The Republican Thread

[lostfan]

If cutting the budget by 20% arbitrarily was even possible it would've been done already. It's not. It's just not. Has anyone who complains about the federal budget ever actually looked at a chart to see where the money goes? Social Security, Medicare, and defense by themselves are probably 2/3 of the budget and those three are basically untouchable (even the thought of proposing cuts to Medicare gets howls of protest and for some people is a career-killer, defense is basically an industry in itself with super-powerful lobbies, and politically, proposing cuts in defense would be a disaster). Discretionary spending is like 20% or so but "discretionary" doesn't mean "pork" and most of that spending is already accounted for somehow too, and couldn't reasonably be called wasteful. There's VA budgets and benefits for military retirees, that's 5% or so, obviously thats going nowhere. To top this off, the recession has dropped revenues (Sarah Palin would say decreased revenue is a good thing).

 

Basically, where is someone going to start ? There just isn't an easy way to "fix the budget." I don't listen to anyone's opinions on it unless they have big ideas that would actually reduce spending in a way that's actually possible to do other than just ranting about how politicians suck, which is what most of those opinions tend to amount to.

[mr_genius]

There just isn't an easy way to "fix the budget." I don't listen to anyone's opinions on it unless they have big ideas that would actually reduce spending in a way that's actually possible to do other than just ranting about how politicians suck, which is what most of those opinions tend to amount to.

 

Social Security - Keep the same. Kind of have to bite the bullet on this one. Unless you have a suggestion, lostfan.

 

Medicare - cut by 40%. Increase the US market with millions of green card doctors and nurses, wages will come back to earth. The best and brightest from overseas will attend to patients at a fraction of the cost. Also consider sending medicare patients to India to live in Healther camps, they will get excellent treatment at a super low cost! (ok the healther camp in India would be controversial)

 

Defense - Cut by 20%. No new aircraft carriers and s***. Use the ones we already have.

 

done and done. want to donate to my political campaign?

Edited January 27, 2010 by mr_genius

[lostfan]

I don't really have a beef with Social Security so much since it has its own tax unlike most of the other budget.

 

I would say Gates more or less wants to do what you suggest on defense but the wars have to end before that happens. He would rather spend money on something that's going to be used in Iraq or Afghanistan 10 months from now than on something that could hypothetically be used in 15-20 years.

[mr_genius]

I don't really have a beef with Social Security so much since it has its own tax unlike most of the other budget.

 

I would say Gates more or less wants to do what you suggest on defense but the wars have to end before that happens. He would rather spend money on something that's going to be used in Iraq or Afghanistan 10 months from now than on something that could hypothetically be used in 15-20 years.

 

And my Medicare fix?

[lostfan]

Sounds plausible if it doesn't reduce quality/availability of care but I don't know enough to be able to speak intelligently on it. How are we going to get more Indian doctors though?

Edited January 27, 2010 by lostfan

[mr_genius]

Sounds plausible if it doesn't reduce quality/availability of care but I don't know enough to be able to speak intelligently on it. How are we going to get more Indian doctors though?

 

Have an unlimited supply of Green Cards for Doctors that can pass certain levels of educational requirements. Currently there a limits on the spaces available to attend medical school, so f*** that, juice up on overseas schools. They would also have to pass exams. Trust me on this, there are a whole lot of Indians willing to learn just about anything to get a green card.

 

Availability to care would increase. Now, I'm not going to lie here, the 'instant green card' doctors aren't going to necessarily be the best around, but good enough and comparatively cheap. Maybe have the green card doctors do the easier type of stuff for a minimum of 5 years at a certain wage (low wage of course). After that time they are free to work wherever they want without wage restriction. They can start a private practice as well, if they so choose.

Edited January 27, 2010 by mr_genius

[southsider2k5]

Have an unlimited supply of Green Cards for Doctors that can pass certain levels of educational requirements. Currently there a limits on the spaces available to attend medical school, so f*** that, juice up on overseas schools. They would also have to pass exams. Trust me on this, there are a whole lot of Indians willing to learn just about anything to get a green card.

