Health Care Bill Debate

[John T. Galt]

In late 2005, the head of the U.S. Army Reserve told President Bush that his service was in peril of becoming a broken force. We've heard much talk about stop-loss, the inappropriate use of Reserve and National Guard troops for extended overseas tours, and other personnel challenges such as diminishing standards for enlistment. We stretched far too thin for Iraq.

The thing is that Iraq was a political choice. The significance of the Iraqi Bush Adventure in terms of the role of the American military is still unresolved. People famously recall Cheney, in 1994, saying that the reason we didn't go to Baghdad the first time 'round was, well, that it would lead to chaos, sectarian violence, and a quagmire. Even more important, though, of all the things I didn't like about Poppy Bush, he was correct when he said during the Gulf War that going to Baghdad was not the traditional mission of our services. Liberating Kuwait was one thing, but taking down Iraq something else entirely.

By any reasonable custom of warfare, we had a proper reason to go to Afghanistan. Not so for Iraq. Had Bush focused on Afghanistan—e.g., a sincere effort—instead of diverting our primary focus to Iraq, I can't tell you what it would look like today. Nobody invades the Kush and wins. Maybe we would be the first. But I have a feeling that if we had 150,000 troops in Afghanistan from the outset, instead of 31,000 at the peak of the Bush administration's commitment to the theatre, I think we would have made better progress.

But no. Iraq, the fraudulent war, was just that much more important.

Heres the original question:

And how, Mr. Tiassa, would you suggest the former president (don't confuse this with support or non support for a specific president) should put that sincere effort into it?

You have yet to answer the question. This (In late 2005, the head of the U.S. Army Reserve told President Bush that his service was in peril of becoming a broken force. We've heard much talk about stop-loss, the inappropriate use of Reserve and National Guard troops for extended overseas tours, and other personnel challenges such as diminishing standards for enlistment. We stretched far too thin for Iraq.) is as close as you have come. Are you saying he should have not allowed troops to be stretched thin? If so, could that also suggest that a sincere effort was being made? If not, how does stretching the troops thin suggest an insincere effort? Mismanagement, yes. Insincere, no. Maybe you should clarify without ranting what exactly you mean by saying sincere effort?

Are you saying he should have sent more from the start? And what was your response to the surge?

The rest of your diatribe is nothing more than a rant and adds nothing to your answer.

-Galt

 

[Tiassa]

(Insert Title Here)

It's really not as hard as you're making it out to be, Mr. Galt.

If we divert our attention and resources from perceived necessity (e.g., national defense) in order to pursue our fancy (e.g., Iraq), we are not making a sincere effort vis á vis necessity.

To reduce it to something utterly simplistic: Imagine your house is on fire. Are you going to call the fire department? Maybe try to put out the flames yourself? Or are you going to go bang a hooker?

 

[pjdude1219]

It's really not as hard as you're making it out to be, Mr. Galt.

If we divert our attention and resources from perceived necessity (e.g., national defense) in order to pursue our fancy (e.g., Iraq), we are not making a sincere effort vis á vis necessity.

To reduce it to something utterly simplistic: Imagine your house is on fire. Are you going to call the fire department? Maybe try to put out the flames yourself? Or are you going to go bang a hooker?

call the fire depatment than go bang hooker

 

[joepistole]

Furthermore, joe, I have and do. I can't help that you have issues with opposition and refuse to respond to the substance of posts.

I gave you a factual portion of the H.C. twice and I got an infraction. I hope honest people will see this and stand up for the idea of debate and what is real trolling and flaming.

I also think something should about done about runaway mods.

First, I have no issues with opposing views or positions as long as they are well reasoned and grounded in an honest search for reasonable solutions. There is an old saying that reasonable men can reasonably disagree, and there is a lot of truth in that old saying. There have been and are conservative and liberal members of this forum in which I disagree but still respect. We come to agree to disagree and the arguements on both sides were reasoned.

Where I draw the line is in emotion ridden fear mongering which has come to be typical of the birthers, teabagers, dittoheads, et al especially when it has come to endanger the health of the economy and the nation. The truely sad thing is that the birthers, dittoheads, teabagers, et al cannot see rational argument or discourse...nor do they welcome it.

When it comes to mods, they have been for the most part in this forum reasonable...not at all runnaway in any sense of the word. I support the mods in their efforts to keep the forum healthy. Again, I may not always agree with them or them with me. But I respect them and encourage you to do so as well.

