American Politics during the Obama Presidency

[QUOTE=Sidney]I believed nothing Bush / Cheney said. I fail to see the relevance of Thatcher. Putin is the typical Russian dictato liar![/QUOTE]We could have double teamed the opposition on the forum.

I agree Putin sucks (to be analytical)

My Thatcher reference was in response to Queso comments on the Cold War. I noted how the conservative leaders of the west were always (to be kind) schizophrenic on the Soviet challenge - they rode the fear of the Reds to power. Then they lined the pockets of their pals in the military industrial complex. Finally, their rhetoric notwithstanding, they pursued policies that were more designed to maintain the status quo than to conquer the evil adversaries. Few liberal leaders were much better.

Today, US Republican House Minority Leader John Boehner (R-OH) one of the most conservative members of Congress, admitted that President Obama is not a socialist!

On Meet the Press, host David Gregory asked Boehner whether he agreed with RNC Chair Steele that health care reform represents a "socialist power grab" by the Democrats.

"Do you really think the president is a socialist?" Gregory asked Boehner.

"Listen, you can call it whatever you want," Boehner responded.

Gregory persisted: "Do you think the president is a socialist?"

"No!" the Ohio House representative exclaimed.

"But the head of the Republican Party is calling him that," Gregory insisted.

"I didn't call him that," Boehner responded. "I won't call him that."

Obviously Boehner doesn't read the posts on Argentina Private!

Big news here. 3.9B is not a figure I see in the news every day.

[url]http://news.yahoo.com/s/ap/20090921/ap_on_go_pr_wh/us_obama_innovation[/url]

Another Obama speech.

This is definitely going our way.

I'm seeing deals made closer to 100 million and in the billions. The Russians sued bank Carnegie for 22 Billion. The worst one is Nathan M Rothschild & Sons. They should get rid of it.

They are offering amnesty to international tax dodgers.

2 men charged in NY with $80 million Ponzi scheme.

Jobs will pick up in 2010 they're saying.

[QUOTE=Sidney]Using idiotic social ideas to ascend![/QUOTE]Sid, Jackson and company, maybe you should climb down off the window ledge!

On Sunday, Republican US Senator Olympia Snowe, from Maine, dismissed the outlandish claims of those who characterize President Obama as a big-government liberal moving heedlessly to expand Washington's role or something worse.

Snowe says: "I almost sense the opposite." She places Obama on the ideological spectrum as "more moderate than liberal."

Her portrait diverges drastically from the "radical" "socialist" "communist" "Marxist" "anti-Capitalist" "fascist" described by other Republicans and the McCarthyites in the media such as Rush Limbaugh, Glenn Beck, Sean Hannity, Michael Savage, Joe Azar, Alan Keyes, and some of our AP crew.

They say: "I Takes One To Know One" – so the moderate lady from Maine probably knows whereof she speaks! And together with House Republican leader Boehner's admitting Obama is no socialist, the debate now is between reasonable conservatives and the unhinged.

Several posters on the Political forum who oppose Obama's attempt to fix the broken US health care and insurance system, have claimed that every American citizen has "access" to "quality" health care because they can be treated in emergency rooms. Well, guess what? That's pure balderdash. The reality is less pretty.

A new medical study links 45,000 U. S. Deaths annually to lack of insurance. The reality is that one American dies every 12 minutes because they lack health insurance and can not get good care. The disturbing situation is detailed in a Harvard Medical School study, published in the American Journal of Public Health.

The study shows that without proper care, uninsured people are more likely to die from complications associated with preventable diseases such as diabetes and heart disease. Another factor is that there are fewer places for the uninsured to get good care. Public hospitals and clinics are closing or scaling back across the country as the poor economy has reduced their financial resources.

The Harvard researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.

"For any doctor. It's completely a no-brainer that people who can't get health care are going to die more from the kinds of things that health care is supposed to prevent," said Dr. James Woolhandler, a professor of medicine at Harvard and a primary care physician in Cambridge, Massachusetts.

The Harvard researchers analyzed data on patients tracked by the U. S. Centers for Disease Control and Prevention's National Center for Health Statistics.

[QUOTE=Ricardo]Today, US Republican House Minority Leader John Boehner (R-OH) one of the most conservative members of Congress, [b]admitted[/b] that President Obama is not a socialist![/QUOTE]Ricardo,

I'm sure you mean to use the word "acknowledged" in the above statement.

Obviously, the word "admitted" would be used by a writer who was subliminally trying to invoke a sensation of guilt, which is clearly not the intent of Boehner's statement.

Oh, unless, of course, you specifically intended to warp the intended meaning of his statement, which would be a standard liberal practice.

Anyway, the fact that two Republican politicians declined to use the word "socialist" to describe the Messiah in a publicly broadcasted interview does not mean that he is NOT a socialist, but I understand you are clinging to any evidence you can to convince us clear-thinking individuals otherwise.

Nice try.

Thanks,

Jackson

Yep he's going on Letterman tonight. Anyone going to catch a feed tonight?

[QUOTE=Jackson]Ricardo,

I'm sure you mean to use the word "acknowledged" in the above statement.

Obviously, the word "admitted" would be used by a writer who was subliminally trying to invoke a sensation of guilt, which is clearly not the intent of Boehner's statement.

Oh, unless, of course, you specifically intended to warp the intended meaning of his statement, which would be a standard liberal practice.

Thanks,

Jackson[/QUOTE]I don't know if Boehner felt guilty, but he looks guilty all the time. It may be the bottle tan!

You say warping meanings is standard liberal practice - yah sure. Here you raise an obvious question - not of etymology, but of psychology - do you understand the concept of projection?

Just in case, here is the definition:

"Psychological projection (or projection bias) is the unconscious act of denial of a person's own attributes, thoughts, and / or emotions, which are then ascribed to another person or people, the government, etc.

"Projection is the most profound and subtle of our psychological processes, and extremely difficult to work with, because by its nature, it is hidden. It is the fundamental mechanism by which we keep our selves uninformed about ourselves.

"Humor has great value in any attempt to work with projection, because humor presents a forgiving posture and thereby removes the threatening nature of any enquiry into the truth."

Ring any bells? (chuckling quietly to myself)

As for "admitted" versus "acknowledged" - that is called "a distinction without a difference" among us literate elite!

[QUOTE=Jackson]Us clear-thinking individuals otherwise.

Jackson[/QUOTE]Damn Jackson, kind of a "Holier Than Thou" statement. Never believed you to be so closed minded.

Let me tell you, I am impressed with the raw intelligence of the people who post on this board. Obviously approaching Einstein level insight.

I would not be surprised if the United States Embassy in Buenos Aires was instructed to clear out several thousand square feet of office space in order to house senior members of Argentina Private.

Sort of a think tank fueled by 200 octane pussy.

45,000 is roughly.0015% of the US population.

In 2008, 37,261 died in car crashes, which was actually down 9.7% from 2007 (41,059 deaths) and which has steadily been decreasing over time.

"Automobile Deaths" is a rough example of something we deal with every day that is close to the quanitity (if not the quality - hard to define exactly) of what are claimed as deaths that are attributed to lack of insurance.

I'm not sure that the number mentioned for lack of medical insurance deaths is enough to warrant the government getting farther into debt and expanding something like Medicare (for example) to ensure that everyone is ensured when the following are considered:

How many of those 45K eat like pigs and smoke like chimneys, take drugs (including too much alcohol) and put THEMSELVES at risk for diabetes, cardiac problems, cancer related to lungs and colon, liver and kidney problems, and so on and so on?

How many of those 45K chose not have insurance (there are those of us who chose not to - me for example)

How many of those 45K simply didn't even try to go see a doctor, even if it would have cost them something, for something simple like a check up where the doctor could have said "geez you're fat, you really should go on a diet and excerise!"

How many of those deaths were in accidents and the people involved simply did not have health insurance (I don't know where the numbers quoted came from as far as the raw data that was collated and examined)

How many of those 45K are illegal aliens?

