OBAMA/TRUMPCARE MEGATHREAD

[NorthSideSox72]

The current political environment isn't going to change any time soon. I know a lot of people on the right cynically lol'd at people on the left who bought into the Obama "new kind of politics" movement and found out it was business as usual, then they bought totally into the Tea Party movement and swore it was going to be different and change everything. Politics is politics.

On the flip side of that, most people scoffed at the idea of Obama or any racial minority becoming the President. Not everything changes, and most things don't change quickly, but things definitely change over time. The political map has changed dramatically over decades, geographically and figuratively.

 

[kapkomet]

Well, let's put it this way. House GOP - vote every day about killing health care because of the outrageous cost (which is true, but whatever). And then immediately put out a "tough vote" on $32 billion in cuts. GMAFB. Tough choices my ass, and real change my ass. They all can go to hell.

[BigSqwert]

Who wouldn't want a doctor like this?

[StrangeSox]

this doesn't follow:

 

Then the board members lightened up and asked me about my practice. Both of them were in their late 60’s. They whipped out their iPhones and told me how their grandkids were teaching them to text and how the internet has a real potential to change healthcare. Then they started complaining about the current state of medicine and the death of the doctor-patient relationship. They loved my practice and congratulated me on being innovative.

 

As of today, I haven’t seen a patient in over three years. This tale was just one minor reason why I stopped practicing.

 

It sounds like the matter was dropped. So why did he stop?

[Iwritecode]

It's in the comments farther down:

 

I stopped because I wanted to build things on the internet that help other doctors do what I did because a few thousand doctors contacted me asking how they could do it as well. So I decided that if I can build a platform that enables this to happen, millions of people could be helped rather than a few thousand of my patients here in Williamsburg. I found that I couldn't do both because building technology is very time consuming. And I didn't want to be the doctor who is only occasionally available and holding true to his promise.

[Balta1701]

There are 14 judges on the Fourth Circuit Court of Appeals, but only three will sit on the panel that hears today’s arguments over the health-care law. Those three are chosen by way of “a computer program designed to achieve total random selection.” And today, that computer program chose two Clinton nominees and an Obama nominee. Game over, says conservative policy reporter Phillip Klein. “ObamaCare is likely to be upheld by 4th circuit.”

Link

[HuskyCaucasian]

Link

I understand that the program is supposed to be completely random, but wouldnt it help to run the program several time and take the top vote getters?

[Balta1701]

I understand that the program is supposed to be completely random, but wouldnt it help to run the program several time and take the top vote getters?

If it's random then eventually if you run the program enough times they should all have close to the same number of votes.

[HuskyCaucasian]

If it's random then eventually if you run the program enough times they should all have close to the same number of votes.

Oh i understand. I am not saying they run it 500 times. maybe like 5-10. That would at least help limit the possibility of such a lopsided group from being formed (not that I am complaining)

Edited May 10, 2011 by Athomeboy_2000

[Balta1701]

Oh i understand. I am not saying they run it 500 times. maybe like 5-10. That would at least help limit the possibility of such a lopsided group from being formed (not that I am complaining)

If the choosing is truly random then the probability of a lopsided group forming is the same whether they do the votes 1 time or 20 times.

[StrangeSox]

Falling life expectancies in the US

 

 

US Healthcare! Best in the world! :headbang

[NorthSideSox72]

Falling life expectancies in the US

 

 

US Healthcare! Best in the world! :headbang

You show that life expetancy continues to increase, but for a specific region and gender, and you manage to take that as a sign of failing health care. Quite a leap, no?

 

Also, look at the region where this is primarily occurring - mid-south and appalachia. I lived in the mid-south. The primary problem isn't access to good health care, its lifestyle choices. Fried foods galore, lots of booze, high % of smokers, all of course linked with poverty. If anything, I think the map suggests its worth investing in a fight against poverty, more than a fight against health care.

 

[StrangeSox]

You show that life expetancy continues to increase, but for a specific region and gender, and you manage to take that as a sign of failing health care. Quite a leap, no?

 

Life expectancy in the US is increasing more slowly than all of those awful socialist countries with terrible healthcare and rationing and millions fleeing to America to get treatment. In some places, it's actually falling, which just doesn't really happen in developed countries.

 

In 737 U.S. counties out of more than 3,000, life expectancies for women declined between 1997 and 2007. For life expectancy to decline in a developed nation is rare. Setbacks on this scale have not been seen in the U.S. since the Spanish influenza epidemic of 1918, according to demographers.

 

"There are just lots of places where things are getting worse," said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, which conducted the research. "We're not keeping up."

 

....A key finding of the data is that "inequality appears to be growing in the U.S.," said Eileen Crimmins, a gerontologist at USC who also co-chaired the 2011 National Academies panel on life expectancies. "We are different than other countries.

