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Arles 02-15-2010 10:12 AM

A quick question, but outside of a desire to reduce an enormous national debt (something both parties in congress have put on their priority scale somewhere between cleaning out toe jam and getting an un-needed root canal) - what's the motivation for congress to keep costs down in a national plan?

It just seems to me that cost will be far behind all the "positive political" gains in other areas and never change under a public plan. Without the need to turn a profit or stay in business, why does anyone think that congress will give a rat's ass about cost?

Then, once again, all of us with good jobs and with good health insurance (a majority of Americans) will see our buying power continue to decrease as congress prints money (or raises taxes) to band aid their own system that is hemorrhaging cash because it's not politically acceptable to reduce coverage/increase cost on those on the plan.

If a company/doctor has a terrible business practice and loses money, they go out of business or are forced to restructure (with someone else taking the business). What happens when a public health care system has the same issues? When you have unlimited cash backing and a government mandate to succeed, I can't imagine things being run with the same urgency as private business.

SportsDino 02-15-2010 10:17 AM

I agree that Silver is oversimplifying things a bit too much. For one, most people can't gather up 30,000 in a pinch, and applying for a loan when you just got cancer... not very feasible. If anything else, I'm pretty sure that such liquidity issues were a big motivation between the insurance market taking off in the first place.

There is some water to the growth rate concern (9-10% is an insane growth rate in costs, double every 7 years or so, yikes). Also I would argue that dumb consumers and hidden subsidies have an impact on the market (encouraging the growth in costs as I mentioned in my long blabfest).

I'd argue that customer service has declined in quality, costs have increased, overhead has increased, and the base product itself has been compromised (by insurers unwilling to man up and pay up their side of the contract, the critical point of the product!). I fall into the public option line of thought simply because I know our government is too easily corrupted to get the private companies in line. Sadly, inefficient administration would still be preferable to outright collapse (which occurs not with the public option, but unmitigated private solution falling apart entirely).

JonInMiddleGA 02-15-2010 10:19 AM

Quote:

Originally Posted by flere-imsaho (Post 2224537)
In your defense, I did edit the post to add that in later, so you might have missed that.


Yeah, I never saw that until just now, will have to review in a bit.

(Holiday? What holiday? At least half the annoying gits in my work life seem to be hard at it already)

flere-imsaho 02-15-2010 10:21 AM

Quote:

Originally Posted by Arles (Post 2224538)
A quick question, but outside of a desire to reduce an enormous national debt (something both parties in congress have put on their priority scale somewhere between cleaning out toe jam and getting an un-needed root canal) - what's the motivation for congress to keep costs down in a national plan?


Using this line of thought, why allow Congress to approve any ongoing programs that spend money?

Quote:

Then, once again, all of us with good jobs and with good health insurance (a majority of Americans)

Ah, this canard again. Your good health insurance is only good up until the point that you develop something really expensive and your insurance company starts looking for ways to get rid of you. And that's not even mentioning lifetime benefit caps.

JPhillips 02-15-2010 10:22 AM

Wow. Evan Bayh is retiring. Wonder if he's looking at a challenge to Obama in 2012 or is simply leaving politics.

Strange timing after he and the DNC have been beating the hell out of Dan Coats since his announcement.

flere-imsaho 02-15-2010 10:22 AM

Quote:

Originally Posted by JonInMiddleGA (Post 2224543)
Yeah, I never saw that until just now, will have to review in a bit.


Yeah, my bad. I posted, re-reviewed what I quoted, saw that it was tangential to my point, and decided to add some stuff to clarify my point.

JonInMiddleGA 02-15-2010 10:27 AM

Quote:

Originally Posted by JPhillips (Post 2224545)
Wow. Evan Bayh is retiring. Wonder if he's looking at a challenge to Obama in 2012 or is simply leaving politics.


Judging from his statement, I suspect he knows that there's a university presidency waiting for him somewhere. And a "non-profit" charity job waiting for him to fill any downtime before that academic spot is ready.

But watching someone launch a challenge to Obama for the nomination would be decent popcorn munching fun.

rowech 02-15-2010 10:41 AM

Quote:

Originally Posted by JonInMiddleGA (Post 2224548)
Judging from his statement, I suspect he knows that there's a university presidency waiting for him somewhere. And a "non-profit" charity job waiting for him to fill any downtime before that academic spot is ready.

But watching someone launch a challenge to Obama for the nomination would be decent popcorn munching fun.


There's still a strong part of me that believes you'll see Hillary run for president.

Arles 02-15-2010 11:00 AM

Quote:

Originally Posted by flere-imsaho (Post 2224544)
Using this line of thought, why allow Congress to approve any ongoing programs that spend money?

I don't think the government does a good job with Education and can't see health care going any better. At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.


Quote:

Ah, this canard again. Your good health insurance is only good up until the point that you develop something really expensive and your insurance company starts looking for ways to get rid of you. And that's not even mentioning lifetime benefit caps.
About 60% of people have employer-supplied health care, 8-9% have non-group coverage, 28% are already in a public-sponsored government plan (some of that number is included in the employer number) and 15% are uninsured. So, if you count everyone in non-group coverage and the unemployed (many of which are kids are single people with no dependents), just 24% of people don't have coverage either provided by a company or an existing government plan. That's where the focus should be on improving coverage and I have no problem if the government wants to provide incentives/strings for subsidies on covering unemployed/self-employed/pre-existing people.

flere-imsaho 02-15-2010 11:17 AM

Quote:

Originally Posted by Arles (Post 2224567)
I don't think the government does a good job with Education and can't see health care going any better.


Are private companies doing any better with education? I've heard plenty of complaints about charter schools, for instance.

Quote:

At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.

Otherwise known as a single-payer system. Contract out all the administration of the program, but the government pays and provides oversight (in an ideal world oversight is done by panels of nonpartisan experts, such as how doctors set treatment guidelines for Medicare).

Quote:

About 60% of people have employer-supplied health care, 8-9% have non-group coverage, 28% are already in a public-sponsored government plan (some of that number is included in the employer number) and 15% are uninsured.

Yes, but how many of them have good insurance? How high is the average deductible for people? How many will be dropped by their companies when they develop critical problems? Etc....

Greyroofoo 02-15-2010 11:21 AM

:jester:
Quote:

Originally Posted by Arles (Post 2224567)
I don't think the government does a good job with Education and can't see health care going any better. At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.


As a guy who works with government contractors...

:lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::jester::lol::lol::crazy::p::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol::lol::jester::lol::lol::crazy::p:lol:

Dutch 02-15-2010 11:58 AM

I work with govt contractors and they are some of the most knowledgable bad ass muthers on the planet. YMMV.

miked 02-15-2010 12:01 PM

Quote:

Originally Posted by Dutch (Post 2224606)
I work with govt contractors and they are some of the most knowledgable bad ass muthers on the planet. YMMV.


Hopefully not the ones that charge 200% of what it costs because they are no bid jobs, or not the ones who rape and kill. Other than that, I guess we're cool.

Arles 02-15-2010 12:16 PM

Quote:

Originally Posted by flere-imsaho (Post 2224586)
Are private companies doing any better with education? I've heard plenty of complaints about charter schools, for instance.

We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.

Quote:

Otherwise known as a single-payer system. Contract out all the administration of the program, but the government pays and provides oversight (in an ideal world oversight is done by panels of nonpartisan experts, such as how doctors set treatment guidelines for Medicare).
Not quite. I would say the government should provide tax subsidies based on certain situations to individuals and to insurance companies. The onus is on the individual to find the right health care plan, but once they do the subsidies can be applied (even as an incentive for the company to accept the person - ie, some pre-existing situations).

Outside of the tax code, the government isn't involved.

Quote:

Yes, but how many of them have good insurance? How high is the average deductible for people? How many will be dropped by their companies when they develop critical problems? Etc....
This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?

If you look at what health insurance should be used for (ie, catastrophic care mitigation), then most people have pretty solid coverage. If you look at it for what a lot of people want it to be (minimal out of pocket for nearly every service/ health situation), then it's probably a bit lacking in some cases.

I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less. So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.

Arles 02-15-2010 12:18 PM

Quote:

Originally Posted by Greyroofoo (Post 2224587)
:jester:

As a guy who works with government contractors...

If the government can't manage groups they can hold up to a certain standard of accountability, make compete against other private groups, fire and replace - what makes anyone think they can manage groups where no accountability exists?

Hoosierbuckeye 02-15-2010 12:18 PM

Quote:

Originally Posted by miked (Post 2224609)
Hopefully not the ones that charge 200% of what it costs because they are no bid jobs, or not the ones who rape and kill. Other than that, I guess we're cool.


