden. 3) Healthcare - there should be fall back provisions to ensure that the people that don't have access can get the care they need (yep you read that right - I will say to my conservative colleagues on the libertarian side of the party, not everything in life boils down to an economic transaction), but the health care bill that was passed does nothing to address the fundamental problem of healthcare in this country - the expense of the actual treatment, it only addressed or tried to, the cost of coverage. 3) Immigration - where's the real push for reform, hell, even GWB did more than Obama and Congress to push reform on this issue. Throwing a few troops to the border isn't enough - where's the comprehensive reform. Instead the administration is focused on Arizona instead of addressing the reasons, right or wrong, Arizona felt it need to pass the law in the first place. 4) Infrastructure - no talk of fixing our crumbling infrastructure anywhere, instead we get high speed rail lines in NV!! I could go on but I think you get the point.

    I should also point out that one Party saying to the other Party "we want you to contribute to a bill as long as you agree with the parts you have the most problems with" is not offering to work with the other Party, its a way of providing political cover by framing the opposition as do nothing'ers. Its a tried and true political tool that has been used by all sides for a very long time.
    Last edited by solarus; 07/09/2010 at 12:48 PM.
  14. #14  
    Quote Originally Posted by davidra View Post
    Like it or not, we have wealth redistribution, and always have. It's what makes a country great. We take tax money and redistribute it to those that serve in the military. We take tax money and pay for interstate highways, paying generally blue-collar construction workers. We use tax money to provide Medicare for those that need it. The very definition of taxation is that money is redistributed. You just don't like how it's redistributed, and you think the rates are too high, when in fact they are too low, the lowest of almost any developed country.
    I would guess that many Americans (myself included) are fine with the redistribution of wealth if that means the wealthy people receive a smaller return on the tax dollars paid in then the blue collar and poorer people. I think the sticking point revolves around the concept of "redistribution of wealth with no pre-conditions". It doesn't bother me if a person earns very little at their job, pays very little taxes, yet receives an unbalanced share of tax dollars in the form of social services and tax returns -- so long as that person is contributing to our society and the very system that supports them. The lowest form of work is still work, and I think those people earn what they receive from our government, just like you and I. It's that percentage of the population that live off the system with no intentions to contribute anything, and expect free health insurance, free money (welfare), free education (public schools), free food and shelter (social programs too numerous to mention), and top it all off by complaining about a government system that doesn't do enough and vote for politicians that promise them more. It's this segment of our population that makes "redistribution of wealth" hard to stomach. What you described in your post, regarding how tax dollars are re-allocated to much-needed government programs such as medicare, interstate highways, and the military, doesn't bother me a bit, and I'm a pretty fiscally conservative person.
    Last edited by joshaccount; 07/09/2010 at 12:55 PM.
  15. #15  
    Quote Originally Posted by solarus View Post
    First and foremost - there is a complete lack of realism when it comes to tax policy. You simply cannot have a productive society when the majority don't pay taxes. I'm not saying give "the rich" more tax cuts, simply acknowledge that everyone should bear some burden to contribute. The fact that almost 50% of people don't contribute is why the "wealth redistribution" issue, rightfully so, gets traction - b/c a soon to be minority pay 100% of the expense of running the country. Its basic fairness.
    I'm not sure about the data, but we seem to have made a similar point, although I like yours better.
  16. #16  
    Quote Originally Posted by joshaccount View Post
    I would guess that many Americans (myself included) are fine with the redistribution of wealth if that means the wealthy people receive a smaller return on the tax dollars paid in then the blue collar and poorer people. I think the sticking point revolves around the concept of "redistribution of wealth with no pre-conditions". It doesn't bother me if a person earns very little at their job, pays very little taxes, yet receives an unbalanced share of tax dollars in the form of social services and tax returns -- so long as that person is contributing to our society and the very system that supports them. The lowest form of work is still work, and I think those people earn what they receive from our government, just like you and I. It's that percentage of the population that live off the system with no intentions to contribute anything, and expect free health insurance, free money (welfare), free education (public schools), free food and shelter (social programs too numerous to mention), and top it all off by complaining about a government system that doesn't do enough and vote for politicians that promise them more. It's this segment of our population that makes "redistribution of wealth" hard to stomach. What you described in your post, regarding how tax dollars are re-allocated to much-needed government programs such as medicare, interstate highways, and the military, doesn't bother me a bit, and I'm a pretty fiscally conservative person.
    There will always be the "leachers" in any society. It is a fact of life. The phrase "and the rich get richer" is true. The top 1% or so controls a large majority of the wealth in our country. The wealth distribution is only get more polarized and eventually it will be the downfall of us if we dont control it. You cant have 50% of America that cant make a living on blue-collar jobs and then have people with an absolutely ridiculous amount of money that they'll never reasonably need. Im not talking about anyone in the 10's of millions area. I'm talking about 100's of millions. These people pay a very small percentage of their total wealth in taxes, with a lot of them pay NONE. This is not right.

