Health Care Debate

It doesn't help the GOP when they announce things like, "FREEDOM DIED TODAY". :donkey:

(R) ideas were incorporated into the bill; interstate exchanges, keeping kids on parents' policies until age 26.




edit: C-sections were mentioned in another thread, thought I'd bring it up here as an example of our fubar system of "care". Along with the insurance reform, we should have had tort reform in the bill. And why are physician standards of practice still set at the CYA bar....?

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The Caesarean section rate in the United States reached 32 percent in 2007, the country’s highest rate ever, health officials are reporting.

The rate has been climbing steadily since 1996, setting records year after year, and Caesarean section has become the most common operation in American hospitals. About 1.4 million Caesareans were performed in 2007, the latest year for which figures are available.

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How crazy is that, one in three women 'have to have' a C-section? Multiple births and older mothers can't explain the entire trend. We've been birthin' babies for thousands of years, but now 1/3 need the knife? No wonder we're losing obstetricians.

The most common surgery in US hospitals, because it generates revenue, and helps offset the losses in other fields like emergency medicine? :(

http://www.nytimes.com/2010/03/24/he...birth.html?hpw

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Originally Posted by Dreadnaught

Still, Hazir I think you are misinterpreting the fact that no Republicans voted for. This is a sign of the majority party not compromising, not the Republicans being obstructionist.

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How do you compromise with someone who isn't looking for it?

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Originally Posted by Illusions

How do you compromise with someone who isn't looking for it?

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:up: That is the politics, in our face. Between political maneuvering and ideology, we can almost SEE how one side refuses to move forward. They'd rather be dragged into the future, kicking and screaming, proud to be reluctant and rebellious, than actually address reality.

Now it's almost not about the issue of health care, but drawing lines in the sand. Name calling, tea partying, twittering, talk radio, pick a side, demonize and dramatize. At least the demonstrations of Hell No We Won't Go was about an unpopular war with an unpopular military draft....

Everyone knows our current system is unsustainable. Everyone. The election results are in place. We HAVE to change, the question is how, not if. I may not like the means but I do like the trajectory forward.

If the Republicans had come up with good sound ideas, they'd have gotten the votes. It was no longer sufficient to say Let the Free Market Decide, and the trickle down Reagonomics will work, if we just give it MORE time.

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Originally Posted by Dreadnaught

it's not my party

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whatever you call yourself this time around, I still find your comment stance a little hilarious. You'll rant and rave, even when it doesn't pertain to the conversation, about people bitching about people bitching about being allowed to be bitchy towards other people. Instead of, I don't know, ignoring the comments that don't pertain towards your political stance; which I can only assume is what you what the people bitching about people bitching about their ability to be bitchy, to do.

As far as Dread goes, maybe he's living an Existential crisis, so we can cut him some slack there? A couple of years ago he was quite ready to downplay and criticize the Ron Paul "Revolution", by claiming he was a right wing wing nut with no credibility, let alone having some power within the Republican party politics.

But now it seems some of those values are being incorporated, and less off-track than on-point, and it's the tea partiers or Palin who are the extremists that don't 'belong'. It's like Bloomberg, Spector and Lieberman switching party affiliation. It IS difficult to put all things into party politics, in a two party system, when they have so many interconnected principles.

Ergo, health care's future does not belong to one party or the other, it belongs to the whole nation, so we'd do well to remember that.

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Originally Posted by Dreadnaught

I will address both quickly to say that there is part media slant here, and part Republican inability to coalesce around alternatives. But on the media front I can't begin to tell you how many reporters, who have their own industry headaches, want a bailout of their industry. But health insurance will do as well.

Still, Hazir I think you are misinterpreting the fact that no Republicans voted for. This is a sign of the majority party not compromising, not the Republicans being obstructionist.

Our system works by generally making it easy for any member (regardless of party) to propose amendments to bills, instead of sit on the sidelines as "shadow" ministers, legislators, etc. After weeks of negotiations it became clear that the Democrat's idea of "bipartisanship" meant trying to shave off a few Republicans to the bill and then leaving it at that. When the contents of the bill became a financial and regulatory boondogle for Republicans, they weren't able to unite around the various Republican counterproposals. And they sure as hell couldn't introduce them because they were the minority party -- they don't set the agenda.

But there have been a number of solid proposals from Republians, with a lot of thought put into it by Congressman Paul Ryan, a Republican from Wisconsin. Not exactly a foaming at the mouth conservative state, mind you. http://www.house.gov/ryan/PCA/

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Sorry Dread, but this 'explanation' does not explain why not even a single Republican thought it was time to give millions of uninsured Americans coverage. With all the shortcomings of this law (even a lot of Democrats who voted for it don't think it's a great law) that underlying message should have had some allure to a Republican willing to listen to reason.

I mean, it wouldn't be the first time a Republican voted for something that was fiscally frivolous.

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Georgia Attorney General Thurbert Baker will not file a lawsuit against the federal government challenging the new health care reform legislation signed into law Monday.

Baker said there was not a viable legal claim that his office could pursue in filing such a lawsuit.

A statement from Baker's office, released Wednesday, said in part, Given that this proposed litigation "is likely to fail and will consume significant amounts of taxpayers' hard-earned money in the process," Baker informed the Governor's office by letter that he would not be instituting litigation against the United States of America over the Patient Protection and Affordable Care Act.

