Well, that didn't take long. Gov. Perry calls a special session for July 1.

Can't let the other side win?

At least they have to take the political hit for it.

It was stupid of them to let it go that long in the first place

They didn't really win though. They just exploited a rule to get around it. I don't agree with the way the vote would go, but I know both sides would call bullshit if the other side did this to them. It's about as undemocratic as you can get.

For the law buffs, why don't gay marriage supporters in the court use the same arguments that were made in Loving v. Virginia? I don't think anyone on this court would dissent to that decision, so how could they dissent to one on gay marriage?

In due process and equal protection cases, different levels of scrutiny are used.

Due Process Clause - Wikipedia, the free encyclopedia

Race was under strict scrutiny. Homosexuality does not have that same level of scrutiny (I've heard folks say its "rational basis with a bite" or "heightened scrutiny"). Gender is intermediate scrutiny, FWIW.

What does that mean, the higher the scrutiny the greater the presumption is against a government law that attacks it. For strict scrutiny, the government has to have a compelling governmental interest and the law must be narrowly tailored to serve that interest.

They haven't really settled on a scrutiny level for gays yet.

How is scrutiny decided? It's based on cases and cases that overtime establish the level by gradual precedent. Though race got strict scrutiny because the 14th Amendment was written with race in mind.

If you argue, well the court is just making scrutiny levels up, well, yeah, we allow them to as part of deciding cases - deciding standards for jurisprudence is part of the job of common law judges.

I do find it funny that a lot of the people who voted for DOMA, or even signed it into law, are cheering it being overturned.

I mean I think it's great that it was overturned and people are happy, but those celebrating put it in place.

About that whole "they targeted Dems too" thing ... guess again

"I think this is the conundrum and gets back to what you were saying in the opening -- whether or not churches should decide this. But it is difficult because if we have no laws on this people take it to one extension further. Does it have to be humans?" - Rand Paul

Well in 1996, many of them were afraid that opposition to DOMA would doom them. Others may have changed their mind on the issue since then. When DOMA was passed, only 27% of Americans were in favor of same sex marriage.

Don't get me wrong, the people who stood in the face of political pressure and opposed it even then (like John Lewis, who gave a stirring speech against it) are courageous and deserve commendation. But I can understand why others couldn't politically oppose it. Clinton was in an easy re-election against Dole and vetoing DOMA could've changed everything.

Except George's truthfulness has to be called into question. At one of the early hearings he said,


and we now have documented proof that that wasn't accurate.

Andrew Sullivan has a great headline on one of his posts examining Clinton and DOMA, "It Was the Economy, Faggots!"

Sullivan annoys me sometimes with that crap thinking that politicians have the same luxury as bloggers to say whatever the heck they feel like (also there is the difference in thought as to how much should politicians represent the positions of the people they represent).

I'd agree, and his long running animosity towards the Clintons really shows, but I still think the headline is funny.

Senate passes immigration. Uncertain future in the House.

Interesting article on US involvement in Egypt. I would have thought Egyptian military would not need to have consult with the US.

Morsi Spurned Deals, Seeing Military as Tamed - NYTimes.com

Well, I think the military wanted to make sure that the US wouldn't get all mad and start bombing. Just a check-in to make sure.

And they wanted to make sure the billions in foreign aid keep rolling in.

Yup.

Billions is overstating it. US aid to Egypt is $1.4 billion.

Well, I was thinking over multiple years, but you're right.

I'd agree, but since it wasn't mentioned that it was annually, I let it slide. Since WWII, we've given them $73B. Since 1998, we've given them $27.5B. $1.5B annually.


http://www.fas.org/sgp/crs/mideast/RL33003.pdf

Of course, looking back on this now. What has this investment done for us? For the region? For the world?

Has it been a value add? What would the Egyptians say? The region? Our allies? Is there a better place to spend this money?

We give the military aid, mostly, so they don't start another war with Israel.

Or rather as a reward for Camp David.

It's also largely a pass through account for American defense contractors.

I'd really like an honest assessment. I don't know that we should be in the business of supplying $1.5B annually (Issidiqui) for something that doesn't seem to be going to them anyway (Jphillips). So is there a value add here or not?

