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Thread: Health Care Debate

  1. #241
    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?
    I like Obama too. History will probably make this whole mess more understandable. He has to play the bipartisan game, because he promised he would. He's not an idealogue, but a pragmatist who also knows the politicking game. After a good effort of bending and reconciling, he probably had to hold his nose and say JUST DO IT.

    I also think he's more in touch with middle class and poor people, even tho he also ran around in elitist and wealthy circles. That's probably a perception thing, carefully orchestrated by handlers, but I know he's more likely to relate to the average citizen than say, John McCain.

    Look, the only way to increase revenue enough to pay for this is to increase taxes. Everyone knows it; no one will admit it.
    Obama says we can hike the tax rate on the wealthy, not much, just back to the pre Clinton era. I agree. Then we get people saying an income of $250,000 is not wealthy. I disagree. Even in NYC or LA with their high cost of living, households taking in that amount of money can tolerate a slight tax increase easier than those making $50-80,000.

  2. #242
    This is a new one. Some (R) legislators are saying "This bill would pay for Viagra for child molesters and rapists".

    No idea where that idea comes from.

    "This bill would impose an unfair tax on diabetics, people in wheelchairs, or anyone who uses a cane!"

    They're using the medical devices tax to scare anyone who has a glucose monitor or mobility device.


  3. #243

  4. #244
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    Quote Originally Posted by GGT View Post
    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.
    No, the opposition was mostly from people on the left who didn't trust private insurance companies not trying to fleece them. The main debate was actually about how much a society can afford to spend on health care.
    Congratulations America

  5. #245
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    Quote Originally Posted by Dreadnaught View Post
    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.
    You are totally off the mark if you think this bill is the problem. The problem of Health care is not that yo strive to give everybody coverage, but that the way health care is priced in the US there is no incentive to not waste money. None whatsoever. For this problem to be tackled you need a mechanism that gives people a stake in reducing cost. And that is what this law is going to do. For two reasons; cost cutting is the main way how insurers can stay in the black, and health care from now on is technically fiscalized. It will have to be on the budget; no longer as the money pit that was somewhat affordable, but as the black hole you fear it is. If anything this law injected realism into the debate.

    The elephant in the room has been mentioned, there will be more talk about it.
    Congratulations America

  6. #246
    Quote Originally Posted by Hazir View Post
    No, the opposition was mostly from people on the left who didn't trust private insurance companies not trying to fleece them. The main debate was actually about how much a society can afford to spend on health care.
    Interesting. Left and Right only have meaning from the center. I also wonder if our insurance companies aren't just going to screw us and laugh all the way to the bank with their profits, with the blessing from our legislators who cut deals with them.

    The US has plenty of money to spend on healthcare, if we made it a priority. But since we don't prioritize very well, much of our wealth is frittered away. After the healthcare vote, some 13 state attorney generals launched law suits to fight the federal initiative. Saying they could not afford the mandate. Never mind how much they'd pay to high priced lawyers to file those briefs....it was about the principle, not the budget.


  7. #247
    http://www.reuters.com/article/idUSN2017888120100325

    (Reuters) - A package of final changes to a landmark healthcare reform law must be approved again by the House of Representatives after the Senate parliamentarian eliminated two minor provisions on Thursday.

    Senate Parliamentarian Alan Frumin upheld two Republican challenges under budget reconciliation rules, Senate Democratic aides said, requiring another vote by the House just days after it passed the package during a contentious debate on Sunday.
    The challenges involve the package's revamp of the student loan program, said Jim Manley, a spokesman for Senate Democratic leader Harry Reid. Under reconciliation rules, each provision in the package must have a budgetary impact.
    The decision came as the U.S. Senate met in a middle-of-the-night session to try to finish the bill, which would put the finishing touches on the sweeping healthcare overhaul signed into law by President Barack Obama on Tuesday.
    Now what's really curious is (and yes, I am aware of the source, so I want confirmation first)