Now, another question:

If everyday healthcare was reasonably affordable WITHOUT insurance, and insurance was only for the really BIG things that most people could not afford, would we need the government to provide a second option to provide "competition" to private industry in a vain attempt to keep costs down? Could we not just use our own judgement as to when we needed to go to the doctor, or do we really NEED health insurance to ensure that people would go to the doctor and make sure they are not dying of something preventable?

In the above question, I meant not just costs paid to the system by clients - after all, will the government really do things more efficiently and truly cost less? Or will the subsidies the government provides to keep costs down to the client really be more in line with what private industries are charging already due to things like fraud, high medical malpractice costs due to wrongly-balanced judgements, high costs of running unneccesary tests to CYA, etc? After all, without much TRUE REFORM in the medical system, how much in the BEST POSSIBLE of circumstances can the US government bring down costs?

Or is it more likely that the amount of cost the government can save will be about the amount of the profits that "for-profit" medical systems currently make, but will be offset (maybe even more so) by the inefficiency that WILL exist in a government-run system?

I believe human life is precious, but not always priceless. That is a hard thing to say, but it has to stop somewhere. If it didn't, we would never be permitted to eat anything that is unhealthy, never be allowed to breath air that has the slightest possible taint of pollutants, never be allowed outside in the daylight, or if we did drive, driving in cars like tanks to ensure we couldn't hurt ourselves, etc, etc. Of course, things like that are growing every day anyway - who the HELL gives ANYONE the right to tell someone they have to wear a helmet on a motorcycle or wear their seat belts in a car or truck if they choose to be stupid and not do so? Where does it stop? I could see a corporation requiring such things to keep their insurance costs down related to their opwn commercial interests, but not a law for everyone.

Can we stop the 35-40K deaths that occur every year via cars? Well, we could legislate cars out of existence but that would be costly. Too costly obviously. I'm not saying that legislating IN health insurance would be as costly, the legislating away cars was an extreme example of trying to keep everyone safe.

Can we say the government can step in and ensure that 100% of the people who die as a result of not having insurance will live? No way. Who knows what the real precentage point of lives saved would be.

What does that 45K really mean? I think it's more likely just another statistic that those on both sides like to use to scare the shit out of people to get their way.

And Ricardo, I don't think there is a single person on this board who really thinks health reform is unneccessary (I could be wrong!). I think most of us think that it is unrealistic to be tackling such an item in the MANNER that Obama proposes because (very short list) 1) it's not quite as big a problem as Obama and the Democrats make it out to be for the BIG MAJORITY of people in this country and 2) the way he is going about it is not going to fix anything (in many opinions, anyway) and we would rather stay with the status quo than make things worse and get more government involved where it doesn't belong.

We'd really rather see things FIXED, but that ain't likely to happen.

I commend you for adding to this thread and understand your thinking on this, but the fact that 45,000 Americans die each year who might have lived longer with insurance is just one of many, many problems with the broken US health system. It is a fatal problem for those who die and poses a moral dilemma for society as a whole.

I won't go into great detail on the intertwined and massive problems with the current system. The information is readily available online.

I will just point out that the US spends more per capita than any other industrial country on health care while leaving large numbers of people with no or inadequate care and gets worse results on a wide range of health measures.

I will also point out that the cost of US care is rising much faster than inflation and will continue to rise, unless the system is reformed - taking more and more essential resources - individual, corporate and government - away from other key priorities.

Unless change occurs the US economy will continue to struggle to right itself and stay globally competitive.

Last week, Obama provided the key points of the new system he will push to get Congress turn into legislation and send to him.

I trust this will clear up lots of confusion that has spread with the President's opponents distortions and the media focussed more on the fight than the content.

Basics.

1. If you like your insurance, you can keep it.

2. No more denial of coverage for pre-existing conditions.

3. No dropped coverage when you get sick.

4. Eliminates yearly and lifetime caps on coverage.

5. Caps out-of-pocket expenses.

6. Required coverage for preventative care.

If you don't have insurance:

1. A new insurance marketplace, the Exchange.

2. New tax credits for individuals and small business.

3. Low-cost coverage for all individuals and small businesses.

4. A public health insurance option.

For All Americans:

1. Won't add a dime to deficit and paid for upfront.

2. Independent medical experts to identify waste, fraud, and abuse.

3. Required coverage for preventative care.

4. Eliminates the prescription drug "Donut Hole"

5. Immediate medical malpractice reform projects

[QUOTE=El Alamo]Let me tell you, I am impressed with raw intelligence of the people who post on this board. Obviously approaching Einstein level insight.

I would not be surprised if the United States Embassy in Buenos Aires was instructed to clear out several thousand square feet of office space in order to house senior members of Argentina Private.

Sort of a think tank fueled by 200 octane pussy.[/QUOTE]Careful. It could turn into a stink tank!

[QUOTE=El Queso]I don't think there is a single person on this board who really thinks health reform is unnecessary (I could be wrong! I think. It's not quite as big a problem as Obama and the Democrats make it out to be for the BIG MAJORITY of people in this country.[/QUOTE]The Business Roundtable, an association of CEOs of leading US companies, that comprise nearly a third of the total value of the U. S. Stock markets and pay nearly half of all corporate income taxes paid to the federal government has issued a policy study calling on Congress to reform the American health care system.

The Key Findings include:

• Without significant reforms, if current trends continue, annual health care costs for employers will rise 166 percent over the next decade, from $10,743 per employee today to $28,530 by 2019.

• These runaway costs, combined with a $56 billion cost shift to payers from uncompensated care, would cripple the employer-based system that currently provides coverage for the majority of Americans and their families.

• If nothing changes, by 2019, total health care spending will reach $4.4 trillion, consuming more than 20 percent of the U. S. Gross Domestic Product.

[QUOTE=Ricardo]Last week, Obama provided the key points of the new system he will push to get Congress turn into legislation and send to him.

I trust this will clear up lots of confusion that has spread with the President's opponents distortions and the media focussed more on the fight than the content.

Basics.

1. If you like your insurance, you can keep it.

[AND, IF YOU DON'T LIKE YOUR INSURANCE, YOU STILL HAVE TO KEEP IT. THIS WILL BE THE OBJECTION HEARD FROM THOSE WHO ALREADY HAVE COVERAGE BUT DON'T LIKE IT.]

2. No more denial of coverage for pre-existing conditions.

[ONLY IF THE PUBLIC OPTION PASSES, WHICH IS UNLIKELY]

3. No dropped coverage when you get sick.

[RARELY HAPPENS EVEN TODAY, THOUGH MIAMI BOB WOULD DISAGREE. THE ACCOUNTS OF THE TWO INDIVIDUALS WHO WERE 'DENIED' COVERAGE, CITED BY OBAMA IN HIS SPEECH, ARE GOOD REMINDERS OF WHAT HAPPENS WHEN YOU DON'T DO YOUR HOMEWORK AND PICK THE WRONG EXAMPLES OF THESE SUPPOSEDLY COMMON PRACTICES. BUT, OF COURSE, THE LEFT WING MEDIA ONLY LIGHTLY REPORTED ON THIS.]

4. Eliminates yearly and lifetime caps on coverage.

[YEP. EVERYONE LIKES "FREE," BUT "THERE'S A SUCKER BORN EVERY MINUTE." HERE, THOSE TWO CONCEPTS ARE BEING MARRIED TOGETHER. THIS WILL BE QUITE EXPENSIVE.]

5. Caps out-of-pocket expenses.

[SEE PREVIOUS COMMENTS.]

6. Required coverage for preventative care.

[MOST MAJOR STUDIES ON PREVENTIVE CARE SHOW THAT THEY AREN'T WORTH THE PRICE OF ADMISSION. IN OTHER WORDS, THEY DON'T REALLY SAVE MONEY. ADMITTEDLY, THERE AREN'T MANY STUDIES ON THIS. THOSE THAT ARE BASED ON REAL-WORLD EXPERIENCE PUT THE LIE TO THE IDEA THAT THIS RESULTS IN NET SAVINGS.]

If you don't have insurance:

1. A new insurance marketplace, the Exchange.

[SIMPLY WON'T WORK THE WAY IT'S PITCHED.]

