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PoliGAF 2017 |OT4| The leaks are coming from inside the white house

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Valhelm

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The idea that single payer is "inevitable" is fucking ridiculous.

The only reason that people push for Single Payer so fucking much over UHC in general is because when people look at Europe, they only look at the UK, because we speak and write in the same language.

No, it's because the British model works very well. A universal health system controlled by the state can offer more consistent and reliable coverage than thousands of competing firms who focus on profit rather than quality.

The biggest roadblock is federalism. We don't enjoy a unitary government like the British do, so poorer states would most likely offer poorer health services. I'm not sure how a national health service could be established without infringing upon state sovereignty.
 
I think Medicare for All has snowballed into something that's impossible to prevent, and more conservative Dem officials will eventually accept this. Actually socialized healthcare, like the British or Cuban system, is a real possibility but not yet on the horizon.

I think it has traction in the House, but I don't know about the Senate. Many of the House members are in a position that makes it is easy to support it considering a few of them are in relatively safe districts. However, the Senate has to worry about the whole state that includes independents, moderates, and conservatives. I don't see the bill getting far there especially if raising of taxes on the middle class is necessary.

The devil is in the details and once they start to work on it; the progress will be extremely difficult and the end result would likely be very different. It is easy for the Democrats to support the bill because they are in the opposition they don't have to worry about getting results. The Democrats could fall in the same failings as the Republicans if they aren't careful.

That is why I believe they will just expand/fix ACA and expand medicaid and/or medicare.
 
The oath is more of a theatrical element for public hearings. The penalties are the same either way. A maximum of 5 years in prison. It's something that the Committee can give to Jr. and Manafort. Anything that encourages them to talk seems like a good idea, especially when the penalties for lying remain the same. I really do think that Grassley and Feinstein are playing good cop/bad cop here.

Preet agrees:

@PreetBharara
Preet Bharara Retweeted ChuckGrassley
This is true. And presumably witnesses will be advised that lying is a crime. It's how FBI and federal prosecutors conduct interviews too.
Private interviews could be better for the investigation as well, since they could ask more substantive questions when they're not hindered by 5 minute rounds and Republicans trying to put on a performance so Fox can get some good soundbites. I'm a little suspicious of Grassley, but I don't want to assume that the change in hearings are because they're trying to scuttle the investigation.
 

kirblar

Member
The most important part of HC coverage is catastrophic care.

This is also the part that people least want to pay for.

This causes a severe number of political issues.
 
The most important part of HC coverage is catastrophic care.

This is also the part that people least want to pay for.

This causes a severe number of political issues.

"I'll never need it!" they loudly proclaim as they light a cigarette, pour some whiskey, and lounge in the blazing July sun.
 
The most important part of HC coverage is catastrophic care.

This is also the part that people least want to pay for.

This causes a severe number of political issues.

I have heard a couple of interesting ideas on that front. Keeping the cost down and getting people acclimated to the idea of paying for UHC by guaranteeing everyone catastrophic coverage, and then having employer and individual market care do everything else. Gear the payout to % income of care cost. You'd obviously also need some pricing controls, but honestly just having EVERYONE on this plan would give it a ton of leverage in and of itself.

Throw preventive care and regular checkups on top, you get something fairly low-cost that everybody wants and doesn't destroy the insurance industry so you don't have to worry about pushback from them.
 
No, it's because the British model works very well. A universal health system controlled by the state can offer more consistent and reliable coverage than thousands of competing firms who focus on profit rather than quality.

The biggest roadblock is federalism. We don't enjoy a unitary government like the British do, so poorer states would most likely offer poorer health services. I'm not sure how a national health service could be established without infringing upon state sovereignty.

Private insurance still exist in the UK. The same will possibly happen in the US if we somehow get single-payer.

I actually don't understand the need to copy other countries. It seems like for some liberals
the need to have a single-payer is a ideological position not a practical one( not saying single payer is practical or not). Why can't there be private insurance for people that want it? I really don't care if there is a single-payer, a public option, health insurers being forced to cover everyone, regulations in place to get people that don't have the money on healthcare. I just care about everyone or the overwhelming population having it and having a easier access to get it. I support whatever is the most practical and makes the most sense for the current and future situation.
 