Baker, a Democrat, is a candidate for Georgia Governor.

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Guess some other state is going to get all the "glory" (or ridicule, whichever is appropriate).

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Originally Posted by Hazir

Well Dread, the problem is that the opponents of the law have not entered into a constructive debate about a much needed health care reform and instead resorted to scare tactics.

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They did what they knew how to do. The GOP was in power too long, Congressionally, it left them with a coherence problem. Umbrella parties work because even if all the factions within the party don't share the same values on everything, they generally don't violently object to any of the other faction's values. This has ceased to be the case for both Dems and Republicans, and the only thing that holds them together anymore is a decent interval out of power, forcing them to focus on some core issues and pressure everyone into going along with them because "hey, we can't accomplish anything until we can replace the Democratic majority."

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Originally Posted by LittleFuzzy

They did what they knew how to do. The GOP was in power too long, Congressionally, it left them with a coherence problem. Umbrella parties work because even if all the factions within the party don't share the same values on everything, they generally don't violently object to any of the other faction's values. This has ceased to be the case for both Dems and Republicans, and the only thing that holds them together anymore is a decent interval out of power, forcing them to focus on some core issues and pressure everyone into going along with them because "hey, we can't accomplish anything until we can replace the Democratic majority."

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Maybe so, but it's not an American tradition, this party discipline. And you can't really afford to have a system that combines the radical swings in policy makers that we know from the British system with the legislative roadblocks the Congressional system has put in place. That is; you can't if you want a semblance of effective government. You can of course if you want the US to be just a bigger version of California.

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Originally Posted by Dreadnaught

Health reform had broad support, and poll after poll shows that support evaporated on the contents of this bill, the narrow partisan majority used to pass it and the methods of passing it.

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No, support eroded because of a concerted effort to confuse and mislead them by the conservative mean machine.

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Sorry if I sound testy, I just have a lot of friends in person who are taking an attitude that people who opposed this are somehow stupid Klansmen.

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Maybe not Klansmen. Maybe not stupid. But definitely ignorant, and mostly taken for a ride.

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Originally Posted by Nessus

<snip> I am very cynical and openly misanthropic.

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But are you privately misanthropic too?

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Originally Posted by GGT

If the Republicans had come up with good sound ideas, they'd have gotten the votes. It was no longer sufficient to say Let the Free Market Decide, and the trickle down Reagonomics will work, if we just give it MORE time.

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This goes on free market...
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Cato.org: We Need Sincere Free Trade
Yet Swedish farmers along with others in the European Union enjoy a comfortable lifestyle, at the expense of poor countries in Eastern Europe, Africa and Latin America. That's because of the EU's Common Agricultural Policy (CAP), which is designed to protect European farmers from competitors in the developing world and elsewhere. (And America plays a similar game.)

The CAP uses quotas and tariffs of several hundred per cent to effectively block the importation of foreign foodstuffs. The result is a huge surplus of foodstuffs piling up around Europe that must be either used or destroyed. So the EU dumps the stuff in poor countries with the help of export subsidies, further undermining the livelihood of competitors abroad.

The EU's protectionism isn't unique; most rich countries have similar systems. And the barriers to imports are especially cruel to developing countries. Western duties (i.e., taxes) on manufactured goods are 30% above the global average. The tariffs are not uniform but rise in proportion to how processed the product is. Partially processed products face, on average, 20% higher tariffs than raw resources. Finished products face almost 50% higher tariffs. To put it simply, developing countries can export fruits, but not the jam they make from those fruits.
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Reaganomics will not work. US has a debt based economy that has created an asymmetry between Chinese and American workers. Americans would need to lose 14/15 of buying power due to the US monetary policy and personal debt of americans, where US exported inflation to China for years, so Americans could compete in the globalized job market. Currently Reagonomics trickle down would go to China.

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Originally Posted by Dreadnaught

I do agree this will likely become more popular, mainly because the bill doesn't darken the skies and open the volcanoes of debt overnight. And there will of course be a media push in a few months/one year to highlight a couple of people who have benefited from their unaffordable subsidies.

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Dude, what does the government do that IS affordable? Are the wars affordable? Was bailing out Wall Street and the banks and AIG affordable? Were GW's tax cuts affordable? Were the fossil energy sector's tax credits affordable? Are the DOD's weapons programs affordable? Are the farm subsidies affordable? Is the highway system affordable? Is the court system affordable? Are the EPA, OSHA, the SEC, NASA, DOE, the FDA, CIA, NSA and the FCC affordable? The reason nobody gives any credibility to your rant about how much this is going to cost is becasue that's ALWAYS the rant! The government is ALWAYS doing all sorts of things it and we can't afford. Usually its something that won't help most of us in any way. But THIS time people are being protected from getting fucked around by big insurance companies. THIS time people who work hard every day but have been fucked out of the our shitty ass health care system by capitalists insisting we can't afford it are going to get covered. Yah! So if we can't afford this either, then fuck it. THIS time what we can't afford is the government actucally FOR the PEOPLE. Yah baby. YAH!

http://my.barackobama.com/page/conte...20100322_BO_ND

How odd. Not nearly as much fun without multiple pens and a huge audience, I'm sure.