Meaning, it sure seems like all that money just led to the military being powerful enough to conduct a coop that shut down a democratically elected government and even though I dislike the concept of the Islamic Brotherhood...I feel like I want my money back now.

True.

Although that doesn't answer the question of "is that worth it?"

You know, I think this possibility means it is completely worth it to the government and, likely, a majority of Americans. So, I guess, it depends.

How could you measure that? Egypt has been relatively friendly and peaceful since Camp David.

Is that because of the $1.5B we give them every year? I guess I agree with you, ultimately though, because you're right...How do we measure it? Perhaps we take it back. Tell them, "Look, we've got our own problems to worry about and we could really use this money for our own military or civilian issues." and then just see what happens.

To be honest, $1.5B a year is peanuts to the US. It's like 0.015% of our annual budget.

If I had a 0.015% hike to our annual budget everytime I heard that...

How about this: it's currently expected that we pay $1.5B per year to Egypt. Complaining about the money in the past is Monday Morning QBing as it's a sunk cost- it's already spent.

If you're doing the budget for the next two years: what do you give Egypt? And what do you think the expected effects will be?

SI

Our discretionary spending budget is $1.5T so it's right at 0.1%, or about equal to the budget for the Small Business Administration.

It does help provide the answer to, "Is this a value add?" and I think the answer is no, but I'm not sure.



Is it all going to American Military Contractors (JPhillips)? Is it a payoff to ensure they don't go suicidal and start a war with Israel, provided they actually get the money (Isiddiqui).

I don't know. That's what/why I'm asking.

I'm guessing if you try to reduce Egyptian spending (and it seems after the military took down the Muslim Brotherhood, it may go UP), you'd have to also reduce Isreali spending ($3B a year, mostly military) or else you may exacerbate Mid East tensions.

I think $1.5B is worth it. They have not been antagonistic against Israel and I think Mubarak was relatively neutral.

So why doesn't Israel pay them $1.5 B then?

Optics.

I don't think Karzai's government is strong enough to stand on its own with a total pull out but its time to leave. He must think he has more options (and friends) than I think he does.

Frustrated Obama Considers Full Troop Withdrawal From Afghanistan - NYTimes.com

Just found out that our longtime family physician, one of the best in the region, has to reduce the number of patients from 3000 to 600 due to "Affordable" Health Care Act. And those 600 has to apply to join MD VIP at $1600/year. Tell me again how increasing costs substantially and/or reducing his number of patients that gets quality care make us better off? :mad:

now he can focus on those 600 patients instead of 5x as many?

i got nothing.

Sounds like a cash grab to me. Just why does he have to cut the number of patients by 80%? I haven't seen reimbursements being cut anywhere close to that figure. Sounds like he wants to work less, use the VIP plan to make up the difference, and use the ACA as a reason he "has" to do this.

Yay for anecdotal examples that fail to even attempt to show a causal link. Did you know that ice cream caused violent crime?

Are you calling my doctor's office and my wife whom this was told to (and presented with the applications) a liar?

Change does affect change, whatever the reasons, and most of them are probably doesn't make things better.

Try not to get butthurt here, Chauncy.

If he's your longtime family physician, my guess is he's probably close to retirement age. He's likely using ACA as a cover to massively cut down his workload while still maintaining the same income level.

Or, like cartman said, a cash grab.

As anti-Obamacare as I am, this definitely runs contrary to anything I've come across, unless virtually all of those 3000 on the books are Medicare patients (in which case, then yeah, I've heard of plans to cut back).

Did the words "Accountable Care Organization" come up by any chance? Or ACO? That's another scenario where I could see a doctor cutting his patient load by 80%, as part of an agreement by the group that'll basically be pooling resources & splitting the profits.

This initial aroma here does indeed smell like a cash grab by the doc, just tbh.

edit to add: And if he's going to the VIP model, he better hope for better luck than the last guy who tried that here. The epic fail on that bordered on comical.

Are cash-grabbing doctors and the ensuing impact on patients not a legitimate concern about Obamacare? Just because it's not a desired result doesn't mean that it's not a foreseeable one.