    http://www.huffingtonpost.com/2010/0..._n_512609.html

    Senate Republicans succeeded early Thursday morning in finding two flaws in the House-passed health care reconciliation package. Neither is of any substance, but the Senate parliamentarian informed Democratic leaders that both are in violation of the Byrd Rule.
    One is related to Pell Grants and the other makes small technical corrections. Why they're in violation of the Byrd Rule doesn't matter; the upshot is that Republicans will succeed in at least slightly altering the legislation, which means that the House is once again required to vote on it. With no substantial changes, House Speaker Nancy Pelosi (D-Calif.) should have little problem assembling the same coalition of 220 Democrats who passed the measure Sunday night. That's already four more than the minimum 216 required for passage.
    But the ruling might give Democrats another option -- the public one.
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  8. #248
    Quote Originally Posted by Dreadnaught View Post
    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.
    If you started with - "ok, lets free up umpteen billions of dollars then lets start expanding health care coverage to people because its the right thing to do" then nothing would ever get done. As AimLess has posted there's probably a trillion dollars of waste in the form of fraud and unnecessary procedures in the current system. It would seem getting control of that would be a good first start.

    I've never said anything about mousetrapping before.

    I'd be personally willing to pay more in taxes to help cover this. I'd vote for policy eliminating fee-for-service payment to doctors. I'd also be willing to look at malpractice tort reform though very cautiously. A single payer system would have reduced a lot of cost administratively - having a zillion insurance companies means you do all those tasks in parallel....

    Quote Originally Posted by GGT View Post
    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.
    I must have missed that over my life time. To me the right has always been about strength - kicking ass and taking names. When I was a child that sort of thing really appealed to me. Probably a gender POV thing...

    Quote Originally Posted by Dreadnaught View Post
    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.
    The most efficient thing to do would be to put people down when they can no longer work. You for that?
    Last edited by EyeKhan; 03-25-2010 at 11:50 AM.
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  9. #249
    Quote Originally Posted by Hazir View Post
    You are totally off the mark if you think this bill is the problem. The problem of Health care is not that yo strive to give everybody coverage, but that the way health care is priced in the US there is no incentive to not waste money. None whatsoever. For this problem to be tackled you need a mechanism that gives people a stake in reducing cost. And that is what this law is going to do. For two reasons; cost cutting is the main way how insurers can stay in the black, and health care from now on is technically fiscalized. It will have to be on the budget; no longer as the money pit that was somewhat affordable, but as the black hole you fear it is. If anything this law injected realism into the debate.

    The elephant in the room has been mentioned, there will be more talk about it.
    You and I seem to be going in circles about this. We're both complaining about costs...but it's absurd that you think this law is going to give people an incentive to save costs. The costs are being nationalized. The plan imposts costs and requirements on insurers that will raise premiums. But the insurance industry is okay with that because their industry is now corruptly protected by the requirement that everyone has to buy insurance. Increasingly, people will be unable to afford insurance and turn to subsidies.

    Read more about the plan, Hazir.

    Quote Originally Posted by EyeKhan View Post
    If you started with - "ok, lets free up umpteen billions of dollars then lets start expanding health care coverage to people because its the right thing to do" then nothing would ever get done. As AimLess has posted there's probably a trillion dollars of waste in the form of fraud and unnecessary procedures in the current system. It would seem getting control of that would be a good first start.

    Also, I've never said anything about mousetrapping before.

    And I'd be personally willing to pay more in taxes to help cover this. I'd also vote for policy eliminating fee-for-service payment to doctors. I'd also be willing to look at malpractice tort reform though very cautiously.

    I must have missed that over my life time. To me the right has always been about strength - kicking ass and taking names. When I was a child that sort of thing really appealed to me. Probably a gender POV thing...
    Then why wasn't cost control the first start? You are explicitly talking about mousetrapping -- setting up an entitlement that can't easily be ended, and then reforming the cost structure. It's completely backwards, and I would expect someone like you to realize this.

  10. #250
    Quote Originally Posted by LittleFuzzy View Post
    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?
    Dude, I live in Michigan. Don't whine to me about how bad it is in California. But seriously, I don't know what the issues are in California other than that your prison guard union seems to have fucked up what used to be a fairly decent penal system, primarily via supporting kick ass sentencing laws like 3 strikes and so on (there was an interesting piece on npr about that... )

    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.
    Yeah. One of two things will happen - the US will rise to the challenge and make this a better place to live for everyone. Or we will fail and slip further back....

