President Donald Trump: The Thread

[RockRaines]

The government already socialized healthcare for the old (Medicare) and some of the poor (Medicaid). Socialized health care, whether it's the more market-oriented model that Germany has or the single-payer system that Canada has or even the fully nationalized healthcare system that Britain has, simply functions better and at lower costs than our abomination of a system. Losing the "freedom" to die from lack of healthcare access but gaining the freedom to not die from not being able to afford health care is a fair trade off in many peoples' eyes.

There has also never and will never be a free market healthcare system. Somehow much of the rest of the civilized world can make sense of Universal healthcare.

[StrangeSox]

Seeing as the ACA put taxes on these plans? Absolutely. What else could you blame?

 

Seeing as how the Cadillac tax doesn't go into effect until 2020, maybe not?

[southsider2k5]

The government already socialized healthcare for the old (Medicare) and some of the poor (Medicaid). Socialized health care, whether it's the more market-oriented model that Germany has or the single-payer system that Canada has or even the fully nationalized healthcare system that Britain has, simply functions better and at lower costs than our abomination of a system. Losing the "freedom" to die from lack of healthcare access but gaining the freedom to not die from not being able to afford health care is a fair trade off in many peoples' eyes.

 

Huge difference between offering it, and making it mandatory if you are going to be alive.

[RockRaines]

Huge difference between offering it, and making it mandatory if you are going to be alive.

It certainly seems that this would be a better option in theory, but why cant anyone come up with something that can make this "hybrid" work?

 

And it still gives the wealthy significantly better options for healthcare which is certainly a philosophical debate.

[StrangeSox]

Huge difference between offering it, and making it mandatory if you are going to be alive.

 

I will say that I'm much less comfortable with requiring people to purchase a service from a private, often for-profit company or face a tax penalty rather than having a simple single-payer system or having a public option that could be purchased. Those latter two are closer to Medicare/Medicaid, where you are paying taxes for it regardless of whether you choose to utilize those services or not.

 

It certainly seems that this would be a better option in theory, but why cant anyone come up with something that can make this "hybrid" work?

 

And it still gives the wealthy significantly better options for healthcare which is certainly a philosophical debate.

 

The mandate exists because if you don't allow pre-existing condition exclusions, you'll have an insurance death spiral without. Healthy people are less likely to sign up and broaden the risk pool until they're sick and need health care.

Edited March 30, 2017 by StrangeSox

[illinilaw08]

It is a loss of freedom. Period. It is just as easy for the government to socialize pretty much anything because "it is for the public good". It is an absolutely terrible reason for anything when it comes to the power of the federal government.

 

We can debate the mandate, but let's start by acknowledging that the ACA didn't socialize medicine. The government doesn't run healthcare, it just mandates that people have to have healthcare or pay a penalty, and it kicks government money into the program. With or without the mandate, however, freedom to not have health insurance is really a freedom for those that can afford the service in the first place. Those who can't afford healthcare don't have the freedom to make any sort of decision.

 

BUT you didn't answer the second part of my question. And that was what should the Republicans have done with healthcare? In the initial post I responded to, you said that the Democrats blew a chance to make healthcare better for the American Public (paraphrasing), and the Republicans blew it as well. That means that you acknowledge the problems inherent in the old health care system. So what opportunity did both the Ds and the Rs blow? What is your proposed fix for healthcare?

[southsider2k5]

It certainly seems that this would be a better option in theory, but why cant anyone come up with something that can make this "hybrid" work?

 

And it still gives the wealthy significantly better options for healthcare which is certainly a philosophical debate.

 

No one cares about hybrids or compromise, nor do they care about going after the actual problem which is the costs of health care in general. It is all about partisan points and meme making.

[southsider2k5]

We can debate the mandate, but let's start by acknowledging that the ACA didn't socialize medicine. The government doesn't run healthcare, it just mandates that people have to have healthcare or pay a penalty, and it kicks government money into the program. With or without the mandate, however, freedom to not have health insurance is really a freedom for those that can afford the service in the first place. Those who can't afford healthcare don't have the freedom to make any sort of decision.

 

BUT you didn't answer the second part of my question. And that was what should the Republicans have done with healthcare? In the initial post I responded to, you said that the Democrats blew a chance to make healthcare better for the American Public (paraphrasing), and the Republicans blew it as well. That means that you acknowledge the problems inherent in the old health care system. So what opportunity did both the Ds and the Rs blow? What is your proposed fix for healthcare?

 

 

No one cares about hybrids or compromise, nor do they care about going after the actual problem which is the costs of health care in general. It is all about partisan points and meme making.

[RockRaines]

No one cares about hybrids or compromise, nor do they care about going after the actual problem which is the costs of health care in general. It is all about partisan points and meme making.