What the heck does this mean? Especially "the ones who rape and kill."?

flere-imsaho 02-15-2010 12:28 PM

Quote:

Originally Posted by Hoosierbuckeye (Post 2224621)
What the heck does this mean? Especially "the ones who rape and kill."?


KBR, Halliburton.

flere-imsaho 02-15-2010 12:31 PM

Quote:

Originally Posted by Arles (Post 2224620)
If the government can't manage groups they can hold up to a certain standard of accountability, make compete against other private groups, fire and replace - what makes anyone think they can manage groups where no accountability exists?


There are parts of the government that manage their contractor relationships well and get value for money, and there are parts that don't. Sometimes even within the same branch of government.

As with all government programs, present and future, we need to demand better non-partisan scrutiny and overview.

JPhillips 02-15-2010 12:31 PM

Quote:

Originally Posted by Arles (Post 2224618)
We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.


Not quite. I would say the government should provide tax subsidies based on certain situations to individuals and to insurance companies. The onus is on the individual to find the right health care plan, but once they do the subsidies can be applied (even as an incentive for the company to accept the person - ie, some pre-existing situations).

Outside of the tax code, the government isn't involved.


This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?

If you look at what health insurance should be used for (ie, catastrophic care mitigation), then most people have pretty solid coverage. If you look at it for what a lot of people want it to be (minimal out of pocket for nearly every service/ health situation), then it's probably a bit lacking in some cases.

I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less. So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.


But those numbers don't mean much because the student bodies are different. Private schools before better in part because of the more engaged parents. I haven't seen any evidence that shows private schools performing better with identical student bodies as those of public schools.

flere-imsaho 02-15-2010 12:33 PM

Quote:

Originally Posted by Arles (Post 2224618)
This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?


How about "coverage whose out-of-pocket expenses don't result in bankruptcy for the insured should they develop an expensive condition (including instances where the insurance company subsequently finds reasons to deny coverage)"?

gstelmack 02-15-2010 12:35 PM

Quote:

Originally Posted by flere-imsaho (Post 2224586)
Are private companies doing any better with education? I've heard plenty of complaints about charter schools, for instance.


Yes, they are. My daughter is getting a MUCH better education in her private school than she would get locally. I don't really want to go into details or examples, but the teachers pay attention to each and every child's needs and interacts heavily with the parents, while the local public school teachers have classes too big and too many disruptive kids to do the same.

Charter schools aren't quite the same as private, and magnet muddies the water, but I can guarantee that my wife and I are very happy with what we get, even though it stretches our budget to the limit, compared to what friends in public school are getting.

JPhillips 02-15-2010 12:36 PM

Quote:

Originally Posted by Arles (Post 2224618)
We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.


Not quite. I would say the government should provide tax subsidies based on certain situations to individuals and to insurance companies. The onus is on the individual to find the right health care plan, but once they do the subsidies can be applied (even as an incentive for the company to accept the person - ie, some pre-existing situations).

Outside of the tax code, the government isn't involved.


This is always an interesting question. What is "good insurance"? Everything is always paid for - no questions asked? 80% paid? 50% paid?

If you look at what health insurance should be used for (ie, catastrophic care mitigation), then most people have pretty solid coverage. If you look at it for what a lot of people want it to be (minimal out of pocket for nearly every service/ health situation), then it's probably a bit lacking in some cases.

I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less. So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.


Insurance should also be there for chronic care management.

gstelmack 02-15-2010 12:38 PM

Quote:

Originally Posted by JPhillips (Post 2224628)
But those numbers don't mean much because the student bodies are different. Private schools before better in part because of the more engaged parents. I haven't seen any evidence that shows private schools performing better with identical student bodies as those of public schools.


"Identical student bodies" is difficult to indentify. However, when I'm looking at a teacher-to-student ratio guaranteed to be under 20:1, and often closer to 8:1 (my daughter's first grade class is 15 kids with two teachers, and they typically will split into two rooms with two teachers once they reach around 30 kids, so worst is usually 15:1), as opposed to the legislature-mandated 24:1 that is often granted exceptions to cut costs, that makes a HUGE difference in how closely the teacher can tune the experience to individual children.

gstelmack 02-15-2010 12:44 PM

The fundamental problem with health insurance is that despite talking about risk groups and spreading the burden around, most insurance works off much smaller groups. Instead of "everyone under BCBS-NC being in one risk group", we get each individual company under its own risk group, with costs varying widely among companies.

A key issue with paying for healthcare in this country is that in order to receive quality care outside of a major trauma incident (and I have close experience with the fantastic care an uninsured person can get without any isurance in such a case) you need to have insurance, in large part because the insurance companies negotiate very low payments for services compared to what an individual walking up with cash would pay, even though that's less paperwork.

Give me a system where costs are fixed no matter who you are for a particular treatment, prescription, or visit, and I think we can work out the insurance / government part of it. But I don't believe the government will do any better than private insurance (note that as medicare cuts payments, folks are getting out of accepting medicare) since they are both playing the same game. We need costs to be separated from who is paying FIRST. Then we need a far more streamlined system for billing and paying that doesn't require huge office staffs to maintain, thus continuing to drive up the costs. And let's get all the pharmaceutical sales people out of a job and let the medical folks decide what meds need to be used when (and avoid having the doctor's day get interrupted by some salesperson walking in while there are patients all over the waiting room).

I'm not in favor of our current health insurance system by a longshot, but I'm not seeing a whole lot better proposed, either.

And let's not forget that we don't have enough doctors to treat every possible patient as it is.

flere-imsaho 02-15-2010 12:46 PM

Quote:

Originally Posted by Arles (Post 2224618)
We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:


I'm having trouble understanding the statistical relevance of comparing one school to an entire school district or even an entire state's worth of schools.

Quote:

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.

I'm not sure how true any of those statements are.

For instance, witness the phenomenon of "absentee" wealthy parents who send their kids to expensive private schools but care less about the quality of education received there than the day-to-day movement in their stock portfolio.

Likewise, there are plenty of school districts with significant involvement from parents (who are also taxpayers). Sure you might see this less in the cities, but there's a reason school boards generate such significant political drama in the suburbs.

Secondly, although private schools compete against other private schools, they also compete against good public school districts. For instance, our district found that during the last recession the influx of kids from private schools (whose parents couldn't afford them, temporarily), generally stayed within the district due to the quality and value.

If anything, your examples point to the value of direct public engagement in the value they're getting for their tax dollars. But if that's the case we should stop having insurance provided through employers, because none of the insured really look at the costs. Make everyone pay for their insurance out of pocket and decide how much risk vs. cost they're willing to bear, and let the market set that rate, right?

Which sounds great in theory until the 90% who then don't get insurance flood the publically-available emergency rooms.

flere-imsaho 02-15-2010 12:52 PM

Quote:

Originally Posted by Arles (Post 2224618)
I would be willing to bet that most of the 60% with current employer coverage will be the same or worse under a public plan. Most certainly won't have better insurance and it definitely will not cost less.


Then why does it cost less in every other country in the world (per capita)?

Quote:

So, once again, a public system throws the baby out with the bath water to improve coverage for small portion of society while making it more expensive (wait time, coverage, needing private to get back to what you had) for the majority with good coverage.

It may be a "small portion" without any coverage whatsoever, but the number of insured people who incur significant expense due to coverage maximums, insufficient coverage or even just the insurance companies weaseling out of their part of the contract is significantly higher.

And do please trot out that "but wait times are more and care is worse" argument, which always rings hollow with anyone who's actually lived in one of those systems.

Greyroofoo 02-15-2010 01:08 PM

I'm more inclined to think that someone who got a good paying job due to their education is more likely to instill the value of a good education in their kids, which includes paying private school tuition.

Someone who has a bottom-feeder job or is on welfare is more likely to not get involved with their kids education.

SportsDino 02-15-2010 01:23 PM

Quote:

Originally Posted by gstelmack (Post 2224638)
The fundamental problem with health insurance is that despite talking about risk groups and spreading the burden around, most insurance works off much smaller groups. Instead of "everyone under BCBS-NC being in one risk group", we get each individual company under its own risk group, with costs varying widely among companies.

A key issue with paying for healthcare in this country is that in order to receive quality care outside of a major trauma incident (and I have close experience with the fantastic care an uninsured person can get without any isurance in such a case) you need to have insurance, in large part because the insurance companies negotiate very low payments for services compared to what an individual walking up with cash would pay, even though that's less paperwork.