    Quote Originally Posted by Dreadnaught View Post
    Then why wasn't cost control the first start? You are explicitly talking about mousetrapping -- setting up an entitlement that can't easily be ended, and then reforming the cost structure. It's completely backwards, and I would expect someone like you to realize this.
    Because if you control the costs, which you won't, then that just means your deficit gets a little smaller. Nobody of your stripe would ever say "hey, we took 300 billion of cost out of health care, now lets expand it to cover everyone!" No, you'd say "lets cut taxes! Give people the money back the government extorted from them!"

    I know this is mousetrapping, I only meant I've never floated or advocated that idea before just now. I know what this is and I know its the only way health reform would ever have been passed.

    Quote Originally Posted by LittleFuzzy View Post
    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.
    Yeah, Bush Sr. was a pretty good president as Republicans go, though I confess I didn't really appreciate how bad a president could be until his son took over.
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  11. #251
    Quote Originally Posted by Dreadnaught View Post
    But there is a wildly divergent view between those who believe in the vigorous expansion of government as an endgame
    There are people who have the expansion of the government as end .. goal? (Not sure about your use of Endgame)
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  12. #252
    Quote Originally Posted by wiggin View Post
    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.
    There was no chance at all to truely address the cost issues. If they would have gone after major cost reform, the industry would have come after the bill like it did in the '90s and nothing would have passed. The Republicans weren't going to be on board with any bill, no matter what. They made their calculation practically before the inaugeration that the way to fight Obama and the Democratic congress was to give them no legislative wins at all. That's the game they've been playing so any claim that this could have been bi-partisan is total bull. Obama did what they could, what they had to do to fix the moral wrongs of our health care system. The financial wrongs will have to wait for another day - one where congress and, god forbid, special interest (???), can actually put the interests of the country above those of power and money.

    Quote Originally Posted by Ziggy Stardust View Post
    There are people who have the expansion of the government as end .. goal? (Not sure about your use of Endgame)
    That's another conservative propaganda slur "Liberals Want Government Big" for its own sake. It goes along with "Big Goverment = Bad."
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  13. #253
    Ziggy, the Byrd rule means not one iota can be changed in the bill as it passed from house of representatives to the senate, not one word.

    Opposing people can use a fine toothed comb (read: staffers, interns) to find any tiny discrepancy, and use that as objection and make the voting go again. At least I think that's what it means. You don't really want to know who Byrd is....

    I doubt they'd use that to ADD the public option, it's too controversial still. Isn't this fun? Go go USA #1!

  14. #254
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    Quote Originally Posted by Dreadnaught View Post
    You and I seem to be going in circles about this. We're both complaining about costs...but it's absurd that you think this law is going to give people an incentive to save costs. The costs are being nationalized. The plan imposts costs and requirements on insurers that will raise premiums. But the insurance industry is okay with that because their industry is now corruptly protected by the requirement that everyone has to buy insurance. Increasingly, people will be unable to afford insurance and turn to subsidies.

    Read more about the plan, Hazir. .
    Indeed, more and more people will turn to subsidies. Which is not really a problem in my eyes as it forces the hand that won't be moved. You and your compatriots from now on will have two choices; politicians that do business as usual, or politicians that do the right thing.

    The first kind will let costs run up by not charging enough, (let's not forget the compulsary insurance is a tax technically) or by not being willing to prune entitlements. The second kind will get its hands dirty on the basis of what your country needs and can afford.

    The great thing about this bill is that nobody is not involved any longer. Your alternative would have been the choice of the deer caught in the headlights, waiting for the end to come.
    Last edited by Hazir; 03-25-2010 at 04:45 PM.
    Congratulations America

  15. #255
    Quote Originally Posted by EyeKhan View Post
    Because if you control the costs, which you won't, then that just means your deficit gets a little smaller. Nobody of your stripe would ever say "hey, we took 300 billion of cost out of health care, now lets expand it to cover everyone!" No, you'd say "lets cut taxes! Give people the money back the government extorted from them!"