 

It's not a leap to lampoon the "rah! rah! best healthcare system in the world!" cheerleading crap based on that.

 

Also, look at the region where this is primarily occurring - mid-south and appalachia. I lived in the mid-south. The primary problem isn't access to good health care,

 

Well, that is a huge problem, especially since it's generally the impoverished areas we're talking about. But...

 

its lifestyle choices. Fried foods galore, lots of booze, high % of smokers, all of course linked with poverty.

 

Agreed, but I'll point to the same "rah! rah!" cheerleaders viciously attacking Michelle Obama for her healthy foods campaign, vehement opposition to trans fat bans or taxes, vehement opposition to food subsidies for the poor, etc.

 

If anything, I think the map suggests its worth investing in a fight against poverty, more than a fight against health care.

 

A big problem with health care and access to it is poverty. But, yeah, ultimately poverty is the larger issue here and a single-payer UHC system is an attempt to address just one area that's largely affected by poverty. It's just that it's a pretty important area.

 

[StrangeSox]

Here is the complete article:

http://www.pophealthmetrics.com/content/9/1/16/abstract

 

Smoking and obesity are cited as primary causes along with wealth inequality.

 

From the article:

"Equally concerning is that between 2000 and 2007, more than 85% of American counties have fallen further behind the international life expectancy frontier, of which 55% were statistically significant at the 90% confidence level. While the US and most of its communities fell further behind, the US maintained its position as the country that spent the most per capita on health care throughout this period."

[southsider2k5]

You show that life expetancy continues to increase, but for a specific region and gender, and you manage to take that as a sign of failing health care. Quite a leap, no?

 

Also, look at the region where this is primarily occurring - mid-south and appalachia. I lived in the mid-south. The primary problem isn't access to good health care, its lifestyle choices. Fried foods galore, lots of booze, high % of smokers, all of course linked with poverty. If anything, I think the map suggests its worth investing in a fight against poverty, more than a fight against health care.

 

And the best part is we are now going to be required to pay for it all.

[bmags]

And the best part is we are now going to be required to pay for it all.

 

We already are.

[Balta1701]

I lived in the mid-south. The primary problem isn't access to good health care, its lifestyle choices.

Access to health care for lower income classes may be hidden behind the scenes, but it's far worse in the deep south than in the rest of the country. Texas of course is the worst in the country.

 

 

 

Of course, diet and lifestyle choices play a part as well. However, simply saying "the primary problem" means I need some means to evaluate that one of those options matters more than the other...because they are both true.

 

Furthermore...even if the primary problem is diet/nutrition, that doesn't mean they should be SOL on access to health care.

[BigSqwert]

Obesity — Not Aging — Balloons Health Care Costs

Contrary to popular belief, people who live longer are healthier and have fewer medical bills. Obese people, however, are living longer with health care costs increasing at an alarming rate. So efforts to prolong vitality are not, in themselves, an economic Frankenstein.

 

“I guess I don’t so much mind being old, as I mind being fat and old.” — Peter Gabriel

 

Our rising life expectancy has been nice for those who like being alive, but it seems a bummer for society as a whole. Even if Social Security doesn’t go bust as baby boomers slowly saunter into the sunset, their massive Medicare costs seem likely to crush the economy. Not surprisingly, further major gains in longevity, which researchers on aging have recently achieved with drugs in animals, is about the last thing deficit-obsessed policymakers want to see happen. Accordingly, less than 0.5 percent of the National Institutes on Health’s annual budget is allotted to basic research on aging.

 

But the idea that anti-aging researchers are tinkering with an economic Frankenstein’s monster rests on a conventional wisdom that is actually a mass hallucination — namely, the notion that when people live longer, they rack up greater health care costs.

 

Here are the facts: People who live an unusually long time tend to be healthier during their later years than shorter-lived people. That means longer-lived ones typically have lower medical costs during their golden years. This health dividend more than offsets the health care costs they accrue by outliving less healthy people.

 

The proof came out in 2003 in the New England Journal of Medicine. Analyzing Medicare data, federal researchers showed that elderly people in good shape at age 70 — meaning they had no difficulties performing tasks of daily living such as walking and shopping — could expect to live to 84.3, and after 70 they had average, cumulative health care bills totaling $136,000. In contrast, less healthy 70-year-olds with at least one limitation in daily-living activities could expect to live to 81.6 — nearly three years less — yet had cumulative medical bills of about $145,000 during their shorter remaining lives.

 

Thus, boosting longevity with anti-aging medicines might well lower Medicare expenses on a per-capita basis. Indeed, the three lifespan-boosting interventions known to work in animals — very low-calorie diets (calorie restriction), certain gene mutations and chronic doses of certain drugs, most convincingly rapamycin — expand the amount of time animals spend in good health during their lives.