Drkirby

Corporate Apologist
I heard on NPR that one idea being floated around was Universal catastrophic coverage. I don't think that is even be a good solution, since catastrophic coverage is the most expensive treatment option. I guess it could give Universal Coverage a foot in the door though, since preventive care could be sold as a cheaper alternative if they got catastrophic coverage in.

Though I don't see any news articles implying it is something the Senate is seriously planning on doing.
 

Plinko

Wildcard berths that can't beat teams without a winning record should have homefield advantage
I'm good with universal catastrophic coverage at this point. I think Medicare for All is the best goal, and I find single-payer (at least in its general "pay 15-20% of your paycheck as insurance" without a law requiring businesses to pass on the extra money to you) a huge, huge misstep at this point.

Latching onto single-payer without addressing how the taxes would devastate low- and middle-income families right now would be something I'd expect democrats circa 2010 to do, but not under new leadership. Don't make that mistake.
 

pigeon

Banned
I heard on NPR that one idea being floated around was Universal catastrophic coverage. I don't think that is even be a good solution, since catastrophic coverage is the most expensive treatment option.

That's mostly the point. If the government underwrote catastrophic coverage, private insurance would just be for covering preventative and routine care, so it'd be a lot cheaper, and the thing where going to the hospital without insurance means you're totally bankrupt forever would go away.

As you note, it's preferable to make sure everybody has access to preventative care, but it's not wrong to note that the vast majority of medical costs are a result of catastrophic care and that those are the events that are most dramatic in people's lives.
 

Valhelm

contribute something
The annual military budget is 600 billion. We have the money for medicare for all and then some, the problem is figuring out how to reappropriate these funds without giving too much ammunition to the nationalist right.
 
I'm good with universal catastrophic coverage at this point. I think Medicare for All is the best goal, and I find single-payer (at least in its general "pay 15-20% of your paycheck as insurance" without a law requiring businesses to pass on the extra money to you) a huge, huge misstep at this point.

Latching onto single-payer without addressing how the taxes would devastate low- and middle-income families right now would be something I'd expect democrats circa 2010 to do, but not under new leadership. Don't make that mistake.

Don't they have to change taxes in the Medicare-for-all bill anyway?

I don't get why the Democrats don't have tax reform plan outside taxing the rich.
 

Plinko

Wildcard berths that can't beat teams without a winning record should have homefield advantage
The annual military budget is 600 billion. We have the money for medicare for all and then some, the problem is figuring out how to reappropriate these funds without giving too much ammunition to the nationalist right.

Exactly why this is a tough sell. There's no way you can take even a sizeable portion of that away in today's political climate.

Don't they have to change taxes in the Medicare-for-all bill anyway?

I don't get why the Democrats don't have tax reform plan outside taxing the rich.

They would at some level, yes.
 
Private insurance still exist in the UK. The same will possibly happen in the US if we somehow get single-payer.

I actually don't understand the need to copy other countries. It seems like for some liberals
the need to have a single-payer is a ideological position not a practical one( not saying single payer is practical or not). Why can't there be private insurance for people that want it? I really don't care if there is a single-payer, a public option, health insurers being forced to cover everyone, regulations in place to get people that don't have the money on healthcare. I just care about everyone or the overwhelming population having it and having a easier access to get it. I support whatever is the most practical and makes the most sense for the current and future situation.

Largely because other countries have done it better. Even the Swiss model sort of has a public option in that each insurer has to provide at least one base Government approved plan. What the US is doing is probably the least efficient way to provide healthcare to a population and our average outcomes are far from impressive.
 
Bernie's legacy is going to be -- at the very least -- single payer. Wouldn't be too surprised if his obituaries call him the father of modern American healthcare.
That could happen. Or we might give that title to Andrew Cuomo.