    I know this is mousetrapping, I only meant I've never floated or advocated that idea before just now. I know what this is and I know its the only way health reform would ever have been passed.
    If you readily believe that that costs are uncontrollable, why do you want to nationalize the costs?

    Quote Originally Posted by Ziggy Stardust View Post
    There are people who have the expansion of the government as end .. goal? (Not sure about your use of Endgame)
    Fair enough, I wrote these posts either early before work or drunk after work.

    Quote Originally Posted by Hazir View Post
    Indeed, more and more people will turn to subsidies. Which is not really a problem in my eyes as it forces the hand that won't be moved. You and your compatriots from now on will have two choices; politicians that do business as usual, or politicians that do the right thing.

    The first kind will let costs run up by not charging enough, (let's not forget the compulsary insurance is a tax technically) or by not being willing to prune entitlements. The second kind will get its hands dirty on the basis of what your country needs and can afford.

    The great thing about this bill is that nobody is not involved any longer. Your alternative would have been the choice of the deer caught in the headlights, waiting for the end to come.
    In general, fiscal conservatives and libertarians don't want to bother to trust politicians because they are inclined to screw it up. Like I said, the "mousetrap" idea is a bad idea. Deliberately trapping a government in obligations it can't sustain to try and make those obligations cheaper is pure fantasy.


    ************************************************** ************************************************** **************************

    ALSO

    OPINION
    MARCH 25, 2010
    ObamaCare and American Power
    The lesson of Europe is that the U.S. can't fund a health entitlement and maintain superpower status.
    By MAX BOOT

    A lot has been written about the impact of ObamaCare on health care and the economy. I am worried about its impact on our global power.

    The United States currently spends roughly as much on defense ($661 billion in fiscal year 2009) as the rest of the world combined. But that's a pittance compared to what we spend on three major entitlement programs—Social Security, Medicare and Medicaid. Combined, they cost $1.38 trillion or almost 35% of the budget, compared with 17% for defense. And entitlements will only grow dramatically. The current unfunded liability for Social Security and Medicare, according to the 2009 Social Security and Medicare Trustees Report, is nearly $107 trillion—seven times the size of our economy.

    It's hard to remember now, but there was a time when the federal government spent most of its money on the armed forces. In 1962, the total federal budget was $106 billion of which $52 billion—almost half—went for defense. It wasn't until 1976 that entitlement spending exceeded defense spending. Since then the totals have been getting more lopsided—more for social programs, less, in relative terms, for defense.

    In 1935, Franklin Roosevelt assured the public that the new Social Security system would not lead to runaway spending. In 1965, Lyndon Johnson pledged that the fiscal impact of Medicare would be minimal. And now Barack Obama cites a Congressional Budget Office estimate claiming that the vast new health-care entitlement will actually reduce the deficit.

    Count me as skeptical. Odds are great that the cost-containment provisions will never be rigorously implemented while the promised subsidies will prove more costly than projected.

    In other words, ObamaCare will likely continue the trend already evident during the first year of the administration—when, thanks to the bank bailout and stimulus bill, federal spending as a share of GDP soared to 24.7%, unprecedented in peacetime. If you add in state and local spending, the government as a whole consumes 37.5% of GDP, up from 34.7% in 2008. Prepare for those figures to climb further as government takes on new health-care obligations.

    To consider the implications for defense, look at Europe. Last year government spending in the 27 European Union nations hit 52% of GDP. But most of them struggle to devote even 2% of GDP to defense, compared to more than 4% in the U.S.

    When Europeans after World War II chose to skimp on defense and spend lavishly on social welfare, they abdicated their claims to great power status. That worked out well for them because their security was subsidized by the U.S.

    But what happens if the U.S. switches spending from defense to social welfare? Who will protect what used to be known as the "Free World"? Who will police the sea lanes, stop the proliferation of weapons of mass destruction, combat terrorism, respond to genocide and other unconscionable human rights violations, and deter rogue states from aggression? Those are all responsibilities currently performed by America. But it will be increasingly hard to be globocop and nanny state at the same time. Something will have to give.