I'd also add to this point, all the work to process these different price structures and verify the insurance is way too cumbersome to be done cheaply. Simpler price structures, set prices based on cost to perform the care, NOT complicated charts of what the insurance companies want to pay for whatever item... would help to decrease overhead and processing costs. Also it would make it a lot clearer where cost savings can be found (once fixing a broken leg returns to the expense of having a doctor in a room, some cast materials, and whatever the painkiller shot costs... its a lot easier to reduce expenses for everyone).

Quote:

Originally Posted by gstelmack (Post 2224638)
Give me a system where costs are fixed no matter who you are for a particular treatment, prescription, or visit, and I think we can work out the insurance / government part of it. But I don't believe the government will do any better than private insurance (note that as medicare cuts payments, folks are getting out of accepting medicare) since they are both playing the same game. We need costs to be separated from who is paying FIRST. Then we need a far more streamlined system for billing and paying that doesn't require huge office staffs to maintain, thus continuing to drive up the costs. And let's get all the pharmaceutical sales people out of a job and let the medical folks decide what meds need to be used when (and avoid having the doctor's day get interrupted by some salesperson walking in while there are patients all over the waiting room).

I'm not in favor of our current health insurance system by a longshot, but I'm not seeing a whole lot better proposed, either.

And let's not forget that we don't have enough doctors to treat every possible patient as it is.


I think its impossible to get the bureaucracy out of the private system right now, they seem thoroughly convinced they can make profit better through paperwork and denial of coverage than through providing coverage at simpler overhead and perhaps even higher price. In fact, the paperwork makes their job seem more necessary than it is... I'd prefer if we get insurance companies back to being closer to a financial pool of money and out of the approving/disapproving health care business which is so expensive and frivilous lawsuit based.

One thing a public system could do is insist on fixed costs and changing supply side at the hospitals. It will be ugly and corrupt like any government interference, but it would actually move instead of the entrenched position the insurance companies are in at the moment (they do not feel they have to or its in their best interest to move, hence paralysis). The government would also have an incentive to get the flow of new doctors into the economy to increase, and opening up the borders for drug importation, and other known economic fixes that the private companies are fighting tooth and nail, for no good reason (other than their bottom line). Only government restriction prevents us from cutting drug costs by importing from Canada.

Getting rid of all the medical marketing would help in the long run as well, doctors should be deciding whether you need Lipitor or not, its pointless to have a commercial.

Do we need public run health care to do this, no, but do you see any company volunteering to do any of this for the public good? They are too stuck in their mindset to move, and have no financial incentive to push them out of it until it hits catastrophic levels. At which point they'll whine for a bailout like every other company.

Bring a big bully to the room in the form of a public option, give it some teeth, and then bring some stick along with the carrot so that private options have grounds to compete on quality of service (but change the marketplace so cost-reducing competition and paperwork streamlining becomes a necessity). If done right, the public option becomes a quaint little safety net that anyone with money sneers at for being 'common' and the private industry makes a tidy profit on rich people that can maintain a contract.

The cost will be government coverage of the commoners, the value gain would be in reduced costs of health care itself (that is, public and private costs for services decrease). That won't come from scale by itself, in fact scale can crush the already stressed health system. It needs to come from a fundamental change in how companies do business (less overhead, reduce costs to materials and labor instead of the implied costs of paperwork which are factored into those rosy statistics the insurance industry keeps posting about 80% of money being applied to claims).

sterlingice 02-15-2010 01:42 PM

Quote:

Originally Posted by Arles (Post 2224567)
I don't think the government does a good job with Education and can't see health care going any better. At some point, the government needs to stop trying to perform the same services as private groups and simply subcontract them. it's the only way to get the best quality of service, high level of accountability and best cost.


I just don't buy this. The federal government has very little to do with education in this country, far less than most things it has its hand in. It sends down unfunded mandates and that's about it.

The much bigger problem with education in this country is that it's handled in that "push the buck down, let the states/local government handle it" crap. Your funding is done at a local level and aside from asinine junk (re: unfunded mandates) like NCLB testing, almost all decisions are made at a local or state level for schooling, not a national one. Education in this country is as decentralized a "government" institution as it gets.

And, guess, what- the item most like the model so many small government folk like to push is one of the most effed up in this country. When you're hiring with a local budget with no uniformity and no structure, you get much more wildly varying degrees of quality.

SI

JPhillips 02-15-2010 01:43 PM

Quote:

Originally Posted by Greyroofoo (Post 2224649)
I'm more inclined to think that someone who got a good paying job due to their education is more likely to instill the value of a good education in their kids, which includes paying private school tuition.

Someone who has a bottom-feeder job or is on welfare is more likely to not get involved with their kids education.


Can you provide any data that supports that? You being inclined to think it doesn't make it true.

sterlingice 02-15-2010 01:54 PM

Quote:

Originally Posted by Arles (Post 2224618)
We're looking at Private schools for Jackson (starting Kindergarten soon) and the differences are pretty major. We are in a very good school district for Arizona (Kyrene) and here's a breakdown of testing results for the private school we are looking at compared to one of the top districts and state overall:

Met or exceed standards for AIMS testing in 2009:

Math
Private: 100%
Kyrene: 85%
Arizona: 73%

Reading
Private: 100%
Kyrene: 82%
Arizona: 70%

Writing
Private: 100%
Kyrene: 90%
Arizona: 78%

I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.


Correlation does not imply causation.

How many students below the poverty line are in the private school? How many students in that private school have parents working 2 jobs to put food on the table and a roof over their heads and thus can't spend as much time helping the child in school.

If there are "dumb students" going in the door to the private school, do they suddenly get smart? Probably not. It just turns out that if you can afford to let your kids go to a private school, you're probably more likely to be engaged with your kid. The private school is self-selective, based on the cost of going to said private school.

If the private schools had to take the same demographics as the public schools then their numbers would be similar. Plain and simple- it turns out that if you can afford to send your kid to private school, you can spend more time with them which gives them an edge on the "nurture" half of the equation and, for the "nature" side, they're likely ahead genetically because you were about the smart threshold to get a good job because otherwise you wouldn't be able to afford to put them in the school in the first place.

Yes, among the private schools, it will be that one school is better than another school because competition breeds better performance. But the reason why they perform better on the whole is because they're skimming the best students off the top. If there were a public school that was doing the same thing, I'm guessing the scores would be similar.

SI

DaddyTorgo 02-15-2010 02:01 PM

Quote:

Originally Posted by sterlingice (Post 2224680)
Correlation does not imply causation.

How many students below the poverty line are in the private school? How many students in that private school have parents working 2 jobs to put food on the table and a roof over their heads and thus can't spend as much time helping the child in school.

If there are "dumb students" going in the door to the private school, do they suddenly get smart? Probably not. It just turns out that if you can afford to let your kids go to a private school, you're probably more likely to be engaged with your kid. The private school is self-selective, based on the cost of going to said private school.

If the private schools had to take the same demographics as the public schools then their numbers would be similar. Plain and simple- it turns out that if you can afford to send your kid to private school, you can spend more time with them which gives them an edge on the "nurture" half of the equation and, for the "nature" side, they're likely ahead genetically because you were about the smart threshold to get a good job because otherwise you wouldn't be able to afford to put them in the school in the first place.

Yes, among the private schools, it will be that one school is better than another school because competition breeds better performance. But the reason why they perform better on the whole is because they're skimming the best students off the top. If there were a public school that was doing the same thing, I'm guessing the scores would be similar.

SI


seriously - i'm surprised you had to post this. i would have assumed it would be common sense.

sterlingice 02-15-2010 02:05 PM

Quote:

Originally Posted by JPhillips (Post 2224672)
Can you provide any data that supports that? You being inclined to think it doesn't make it true.


One of the chapters of Freakonomics hit this pretty hard (ch 6, iirc). Basically, it turns out parent income, which correlates quite strongly to intelligence is a great predictor of future education.

SI

sterlingice 02-15-2010 02:12 PM

Quote:

Originally Posted by Hoosierbuckeye (Post 2224621)
What the heck does this mean? Especially "the ones who rape and kill."?


The Daily Show With Jon StewartMon - Thurs 11p / 10c
Rape-Nuts
www.thedailyshow.com
Daily Show
Full Episodes
Political HumorHealth Care Crisis


Green Beret electrocuted in shower on Iraq base - CNN.com

SI

rowech 02-15-2010 02:40 PM

Quote:

Originally Posted by sterlingice (Post 2224689)
One of the chapters of Freakonomics hit this pretty hard (ch 6, iirc). Basically, it turns out parent income, which correlates quite strongly to intelligence is a great predictor of future education.

SI


Yes...and an offshoot of this is the highest educational level obtained by the mother.

