quote:Originally posted by The Pixiest: But the hard working middle class and upper classes who are there because they scrimped and saved and worked for it should not be looted to pay for those unwilling to do the work.
To put it mildly, you disgust me. When and how did you become such a hatefully arrogant person? Because I really hadn't seen any indication of this kind of petty selfishness and misanthropy from you before this issue came up. Now it's written all over everything you say.
I think it would be more useful to the debate to point out WHY Ayn Rand is NOT to be taken seriously and focus on the discussion as to why it is ethical for those with more to care for the those with less. Could be wrong but I think Utilitarianism I think may provide some of the better thoughtout arguments.
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quote:Originally posted by kmbboots: Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).
A favorite of mine, too. [Even if we know it's not J Rawls!]:
quote:As a thought experiment, the original position is a hypothetical designed to accurately reflect what principles of justice would be manifest in a society premised on free and fair cooperation between citizens, including respect for liberty, and an interest in reciprocity.
In the state of nature, it might be argued that certain persons (the strong and talented) would be able to coerce others (the weak and disabled) by virtue of the fact that the stronger and more talented would fare better in the state of nature. This coercion is sometimes thought to invalidate any contractual arrangement occurring in the state of nature. In the original position, however, representatives of citizens are placed behind a "veil of ignorance", depriving the representatives of information about the individuating characteristics of the citizens they represent. Thus, the representative parties would be unaware of the talents and abilities, ethnicity and gender, religion or belief system of the citizens they represent. As a result, they lack the information with which to threaten their fellows and thus invalidate the social contract they are attempting to agree to.
posted
It may not be in the bill, but the President himself has raised the possibility of a panel deciding what will and won't be given.
quote:Folks who really want to stick it to Obama and sow hysteria about "death panels" will extract this from Obama's same fateful interview with David Leonhardt of the Times (my emphasis):
THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?
I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
DAVID LEONHARDT: So how do you — how do we deal with it?
THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.
So Obama "suspects" that the legislative process will produce some sort of independent group that can give non-determinative "guidance" on end-of-life care for the chronically ill, with an eye towards saving money. Just don't call them death panels!
And there you have it. An independent group set up find ways of saving money. Brilliant. It's 1984! It's 1984! There are independent groups! It's not determinative! A single line in an interview that is not concerning actual litigation is more telling than everything discussed within that litigation or by the countless legislators and officials who mght preside over that system, NOT TO MENTION THE VOTERS! FUR RLZZ> OH NOOZZZ WE HAZ TEH DEPTH PANULLZZZZ!!!
posted
do you mean "legislation" there where you wrote "litigation", Orincoro?
I think Obama was only stating the obvious: when you have a limited pool of resources, something/somebody will have to decide where to allocate them. So what? Would it be better if he publicly fantasized that everyone will get the equivalent of millions of dollars worth of care for as long as they care to continue receiving it?
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quote:Originally posted by ClaudiaTherese: Oops, just saw Rawls was already suggested and declined.
Was on a dying computer and missed it -- ah well. Still, good to jog my memory. I like Rawls.
I like him too.
The only time I've heard him referenced in a nonacademic medium was the West Wing when Will Bailey was trying to justify the tax increase on the wealthy to his interns. Perhaps that's where you've heard it?
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quote:Originally posted by scifibum: do you mean "legislation" there where you wrote "litigation", Orincoro?
I think Obama was only stating the obvious: when you have a limited pool of resources, something/somebody will have to decide where to allocate them. So what? Would it be better if he publicly fantasized that everyone will get the equivalent of millions of dollars worth of care for as long as they care to continue receiving it?
Should we also fool ourselves into believing that the equivalent doesn't *already exist* in the private sector?
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posted
Could have been. Could have been on a T-shirt. It likely was Rawls or Rawls-derived. I just didn't know it was Rawls.
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posted
I didn't expect you to acknowledge the plausibility of it, Orincoro. Goodness knows people will lie to themselves to an amazing degree in order to keep thinking well of themselves.
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posted
The President raised the possibility of a panel deciding what will and won't be given when he specifically said such a panel wouldn't decide what will and won't be given?
quote:And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance.