    President Obama's budget projects that "core" defense spending (excluding supplemental appropriations for wars) will fall as a percentage of GDP to 3% in 2019 from 3.9% in 2010. Assuming the economy keeps growing, that will still deliver more defense spending in absolute terms—but economic growth may well be endangered by the higher taxes needed to fund ObamaCare. Even if defense spending stays steady, it will be increasingly hard to replace aging weapons systems such as Bradley Fighting Vehicles, Abrams tanks and Black Hawk helicopters, which were purchased during the Reagan defense buildup.

    The Air Force, which is responsible for maintaining air and space superiority—a sine que non of American power—faces a particularly big budget crunch. Its aircraft are aging and need to be replaced (KC-135 tankers and B-52 bombers are more than 40 years old), but each new plane is much costlier than its predecessor.

    The Navy faces a similar problem. It now has only 283 ships—the smallest number since 1916. Granted, each of those vessels is much more capable than earlier models. But at some point quality cannot substitute for a crippling lack of quantity.

    The crunch will not come anytime soon. The U.S. will remain strong for years to come. But if we are looking at major threats to our global standing, we should not look at China, Iran or Russia. We have met the enemy and he is us—specifically, our insatiable demand for entitlement spending, which ObamaCare will only exacerbate.

    Mr. Boot is a senior fellow in National Security Studies at the Council on Foreign Relations and author most recently of "War Made New: Technology, Warfare, and the Course of History, 1500 to Today" (Gotham, 2006).

    http://online.wsj.com/article/SB1000...210163602.html

  16. #256
    Quote Originally Posted by Dreadnaught View Post
    In general, fiscal conservatives and libertarians don't want to bother to trust politicians because they are inclined to screw it up. Like I said, the "mousetrap" idea is a bad idea. Deliberately trapping a government in obligations it can't sustain to try and make those obligations cheaper is pure fantasy.
    You know, we let the private sector have its way for a long time and they destroyed our economy. Do you trust them to turn healthcare around without the government's firm grasp on their tail? The people we would need to trust are rats, not mice.
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  17. #257

  18. #258
    Quote Originally Posted by Dreadnaught View Post
    Yes, the economy destroyed the economy.
    Haha, a one liner from Dread. Is the private sector the economy or just part of it? Government has not shipped jobs overseas at anywhere near the rate as the private sector. The private sector bears most of the responsibility for the current state of our economy.
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  19. #259
    Quote Originally Posted by Dreadnaught View Post
    Yes, the economy destroyed the economy.
    You have the idea that everything that the government does is less efficient than private businesses.
    Not true. Healthcare market is inelastic, which means that increase in the supply side (healthcare centers or insurance companies) will not lower prices. Indeed, since people pay whatever price to stay alive, costs go on the rise with a private system. So current US system is like paying mafia protection.

    Historically US have had private healthcare during 20th century and prices have been raising.
    A History of Overhauling Health Care - Interactive Feature - NYTimes.com

    How do you explain this?
    The US healthcare system: Best in the world, or just the most expensive?
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  20. #260
    Quote Originally Posted by Dreadnaught View Post
    If you readily believe that that costs are uncontrollable, why do you want to nationalize the costs?
    Is your not reading my posts and then responding to something (else) you can argue against intentional, like what Loki used to do, or is this part of having your brain sucked out and replaced with Conservatism?
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  21. #261
    Quote Originally Posted by Being View Post
    Haha, a one liner from Dread. Is the private sector the economy or just part of it? Government has not shipped jobs overseas at anywhere near the rate as the private sector. The private sector bears most of the responsibility for the current state of our economy.
    The fact that you see the private sector and the government as inimically opposed actors in a zero sum game belies a pretty socialist outlook.

    Time for work. In my private sector job. In America. Oh dear, I'm a vampire, aren't I!

    Quote Originally Posted by EyeKhan View Post
    Is your not reading my posts and then responding to something (else) you can argue against intentional, like what Loki used to do, or is this part of having your brain sucked out and replaced with Conservatism?
    Forgive me, but when someone says, "Because if you control the costs, which you won't..." it gives me the impression that they don't think the costs can be controlled at all. Please clarify, you're bouncing all over the place.