Thats the problem. Plus healthcare is complex.

[illinilaw08]

No one cares about hybrids or compromise, nor do they care about going after the actual problem which is the costs of health care in general. It is all about partisan points and meme making.

 

Cost is an issue, but I'd argue that cost, access, and quality of care are all inter-related issues that need to be solved. The ACA did good work on access and quality of care (at least quality of what is covered under an insurance policy). It has warts, and didn't do enough on the cost side. But it's a framework that can be built on to deal with some of the cost issues.

 

The only real talking points I've seen on cost are: (1) policies across state lines; (2) tort reform; and (3) publishing costs for procedures at each hospital.

 

On 1, I tend to think that policies across state lines leads to a race to the bottom in terms of coverage. All policies would end up coming out of health care's version of Delaware. That sets you back on quality of care.

 

On 2, I'm torn. It's bad when good doctors are paying premiums out the nose. But it's also bad when a doctor seriously screws up and kills or maims somebody. But I see how reducing doctor's costs in theory passes costs savings down to consumers.

 

3 is an important step, but it really only helps with elective surgery. If I have a heart attack, the ambulance is taking me to closest hospital, not to the most cost effective hospital.

 

A fourth point - I've long thought that subsidizing med school (to some degree) would help on the cost side. If people are leaving med with north of $200k in debt, they need to have substantially high salaries to survive that debt which impacts the cost side of things. It requires more government money into the health care system, but there isn't a way to solve the issues with health care absent a greater influx in cash from the government.

 

In any event, I do think we need a more substantive policy discussion on healthcare. For the last 8 years, one side of the aisle has campaigned exclusively on how bad the ACA is. I think they would have found lawmakers on the left willing to work on making the ACA better to address cost issues, and work to make the system better. Ideally, now that the R plan was an objectively worse version of the ACA that is dead, we will see some real legislating that gets us to a better place on healthcare.

 

[StrangeSox]

FWIW tort reform has been tried in several states, and the empirical results are that it does nothing to control costs.

 

Extremely expensive medical school and artificial AMA restrictions on the numbers of doctors driving up salaries certainly don't help, nor do our higher-than-everywhere-else drug prices. Allowing Medicare/aid to negotiate drug prices would put a decent dent in healthcare spending in this country.

[StrangeSox]

Charles Lister ✔ @Charles_Lister

@selectedwisdom at Senate Intel:

 

- ‘#Russia bots push conspiracy theories when #Trump is clearly online, tagging him & hoping for traction' pic.twitter.com/DVEGUBNgmy

Follow

Charles Lister ✔ @Charles_Lister

Stunning exchange at Senate Intel:

 

Q: GOP Sen - ‘Why do #Russia active measures work?

 

A: @selectedwisdom - “Because #Trump embraces them." pic.twitter.com/XWSAzTnjkM

https://twitter.com/Charles_Lister/status/847477859018973184

[southsider2k5]

FWIW tort reform has been tried in several states, and the empirical results are that it does nothing to control costs.

 

Extremely expensive medical school and artificial AMA restrictions on the numbers of doctors driving up salaries certainly don't help, nor do our higher-than-everywhere-else drug prices. Allowing Medicare/aid to negotiate drug prices would put a decent dent in healthcare spending in this country.

 

It is amazing that the more something is subsidized by the government, the more the price goes up...

[StrangeSox]

It is amazing that the more something is subsidized by the government, the more the price goes up...

 

Speaking of talking points and memes...

 

 

But we have additional empirical evidence that, especially when it comes to healthcare, this is the exact opposite of true. Every other developed country spends far less with equal or better outcomes while covering their whole population. Some countries, like Norway, even subsidize their doctors' entire medical educations rather than loading them with hundreds of thousands of dollars in student loans.

[southsider2k5]

Speaking of talking points and memes...

 

 

But we have additional empirical evidence that, especially when it comes to healthcare, this is the exact opposite of true. Every other developed country spends far less with equal or better outcomes while covering their whole population. Some countries, like Norway, even subsidize their doctors' entire medical educations rather than loading them with hundreds of thousands of dollars in student loans.

 

The government subsizes both of these activities to a large degree, as do employers when it comes to health care. You flat out said that we spend more than anyone, yet the solution to solve that is? To spend even more.

[StrangeSox]

The government subsizes both of these activities to a large degree, as do employers when it comes to health care. You flat out said that we spend more than anyone, yet the solution to solve that is? To spend even more.

 

No, that's not what I've said or what I said the solution should be. You're getting wrapped up in your own talking points again.

 

Other countries socialize health care a whole hell of a lot more than we do. They spend a lot less on health care for equal or better outcomes. Cutting out private health insurance as the main provider would increase government costs but lower overall healthcare spending. This isn't hypothetical. It's what we see in dozens of countries around the world.

