Mandated healthcare.

[dblack]

I cannot see how the current proposal will NOT drive up the cost of medical care.

I see nothing in that bill that will do a damned thing to increase the supply of health care and plenty that is going to drive up the demand for it.

Shhh! We must not speak of the elephant!

 

[naturegirl]

Simple way to control heath care costs. Rein in the Trial Lawyers, pass a loser pays all and see how fast the frivolous law suits disappear. The law suits that drive up the cost of liability insurance for the hospitals and doctors.

Attorneys get paid whether they win or not, the have absolutely nothing to lose filing a suit knowing their client doesn't have a chance.

 

[Bfgrn]

Republicans Spurn Once-Favored Health Mandate

Orrin Hatch of Utah is one of four Republican lawmakers still
in the Senate who supported a 1993 GOP bill requiring an
"individual mandate."

For Republicans, the idea of requiring every American to have health insurance is one of the most abhorrent provisions of the Democrats' health overhaul bills.

"Congress has never crossed the line between regulating what people choose to do and ordering them to do it," said Sen. Orrin Hatch (R-UT). "The difference between regulating and requiring is liberty."

But Hatch's opposition is ironic, or some would say, politically motivated. The last time Congress debated a health overhaul, when Bill Clinton was president, Hatch and several other senators who now oppose the so-called individual mandate actually supported a bill that would have required it.

In fact, says Len Nichols of the New America Foundation, the individual mandate was originally a Republican idea. "It was invented by Mark Pauly to give to George Bush Sr. back in the day, as a competition to the employer mandate focus of the Democrats at the time."

The 'Free-Rider Effect'

Pauly, a conservative health economist at the University of Pennsylvania's Wharton School, says it wasn't just his idea. Back in the late 1980s — when Democrats were pushing not just a requirement for employers to provide insurance, but also the possibility of a government-sponsored single-payer system — "a group of economists and health policy people, market-oriented, sat down and said, 'Let's see if we can come up with a health reform proposal that would preserve a role for markets but would also achieve universal coverage.' "

The idea of the individual mandate was about the only logical way to get there, Pauly says. That's because even with the most generous subsidies or enticements, "there would always be some Evel Knievels of health insurance, who would decline coverage even if the subsidies were very generous, and even if they could afford it, quote unquote, so if you really wanted to close the gap, that's the step you'd have to take."

One reason the individual mandate appealed to conservatives is because it called for individual responsibility to address what economists call the "free-rider effect." That's the fact that if a person is in an accident or comes down with a dread disease, that person is going to get medical care, and someone is going to pay for it.

"We called this responsible national health insurance," says Pauly. "There was a kind of an ethical and moral support for the notion that people shouldn't be allowed to free-ride on the charity of fellow citizens."

 

[dblack]

Simple way to control heath care costs. Rein in the Trial Lawyers, pass a loser pays all and see how fast the frivolous law suits disappear. The law suits that drive up the cost of liability insurance for the hospitals and doctors.

Attorneys get paid whether they win or not, the have absolutely nothing to lose filing a suit knowing their client doesn't have a chance.

It'd be nice if it were that easy, and I agree tort reform might help a little. But from what I've read it doesn't look like the costs associated with malpractice claims are really driving health care inflation and the effects of addressing it wouldn't put a dent in spiraling health care prices.

In my estimation, the problem with the health care market is that there is no downward price pressure. We've set things up so there is effectively no demand for cheaper health care.

 

[Greenbeard]

I cannot see how the current proposal will NOT drive up the cost of medical care.

I see nothing in that bill that will do a damned thing to increase the supply of health care and plenty that is going to drive up the demand for it.

There's good reason to believe that capacity isn't the issue, but rather payment and delivery system organization are the real problems. This short opinion piece is good: Physician Workforce Crisis? Wrong Diagnosis, Wrong Prescription.

The situation in Massachusetts reflects the problem with focusing narrowly on the physician workforce. Massachusetts has seen its supply of physicians per capita more than double since 1976, and it now has the highest physician- to-population ratio of any state, in primary care as well as overall. Yet the Massachusetts Medical Society has issued several annual reports asserting that there is a severe physician shortage, and patients report that the availability of primary care continues to decline.5

We believe that the perception of a physician shortage, both nationally and in Massachusetts, is just one symptom of the underlying problems in our health care system. The current delivery and payment systems often make it more “efficient” for primary care physicians to see patients they already know (diminishing others’ access to primary care) and for all physicians to narrow their scope of practice (increasing referrals to specialists) and to admit patients to the hospital (where hospitalists manage their care). Data showing that physicians in high-supply regions are more likely to report difficulty gaining both hospital admissions and specialist referrals are consistent with this hypothesis.1 In the absence of reform of the delivery system, additional growth will lead to further fragmentation of care that will exacerbate the problem of access and worsen the apparent scarcity it is intended to remedy.