And there you have it. An independent group set up find ways of saving money. Brilliant. It's 1984! It's 1984! There are independent groups! It's not determinative! A single line in an interview that is not concerning actual litigation is more telling than everything discussed within that litigation or by the countless legislators and officials who mght preside over that system, NOT TO MENTION THE VOTERS! FUR RLZZ> OH NOOZZZ WE HAZ TEH DEPTH PANULLZZZZ!!!
(edit: I'm Srsly)
you spend too much time on Encyclopedia Dramatica.
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quote:Originally posted by FlyingCow: Well, first off, the current bill on the table is not the same as Universal Health Care. It is creating a parallel government-run option alongside existing insurance companies - much like the tax-subsidized US postal service exists in a world with FedEx and UPS.
Is now a good time to point out that the post office is millions in debt? </tongue in cheek> I'm only nervous about the government option in conjunction with the universal insurance requirement. Telling people they have to buy insurance when you know the only plan they can afford is yours is conflict of interest. I much prefer the non-profit idea I'd heard floated around. But I work for a credit union, so I'm biased towards the non-profit approach.
quote: Though I think the regulatory changes that would be needed to "fix" the current system and wrangle the existing insurance companies would be such top-down pressure that it would be as though the government was in charge of all the insurance companies.
I suppose that depends on what it would take the insurance companies and doctors to renegotiate. If they won't do it without government pressure, than I suppose the market has left us no choice and it's corporate Darwinism at work. But maybe they just need a few incentives. Maybe groups that negotiate better prices for doctors that coordinate care and promote wellness could get a spiffy tax break or grant dollars. I guess I'm not convinced we need the stick yet when a carrot might suffice - and doesn't seem to have been tried.
quote: You would need to force the insurance companies to do things like taking customers they don't want to insure, raising costs on healthy customers evenly, forcing a tiered payment structure among all companies to enforce fairness, etc.
Right now, the insurance companies seem willing to agree to take pre-existing conditions if everyone has to buy insurance. While many boards and CEOs are probably happy to fiddle while Rome burns, I do think enough want to save the industry and ensure future profits to make some changes. What we could really use is a way of telling one group from the other and encouraging HR departments everywhere to only use the latter. Enough money changing hands might be all it takes to ensure the system we want to see.
quote: I don't know if all of those things are even constitutional.
Well, that's a different problem. I'm not sure how we'd know until we tried it. I suppose it'd be FDR all over again. Keep putting something out there until something sticks.
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posted
Kath, that quote from the President is suggesting an independent group of ethicists, scientists, and doctors to help determine where we should and should not draw the lines on coverage. It won't say, "You can't have that procedure" only "we can't pay for it." Other options from donations to private pay would be available. The panel are to recommend, with no enforcement listed.
Do you see why claiming that is a "Death Panel that would kill my Down Syndrome Baby" is a lie?
Do you see that such panels exist now, but without the ethicist, the public oversight, or the independent doctors--but with the accountants and bean counters who are determining profits.
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quote:Originally posted by katharina: I didn't expect you to acknowledge the plausibility of it, Orincoro. Goodness knows people will lie to themselves to an amazing degree in order to keep thinking well of themselves.
I didn't expect you to have any real sense of proportion. And you don't!
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quote:Originally posted by The Pixiest: The government never does things better or cheaper.
This is completely untrue and is the second startlingly untrue statement which you have based your opposition to UHC upon.
Your conclusions are broken because they follow from very bad premises such as that one,
quote:the government is a monopoly with no incentive to reduce waste.
that one,
quote:It is absolutely INSANE to think that the government can handle this more efficiently than the private sector.
that one (especially considering that this apparently 'insane' notion is actually strongly evidenced by every single other high-income nation on earth and that a case directly rebutting your statement is presented in this very thread), etc
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posted
I read this on AARP's website and it is pretty interesting to me. AARP
quote: HOW IT'S PAID FOR: Revenue-raisers include: $544 billion from a new income tax surcharge on single people making $280,000 a year and households making $350,000 and above; $37 billion in other tax adjustments. About $500 billion in cuts to Medicare and Medicaid. About $200 billion from penalties paid by individuals and employers who don't obtain coverage.
