Health Carepalooza 2010 Catch-All

I think David Frum put it the best:

link

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

Barack Obama badly wanted Republican votes for his plan. Could we have leveraged his desire to align the plan more closely with conservative views? To finance it without redistributive taxes on productive enterprise – without weighing so heavily on small business – without expanding Medicaid? Too late now. They are all the law.

No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?

We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.

I don't see it as an abject defeat for republicans. There's no public option, there's no NHS-style system, the government still can't negotiate drug prices, and private insurers will see a whole bunch of new customers while figuring out ways to legally deny coverage. The senate bill was watered down after negotiations by republican senators, who then withdrew their votes. So what we have is a compromise bill.

Paleocon wrote:

I think David Frum put it the best:

link

I like his ideas and would like to subscribe to his newsletter. Particularly his comments on the real leaders being the pundits in the entertainment business, and how their interests do not necessarily align with the rest of the country's. It mirrors some of the discussions Dan Carlin's been having lately about the intentional divisiveness being peddled by talk radio of all stripes.

Funkenpants wrote:

I don't see it as an abject defeat for republicans. There's no public option, there's no NHS-style system, the government still can't negotiate drug prices, and private insurers will see a whole bunch of new customers while figuring out ways to legally deny coverage. The senate bill was watered down after negotiations by republican senators, who then withdrew their votes. So what we have is a compromise bill.

I think, however, that it was a tremendous strategic defeat. Though it can be very successfully argued that the Republicans got "their" health care proposal (it was functionally the 1994 Heritage Foundation proposal in every meaningful way), they fought it every step of the way, made no meaningful effort to shape it other than to demonize it as "socialism", and divorced themselves from being able to claim any credit for it. For Republicans, this will be remembered for the incident in which we allowed Democrats to steal our ideas, make us fight them, and make us look like idiots.

This will be a 40 year burden on the party.

Paleocon wrote:

..they fought it every step of the way, made no meaningful effort to shape it other than to demonize it as "socialism", and divorced themselves from being able to claim any credit for it. For Republicans, this will be remembered for the incident in which we allowed Democrats to steal our ideas, make us fight them, and make us look like idiots.

I don't think they'll mind. Republican leaders have a few core issues they care about (tax cuts, less regulation of business, and heavy defense spending), and chances are that the burden of subsidizing insurance coverage for the poor will fall on the middle class. The leadership doesn't really care about this program except for it's value as a way to regain the house or senate in the fall.

IUMogg wrote:

I will just say I'm shocked the Democrats got this done. I feel like I don't know enough about the intricacies to comment in depth, but the system is so broken, I don't see how changes could make it worse.

Ways in which this could make it worse:

1) Unless Obama screws up so badly other Democrats run on the "not Obama" platform, Democrats will no longer fight to change it. Ever.
2) Any further attempt at change will be met with, "we just changed it, let's give it some time."
3) Any further attempt at change will be met with, "if it didn't work last time it won't work this time."

This system did not need reform. It needed to be torn down and rebuilt from the ground up. That will never happen in our political system as it exists - be it a Democrat or a Republican in office - and that's another system that could use some dramatic remodeling.

I hope the change at least helps a little but I'm honestly not holding my breath. As far as I'm concerned, all it's done is give insurance companies an excuse to jack up their prices before the new laws take effect, create deeper divisions between the two parties, and reveal just how people react to legislation that's intentionally crafted to be impenetrable.

Paleocon wrote:

For Republicans, this will be remembered for the incident in which we allowed Democrats to steal our ideas, make us fight them, and make us look like idiots.

Or those who do remember (and believe in) the Heritage Foundation deal will remember it as the time they got their enemy to give them what they wanted while still appearing to be against it. So they can further demonize the Democrats if and when it doesn't work out.

Pigpen wrote:

That said, its not socialized from the true sense of the work, because, those in the military work and work damn hard for it. We don't get it for free, we pay in blood, sweat and tears.