2. New tax credits for individuals and small business.

[I'm NOT HOLDING MY BREATH ON THIS ONE.]

3. Low-cost coverage for all individuals and small businesses.

[NOT REALLY. THE TAX ON THE "MIDDLE CLASS" TO PAY FOR THIS IS $3,800 OR SO FOR A FAMILY. AS I've ALWAYS SAID, I'm NOT IN FAVOR OF NEW TAXES FOR ANYONE. THE IDEA THAT THIS ISN'T A TAX IS LAUGHABLE. CITIZEN: "BUT I DON'T WANT INSURANCE." GOVERNMENT: "YOU HAVE TO HAVE IT." CITIZEN: "BUT I WON'T GO TO THE DOCTOR." GOVERNMENT: "THAT'S NOT OUR FAULT. FORK OVER THE $3,800."]

4. A public health insurance option.

[GET YOUR INSURANCE FROM UNCLE SAM. THE SAME FOLKS WHO BROUGHT YOU MEDICAID, AMTRAK, FANNIE MAE AND THE POST OFFICE. HAVING MASTERED THOSE AREAS, HE'S NOW MOVING INTO HEALTH CARE. PERSONALLY, I GET THIS IMAGE OF THE SNAKE OIL SALESMAN FROM THE MEDICINE SHOW IN HUCK FINN EVERY TIME I HEAR SOMEONE CLAIM THAT THE PUBLIC OPTION IS GOING TO KEEP THE PRIVATE SECTOR "HONEST." RIGHT. GEE, WHAT ELSE CAN THE GOVERNMENT CURE?]

For All Americans:

1. Won't add a dime to deficit and paid for upfront.

[HAHAHAHAHAHAHAHAHAHAHA! BROOKLYN BRIDGE, MEET YOUR NEW OWNER. SORRY, I KNOW THAT'S MEAN-SPIRITED. RICARDO, IF YOU'VE REALLY WORKED IN GOVERNMENT ALL THIS TIME, YOU KNOW THIS ONE IS SILLY. IF YOU BELIEVE IT, YOU'RE A HOPELESS IDEALOGUE. MORE LIKELY, EVEN YOU DON'T BELIEVE THIS ONE, BUT YOU BELIEVE IT'S BETTER TO INCREASE THE DEFICIT TO SOME DEGREE THAN STICK WITH THE STATUS QUO. IF IT'S THE LATTER, IT WOULD BE WHERE YOU AND I PART COMPANY. I'LL TAKE STATUS QUO OVER THIS PLAN. THE SOPS THAT ARE BEING OFFERED TO DEMOCRATIC CONSTITUENTS [B]ALREADY[/B] (E. G. UNIONS) WILL DRASTICALLY INCREASE THE DEFICIT.]

2. Independent medical experts to identify waste, fraud, and abuse.

[RIGHT. JUST AS THEY DO WITH MEDICARE AND MEDICAID. HOPEFULLY, THEY'VE BEEN HOLDING BACK ON THE "REAL" EXPERTS FOR JUST THIS MOMENT SO THEY COULD LURE ALL OF THE WASTERS, FRAUDSTERS AND ABUSERS INTO A FALSE SENSE OF SECURITY.]

3. Required coverage for preventative care.

[DOESN'T DO WHAT IT'S SUPPOSED TO DO.]

4. Eliminates the prescription drug "Donut Hole"

[LOTS OF AMERICANS LIKE DONUT HOLES. I WOULDN'T BE SO QUICK TO ELIMINATE THESE, IF I WAS OBAMA.]

5. Immediate medical malpractice reform projects.

[WILL NOT HAPPEN IN REALITY. PLAINTIFFS LAWYERS ARE TOO LARGE A SOURCE OF INCOME FOR THE DEMOCRATIC PARTY. OBAMA IS TOO SMART TO CUT HIS NOSE OFF TO SPITE HIS FACE, AND THIS GROUP WILL NOT WILLINGLY PARTICIPATE IN TORT REFORM JUST BECAUSE IT IS THE "RIGHT THING TO DO." THIS IS EVEN MORE IMPLAUSIBLE THAN #1 RE DEFICIT SPENDING. DON'T GET ME WRONG. THEY'LL PROBABLY PAY LIP SERVICE TO TORT REFORM. BUT IT WILL BE ONLY THAT.] [/QUOTE]My personal opinion: If they don't get this passed before Thanksgiving, they won't get it passed at all. Mid-term elections are less than a year away at that point and campaigning will begin in earnest for 1/3 of the senate. Legislators are going to get another earful on this when they go back to their constituents. Enough senators will be scared straight that it won't pass. The more folks find out about this plan, the less they'll want it.

This will be especially true with respect to the mandatory insurance tax. I understand why they're doing it. But, there will be a significant minority of folks who will object to the idea that they are forced to purchase insurance. And well they should object. In reality, this is government's effort to force those who don't need insurance (the young and healthy) to subsidize those who do (the elderly and those with pre-existing conditions) It is unquestionably a tax. More importantly, there are serious questions as to whether this portion will be Constitutional. If, as I suspect, it is unConstitutional, then who's going to subsidize the elderly and those with pre-existing conditions? I'll give you two guesses.

We'll see. At least it's kept Congress distracted long enough such that they haven't been able to do too much more damage.

Should be interesting -- at least as interesting as watching sausages get made.

[QUOTE=Stan Da Man]My personal opinion: If they don't get this passed before Thanksgiving, they won't get it passed at all.

Should be interesting -- at least as interesting as watching sausages get made.[/QUOTE]Based on a few years working on the Hill and working in poliitics for almost 20 years, my (semi) professional opinion is Obama will be signing health care reform into law before mid-January 2010.

It will deny the insurance companies the freedom to fuck their customers that they have enjoyed (my choice of a verb is deliberate) for too long.

It will include both a mandate requiring Americans to insure themselves and a triggered public option.

It will cover most, but not 100% of Americans.

A small handful of Republicans in the both houses will support it.

The right wing noise machine will say its the end of the world as we know it and within 48 hours will find some other evil thing to pin on Obama the antichrist.

You heard it hear first!

My 2 cents:

If that happens, I predict O BAMA will also have to pay a price; maybe someone will make a move to "integrate" Mount Rushmore. A tribute to his ambition and socialist causes. Personally I think it would be defacing a nation monument.

Oh well, I guess when the talking stops, and logic fails, and a dictator refuses to listen, it's Americans right and privilege too defend democracy. Something Argentineans know little to nothing about.

I agree pretty much with all stated problems in the health system, even to the 45K dying realted to a lack of insurance being another symptom of the problem.

When I said this in my first post in this thread:

"It's not quite as big a problem as Obama and the Democrats make it out to be for the BIG MAJORITY of people in this country."

I should have added "to be solved immediately, in the next few months." Reading Ricardo's response to that particular quote I realized that it didn't come out as clearly as I intended it. I tend to write too fast (I'm a busy guy) and don't choose my words as carefully as I should in order to completely express myself.

I understand that there had to be some fast movement to prop up a failing financial system, as far as the failing global economy, et al. I don't think that Obama and the Democrats spent the money wisely (at least not a generous portion of it) but I also don't think it was (or will be) a complete failure.

The truth is, I write software and have only a more-than-general understanding of the really high-level complex issues involved. I haven't written too much in oposition to the expenditure that has taken place for that reason. A few comments to note my uncertain dissatisfaction, that's about it.

I have run a business for the last eight years or so, and before that I was involved at middle-level management in a large corporation. I've seen how healthcare impacted people in general as an employee who saw his contribution go up significantly over time, to a manager who had to tell his people about the latest hike or loss of benefits and worry that some of his best people were going to flee to other places, and as a self-employed person who has had to survive without insurance and fret that he wouldn't be able to hire people because he couldn't offer insurance.

Under that last category, I began to understand that insurance is not the necessity that it seems almost everyone thinks it is.

I have raised the point "why should we need health insurance" in two threads now, at least once in each one. I was hoping I might get some specific comments in this thread, me being the first response to Ricardo and all, which should have brought some prominence to the fact it was asked. Maybe the point has been mixed in among my other comments too much.