Those numbers seem very optimistic to me. The $200 billion from penalties is a little frightening as well.
quote: REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.
So if you fail to have health insurance for a day you are penalized for it? Now I see how they can raise $200 billion in tax penalties. From HR2300:
quote: SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
`(a) Tax Imposed- In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of--
`(1) the taxpayer's modified adjusted gross income for the taxable year, over
`(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.
This is from the AARP website:
quote: REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt.
I find this to be a little misleading. If I reading the bill correctly, Employers, on a sliding scale up from $250,000, MUST pay 8%. If you choose not to have health insurance from your employer (ie. covered by spouse's insurance) then your company, depending on payroll, must pay an average payroll amount of 8% to the Health Insurance Exchange Trust Fund. So even though you are covered by health insurance you are still going to lose a percentage of your salary to pay for health care. The exact percentage could be higher than 8% unless your employers spreads the tax across all employees.
quote: SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
(a) In General- A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution--
(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and
(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.
quote:Originally posted by The Pixiest: boots, dear, we work for it, we save it, we don't frivolously blow it, we don't spend it on meth, alcohol or other drugs, we don't commit crimes and go to prison, we plan for the future, we skip fun things that are too expensive...
Our wealth is ours because we're responsible. To take it away for those who do not do all those things is downright evil. Further it rewards laziness, drug use, crime and frivolous wastes of money. Simply because there's no reason to work hard and be frugal.
This is the heart of the libertarian philosophy -- that those who have many have (generally) earned it and those who haven't have (generally) done something wrong. It's the part that sounds nice on paper. Unfortunately, in real life I have seen no such clear breakdown of who has wealth and who doesn't based on level of responsibility. Even though we theoretically live in a society with "equal opportunity" the vast majority of us end up in approximately the same social class as our parents. We have approximately the same opportunities they did. Knowing the right person still is a better way to get a job than actually being competent. Plenty of people who have middle class jobs are useless and weigh their company down and plenty of them don't get fired because they go out to lunch with the boss and know how to brown nose. My father has a government job and calls it "welfare for the middle class" because of all the people who do nothing and yet earn a paycheck.
I had more thoughts but I gotta go...
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posted
Part of the challenge is that it actually IS more profitable for society to help people be well, but most folks (including those In Charge) want immediate results. There's a cultural challenge. In order for long-term prosperity, people in the short term have to see how their small actions contribute to the whole picture. For instance, people are discovering that small actions like reusing bags at the grocery store and turning off the lights can help everyone be better off in the long run. But it is a little late, considering the Big Picture, to stop or reverse climate change. We're in the midst of it, and the best we can hope for is mitigation. I think the same thing is happening with health care. Our population is huge, and resources are limited. Regardless of wealth distribution, some people are GOING TO DIE from not being able to access the care they need when they need it. The difficult decisions must be made. The question is, who will be put in the position to make those decisions? Government, medical professionals, insurance company executives, families, or individuals? Personally, I think that each individual capable of making a decision should have as much control over his or her health decisions as possible.
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Blayne Bradley
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Hahahahahahhahaha! Glenn Beck is funny! Hes saying your about to lose the best healthcare system in the world YET 16 months ago he was talking about how terrible the US system is.
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Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart. Posts: 11187 | Registered: Sep 2005
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quote:Originally posted by Christine: Even though we theoretically live in a society with "equal opportunity" the vast majority of us end up in approximately the same social class as our parents. We have approximately the same opportunities they did. Knowing the right person still is a better way to get a job than actually being competent.
As a total aside, I find it interesting to be the product of one parent who lived in low class poverty, and another parent who grew up in what 1950's California would have termed upper middle class surroundings. I suppose if you do the math, I should statistically be driven towards the middle, and what's even more interesting is that my parents encourage all of their children in their higher education pursuits, *none* of which was in what could be called a money making field of study.
That said, I'm slightly ashamed to admit that I could probably get myself on the staff of a couple of different US Senators and Representatives through family connections. I probably would have had to pursue a different course in college, but it would have been doable. I won't, for a lot of reasons, but I could were I inclined to. I think Pix or Kat would have a hard time disagreeing with the idea that I probably wouldn't be the best person for that job, and yet I know I could get it.