JonInMiddleGA 02-15-2010 02:54 PM

Quote:

Originally Posted by sterlingice (Post 2224680)
If there are "dumb students" going in the door to the private school, do they suddenly get smart? Probably not.


Entirely anecdotal of course but I've never been able to identify the students on financial aid from the rest of the student body based on academic performance at the best of the three schools we've dealt with nor at the least of the three, you could do it a little bit at the middle one I'd say but it was a parochial schools that had the most lax standards of the three.

panerd 02-15-2010 03:30 PM

Quote:

Originally Posted by sterlingice (Post 2224670)
I just don't buy this. The federal government has very little to do with education in this country, far less than most things it has its hand in. It sends down unfunded mandates and that's about it.

The much bigger problem with education in this country is that it's handled in that "push the buck down, let the states/local government handle it" crap. Your funding is done at a local level and aside from asinine junk (re: unfunded mandates) like NCLB testing, almost all decisions are made at a local or state level for schooling, not a national one. Education in this country is as decentralized a "government" institution as it gets.

And, guess, what- the item most like the model so many small government folk like to push is one of the most effed up in this country. When you're hiring with a local budget with no uniformity and no structure, you get much more wildly varying degrees of quality.

SI


None is this is even close to being true. Try again. NCLB has absolutely taken control of every aspect of education. I will state as a teacher in a "rich" school district in St. Louis County it is a major part of every single thing that we do and I know this is true in every neighboring district that I have worked with people in. So go ahead and show some pie chart about what percentage the federal government contributes to education and I will invite you to go to any school and talk to them about the one size fits all testing standards that every state and local government has developed to meet and to try and comply with a bunch of bureaucrats in Washington DC. (Its a lot more comlicated law than anyone can possibly fathom) I am willing to engage in spirited debate but once you tell me that I am wrong I refuse to waste any more time responding to someone who has no idea what they are talking about (pie charts, unfunded NCLB doesn't really mean anything) telling me the realities of my job. <--- This last sentence is important. I don't necessarily think that you will do this SI but I have had plenty of people do it. And I don't need to waste my time explaining how for the past 7 years I have heard about this bullshit almost daily to somebody who has done nothing more than typed NCLB into wikipedia.

(Don't even get me started on what this has done to our history classes where kids are being double dealt math and reading at the expensive of actually being taught US history, world history, civics, economics, etc to figure out how fucked up the government is actually becoming.)

And if we want to take it a step furthur we can next look at the impact of IDEA and special education (again federal mandates that were not thought out at all) in the past 20-30 years.

RainMaker 02-15-2010 03:33 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224488)
Because they aren't in the business of providing medical treatment, they're offering a risk management opportunity. They're a business that exists solely for the purpose of making money for the owners/investors just like real estate or advertising and it boggles my mind that so many people seem not to understand that or to be in some state of denial about it.

Actually they are. They have to approve hospital stays, duration, procedures, and prescriptions. They are just as important, if not more important than your doctor in providing medical care.

sterlingice 02-15-2010 03:56 PM

Quote:

Originally Posted by panerd (Post 2224737)
None is this is even close to being true. Try again. NCLB has absolutely taken control of every aspect of education. I will state as a teacher in a "rich" school district in St. Louis County it is a major part of every single thing that we do and I know this is true in every neighboring district that I have worked with people in. So go ahead and show some pie chart about what percentage the federal government contributes to education and I will invite you to go to any school and talk to them about the one size fits all testing standards that every state and local government has developed to meet and to try and comply with a bunch of bureaucrats in Washington DC. (Its a lot more comlicated law than anyone can possibly fathom) I am willing to engage in spirited debate but once you tell me that I am wrong I refuse to waste any more time responding to someone who has no idea what they are talking about (pie charts, unfunded NCLB doesn't really mean anything) telling me the realities of my job. <--- This last sentence is important. I don't necessarily think that you will do this SI but I have had plenty of people do it. And I don't need to waste my time explaining how for the past 7 years I have heard about this bullshit almost daily to somebody who has done nothing more than typed NCLB into wikipedia.

(Don't even get me started on what this has done to our history classes where kids are being double dealt math and reading at the expensive of actually being taught US history, world history, civics, economics, etc to figure out how fucked up the government is actually becoming.)

And if we want to take it a step furthur we can next look at the impact of IDEA and special education (again federal mandates that were not thought out at all) in the past 20-30 years.


Obviously things have changed a lot in the last 10 years- I've heard quite a bit about it from my wife's mom (she's a high school math teacher in Iowa). But you haven't really refuted the point I was trying to make.

Please, correct me if I'm wrong, but we now have two separate mechanisms:
-the funding is still primarily done at a local level
-however, there are numerous unfunded mandates to test extensively, dedicate substantial money to special needs, etc so your local resources are now doing much more than they had to previously

Couple those with the gutting of state education funding by budget gaps in state legislatures and, yeah, public schools are getting brutally killed with less funding, more restrictions, and a weaker talent pool than "comparative" private schools which are not really a fair comparison at all.

(As an aside, so how's that "small government" Bush preached about working where he did this to schools? Hell, it's almost as if he wanted the public school system that much more stressed a decade or two down the line so we can go "see, we need privatization" which just basically serves to perpetuate and grow the gap between the haves and the have nots)

SI

JonInMiddleGA 02-15-2010 03:59 PM

Quote:

Originally Posted by RainMaker (Post 2224740)
Actually they are. They have to approve hospital stays, duration, procedures, and prescriptions. They are just as important, if not more important than your doctor in providing medical care.


No, they approve whether or not they're going to pay for it under the terms of your relationship with them and/or the provider. They neither provide care nor do they deny anyone from seeking that care.

Point being, it's "insurance" not "free health care for whatever you damned well please". But generally it's become misdefined as the latter. For all the hand wringing about health insurance costs, I don't believe anyone actually wants to see what those rates would be if it was actually the latter.

JonInMiddleGA 02-15-2010 04:09 PM

Quote:

Originally Posted by panerd (Post 2224737)
(Its a lot more comlicated law than anyone can possibly fathom)


I have to hope that someone can fathom it somewhere, or at least a group of someones who can fathom enough pieces between them to make the whole.

I'll be honest with you, I spent several years (ghost)writing most of the local newspaper coverage of it when it was rolled out, meaning only that I've probably read a lot more of the specifics in detail than the average Joe Q. Taxpayer. I found plenty of quirky governmental language* but didn't think it was that difficult to understand in principle or in big picture ways, and with time spent on the specific details didn't think it was that tough to grasp either.

Now, about that *asterisk. Sometimes, especially as things were tweaked since the initial concept, some of that governmental language reached the point of being pretty fucked up maybe even contradicting itself. But I don't think that's unique to NCLBA.

Full disclosure (for those who haven't seen me say this already), I'm about as unapologetic a supporter of NCLBA as you're likely to find in the general population. That said, that's increasingly become a matter of trying to find any sort of accountability for the massive amounts of money funneled into public education than about believing there's much reality behind what was perhaps a noble basic idea but when it's applied to reality it breaks down badly & quickly.

I'd be happy to work with anyone on coming up with a better method of accountability for those dollars but I'd still fight to my last breath to defend even a flawed NCLBA over a return to the previous state of affairs.

flere-imsaho 02-15-2010 04:12 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224756)
No, they approve whether or not they're going to pay for it under the terms of your relationship with them and/or the provider.


Which is effectively the same as them approving care or not.

If your doctor says you need a CT scan but your insurance company says you don't, who's wins? And is that right?

RainMaker 02-15-2010 04:12 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224756)
No, they approve whether or not they're going to pay for it under the terms of your relationship with them and/or the provider. They neither provide care nor do they deny anyone from seeking that care.

Point being, it's "insurance" not "free health care for whatever you damned well please". But generally it's become misdefined as the latter. For all the hand wringing about health insurance costs, I don't believe anyone actually wants to see what those rates would be if it was actually the latter.

But that's the purpose of health insurance. To have something in place to pay for something you would normally not be able to pay in an unfortunate incident. People don't have $150,000 lying around for when they come down with cancer. Just as homeowners don't have $300,000 lying around for when their home burns down. That is the sole reason you purchase insurance. Because without it, you wouldn't be able to afford a worst-case scenario.

So when insurance doesn't cover something, there is typically no other option for that person. Doctors are reluctant to take patients who don't have insurance and pharmaceutical companies don't sell their drugs on credit.