Rather than treat the symptoms, we should focus on the underlying disease — a largely disorganized and fragmented delivery system characterized by lack of coordination, incomplete patient information, poor communication, uneven quality, and rising costs. Pilot projects intended to address these problems are under way in both the private and public sectors, with growing interest in primary care– based medical homes, enhanced care coordination, programs for chronic-disease management, and payment reform.

 

[dblack]

Republicans, the idea of requiring every American to have health insurance is one of the most abhorrent provisions of the Democrats' health overhaul bills....

I'm always a little curious about the intent of these kinds of observations. I suppose the point is to show established Republicans to be hypocrites, who might just as easily be arguing the other side of the current debate. But it also raises the question: Why in the world did Democrats pass a Republican bill? Doesn't that make them just as hypocritical?

I think we need to understand that the Democrats and Republicans are the same side.

 

[Bfgrn]

Republicans, the idea of requiring every American to have health insurance is one of the most abhorrent provisions of the Democrats' health overhaul bills....

I'm always a little curious about the intent of these kinds of observations. I suppose the point is to show established Republicans to be hypocrites, who might just as easily be arguing the other side of the current debate. But it also raises the question: Why in the world did Democrats pass a Republican bill? Doesn't that make them just as hypocritical?

I think we need to understand that the Democrats and Republicans are the same side.

Yes, Democrats passed a Republican health care bill. The charges of socialist party are false. The progressive wing of the Democratic party was shut out on the bill.

And Republicans made a collective decision to undermine reform, not for the benefit of the American people, but for the benefit of the party, and the destruction of our President. If the country is destroyed with him, so be it. That my friend is domestic terrorism.

David Frum, GWB speechwriter:

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

Waterloo | FrumForum

 

[Moonglow]

I cannot see how the current proposal will NOT drive up the cost of medical care.

I see nothing in that bill that will do a damned thing to increase the supply of health care and plenty that is going to drive up the demand for it.

healthcare cost go up even without Obamacare

 

[Full-Auto]

And Republicans made a collective decision to undermine reform, not for the benefit of the American people, but for the benefit of the party,



Only an opinion, Yet we witnessed democrats take bribes for their votes. Weak argument.

 

[Greenbeard]

And what bribes would those be?

 

[RealChange]

Republicans, the idea of requiring every American to have health insurance is one of the most abhorrent provisions of the Democrats' health overhaul bills....

I'm always a little curious about the intent of these kinds of observations. I suppose the point is to show established Republicans to be hypocrites, who might just as easily be arguing the other side of the current debate. But it also raises the question: Why in the world did Democrats pass a Republican bill? Doesn't that make them just as hypocritical?

I think we need to understand that the Democrats and Republicans are the same side.

Excellent point. I'm so tired of this right vs left BS. That deserves a round of applause.

 

[Bfgrn]

And Republicans made a collective decision to undermine reform, not for the benefit of the American people, but for the benefit of the party,



Only an opinion, Yet we witnessed democrats take bribes for their votes. Weak argument.

It is not just an opinion. George W. Bush's former speechwriter said it as fact. It cost him his 6 figure position at the American Enterprise Institute.

David Frum and the Closing of the Conservative Mind
by Bruce Bartlett

As some readers of this blog may know, I was fired by a right wing think tank called the National Center for Policy Analysis in 2005 for writing a book critical of George W. Bush's policies, especially his support for Medicare Part D. In the years since, I have lost a great many friends and been shunned by conservative society in Washington, DC.

Now the same thing has happened to David Frum, who has been fired by the American Enterprise Institute. I don't know all the details, but I presume that his Waterloo post on Sunday condemning Republicans for failing to work with Democrats on healthcare reform was the final straw.

Since, he is no longer affiliated with AEI, I feel free to say publicly something he told me in private a few months ago. He asked if I had noticed any comments by AEI "scholars" on the subject of health care reform. I said no and he said that was because they had been ordered not to speak to the media because they agreed with too much of what Obama was trying to do.

David Frum and the Closing of the Conservative Mind | Capital Gains and Games

Bruce Bartlett was a domestic policy adviser to President Ronald Reagan and was a Treasury official under President George H.W. Bush.

 

[editec]

I cannot see how the current proposal will NOT drive up the cost of medical care.

I see nothing in that bill that will do a damned thing to increase the supply of health care and plenty that is going to drive up the demand for it.

healthcare cost go up even without Obamacare

Yup.

Essantially, except for creating more demand on the market by makng more uninsured insured, and except for giving the HC insurance industry a GIAGANTIC WINDFALL by insisting that everybody BUY HC insurance(!?!?), I see nothing really changed in the HC picture.