In regards to what you've said Christine, I entirely agree. The theory is nice sounding, but is completely blown away in practice. It's also far too anarchistic and barbarian for my personal sensibilities. It's really never outside the realm of possibility for anyone to lose everything they have, no matter how careful and diligent and honest and hard working they've been. You could be framed for a murder tomorrow, or struck with an incredibly expensive disease, and be completely devastated by it, financially and emotionally. Would that be your fault? Would you be to blame for the murder and the disease because you didn't live in such a way that such a thing would never happen to you in any circumstances? Or are you willing to roll the dice in life just for the chance of getting ahead partly on luck, and then slamming the door on those who never got the least bit lucky?
Pix, you've suffered from depression right? Somebody helped you to get over that, didn't they? In your head, did that person do so in order solely to profit from your successful treatment? Had you been stuck in the hands of an incompetent person, or a person who had betrayed your trust, would you have been at fault for that, in the condition you were in? At what point did your personal responsibility for the turnout end? Or has no one ever helped you, not really, in anything in your life?
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quote:Originally posted by kmbboots: Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart.
The guy has started naming threads after TV Tropes topics, so I think we're not seeing any attempt at subtlety here.
Which is fine with me- Blayne's gotten funnier since he started reading a little more widely.
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Blayne Bradley
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quote:Originally posted by Orincoro:
quote:Originally posted by kmbboots: Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart.
The guy has started naming threads after TV Tropes topics, so I think we're not seeing any attempt at subtlety here.
Which is fine with me- Blayne's gotten funnier since he started reading a little more widely.
posted
I'm just teasing you, Blayne. I watch Jon Stewart, too.
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Blayne Bradley
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I know, but I'm curious which posts were funnier then usual so i can determine if they were intentionally funny or unintentionally funny
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I don't know really, you're just not trying to be funny in the way that wasn't funny before, and thus are naturally funny rather than simply having no one get it. That and you're reading TV Tropes, which is a bottomless bag of funny, so you're just absorbing the mojo.
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posted
So, between Sibelius' CBS interview (where she suggested the public option wasn't essential), Obama's statement in Colorado that it was "just a sliver" of necessary reform, and Sen. Conrad's statement that he wouldn't vote for any bill containing a public option, it seems the public option is dying in the dog days of August (Howard Dean notwithstanding). The Baucus-Conrad co-op compromise seems to be gaining momentum as the most likely structural mechanism for implementing reform.
Now if we could just couple that with Sen. Wyden's Healthy Americans Act, Peter Orzag's IMAC panel, and some rational tort reform to contain defensive medicine costs and I think we'd have a bill that would 1) maintain significant individual autonomy over care 2) provide universal health insurance and 3) decrease the overall amount spent on healthcare in the US.
<edit>I thought the IMAC panel would review the Medicare prescription drug costs; turns out I was wrong. The CBO found the IMAC panel wouldn't significantly impact health costs. What really is needed is for Obama to fulfill his campaign promise to setup a review of drug costs under medicare. Unfortunately, he evidently promised a lobbyist that he wouldn't (in exchange for industry support of the current reform plans). What we need is IMAC, but with a review not only of procedures and fraud cases, but also of the Medicare drug plan. While IMAC as currently stood up would only save $2 billion over the next decade (according to the CBO analysis), the drug review could save as much as 100 times that much (according to candidate Obama's estimate, based on an Institute for America's Future study).</edit>
<edit2>And I should have included electronic medical records (preferably that could travel with the individual on a smart card) as part of the "good idea" plan above. I believe there were some funds within the ARRA to do that, and maybe that was sufficient; but if not, it should be more fully funded.</edit2>
quote: So Conrad has come up with an alternative: public cooperatives. These non-profit groups, run similarly to rural electric co-ops would be given several billion dollars of government money to get started and would -- in theory -- compete with insurance companies to offer better and cheaper medical coverage.
As long as everyone gets covered at affordable rates, I'll be happy.
(And that means I would also be in favor of government subsidies for people who still can't afford whatever options are out there.)