As for your posts, I think they are self evident and speak for themselves.

 

[John T. Galt]

It's really not as hard as you're making it out to be, Mr. Galt.

If we divert our attention and resources from perceived necessity (e.g., national defense) in order to pursue our fancy (e.g., Iraq), we are not making a sincere effort vis á vis necessity.

To reduce it to something utterly simplistic: Imagine your house is on fire. Are you going to call the fire department? Maybe try to put out the flames yourself? Or are you going to go bang a hooker?

So then, you supported the surge. What the hell is the problem then?

 

[pjdude1219]

The dems should follow clinton's advice ignore the GOP. They aren't the people's voice.

 

[joepistole]

Obama spanked some Republican Butt this evening in his speech before the joint session of Congress! He called the Republicans on the carpets for the lies they have been spreading. Now it remains to be seen if he continues along that line as he promised.

I could not help but notice the uncomfortable look on the faces of Republicans and in particular John Boehner, House Minority Leader. I hope the Republicans face many more such uncomfortable events as Obama holds them accountable for their lies.

 

[dsdsds]

Another great speech. He showed confidence, toughness, and intelligence. I'm glad he didn't shy away from referring to the previous admin failed policies. The GOP was represented (mainly) by the classless Joe Wilson who heckled the POTUS (called him a liar) during the speech. I hope he'll pay for that. -- maybe not - South Carolina. :crazy:

 

[John T. Galt]

Obama spanked some Republican Butt this evening in his speech before the joint session of Congress! He called the Republicans on the carpets for the lies they have been spreading. Now it remains to be seen if he continues along that line as he promised.

I could not help but notice the uncomfortable look on the faces of Republicans and in particular John Boehner, House Minority Leader. I hope the Republicans face many more such uncomfortable events as Obama holds them accountable for their lies.

What lies?

First, end of life decisions. As Krauthammer says it isn’t the sinister thing that Palin makes it out to be, but it isn’t innocuous either.

Second, for keeping your current coverage, the supposed number of uninsured, the cumulative costs of having the public option (single payer) IBD has the rest of the alleged lies covered. I would caution you though, because the lies aren’t coming from the right.

Oh, and I am familiar with the Hawking issue. IBD does address this and then some. Furthermore keep the thought in mind that simply because one mistake was made, doesn’t dismiss the entire story.

 

[joepistole]

The other thing I found interesting is the Republican response. It reitterated many of the Republican misinformation about healthcare reform. But the really interesting part is where they claim they want to insure that everyone has access to affordable healthcare. But if you look closely at their response, their solution to affordable healthcare is more government subsidy like Medicare Prescription Drug Bill (Part D) which was totally unfunded like similar Republican measures of the past. And Medicare Prescription Drug bill was full of no bid contracts and costs more than a half trillion dollars over 10 years...more than half what Obama is proposing to insure all Americans over the same time period.

So bottom line, Republicans are now claiming they too want healthcare reform. But there is nothing in their plan that will reduce healthcare costs. Moving healthcare costs from consumers and businesses to public coffers without tax increases and without off setting cuts else where is just plain irresponsible...the same kind of fiscal irresponsibility we have seen from the Republicans for the last eight years. I honestly don't know how they can look themselves in the mirror each morning.

 

[iceaura]

What lies?

Every single declarative statement made by any GOP spokesman about the current health care proposals has been wrong, sometimes flagrantly so.

As far as whether they are lying, or stupid - that's been the continual question with these guys for years now.

For example, this:

the cumulative costs of having the public option (single payer)

Now is that parenthetical nonsense (the public option is what the various plans include instead of the single payer setup, which was prescreened out and never considered) a lie or a dumb mistake? Dishonest or dumbass?

Furthermore keep the thought in mind that simply because one mistake was made, doesn’t dismiss the entire story.

How about one thousand mistakes, and nothing but mistakes?

Not the mistake, but the example of Hawking, dismisses the entire story. It was the central issue of the entire essay. It was typical and illustrative of the entire wingnut campaign against medical care delivery reform.

They've been repeating their bullshit so loudly and so often for so long that they can't see the reality of any of these situations. They don't check their "facts" - all of them are wrong.

 

[joepistole]

Perhaps the better question is, what have Republicans and their healthcare industry industry masters said about healthcare reform is true? I think you could easily answer that with one word, nothing.