An increasingly socialized medical system is preparing to pay the PRIVATE SECTOR (that would be the HC providers, FYI) as much money as it takes.

Now, that isn't a formula for reduced costs.

In fact, that is the formula for another period of rapidly increasing HC costs.

 

[dblack]

And Republicans made a collective decision to undermine reform, not for the benefit of the American people, but for the benefit of the party, and the destruction of our President. If the country is destroyed with him, so be it. That my friend is domestic terrorism.

Nonsense. It's an opposition party doing its job - opposing. If only the Democrats had take their role as seriously during the Bush administration we might not be still slogging around in the middle east ten years later. We might not be teetering under the yoke of a radically expanding police state.

I'm fully aware that the driving force behind such opposition is political ambition, and not the welfare of the nation. But that opposition is valuable, nonetheless, and our system depends on it. A solid opposition, challenging everything the majority tries to do, keeps them honest. Most importantly, it ensures that no major decisions are made that don't have broad support. For my money, the roadblocks set up by partisan politics need to be amplified, not silenced.

 

[Dragon]

With all due respect that's ridiculous. You're confusing people with corporations some of which have managed to pay very little tax but the people that work for the corporations do pay their "fair share" and that includes the rich. The top 5% of tax payers pay 54% of total income tax but earn 33% of total income. Is that not a fair share?

No, it's not, for four reasons.

First, you're conflating income tax with all taxes. Everyone with a job pays payroll taxes, and so pays a much higher percentage of his income than income tax bracket alone would indicate.

Second, you are engaging in a statical fallacy that I call "category reversal." It's an error of set theory. The percentage of all income tax paid by the rich is not the same as the percentage of their income that they pay, and is actually irrelevant.

Third, the income tax system is supposed to be progressive. The rich are supposed to pay a higher share of their income than the non-rich.

And fourth, the system as it's currently set up is really for the benefit of the top 1%, not the top 5%. That's not splitting hairs, either, since the top 1% of income-earners generally take all or most of their income in the form of capital gains rather than salary, and so pay a lower tax rate.

A big problem in this country is over consumption.

I completely disagree. We have an underconsumption problem at present, and even when we didn't (e.g. in the 1990s) we sustained the consumption levels necessary for economic health only by unhealthy consumer borrowing. We have an underpayment problem is what we really have. Wages are too low (even for those with jobs) as a ratio of productivity.

The reason for the "budget bite" is the fact that we no longer produce anything in this country.

That's untrue.

U.S. Manufacturing: Output vs. Jobs Since 1975 | Mercatus

"Since 1975, manufacturing output has more than doubled, while employment in the sector has decreased by 31%." You should not confuse the loss of manufacturing jobs, which are a combined result of automation and outsourcing, with loss of manufacturing output, which has not happened at all.

I don't think we're ever going to see a return to the huge number of factory workers that presented the norm in the 1960s and earlier. If we correct the systemic abuses that encourage outsourcing, that may at least temporarily boost manufacturing employment by a small amount, but it will also increase the incentives to automate. (Right now, a lot of manufacturing that could be done by machines is instead being done by cheap foreign labor.) There's nothing wrong with having most employment be in the service sector, as long as we ensure that the rights of service workers are protected. There was a time before most of us were born when factory work didn't pay shit, either, and had no benefits, etc. Unions and labor-friendly government policies fixed that. It's not the nature of the work that dictates lower wages, it's the politics of the times.

 

[Dragon]

Likewise! How ya been?

Not too bad. Working as a freelance writer these days.

I think that gets to the core of it. I'm still hopeful that that can change

Honestly, I don't see how it can. As I said in the rest of the post, there are things that either the government does or don't get done. That includes everything that can't be done for a profit, or can be done by public service better than for a profit, and that people won't voluntarily shell out to cover because it's benefiting too many people including those they don't personally give a damn about.

The richer a society becomes, the higher a percentage of its wealth goes to public services. You can see this happening over time, especially since the industrial revolution. A poor society puts up with shit that a rich society chooses not to, for the same reason that a poor family does without things that a rich family spends its extra money on. As the society becomes richer, it invests in things like sound infrastructure, public health, public education, libraries, national parks and recreation, public support for the arts or for scientific research, and so on, all because these are good things and the money is available. America didn't have the equivalent of FEMA in 1900 when a hurricane killed thousands of people in Texas partly because the technology didn't exist yet but partly because we were a poorer country in 1900 and the necessary taxes for that and other public services we take for granted today would have hurt more. Germany has higher taxes than Bangladesh not because the Germans are anti-liberty but because Germany is rich and Bangladesh is poor, and the Germans can afford more in the way of public services than the Bangladeshi can and want to have them.

None of this is meant as a defense of the ACA; I've expressed myself on its shortcomings elsewhere and have not changed my mind. You are right that it doesn't do much to control health-care costs and that's by design, because the insurance companies and the medical industry had too much influence on it. A single-payer system would solve the whole problem.

 

[Bfgrn]

And Republicans made a collective decision to undermine reform, not for the benefit of the American people, but for the benefit of the party, and the destruction of our President. If the country is destroyed with him, so be it. That my friend is domestic terrorism.

Nonsense. It's an opposition party doing its job - opposing. If only the Democrats had take their role as seriously during the Bush administration we might not be still slogging around in the middle east ten years later. We might not be teetering under the yoke of a radically expanding police state.

I'm fully aware that the driving force behind such opposition is political ambition, and not the welfare of the nation. But that opposition is valuable, nonetheless, and our system depends on it. A solid opposition, challenging everything the majority tries to do, keeps them honest. Most importantly, it ensures that no major decisions are made that don't have broad support. For my money, the roadblocks set up by partisan politics need to be amplified, not silenced.

You are clearly either young, misguided or not very intelligent. There is a VAST difference between a loyal minority and what the Republicans pulled. They are thumbing their noses at the will of the people. Obama ran on the healthcare reform he delivered.

They NEVER intended to be constructive or work for the people. You need to take a course in civics, and ETHICS...!!!

Insurgency

Friday, February 6, 2009

Texas Republican Congressman Pete Sessions compares GOP strategy to Taliban insurgency

"Insurgency, we understand perhaps a little bit more because of the Taliban, and that is that they went about systematically understanding how to disrupt and change a person's entire processes. And these Taliban -- I'm not trying to say the Republican Party is the Taliban. No, that's not what we're saying. I'm saying an example of how you go about [sic] is to change a person from their messaging to their operations to their frontline message. And we need to understand that insurgency may be required when the other side, the House leadership, does not follow the same commands, which we entered the game with."

Congressman Pete Sessions Compares House Republicans To Taliban | Capitol Annex

 

[dblack]

You are clearly either young, misguided or not very intelligent.

Well, I'd happily accept misguided and stupid in exchange for youth ... but, unfortunately I'm old, misguided or not very intelligent.

There is a VAST difference between a loyal minority and what the Republicans pulled. They are thumbing their noses at the will of the people. Obama ran on the healthcare reform he delivered.

This is blatantly untrue. He campaigned against the individual mandate and for the public option. He delivered the opposite.

In any case, I'm in no way interested in defending ugly politics, from either side. My point is that simply being obstructionist is NOT a bad thing. It serves as a valuable check on whim and questionable lawmaking. The fact that the system includes tools for the minority to resist the will of the majority is a good thing, in my opinion.

 

[Bfgrn]

You are clearly either young, misguided or not very intelligent.

Well, I'd happily accept misguided and stupid in exchange for youth ... but, unfortunately I'm old, misguided or not very intelligent.

There is a VAST difference between a loyal minority and what the Republicans pulled. They are thumbing their noses at the will of the people. Obama ran on the healthcare reform he delivered.

This is blatantly untrue. He campaigned against the individual mandate and for the public option. He delivered the opposite.

In any case, I'm in no way interested in defending ugly politics, from either side. My point is that simply being obstructionist is NOT a bad thing. It serves as a valuable check on whim and questionable lawmaking. The fact that the system includes tools for the minority to resist the will of the majority is a good thing, in my opinion.

Does the truth have any importance to a self proclaimed intelligent person? Because the Republicans perpetrated the biggest lies of the year during the health care debate. Lies that will cost fellow Americans their very LIVES in some cases...How the **** is THAT intelligent???

"Mark my word, if and when these preachers get control of the Republican party, and they're sure trying to do so, it's going to be a terrible damn problem. Frankly, these people frighten me. Politics and governing demand compromise. But these Christians believe they are acting in the name of God, so they can't and won't compromise. I know, I've tried to deal with them."
Barry Goldwater

 

[Listening]

Does the truth have any importance to a self proclaimed intelligent person? Because the Republicans perpetrated the biggest lies of the year during the health care debate. Lies that will cost fellow Americans their very LIVES in some cases...How the **** is THAT intelligent???

Please provide the lies and your case that they were as such.

I certainly saw a lot of extrapolation on both sides and don't hear either side fessing up to it's mistakes.

There are lots of things that cost Americans their lives.

How do we continue to let people smoke and drink ? Please tell me that if you are so concerned about our choices that you would remove these from the menu of options that Americans currently enjoy.

Or were you refering to our misguided wars ?