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Originally Posted by littlelolligagged

How odd. Not nearly as much fun without multiple pens and a huge audience, I'm sure.

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Got to admit, I sure don't have the skills to sign my name with 22 different pens and still have it come out looking OK.

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Originally Posted by Hazir

Maybe so, but it's not an American tradition, this party discipline.

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Yes and no. It's always been more prevalent with the Opposition, because if a measure is going to pass anyway, they can have their cake and eat it too.

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And you can't really afford to have a system that combines the radical swings in policy makers that we know from the British system with the legislative roadblocks the Congressional system has put in place. That is; you can't if you want a semblance of effective government. You can of course if you want the US to be just a bigger version of California.

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I ain't happy with it. 'tis why I'd like us to shift to a more proportional, multi-party system.

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Originally Posted by EyeKhan

Dude, what does the government do that IS affordable? Are the wars affordable? Was bailing out Wall Street and the banks and AIG affordable? Were GW's tax cuts affordable? Were the fossil energy sector's tax credits affordable? Are the DOD's weapons programs affordable? Are the farm subsidies affordable? Is the highway system affordable? Is the court system affordable? Are the EPA, OSHA, the SEC, NASA, DOE, the FDA, CIA, NSA and the FCC affordable? The reason nobody gives any credibility to your rant about how much this is going to cost is becasue that's ALWAYS the rant! The government is ALWAYS doing all sorts of things it and we can't afford. Usually its something that won't help most of us in any way. But THIS time people are being protected from getting fucked around by big insurance companies. THIS time people who work hard every day but have been fucked out of the our shitty ass health care system by capitalists insisting we can't afford it are going to get covered. Yah! So if we can't afford this either, then fuck it. THIS time what we can't afford is the government actucally FOR the PEOPLE. Yah baby. YAH!

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Uhm, most of your examples are silly. The reason the current healthcare system is unsustainable and not affordable is because it will rapidly consume all of the federal budget. No other government program comes close in size or cost (*with the exception of other mandatory spending - Social Security and interest mainly*). Without significant reform or significantly increased taxes, the government can't pay for it.

Let's look at your list:
1) Wars (presumably Iraq and Afghanistan): Expensive, but still only ~$200 billion a year and temporary at that. War spending decreases over time; healthcare spending increases with no end in sight.

2) Bailouts: Absolutely affordable. Not too expensive in the long run (especially compared to the stimulus), a one-time charge, and worth averting a much bigger collapse of the financial system.

3) Tax cuts put into place by Bush and extended by Obama: probably not affordable, though they may have looked that way at the time (given a smallish budget surplus and unprecedented prosperity). Certain bits might be kept affordably, but the entire package was money the government couldn't really give up, given the huge looming entitlements bill. I think these tax cuts should be carefully examined, and the ones with significant positive value should be kept and the rest discarded. Similar to my position on healthcare benefits.

4) Tax cuts for fossil fuel producers - pretty cheap, so largely affordable. I would dispute whether they were worth it, but it's not a huge chunk of change we're talking about, and it keeps energy prices low for Americans. *shrugs*

5) Weapons programs - some are affordable, some are not. Total procurements is still pretty low - procurements plus R&D is about $200 billion a year. High, perhaps unacceptably so (I have a blog post in the works about this) but not that big compared to Medicare (~500 billion) and Medicaid (~250-300 billion). Furthermore, growth in procurements is overshadowed by growth in entitlement spending outside the military, and personnel costs inside the military. I'd say many weapons programs could be shelved to make the overall bill cheaper, but it's not unbearably expensive.

6) Highways: Yeah, we barely spend any money on this in the grand scheme - about 43 billion a year, with minimal increases.

7) Courts: Very cheap. The entire department of Justice, including prison and court costs, is about 46 billion a year. Again, budget growth is restrained.

8) A bunch of acronyms - Mostly cheap, though some would argue there's some pork in DOE and NASA that could be cut out. Total price tag is quite low.


The point is that this is an entirely different realm of unaffordability than most government programs (though I would happily campaign to reduce unnecessary costs and waste in other programs as well). We can't pay for our current entitlement costs, let alone expand them. This is the real threat to our fiscal security. We absolutely needed healthcare reform, and I'm even willing to concede that it would be nice to equitably solve the access issue. But the real problem is cost containment, and the bill completely fails to adequately address this problem. This is what Dread and other have been concerned about, and it's a very valid concern. You can't magic away these problems.

Before you go suggesting that good substantive recommendations have not been made by the opposition (both within the Democratic party and elsewhere), I'd suggest you read up on some of the - very reasonable - suggestions for reform that have been made. There's no reason they couldn't have been included in the bill, and would likely have drastically reduced the price tag for future healthcare spending. Unfortunately, that was clearly not on the agenda for Congressional leadership.