Whether you fight or not doesn't change the fact that the military is government run and government funded. The VA benefits you receive are just as socialist as they are for a veteran like my coworker sitting right next to me who was in the Navy and served his time before Desert Storm. The closest he came to action was in boot camp yet he receives VA benefits which are just as socialist as the VA benefits you receive. There are no sub-qualifiers which make it "less" socialist. It is what it is.

If you are truly against socialism, you would forego your VA benefits and purchase your own insurance policy.

LobsterMobster wrote:

Ways in which this could make it worse:

1) Unless Obama screws up so badly other Democrats run on the "not Obama" platform, Democrats will no longer fight to change it. Ever.
2) Any further attempt at change will be met with, "we just changed it, let's give it some time."
3) Any further attempt at change will be met with, "if it didn't work last time it won't work this time."

This system did not need reform. It needed to be torn down and rebuilt from the ground up. That will never happen in our political system as it exists - be it a Democrat or a Republican in office - and that's another system that could use some dramatic remodeling.

Much wisdom from the lobster.

LobsterMobster wrote:

I hope the change at least helps a little but I'm honestly not holding my breath. As far as I'm concerned, all it's done is give insurance companies an excuse to jack up their prices before the new laws take effect, create deeper divisions between the two parties, and reveal just how people react to legislation that's intentionally crafted to be impenetrable.

And this is just one of the unintended consequences I mentioned. Insurance companies HAVE to charge more for riskier people. It's the way insurance works. By forbidding that, this legislation is effectively forcing insurance companies to charge more for everybody to cover the inevitable losses caused by the risky people. I'm not crying for the insurance companies, or defending them, just stating the facts.

And when they raise the prices across the board, it will make it that much more difficult for employers to offer the plans they're offering now. The inevitable result will be a decrease in benefits offered (down to the point where the plan wouldn't qualify and would result in a fine), or a reduction in salary or other benefits to cover the increased cost. This really is a zero sum game, the money has to come from somewhere, it doesn't just materialize at the signing of the bill.

Pigpen wrote:

That said, its not socialized from the true sense of the work, because, those in the military work and work damn hard for it. We don't get it for free, we pay in blood, sweat and tears.

I hate this argument. I mean no disrespect to veterans or those in the military, but the military in the U.S. is 100% volunteer. You sign up to pay in blood, sweat, and tears. I don't know that your service is more noble than a student who works hard and gets a doctorate and teaches, or a tradesman that builds affordable housing.

SallyNasty wrote:

I don't know that your service is more noble than a student who works hard and gets a doctorate and teaches, or a tradesman that builds affordable housing.

I think a volunteer soldiers' intent is noble...it's just that our military hasn't been used for a noble purpose in over 60 years.

I would have liked to see a better bill, but in the face of the opposition that wasn't going to happen. No concessions would have gotten the republicans to move forward. In the face of that, and knowing our history with health care reform, I would rather have seen this pass than wait another ten years for new legislation. Something HAD to be done, and the only people willing to do the work can be forgiven their imperfect solution. 80% of the bill is still good.

I think the Federal government should immediately cease all Medicaid and Medicare payments to those states. Let's see how long it takes for them start screaming for government healthcare.

A great idea, actually. DOT frequently wields a threat of withholding federal subsidies to the states that refuse to comply with NHTSA regulations.

Oh yes - the fact that the government can't haggle with pharma companies if f*cking amazing. When I think of capitalism, I think of haggling.

Regarding the fate of the public option: technically, who's going to stand up to Obama if he simply scribbles it into the bill as a "signing statement"?

I think a volunteer soldiers' intent is noble...it's just that our military hasn't been used for a noble purpose in over 60 years.

I'm sure those Marines who just spent the last few months down in Haiti helping that nation stay afloat would love to know that what they did was just sh*t.

MaverickDago wrote:
I think a volunteer soldiers' intent is noble...it's just that our military hasn't been used for a noble purpose in over 60 years.

