An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

[Red Cloud]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

That doesn't take affect until 2018, correct?. So we go 8 more years of them wasting money before we see any benefit. Not sure how that makes any sense if what you say is true( encouraging overuse)

Don't forget about all of those people we've repeatedly been told are dying because they lack health insurance that is such a big huge major deal that we HAD to force this thing through NOW that will continue to die through 2014.

 

[Rover]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

That doesn't take affect until 2018, correct?. So we go 8 more years of them wasting money before we see any benefit. Not sure how that makes any sense if what you say is true( encouraging overuse)

Correct, but as Scooby correctly stated you'll most likely start seeing a retreat from these plans beforehand given the looming change.

Moving on, looks like financial regulation is up next:

http://dyn.politico.com/printstory.cfm?uuid=92F2BFC8-18FE-70B2-A8113FC6693D9C5F

So, that would be health care, student loans, Afghanistan and financial regulation all improved since taken office. A pretty stellar record of accomplishment there.

 

[busterman62]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

I like how people initially think I'm too hard on the righties, but then when they start seeing their posts always come around to agreeing with my treatment of them.

But to answer your questions:

1) As les has detailed many, many times, if you can get people looked at long before they show up at the ER with life threatening conditions, you've reduced the costs to the health care system. Getting everyone insurance and stopping people with pre-existing conditions from being denying insurance goes a long way towards addressing this issue. Again, for the sake of brevity, just read les' posts. There are other items also, but lets just start with this one.

In your brevity, you seem to have conveniently forgotten another of les's salient points. Who's going to see these patients? The lack of primary care providers remains unaddressed. Thus far the Mass. program (the one this is supposedly modeled after) has more access problems and costs have risen. I've yet to see stats about ER usage but I seriously doubt they will be down. Even though the old investment commercial says that "past performances are not indicative of future results," I tend to think Santayana is probably more correct in this case

 

[Plante26]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

I like how people initially think I'm too hard on the righties, but then when they start seeing their posts always come around to agreeing with my treatment of them.

But to answer your questions:

1) As les has detailed many, many times, if you can get people looked at long before they show up at the ER with life threatening conditions, you've reduced the costs to the health care system. Getting everyone insurance and stopping people with pre-existing conditions from being denying insurance goes a long way towards addressing this issue. Again, for the sake of brevity, just read les' posts. There are other items also, but lets just start with this one.

2) Several ways. First, the uninsured and small businesses can now go to a national exchange where there's competition for their business, instead of being forced to deal with the only insurer in the market in many cases. Also, seniors now have the donut hole exemption closed, and as many with elderly grandparents can attest their prescription bills easily put them in this category. Lastly, you're also cracking down on cadillac plans that encourage overuse of the health care system. Once again, for the sake of brevity I'll stop here and let you digest.

The use of ERs for last-minute care for life-threatening conditions is vastly overstated. As I pointed out a couple weeks ago, the total uncompensated care for uninsureds is less than $65 billion each year--a drop in the bucket compared to what this bill is spending. That amount is also being covered by the taxpayers, as state and federal governments pick up the tab--thus this cost is not being passed along to consumers. I agree with getting primary preventive health care in place for the un/underinsursed--which this bill lays out with $12 billion in spending for community health clinics.....one of a few good provisions in this bill that could have been a great starting point for a NEW bill. Ironically (make sure your head doesn't explode, Rover), it was President Bush that funded these new clinics:

President Bush will leave office "with a health care legacy in bricks and mortar: he has doubled federal financing for community health centers, enabling the creation or expansion of 1,297 clinics in medically underserved areas," the New York Times reports. According to the Times, "Bush came to admire the missionary zeal and cost-efficiency of the not-for-profit community health centers" as governor of Texas. In 2001, Bush proposed opening or expanding 1,200 clinics over five years, which he did, and proposed doubling the number of patients served at the centers. The number of people receiving services at the centers actually has increased by about 60%, according to the Times.

Essentially, this bill is complete overkill. Hamstringing the insurance companies with legislation will only drive health insurers into the ground due to the negating of the actuarial calculations which drive the profitability of the entire insurance industry. Basically, once a premium rate is set, it can't be raised for any reason. No matter the rising cost of health care, or increase in claims by those with pre-existing conditions, or the fraction of those who reach and exceed their no-longer-existent lifetime cap. How does the insurance company stay in business?

Also, the bill does not set up a national exchange--there will be state insurance exchanges, which is basically where things are now. Insurers would be forced to charge the same prices for coverage both inside and outside of the exchange, and any premium rate hikes would be subject to approval by the state exchange.....which is a situation that reeks of corruption, if you ask me.

Closing the "donut hole" I can understand. But it surely doesn't take a multi-trillion dollar solution to do so.

As for cadillac plans encouraging over-use......that is just silly. The people that have/pay for these plans are either:

1.) Working at a job that pays well, or
2.) Chronically ill, and paying the higher premium to avoid higher co-pays and deductibles.

Health insurance isn't anything like gorging yourself at a $9.99 all-you-can-eat buffet. 99.99% of people aren't merely going to the doctor because they've paid their premiums, and saying "By God, I'm going to get what I paid for!" People seek medical attention because they need to, not because they want to.

 

[LynahFan]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

1) As les has detailed many, many times, if you can get people looked at long before they show up at the ER with life threatening conditions, you've reduced the costs to the health care system. Getting everyone insurance and stopping people with pre-existing conditions from being denying insurance goes a long way towards addressing this issue. Again, for the sake of brevity, just read les' posts. There are other items also, but lets just start with this one.

This argument is just never very convincing for me, because guess what? We're all going to need end-of-life care, which is almost certainly the #1 driver for costs. If an untreated condition progresses to a life-threatening situation today, then you spend that end-of-care money now. But if you treat that condition today, then you pay for that condition now PLUS that person's end-of-life care later on anyway. What if every person you treat for heart disease now ends up with lung cancer in 5 years? I'm not convinced that treatment today leads to cost reduction. I am convinced, however, that if people would choose to live healthier lifestyles (diet + exercise) then total health care costs would go down, but that's a completely separate issue from access to treatment - at that point, the horse is already out of the barn.

Reductio ad absurdum says that we should just let people die as soon as they get sick, which is clearly by far the cheapest solution...

 

[Rover]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

This argument is just never very convincing for me, because guess what? We're all going to need end-of-life care, which is almost certainly the #1 driver for costs. If an untreated condition progresses to a life-threatening situation today, then you spend that end-of-care money now. But if you treat that condition today, then you pay for that condition now PLUS that person's end-of-life care later on anyway. What if every person you treat for heart disease now ends up with lung cancer in 5 years? I'm not convinced that treatment today leads to cost reduction. I am convinced, however, that if people would choose to live healthier lifestyles (diet + exercise) then total health care costs would go down, but that's a completely separate issue from access to treatment - at that point, the horse is already out of the barn.

Reductio ad absurdum says that we should just let people die as soon as they get sick, which is clearly by far the cheapest solution...

This is the old tobacco company argument. They're actually doing the country a favor by having smokers die off early. In hindsight, we've come to find that 99.9% of tobacco company statements were false at best and criminal at worse. No offense if I categorize this the same way.

In your brevity, you seem to have conveniently forgotten another of les's salient points. Who's going to see these patients? The lack of primary care providers remains unaddressed. Thus far the Mass. program (the one this is supposedly modeled after) has more access problems and costs have risen. I've yet to see stats about ER usage but I seriously doubt they will be down. Even though the old investment commercial says that "past performances are not indicative of future results," I tend to think Santayana is probably more correct in this case

Something I've covered repeatedly but will reiterate for your sake. The strain on medical providers is a very real concern and one of the best points brought up. Its very interesting that the right chose to focus on death panels and other such nonsense instead of this legitimate concern. My answer is as follows:

1) While this concern is real, I don't think continuing to deny 32M people insurance is the answer.

2) When confronted with a known issue and some time to work it out, occasionally industries respond. Y2K being a classic example of what can be accomplished in a small amount of time.

3) I'm hopeful innovation such as the medical clinics set up in CVS for example will allow more people to get routine treatment easier.

 

[LynahFan]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

No offense if I categorize this the same way.

Uh-huh. Dismissiveness and labeling. Good strategies when you got nuthin.

 

[Patman]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

Something I've covered repeatedly but will reiterate for your sake. The strain on medical providers is a very real concern and one of the best points brought up. Its very interesting that the right chose to focus on death panels and other such nonsense instead of this legitimate concern. My answer is as follows:

1) While this concern is real, I don't think continuing to deny 32M people insurance is the answer.

2) When confronted with a known issue and some time to work it out, occasionally industries respond. Y2K being a classic example of what can be accomplished in a small amount of time.

3) I'm hopeful innovation such as the medical clinics set up in CVS for example will allow more people to get routine treatment easier.

Part 1 doesn't address the concerns at hand... though clearly you have made and legitimized the trade-off. You are OK with it... so are a lot of other democrats... the problem is they won't say so out loud and they won't tell people that's the plan.

2... possibly... solutions can come via the pressure of incentives... but at the same time it assumes that the solution exists. This is more faith than anything else.

3... you could do this now... the problem is that it comes at a price.

In the end though, you don't end up dealing the the large lot of the problems. People are going to expect that you are going to give them better for cheaper. The problem is that you are not going to give them better for cheaper... whether its better could be debatable (and certainly will be for seniors) and its being made clear for the large share of us that it will not be cheaper.

In the end the policy fails because we're trying to set policy with our hearts. That's all that is... your heart breaks more for those 32 million than it does for the old... that's the trade you've made and you've justified it. The problem with policies of the heart is that it assumes that we have the capacity within our nation to afford it. You are going to see that we can't regardless of the capacity of your heart.

 

[Rover]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

Part 1 doesn't address the concerns at hand... though clearly you have made and legitimized the trade-off. You are OK with it... so are a lot of other democrats... the problem is they won't say so out loud and they won't tell people that's the plan.

2... possibly... solutions can come via the pressure of incentives... but at the same time it assumes that the solution exists. This is more faith than anything else.

3... you could do this now... the problem is that it comes at a price.

In the end though, you don't end up dealing the the large lot of the problems. People are going to expect that you are going to give them better for cheaper. The problem is that you are not going to give them better for cheaper... whether its better could be debatable (and certainly will be for seniors) and its being made clear for the large share of us that it will not be cheaper.

In the end the policy fails because we're trying to set policy with our hearts. That's all that is... your heart breaks more for those 32 million than it does for the old... that's the trade you've made and you've justified it. The problem with policies of the heart is that it assumes that we have the capacity within our nation to afford it. You are going to see that we can't regardless of the capacity of your heart.

Actually, I approach this strictly from a finance perspective. I don't give a ton of thought to the uninsured because I don't know anybody in that predicament personally. While I think extending insurance to these people is a good idea, its not my biggest issue.

Rather, its the idea that if you get people insured, and then get them access to regular care, the cost to the rest of us goes down. Others (Lynah, etc) may disagree with that, just like others may disagree with CBO estimates, etc - but I'm on board. I'm on board with an exchange for the uninsured and small business to be able to purchase insurance. I'm on board with an independent board recommending changes to save $$$. I'm also on board with some higher taxes to pay for all this, because the cold, hard reality of our existance is that some taxes will have to be increased in our lifetimes to balance the budget. As a relatively high earner, I'm going to be somebody who's affected by this, but its not a problem. That's why I support this bill. Its the first time since 1993 that the country's political establishment went out of their way to tackle a pressing domestic problem, and kudos to them for doing so.

 

[LynahFan]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

Actually, I approach this strictly from a finance perspective. I don't give a ton of thought to the uninsured because I don't know anybody in that predicament personally. While I think extending insurance to these people is a good idea, its not my biggest issue.

Rather, its the idea that if you get people insured, and then get them access to regular care, the cost to the rest of us goes down. Others (Lynah, etc) may disagree with that, just like others may disagree with CBO estimates, etc - but I'm on board. I'm on board with an exchange for the uninsured and small business to be able to purchase insurance. I'm on board with an independent board recommending changes to save $$$. I'm also on board with some higher taxes to pay for all this, because the cold, hard reality of our existance is that some taxes will have to be increased in our lifetimes to balance the budget. As a relatively high earner, I'm going to be somebody who's affected by this, but its not a problem. That's why I support this bill. Its the first time since 1993 that the country's political establishment went out of their way to tackle a pressing domestic problem, and kudos to them for doing so.

The cost to the rest of us goes down, but our taxes go up? Which is larger - the cost savings or the tax increase?

 

[solovsfett]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

What happened with this?

Here's what's happened. My quarrel is with those who really believe that Obama is simply is pushing this bill for the greater good, he's not a socialist, etc.

To take a page from Obama..."I don't pay attention to the daily gyrations of the stock market" "this isn't about how this gets done"

etc.

Will I argue with Lesp? No. I'm not a doctor and to be honest there are some fixes in the bill that are necessary, fixing the "donut hole" problem.

HOWEVER. my disagreement with single-payer, Obama's spending spree, his disdain for free-speech, his lack of having actual debate on ANYTHING, his bat**** determination to remake this country in Che Guevara's image...that's what I care about most...

how's that for an OBAMA-like non response

 

[Rover]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

The cost to the rest of us goes down, but our taxes go up? Which is larger - the cost savings or the tax increase?

The cost savings.

 

[Plante26]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

The cost savings.

Wrong.

I'll give you one more guess. Hint: It's the other one.

 

[DaveStPaul]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

Here's what's happened. My quarrel is with those who really believe that Obama is simply is pushing this bill for the greater good, he's not a socialist, etc.

To take a page from Obama..."I don't pay attention to the daily gyrations of the stock market" "this isn't about how this gets done"

etc.

Will I argue with Lesp? No. I'm not a doctor and to be honest there are some fixes in the bill that are necessary, fixing the "donut hole" problem.

HOWEVER. my disagreement with single-payer, Obama's spending spree, his disdain for free-speech, his lack of having actual debate on ANYTHING, his bat**** determination to remake this country in Che Guevara's image...that's what I care about most...

how's that for an OBAMA-like non response

Your argument reminds me of when I was in college in the 80s. I would -- as a fiscal conservative -- say I was glad people were looking at Welfare reform. The rebuttal I almost always got was that Reagan was a Fascist. (I know, you don't get a lot of nuance from 19-yr-olds; I'm not holding up a bunch of people I used to know as proof of one side or the other.)

But when I pressed them with what I thought were obvious flaws in the way the whole system was run, usually I'd also get a concession from them that there were indeed big problems. So you could sum up their position as, "Yes, there are in fact major problems, and they probably should be fixed -- or at least attempted to be fixed; but it's all part of Reagan's plan to turn us into a heartless evil country. You can't tell me he's not really a Fascist." etc etc etc

I'm glad you took the time to respond, but your argument now sounds as strange to me as the same version (from the other side) sounded 25 years ago.

 

[huskyfan]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

This is the old tobacco company argument.

no. no. no. this is to be used in the Global Warming debate, not the health care debate.

 

[Rover]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

no. no. no. this is to be used in the Global Warming debate, not the health care debate.

The problem with Lynah resurrecting the tobacco company argument (that they're doing the country a favor by killing people off early) is that it doesn't pass the common sense test. If people are living longer, healthier lives, either by not smoking or by getting regular care, when end of life comes, the treatments are different. If you live until 95, chances are doctors are going to recommend against surgery given your age. If you're 50 and in poor health, the notion that you could live another 30 years if properly treated is a far different and costly consideration.

There's also the hard to guage but real question of productivity. Is it better to have sickly people unwell for decades before an early death or healthy ones who live longer and stay productive?

 

[Rover]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

Here's what's happened. My quarrel is with those who really believe that Obama is simply is pushing this bill for the greater good, he's not a socialist, etc.

To take a page from Obama..."I don't pay attention to the daily gyrations of the stock market" "this isn't about how this gets done"

etc.

Will I argue with Lesp? No. I'm not a doctor and to be honest there are some fixes in the bill that are necessary, fixing the "donut hole" problem.

HOWEVER. my disagreement with single-payer, Obama's spending spree, his disdain for free-speech, his lack of having actual debate on ANYTHING, his bat**** determination to remake this country in Che Guevara's image...that's what I care about most...

how's that for an OBAMA-like non response

Where did that individual mandate requirement come from?!?!

http://news.yahoo.com/s/ap/us_health_overhaul_requiring_insurance

 

[busterman62]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

Something I've covered repeatedly but will reiterate for your sake. The strain on medical providers is a very real concern and one of the best points brought up. Its very interesting that the right chose to focus on death panels and other such nonsense instead of this legitimate concern. My answer is as follows:

1) While this concern is real, I don't think continuing to deny 32M people insurance is the answer.

2) When confronted with a known issue and some time to work it out, occasionally industries respond. Y2K being a classic example of what can be accomplished in a small amount of time.

3) I'm hopeful innovation such as the medical clinics set up in CVS for example will allow more people to get routine treatment easier.

To your credit Rover, you have at least acknowledged this problem in the past. Far more so than what the the clowns in DC have. Unfortunately, your "fix" is about the same as theirs, "just get it done and let's hope it works out" The Mass. experience with a similar plan, at least in the short term, suggests that access will remain a problem and costs will increase. (I've always loved the description that insanity is doing the same thing and expecting different results) No one with any sense would argue that reform isn't needed, but why should we implement a similar plan nationally prior to working out the bugs and preparing for it? Simple answer.....Politics>>>>>Principles.

 

[Rover]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

To your credit Rover, you have at least acknowledged this problem in the past. Far more so than what the the clowns in DC have. Unfortunately, your "fix" is about the same as theirs, "just get it done and let's hope it works out" The Mass. experience with a similar plan, at least in the short term, suggests that access will remain a problem and costs will increase. (I've always loved the description that insanity is doing the same thing and expecting different results) No one with any sense would argue that reform isn't needed, but why should we implement a similar plan nationally prior to working out the bugs and preparing for it? Simple answer.....Politics>>>>>Principles.

I see it more as you can't solve every single issue with this legislation. That's what the doubters want to pro-reformers to address. As I've also said a lot, its not a Constitutional amendment. I can be adjusted as needed.
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More Tea party idiocy:

http://www.nytimes.com/2010/03/28/us/politics/28teaparty.html?partner=rss&emc=rss

 

[solovsfett]

Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover

Where did that individual mandate requirement come from?!?!

http://news.yahoo.com/s/ap/us_health_overhaul_requiring_insurance

I understand Mitt Romney was behind the idea in Mass (which hasn't turned out nearly as well as he'd like to have people believe) and earlier Nixon was. I'm not, and those 2 guys don't represent the best in conservative economic though imo.

What would Bill Buckley or Reagan do? that would be more along the avenue I'd be seeking

also - if Romney runs for president and runs against the bill he's a hypocrit of the highest order.