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Originally Posted by EyeKhan

Dude, what does the government do that IS affordable? Are the wars affordable? Was bailing out Wall Street and the banks and AIG affordable? Were GW's tax cuts affordable? Were the fossil energy sector's tax credits affordable? Are the DOD's weapons programs affordable? Are the farm subsidies affordable? Is the highway system affordable? Is the court system affordable? Are the EPA, OSHA, the SEC, NASA, DOE, the FDA, CIA, NSA and the FCC affordable? The reason nobody gives any credibility to your rant about how much this is going to cost is becasue that's ALWAYS the rant! The government is ALWAYS doing all sorts of things it and we can't afford. Usually its something that won't help most of us in any way. But THIS time people are being protected from getting fucked around by big insurance companies. THIS time people who work hard every day but have been fucked out of the our shitty ass health care system by capitalists insisting we can't afford it are going to get covered. Yah! So if we can't afford this either, then fuck it. THIS time what we can't afford is the government actucally FOR the PEOPLE. Yah baby. YAH!

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:) Is this meant for Dread or your Teaparty brother?

A couple of years ago we had a change which was similar to what this bill will do in the US. I lost my privileged status as a holder of a private health insurance and now have a basic policy plus a dental plan just like pretty much anybody else. In the years in between I have not noticed any loss with regards to health care. If other people's care got better (and I am under the impression that it did because I hardly ever hear people about waiting lists any longer) then I think not being privileged any longer was a small price to pay.

Sen. Carl Levin (D-MI) released the following statement today in response to Senate Republicans' refusal to hold committee hearings, including a hearing of the Senate Armed Services Committee, which Levin chairs:

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"It is astounding to me that Republicans have taken a step of such pointless, blind obstructionism. It cannot achieve their goal of obstructing health care reform. Instead, they are obstructing a hearing that has nothing to do with the health care debate and everything to do with the defense of our nation. And they have disrupted the schedules of senior commanders who in two cases have traveled thousands of miles from their troops, and who would be providing the Senate with information on pressing national security topics such as North Korea's nuclear program, Chinese military capability and the threat of cyber-warfare. Our national security should not be held hostage to Republican pique over health care."

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But remember children, its all the Democrats fault for how they passed the health care bill.

Hazir, what was this "privileged status" and why did you have it in the first place? Was it because you're a government employee?

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Originally Posted by GGT

Hazir, what was this "privileged status" and why did you have it in the first place? Was it because you're a government employee?

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I am not a government employee and have never been except for a short period when I worked for the University of Utrecht. We used to have a two tier system in Holland, with a proscribed cooperative type health insurance for people under a certain income. Everybody who earned more than the threshold was automatically not eligible for this and would have to get a private policy (or none). I was in the second category and decided to take out a private policy since my employer would pay the premium on the condition I would take out my insurance with an insurer he had a deal with. The collective patients were less lucrative for the health care providers, so without fail you would have much more choice and usually could get care much faster.

All of this got scrapped, the coops were privatized and very often bought up by private insurerers who by law were obliged to offer to any applicant, regardless of previous insurance status or pre-existing conditions a government defined policy with a price within a price-band also set by the government. On top of this basic policy insurers are free to offer additional coverage, like dental plans for people older than 18, policies that cover alternative therapies, childbirth, etc etc etc. For these latter the insurer can reject people. The system works because insurers can make money in two ways; drive a hard bargain for the care covered by basic policies. Besides that they can make extra money because of the extra coverage people will take out.

There is a serious incentive too to keep the COST of healthcare down. Every year at the end of the year your insurer is obliged to inform you of the fact that you are free to change over to another insurer during the month of january.

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a government defined policy with a price within a price-band also set by the government.

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Did the opposition claim your Freedom Died? Or that your government was being fascist or Marxist or tyrannical? ;)



Anyway, now I'm reading that the (R) leadership wants to "Repeal and Replace" the new bill. Reduce taxes and INCREASE Medicare spending by $500 million. :confused:

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Originally Posted by Ominous Gamer

Sen. Carl Levin (D-MI) released the following statement today in response to Senate Republicans' refusal to hold committee hearings, including a hearing of the Senate Armed Services Committee, which Levin chairs:
[I]

But remember children, its all the Democrats fault for how they passed the health care bill.

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This is so disappointing. Why would they shut down those committees that are talking about Veteran homelessness and national defense? If that isn't called Obstructionism, then what's it called?

The procedural rule book needs to be updated. These tactics are just insane.

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Originally Posted by wiggin

Uhm, most of your examples are silly. The reason the current healthcare system is unsustainable and not affordable is because it will rapidly consume all of the federal budget.

<snip>

Before you go suggesting that good substantive recommendations have not been made by the opposition (both within the Democratic party and elsewhere), I'd suggest you read up on some of the - very reasonable - suggestions for reform that have been made. There's no reason they couldn't have been included in the bill, and would likely have drastically reduced the price tag for future healthcare spending. Unfortunately, that was clearly not on the agenda for Congressional leadership.

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#1. Um, you take my rant way too seriously. But I appreciate, I guess, the attention to detail, though I know you do this with everything.

#2. I know there's a lot of suggestions out there for cost reduction. And I know, as do you, that some of them will definitely have to be taken very seriously. The bucket of money that we pour into health care has to be limited. That means either people get denied care, care gets cheaper, or fat gets trimmed. Or all three.