 

[superstring01]

I find myself, grudgingly, rooting for the Democrats in the Congress.

I absolutely detest the thought of a federally controlled health care scheme, but I find myself even MORE horrified by continued corporate control. I can craft a dream solution (1- universal catastrophic coverage; 2- tort reform; 3- elimination of pre-existing conditions & dropping of covered members; 4-health care exchange), but I don't see it happening.

Why root for the Democrats over Republicans? Simple. The Republicans' plate was never so full over their 6 years of near-absolute power (the Congress & President) that they couldn't have tackled this problem. The fact that they had the ability, the motive, the moral reason and the momentum and STILL didn't lift a finger, removes pretty much any right they have from pretending to occupy the high ground. Bitching about the cost of such reform is the epitome of hypocrisy (it's not like the same voices were being heard during tax cuts and the Iraq invasion, which actually cost MORE than this bill will, at present).

In the end, I hope and think this bill will achieve at least the three things from my list (but leaves out tort reform; which is total pandering to trial lawyers). At the end of the day, if Obama and the Democratic Congress can't get this passed, then there's little hope for anything else until after the next elections.

~String

 

[iceaura]

1- universal catastrophic coverage;

The big savings come from universal ordinary coverage.

In the end, I hope and think this bill will achieve at least the three things from my list (but leaves out tort reform; which is total pandering to trial lawyers).

The big thing it will not achieve is cost control. Tort reform is a small part of that (and a part Obama addressed directly), far moer important (a third of the cost, currently) is the coddling of phony notions of "competition", as a means to protect insurance company profits.

 

[kmguru]

Republicans want a lot of doctors to stir competition. Is not that a good thing? But here is the catch. There will be only $10 Million available as student loan for flooding the country with new doctors. Since it takes $200K to educate a doctor, that is 50 doctors total in next ten years.

Another item is if that doctor who took a loan of $200K would work at a community hospital (we have those?) for 5 years at perhaps $80K per year, the GOP will forgive $50K. What a deal!

 

[nirakar]

What I see Obama advocating for is a national version of the Massachusetts plan which is a bad plan. The Massachusetts plan may have been good for the Insurance industry and good for large corporate employers looking for small reductions in their insurance payments for their workers but Taxpayers lost and young lower middle class healthy people who were forced to buy overpriced insurance that they did not want at those prices lost.

Even though the current US health care system is the most inefficient health care system in the World, it would still be better to have no health care "reform" than to have this thing that Obama and Congress and the insurance industry and some big corporate employers are cooking up together.

 

[Tiassa]

Plot twist?

Just in case this wasn't ridiculous enough:

O'REILLY: The public option now is done. We discussed this, it's not going to happen. But you say that this little marketplace that they're going to set up, whereby the federal government would subsidize insurance for some Americans, that is, in your opinion, a public option?

OWCHARENKO: Well, it has massive new federal regulation. So you don't necessarily need a public option if the federal government is going to control and regulate the type of health insurance that Americans can buy.

O'REILLY: But you know, I want that, Ms. Owcharenko. I want that. I want, not for personally for me, but for working Americans, to have a option, that if they don't like their health insurance, if it's too expensive, they can't afford it, if the government can cobble together a cheaper insurance policy that gives the same benefits, I see that as a plus for the folks.

(Huffington Post)​

You know ... just ... because.
___________________

Notes:

"Bill O'Reilly Backs Public Option". Huffington Post. September 17, 2009. HuffingtonPost.com. September 17, 2009. http://www.huffingtonpost.com/2009/09/17/bill-oreilly-backs-public_n_290658.html

 

[Tiassa]

Doctors onboard with public option

Source: National Public Radio
Link: http://www.npr.org/templates/story/story.php?storyId=112818960
Title: "Poll Finds Most Doctors Support Public Option", by Joseph Shapiro
Date: September 14, 2009

On Monday's All Things Considered, Joseph Shapiro reported on a Mount Sinai School of Medicine survey suggesting that 73% of doctors support some form of a public option. According to Shapiro:

Most doctors — 63 percent — say they favor giving patients a choice that would include both public and private insurance. That's the position of President Obama and of many congressional Democrats. In addition, another 10 percent of doctors say they favor a public option only; they'd like to see a single-payer health care system. Together, the two groups add up to 73 percent.