I'm not arguing costs or anything of that nature, just the notion that insurance companies are not the ones treating you. If your ever stuck in a hospital and your insurance company wants you there one less day than your doctor, good luck telling the hospital that "you're good for the extra $15,000" on the bill. They will make sure to have you out the day the insurance company wants you out. That is the insurance company making medical decisions and determining what is best for your health.

flere-imsaho 02-15-2010 04:16 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224756)
Point being, it's "insurance" not "free health care for whatever you damned well please".


I'd argue it's neither. It's certainly not "free health care for whatever you damned well please" as anyone who's read their benefits booklet can attest. However, I'm not ready to call it "insurance" until the industry stop using a phalanx of lawyers to avoid or delay paying on big ticket items worded ambiguously in their contract and also employ thousands of bureaucrats to argue about medical care with doctors.

What we have now I'd call a "Semi-critical pre-payment reimbursement plan".

JonInMiddleGA 02-15-2010 04:20 PM

Quote:

Originally Posted by RainMaker (Post 2224760)
But that's the purpose of health insurance. To have something in place to pay for something you would normally not be able to pay in an unfortunate incident. People don't have $150,000 lying around for when they come down with cancer. Just as homeowners don't have $300,000 lying around for when their home burns down.


Fine, we're in general agreement.

But
Quote:

If your ever stuck in a hospital and your insurance company wants you there one less day than your doctor, good luck telling the hospital that "you're good for the extra $15,000" on the bill.

Neither is a homebuilder going to rebuild your home for more than the amount the insurance covered it for unless they've got guarantees that they're going to be paid for their work. There are policies for full replacement and you pay for those if you want them.

Quote:

That is the insurance company making medical decisions and determining what is best for your health.

No, they're making decisions based on the agreement you have with them including being subject to financial limitations on their liability. Whether you pursue treatment beyond that, or even whether you have the financial ability to pursue additional treatment beyond those limitations isn't neither their problem nor their fault.

DaddyTorgo 02-15-2010 04:21 PM

Quote:

Originally Posted by RainMaker (Post 2224760)
But that's the purpose of health insurance. To have something in place to pay for something you would normally not be able to pay in an unfortunate incident. People don't have $150,000 lying around for when they come down with cancer. Just as homeowners don't have $300,000 lying around for when their home burns down. That is the sole reason you purchase insurance. Because without it, you wouldn't be able to afford a worst-case scenario.

So when insurance doesn't cover something, there is typically no other option for that person. Doctors are reluctant to take patients who don't have insurance and pharmaceutical companies don't sell their drugs on credit.

I'm not arguing costs or anything of that nature, just the notion that insurance companies are not the ones treating you. If your ever stuck in a hospital and your insurance company wants you there one less day than your doctor, good luck telling the hospital that "you're good for the extra $15,000" on the bill. They will make sure to have you out the day the insurance company wants you out. That is the insurance company making medical decisions and determining what is best for your health.


i'm not sure why jon doesn't understand this? I wonder sometimes if he's playing semantical-games in order to avoid having to deal with the actual (legitimate) underlying question...?

flere-imsaho 02-15-2010 04:22 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224758)
I'd be happy to work with anyone on coming up with a better method of accountability for those dollars but I'd still fight to my last breath to defend even a flawed NCLBA over a return to the previous state of affairs.


I'm all for accountability on ROI for tax dollars (hey, let's start with defense contracts!), but using standardized testing as a way to do this was always lazy and stupid.

Arles 02-15-2010 04:23 PM

Quote:

Originally Posted by sterlingice (Post 2224680)
If the private schools had to take the same demographics as the public schools then their numbers would be similar. Plain and simple- it turns out that if you can afford to send your kid to private school, you can spend more time with them which gives them an edge on the "nurture" half of the equation and, for the "nature" side, they're likely ahead genetically because you were about the smart threshold to get a good job because otherwise you wouldn't be able to afford to put them in the school in the first place.

It would certainly be worse than what it is, but that doesn't mean it's not significantly better than an average public school. The place we checked out had a 6:1 student-teacher ration - sometimes having as many as 5 qualified teachers (plus 2 parent assistants) in classes of under 20 kids. I'm pretty sure that's more 1-on-1 time than your average public school.

- They also have a PHD expert on learning techniques that sets their curriculum based on data and studies on what works the best for each age group.
- They send out weekly packets going exactly through what their children will be learning so the parents can monitor progress.
- They give constant status reports on each kid and if someone is falling behind, they adjust the material for that specific kid to help them catch up.
- They have specific instructors for art, music, science and technology that specialize in those areas and take over each class when it's time to learn those subjects (as early as kindergarten)

We've taken tours of private schools and compared them to what is offered by a very solid public school in our area and it's night and day in terms of the learning environment. Now, that's not to say that a kid can't get a good public education, but the advantages they get in a private school are enormous.

Quote:

Originally Posted by flere-imsaho (Post 2224643)
Then why does it cost less in every other country in the world (per capita)?

We have a higher expectation of health care and much larger population than most other countries. They don't mind waiting months for minor surgeries and have different health care expectations. Throwing money at it isn't the solution.

Greyroofoo 02-15-2010 04:26 PM

We're also fatter.

Arles 02-15-2010 04:27 PM

Quote:

Originally Posted by Greyroofoo (Post 2224778)
We're also fatter.

Our fast food lifestyle with no exercise certainly doesn't help.

flere-imsaho 02-15-2010 04:28 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224766)
No, they're making decisions based on the agreement you have with them including being subject to financial limitations on their liability. Whether you pursue treatment beyond that, or even whether you have the financial ability to pursue additional treatment beyond those limitations isn't neither their problem nor their fault.


That's great in theory, but examples to the contrary are unfortunately rife throughout the industry, even amongst otherwise reputable insurance companies.

JonInMiddleGA 02-15-2010 04:29 PM

Quote:

Originally Posted by flere-imsaho (Post 2224771)
I'm all for accountability on ROI for tax dollars (hey, let's start with defense contracts!), but using standardized testing as a way to do this was always lazy and stupid.


I disagree almost completely about the usefulness of standardized testing as a means to assess the efficacy of what has always been smoke & mirrored previously.

1) Here's what we expect students to know
2) Can they prove they know it?

This isn't exactly brain surgery.

One of the biggest failures of NCLBA was not providing stricter guidelines for point one & instead leaving too much of that in the hands of the very people desperate to save jobs they often don't deserve.

It's other big failure was trying to make the politically correct assumption that the expectations in part 1 up there could be universal instead of being tiered to some extent. But God help us, I can only imagine the keening that would have gone on when that was even suggested.

flere-imsaho 02-15-2010 04:31 PM

Quote:

Originally Posted by Arles (Post 2224773)
We have a higher expectation of health care and much larger population than most other countries. They don't mind waiting months for minor surgeries and have different health care expectations. Throwing money at it isn't the solution.


And so part of my argument is that we'll need to change our expectations (while continuing to allow private health insurance for those who want to pay for gold-plated care) otherwise we (the average American) won't have anything in a decade or two.

And if that happens, just watch our productivity and GDP go into the toilet.

flere-imsaho 02-15-2010 04:47 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224783)
I disagree almost completely about the usefulness of standardized testing as a means to assess the efficacy of what has always been smoke & mirrored previously.


Well sure, if you're going to compare it to what was done before (which ranged from nothing to willful obfuscation) then of course standardized testing is better.

That still doesn't mean it's good, helpful or relevant.

Look, we now live in a world where organizations from non-profits to corporations use an ever-increasing array of sophisticated data analysis tools and approaches to turn what were previously subjective assessments into objective ones. Look, for instance, at the kind of analysis the Gates Foundation requires to determine if their money is making the impact they want in their various programs.

There's certainly still a place for determining if students are learning the black-and-white aspects of their curriculum. Can they name the 50 states? Can they spot spelling errors? Can they add/divide/multiply? Etc....

But that's the easy & lazy part of the analysis. We need better measures and better models that can be appropriately localized. And these go far beyond just standardized testing.

Coffee Warlord 02-15-2010 04:54 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224783)
1) Here's what we expect students to know
2) Can they prove they know it?

This isn't exactly brain surgery.

One of the biggest failures of NCLBA was not providing stricter guidelines for point one & instead leaving too much of that in the hands of the very people desperate to save jobs they often don't deserve.


An individual teacher is responsible for 1 year of instruction (at elementary levels). They have no control over the yahoo who taught these kids the year before, and often get kids who are VERY behind the others -- there's just no way in hell these kids can get up to the level they should be at during a single school term. These are kids who SHOULD have been held back at some point. But people who are trying to tie pay and jobs to test results do not understand that a good teacher can get royally screwed if they suffer the misfortune of inheriting a bunch of kids who are well below where they should be.