#3. The nice thing about having this health care bill is that first we are going to do the right thing and care for everyone's health. And second, that will force us to start fixing the financial problems with health care, which are many, and which, I'm convinced are fixable while still taking good care of everyone. I'm an optimist on this. :) But while the way we were handling the bucket problem was by leaving more and more people out, there was no way to do the right thing. That's why this unaffordable bill had to be passed first.

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Originally Posted by Illusions

How do you compromise with someone who isn't looking for it?

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Republicans provided crucial votes to bring some of the early draft bills out of committee. :confused:

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Originally Posted by Ominous Gamer

whatever you call yourself this time around, I still find your comment stance a little hilarious. You'll rant and rave, even when it doesn't pertain to the conversation, about people bitching about people bitching about being allowed to be bitchy towards other people. Instead of, I don't know, ignoring the comments that don't pertain towards your political stance; which I can only assume is what you what the people bitching about people bitching about their ability to be bitchy, to do.

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Because the people I know in person who have a different political stance on this issue know very little about the issue, but lurve to frame this in terms of "dem ignorant racist bigots who like watching people die in the streets"

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Originally Posted by GGT

As far as Dread goes, maybe he's living an Existential crisis, so we can cut him some slack there? A couple of years ago he was quite ready to downplay and criticize the Ron Paul "Revolution", by claiming he was a right wing wing nut with no credibility, let alone having some power within the Republican party politics.

But now it seems some of those values are being incorporated, and less off-track than on-point, and it's the tea partiers or Palin who are the extremists that don't 'belong'. It's like Bloomberg, Spector and Lieberman switching party affiliation. It IS difficult to put all things into party politics, in a two party system, when they have so many interconnected principles.

Ergo, health care's future does not belong to one party or the other, it belongs to the whole nation, so we'd do well to remember that.

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Ron Paul arguably has less power than he did before, and I still find many of his ideas such as abolishing the Federal Reserve absurd.

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Originally Posted by Hazir

Sorry Dread, but this 'explanation' does not explain why not even a single Republican thought it was time to give millions of uninsured Americans coverage. With all the shortcomings of this law (even a lot of Democrats who voted for it don't think it's a great law) that underlying message should have had some allure to a Republican willing to listen to reason.

I mean, it wouldn't be the first time a Republican voted for something that was fiscally frivolous.

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Because the bill is terrible. You can't seriously frame this as, "If you don't vote for this, you want to kill babies." Republicans were on the multiple committees that drafted early reform bills, and Republicans even voted with some of these early drafts. There are concrete reasons most Republicans they didn't vote for it when it hit the full floor.

Your idea of an allure is sort of a fantasy; it's like asking someone to smile and co-sign for a mortgage with crippling interest.

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Originally Posted by EyeKhan

Dude, what does the government do that IS affordable? Are the wars affordable? Was bailing out Wall Street and the banks and AIG affordable? Were GW's tax cuts affordable? Were the fossil energy sector's tax credits affordable? Are the DOD's weapons programs affordable? Are the farm subsidies affordable? Is the highway system affordable? Is the court system affordable? Are the EPA, OSHA, the SEC, NASA, DOE, the FDA, CIA, NSA and the FCC affordable? The reason nobody gives any credibility to your rant about how much this is going to cost is becasue that's ALWAYS the rant! The government is ALWAYS doing all sorts of things it and we can't afford. Usually its something that won't help most of us in any way. But THIS time people are being protected from getting fucked around by big insurance companies. THIS time people who work hard every day but have been fucked out of the our shitty ass health care system by capitalists insisting we can't afford it are going to get covered. Yah! So if we can't afford this either, then fuck it. THIS time what we can't afford is the government actucally FOR the PEOPLE. Yah baby. YAH!

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Portugal had its debt downgraded today. How do you think it's going over there?

I'm kind of stunned that you think we can just borrow enormous tons of money forever. Government debt has been the constant refrain for years because, with massive stead debt accumulation, you can usually see the problem years in advance unless you're small minded enough to think the government can borrow trillions forever.

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Originally Posted by Dreadnaught

I'm kind of stunned that you think we can just borrow enormous tons of money forever. Government debt has been the constant refrain for years because, with massive stead debt accumulation, you can usually see the problem years in advance unless you're small minded enough to think the government can borrow trillions forever.

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Where there is a will, there is a way. First we had to establish what we were going to do. Now that we've done that, we will do it. That means lowering costs however it has to be done. I don't believe for a second we will rack up the kind of debt you're afraid of, pie chart or no. It will be fixed. But the only way to get there was to commit to covering everyone first.

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Originally Posted by Dreadnaught

I'm kind of stunned that you think we can just borrow enormous tons of money forever. Government debt has been the constant refrain for years because, with massive stead debt accumulation, you can usually see the problem years in advance unless you're small minded enough to think the government can borrow trillions forever.

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Somebody forgot to get that memo to Reagan and the Bush clan.



More healthy and less stressed workers can lead to higher tax revenues. And if we transition from the old system with a positive attitude toward decreasing healthcare costs then we have a better chance of acheiving the objective than by fighting it with tactics that just end up sucking away some of those savings in the end.

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Originally Posted by EyeKhan

Where there is a will, there is a way. First we had to establish what we were going to do. Now that we've done that, we will do it. That means lowering costs however it has to be done. I don't believe for a second we will rack up the kind of debt you're afraid of, pie chart or no. It will be fixed. But the only way to get there was to commit to covering everyone first.