As far as strategies for achieving single payer go, what's wrong with John Edwards's idea of covering all kids under Medicare and ratcheting down the eligibility age to eventually cover everyone? Under 18 and over 55 would go a long way.
 

sc0la

Unconfirmed Member
That's mostly the point. If the government underwrote catastrophic coverage, private insurance would just be for covering preventative and routine care, so it'd be a lot cheaper, and the thing where going to the hospital without insurance means you're totally bankrupt forever would go away.

As you note, it's preferable to make sure everybody has access to preventative care, but it's not wrong to note that the vast majority of medical costs are a result of catastrophic care and that those are the events that are most dramatic in people's lives.
I disagree, preventive care can be super dramatic too, you ever seen my kid when it's time for vaccines or flu shots? Dramatic as fuck


;)
 

pigeon

Banned
Don't they have to change taxes in the Medicare-for-all bill anyway?

I don't get why the Democrats don't have tax reform plan outside taxing the rich.

What...tax reform plan would you expect them to have outside of taxing the rich?

Any large-scale social services plan will likely mean increasing taxes on the lower and middle classes*. That's how all the other social democratic countries do it. So you can understand why the Democrats don't want to talk about that right now!


* Unless you want to go full MMT, and nobody wants to go full MMT.
 
I sound like Shinra, but...

Should we really be surprised that spoiled young people look at the shiny single-payer system in the UK and say, "I want that!" despite that system's relative incompatibility with this country's existing health infrastructure? They must have their single-payer NOW because they've been raised on instant gratification.

244280754 said:
IggyChooChoo;]As far as strategies for achieving single payer go, what's wrong with John Edwards's idea of covering all kids under Medicare and ratcheting down the eligibility age to eventually cover everyone? Under 18 and over 55 would go a long way.

Absolutely nothing. I'd say that's one of a number of sensible solutions, despite its source. Our goal should be make the transition as easy as possible. Expanding Medicare/caid and/or offering a public option allows us to gradually diminish private insurance, minimizing damage to jobs and the economy, while an abrupt transition to single-payer would be catastrophic. Sometimes you go with incremental progress because you want to maintain stability.
 

Stinkles

Clothed, sober, cooperative
The annual military budget is 600 billion. We have the money for medicare for all and then some, the problem is figuring out how to reappropriate these funds without giving too much ammunition to the nationalist right.


The Nationalist Right has no right to speak about anything until acknowledges that the president is the greatest threat to our sovereignty.
 

Ogodei

Member
Supposedly 50% of healthcare spending in this country is on about 5% of all patients, so universal catastrophic coverage with generous income tax credits and expanded Medicaid would basically solve all the problems, because the remaining healthcare pool would be 50% of nationwide spending spread across 95% of the population and costs would drop like a stone.
 

pigeon

Banned
I sound like Shinra, but...

Should we really be surprised that spoiled young people look at the shiny single-payer system in the UK and say, "I want that!" despite that system's relative incompatibility with this country's existing health infrastructure? They must have their single-payer NOW because they've been raised on instant gratification.

Young people aren't spoiled, are you kidding? The Boomers destroyed the whole country for the Millenials and then complained about their food choices.
 

Drkirby

Corporate Apologist
That reminds me, when do we expect Trump or Congress to actually revisit Trump's Amazing tax plan
9y9Tklm.png
 

sc0la

Unconfirmed Member
Young people aren't spoiled, are you kidding? The Boomers destroyed the whole country for the Millenials and then complained about their food choices.
Yep. I still get boomers telling me how they paid their college tuition with their summer job money. You dense motherfucker it is not the same today.
 

Zolo

Member
To me, the worst thing about discussing politics is how a lot of people just get entrenched in their position and seem to lose all critical thinking ability. There are people I know who are incredibly intelligent usually and can recognize bullshitters easily......but when it comes to politics, they suddenly dive in a cult mentality.
 

Stinkles

Clothed, sober, cooperative
Mitch McConnell trying for a third time next week is the clearest evidence yet that they expect the Trump investigation to explode soon.

They've stopped even talking about tax reform and are desperate to pass this disguised tax cut before Mueller either reveals something catastrophic or actually files charges.

That and the sudden withdrawal of Koshliak makes me think something big is going down this week.
 
Young people aren't spoiled, are you kidding? The Boomers destroyed the whole country for the Millenials and then complained about their food choices.

You're right, I was being hyperbolic. But the point about instant gratification and complete aversion to/ignorance of politics still stands.

But then again, I guess that could encompass most age groups.

Maybe people are just dumb and impatient.
 
What...tax reform plan would you expect them to have outside of taxing the rich?

Any large-scale social services plan will likely mean increasing taxes on the lower and middle classes*. That's how all the other social democratic countries do it. So you can understand why the Democrats don't want to talk about that right now!


* Unless you want to go full MMT, and nobody wants to go full MMT.

Offshore corporate loop-holes, fixing loopholes for small business, perhaps deregulation for some things that might hurt business( heavily depends), new forms regulations, and of course things like increasing/decreasing corporate rates, taxing the rich more, and increasing/decreasing taxes for the middle to lower classes, etc. Obama and Hillary both talked about these ideas frequently.

I thought pretty much every politician thinks the tax code needs fixing.
 
You're right, I was being hyperbolic. But the point about instant gratification and complete aversion to/ignorance of politics still stands.

But then again, I guess that could encompass most age groups.

Maybe people are just dumb and impatient.

People seek rapid solutions because the threats they face are immediate.

There is nothing dumb or ignorant about that.

I think i understand what you were trying to say, but please keep this in mind.
 

FyreWulff

Member
Private insurance still exist in the UK. The same will possibly happen in the US if we somehow get single-payer.

I actually don't understand the need to copy other countries. It seems like for some liberals
the need to have a single-payer is a ideological position not a practical one( not saying single payer is practical or not). Why can't there be private insurance for people that want it? I really don't care if there is a single-payer, a public option, health insurers being forced to cover everyone, regulations in place to get people that don't have the money on healthcare. I just care about everyone or the overwhelming population having it and having a easier access to get it. I support whatever is the most practical and makes the most sense for the current and future situation.

The point of single payer is that the government becomes the largest single purchaser of medical procedures and medicine and therefore has the market of 400 million customers to push prices down, or you don't do business because you can't meet the government's price demands.

In this scenario private insurance companies would be very small customer bases and wouldn't have much influence on pricing.

The reason all those other countries are doing it because they found out it's the optimal way to do it. "Competition" is actually not desirable in natural monopolies, especially for things that are human rights like healthcare and water supply etc.
 

Stinkles

Clothed, sober, cooperative


NC congressman on MSNBC just now reacting to that tweet said that the prez is just trying to fight isis with Russia support because "Russia has 20 million Muslims within its own borders."

Um you know America has about four million Muslims within its borders too? Wtf does that have to do with Isis?
 

Drkirby

Corporate Apologist
I don't really understand why the Republicans/Mitch are so hell bent on getting Health Care Legislation done this instant. Can they really not move onto their Tax Reform without updating our Health Care Laws first? Do they think if they passed the laws in June 2018, it would negatively impact their polling for the Midterms? Do they think they won't have the political capital next year, due to this investigations into Trump?

I think Stinkles opinion is the most likely, the Republican Party/Mitch McConnell know this Russian Investigation is only going to get worse from here and start implicating Republican members of Congress, making any sort of controversial legislation impossible.
 

Ogodei

Member

kirblar

Member
No, but there is something dumb about the fact that they got themselves into this mess by voting for "rapid solutions" (e.g., Reagan promising to bring back morning in America by cutting welfare so the lazy ghetto queens couldn't use it) despite everyone with common sense telling them not to, and now they want "rapid solutions" to fix the problems that they've caused since the freakin' '70s because they were too hateful and myopic to realize that Republicans would hurt them, too.
"No Nixon, I'm going to turn down your deal because I think we'll get a better one under the next Dem president"

*Carter Happens*
 
"No Nixon, I'm going to turn down your deal because I think we'll get a better one under the next Dem president"

*Carter Happens*

Speaking of which, are there any statistics that show the Carter-Reagan voters like we have for the Obama-Trump voters? I imagine the migration to Reagan had to have been pretty large, hence the term "Reagan Democrats."
 

pigeon

Banned
I don't really understand why the Republicans/Mitch are so hell bent on getting Health Care Legislation done this instant. Can they really not move onto their Tax Reform without updating our Health Care Laws first? Do they think if they passed the laws in June 2018, it would negatively impact their polling for the Midterms? Do they think they won't have the political capital next year, due to this investigations into Trump?

I think Stinkles opinion is the most likely, the Republican Party/Mitch McConnell know this Russian Investigation is only going to get worse from here and start implicating Republican members of Congress, making any sort of controversial legislation impossible.

I mean, they ran on repealing Obamacare for eight years and arguably won control of the entire government based on doing that.

Traditionally it's considered a political disaster to spend a decade saying if you get elected you'll do a specific thing and then get elected and say "actually we're kidding, nobody can do that thing, especially not us."
 
I don't really understand why the Republicans/Mitch are so hell bent on getting Health Care Legislation done this instant. Can they really not move onto their Tax Reform without updating our Health Care Laws first? Do they think if they passed the laws in June 2018, it would negatively impact their polling for the Midterms? Do they think they won't have the political capital next year, due to this investigations into Trump?

I think Stinkles opinion is the most likely, the Republican Party/Mitch McConnell know this Russian Investigation is only going to get worse from here and start implicating Republican members of Congress, making any sort of controversial legislation impossible.

They need the savings from gutting healthcare to pay for any tax reform. For all intents and purposes, the Healthcare bill is their tax reform.
 

Ryuuroden

Member
I was talking to my sister, her husband, and my dad today (all doctors) and all of them said health care costs is a mess and its due to many ingrained things in the system as well. There are so many problems that cause costs to rise that its not a very solvable issue. Its on the same if not harder than tax reform. One of the big price multipliers my dad talked about was the overspecialization of medicine so that every single issue needs a consult because every doctor is so specialized that they don't know much outside their area. Each consult can cost thousands of dollars. On top of that, doctors have to consult even if they know the answer and they call it the CYA consult. Cover Your Ass. they will list on the chart, needs CYA consult. He talks about all the times they have to call other doctors and say I know this is a stupid question that we already know the answer to but I need you to look at it and put your name down that we consulted you so to cover our asses.

He also talked about times where he called up a doctor asked an opinion of what type of scan should be ordered and was told not ultrasound but a CT (might of been MRI) scan would be best because ultrasound will not tell us what it is just that theres a mass in his leg which we already know. So he orders a MRI/CT and the insurance refuses to pay for it unless there is an ultrasound first. So he orders the utrasound, results come back inconclusive, no idea what it is, so they then have to order the MRI, which the insurance then approves.

There was a ton other shit but a lot of the expanding costs are built into the medical training of doctors now. They also talked about how nurse practitioners don't know anything but what the latest pharmaceutical rep has told them and often prescribe stuff that wont even work and is a waste of money. Whole bunch of stuff and I don't know where to start to fix it

My dad also mentioned Tort reform which I know will get a bad rap around here but he also told me there's a national list that any doctor who gets sued regardless of weather they are in the wrong or not gets put on that does a lot of harm to costs. Basically it means doctors will not settle any lawsuit no matter what it is because being on the list is death. If you settle, you go on the list. So doctors who used to settle and pay out 5000 dollars instead fight the lawsuits even when they were innocent (its cheaper to settle than fight) and costs get put into hospital costs, insurance, etc. Its no longer worth it to settle even if its cheaper.

Edit: All of them are democrats and think health care costs are ridiculous and they can see many of the reasons why its costly but there is no quick fix to the issue. There are ways to alleviate the problem and slow it down but it will have to come in a multitude of reforms. not one single reform will fix it. Just making single payer will not fix the problems built into the system.
 
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