    In your mind, these "leachers" are living a good life. Do you honestly believe that? If someone is on Medicare, their standard of living is terrible. Noone wants to be that person, they fall into that life as a mistake or lack of knowledge. These people aren't getting a "free ride"..they're living in the dumps and we're giving them the most basic means for a pitiful existence. thats the fact.
  17. #17  
    Quote Originally Posted by EVOandBACK View Post
    There will always be the "leachers" in any society. It is a fact of life. The phrase "and the rich get richer" is true. The top 1% or so controls a large majority of the wealth in our country. The wealth distribution is only get more polarized and eventually it will be the downfall of us if we dont control it. You cant have 50% of America that cant make a living on blue-collar jobs and then have people with an absolutely ridiculous amount of money that they'll never reasonably need. Im not talking about anyone in the 10's of millions area. I'm talking about 100's of millions. These people pay a very small percentage of their total wealth in taxes, with a lot of them pay NONE. This is not right.
    Hopefully everyone realizes that more than 50% of Americans pay ZERO income taxes, right? That's more than HALF of us. At what percentile does it become leaching? 30%, 20%? Just curious.

    BTW, please highlight that statement joahaccount made about being fine with redistribution of wealth... and then look up which forms of government promote that concept... I think you will find that 100% of those that are "fine" with redistribution are also in the 50% that aren't paying taxes. Holy Crap!

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  18. #18  
    Quote Originally Posted by EVOandBACK View Post
    There will always be the "leachers" in any society. It is a fact of life.
    I am in complete agreement, these people will never completely go away. My point is that we should not be subsidizing the "leaching" behavior. Our social services system rewards those who don't contribute (many free services) and penalize those who do (the more you earn, the more you pay, the less you receive in the above mentioned social services). So I do not feel for the leachers nor do I think we should carry them financially; although I do feel badly for their children.

    Quote Originally Posted by EVOandBACK View Post
    The phrase "and the rich get richer" is true. The top 1% or so controls a large majority of the wealth in our country.
    I agree again, yet this same 1% pay the most in taxes per wage earner and receive the least in social services. But as you say, when you have obscene amounts of money, it probably doesn't matter.


    Quote Originally Posted by EVOandBACK View Post
    In your mind, these "leachers" are living a good life. Do you honestly believe that? If someone is on Medicare, their standard of living is terrible. Noone wants to be that person, they fall into that life as a mistake or lack of knowledge. These people aren't getting a "free ride"..they're living in the dumps and we're giving them the most basic means for a pitiful existence. thats the fact.
    Not necessary to tell me whats in my mind. I'm in public health, acutely aware of the issue, and realize its not exactly "a good life". I believe you are correct when you say "no one wants to be that person", but in my work I see a conscious decision made by millions of people. If you are "that person", you typically have two choices: Do nothing, subsist on the system as it is, and live "in the dumps" as you describe it...or...you can stand up, dust yourself off, find a low-paying often minimum wage job, find a way to put your kids in daycare while you work, put in 40-60 hours a week to pay all of your bills, and still live "in the dumps" much the same way you lived before you found the job. So you can see here, and theories such as the health belief model and theory of reasoned action show this to be true, how and why many people would choose to be a "leacher" versus a working contributor.
  19. Micael's Avatar
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    If he's such "the cat's meow" to healthcare, why slip him in past the senate confirmation process like a thief in the night?

    This is a case of Obama "playing politics", not the right. Nice spin.
    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
    If he's such "the cat's meow" to healthcare, why slip him in past the senate confirmation process like a thief in the night?

    This is a case of Obama "playing politics", not the right. Nice spin.
    Oh, snap! Micael scores!

    As I mentioned before, if this guy was a major influence for the last 15 years, then he must be to blame for the mess we have accumulated over the lat 10-15 years.
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