They could make these kinds of moves with or without the ACA being in place, and have done so in the past.

I am anti-Obamacare much like JiMGa but have to agree that Obamacare gives these doctors a good cover to cut down on their caseload without the fallout if they said "I just don't want 3000 patients". I have had two physicians do this to me in the past couple of years as well. They charge a yearly fee and still get reimbursed for procedures like the currently are so they are able to take on significantly fewer patients. It didn't really make sense for my family sense we all probably visit the doctor once a year for a physical.

Agree with Molson though that this is a very predictable result and I wonder if this doesn't jibe with the supposed waiting lists for simple procedures in countries like Canada and England. (I say supposed because I admit I have just heard this to be the case and it is possibly just a GOP talking point that I assumed to be true)

Hmm ... lemme ponder this one a second, maybe there IS a tiny pinpoint of light in the Obamacare abyss.

If the doctors walk (and they seem quite happy to do so), then we get waiting lists ... but in the end, we might actually see some Medicare savings. It won't be from the lower rates, it'll be the enormous reduction in people able to get treatment.

I think my statement was pretty clear. Your anecdotal example failed to explain how A (Obamacare) led to B (Reduction in patients for your family doctor). Bringing your wife into this was a ridiculous way to try and make this personal, especially since she was told this by the doctor, she could be telling the truth even if the doctor was lying or mistaken.

I'm not sure why Obamacare would force a doctor to have all his patients sign up with the same private insurance carrier.

You enjoy talking about the free market... find another doctor :p.

The free market spurs competition too right? So you might even save money??? :p

Is the Affordable Care Act the reason for this? The VIP programs have been on the rise for a while now and has nothing to do with "impending Obamacare doom".

Isn't that the effect of the 'boomers getting up in years and wanting to spend increasing money on health care?

SI

MD VIP is marketed to physicians as a means of maintaining or increasing revenue while reducing patient population. This is exactly how it was depicted when I first ran across a recruiter at a conference a few years ago (well before ACA, by the way), and it's been the same story ever since. They apparently offer services or benefits not usually offered by traditional medical practices. The rationale is that the extras justify (pay for) the fees. What all of these services and benefits are, I'm not exactly sure of since I decided to go a different route.

What really catches my attention in your situation is the size of the cut to your family physician's patient panel. I can't fathom what essentially amounts to telling 80% of my established patients to take a hike. Most of the time, downsizing is gradual and done behind the scenes. It's far more common for physicians wishing to downsize to put a hold on accepting new patients and just allow attrition to take its course. An 80% cut makes me wonder if your doctor might be transitioning to retirement from the profession but is using this as an intermediate step to keep the income flowing for a bit longer.

Keeping accountable care organizations out of the conversation since that's a whole other animal, I think we're going to see more physicians adopting a similar business model but without the annual/monthly fees. Many have already done so under the name "Ideal Medical Practice". The core principle behind the IMP is reduced patient population made possible by minimization of overhead. So, no extra fees are required and additional services are still offered due to time being available. That's the model I ended up going with after getting out of traditional employed medicine.

One good thing about the Affordable Care Act is that is gives every business and/or doctor and/or insurance company something to blame when they choose and/or are forced to increase costs and/or reduce services.

Looks like the GOP is going to battle with the IRS. Would love to see a movement toward a simplified tax that would significantly reduce the IRS's role.

House Republicans push to slash IRS budget by 24 percent, cite abuses and sequestration | Fox News

Unfortunately that's just a stunt that will make it harder to audit and encourage more cheating. Simplifying the tax code won't happen anytime soon as the people who pay for congress are generally quite happy with the complexity of the tax code.

Battle the IRS, my ass. This is just more of the "small enough to drown in a bathtub" boobery. The GOP has no desire to simplify the tax code any more than the Dems: how else do you get campaign donations. This just means that the same code is on the books but less people will actually be collecting it so more people can duck it. Hooray!

SI

A guy can dream, no????

See - I think MBBF knows this and is just being disingenuous about the "benefits" of this. Because the alternative is just that he's stupid, which I don't believe, because he's obviously got a successful business. So instead he's lying and parroting the "company line" trying to win people over into how this is some altruistic thing that's going to improve the situation.