Can someone please answer me:

If we were going to do REAL REFORM, and not just pile more overhead and government onto the current issue in an attempt to fix things, why didn't we take a little time, as grown-ups who realize that the current system and possibly the entire current thought process on how to provide better medical care to as many people as want it, just sit down and think about it for a little bit instead of rushing into this?

Of course, the real answer is politics. Obama knew that he couldn't sit around and wait for a real discussion, because he had a particular brand of reform in mind, one that is VERY hard to swallow for a LARGE number of people in our country. He knew that he had to ram his plan through his first year in office while he still had impetus and certainly before the midterm elections when he is likely to lose the large and important majority that he has in Congress.

Ok, so I can understand the political necessity if he wants to do what he has in mind. But I don't have to like it.

To me, this situation and what Obama is doing with healthcare points to why I distrust government. I know it's imperfect, as demonstrated, but to me that is why government should do less, at least actively. Pass laws where necessary, leave out loopholes for your buddies, and then enforce with righteousness that which you have put into place. Human nature seems to not allow that to happen, and human nature is to put more bandages on the festering wound until it has to be amputated.

So again, why insurance for every little ache and pain, every visit to the doctor, every test that should be run?

I was not a wealthy person by any stretch of the imagination, when I was living in the States and worked, and managed people, etc, etc. I was more fortunate than many, but I was way less fortunate than a lot of people I knew, much less than existed in the US as a whole. But I managed for a good number of years to not have to buy anything but catastrophic-level insurance.

Why can't we fix things for real so that medical costs aren't outrageous, so that people could afford to visit the doctor's office and have checkups and keep healthy out of their own pockets?

Something so that about 3/4 of the country could afford normal health care without insurance and the 1/4 that couldn't we would figure out how to pay for them?

Why can't we take a step back and figure out the right way to do this instead of being caught up in this paradigm that you need medical insurance to live day by day?

Have catastrophic insurance, sure. I understand that shit will happen that is over the edge as far as costs go, even in a situation where health care in general is not as expensive. In fact, it is the big stuff that wreaks some of the worst havoc.

If you start paying for catastrophic insurance when you're young, you'll have built up enough equity (under a fair system) to deal with the age-related problems that are going to cost more. Insurance is about spreading risk, and the cost of that which happens to young people also gets spread out among the general population.

I've written so much now that I can't go on to provide examples or more detail.

But why can't we talk about real reform instead of piling more crap on the dung heap?

It's already too late. Again.

My top ten list for health care reform:

I'm aware this isn't perfect but we're not dealing with some 3rd world system, we have the best system, it only needs some common sense.

1. No more denial of coverage for pre-existing conditions. Insurance companies are going to have to take it in the shorts, along with the next 4 items below.

2. No dropped coverage when you get sick.

3. No waiting period for coverage.

4. Eliminates yearly and lifetime caps on coverage.

5. Force insurance companies to provide comparable coverage in all states. Lets' face it they have a monopoly. Huge savings here.

6. Tort reform, fricking lawyers do nothing but add to the cost, big savings here.

7. Send all illegal Mexicans back to Mexico or force them to p2p for health care, currently they only take from the health care system, plus they send their cash back home. Savings everywhere here.

It's like mexicans can walk into any emergency room and service (fix a broken arm, or a BBBJ etc. Is free, americans have to pay, that aint right.

8. Modernize the record keeping process and eliminate cost. Obama was right on this one. Moderate savings.

9. Leave Medicare / Medicaid alone for now. This is already a (government mess) The biggest saving of all, maybe in a couple years or so.

[QUOTE=Stan Da Man]My personal opinion: If they don't get this passed before Thanksgiving, they won't get it passed at all.[/QUOTE]Stan,

The Dems are not going to let their boy go down in flames, and thus I can state with great certainty that Congress will pass [u]a[/u] [u]bill[/u] of some type that they will trumpet as "Health Reform", including a wildly promoted "Presidential Signing Ceremony" and endless claims of Democratic victory.

The only issue is whether or not they pass a bill that [u]ACTUALLY[/u] reforms the health insurance business, including the health justice business, which the country has needed for many years.

Thanks,

Jackson

[QUOTE=Ricardo]1. Won't add a dime to deficit and paid for upfront.[/QUOTE]Okay, is there anyone on this forum that actually believe this, or am I the only one who is ROTFLMAO?

No, seriously. I'd like to hear the supporting arguments from anyone who can make a case that [u]any[/u] of the Dems proposed health care bills "[i]won't add a dime to deficit and paid for upfront[/i]".

Alternatively, is there anyone that would like to make a bet on this?

Thanks,

Jackson

Dctex99 [QUOTE=Cowpie]My top ten list for health care reform:

I'm aware this isn't perfect but we're not dealing with some 3rd world system, we have the best system, it only needs some common sense.

1. No more denial of coverage for pre-existing conditions. Insurance companies are going to have to take it in the shorts, along with the next 4 items below.

2. No dropped coverage when you get sick.

3. No waiting period for coverage.

4. Eliminates yearly and lifetime caps on coverage.

5. Force insurance companies to provide comparable coverage in all states. Lets' face it they have a monopoly. Huge savings here.

6. Tort reform, fricking lawyers do nothing but add to the cost, big savings here.

7. Send all illegal Mexicans back to Mexico or force them to p2p for health care, currently they only take from the health care system, plus they send their cash back home. Savings everywhere here.

It's like mexicans can walk into any emergency room and service (fix a broken arm, or a BBBJ etc. Is free, americans have to pay, that aint right.

8. Modernize the record keeping process and eliminate cost. Obama was right on this one. Moderate savings.

9. Leave Medicare / Medicaid alone for now. This is already a (government mess) The biggest saving of all, maybe in a couple years or so.[/QUOTE]Congratulations Cowpie, and well done!

I was contemplating posting my own list of what a good health insurance reform bill should include, but you've beat me to it.

Among other other things that you've enumerated, your plan...

- Does not raise anyone's taxes.
- Does not increase the Federal Budget or the National Debt.
- Does not force anyone to buy health insurance.
- Does not fine anyone for NOT buying health insurance.
- Does not effect anyone's current health insurance provider.
- Does not increase the cost of anyone's current health insurance.*

*Note: Obviously, eliminating pre-existing conditions and the cap on lifetime payouts will raise the average cost of everyone's health policies as these increased costs are spread across all policy holders, but I predict that this will be offset by the reduced costs from health insurance reform and increased competition.

One point though. There's no need to "force" insurers to do business across state lines. All we need to do is replace the state-level licensing and other regulations with uniform federal licensing and regulations. This would allow insurers to sell their policies in any and every state. You know, just like you can buy your auto insurance from any company in the country.

The problem for the Libs is that your proposal does not facilitate their true goal of wealth redistribution, nor does it allow them to give anything to their low-income constituencies, or to illegal aliens for which they have aspirations of turning into loyal Democrat voters.

In other words, its only good for the country as a whole.

Thanks,

Jackson

If there are no waiting periods and no limits on pre-existing conditions, won't the smart move be to not purchase health insurance until you get sick and drop it as soon as you get well?

If only sick people actually buy health insurance, isn't that going to badly skew the risk pool and underwriting results for companies providing the coverage? Won't they need to substantially increase premiums to survive? Who is going to be able to afford those dramatically premiums?

Insurance costs are just a symptom of the real problem of high medical costs in the USA and, if we want a market-based solution, somebody is going to have to figure out a way to have a system where the the bulk of consumers have a direct stake in the price of medical care and can afford to buy it when they need it.

My insurance premium goes up 7-10% each year, my co-pays rise ($10/ office visit to $20/ visit in the past 5 years) and my choices become more limited (30% copay to go out-of-network vs 20% just a few years ago) 20 more years of that and private health insurance will be too expensive and too restricted to be a viable alternative to a single-payer system that has can pool risk across 300 million people, can directly control costs by setting prices, and can set limits on treatments.

Here's kind of a fun article from 2005 about the value of preventing states from limiting interstate competition.