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What are we going to do? This thing is passed and practically no one has any idea. You can't say "we're going to give people coverage!" if you have no idea how to pay for it.

Why commit to an endless entitlement without any sense of how it's going to be paid for? What would you trade for this? Would you trade our military prominence? Our fiscal solvency?

Though unless I'm mistaken, this is something you said before -- that you were willing to commit to things like this just to mousetrap the politicians into finding a way to pay for it.

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Originally Posted by Being

Somebody forgot to get that memo to Reagan and the Bush clan.

[shot]http://zfacts.com/metaPage/lib/National-Debt-GDP-L.gif

More healthy and less stressed workers can lead to higher tax revenues. And if we transition from the old system with a positive attitude toward decreasing healthcare costs then we have a better chance of acheiving the objective than by fighting it with tactics that just end up sucking away some of those savings in the end.

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Yes, that's why people have been warning about this for years now. It's a complete farce that this is going to somehow lower costs. The bill is a redistribution bill, but unlike social security and Medicare (which are essentially semi-functioning pyramid schemes), this isn't some kind of inter-generational handoff.

It's wealth re-distribution. And any attempts to reform it will increasingly be turned into class warfare for political benefit.

The odd thing about this, politically at least, is where we'd "plot" party optimism or skepticism. The conservative right had always represented a hopeful, can-do spirit, and tapped into some national patriotism that way. Not just rugged individualism, but a cooperative effort to make things work well. At least that's how I used to view the GOP.

But now they're the party of No, everything is horrible and scary, we can't afford anything, we can't problem solve, every change is a threat to our freedom and Constitution, everyone is out to get us and kill us or kill our freedom, if you're not for us you're against us, government is teh evil, shame on us. Oh, but we're still the greatest nation in the world! Exceptional, even. Vote for me and I'll keep it that way!

:confused:

Of course we can solve problems. Rep. Paul Ryan put forward a plan with a lot of solid ideas.

But there is a wildly divergent view between those who believe in the vigorous expansion of government as an endgame, and those who want government to revise and alter the laws to make society better and more efficient.

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Originally Posted by Dreadnaught

It's wealth re-distribution. And any attempts to reform it will increasingly be turned into class warfare for political benefit.

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Since Reagan, the people most negatively affected by wealth redisribution has steadily moved from those with the highest incomes to those with lower incomes. The assumption has always been that by letting higher income earners keep more of their income would benefit the U.S. as a whole. But guess what, that assumption is what is now biting you in the ass because you are now one of those lower income earners bearing the brunt of that shift. Redistribution is secondary to that shift in who bears its brunt.

Do you think that the cost of healthcare reform will match our trade imbalance with China any time soon?

Maybe there are more important economic problems to consider while we work toward reducing healthcare costs to more closely match the costs experienced by the rest of the developed world. Problems like where are all the jobs promised when we began shifting the redistribution burden down the income pyramid.

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Originally Posted by EyeKhan

Where there is a will, there is a way. First we had to establish what we were going to do. Now that we've done that, we will do it. That means lowering costs however it has to be done. I don't believe for a second we will rack up the kind of debt you're afraid of, pie chart or no. It will be fixed. But the only way to get there was to commit to covering everyone first.

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Oh, you mean like how things have been going here in California? Only with your ideal dreams as the results instead of the people trying to fix things meeting constant failure because of public apathy or outright opposition, as actually ends up happening?

Sure, in the long term things will get fixed. Nothing lasts forever, and that includes broken systems. I wouldn't lay bets that it will happen before a massive fiscal crisis that could as easily end up dismantling the reform just passed as part of the response.

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Originally Posted by Dreadnaught

Of course we can solve problems. Rep. Paul Ryan put forward a plan with a lot of solid ideas.

But there is a wildly divergent view between those who believe in the vigorous expansion of government as an endgame, and those who want government to revise and alter the laws to make society better and more efficient.

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Right. So where were the Republicans twenty years ago? Besides cutting taxes for the wealthy, waging unfunded wars that are "unwinnable", nation building off-shore, expanding the weapons industry, raising our debt burdens, taking a surplus to huge deficits, and also increasing expenditures to Medicare.

They took the borrow and spend approach. Was still bad policy. No better than tax and spend. I've been bitching about legacy costs related to health care, and trade inequities related to health care, for decades. The Republicans took the "be in charge of your own health and disease" stance, unless you have a big employer (like GM?) or you're a Senior Citizen, which is utter bullshit.

Now the hen has come home to roost and they STILL act like ostriches. After reading munchkin's plight, surely you must see how fucked up this is.

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Originally Posted by GGT

Right. So where were the Republicans twenty years ago? Besides cutting taxes for the wealthy, waging unfunded wars that are "unwinnable", nation building off-shore, expanding the weapons industry, raising our debt burdens, taking a surplus to huge deficits, and also increasing expenditures to Medicare.

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I'm pretty sure none of that was happening in 1990. Bush Sr. raised taxes and didn't engage in any noticable nation-building, Persian Gulf 1 was funded and ended quickly, the debt-burden shrank, there was no surplus at the time and no sign of one anytime soon, he didn't do jack with Medicare. . .