If it keeps money out of the government's hands ... clap clap clap afaic.

When they flatten the tax rate, I'll consider revisiting my position.

Who knows, but this isn't the first time a doctor or business has attributed some new drastic action to Obamacare, where the Obamacare supporters come back and point out that it's not really a direct effect. If doctors and businesses are using Obamacare as an excuse to do things, I don't see what the difference is. That's a real-world issue for those patients. I guess we can't really know if these doctors and businesses would have done the same things anyway, even without Obamacare, I'm just saying those potential impacts "count" when evaluating the impact of Obamacare, even though it isn't a desired impact. That's one of the classic idealist/conservative debates - sometimes everything sounds great, in theory, until it's put into practice and you have all these potential undesirable impacts.

Edit: It's a similar dynamic with some of Obama's campaign promises that weren't fulfilled because of Republican obstructionism. A lot of people, like Hillary Clinton, criticized Obama on some of this stuff, saying that it was too optimistic. That was the whole knock on Obama. And when the criticism turned out to be accurate, somehow the broken promises weren't his fault.

What if it's not really because of ACA but a change they were going to make anyway and this provides a convenient scapegoat. Does that make the scapegoat bad?

"I'm removing 80% of my patients because of waffles!" Are waffles suddenly bad?

SI

Sure, the scapegoat is bad, but government policy has to account for scapegoats and even criminals. Any government policy can be taken advantage of in nefarious ways, but that stuff should "count" against the effectiveness of the policy. You can't eliminate 100% of that stuff, but it counts, and if its widespread and defeats the purpose of the policy (not saying we're there yet), then it's a bad policy. You might have the greatest policy in the world on paper, but if it doesn't work in real life with real people, then it's bad.

Wow

Wow yourself. Are you saying government shouldn't be considered with how policy may be abused? Should IT companies worry about security? Should large companies have PR departments? I'm not saying anything controversial here. The game isn't won with the idea alone. The important part is the execution and how the policy actually carries out what you want it to.

But they aren't abusing the policy. They are simply making shit up. Based on your criteria, it would be impossible to come up with a good policy.

Doesn't that also give credence to arguments that spending cuts mean no roads or schools? That's an argument that you've been very much opposed to in the past.

What difference does it make? Let's say that while Obamacare was being debated, someone was concerned about this very possibility - doctors making widespread cash grabs, firing patients, drastically reducing the accessibility of care, at least in the short term, and using Obamacare as a scapegoat. Would that have been a legitimate concern? Or is that something that should have just been ignored because because it wasn't a desirable outcome. How would a pro-Obamacare supporter have responded? Would they have denied that would happen, admit that it could be an issue but there was a plan to minimize any damage to the patients, or just, I guess as you suggest they could have done, say, "hey, that's not a desired outcome so whatever, this is a brilliant plan on paper and that's all that counts!".

So we shouldn't implement a policy because those who are against it might make something up that is completely unrelated to the policy and use it to discredit the policy. Gotcha.

Wow.

Nah, I'm not saying Obamacare is bad because of a handful of greedy doctors, I'm just saying the reality of greedy doctors should be accounted for and mitigated as much as possible. And maybe it is, I don't know. Maybe they thought of this, and it's just a minor setback, and all those fired patients will have great opportunities for affordable care elsewhere and it's a net gain for humanity. All I'm saying is that ALL of the negative impacts of a policy count against a policy, even the ones you think are someone else's fault (most negative impacts are going to be someone else's fault). That's part of the challenge of creating good policy.

Right dude, we should never implement policy, that's exactly what I'm saying.

Federal spending cuts were the reason for the bridge collapse.

ergo we can't cut federal spending.

Then what are you saying? It seems to be that a policy has to handle any possible situation that could be attributed to it, be it true or false, before you can consider it a good policy.

But in the real world how to you account for people doing things and blaming unconnected policy for the effects? It certainly seems like your idea would give all the power to groups of people that could find any tenuous connection to any policy.

At some point don't you have to try to reasonably discern if and how actions and policy are connected?