  22. #262
    Quote Originally Posted by Dreadnaught View Post
    Forgive me, but when someone says, "Because if you control the costs, which you won't..." it gives me the impression that they don't think the costs can be controlled at all. Please clarify, you're bouncing all over the place.
    #1. You are forgiven (rest easy my friend).

    #2. What I meant was that no policy, at this point anyway, to make real cost reform in the health care industry had or has a chance of passage. The only reason we got the moral reforms is because the industry didn't feel any real threat to their Money. And the reason they felt safe is because the Obama Administration cut a bunch of deals with them at the outset. (Sorry for not being more clear, btw )
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  23. #263
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    Quote Originally Posted by Dreadnaught View Post
    If you readily believe that that costs are uncontrollable, why do you want to nationalize the costs?
    Because of accountability. There was none before, now there is.

    The article from the WSJ is nonsense.
    Congratulations America

  24. #264
    I didn't particularly like that WSJ article, either. Losing our global importance as a military force isn't such a 'bad thing'; shifting social spending to military spending isn't such a 'good thing'. Protecting the world's Freedom as globocop shouldn't fall just to us anyway, that's the old Republican party (FRIGHT) view of our role in the world and it's losing public support, for valid reasons.

    Regarding cost containment:

    Health care reform’s cost-cutting scalpel

    Research technique decides effectiveness ignoring age, cost or marketing
    BusinessWeek.com

    By Alex Nussbaum, Meg Tirrell, Pat Wechsler and Tom Randall
    updated 8:01 a.m. ET, Fri., March. 26, 2010

    One often-heard criticism of the health-care reform legislation that President Barack Obama has now signed into law is that it won't do enough to rein in the cost of treatment. U.S. medical spending has soared to $2.5 trillion per year (a price tag that has more than doubled in 15 years) and represents 18 percent of the nation's gross domestic product. Can Obamacare begin to cope with that?

    The answer is a qualified yes. Tucked inside the 2,400-page bill is an item (it's right there on page 1,617) that has generated far less attention and political heat than other parts of the White House's plan to expand medical coverage to 32 million uninsured Americans. The measure requires the U.S. to put aside $500 million or more a year for something called "comparative effectiveness research," an ungainly name for a process Obama hopes will reduce costs. The studies, designed to show which drugs, devices, and medical treatments work best, could have an enormous impact on the delivery of health care in the years ahead, scrutinizing everything from cholesterol drugs and heart stents to hospital procedures.

    By using statistics-driven research methods, its backers say, comparative effectiveness promises to bring scientific rigor to medical decision-making that is too often influenced by tradition and marketing. As such, the research is one of the few measures in the new law that has any chance of flattening America's medical cost curve, according to Boston-based health-care analyst John Sullivan of Leerink Swann.
    continued -- http://www.msnbc.msn.com/id/36043001...sinessweekcom/


    Reminds me of when DRGs hit the scene for Medicare reimbursements. Analytics groups made software assigning a price for every ICD-9 code, adjusted by region. Unfortunately, (predictably) the providers shifted reimbursement gaps to private insurers, since they paid more, and billed patients outside big networks for the balance. That's where the medical bankruptcies originate.

    Maybe if this model is used by everyone, it really will weed out waste, redundancy, and bring down costs?

  25. #265
    Quote Originally Posted by Hazir View Post
    Because of accountability. There was none before, now there is.

    The article from the WSJ is nonsense.
    There's accountability now? What are you talking about?

    Quote Originally Posted by GGT View Post
    I didn't particularly like that WSJ article, either. Losing our global importance as a military force isn't such a 'bad thing'; shifting social spending to military spending isn't such a 'good thing'. Protecting the world's Freedom as globocop shouldn't fall just to us anyway, that's the old Republican party (FRIGHT) view of our role in the world and it's losing public support, for valid reasons.
    It shouldn't just fall to us, but few are stepping up except in exceptional circumstances such as Afghanistan. If we willingly abdicate to fund a fantasy about being able to afford universal health care, global security will be left in the hands of...well, who? China?

  26. #266
    Conservatives and Republicans today suffered their most crushing legislative defeat since the 1960s.