I suppose you can blame him for an "expansion of the weapons" industry, but really, he just inherited that from Reagan.

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Originally Posted by LittleFuzzy

I'm pretty sure none of that was happening in 1990. Bush Sr. raised taxes and didn't engage in any noticable nation-building, Persian Gulf 1 was funded and ended quickly, the debt-burden shrank, there was no surplus at the time and no sign of one anytime soon, he didn't do jack with Medicare. . .

I suppose you can blame him for an "expansion of the weapons" industry, but really, he just inherited that from Reagan.

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The surplus was during the Clinton era. Desert Storm never really ended, it just escalated. We've been "engaged" in war since 1990. We might call some of the previous conflicts, like Somalia or Bosnia, as other than nation-building, but it's probably semantics.

Bush Jr enacted Medicare part D prescriptions and the whole doughnut hole fiasco, totally unfunded. Taxes for the upper income brackets have been lower than the Reagan era, but the (R)s don't even want to go back to that. They still hold up Reagonomics as the best thing since sliced bread.

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Originally Posted by LittleFuzzy

I'm pretty sure none of that was happening in 1990. Bush Sr. raised taxes and didn't engage in any noticable nation-building, Persian Gulf 1 was funded and ended quickly, the debt-burden shrank, there was no surplus at the time and no sign of one anytime soon, he didn't do jack with Medicare. . .

I suppose you can blame him for an "expansion of the weapons" industry, but really, he just inherited that from Reagan.

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Bush Sr. didn't raise taxes, the Democratic Congress raised taxes which he accepted as a bargaining chip to get his spending cuts. Bush did try to deal with the defecit but his spending cuts and Democrat's tax increases were not enough to counter the lost revenue and increased expenditures brought on by a short recession early in his tenure.

We could play the academic blame game until the cows come home. We are where we are, we have to move forward, learning from past mistakes. Looking at the world as it is, complicated and messy, dynamic and changing. I thought the Union won, didn't we already have that internal fight?

The last thing that would benefit the Union would be to wage more of these smaller internal wars. I like local prudence and jurisdiction, but we have to act as a cohesive whole. We need to be mobile and fluid within our borders, trusting that things won't be like moving to another country when we move to another state.....

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Originally Posted by EyeKhan

#2. I know there's a lot of suggestions out there for cost reduction. And I know, as do you, that some of them will definitely have to be taken very seriously. The bucket of money that we pour into health care has to be limited. That means either people get denied care, care gets cheaper, or fat gets trimmed. Or all three.

#3. The nice thing about having this health care bill is that first we are going to do the right thing and care for everyone's health. And second, that will force us to start fixing the financial problems with health care, which are many, and which, I'm convinced are fixable while still taking good care of everyone. I'm an optimist on this. :) But while the way we were handling the bucket problem was by leaving more and more people out, there was no way to do the right thing. That's why this unaffordable bill had to be passed first.

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That's total bull. Effective reform of a giant entitlement program isn't going to happen every day. Obama and Congress had a golden opportunity - everyone recognized that healthcare desperately needed to be fixed, and there was significant popular support for doing so (across party lines). Yet of the two major issues, only one was addressed. Addressing the other is going to be incredibly difficult to do now that a new system is entrenched, one that will only worsen deficit problems with time. In fact, some estimates indicated that the structure of the bill was specifically designed to hide the true costs, though I think the argument could go both ways on that one.

The point is that you can't do two piecemeal overhauls of such a complex system (or at least have any prayer of passing both) - these chances come alone once every couple of decades. And they blew it.

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Originally Posted by Being

Somebody forgot to get that memo to Reagan and the Bush clan.

More healthy and less stressed workers can lead to higher tax revenues. And if we transition from the old system with a positive attitude toward decreasing healthcare costs then we have a better chance of acheiving the objective than by fighting it with tactics that just end up sucking away some of those savings in the end.

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I was quite unhappy about GWB's budgetary policies; I'm not sure how your argument is relevant, though (to be honest, though, his deficits were manageable in his later years once the recessions from early in his term wore off). You can argue that some Republican politicians are idiots for being partisan, but why argue with me or Dread or whatever? We are concerned about America's fiscal future regardless of who is in office.

Additionally, I can't believe that you actually think that improving access to the margins of our society is somehow going to increase our tax receipts enough to pay for current entitlement spending. There is no culture of being cost-conscious here; quite the opposite. At best, cost containment was given lip service and little else.

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Originally Posted by GGT

The surplus was during the Clinton era. Desert Storm never really ended, it just escalated. We've been "engaged" in war since 1990. We might call some of the previous conflicts, like Somalia or Bosnia, as other than nation-building, but it's probably semantics.

Bush Jr enacted Medicare part D prescriptions and the whole doughnut hole fiasco, totally unfunded. Taxes for the upper income brackets have been lower than the Reagan era, but the (R)s don't even want to go back to that. They still hold up Reagonomics as the best thing since sliced bread.

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Of course, you do realize that the reason why the federal budget was so lean during the Clinton years was because of the Republican Revolution in '94 as a result of Clinton's botched attempt at healthcare reform. That, and the fact that he presided over a period of unprecedented prosperity as the unchallenged global hegemon and drastic cuts in defense budgets in the wake of the fall of the USSR.