I think it's fair to look at Medicare/Medicaid reimbursement rates and how they might incentivize doctors to reduce patient loads. That should be a part of the discussion. But, I don't see how you can predict and plan for people making claims that don't hold up under scrutiny.

Maybe it's 100% unforeseeable that anyone would try to use politically-charged policy to their advantage, but I doubt it. Again, I'm not saying that that all of Obamcare should have been scrapped over any legitimate concern, just that these concerns are legitimate and should be addressed, if possible. Why is that so crazy?

Let me go back a few posts. Let's say Obama is having a meeting an an adviser says, "hey boss, I have a concern, this healthcare thing is so politically charged, I've talked to some people in the medical profession, they think some doctors are going to use the anger over this as a way to make money grabs and leave some patients out on the street."

I think there would be two perfectly valid responses to that from Obama. 1. "That is a concern, and might cause some short-term issues, but I think those patients will be OK because of X and Y, and the plan does so much good for so many other people, so it's a net gain, we're good", or 2. "that is a concern, let's make sure that it's more difficult for doctors to do this, or that patients have reasonable heads-up by doing X and Y". Or, I guess what you and cartman would advocate, is for him to just say, "well, fuck them, not our problem, that's between the doctors and the patients, I'm not going to spend a second worrying about anything that isn't a direct black and white impact of this. I don't have the stomach for that real-world human nature stuff."

Edit: Or maybe there's a 4, that nobody thought of it so it was never discussed and accounted for. I don't really believe that, but even assuming that no human being anywhere could have predicted such a reaction, it's still an inherent weakness of the policy. Not necessarily one that can't be easily overcome in the long-term, but if the problem was big enough that the policy didn't work because of it, then it's not a good policy.

Great, then we're on the same page.


I'm not sure that it was necessarily 100% unforseeable that some doctors would react like this. And hey, maybe the policymakers DID forsee it, and Obamacare, on the whole will do a great job of mitigating it. Then great! All I'm saying is that when history is written, and we're looking at whether Obamacare worked or not, everything that happens in the real-world execution of this counts towards that analysis. How much of any failures we can specifically blame on any one person is a whole different analysis. But I think often in the liberal/conservative traditional debate, this is a big thing. How we hope things work v. how we're worried shit might really go down. An optimistic, let's go for it view v. a more pessimistic, shit's going to get fucked up view. I don't think either one is inherently correct (and we probably need a little of both), but I don't think the left side can just completely disregard the real-world slip-ups part. That's one of the points of the whole debate.

Isn't that exactly the same as when you say racism charges against the Tea Party are bullshit or bringing up roads/schools as an argument against any spending cuts is bullshit? With some policies you seem to very clearly favor having clearly established connections between political argument and policy outcome.

And I'd argue that #1 is what happens with people of all ideological stripes. Certainly there was plenty of discussion around here that there would be problems with ACA, but overall it is better than status quo.

So you are basing your stuff off of a hypothetical meeting where there is no record of a question like that ever being raised in reality? And if this hypothetical meeting did actually take place and happened like you said, how do you know that Reponse #1 was the answer, and not the one you seem to believe that JPhillips and I are advocating? Response #2 would actually be a new policy, and then there could be a whole other set of falsehoods attached to it.

You've totally lost me on the road thing. I think we actually agree. Potential indirect impacts of policy should be considered when making policy. Negative potential impacts should be mitigated as much as possible.

I think we only disagree about how to characterize these indirect negatives afterwards. I would say that this is a strike against Obamacare (recognizing that it could be an irrelevant strike, or one that is easily outweighed by the good). Where you and cartman would say (correct me if I'm wrong), that this doesn't even really count as a "strike", because it's someone else's fault, and not a direct impact of the policy.

You've argued repeatedly that saying any spending cuts leads to no roads or schools is bullshit demagoguery, and you've said the same thing about arguments regarding racism and the Tea Parties. In other places you recognize that there is a difference between things that can be directly connected and potentially false arguments geared to push a political agenda.

So if I tell customers that I can't work on their computer unless they pay me a fee due to regulations in the Computer Fraud and Abuse Act, that is a strike against the the CFAA? Even though there is no such language in the bill?

Depends how likely your customers are to believe it. How does the knowledge base of your customers regarding CFAA compare to health care customers knowledge base regarding health care reform?