 

Unfortunately, there’s a giant exception to the rule that the longer life tends to be a healthier one: Obese people are living longer, thanks to factors such as cholesterol-cutting medicines (as is the entire population), but much of their extra time is spent in ill health, and as a result, their annual medical bills are some 42 percent higher than those of normal-weight people. In fact, the obesity epidemic has greatly increased the prevalence of chronic diseases such as diabetes, but contrary to much of the media coverage on the epidemic, it has had little effect on mortality rates. As the title of one study put it, “Smoking kills, obesity disables.”

 

Even if rising obesity rates top out — and that may happen, now that more than a third of U.S. adults are obese — the associated medical costs will become much heavier in coming years as people with obesity-associated diseases get older and sicker. Tens of millions of pot-bellied boomers entering their Medicare years is not a pretty sight from a medical economist’s perspective.

 

The CDC recently attributed $147 billion a year in U.S. medical costs to obesity — over 9 percent of all U.S. health care spending. The nation’s obesity bills are just beginning to ramp up, though, and will soon be growing at a pace comparable to the increase in government medical spending due to the graying of boomers. Annual obesity-related health care costs are projected to rise by nearly $265 billion a year between 2008 and 2018, while annual Medicare expenditures are expected to increase by about $360 billion during the same period. And much of the rise in Medicare spending will go toward treating obesity-related diseases. As one researcher noted, when it comes to chronic health problems, being obese is roughly equivalent to being aged by 20 years.

 

You might think that anti-aging drugs, like conventional medicines, would only increase these expenses by effectively increasing morbidity faster than mortality. But if obesity essentially accelerates aging, medicines that brake aging are precisely what the doctor should order (along with exercise and eating right). Indeed, longevity-boosting agents that work in animals, such as rapamycin, appear to mimic the effects of calorie restriction, and thus induce metabolic changes very much like those caused by stringent, long-term dieting — which is what calorie restriction is. (Calorie restriction has been shown to increase healthy lifespan by 30 percent or more across a wide range of species.) That suggests such drugs, if proved safe to take chronically as preventive medicines, would have unprecedented efficacy in ameliorating or warding off obesity-associated diseases, regardless of whether they induce weight loss.

 

Supporting this argument, metformin, a diabetes drug that steadies blood-sugar levels in people and mimics the effects of calorie restriction on gene activity in mice, has been shown to extend healthy lifespan in nondiabetic rodents. More than 50 million prescriptions for metformin are written annually in the U.S. This means the anti-aging revolution may already have been accidentally launched — years from now, we may discover that long-term use of metformin by diabetics has increased their healthy lifespan far more than can be explained by its effect on their blood sugar levels. (Which is what you’d expect from a drug that brakes aging, and thus delays or averts diseases of aging.) There’s already evidence that people on metformin have lower risk of cancer, dementia, heart failure and other diseases of aging.

 

Peter Gabriel had it almost right: What’s truly bad about getting old is getting old and sick. Aging science has shown a way to mitigate this sad conjunction more effectively than any other medical advance on the horizon.

 

As a society, however, we’ve shown little interest in pursuing this “longevity dividend”— not surprising, given anti-aging research’s Frankenstein rap. And that’s more than a little ironic, given that no pursuit better serves both our instinctive self-interest and the larger interests of society than attempting to buy us quality time — extra years spent in good health — as cheaply as possible.

[Iwritecode]

Need health care? Just rob a bank.

[Balta1701]

A F***ING REPUBLICAN JUDGE VOTED TO APPROVE THE INDIVIDUAL MANDATE! THE WORLD IS ENDING! REPENT, REPENT YOUR SINS NOW!

The Obama administration won the first appellate review of the 2010 health care law on Wednesday as a three-judge panel from the United States Court of Appeals for the Sixth Circuit in Cincinnati held that it was constitutional for Congress to require that Americans obtain health insurance.

 

...

 

The Sixth Circuit opinion is the first on the merits that has not broken down strictly along seemingly partisan lines. Two of the judges on the panel were appointed by Republican presidents and one was appointed by a Democrat. At the lower District Court level, five judges have divided on the question, with three Democratic appointees ruling in favor of the law and two Republican appointees rejecting it.

[BigSqwert]

Proud to be an American, Where At Least I Know I'm Free

by David Atkins ("thereisnospoon")

 

About a month ago I was met with an unfortunate occurrence. Somehow, in the process of drinking an iced tea with small granules at the bottom, I awkwardly swallowed a larger-than-usual granule. Having had a tonsillectomy and adenoidectomy in my youth, I have occasionally had the annoying misfortune of getting foreign objects lodged in the passage between the nose and throat. The granule felt as if it had found the same unhappy spot.