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Originally Posted by wiggin

...Additionally, I can't believe that you actually think that improving access to the margins of our society is somehow going to increase our tax receipts enough to pay for current entitlement spending. There is no culture of being cost-conscious here; quite the opposite. At best, cost containment was given lip service and little else.

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The margins of our society are precisely the ones who need help, just like minorities being protected. Be honest, we have not had a "culture of cost-conscious[ness]" in quite a while. Or it's been throw the baby out with the bathwater. It obviously makes more sense to fund the education and health of a nation, so the recipients of those programs can progress, and create more progression. But those are the very programs that have been underfunded or put aside. Or left to state idiosyncracies. We end up with a bunch of undereducated, sick, desperate people. yay?

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Of course, you do realize that the reason why the federal budget was so lean during the Clinton years was because of the Republican Revolution in '94 as a result of Clinton's botched attempt at healthcare reform. That, and the fact that he presided over a period of unprecedented prosperity as the unchallenged global hegemon and drastic cuts in defense budgets in the wake of the fall of the USSR.

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The Clinton administration blundered in their attempts at health reform, in their strategy. All administrations inherit things from their predecessors, it's what they do moving forward that really matters. That's why the politico party blame game is fruitless.

Mr Gorbachev, tear down this wall! only meant something since countries decided their own fate, and made progressive changes. It would be arrogant to say the US alone was responsible for that. Maybe I'm a minority, but the US needing credit for everything has grown trite.

For being the most powerful and free nation in the world, when we can't even tend to our own citizens, just has a very hollow ring.

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Originally Posted by wiggin

Additionally, I can't believe that you actually think that improving access to the margins of our society is somehow going to increase our tax receipts enough to pay for current entitlement spending. There is no culture of being cost-conscious here; quite the opposite. At best, cost containment was given lip service and little else.

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Defeatism is one of the things that will unnecessarily suck away a portion of savings that healthcare reform can produce. If the alternative to healthcare reform is less healthy and more stressed workers will that increase revenue? Why not look at the revenue problem from the perspective of how we can productively increase it? There are at least 50 some million people in this country that would love to pay more taxes. Let's get them jobs; preferably jobs with healthcare benefits.

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Originally Posted by GGT

The margins of our society are precisely the ones who need help, just like minorities being protected. Be honest, we have not had a "culture of cost-conscious[ness]" in quite a while. Or it's been throw the baby out with the bathwater. It obviously makes more sense to fund the education and health of a nation, so the recipients of those programs can progress, and create more progression. But those are the very programs that have been underfunded or put aside. Or left to state idiosyncracies. We end up with a bunch of undereducated, sick, desperate people. yay?

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I never said that it wasn't laudable to improve the lot of those on the margins; I just doubted the claim by Being that the marginally improved tax revenues would offset growth in entitlement spending.

I would agree that Congress as a whole has not been particularly good at being cost-conscious in recent years. That doesn't excuse its lack now, when they had an opportunity to actually secure our fiscal future for decades to come. This is a time when the electorate is very aware of the deficit and debt issues, both of the government and the private sector. It has consistently polled very high on list of public concerns as it has become clear that much of the ill-advised private sector debt has been effectively transferred to government debt. Obama had an opportunity to give us the straight talk about the budget in his 2011 budget request, but at most he did some window dressing and appointed a toothless fiscal commission. To say I was disappointed would be an understatement. Similarly, in his push for healthcare reform and finally coming out with his own plan, I hoped he would capitalize on the public concern about deficits to explain the tough measures that were necessary while at the same time expanding access in as cost-efficient way as possible. Yet he did not do so; in fact, Congress is currently trying to pass through the 'fix' bill that will cave in to some special interest groups and increase the cost by some $50 billion.

I like Obama and I think he genuinely means to make the US a better place. I just can't wrap my mind around his current priorities. Let's say he ignored the pro-life Democrats and had instead courted fiscal conservative Republicans by aggressively bending Democratic Congressional leaders to his will on cost containment. Might he have still passed the bill, but in a way with more substantive improvements and grudging respect from more Americans?

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Originally Posted by Being

Defeatism is one of the things that will unnecessarily suck away a portion of savings that healthcare reform can produce. If the alternative to healthcare reform is less healthy and more stressed workers will that increase revenue? Why not look at the revenue problem from the perspective of how we can productively increase it? There are at least 50 some million people in this country that would love to pay more taxes. Let's get them jobs; preferably jobs with healthcare benefits.

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Uhm, the question isn't whether it would raise more revenues, the question is whether the revenues would offset even the cost of their own benefits, let alone help to contain cost growth of others' benefits. I sincerely doubt it would do either.

Furthermore, you're way off on that 50 million number. About 37 million (maybe) Americans are uninsured and of employable age, and more than 2/3 of those already have some sort of employment. I'm doubtful you'll see that much more productivity out of this group due to their receiving (or having to buy) healthcare. Sure, you'll get some long-term cost savings from better preventative care (at least in theory), but it's a drop in the bucket. Much more cost effective reforms would be to push preventative care for the rest of the population.

Look, the only way to increase revenue enough to pay for this is to increase taxes. Everyone knows it; no one will admit it.