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Blayne Bradley
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posted
Ultimately reasons n+x to not live in the united states unless your making 6 figure.
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quote:Originally posted by Katarain: (And that means I would also be in favor of government subsidies for people who still can't afford whatever options are out there.)
Such subsidies (up to 400% of poverty level) are a part of Sen. Wyden's plan. He essentially funds them by repealing the employer tax <edit>deduction</edit>. Repealing the tax <edit>deduction</edit> is anathema to unions which is why his plan has caught a lot of flak from the Democratic establishment.
posted
Here's an interesting New Yorker article (linked to in the Slate article from the last post) by a cancer surgeon on the pragmatics of health-care reform. The central premise is that any transformation of the health care system needs to be based around small increments from the current state. Any broad-based change (like a shift to single-payer overnight) is likely to disrupt the system and incur significant transaction costs (like, for instance, lives lost due to paperwork requirements). He points out that of the several nations with UHC, none of them do it exactly the same, and all of them built their particular form of coverage on whatever underlying health care structure already existed.
The author cites Massachusetts' program as one that achieves quality care, on an arc toward universality, while not significantly disrupting the system. He does ding the MA solution, though, for not appropriately reining in costs, and for failing to anticipate the growth in demand for subsidies as people lost their jobs in the recent downturn.
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posted
One note I have heard often recently, though I don't know its validity (Senators were shouting it.) The majority of Health Care Bankruptcies in the US are from people who have health insurance.
Between large co-pays (20% of $1,000,000 is still a lot of money.), Deductibles, and hidden costs--even with insurance in this system, a major illness strips you of everything.
Posts: 1941 | Registered: Feb 2003
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quote:Originally posted by SenojRetep: Here's an interesting New Yorker article (linked to in the Slate article from the last post) by a cancer surgeon on the pragmatics of health-care reform. The central premise is that any transformation of the health care system needs to be based around small increments from the current state.
What a great article, Senoj. I loved the history of how other countries came to have their systems. I think he's right. I don't think any of those systems would work best for us since we're not in the same situation as any of those countries were.
If the non-profit insurance groups get founded, I wonder if they could carry good insurance plans for just a few months at a better price than Cobra. That might take some of the pressure off people who change jobs, especially if the pre-existing conditions exclusions are outlawed. I agree with the Slate article that employer based coverage leaves something to be desired, but that might be a small fix to keep it relevant.
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The G.O.P. has realized they can no longer filibuster and they are as we speak moving the goalposts.
quote:Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."
quote:Well, we're talking about one sixth of the American economy. This is a pretty important thing. And I always look at bipartisan bills as somewhere between 75 and 80 votes, both Democrats and Republicans. And one reason why I decided to leave the group of seven is because -- well, there were a number of reasons. Number one, I don't think they've given Senator -- the Democrats have given Senator Baucus very good flexibility to really be able to put something together. Eighty of the top Democrats in the House are insisting upon a government option or a government plan. I can't be for that, and I don't think -- I don't know of any Republican who is really for that.
quote:As the senior Republican on the Finance Committee, Grassley has the potential to attract GOP votes by giving his blessing to a bill, and congressional Democrats and the White House consider him the key to winning bipartisan support for President Obama's top domestic priority. In recent days, however, some Democrats have accused Grassley of trying to undermine the reform effort, for example by refusing to debunk rumors that the Democratic health bills would create "death panels" empowered to decide whether the infirm live or die.
On Wednesday, he denied those claims and fired back at Obama, saying the president should publicly state his willingness to sign a bill without a controversial government-run insurance plan. Such a statement, he said, is "pretty important . . . if you're really interested in a bipartisan bill."
"It's not about getting a lot of Republicans. It's about getting a lot of Democrats and Republicans," Grassley said. "We ought to be focusing on getting 80 votes."
I was not expecting unfilibusterability for this reform bill currently? What's going on? The news has been all about the townhalls and the invective, so color me confused as to why it's translated into a worse situation for the GOP.
Is this temporary, or is this bill going to go down painlessly on a party line vote?
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The Republicans have seen this and are now crying for bipartisanship, but as Nate Silver pointed out at 538 today, they have no real interest in bipartisanship with their complete rejection of the co-op proposal as an alternative to the public option. They didn't even give the impression of wanting to compromise. I think that the Democrats are finally wising up and realizing that the Republicans aren't interested in being constructive with health care reform. They just let the misinformation go floating around without unequivocal rejection. By letting lies go uncontested, the democrats and Obama have been losing points in favorability, so why should they stop a good thing for them politically? They're being obstructionists, so the democrats are saying, in slightly more diplomatic terms, "We tried to be nice, but screw you."
Nate Silver thinks this is a bluff, and I think it could very well be. Either way, it is somewhat changing the tides for the moment.
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quote:Originally posted by Vadon: The Republicans have seen this and are now crying for bipartisanship, but as Nate Silver pointed out at 538 today, they have no real interest in bipartisanship with their complete rejection of the co-op proposal as an alternative to the public option. They didn't even give the impression of wanting to compromise.
They did give the impression of wanting to compromise. It was just false. This is because they have no strategic option besides stonewalling any health care reform. If health care reform works, they lose.
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posted
I don't get why being opposed to the current bills means you are against healthcare reform? To make a blanket statement against Democrats like the ones being made against Republicans...this means Democrats are in favor of imposing a tax penalty of 2.5% of your yearly income for being without health insurance for a single day. Is that really what you want? Change jobs and most likely have to pay a whopping penalty because you went without health insurance for a day? How about this scenario...a married couple both work, both companies provide health insurance but the plan for the wife is much better than the plan offered by the husband's company. The husband declines the health care from his company (he is covered by his wife's) and is given $1000 (This is true where I work although YMMV.) Under Obama's plan the husband's company would have to pay 8% of the average pay in his company to the government even though the husband has health insurance. Not 8% of the husband's pay, but 8% of the average pay.... Is this really what you want?
Posts: 1918 | Registered: Mar 2005
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quote:Originally posted by DarkKnight: Is that really what you want? Change jobs and most likely have to pay a whopping penalty because you went without health insurance for a day?
Why are you so confident that this exact language will be preserved in the final bill, or that should it happen this way, there will not be legislation undertaken to amend such an unfair policy? I mean, I'm against this particular picayune, but it's not a deal breaker for me at all. I believe if this were the only sticking point, congress would be able to smooth it out fairly easily.
See, it's not that I think being against this bill means you are against any reform, but the people against this bill are sure *acting* as if they are against *any* type of reform. What you're pointing out is important, but in what way is this one point a deal breaker, or something you think couldn't or wouldn't be resolved? Do you believe legislation can actually be passed on anything without us having to go back in time and fix things like this so that they work better? Do you think all legislation, no matter how important, should be held up until there is no objection to any fine point? Honest question: how do you think this is a different case from the myriad legislation congress deals with every session?
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quote: Why are you so confident that this exact language will be preserved in the final bill, or that should it happen this way, there will not be legislation undertaken to amend such an unfair policy? I mean, I'm against this particular picayune, but it's not a deal breaker for me at all. I believe if this were the only sticking point, congress would be able to smooth it out fairly easily.
Except that they are not and they plan on $200 BILLION coming from tax penalties against individuals and employers...so how do you remove that and not come up $200 billion short?
quote: What you're pointing out is important, but in what way is this one point a deal breaker, or something you think couldn't or wouldn't be resolved?
It is a deal breaker to me because I am sure the are other small sentences in the bill that are just like that one.
quote: Do you believe legislation can actually be passed on anything without us having to go back in time and fix things like this so that they work better?
Irrelevant point. The issue is not whether this particular bill just needs to be tweaked slightly or not. The issue is that they are trying to tackle a gigantic complex issue in one massive plan which is bound to fail because of unintended consequences. Instead let's do it many smaller steps instead of one big overall sweeping massive reform. Focus on getting people without health insurance coverage first. Start with the people who are eligible for Medicaid but don't have it and get them enrolled. A possible way to do that would be to start at where people without health insurance go to get health care. If you can't pay, you get treated first, and then you are referred to a caseworker who can see if you are one of the millions who are eligible for Medicaid or other government assistance. In the end, the provider can get paid if the individual is supposed to be covered. In another bill, we can work with health insurance companies to provide a low cost catastrophic care plan to young people who are healthy and people who make enough money to have health insurance but choose not to have it. Work on getting electronic records passed as well. These are just smaller first steps which would be much easier to get passed.
quote: Do you think all legislation, no matter how important, should be held up until there is no objection to any fine point?
This is the same question you asked before.
quote: Honest question: how do you think this is a different case from the myriad legislation congress deals with every session?
Honest answer: The Cash for Clunkers program should have been a simple easily run program yet is far behind in payments and is managed terribly. The government couldn't deal with a small, popular, billion dollar program yet they are going to perform well with a gigantic trillion dollar plus program? Start small. Keep going forward but allow the changes you made to take place before you keep throwing changes at a massive system. Sure it will take time but it has a much better chance of being done right
Posts: 1918 | Registered: Mar 2005
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quote:Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."
"A supermajority is not enough! Your legislation doesn't truly have the public's support unless a superdupermajority voted for it!"
Posts: 15421 | Registered: Aug 2005
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quote:Originally posted by DarkKnight: Start small. Keep going forward but allow the changes you made to take place before you keep throwing changes at a massive system. Sure it will take time but it has a much better chance of being done right
You are perfectly aware of the political ramifications of either slowing or hurrying the process. In an ideal situation, yes, the administration could afford to enact reform on a longer time scale. However, I'm not entirely sure that would ever work. The pace of reform has raised the collective blood pressure in Washington, but it's also made public and in the open a lot of the handwaving done about reform by conservatives. Given a longer time frame, I would expect conservatives to simply have more time to stonewall and win smaller victories against reform, whereas doing this all at once, in the broad daylight with all eyes focused on the prize, certainly catches public attention and shows people that there is a debate going on, and encourages them to join it. Do you think we'd be discussing this with any vigor if it were yet another of dozens of bills passed slowly over years, for which either party had plenty of time to invent rationales for failure or handwaving dismissals of success?
As Tom said a ways back, we've been waiting 30 years for reform, and in the meantime thousands of people die every year, needlessly, at the hands of a morally corrupt insurance system. I don't want this process to be done when I'm 50, and I think if we try to do it that way, it will never happen.
Posts: 9912 | Registered: Nov 2005
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posted
There will also necessarily be jumps in reform which cannot be small, such as the inevitable leap towards universal coverage. And I will reiterate that universal coverage will happen; it's only a matter of time.
This is a perfect example of a scenario in which it is worse, policywise, to 'slowly' expand coverage, like if we were to progressively lower the age of medicare enrollment and progressively expand the extent of medicaid coverage. It would expand costs associated with increased coverage but the system would still leave a bulk of our working populace uncovered, so that nothing is being done about their health which centrally allows us to gain access to the overall improvements in quality of life, economic benefits, and reduction in cost that uhc systems provide.
These 'small changes' would be tantamount to looking again at a structure with a weak foundation and attempting to solve that problem by asking "so how many floors should we add to it?"
You don't do this. You go for the big change. You demolish the structure and build the new kind that works so well that every other block in the city has it.
This isn't to say that "many smaller steps instead of one big overall sweeping massive reform" doesn't have its place. I, myself, certainly wished the G.O.P. had chanced upon the idea that this logic should also apply when it comes to their own plans as well, such as the Patriot Act.
Posts: 15421 | Registered: Aug 2005
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For pages and in threads the Pro-Obama care people have asked for rational debate, not name calling, screaming, or panic.
You offered it, and it seems that some folks try push you off with--"That doesn't matter" or "Its politics"
You have a good point. There will be a fine system for being un-insured. You go without insurance, you pay a fine.
The bill does not make clear if there will be a grace period to allow you to shop and get the insurance that best suits you, or if you will have to grab the closest thing to avoid a big fine.
However, your $20,000,000 in fines and payments is not going to come from charging $20 to millions of people per day they are not insured. It will come from corporations and small businesses that would rather pay the government than go to the efforts of supplying their employees with insurance.
I would argue more, but my son is begging for attention, by sitting on the computer.
Posts: 1941 | Registered: Feb 2003
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