 

But unlike in past circumstances, the granule did not seem to dislodge. After taking steps to flush my sinuses and research the subject online, I came to the conclusion that it might simply be a scratch. But it certainly felt as though there was an object there, and I was having a sinus reaction accordingly. Unfortunately, it was also 8 o'clock in the evening, which meant that I had two choices: stick it out until morning and see a regular physician, or head to the emergency room. I'm not the type to go to the emergency room for colds or flu; I tend to use medical services sparingly. But the discomfort was intense. After much internal debate, I decided to go to the emergency room. After all, I was having a physical reaction to whatever it was that was making basic swallowing difficult. I have insurance, and whether it were a foreign object or just a scratch, it couldn't be too complicated or expensive.

 

I knew it would take some time to be seen; after all, my case was probably the least critical they had. So I brought a book and settled in for the long haul. After 3 hours waiting on the floor of the emergency room without even a chair to sit in, I was finally admitted. A harried doctor examined me for approximately 30-90 seconds with a regular scope, said he couldn't see anything but that there might still be blockage that he was unequipped to detect, said there was nothing else he could do, and sent me on my way. The actual visit took less than two minutes.

 

Today I got my bill. The total? $371. $371 for a three-hour wait, followed by a two-minute visit, with no procedures of any kind performed. And that's with pretty decent insurance.

 

This story should be an outrage. But, of course, it isn't. It's a completely typical occurrence in modern America, a most trivial complaint in a sea of raging injustice that bankrupts hundreds of families every day for the crime of having gotten sick.

 

But here's the rub: even such a trifling issue as the one I've described can serve an object lesson in the failure of conservative economics. I run a small business; most the work I do is performed in-house, but I do often employ subcontractors. The degree to which I employ them is predicated on demand: i.e., whether I can keep up with the workload without losing income by farming it out to others.

 

With an unexpected $371 to pay, I will be forced to take on more work myself, and be stingier about hiring a subcontractor. That decision will have a domino effect on all sorts of businesses and services that I and my subcontractors might use. In its own small way, it's a hit to economic growth.

 

But conservatives expect that I should be grateful for keeping my corporate tax rates low, even though those tax rates make almost zero impact on whether I hire a subcontractor or not. Remember: it's demand that drives hiring, not tax rates. Either there's too much work for me to handle comfortably or there isn't. A marginal difference to my tax percentage on end-of-year profits makes essentially zero difference to my hiring decisions.

 

But that $371 medical bill certainly does. To say nothing of the fact that it will dissuade me from seeing a physician next time something goes wrong--and that next time it might just be serious.

 

So thanks, conservatives, for fighting against a decent healthcare system to keep my corporate taxes low! You've done a great service...for somebody. But not for me as a small business owner. And not for my employees and subcontractors. And not for this country, which still yearns to be free of your small-minded, economically ignorant tyranny under the guise of "freedom from taxes."

 

link

[bigruss]

I am genuinely confused, $371 makes an impact but rising taxes don't? Wouldn't those taxes most likely cost him much more than $300?

Edited July 26, 2011 by bigruss22

[Y2HH]

link

 

While I understand what he's trying to say, and I agree with the attempted point, it shows he doesn't quite understand the system in the first place.

 

It's simply this: Whether the government supplied you with insurance or money to pay the bill in full, or an insurance company pays it in full or helps you pay it in part, or whether it comes out of your own pocket, it's *still* an astronomical and totally unjustified amount.

 

Breaking this down, a 2 minute visit charged at 371$ = $267,120 a day.

 

This -- once again -- goes back to my argument from the very beginning of this entire debate. It's not insurance companies. It's not government subsidies. It's the doctors/hospitals and all the waste in between, it always was, and it always will be. For two minutes of "work", in which very little service and no actual solution was rendered, any bill of this amount is totally absurd.

 

Whether it's the government paying that, or an insurance company, or a person...it's out of control.

[Y2HH]

I am genuinely confused, $317 makes an impact but rising taxes don't? Wouldn't those taxes most likely cost him much more than $300?

 

It shows he doesn't understand the underlying problem, and yes...what you said is right. That said, it doesn't matter...nobody should be getting bills for 300+$ for 2 minutes of work in which no solution was found. Ever. I don't care if it was the government paying it...no, no...and no.

[bigruss]

It shows he doesn't understand the underlying problem, and yes...what you said is right. That said, it doesn't matter...nobody should be getting bills for 300+$ for 2 minutes of work in which no solution was found. Ever. I don't care if it was the government paying it...no, no...and no.

I agree, especially because that's the price AFTER insurance. So that means the hospital charged even more than that $300+.