 

Availability to care would increase. Now, I'm not going to lie here, the 'instant green card' doctors aren't going to necessarily be the best around, but good enough. And super cheap. Can't have it both ways. Maybe have the green card doctors do the easier type of stuff for a minimum of 5 years at a certain wage (low wage of course). After that time they are free to work wherever they want in medicine.

 

And at the end of the day, it is a lack of supply that has caused the medical field to get so expensive.

[lostfan]

Have an unlimited supply of Green Cards for Doctors that can pass certain levels of educational requirements. Currently there a limits on the spaces available to attend medical school, so f*** that, juice up on overseas schools. They would also have to pass exams. Trust me on this, there are a whole lot of Indians willing to learn just about anything to get a green card.

 

Availability to care would increase. Now, I'm not going to lie here, the 'instant green card' doctors aren't going to necessarily be the best around, but good enough and comparatively cheap. Maybe have the green card doctors do the easier type of stuff for a minimum of 5 years at a certain wage (low wage of course). After that time they are free to work wherever they want without wage restriction. They can start a private practice as well, if they so choose.

I believe it

[Balta1701]

And at the end of the day, it is a lack of supply that has caused the medical field to get so expensive.

Disagree.

[southsider2k5]

Disagree.

 

I don't know why I would think that... What between the long waits in the emergency room, months of waits for specialists, crowds in the doctors offices and all...

[Balta1701]

I don't know why I would think that... What between the long waits in the emergency room, months of waits for specialists, crowds in the doctors offices and all...

But wait, I thought that wait times weren't a problem in the U.S.? Best system in the world, after all, right?

[southsider2k5]

But wait, I thought that wait times weren't a problem in the U.S.? Best system in the world, after all, right?

 

Who said that wait times weren't a problem now? Not me. Also, try adding 10, 30, 50, 80, [or whatever the number of the day] million people to the waiting rooms and tell me how that will make things better. I have asked this all along, but where exactly is all of the spare capacity in the system?

[Balta1701]

Who said that wait times weren't a problem now? Not me. Also, try adding 10, 30, 50, 80, [or whatever the number of the day] million people to the waiting rooms and tell me how that will make things better. I have asked this all along, but where exactly is all of the spare capacity in the system?

So basically, you're an advocate of rationing care as a means to keep wait times from increasing. Rationing! You commie-Nazi!

[lostfan]

Balta I don't recall you ever actually answering that question, FWIW

[southsider2k5]

So basically, you're an advocate of rationing care as a means to keep wait times from increasing. Rationing! You commie-Nazi!

 

And as usual instead of trying to solve the root causes, you are trying to get the government to fix the problem.

[Balta1701]

Balta I don't recall you ever actually answering that question, FWIW

I actually did have an answer, although its not going to satisfy 2k5 because he's going to argue that my answer is impossible because a private market is always the most efficient system. 2k5's argument is that we can't afford to bring everyone into the system because covering everyone would require additional doctors. A corollary of this is that covering everyone requires more doctors per capita than the U.S. has. This is not born out by data. Some countries with nationalized health care systems (i.e. France) have more doctors per capita than the U.S. (in France they drive to your house. It's fun) while other countries (i.e. the U.K., Japan) get along with significantly fewer doctors per capita than the U.S. does, and they do so without being held up as an example of horrendous wait times as well.

 

The issue is therefore not one of capacity, it's an issue of how the capacity is used. Like virtually everything else in the U.S. system, the additional capacity is used up by how the profitability in our system is used up; its more profitable to spend your time doing expensive treatments on the well-insured than it is doing preventative care before people get really sick.

 

I'm not opposed to allowing additional doctors into this country on Visas, that would be fine by me. My argument is, it's unnecessary. The necessary capacity in the U.S. system already exists, it's just deployed in inefficient ways due in no small part to the private nature of our system, where the ultimate goal is profit and positive health outcomes are a side effect.

[Balta1701]

And as usual instead of trying to solve the root causes, you are trying to get the government to fix the problem.

And as usual, you conclude that the root causes can only be solved by the very people who created the problem in the first place.

[kapkomet]

And as usual, you conclude that the root causes can only be solved by the very people who created the problem in the first place.

 

 

Um, no. You are reading too much into that. That's not what he's saying.

[southsider2k5]

I actually did have an answer, although its not going to satisfy 2k5 because he's going to argue that my answer is impossible because a private market is always the most efficient system. 2k5's argument is that we can't afford to bring everyone into the system because covering everyone would require additional doctors. A corollary of this is that covering everyone requires more doctors per capita than the U.S. has. This is not born out by data. Some countries with nationalized health care systems (i.e. France) have more doctors per capita than the U.S. (in France they drive to your house. It's fun) while other countries (i.e. the U.K., Japan) get along with significantly fewer doctors per capita than the U.S. does, and they do so without being held up as an example of horrendous wait times as well.

 

The issue is therefore not one of capacity, it's an issue of how the capacity is used. Like virtually everything else in the U.S. system, the additional capacity is used up by how the profitability in our system is used up; its more profitable to spend your time doing expensive treatments on the well-insured than it is doing preventative care before people get really sick.

 

I'm not opposed to allowing additional doctors into this country on Visas, that would be fine by me. My argument is, it's unnecessary. The necessary capacity in the U.S. system already exists, it's just deployed in inefficient ways due in no small part to the private nature of our system, where the ultimate goal is profit and positive health outcomes are a side effect.

 

So where is the capacity actually at then?

[Balta1701]

So where is the capacity actually at then?

It's used up inefficiently, dealing with things that could be better dealt with through other method (spreventative care, avoiding ER visits, etc.). If a farmer plows each of his fields 3 times, he may use up all of his time, but that doesn't mean he can't take on additional land the next year.

[southsider2k5]

It's used up inefficiently, dealing with things that could be better dealt with through other method (spreventative care, avoiding ER visits, etc.). If a farmer plows each of his fields 3 times, he may use up all of his time, but that doesn't mean he can't take on additional land the next year.

 

Most of that work isn't done by doctors anymore. It is done by nursing staff of various levels. It has no effect on the relative levels of doctors per person. One big factor that is missing in that prior number is how physically big the United States is. You are going to have to have many more doctors per person to cover the much less dense population distribution of people in this country, when compared to anywhere in Europe. It is a pointless number in comparison.

[Balta1701]

Most of that work isn't done by doctors anymore. It is done by nursing staff of various levels. It has no effect on the relative levels of doctors per person. One big factor that is missing in that prior number is how physically big the United States is. You are going to have to have many more doctors per person to cover the much less dense population distribution of people in this country, when compared to anywhere in Europe. It is a pointless number in comparison.

So your argument is that rural doctors have less to do and thus they charge more per procedure and this drives costs up, because they have a lot of spare capacity in doctors in rural areas?

[southsider2k5]

So your argument is that rural doctors have less to do and thus they charge more per procedure and this drives costs up, because they have a lot of spare capacity in doctors in rural areas?

 

Yeah, you just keep making up whatever you want me to say.

[Balta1701]

Yeah, you just keep making up whatever you want me to say.

No, you argued that somehow the spatial distribution of patients plays a role in limiting capacity, and you argued that U.S. capacity is more limited than overseas which leads to higher costs. To me, the capacity of a physician is determined solely by the number of patients they can see, not by the distance a patient needs to travel to see them, which is why that last interpretation sounded so bizarre; because the idea that spatial distribution affects the number of patients a doctor can see is equally bizarre.

[southsider2k5]

Yeah, that's why I gave up trying to talk to recently. I really should learn my lesson and walk away. Trust me, you'll be great in the college environment.