Trying to actually teach a kid to learn and improve is a helluva lot different than just trying to coach 'em through a standardized test.

Don't get me wrong. I want accountability in teachers & administrators. I personally think tenure in the education profession is asinine. I also think that this whole 'pass everybody' mindset is equally asinine. But standardized testing ain't a good way to do it, as these kids ain't anything near standard.

sterlingice 02-15-2010 06:20 PM

Quote:

Originally Posted by Arles (Post 2224773)
We've taken tours of private schools and compared them to what is offered by a very solid public school in our area and it's night and day in terms of the learning environment. Now, that's not to say that a kid can't get a good public education, but the advantages they get in a private school are enormous


But the problem is that's not the point we're arguing. Yeah, private vs public is night and day. Why? Because they pay a lot more per student and have better students. So, yeah, the private school is going to be better. That doesn't mean we scrap the public schools.

And it sure as hell doesn't mean that with the same kids/parents the private schools would do better than the public school as you implied earlier (below)

Quote:

Originally Posted by Arles
I think it's safe to say that when parents actually pay tuition (even if it's subsidized), they are more likely to be involved. Private schools compete with other private schools for students and therefore need a high quality of education to keep people coming in. If they are just "as good" as the local public school, there's little reason to pay the tuition. Public schools lack that level of accountability to parents and that's why many don't do as well.


SI

RainMaker 02-15-2010 09:16 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2224766)
Neither is a homebuilder going to rebuild your home for more than the amount the insurance covered it for unless they've got guarantees that they're going to be paid for their work. There are policies for full replacement and you pay for those if you want them.

And the doctor is saying that full replacement would be staying in the hospital another day. A better example would be burning down your home, having the fire chief say it has been destroyed by fire and must torn down. Then having the insurance company come out without looking at the home and saying "well we don't agree with the expert on fire so we aren't paying for it".

Quote:

Originally Posted by JonInMiddleGA (Post 2224766)
No, they're making decisions based on the agreement you have with them including being subject to financial limitations on their liability. Whether you pursue treatment beyond that, or even whether you have the financial ability to pursue additional treatment beyond those limitations isn't neither their problem nor their fault.

You don't have an agreement that says "we don't allow you to stay in the hospital 4 days when you have knee surgery". They are using their judgement and since most people don't have the financial ability to contest or pay for it on their own, they are making the medical decisions for you.

The other issue is that you can't always get additional treatment. Even if you're a millionaire, you are treated differently if you don't have insurance.

sterlingice 02-15-2010 09:54 PM

Quote:

Originally Posted by RainMaker (Post 2225054)
And the doctor is saying that full replacement would be staying in the hospital another day. A better example would be burning down your home, having the fire chief say it has been destroyed by fire and must torn down. Then having the insurance company come out without looking at the home and saying "well we don't agree with the expert on fire so we aren't paying for it".


A better analogy would be the insurance company saying "Well, you don't really need that garage you had before so we're only going to give you $150K for the house instead of the $200K we appraised it at"

SI

Greyroofoo 02-15-2010 10:37 PM

Quote:

Originally Posted by sterlingice (Post 2224857)
But the problem is that's not the point we're arguing. Yeah, private vs public is night and day. Why? Because they pay a lot more per student and have better students. So, yeah, the private school is going to be better. That doesn't mean we scrap the public schools.

And it sure as hell doesn't mean that with the same kids/parents the private schools would do better than the public school as you implied earlier (below)



SI


I went to a private elementary school and they did NOT get as much funding per student as the public school did.

sterlingice 02-15-2010 10:44 PM

I went to a pretty mediocre private grade school, too. And, yeah, they cost about the same as a public school, too. But it's a bit different story when you're talking about private schools that cost more than public universities.

SI

Arles 02-15-2010 10:46 PM

Quote:

Originally Posted by sterlingice (Post 2224857)
But the problem is that's not the point we're arguing. Yeah, private vs public is night and day.


My response was directed at this question:

Quote:

Originally Posted by flere-imsaho (Post 2224586)
Are private companies doing any better with education? I've heard plenty of complaints about charter schools, for instance.


And I think it's pretty clear that most private schools do a much better job educating kids than public schools.

Quote:

Why? Because they pay a lot more per student and have better students. So, yeah, the private school is going to be better.

It costs about half (3-4K) for a private school to educate a child than it does for a public school (8-9K). The difference is that private schools currently lack the capacity to handle all the kids in the public school. If that could be solved, the cost and quality of education would be much higher.

Quote:

That doesn't mean we scrap the public schools.
If private capacity could meet the public school demand, I would have no problem scrapping public schools.

flere-imsaho 02-16-2010 12:08 PM

One view of Bayh's decision to retire:

(the below are excerpts only, the full opinion piece is at the link above)

Quote:

And could he have said it any better for you or me than this? “For some time, I have had a growing conviction that Congress is not operating as it should,” Bayh said Monday. “There is too much partisanship and not enough progress—too much narrow ideology and not enough practical problem solving. Even at a time of enormous challenge, the people’s business is not being done.” Anyone out there want to contradict him?

So another bright, honest person, another legislator of temperate manner and moderate politics, is soon gone, to be replaced almost certainly by a man or woman who will continue to make Capitol Hill even more partisan, rancorous, and paralyzed in its vital work. In this respect, the Congress is sadly becoming the living embodiment of the old Groucho Marx joke. Good guys like Sen. Bayh, who really ought to be running the country from the Senate, “don’t care to belong to any club that will have [him] as a member.”


Even 9/11 couldn’t break the Senate’s decades-long descent into senselessness. Left or right, Democrat or Republican, it doesn’t matter any longer who started the murder-suicide pact. It just needs to end.


“In my father’s day, you legislated for four years and campaigned for two; now it’s full time. The politics never stops,” Bayh said Monday.


Bayh isn’t in the wrong for leaving. Too many of his colleagues are in the wrong for staying. It’s the ones Bayh leaves behind on Capitol Hill who really should be facing the week’s questions. Can they look themselves in the eye, ask the same questions Bayh did, and be honest enough with themselves and their constituents to abide by the answer? My guess is no. Which means things will get much worse before they get any better.


It's a common enough thing to decry the bitter partisanship of politics and claim that this is as bad as it's ever been, when in truth there are plenty of examples of serious dischord at the national political level in the past.

However, it's pretty bad right now. Congress is almost completely disfunctional at this point, and anything they do manage to pass is often just terrible.

JonInMiddleGA 02-16-2010 12:32 PM

Quote:

However, it's pretty bad right now. Congress is almost completely disfunctional at this point, and anything they do manage to pass is often just terrible.

This goes back to what I've said for a number of years now though: that politics is simply a reflection of the larger society, not the cause of any of it.

That's what the VF writer fails to recognize (although not as badly as what I usually read). The constituents are the ones who put the relatively hard to get along with folks in office. I wouldn't want anything less than the guy I've got (Broun-R) and Lord knows he's not known for compromise. And there are those equally adamant on the opposite end of the socio-political spectrum.

We aren't divided by politics, our beliefs/view/worldview/etc divide us and the politics just have to come along for the ride since we're given the opportunity to choose our representatives.

I'm fine with Bayh choosing not to deal with that reality any more, I'll readily acknowledge how difficult the stress of the position would be regardless of party affiliation. I'll even tentatively wish him a fare-thee-well (at least until he gets his hands on something & starts to screw it up). But if he were trying to give away the farm from my side of the aisle, I'd also be glad to have helped him pack his bags.

flere-imsaho 02-16-2010 12:52 PM

Quote:

Originally Posted by JonInMiddleGA (Post 2225329)
That's what the VF writer fails to recognize (although not as badly as what I usually read). The constituents are the ones who put the relatively hard to get along with folks in office.


Then you'll prefer this take:

Quote:

One overlooked reason: Despite their growing grumbles, America's voters kept electing the same partisan pols. When better than 80% of senatorial incumbents and 90+% of House incumbents get reelected from both sides, often using the most partisan, negative advertising, the lesson learned properly by those pros is that the voters are the hypocrites, denouncing partisanship and gridlock and punishing such tactics by repeated reelection.

:D

JonInMiddleGA 02-16-2010 12:58 PM

Quote:

Originally Posted by flere-imsaho (Post 2225349)
Then you'll prefer this take:


It definitely seems more in touch with reality than the first one, that's for sure.

The whole "we hate the partisanship" hue & cry reminds me a lot of the old joke about surveys that showed how everyone loved PBS ... and the reality that outside of Sesame Street & Masterpiece Theater no one knew anyone who actually watched it.

flere-imsaho 02-16-2010 01:01 PM

Speaking broadly, people hate Congress but love what their Rep & Senators do for them without realizing that, writ large, what their Rep & Senators do for them generally contributes to what they hate about Congress.