    It’s hard to exaggerate the magnitude of the disaster. Conservatives may cheer themselves that they’ll compensate for today’s expected vote with a big win in the November 2010 elections. But:

    (1) It’s a good bet that conservatives are over-optimistic about November – by then the economy will have improved and the immediate goodies in the healthcare bill will be reaching key voting blocs.

    (2) So what? Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now.

    So far, I think a lot of conservatives will agree with me. Now comes the hard lesson:

    A huge part of the blame for today’s disaster attaches to conservatives and Republicans ourselves.

    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.

    Only, the hardliners overlooked a few key facts: Obama was elected with 53% of the vote, not Clinton’s 42%. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course the Democrats also remember their history, and also remember the consequences of their 1994 failure.

    This time, when we went for all the marbles, we ended with none.

    Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

    Barack Obama badly wanted Republican votes for his plan. Could we have leveraged his desire to align the plan more closely with conservative views? To finance it without redistributive taxes on productive enterprise – without weighing so heavily on small business – without expanding Medicaid? Too late now. They are all the law.

    No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?

    We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.

    There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

    I’ve been on a soapbox for months now about the harm that our overheated talk is doing to us. Yes it mobilizes supporters – but by mobilizing them with hysterical accusations and pseudo-information, overheated talk has made it impossible for representatives to represent and elected leaders to lead. The real leaders are on TV and radio, and they have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination. When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

    So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished. For the cause they purport to represent, it’s Waterloo all right: ours.
    http://www.frumforum.com/waterloo
    The light that once I thought compassion still casting shadows in your action
    The words you shared were cold transactions that bring me to curse what you've done
    When you're up there absorbed in greatness with such success you've grown complacent
    I hope you scorch your many faces when you fly too close to the sun

  27. #267
    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.

    We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.

    There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?
    Exactly. When they complain the Dems didn't listen or want to work with them they show the level of integrity they play with. Liars and backstabbers who don't care one rats ass about this country; just about having the power. Fuck them. They arn't any more fit to govern than when GW was fucking up everything.

    EDIT: I've never considered it from this perspective, but he makes a lot of sense:

    When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

    So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished. For the cause they purport to represent, it’s Waterloo all right: ours.
    And good, I hope he's right.
    Last edited by EyeKhan; 03-27-2010 at 02:22 AM.
    The Rules
    Copper- behave toward others to elicit treatment you would like (the manipulative rule)
    Gold- treat others how you would like them to treat you (the self regard rule)
    Platinum - treat others the way they would like to be treated (the PC rule)

  28. #268
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    Quote Originally Posted by Dreadnaught View Post
    There's accountability now? What are you talking about?



    It shouldn't just fall to us, but few are stepping up except in exceptional circumstances such as Afghanistan. If we willingly abdicate to fund a fantasy about being able to afford universal health care, global security will be left in the hands of...well, who? China?
    Look you are used to a situation where nobody was responsable for overspending on health care because near everybody was responsable only for his part. From now on the budget will be more and more about the cost of health care and there will be micro management necessary to make it affordable. That change will not come overnight, but it will come. Like I said before, the elephant in the room has been mentioned and can't be unmentioned again.
    Congratulations America

  29. #269
    Frum got canned from his position at AEI for that truth, and saying "we used to think Fox news worked for us [the RNC], but we work for them". Paraphrased.

    Dread:
    If we willingly abdicate to fund a fantasy about being able to afford universal health care, global security will be left in the hands of...well, who? China?
    Maybe our fantasy is funding and providing global security, clinging to a superpower status that kills 'empires'?

  30. #270
    Quote Originally Posted by Hazir View Post
    Look you are used to a situation where nobody was responsable for overspending on health care because near everybody was responsable only for his part. From now on the budget will be more and more about the cost of health care and there will be micro management necessary to make it affordable. That change will not come overnight, but it will come. Like I said before, the elephant in the room has been mentioned and can't be unmentioned again.


    That's pretty much the same logic that got the US government into the Fannie Mae and Freddie Mac mess.

    Mortgage interest rates are too high for poor people. Well, let's mettle into the mortgage market and buy lots of mortgages with an implicit government guarantee. It will lower costs for everyone! And if there are imbalances, legislation will fix them.

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