I'm sure those Marines who just spent the last few months down in Haiti helping that nation stay afloat would love to know that what they did was just sh*t.

Should have clarified. I meant in terms of war. Ya know, the main purpose of the military.

Missions like Haiti or stacking sandbags for the folks at home are noble to be sure, but you don't need to join the military to do it. There were lots of non-military Americans down in Haiti helping out.

This bill was not controversial in the least. We had manufactured controversy. Most of it are predictable and natural evolutions of existing policy. Denial of sick people should have been gone decades ago. Expansion of Medicare happens every 5 years or so.

Any controversy was by some on the hill who mistake obstinance with principles, who are getting campaign advice from Sarah Palin. And we will see how this shakes out in November. Ads will start really running.

This whole process so utterly sickens me as a big illustration of how f*cked up American politics can be that people will refuse to vote on a bill full of items they lobbied for 5-10 years ago just because of the colored fella in the house over there.

Gorilla.800.lbs wrote:

Regarding the fate of the public option: technically, who's going to stand up to Obama if he simply scribbles it into the bill as a "signing statement"?

I think signing statements have mostly been used to exempt the executive branch from laws they don't like, starting under Bush and continuing under Obama. Using a signing statement to create an entirely new program would be unprecedented, as far as I know. And it would pretty clearly be unconstitutional--making new laws is not the president's role.

And for "who's going to stand up to Obama": the Supreme Court would likely have something to say about it, and Congress would get really, really angry. Like, impeachment angry.

KingGorilla wrote:

This bill was not controversial in the least. We had manufactured controversy. Most of it are predictable and natural evolutions of existing policy. Denial of sick people should have been gone decades ago. Expansion of Medicare happens every 5 years or so.

Any controversy was by some on the hill who mistake obstinance with principles, who are getting campaign advice from Sarah Palin. And we will see how this shakes out in November. Ads will start really running.

This whole process so utterly sickens me as a big illustration of how f*cked up American politics can be that people will refuse to vote on a bill full of items they lobbied for 5-10 years ago just because of the colored fella in the house over there.

Yes 100% true. Most of the controversy was political theater. Most people after reading the bill will agree with way more than half of it. And it should appease Republicans but they are still in political theater mode with State AGs threatening lawsuits. (Tort reform?!?)

BTW - The military is a pure Socialistic entity. Maybe that is the reason why Beck followers are confused about Nazism being left wing. ;-D

goman wrote:
KingGorilla wrote:

This bill was not controversial in the least. We had manufactured controversy. Most of it are predictable and natural evolutions of existing policy. Denial of sick people should have been gone decades ago. Expansion of Medicare happens every 5 years or so.

Any controversy was by some on the hill who mistake obstinance with principles, who are getting campaign advice from Sarah Palin. And we will see how this shakes out in November. Ads will start really running.

This whole process so utterly sickens me as a big illustration of how f*cked up American politics can be that people will refuse to vote on a bill full of items they lobbied for 5-10 years ago just because of the colored fella in the house over there.

Yes 100% true. Most of the controversy was political theater. Most people after reading the bill will agree with way more than half of it. And it should appease Republicans but they are still in political theater mode with State AGs threatening lawsuits. (Tort reform?!?)

BTW - The military is a pure Socialistic entity.

Yup. The GOP loved it in 1994 when it was the Heritage Foundation's response to Hillarycare. It is hilarious to watch the gyrations as Heritage is now calling for repeal. Good luck with that. Try selling bringing back pre-existing conditions to the American people.

Pigpen wrote:

But again, want to reiterate, I see some good provisions in the bill, and I do recognize the need for reform and controlling premiums. I just think we missed hitting the targeted boat, and instead, took aim and shot at the ocean...

At the very least, this bill means we can't put off fixing the health care insurance (since our health care system is great, we just have a terrible system for paying for it) problem any longer. If this turns out to be the wrong way to do it, well, now it's a problem that can't be ignored, because the government 'owns' this problem and people now have their politicians to blame if it's not working

1Dgaf wrote:

THis isn't 'socialised' healthcare. It's bears no resemblance the system we have here. Your government isn't running your healthcare system or attempting to.

Yeah, this always gets lost in the debate: this is a law regarding (for the most part) health insurance, not health care. Normally these things would be called a social welfare entitlement program, but this thing isn't even that. This is, I don't know: a government mandate for people to buy health insurance with a combination of insurance laws/subsidies/tax breaks designed so that everyone can get access to a plan they can afford?

Paleocon wrote:

Yup. The GOP loved it in 1994 when it was the Heritage Foundation's response to Hillarycare. It is hilarious to watch the gyrations as Heritage is now calling for repeal. Good luck with that. Try selling bringing back pre-existing conditions to the American people.

To the loud mouth conservatives today, the GOP of 1994 was a bunch of socialists, things have drifted so far right.

CheezePavilion wrote:
1Dgaf wrote:

THis isn't 'socialised' healthcare. It's bears no resemblance the system we have here. Your government isn't running your healthcare system or attempting to.

Yeah, this always gets lost in the debate: this is a law regarding (for the most part) health insurance, not health care. Normally these things would be called a social welfare entitlement program, but this thing isn't even that. This is, I don't know: a government mandate for people to buy health insurance with a combination of insurance laws/subsidies/tax breaks designed so that everyone can get access to a plan they can afford?

Too bad it isn't healthcare. A standardized minimum level of healthcare (check ups, preventative care & information resources), I could support. Mandatory insurance causes pain to my inner child who screams that "mandatory insurance" does not make logical sense.

CheezePavilion wrote:

To the loud mouth conservatives today, the GOP of any period prior to now was a bunch of limp-wristed appeasers, things have drifted so far right.

FTFY

THe insurance companies could diversify their products and make more money. They could have a bare bones plan for healthy people that don't feel they need healthcare, but now have to take it.

If you are truly against socialism, you would forego your VA benefits and purchase your own insurance policy.

This. My health insurance is a *benefit*; I pay twice what my company puts in for it. When I stop working for them, it goes away. The VA is a lifetime service funded by the government, owned and operated by the government, and with policies established completely by the government. It doesn't get more socialist than that, comrades.

And yet, why would we want our vets unable to afford health care? The fact is, that's a benefit for vets that all citizens pay for, and gladly. Kind of like how red states take more back in government benefits than blue states, but complain more about it. And the blather about the dangers of "socialism" in the context of insurance is ridiculous, because *all* insurance is socialist. You have to have a large pool of participants to draw from, and some will get more according to their needs, while everyone pays according to their ability... Whether it's car, life, home or health insurance, you're more than dipping your toes in the benefits of socialism by partaking of insurance. Because of course, you could just *save* enough money to replace your car or house or spouse after you lose them; that's a good free market method, I guess. If you aren't disciplined enough to save that much money, well, then, let the RNC tell you how weak-willed you are, because hey, equality of outcome isn't guaranteed. (Funny how many people ignore that that's what insurance is all about...)

If you don't think VA benefits are good enough, then just go and buy your own health care at the level you want. It'll be an eye-openeing experience just pricing that... But at least you'll be ideologically pure.

THe insurance companies could diversify their products and make more money. They could have a bare bones plan for healthy people that don't feel they need healthcare, but now have to take it.

And the minimum requirements for that are in the bill.

Is there anything that sets an American warrior apart from, say, an American retail employee that would cause the warrior to deserve free health care when the retail employee doesn't?

Getting shot at for a living?

All American employees are covered against work-related injuries.

Malor wrote:

Getting shot at for a living?

Never worked the night shift at the Seven-Eleven?

I'm don't want to hijack this thread by debating the concepts of military service (even a cook or mailroom clerk or gent flying a UAV) - all of who can at any time be pushed forward to the front - we are soldiers, sailors and airmen first, and second. For those in the thread who can't differentiate, well, the point would seem to be lost on the outset and debate would be pointless. The fact is, the military is more a calling for most of us, and one of the benefits of foregoing the rat-race for $$$ and bigger houses for service is the health care. You do not get full health care benefits for no reason (medical, retirements, deployments, etc qualify for the whole plan). Do the military members deserve it over the guy working on a factory line, or the lady working in an office. You betcha...make the sacrifice, and then enjoy the benefits. It's easy to compare one job in civilian sector to one in the military until you commit to make the sacrifice - the blood, sweat and tears - once you've done that, I'll listen...you haven't, and your frame of reference to compare is missing.

Please don't take this as me dismissing the importance of all the jobs in the markets - to the contrary, jobs from farm jobs to union factory jobs, to white collar and tech jobs, to service industry and student jobs...they all are critical and important to this country. I simply go back to my framework that you serve the country and you deserve the rewards...the merits of this system are totally different from a network designed to insure all legal citizens.

For those that thought I was trashing the VA or its benefits, I was not. I meant it is no Cadillac plan in my opinion. That said, I passed on my companies health benefits to keep with my Tricare Prime for my family, and had no second thoughts at all. I support the VA, (and most certainly enjoy my disability benefits) despite being underfunded and in need of an overhaul imho...badly.

Is the military health plan socialism - depends on how you read the definition and its intent. I tend to view socialism as more of a spread the wealth/benefits, government run issue/ideology. Great in theory, impractical in reality. Is the VA that? Doesn't matter if I say no because it's a government run plan for a targeted group, not for all. If you want to describe it as socialism at its finest, makes no difference to me, and I welcome you to your opinion. But we are just playing with semantics - and I'm fine if you want to call it socialism, or not. Its not a core issue to me.

My central belief remains that a) the government is not responsible for universal health care at the federal level (or should not be), b) that the government system will not result in the economies of scale they are hoping for because of the FAR, among other issues, and c) that a bill should target what a lot of what you all talk about, such as that you pay for health plans, and the insurer can pull them at any time or the insanely high premiums many face or the lack of care for pre-existing conditions. Issues like (c) are what should be targeted, but we lose our focus and way in the process of seeking the larger bill that we got.

It will be interesting to see what really pops out as this bill winds through the corridors of the federal government and the courts. Wish I could say I'm hopeful, but Pelosi's smiling face has that hint of 'gotcha' written all over it.

goman wrote:
KingGorilla wrote:

This bill was not controversial in the least. We had manufactured controversy. Most of it are predictable and natural evolutions of existing policy. Denial of sick people should have been gone decades ago. Expansion of Medicare happens every 5 years or so.

Any controversy was by some on the hill who mistake obstinance with principles, who are getting campaign advice from Sarah Palin. And we will see how this shakes out in November. Ads will start really running.

This whole process so utterly sickens me as a big illustration of how f*cked up American politics can be that people will refuse to vote on a bill full of items they lobbied for 5-10 years ago just because of the colored fella in the house over there.

Yes 100% true. Most of the controversy was political theater. Most people after reading the bill will agree with way more than half of it. And it should appease Republicans but they are still in political theater mode with State AGs threatening lawsuits. (Tort reform?!?)

BTW - The military is a pure Socialistic entity. Maybe that is the reason why Beck followers are confused about Nazism being left wing. ;-D

Yes, the military is 100% socialist. It is also subject to it's own, very strict, code of law, and the people live in a dictatorship where failure to do what you're told can lead to execution. You also forgo several of your rights garunteed to you by the Constitution, primairly liberty. You can be punitively punished without trial or representation. You have mandatory work hours, and failure to show up on-time (let alone not at all) can lead to prison.

If you want to subject everyone sucking off the government teet to these kind of rules, I'm ok with that.