But that's old news at this point for most of us here.

miked 02-16-2010 01:31 PM

Saxby Chambliss keeps getting re-elected without doing a single thing. It must be an awesome job!

Mizzou B-ball fan 02-16-2010 01:32 PM

Quote:

Originally Posted by flere-imsaho (Post 2225356)
Speaking broadly, people hate Congress but love what their Rep & Senators do for them without realizing that, writ large, what their Rep & Senators do for them generally contributes to what they hate about Congress.

But that's old news at this point for most of us here.


Sad, but true.

There really needs to be a term or age limit for some of these guys. Prime example right now is Sen. Byrd. I know that there were complaints about Republicans forcing some votes that caused him to have to be up past his bedtime or for long hours. While I certainly sympathize with the plight of being 90+ years old, that's part of the job. If you're not able to perform it, move on. Strom was another fine example. They need to say no more re-elections after 80 years old or something. This is just getting out of hand.

Arles 02-16-2010 02:15 PM

Yes, this congress is exactly who I want to try and fix a major issue like Health care. What could go wrong?

JPhillips 02-16-2010 03:39 PM

Quote:

Originally Posted by Mizzou B-ball fan (Post 2225376)
Sad, but true.

There really needs to be a term or age limit for some of these guys. Prime example right now is Sen. Byrd. I know that there were complaints about Republicans forcing some votes that caused him to have to be up past his bedtime or for long hours. While I certainly sympathize with the plight of being 90+ years old, that's part of the job. If you're not able to perform it, move on. Strom was another fine example. They need to say no more re-elections after 80 years old or something. This is just getting out of hand.


But the counter to that is if WV voters want him as their representative why shouldn't they be allowed that?

I'd like to see more turnover and more primaries for the legislative branch, but I'm skeptical that term limits will make things better.

Mizzou B-ball fan 02-17-2010 07:04 AM

Why are the conservative sites pretending like this CNN poll is such a shocker? CNN poll says that majority of responders say that Obama doesn't deserve a second term. Given how poorly his first year has gone, this should surprise no one.

http://i2.cdn.turner.com/cnn/2010/im...2/16/rel4a.pdf

flere-imsaho 02-17-2010 08:36 AM

Quote:

Originally Posted by Mizzou B-ball fan (Post 2225731)
Given how poorly his first year has gone


I'm curious: what did you expect? Two wars, a hostile and obstructionist opposition in Congress, the worst economic downturn since the Great Depression, a considerable number of legal problems left over from the Bush Administration, etc....

Don't tell me you were one of those people who expected he'd wave his magic wand and give everyone fairies and unicorns, were you?

Mizzou B-ball fan 02-17-2010 08:50 AM

Quote:

Originally Posted by flere-imsaho (Post 2225760)
I'm curious: what did you expect? Two wars, a hostile and obstructionist opposition in Congress, the worst economic downturn since the Great Depression, a considerable number of legal problems left over from the Bush Administration, etc....

Don't tell me you were one of those people who expected he'd wave his magic wand and give everyone fairies and unicorns, were you?


Absolutely not. I thought it would go just about how it went. A whole lot of blame on the previous administration and the minority in Congress along with very little of Obama's policies actually coming to fruition despite a large party majority in both houses. I'm happy with the change in stem cell policy, but very little else.

Flasch186 02-17-2010 08:51 AM

Poll results for the congress shows an increase in those that would vote for a democrat m/m. a decrease for Gop m/m.

an increase in re-electing those in congress which would mean another Democratically held congress.

NOw here is my point:

I dont care really and think its a bunch of bunk BUT MBBF, after months of saying how the Dems are retiring and washing out for fear of not being re-elected (remember when he called congresspeople 'scared' for cancelling Town halls for fear of being attacked after receiving threats....and then people started showing up with guns) fails to point out shit like that while pointing out the one thing that fits his narrative. Instead of his own faux-shock I love how he now points fingers LOL. The new MMBF = embracing his willingness to make fun of others misfortune or handicap AND a willingness to tout hypocrisy for the sake of the narrative. Love the new MBBF....remember when he predicted McCain to win, only to backpedal and say he didnt insinuate that, leaving him to be 'right' no matter who won. Love the new MBBF, at least we dont have to worry about his faux shock should one choose to use the word 'X'.

JPhillips 02-17-2010 09:16 AM

To be fair, though, if you weight the election results properly McCain did win.

JonInMiddleGA 02-17-2010 09:22 AM

Quote:

Originally Posted by Flasch186 (Post 2225764)
Poll results for the congress shows an increase in those that would vote for a democrat m/m. a decrease for Gop m/m.


Maybe I'm just having a blonde moment but ... what is "m/m"?

JPhillips 02-17-2010 09:35 AM

Here's a nice column on the effectiveness of the stimulus, but as Leonhardt says, it's hard to sell, "things could have been much worse".

http://www.nytimes.com/2010/02/17/bu...rssnyt&emc=rss

JPhillips 02-17-2010 09:36 AM

Quote:

Originally Posted by JonInMiddleGA (Post 2225773)
Maybe I'm just having a blonde moment but ... what is "m/m"?


Yeah, I don't think it's that surprising that the GOP had a decrease in support of man for man.

molson 02-17-2010 09:45 AM

Quote:

Originally Posted by flere-imsaho (Post 2225760)

Don't tell me you were one of those people who expected he'd wave his magic wand and give everyone fairies and unicorns, were you?


The only people that expected that were the ones who took that ridiculous campaign seriously. (Of course now, nobody admits to being a part of that group).

cartman 02-17-2010 09:50 AM

Quote:

Originally Posted by molson (Post 2225790)
The only people that expected that were the ones who took that ridiculous campaign seriously. (Of course now, nobody admits to being a part of that group).


The only ones that put it in those terms (rainbows, unicorns, etc.) were the derisive right wings sites, once Obama's campaign started gaining serious traction.

Mizzou B-ball fan 02-17-2010 09:51 AM

Quote:

Originally Posted by molson (Post 2225790)
The only people that expected that were the ones who took that ridiculous campaign seriously. (Of course now, nobody admits to being a part of that group).


To be fair, there are some that admit to it, but they're the same people who are having buyer's remorse at this point.

molson 02-17-2010 09:55 AM

Quote:

Originally Posted by cartman (Post 2225795)
The only ones that put it in those terms (rainbows, unicorns, etc.) were the derisive right wings sites, once Obama's campaign started gaining serious traction.


Well, you can replace the words "rainbows" and "unicorns" with things like "close GITMO" and the point is the same.

Edit: GITMO was one of the hottest political issue here for a while, everyone trashed Bush and couldn't understand why these people couldn't just be transfered to supermax. Then Obama comes out and whines about it being harder than people realized, and that's just accepted.

And to me, the "change" nonsense was a rainbow/unicorn promise.

flere-imsaho 02-17-2010 10:00 AM

Quote:

Originally Posted by molson (Post 2225801)
Well, you can replace the words "rainbows" and "unicorns" with things like "close GITMO" and the point is the same.


Are you serious?

If you can't see a difference between the way Obama supporters were stereotyped (including by people on this board) as naive hippies who expected Obama's inauguration to be immediately followed by a new American Golden Age and supporters who hoped he'd be able to address a laundry list of grievances they had against the Bush Administration, then you really need your cognitive abilities examined.

molson 02-17-2010 10:02 AM

Quote:

Originally Posted by flere-imsaho (Post 2225806)
Are you serious?

If you can't see a difference between the way Obama supporters were stereotyped (including by people on this board) as naive hippies who expected Obama's inauguration to be immediately followed by a new American Golden Age and supporters who hoped he'd be able to address a laundry list of grievances they had against the Bush Administration, then you really need your cognitive abilities examined.


It was more than "naive hippies" that expected a golden age - maybe not immediately after Obama's inauguration, but certainly by now, and absolutely during his presidency.

His campaign was nauseating, and it promised a golden age. He's just an ordinary hack politican, as it turns out, and now his followers are yelling, "what did you expect!" Well, actually, the more dopey followers (the ones who got him elected) have gone back to ignoring politics for the most part, I think. I do think that there's plenty of regular people that didn't expect a golden age, but certainly expected foreign policy differences from Bush.

I mean seriously - does anyone eles remember this campaign? Hillary Clinton ripped it in the primaries for being ridiculous and idealistic.

flere-imsaho 02-17-2010 10:08 AM

Quote:

Originally Posted by molson (Post 2225801)
Edit: GITMO was one of the hottest political issue here for a while, everyone trashed Bush and couldn't understand why these people couldn't just be transfered to supermax. Then Obama comes out and whines about it being harder than people realized, and that's just accepted.