When the American public is polled, anywhere from 50 to 70 percent favor a public option. So that means that when compared to their patients, doctors are bigger supporters of a public option.​

​

In a follow-up segment with Melissa Block, NPR health policy correspondent Julie Rovner explained:

A lot of doctors I talked to have plenty of complaints about Medicare and particularly Medicaid, which has really low pay, but they say they're hassled by private insurance companies even more. And what appears to be an increasing number are coming to the conclusion that they'd rather deal with one government bad guy than dozens of private insurance bad guys.​

We need to remember as opponents of the reform package speak their alarm about government bureaucracies that the private bureaucracy in the health care industry is nothing to boast of.

And, you know, there's something of a sad irony in the whole recission thing. I had this moment earlier in the week where I was filling out some papers for my daughter's school, and at one point I wrote the wrong phone number on the wrong line. Now, that's the kind of thing Wendell Potter and others have accused insurance companies of, and that's the kind of thing three CEOs said they would not quit doing. Imagine that—an inconsistency in redundant paperwork. And here's the irony. People's premiums paid for the special effort that got them kicked off the roll in a time of need. Three hundred million dollars. That's about fifteen thousand dollars per person. Fifteen thousand. You're not even worth fifteen thousand dollars to these companies.

And that's a benefit of a robust private bureaucracy.
____________________

See Also:

Rovner, Julie and Melissa Block. "Poll Of Doctors And Public Option Examined". All Things Considered. September 14, 2009. NPR.org. September 18, 2009. http://www.npr.org/templates/story/story.php?storyId=112828974

National Public Radio. All Things Considered. September 14, 2009. NPR.org. September 18, 2009. http://www.npr.org/templates/rundowns/rundown.php?prgId=2&prgDate=9-14-2009

 

[milkweed]

I dont see this action as 'reform'. I see it as another tax (mandated health insurance). There was plenty the gov could have done without wrapping this one in a one-fell-swoop. There are a few examples of insurance company bs, such as dropping people when they need the insurance over a un-reported back injury, when the two issues are treatment for cancer vs unrelated back injury. This could have been handled with forced to maintain the policy while an appeal goes through. It would have limited insurance efforts to real cases of fraud.

Mandated insurance does not reduce costs, it increases them. MN vs WI is a good example. MN has forced no-fault car insurance, wisconsin does not. The price for car insurance in wisconsin is 1/2 to 1/3rd of car insurance in MN. Companies have to compete for the insurance dollar rather than having it guarenteed by law.

With this bill we will see health insurance prices go up and people being dropped from coverage, just like the credit card companies are doing now during the gap between when the bill is signed and the effective date.

For profit insurance needs to be reformed, with salary caps, administrative cost caps, and broader access across regions (ie uniformity between state laws).

Its too big of an issue to just rush through whatever we (congress) can get passed. And that seems to be whats happening.

 

[Tiassa]

The important thing about health care ... money?

An interesting point that seems nowhere to be found in the ongoing fracas over health care reform—medical school and compensation:

Running right down the median costs, paying off that $800,000 or so in debt (financed at about 5% a year) over the next thirty years of work eats up about $4300 a month; paying it off in ten years would cost nearly $8500 a month. A pediatrician or internist can expect to make about $14500 a month before tax; paying off this debt over thirty years will cost them about a third of their gross income. About half of that money will go to the financial services industry, in the form of interest.

If you want physician’s salaries to come down in the United States, without a true reduction in physician compensation, the natural choice would be to aggressively subsidize medical education and ensure young doctors come out of school carrying much less debt. A small amount of public investment up front will reduce a massive and ongoing source of inefficiency in the American medical system.

(Golob)​

Dear Science also notes the earnings involved, putting the average American salary at $42,000, the average American pediatrician or internist at $175,000, a general surgeon at $290,000, and a British primary care physician at between £53-80,000. Residency, "typically a brutal three to five years" in American medical practice, brings about $40,000 annually.

Comparatively few American doctors would admit to going into medicine strictly for the money, though there remains a social myth encouraging that course. But you pile up loads of debt, pay half of that to the service companies, and some years down the road start making that good money. Is it at all possible that, along with insurance company policies, tort reform, and all the other wonderfully messy issues involved in health reform, we might consider how we train and compensate doctors as part of understanding the expenses?
____________________

Notes:

Golob, Jonathan. "Why Are American Doctors So Damn Expensive?". Dear Science. September 15, 2009. DearScience.org. September 21, 2009. http://dearscience.org/2009/09/15/why-are-american-doctors-so-damn-expensive/