Edited March 30, 2017 by StrangeSox

[StrangeSox]

More on today's Senate hearings.

 

Tom LoBianco‏Verified account @tomlobianco 25m25 minutes ago

More

"The commander in chief has used Russia active measures against his opponent" Watts said

Tom LoBianco‏Verified account

@tomlobianco

 

Stunning testimony from Watts right now -- says that Russian bots push conspiracies on social media when they know Trump is online

 

"Useful idiot" has never been a more appropriate phrase.

[southsider2k5]

No, that's not what I've said or what I said the solution should be. You're getting wrapped up in your own talking points again.

 

Other countries socialize health care a whole hell of a lot more than we do. They spend a lot less on health care for equal or better outcomes. Cutting out private health insurance as the main provider would increase government costs but lower overall healthcare spending. This isn't hypothetical. It's what we see in dozens of countries around the world.

 

Our federal government is not equipped to fix anything of this structure. The more involved they have gotten, the more expensive and less productive it is. We have already seen them do this to the insurance industry. Cutting that out completely would turn out health care system into a VA style system where care suffers emmensly. For god's sake, all you have to do is look at the VA to realize that the federal government can't handle health care and insurance for a smaller subset of society in our veterans. To expect them to get better at with hundreds of millions more people to take care of? I can't think of a scarier proposition.

[StrangeSox]

Our federal government is not equipped to fix anything of this structure. The more involved they have gotten, the more expensive and less productive it is. We have already seen them do this to the insurance industry. Cutting that out completely would turn out health care system into a VA style system where care suffers emmensly. For god's sake, all you have to do is look at the VA to realize that the federal government can't handle health care and insurance for a smaller subset of society in our veterans. To expect them to get better at with hundreds of millions more people to take care of? I can't think of a scarier proposition.

 

VA is more like the NHS, though, than a single-payer (Canada, most developed countries) or a public option would be.

 

I can also look at Medicare and see that the government can handle being the single-payer provider for tens of millions of Americans, and I can look to dozens of other countries to see better outcomes than what we have. I see no reason to flatly assume that our government is incapable of ever providing a cost effective health care solution that covers all Americans since so many other countries with much fewer resources manage to do it and do it well. If we can't ever expect the government to provide what should be would consider a basic and essential service, then we better just shut the whole thing down.

[Soxbadger]

Instead of talking about healthcare like the price of a product, I think we need to first decide if we believe that all Americans deserve healthcare.

 

I personally believe that all American's should have access to some sort of healthcare and I understand that likely means I have to pay for it.

 

Somethings arent about the bottom line, although I do believe a good argument can be made that the US will benefit economically if we have a healthier populace.

[illinilaw08]

Our federal government is not equipped to fix anything of this structure. The more involved they have gotten, the more expensive and less productive it is. We have already seen them do this to the insurance industry. Cutting that out completely would turn out health care system into a VA style system where care suffers emmensly. For god's sake, all you have to do is look at the VA to realize that the federal government can't handle health care and insurance for a smaller subset of society in our veterans. To expect them to get better at with hundreds of millions more people to take care of? I can't think of a scarier proposition.

 

Yeah, I'm not entirely clear why the VA is so messed up, but everyone I know who is on Medicare is extremely happy to be on Medicare. There's a disconnect somewhere there. Why does Medicare work and why does the VA not work (SS discussed this below)?

[RockRaines]

Instead of talking about healthcare like the price of a product, I think we need to first decide if we believe that all Americans deserve healthcare.

 

I personally believe that all American's should have access to some sort of healthcare and I understand that likely means I have to pay for it.

 

Somethings arent about the bottom line, although I do believe a good argument can be made that the US will benefit economically if we have a healthier populace.

IMO, as long as profit is the #1 driver for a business, the customers will never be the priority. The bottom line is the only thing that really matters. Its the same with these stupid for profit schools that are being proposed.

[StrangeSox]

So Pence totally drunkenly cheated on his wife at some point right?

 

I wasn't sure what this referenced at first, but apparently Pence refuses to be alone in a room with any woman who isn't his wife. Some conservatives are rushing to his defense and asking "if you're a married man, why would you be friends with a woman?"

[RockRaines]

I wasn't sure what this referenced at first, but apparently Pence refuses to be alone in a room with any woman who isn't his wife. Some conservatives are rushing to his defense and asking "if you're a married man, why would you be friends with a woman?"

Thats correct, and the pundits saying having lunch or dinner with another women is disrespectful to your spouse is hysterical to me. Not having trust and controlling your spouse isnt healthy.

[StrangeSox]

How do you function as a high-level executive without ever having one-on-one meetings with a woman? I'm far from a high level executive much less a governor or Vice President of the United States, and I've had one-on-one business meetings with women that somehow did not end in adultery.