We've gone from an Administration that 100% opposed any movement on GITMO and used every legal obfuscation in the book in this cause to an Administration that is making progress on the issue whilst also trying to unravel all of those legal obstacles.

You would have us believe that Obama supporters are taking exactly the same message from Obama that they got from Bush and accepting it wholesale just because it came from our messiah.

Do you even think before you post this shit?

Quote:

And to me, the "change" nonsense was a rainbow/unicorn promise.

What percentage, do you really think, of the people who voted for Obama really figured he was the messiah who would bring about a new way of doing business in Washington?

But please, go on spinning and stereotyping.

larrymcg421 02-17-2010 10:09 AM

Quote:

Originally Posted by molson (Post 2225801)
Well, you can replace the words "rainbows" and "unicorns" with things like "close GITMO" and the point is the same.

Edit: GITMO was one of the hottest political issue here for a while, everyone trashed Bush and couldn't understand why these people couldn't just be transfered to supermax. Then Obama comes out and whines about it being harder than people realized, and that's just accepted.

And to me, the "change" nonsense was a rainbow/unicorn promise.


If you can't see why we'd accept "I want to close it, but it will take some time" vs. "I don't want to change it. It's fine." then I'm not sure what I can say. I guess it's easier for you to imply that we're a bunch of hypocrites than look at the logic of the situation.

flere-imsaho 02-17-2010 10:11 AM

Quote:

Originally Posted by molson (Post 2225807)
It was more than "naive hippies" that expected a golden age - maybe not immediately after Obama's inauguration, but certainly by now, and absolutely during his presidency.


Really? The whatever-percentage of independents and moderate Democrats that voted for Obama (surely a considerably larger group than the "naive hippies") expected a "golden age" after he'd been in office for a year? In the context of an environment that included two wars and the worst economic downturn in two generations?

Really? This is your argument?

Get some perspective, man. Did Democrats kill your dog at one point or something?

molson 02-17-2010 10:11 AM

Quote:

Originally Posted by flere-imsaho (Post 2225811)

What percentage, do you really think, of the people who voted for Obama really figured he was the messiah who would bring about a new way of doing business in Washington?

But please, go on spinning and stereotyping.


"messiah" throws things off a little bit, but I'd estimate the % of people who figured Obama would "bring about a new way of doing business in Washington" at at least 80%. He actually used that very phrase repeatedly in his campaign speeches.

molson 02-17-2010 10:13 AM

Quote:

Originally Posted by larrymcg421 (Post 2225815)
If you can't see why we'd accept "I want to close it, but it will take some time" vs. "I don't want to change it. It's fine." then I'm not sure what I can say. I guess it's easier for you to imply that we're a bunch of hypocrites than look at the logic of the situation.


I can see accepting "I want to close it, but it will take some time", but that's definitely not what was promised during the campaign. Nor was "health care reform once we can get Republicans on board with the plan"

cartman 02-17-2010 10:13 AM

Quote:

Originally Posted by molson (Post 2225819)
"messiah" throws things off a little bit


Yet "rainbows and unicorns" doesn't. Gotcha.

JPhillips 02-17-2010 10:14 AM

Quote:

Originally Posted by molson (Post 2225807)
It was more than "naive hippies" that expected a golden age - maybe not immediately after Obama's inauguration, but certainly by now, and absolutely during his presidency.

His campaign was nauseating, and it promised a golden age. He's just an ordinary hack politican, as it turns out, and now his followers are yelling, "what did you expect!" Well, actually, the more dopey followers (the ones who got him elected) have gone back to ignoring politics for the most part, I think. I do think that there's plenty of regular people that didn't expect a golden age, but certainly expected foreign policy differences from Bush.

I mean seriously - does anyone eles remember this campaign? Hillary Clinton ripped it in the primaries for being ridiculous and idealistic.


Obama and HRC had very close policy positions. If Obama's policies were ridiculous and idealistic her's were too. Obama won the primaries because of charisma and tactics, not a wildly more progressive policy than HRC.

larrymcg421 02-17-2010 10:14 AM

And here are my "rainbow/unicorn" expectations from the first page of the thread:

Quote:

*Stem cell research executive order reversed. I hope this is the first thing he does.

*Gitmo closed. End of human rights abuses.

*Lots of liberal justices on the federal courts.

*A more thoughtful foreign policy. Listening to a wide variety of opinions instead of just a select few.

*Strengthened middle class that powers us out of the recession.

*More qualified people in important posts like FEMA director.

He's either accomplished or going in the right direction on most of these.

JPhillips 02-17-2010 10:16 AM

Quote:

Originally Posted by molson (Post 2225820)
I can see accepting "I want to close it, but it will take some time", but that's definitely not what was promised during the campaign. Nor was "health care reform once we can get Republicans on board with the plan"


From Politifact:
Quote:

Obama said after the inauguration that he hoped to close Guantanamo within one year, and administration officials admit they won't make that deadline. During the campaign, Obama gave himself no such deadline, and we're judging him here on his campaign promises. He said he would close Guantanamo Bay, and concrete steps are being taken to do so. The promise remains In the Works.

Mizzou B-ball fan 02-17-2010 10:16 AM

Quote:

Originally Posted by flere-imsaho (Post 2225811)
What percentage, do you really think, of the people who voted for Obama really figured he was the messiah who would bring about a new way of doing business in Washington?


I'll agree with this if you're implying this wasn't the main motivation to vote for him. I'd argue the majority of Obama voters were just voting against Bush (despite the fact that he wasn't even running for President). That's an even worse reason to vote for a guy than the rainbow/unicorn option IMO. Now only a year later, I see a similar situation setting up where the 2010 and 2012 elections will be about voting against Obama rather than voting based on what's best for the nation. I'm not sure that's any better than the real reason Obama became president in the first place.

flere-imsaho 02-17-2010 10:16 AM

Quote:

Originally Posted by Mizzou B-ball fan (Post 2225763)
I thought it would go just about how it went.


Of course you did, because as we all know, your powers of prediction are without peer.

molson 02-17-2010 10:18 AM

Quote:

Originally Posted by JPhillips (Post 2225827)
From Politifact:


I see that website only recognizes a mere 15 broken promises, and 84 "stalled". Let's see how many of the 273 "in the works" ever happen.

I don't believe any Obama supporter that claims that they didn't believe GITMO would be closed by now.

molson 02-17-2010 10:20 AM

And back to health care - when the "public option" went away there was a very brief backlash here, and someone here said they wouldn't vote for Obama in the primaries if that was the case. (I'll try to find who that was).

And there were repeated discussions here where everyone insisted that there was ZERO reason for GITMO to exist, and ZERO reason not to have civilian criminal trials for all terrorists. I think, though I'm not sure, that the implication was that Dick Cheney just got off torturing people and that was the driving force behind Bush's foreign policy. But Obama faced the realities of national security and started saying the same things that I and many others were saying back then (both about GITMO, and about civilian trials), and now suddenly nobody cares anymore.

Ronnie Dobbs2 02-17-2010 10:24 AM

I was hoping for Obama to govern pragmatically while aspiring to certain goals I personally had (gay rights, GITMO/torture, stem cell research). He's made decent movement on those issues, succeeded with a pragmatic foreign policy, and blundered a pragmatic domestic policy. So far he's got an INC from me.

flere-imsaho 02-17-2010 10:25 AM

Quote:

Originally Posted by molson (Post 2225819)
I'd estimate the % of people who figured Obama would "bring about a new way of doing business in Washington" at at least 80%.


:lol:

Quote:

Originally Posted by Mizzou B-ball fan (Post 2225828)
I'd argue the majority of Obama voters were just voting against Bush (despite the fact that he wasn't even running for President). That's an even worse reason to vote for a guy than the rainbow/unicorn option IMO.


Oh please. McCain, in both word & action, offered little to indicate he'd do much else besides continue Bush's policies. If you think the current president is going in the wrong direction (and a majority of Americans did) and you're offered the choice between someone who will continue on the same path as the current president, and someone who says he'll go in a different direction, it certainly makes sense to vote for the second guy.

(Yes, yes panerd & Bucc, maybe it makes more sense to vote for another guy altogether.)

For the converse, see 1988.

flere-imsaho 02-17-2010 10:26 AM

Quote:

Originally Posted by molson (Post 2225830)
I don't believe any Obama supporter


Honestly, I think you could have ended the sentence right there and saved us a lot of time.


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