[url]http://www.opinionjournal.com/editorial/feature.html?id=110007011[/url]

The fun part is the way the article uses financial deregulation in refuting the concern that there would be a deregulatory race to the bottom.

"The best analogy for what to expect here is probably our experience with interstate banking, which has indeed resulted in operators moving to friendly climes like Delaware and South Dakota but which has also proven nothing but a boon to consumers. A national market has allowed the growth of big, financially stable institutions that have earned consumer trust."

Ain't that a crackup.

They do make good points about special interests increasing costs by loading up coverages and the dangers of adverse selection posed by guaranteeing access. Although for some reason, they seem to assume that the same special interests will give up and crumble when faced with a multi-state environment.

[QUOTE=Cowpie]My 2 cents:

If that happens, I predict O BAMA will also have to pay a price; maybe someone will make a move to "integrate" Mount Rushmore. A tribute to his ambition and socialist causes. Personally I think it would be defacing a nation monument.

Oh well, I guess when the talking stops, and logic fails, and a dictator refuses to listen, it's Americans right and privilege too defend democracy. Something Argentineans know little to nothing about.[/QUOTE]But 2 cents for this opinion seems a little stiff!

[QUOTE=El Queso]I began to understand that insurance is not the necessity that it seems almost everyone thinks it is.

IT IS LIKE CAR INSURANCE, YOU DON'T NEED IT UNTIL YOU ARE IN A SERIOUS ACCIDENT. THEN WITHOUT IT YOU CAN BE TRULY FUCKED!

If we were going to do REAL REFORM, and not just pile more overhead and government onto the current issue in an attempt to fix things, why didn't we take a little time, as grown-ups who realize that the current system and IT'S BUSINESS. Possibly the entire current thought process on how to provide better medical care to as many people as want it, just sit down and think about it for a little bit instead of rushing into this?

UNFORTUNATELY, STARTING FROM SCRATCH IS NOT A REALISTIC OPTION. THAT'S LIKE ASKING MICROSOFT TO DO WINDOWS OVER STARTING FROM SCRATCH. WHEN A SYSTEM CONTROLS 16% OF THE ECONOMY, OR FOR MICROSOFT 80% OF THE MARKET, YOU CAN'T DO A REWITE, YOU CAN HARDLY DO A REBOOT. SAD BUT TRUE.

Of course, the real answer is politics.

IT'S NOT POLITICS - THE POLITICALLY SMART THING WOULD HAVE BEEN FOR OBAMA TO TAKE THE ISSUE OFF THE AGENDA AND SAY THE ECONOMIC CRISIS HAD TO TAKE PRECEDENCE. HE DIDN'T BECAUSE HE UNDERSTANDS THEY ARE INEXTRICABLY INTERTWINED.

ITS BUSINESS - THE INSURANCE / MEDICAL BUSINESS INTERESTS HAVE OBSTRUCTED ANY ATTEMPT TO CHANGE THE SYSTEM, OTHER THAN GETTING GOVERNMENT TO GIVE THEM MORE CUSTOMERS AND TO PICK UP THE TAB, SINCE MEDICARE WAS INTRODUCED IN 1964. THEY MADE QUARTERLY PROFITS THE HOLY GRAIL REGARDLESS OF ANY OBLIGATION TO THEIR CUSTOMER BASE AND LIKE THE WALL STREET MASTERS OF THE UNIVERSE, HAVE PUT THE WHOLE SYSTEM AT RISK. INSURANCE ISN'T INSURANCE WHEN IT CAN BE CANCELLED ON A CORPORATE WHIM DESPITE YEARS OF PAYING PREMIUMS ON TIME.

Obama knew that he couldn't sit around and wait.

THE COUNTRY HAS BEEN WAITING FOR 79 YEARS SINCE TEDDY ROOSEVELT FIRST CALLED FOR UNIVERSAL HEALTH INSURANCE. THERE HAVE BEEN 18 PRESIDENTS OVER THAT TIME, AT LEAST EIGHT OF WHOM ATTEMPTED TO HAVE THE US NOT BE THE ONLY INDUSTRIAL ECONOMY THAT DOESN'T HAVE IT.

OBAMA TOOK ON THE ISSUE, BECAUSE EVERY KNOWLEDGEABLE ECONOMIC EXPERT - RIGHT OR LEFT - SAYS WHAT THE BUSINESS ROUNDTABLE SAYS - CHANGE HEALTH CARE OR IT WILL UNDERMINE ANY HOPE OF LONG TERM ECONOMIC RECOVERY.



He knew that he had to ram his plan through his first year in office. Certainly before the midterm elections when he is likely to lose the large and important majority that he has in Congress.

YOU MAKE MY POLITICAL POINT - TAKING ON THE ISSUE WAS HIGH RISK, AND MOST POLITICIANS AVOID HIGH RISKS. OBAMA SAW WHAT HEALTH CARE DID TO CLINTON, SO IT WOULD HAVE BEEN POLITIC TO LEAVE IT ALONE. BUT HE TAKES HIS JOB SERIOUSLY. HE CHOSE TO BE ECONOMICALLY RESPONSIBLE AND POLITICALLY FOOLHARDY.

To me, this situation and what Obama is doing with healthcare points to why I distrust government.

GIVEN WHAT WE ALL HAVE LEARNED ABOUT HOW THE INSURANCE COMPANIES OPERATE - AND WHAT WALL STREET DID OVER THE LAST FIFTEEN YEARS - YOU DON'T TRUST GOVERNMENT? HOW ABOUT WE CAN'T TRUST INSTITUTIONS RUN BY PEOPLE WHO LET GREED OR A LUST FOR POWER RULE THEIR BEHAVIORS!

But I managed for a good number of years to not have to buy anything but catastrophic-level insurance.

WITH THE COST OF TREATMENT IN THE US, GETTING A TOOTH PULLED AND REPLACED CAN RUN UP BILLS THAT ARE CATASTROPHIC FOR MOST MIDDLE CLASS FAMILIES!

But why can't we talk about real reform instead of piling more crap on the dung heap?

I AGREE WITH THE SENTIMENT BUT THINK THE WORLD DOESN'T WORK THAT WAY ANYMORE! [/QUOTE]YOU ARE A SMART GUY - EVEN MORE IDEALISTIC THAN ME (WHICH WILL SCARE SOME OF OUR FELLOW BLOGGERS) I WAS DUMB ENOUGH TO WORK IN POLITICS TO END POVERTY, RACISM AND WAR. THOSE MIGHT BE EASIER TASKS THAN HEALTH CARE!

[QUOTE=Cowpie]My top ten list for health care reform:

I'm aware this isn't perfect but we're not dealing with some 3rd world system, we have the best system, it only needs some common sense.

1. No more denial of coverage for pre-existing conditions. Insurance companies are going to have to take it in the shorts, along with the next 4 items below.

2. No dropped coverage when you get sick.

3. No waiting period for coverage.

4. Eliminates yearly and lifetime caps on coverage.

5. Force insurance companies to provide comparable coverage in all states. Lets' face it they have a monopoly. Huge savings here.

6. Tort reform, fricking lawyers do nothing but add to the cost, big savings here.

7. Send all illegal Mexicans back to Mexico or force them to p2p for health care, currently they only take from the health care system, plus they send their cash back home. Savings everywhere here.

It's like mexicans can walk into any emergency room and service (fix a broken arm, or a BBBJ etc. Is free, americans have to pay, that aint right.

8. Modernize the record keeping process and eliminate cost. Obama was right on this one. Moderate savings.

9. Leave Medicare / Medicaid alone for now. This is already a (government mess) The biggest saving of all, maybe in a couple years or so.[/QUOTE]The only item of disagreement is deporting illegal aliens, which sounds easy but it ain"t. And they will not get any more assistance under the reformed system unless their employer (who knows they are illegal but likes to pay low wages) lets them but into a company plan where the illegal then pays for coverage, not the taxpayer)

[QUOTE=Jackson]Dctex99 Congratulations Cowpie, and well done!

I MUST ASSUME LIKE COWPIE YOU ENDORSE 9 KEY ELEMENTS OF THE OBAMA PLAN, THEN YOU GO OFF THE SKIDS, BECAUSE YOU CAN'T GET THERE FROM HERE.

- Does not raise anyone's taxes. -

- THAT'S DOABLE AND PROPOSED.

- Does not increase the Federal Budget or the National Debt.

- DOABLE AND PROPOSED.

- Does not force anyone to buy health insurance.

- MANDATORY VIRGINITY DISAPPEARED A WHILE BACK. WE MANDATE CONTRIBUTING TO SSI AND MEDICARE AND BUYING CAR INSURANCE. AS WELL AS ME PAYING FOR A FEW WARS IN MY LIFE I OPPOSED. EVERYONE PICKS UP THE BILL FOR THE VOLUNTARY UNINSURED WHEN THEY GET SICK. MANDATORY IS NECESSARY. AND WE KNOW LIBERTARIANS DON-T LIKE IT.

- Does not fine anyone for NOT buying health insurance.

FINES ARE THE ENFORCEMENT MECHANISM OF A MANDATORY FEATURE.

- Does not effect anyone's current health insurance provider.

DOABLE AND PROPOSED. EMPLOYERS RETAIN THE "FREEDOM" OF TO CHANGE PROVIDERS IF COVERAGE GETS TOO EXPENSIVE. THEN THE EMPLOYER CHANGES HIS EMPLOYEES PROVIDER, NOT THE GOVERNMENT.

- Does not increase the cost of anyone's current health insurance.*

I ASSUME YOU MEAN BEYOND THE HUGE INCREASES THAT THE INSURANCE PROVIDERS INTEND TO IMPOSE THAT MAY DOUBLE COSTS IN THE NEXT TEN YEARS.

*Note:. All we need to do is replace the state-level licensing and other regulations with uniform federal licensing and regulations.

I ASSUME THE FEDERAL REGULATIONS WOULD PRECLUDE THE PROVIDERS FROM THEIR CURRENT PRACTICES THAT COWPIE'S (AND OBAM'AS) PLAN WOULD ELIMINATE!

The problem for the Libs is that your proposal does not facilitate their true goal of wealth redistribution, nor does it allow them to give anything to their low-income constituencies, or to illegal aliens for which they have aspirations of turning into loyal Democrat voters.

RANT ON KEMOSABE!

Jackson[/QUOTE]INTERESTING TAKE YOU HAVE JACKSON, ALL THE INTERNAL CONTRADICTIONS ASIDE!

My intent was to try and make sense. OBAMA is trying to force National health care on eventually everyone. Can you imagine another payroll deduction called comrade health care in addition FICA, Medicare, Medicaid, and social security. That's exactly what he's up to.

As for Jackson's comments below:

I totally agree with him it reflects a common sense conservative view point. Who in the hell wants to be forced to pay more and get less, especially for a bunch of assholes who only want to take from America and not pay their share?

- Does not raise anyone's taxes.

- Does not increase the Federal Budget or the National Debt.

- Does not force anyone to buy health insurance.

- Does not fine anyone for NOT buying health insurance.

- Does not effect anyone's current health insurance provider.

- Does not increase the cost of anyone's current health insurance

[QUOTE=Ricardo]YOU ARE A SMART GUY - EVEN MORE IDEALISTIC THAN ME (WHICH WILL SCARE SOME OF OUR FELLOW BLOGGERS) I WAS DUMB ENOUGH TO WORK IN POLITICS TO END POVERTY, RACISM AND WAR. THOSE MIGHT BE EASIER TASKS THAN HEALTH CARE![/QUOTE]Thanks for the compliment:)

But really, I don't necessarily see myself as idealistic. To me, much of this is common sense, but of course, "common sense" is only common to those who are infected with the same memes, or who don't have other, contradictory memes to interfere.

My grandmother, who died in February of this year at the ripe age of 92, used to tell me a story about when she first had healthcare, through the bank she worked at in Tulsa, Ok. This was, if I recall the time period correctly, the late '50s.

She used to go to the doctor as often as required and paid her own way, and that of her two boys. She was poor - her husband was not in the picture any more, in any sense. She worked two jobs. Her sons (obviously my father and my uncle) worked as well to help provide for the family, as young as 14. They lived modestly, yet with pride in themselves and the fact that they were productive members of their society.

Her doctor used work with patients in trade, in payments, whatever to make sure that he could provide the best care to them that he could provide because he actually cared about being a doctor more than being rich - at the time.

Shortly after getting insurance, things changed. The doctor's prices went up by almost 100%. My grandmother was worried about this, but the doctor told her not to worry because with the new insurance that she had, he was able to accept a little less from her than normal, and yet he could turn around and charge the insurance company more because they would accept it.

Well, obviously, that seems to me to be the beginning of the end.

I don't believe that we necessarily have to start over to do true reform. I don't believe there is a way to return to the past, but also, using the excuse that it's too difficult to "do the right thing" (whatever that may end up being) is a cop out.

My comments about Obama's political manueverings were not a criticism that he had to do that to get something done. It was a statement of fact that if he wanted to get something done, he would have to play that particular game to get it passed, particularly at this moment in time, because there are too many people opposed to what he wants to do.

The problem I have is that he is not setting things right, I believe. I think he is compounding the mistakes that already exist, much like (it can be argued) Roosevelt did by many of his New Deal programs in an attempt to fix previous problems.

I guess from this standpoint, perhaps, I AM idealistic. To think that we can actually set things right in this day and age, with so many people with so many different ideas, may be impossible.

Before I came to live in Argentina, I had an idea that what was going on in the States was dangerous. Since I have come to live here, I have come to the definite conclusion that what is being done is dead wrong.

Personal responsibility is lost when you try to do too much for people who do not do for themselves. In the States, it is still true (though I don't know for how much longer) that ANYONE who applies themselves can get ahead. But there are too many organizations and "politically correct thinking" that allow whoever wants to to cry, ***** and moan about their "plight."

The problem is, every social program that is enacted sucks the money from the people who have worked hard for it and who would invest it back into the economy and gives it to people who don't produce, for one reason or another. The government will NEVER be able to do things truly efficiently, it's the nature of the beast.

"Redistribution of Wealth" by any artificial means is destructive.

I watch here in Argentina as the "fearless leaders" fly free in the face of "terrible world capitalism" and buddy up with poeople like Hugo Chavez, telling the people that countries like the US are what's wrong with the world, and that their poverty is all our fault.

My sister-in-law (who is 13 and whom I have invited to come from Paraguay to get a better education) is forced to read that famous book that Chavez gave to Obama (who accepted it like an idiot - sorry, but I think that was stupid and amateurish) - "Las Venas Abiertas de Latina America" (The Open Veins of Latin America) in school here.

In the opening chapter of the book, it states very clearly its intent to prove that the US primarily, and some European powers as well, conspire to do everything they can to keep Latin America in its place and ensure that all of their resources are sucked out to leave them penniless and powerless. Of course, she is such an intelligent young ldy, that she comes to me every so often, pointing out obvious (even to a 13 year old!) Serious nconsistencies in what the author is saying.

As I told my sister-in-law, there is some truth to what she will read, but it's only a partial truth (not even a half-truth really)

Here, there is a small percentage of people who have money and everyone else contributes to them in one fashion or another. Through taxes, through unfair wages, through unfair patronage and many other things. And the people here honestly believe that their government is doing what they can to combat those rich people and redistribute their wealth as best they can.

Well, the uneducated masses believe that. The educated minority knows better, but they are powerless to do anything. The government here actually pays the poor to come to rallies and money magically gets distributed to key places that affect the poor just before elections. The poor are very ignorant and almost always vote the way the government wants them to.

The unions have power here as well - but the government, for example, has ruled that the business themselves must pay the union fees. On top of a 40% contribution in taxes, on top of the mandatory healthcare payment, on top of many other local taxes and other crap that businesses have to put up with. It makes it very very difficult to do business here and make money.

I see similar things happening in the US as the "poor" scream that they are being left behind, and as the "left" says "we have to take the wealth from the richer, who can afford it, and give it to the 'poor' who are down-trodden and left behind."

I put the word "poor" in quotes above, because the truth is, I don't think there are very many poor in the US who have really any idea what poor means. Why is that? Because those we consider poor in the States often live better lives than (or at least equal to) many of the people who consider themselves middle class here.

I used to live in the Fifth Ward in Houston. I know whereof I speak. I certainly would not like to live like that - so I worked my ass off to ensure that I would not. But the people who live in places like that live better than most of the people who live around me, outside of my "special" closed neighborhood out here in Pilar. And this is an affluent area!

The Argentino rich live in closed neighborhoods, but the middle class live in small houses, on small properties, with walls around their one or two bedroom houses (with 3-6 family members) living in fear from the real poor, who live in crumbling unfinished-wall brick "buildings" (very ugly houses) The streets here, to my neighborhood, are so terrible that they are difficult to drive on and my car constantly has problems with tire balancing and front end alignment. But the streets to where many of the middle class live are unpaved and often muddy, and the streets to the poor even more so.

And that's just here in a small place in Buenos Aires. This is quite affluent compared to most of the rest of what I have seen in Latin America. Paraguay is a trip and a half!

I have written at times about my wife's family's origins. This is true povery of the class that you see on TV where people are begging money to help these truly, truly poor people who live (barely) at the whim of the weather on subsistence farming.

In the States, very few people have ANY idea what poverty is. My mother and my grandmother lived in poverty very similar to what I have described in Paraguay. That kind of poverty doesn't really exist any more in the States. Why? Because we HAD a work ethic where people were too proud to accept handouts from the government and we pulled ourselves up by the bootstraps.

Because although things are not perfect and people abuse the system, capitalism has allowed EVERYTHING to raise in relation to the rest of the world where capitalism is not practiced.

In my opinion, a free market system in which everyone has an opportunity (and the "poor" are not sucking the wealth [as in "redistribution"] from those who keep it running) will far out perform any socially-engineered program that man, at this point in time, can implement.

So in my opinion, what Obama is doing with many of the things he wants to do is fucking up the system with more overhead and engineered things, instead of focusing on things that are truly unfair practices by those in power and behind PACs who try to get everything they can for themselves, and whatnot.

Let me give you an example of healthcare:

One of my clients is an Ob / Gyn physician, employs two other physicians and 18 employees. Each year the amount insurance companies pay for specific procedures (office, hospital and out patient surgery centers) declines. Add to this the fact the insurance companies continue to "bundle" services together at a lower price and the physician has seen a steady decline in income over the last 10 years while expenses have continued to rise. The physician has attempted to add more patients but reached a point where medical care was compromised and decided to stick with good care and continue to ride the decline in income. (I am sure malpractice concerns played a role in this decision as well as this client being an excellent physician who really cares about the patient)

Today this physician is still seeing more patients than 10 years ago but is making 41% less in take home pay due to the decline in reimbursement and increases in expenses. I should add this physician sponsors a 401(k) for the employees, contributes up to 10% in matching and provides PPO healthcare coverage for the employees.

Add to this the government required move to electronic medical records (a really good thing in the long run) but the physician had to shell out $350K for the hardware and software not to mention $28.8K in annual software and hardware support.

Now the reward for being a good corporate citizen and taking care of employees is ObamaCare. This physician has decieded if what is being talked about now passes, the area will be one OB / GYN physician short and 20 people will be out of a job as she will fold her tent and do something else, make a little less money and get out of the rat race. Now if you check the polls there are many physicans in the same boat, get out and do something else.

Fix healthcare? Get the lawyers out of it, get the government out of it, return to personal responsiblilty, referenced in earlier posts. Jackson and I had this very discussion in July, when we grew up you paid your on way, only went to the doctor when you really had to, only went to the ER if there was free flowing blood or bones sticking out and only had catstrophic care for the rally big bad things. IMHO, the worst thing that happend to healthcare is when the insurance companies invened to "CO-PAY" and you could consume all the healthcare you could for $10 $20 or $30. It completly divorced the cost of care from the payment of care for the patient.

[QUOTE=Jackson]Stan,

The Dems are not going to let their boy go down in flames, and thus I can state with great certainty that Congress will pass [u]a[/u] [u]bill[/u] of some type that they will trumpet as "Health Reform", including a wildly promoted "Presidential Signing Ceremony" and endless claims of Democratic victory.

The only issue is whether or not they pass a bill that [u]ACTUALLY[/u] reforms the health insurance business, including the health justice business, which the country has needed for many years.

Thanks,

Jackson[/QUOTE]Don't be so sure. Remember what happened last time sweeping health care was proposed? It was called HillaryCare. It was [I][b]the[/b][/i] big item for the new President Clinton. It was essential. We had to have it to maintain prosperity.

It was defeated and we went on to a decade or so of great prosperity, albeit with a few blips in between.

And, do you recall what came after it was defeated? Remember? It wasn't that long ago. Democrats tried to craft a number of plans and counter-plans, all with compromises designed to mollify this or that constituency -- exactly what is starting to happen now with the current plan. HillaryCare was finally declared DOA in September of 2004, just two months before mid-term elections, but the damage already had been done. Democrats were swept from office by an electorate that was angry about efforts to federalize everything.

Then, it was called the "Republican Revolution." It resulted in a net gain of 54 seats in the House of Representatives, and a pickup of eight seats in the Senate. Plus, the day after the election, Democratic Senator Richard Shelby of Alabama changed parties, and became a Republican. The gains in seats in the mid-term election resulted in the Republicans gaining control of both the House and the Senate in January 1995.

Now, I'm not predicting that will again occur. But, we've already seen the start of some serious discontent over this. It does not matter what the "majority" wants. It matters what the majority of voters want. You piss off a large chunk of the population and they [b]will[/b] show up at the polls.

Democrats definitely remember this. There has been just one intervening administration since this took place, and they only recently took back control of both houses. We can say what we want here about either party, but at the end of the day, every one of these guys and gals is most interested in one thing: How do I get re-elected?

Democrats tenuously picked off a number of Republican seats this last go-round. Those representatives are going to be mighty nervous next election, but they don't matter much because they are mostly in the House. The House has little bearing on health care. Democrats could lose a bunch of seats there and they still would have sufficient votes to pass ObamaCare. It's the Senate that's really the issue.

There are at least 36 Senate seats that will be up for grabs on or before November 2, 2010 (34 regular seats and two special elections) That's why my prediction is that this thing will not pass if it is not passed before Thanksgiving. After Thanksgiving, the campaigning for these 36 seats will begin in earnest. Those who vote for this things will have to defend themselves. They remembered what happened last time they decided to kick a hornet's nest. They will not let this thing fester. The longer they do, the more they are tempting fate.

Also, failure to pass this thing will not be "letting Obama go down in flames," just as it wasn't "letting Clinton go down in flames" last time around. He served 7 more years after HillaryCare was defeated and, arguably, got stronger every year until his last year in office, when he went on a pardon-binge for all the Friends of Bill and his popularity dimmed. From my perspective, he learned his lesson: Once HillaryCare was defeated, he never again tried to do too much, and he turned into a stellar executive.

Finally, one stray comment: Auto insurance is the same as health insurance. It's regulated by each of the 50 states. As a practical matter, it's not that difficult to get around state insurance regulation. It's called "surplus lines" in most states. Generally, you just need to establish that a certain type of coverage is not offered in a state. You do so by having an independent entity (usually a surplus lines broker) call up three carriers to see if they offer a particular type of coverage. For example, say you want to offer property insurance. You put a clause in your policy that says you cover a particular type of boiler against loss. Then, your surplus lines broker calls around and asks whether three random admitted carriers in a particular state offer this type of boiler coverage in their policies. They document that they don't and, voila! You can offer coverage from out of state.

Usually, carriers will form a separate off-shore entity to do this in some insurance haven like the Cayman Islands or British Virgin Islands. It happens all the time. If you're a business owner, check your policy. There will always be a disclaimer there when you are buying coverage from a non-admitted carrier. Insurance companies figured a way around most state regulation long ago. And, these are not fly by night companies. My workers comp policy, for example, is offered by a Warren Buffet company. It is non-admitted and based in Bermuda, I believe. Great company. Surplus lines is not as common for health insurance, but it does exist.

[QUOTE=Doppelganger]I ASSUME YOU ARE AWARE THAT THE US IS VIRTUALLY ALONE IN HAVING A HEALTH CARE SYSTEM BUILT ON A REIMBURSED FEE-FOR-SERVICE FOR-PROFIT MODEL.

Let me give you an example of healthcare:

Each year the amount insurance companies pay for specific procedures (office, hospital and out patient surgery centers) declines.



BUT INSURANCE COMPANY PROFITS DON'T!

. Insurance companies continue to "bundle" services together at a lower price and the physician has seen a steady decline in income over the last 10 years while expenses have continued to rise.

BUNDLED SERVICES PROTECT PROFIT MARGINS.

The physician has attempted to add more patients but reached a point where medical care was compromised and decided to stick with good care and continue to ride the decline in income.

YOU HAVE AN HONORABLE CLIENT.

Add to this the government required move to electronic medical records (a really good thing in the long run) but the physician had to shell out $350K for the hardware and software not to mention $28.8K in annual software and hardware support.

THE COST OF THAT EQUIPMENT SOUNDS EXCESSIVE. AS FAR AS I KNOW SUCH SYSTEMS ARE NOT MANDATORY. AND THE OBAMA STIMULUS PLAN INCLUDED SERIOUS MONEY FOR EQUIPMENT AND SOFTWARE DEVELOPMENT TO MAKE FUTURE SYSTEMS AFFORDABLE.

Now if you check the polls there are many physicans in the same boat, get out and do something else.

TRADITIONALLY THE MEDICAL PROFESSION HAS HAD THE HIGHEST PERCENTAGE OF MEMBERS HARBORING SECOND THOUGHTS ABOUT THEIR CAREER CHOICE. THE CURRENT SQUEEZE IS MAKING IT WORSE.

Fix healthcare? Get the lawyers out of it, get the government out of it, return to personal responsiblilty.

LAUDABLE SENTIMENTS - AS REALISTIC AS MY WISH FOR RACISM, POVERTY AND WAR TO DISAPPEAR - (apologies to Jackson) - BUT THE ONLY CLOCKS YOU CAN TURN BACK ARE IN THE MOVIES.

It completly divorced the cost of care from the payment of care for the patient.

MORE THAN CO-PAYS CAUSED THIS - BUT THIS IS THE HEART OF THE PROBLEM[/QUOTE]I have yet to hear the opponents to so-called Obamacare propose any fix for the broken system that is reality based. If we go back to personal responsibility based health care, the number of doctors who will head for the exits will be a stampede.

[QUOTE=Ricardo]I have yet to hear the opponents to so-called Obamacare propose any fix for the broken system that is reality based. If we go back to personal responsibility based health care, the number of doctors who will head for the exits will be a stampede.[/QUOTE]I doubt that last statement.

Also, I don't think no one has offered any alternatives. One thing that has been said again and again in these threads is insurance for the big things makes sense, for example.

The small everyday stuff should not be insured. General practitioners, the day-to-day part of their business, could run their practice as a regular business, I bet, if they weren't so worried about lawsuits if they honestly missed something (or being ruined if they made a mistake, etc) figuring out how to bill everyone's insurance and hoping that the bill gets paid in any kind of reasonable time without any kind of major headache, etc, etc.

Check out this related incident: [url]http://www.lewrockwell.com/orig7/foye7.1.1.html[/url]

I know, it's on LewRockwell. Com, haven of those crazy liberterians, but there is a lot of sense made there for people with an open mind.

Notice the part where he talks about paying cash at the doctor's office. The doc gives a 30% discount. Wow. Seems the doctor would prefer not to deal with the crap involved in filing insurance claims? Would this guy head for the exit with the proposed stampede if he didn't have to deal with health insurance?

Imagine how much this doctor could lower his rates if he didn't have to deal with all the bureaucratic crap he normally deals with? If he didn't have to pay a fortune for malpractice insurance? And everything else that is wrong with the current system.

Is it that we can't have real reform that would allow people to take care of their own day-to-day issues because "politics" won't allow it? Or is it because it doesn't make a good idea?

A policy that limits people to, say, $5K to $10K in out of pocket expenses for big things wouldn't be all that bad. It wouldn't be the end of their financial future paying off something like that and the big ticket items would be covered.

But in order to get things to the point where people would feel comfortable doing this, as stated previously, we would have to get rid of all the overhead crap, large settlements and cost of malpractice insurance, make sure that pre-existing conditions are not excepted, insurance can't be dropped, so and and so forth.

I guess the reality is that the American people have been hoodwinked by the AMA and the insurance and lawyers' lobbies into believing that insurance for every little thing is necessary and the politicians, some of whom at least know better, are turning a blind eye for one reason or another.

Everyone knows the saying "if it ain't broke, don't fix it." While that does not apply in Obama's case (something does need to be fixed) I think the proper corrollary to that would be "if you can't fix it, don't try because you'll only make it worse."

You know, thinking about car insurance vs health insurance - imagine how expensive car insurance would be if it covered oil changes, wiper changes, general checkups, balancing of tires, cleaning and waxing and all the things required to maintain a car in good working order.

Honestly - if a policy covered all that and you had to have an insurance policy for your car anyway, wouldn't you use the coverage to do all the maintenance items? Whenever you felt the slightest shimmy in the left front tire (even though you just took it in a week ago and they couldn't find anything) Whenever the wipers left a little streak on the windshield?

Man, I bet mechanics would love that.

I know it's not a perfect analogy. Right off the bat, one can say "don't buy a car if you can't afford to maintain it," for example. But seriously, think about it.

[QUOTE=El Queso]I doubt that last statement.

Also, I don't think no one has offered any alternatives. One thing that has been said again and again in these threads is insurance for the big things makes sense, for example.

IF THERE WAS A WAY TO MAKE SMALL AND MEDIUM SIZE THINGS NOT COST AN ARM, LEG AND HALF A TESTICLE WHAT YOU SUGGEST MIGHT WORK, BUT THERE AIN'T. HIGH COST PERMEATES HEALTH CARE.

Imagine how much this doctor could lower his rates if he didn't have to deal with all the bureaucratic crap he normally deals with? If he didn't have to pay a fortune for malpractice insurance? And everything else that is wrong with the current system.

THE MALPRACTICE PROBLEM IS REAL BUT OVERSTATED. WHAT IS MORE REAL AND UNDERSTATED IS THE GROWTH OF SPECIALIZATION. THE DOCTORS YOU AND OTHERS TALK ABOUT - GENERAL PRACTITIONERS ARE A DYING BREED. NO ONE SPEND YEARS IN MEDICAL SCHOOL ANYMORE TO STUDY TO BECOME AN INTERNIST AND MAKE HALF WHAT A SPECIALIST MAKES.

Is it that we can't have real reform that would allow people to take care of their own day-to-day issues because "politics" won't allow it? Or is it because it doesn't make a good idea?

IT'S NOT POLITICS AND YOU GUYS SHOULD GET THE IDEA IT IS OUT OF YOUR HEADS. POLITICIANS HAVE DUCKED THIS ISSUE FOR 80 YEARS. THE ONES WHO TOUCHED IT GOT BURNED. OBAMA IS DUMB IN MANY WAYS TO TAKE IT ON. BUT HE HAS BECOME CONVINCED, AS HAS THE MAJOR NON-MEDICAL BUSINESS INTERESTS THAT NO CHANGE IN HEALTH CARE MEANS THE US CONTINUES TO SLIDE BACK ECONOMICALLY.

Everyone knows the saying "if it ain't broke, don't fix it." While that does not apply in Obama's case (something does need to be fixed) I think the proper corrollary to that would be "if you can't fix it, don't try because you'll only make it worse."[/QUOTE]BUT WHAT IF THE REALITY IS IF WE DON'T FIX IT WE'RE FUCKED?