And it depends on prevalence. I don't know anything about the CFAA. Would you expect many people in your position to charge such fees? And if so, what kind of response would there be from your customers, and how would that response compare to Buccaneer's?

I haven't heard of a mis-information campaign targeted at the CFAA.

It is. Doctors exploiting Obamacare to make money grabs and fire patients is also bullshit. I'm not saying that's awesome behavior. I'm not saying that anyone who supports Obamacare also supports those doctors. That's where your comparison breaks down. It's not racist to argue in favor of government fiscal restraint. And it's not pro-greedy doctor to argue that Obamacare, as a whole, is still a good policy in spite of those possibly minor setbacks.

Edit: And tea party supporters would be WELL advised to be very aware of the crazies in their ranks and how to neutralize or minimize them. Same with OWS, if that still exists. Plenty of otherwise good policies or organizations fail because of exploitation by crazies, criminals, or the unethical. Those roadblocks should be addressed to the extent possible. In the same way, policymakers should seek to mitigate the impact of the criminals and greedy doctors, not just wave their hand and disclaim responsibility.

Eh, stuff like that is why I don't like getting involved in the political thread. Is there something you're trying to say here?

Trying to make an apples to apples comparison. Molson clearly stated that he thought it was a strike against the ACA that someone could make up something not related to the bill and try to blame the bill for that action. Same thing with me charging a fee for computer work, and then trying to blame the CFAA as the reason I had to charge the fee, when there is nothing in the bill to support a fee.

If the CFAA encouraged tens of thousands of IT guys to stop working on computers, and small businesses were struggling to get adequate IT support, than ya, I think maybe we should re-revist the CFAA. I can't imagine why you think that would be a bad idea. You would just want to continue on with any policy because you like how it works theoretically, regardless of any indirect real-world obstacles?

So there we have it. Tell a lie enough times and it becomes the truth.

Wow.

What's the object of policy, just to have the idea in the first place, or to implement something positive in society?

If criminals or the unethical are hindering the positive impact of a policy, you can prosecute the criminals, or regulate the unethical behavior. Every policy does this to some extent. That's not that wild and crazy an idea. You can't eliminate all criminal or unethical activity, but you can be aware of it and mitigate it. If you fail to do that, or its impossible, and the criminal or unethical activity completely neuters the intended impact of the policy, then the policy failed. Apparently, you would still consider such a policy a success.

Edit: What would happen if an IT project was destroyed because of a virus? Would you say, "hey, not my fault, someone else put that virus here!" Or would your client have a question or two about your security plan?

The breakdown in your thinking is your unsubstantiated claim that the ACA is encouraging tens of thousands of doctors to stop working.

You're taking one (or several for that matter) anecdotal examples of something happening, for a reason (which even Jon admits seems to not pass the smell test), and blowing that up to TENS OF THOUSANDS of doctors quitting for a reason that doesn't pass the smell test to the guy on this board who is self-acknowledged to be the furthest-right poster on the board.

Nope, I'm definitely not making that claim. if this is limited to this one doctor in Colorado, then this is a completely irrelevant strike with almost zero impact on Obamacare as a whole. I'm not making any argument regarding the impact of this issue on Obamacare, because I really don't know what it is or will be. As I've said, the policymakers could have planned for this, they may know about the risk, but they may have accounted for it and feel it won't be a big problem. Fine. I'm just saying indirect impacts can effect policy, policymakers should attempt to account for such indirect impacts, and that those indirect impacts can ultimately play a big part in whether a policy succeeds or not.

So if a predictided outcome occurs based on a false premis, then any (and all) premis with the same predicted outcome should be deemed creditable?

This seems dangerously close to self fullfillimg prophecy and cultral racism/sterotypes.

Hamilton seems to argue this point in his if men were angles the controls of government would not be needed quote. Perhaps, our system is set up explicitly to address and defeat the lesser angles arguments.

If this guy has been Bucc's family doctor for what did he say, like 35 years, then he's obviously getting damn close to retirement age. How is his ageing and wanting to retire the fault of the ACA at all?? :confused: :confused: :confused: