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View Poll Results: How is Obama doing? (poll started 6/6)
Great - above my expectations 18 6.87%
Good - met most of my expectations 66 25.19%
Average - so so, disappointed a little 64 24.43%
Bad - sold us out 101 38.55%
Trout - don't know yet 13 4.96%
Voters: 262. You may not vote on this poll

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Old 01-13-2010, 09:17 AM   #7301
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I think Huckabee's out of the picture after the clemency stuff.

Yeah, that one is definitely going to leave a permanent mark.
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Old 01-13-2010, 09:36 AM   #7302
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Hey, it turns out that I agree with the GOP on some things more than the Democrats. I support the death penalty, I'm more in line with their immigration stance, and... well, I wanted to make a joke about how I also support Michael Steele having the GOP job here but it would dull the rest of the point.

I'd say fiscal policy, but, nah- they're not for real budget balancing, just for election year tax cut bribes and then cutting social services they don't like to pay for it and ignoring the military budget whereas I prefer the social programs remain in place and don't mind paying for it. And that turns out to be one of the reasons I'm a liberal. Not much to hide there, really. And, honestly, over the last few years, I've become moreso than when I started posting on this board, not from anything here but just from living life, in general.

But I also don't go around today claiming to be something I'm not and trying to pretend I have some neutrality so that my argument has more weight or something. That said, these things do sort themselves out- people know who is more or less one way or the other- but it does need to be pointed out when you keep trying to paint yourself as a persecuted innocent bystander when it's just not true.

SI

Wow...you and I are pretty much in agreement on all of this. I think you summed me up pretty well.

If there was a party dedicated to getting a balanced budget amendment to the constitution, 100% federally-funded elections and getting the lobbyist $$ out of politics, ensuring individual liberties (gay marriage, abortion, etc), reasonable social services, and a sensible foreign-policy (added here to refute the cries of "you should be a libertarian" because i'm sorry...isolationism just doesn't work), I would be a reliable voter 100% of the time.

Unfortunately there's not, so I'm left saying "Gee I agree with the GOP on this and the Democrats on that, but ultimately I recognize that the GOP's 'fiscal conservatism' dissapears as soon as they get in power, and frankly I am more concerned about their right-wing social agenda then I am about my taxes."
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Old 01-13-2010, 09:42 AM   #7303
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I am more concerned about their right-wing social agenda then I am about my taxes."

Hey, we've found something else you & I have in common. We're on opposite sides of it, but the quoted sentence actually works for both of us
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Old 01-13-2010, 09:49 AM   #7304
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Hey, we've found something else you & I have in common. We're on opposite sides of it, but the quoted sentence actually works for both of us

haha. too true...too true!
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Old 01-13-2010, 10:53 AM   #7305
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Interesting that this article was linked up over on Huffington Post given that Rainmaker said this paper is only linked up by conservative websites. The support for the Dem candidate in Massachusetts by pharma and HMO lobbyists tells you all you need to know about the 'reform' that the health care bill brings to the table.

Coakley in trouble? Pharma and HMO lobbyists to the rescue | Washington Examiner
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Old 01-13-2010, 11:11 AM   #7306
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Interesting that this article was linked up over on Huffington Post given that Rainmaker said this paper is only linked up by conservative websites. The support for the Dem candidate in Massachusetts by pharma and HMO lobbyists tells you all you need to know about the 'reform' that the health care bill brings to the table.

Coakley in trouble? Pharma and HMO lobbyists to the rescue | Washington Examiner

Dunno bout everyone else but I've been saying that all along - I think that has been pretty clear to most people that Pharma & HMO love this new "reform" bill because it doesn't go far enough.

And I think you're seeing Pharma & HMO come to her rescue because she has said she'll be a "yes" vote for it where Brown has said he'll be a "no" vote (clearly).

HOWEVER I don't think a "no" vote is the right thing. Killing the bill is just going to result in another generation having to pass with more and more people going bankrupt and insurance companies taking more and more of our salaries (you want to talk about costs being raised on people, aka "taxes", why do people never look at the cost of health insurance as a "living tax?") before we are finally able to bring things under control. Although I am the first in line to say that this bill as currently constructed is a POS I'm not of the opinion that it's without any good at all, and it will certainly be the first of many steps on the path to real healthcare reform.

But I do think it has many aspects of a "giveaway to the insurance industry" and I hope that those can be stripped-out in conference/reconcilliation to give us a better bill. I hope. I don't have my hopes up too high, because some of the giveaways will surely still be in there, but maybe they can get rid of a decent % of them.

Pretty sad commentary on our Congress - and yet again why I feel that strict 100% public financing and much stronger regulation of lobbyists is the only way we'd actually have "government for the people" as opposed to "government for the corporations."
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Old 01-13-2010, 11:24 AM   #7307
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Dunno bout everyone else but I've been saying that all along - I think that has been pretty clear to most people that Pharma & HMO love this new "reform" bill because it doesn't go far enough.

And I think you're seeing Pharma & HMO come to her rescue because she has said she'll be a "yes" vote for it where Brown has said he'll be a "no" vote (clearly).

HOWEVER I don't think a "no" vote is the right thing. Killing the bill is just going to result in another generation having to pass with more and more people going bankrupt and insurance companies taking more and more of our salaries (you want to talk about costs being raised on people, aka "taxes", why do people never look at the cost of health insurance as a "living tax?") before we are finally able to bring things under control. Although I am the first in line to say that this bill as currently constructed is a POS I'm not of the opinion that it's without any good at all, and it will certainly be the first of many steps on the path to real healthcare reform.

But I do think it has many aspects of a "giveaway to the insurance industry" and I hope that those can be stripped-out in conference/reconcilliation to give us a better bill. I hope. I don't have my hopes up too high, because some of the giveaways will surely still be in there, but maybe they can get rid of a decent % of them.

Pretty sad commentary on our Congress - and yet again why I feel that strict 100% public financing and much stronger regulation of lobbyists is the only way we'd actually have "government for the people" as opposed to "government for the corporations."

Outside of you saying that a yes vote is best, I agree with most everything else you've said.
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Old 01-13-2010, 11:30 AM   #7308
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Outside of you saying that a yes vote is best, I agree with most everything else you've said.

I'd almost argue that a "no" vote is best, but I really do fear that if it doesn't pass this time it's going to be "trumpted" by the right in an attempt to show that the majority of the population doesn't want it (when in fact if you look at polls it shows that the majority of people do when it's explained to them, and the vast majority of the opposition to it has been whipped-up by congressmen who are in the pockets of drug&pharma - liberman, etc, or even in some cases by the drug&pharma employees themselves at those tea-parties).

And I honestly don't want to think about all the people that would leave uncovered, and for how long. an imperfect solution that can be amended later is better than no solution.
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Old 01-13-2010, 11:35 AM   #7309
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Interesting that this article was linked up over on Huffington Post given that Rainmaker said this paper is only linked up by conservative websites. The support for the Dem candidate in Massachusetts by pharma and HMO lobbyists tells you all you need to know about the 'reform' that the health care bill brings to the table.

Coakley in trouble? Pharma and HMO lobbyists to the rescue | Washington Examiner
I didn't say the paper, I said that particular article you posted yesterday. Here are the sites linking to that article yesterday. You be the judge. You can do the same thing on an almost daily basis for the articles you post and see the same exact conservative sites linking to it. Not saying it's wrong, just that you tend to be Michelle Malkin's RSS feed.

link:http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/Desperate-Dems-try-to-Palinize-Massachusetts-Senate-race-81198087.html -site:washingtonexaminer.com - Yahoo! Search Results
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Old 01-13-2010, 12:37 PM   #7310
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No, no, for the love of all that is holy NO! Do not vote 'yes' on a bill just because its something. I have horrible nightmares of TARP flashing back to me when you say it. They never go back and fix it.

The bill as it stands is pretty much set to get the government to strongarm people into bullshit plans that will cover nothing and cost plenty. They'll ramp up the demand and then use it as an excuse for multiple rippling waves of further cost increases.

When the economy recovers (I'm assuming this because if it don't we'll have more shit going through the fan we can handle anyway) these rules will then be enforced with a massive bureaucracy that will put the vise on working people at all levels to buy shoddy, over-priced insurance. Companies will be smarter than the average bear and slither out of the business in many places, leaving a massive mess of consumers paying retail prices and fighting their coverage providers in lawsuits to get any care. Again, an argument will be made that increasing legal costs necessitate further price increases, and healthcare's death spiral will accelerate.

Do not pass an insurance company friendly bill because we need to 'do something'. We are going to pay a hefty price on the backend of TARP (despite them 'paying it back...').
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Old 01-13-2010, 12:39 PM   #7311
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No, no, for the love of all that is holy NO! Do not vote 'yes' on a bill just because its something. I have horrible nightmares of TARP flashing back to me when you say it. They never go back and fix it.

The bill as it stands is pretty much set to get the government to strongarm people into bullshit plans that will cover nothing and cost plenty. They'll ramp up the demand and then use it as an excuse for multiple rippling waves of further cost increases.

When the economy recovers (I'm assuming this because if it don't we'll have more shit going through the fan we can handle anyway) these rules will then be enforced with a massive bureaucracy that will put the vise on working people at all levels to buy shoddy, over-priced insurance. Companies will be smarter than the average bear and slither out of the business in many places, leaving a massive mess of consumers paying retail prices and fighting their coverage providers in lawsuits to get any care. Again, an argument will be made that increasing legal costs necessitate further price increases, and healthcare's death spiral will accelerate.

Do not pass an insurance company friendly bill because we need to 'do something'. We are going to pay a hefty price on the backend of TARP (despite them 'paying it back...').

valid points. but i think until we get public campaign finance reform and get lobbyists $$ out of politics we'll never see a bill that actually benefits the people anyways
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Old 01-13-2010, 12:40 PM   #7312
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Pretty sad commentary on our Congress - and yet again why I feel that strict 100% public financing and much stronger regulation of lobbyists is the only way we'd actually have "government for the people" as opposed to "government for the corporations."

I would just about kill for publicly funded elections but it will never happen as the people who determine how our elections run have the most to lose from making them publicly funded

SI
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Old 01-13-2010, 12:44 PM   #7313
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I would just about kill for publicly funded elections but it will never happen as the people who determine how our elections run have the most to lose from making them publicly funded

SI

i would kill for it.

the tree of liberty my friend...the tree of liberty.


and SportsDino - even if it is a bad bill (which it seems most people understand it to be, at least in its current form) at a minimum it will be providing coverage to a bunch more people and might have some effect on-the-margins as faar as denial of preexisting conditions and such (there are still ways around that i know, but it might help a little).
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Old 01-13-2010, 12:58 PM   #7314
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I didn't say the paper, I said that particular article you posted yesterday. Here are the sites linking to that article yesterday. You be the judge. You can do the same thing on an almost daily basis for the articles you post and see the same exact conservative sites linking to it. Not saying it's wrong, just that you tend to be Michelle Malkin's RSS feed.

I don't even read Michelle Malkin's website, so if she posted that article, it was nothing more than coincidence. You might as well accuse me of being Arianna Huffington's RSS feed. I post article from her site all the time and post more links from her site than any other site. It's the first site I check every morning. But you wouldn't want to do that because it wouldn't fit into your general notion of lumping people on the left or right and generalizing their stances. It's a very lazy way of debating as it carries no significat discussion points or counter points regarding the topic.

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Old 01-13-2010, 01:01 PM   #7315
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and SportsDino - even if it is a bad bill (which it seems most people understand it to be, at least in its current form) at a minimum it will be providing coverage to a bunch more people and might have some effect on-the-margins as faar as denial of preexisting conditions and such (there are still ways around that i know, but it might help a little).

That's an awfully rosy picture you paint of the bill in its current form. Whole lot of 'might' and 'at a minimum' assumptions. I disagree with your assessment.
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Old 01-13-2010, 01:08 PM   #7316
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Eh, the anti-abuse parts are toothless, built that way from the start in a method they already have established a legal attack against.

The expanded coverage will have so many gotchas on it that many people scraping by will have no help at all, but they'll certainly feel the increased prices and decreased service availability. I know I usually rail against subsidies... but I'm not totally opposed to them, I'm just like to view things almost as a mechanism... if you increase the stresses on a system in one place, restrict the supposed release mechanisms to only certain flows, and then provide a big subsidy to a certain group of actors while changing nothing fundamentally about the supply side which is under a general consensus of FUBAR???

To me that screams a massive squeeze (from an economic standpoint) on the least flexible actors (mostly lower middle class and lower class above poverty line in this scenario, which is a massive segment)... who coincidentally are no longer allowed the option to not participate. Cue massive price gouging feedback loop, and sadly, it will be obviously justified that prices increase since they can point to a host of real facts as the causes.

Since it seems that prices must rise from common sense, there will be two opposition factions, the whacknuts that think the answer is government style communism of prices on all things healthcare... that won't gain traction at all but will get the populist fervor... or the insurance company apologists that will get some further subsidies and maybe light concessions from corporate to bandaid some people, but keep the systemic crisis charging along to keep a profitable but growing problem. At that point no one will be able to see that it is the market restrictions and subsidies that are amplifying the problem, anymore than they do in the number of locations such problems already exist.

Hence, passing this legislation commits us to a bigger problem, in my opinion. Its worst than doing nothing, unless you want to play the democrat/republican headcount game which I've long determined is a farce... a circus for the masses to distract them while they are stealing the bread! Who cares about perceptions of strength of political parties that are both bought out, I think the ladies (and women in Congress) do protest too much. I personally think they didn't script out what would actually happen in their show if a party got 60 votes so they are now hyping up the 'filibuster' to levels that don't even make sense. Clever of them, but bad for the country that we can be so easily gimmicked.

If you want to see a bunch of people pushed into the pile of folks who work their ass off to get a marginal increase over the welfare state (for instance my little sister who has her first real job and is literally trying to find out how its different than being below poverty level when her obligations raise almost as much as her cash flow).

I don't want life by loophole, people surviving on the mercy of what clauses congress decided to throw into a bill to pretend they are helping someone. Don't give real teeth to laws that hurt people (forced purchase of healthcare... really is that what is bringing down the system, really, where is the math on it... oh wait, don't add up, never mind...)... and then sell a bill on a few scraps it throws to the masses which can disappear almost instantly once you read the fine print. It is sickening. Do better or stay the fuck home, let the government go into paralysis and see if they can hold a filibuster and still get elected.
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Old 01-13-2010, 01:11 PM   #7317
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if people don't have healthcare then getting sick could kill them though...that's not a situation i want to see happen either.
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Old 01-13-2010, 01:15 PM   #7318
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if people don't have healthcare then getting sick could kill them though...that's not a situation i want to see happen either.

Ask homeless people or illegal aliens how tough it is to get seen in an emergency room if they need it. Neither of those groups have any insurance.
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Old 01-13-2010, 01:16 PM   #7319
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if people don't have healthcare then getting sick could kill them though...that's not a situation i want to see happen either.

I've got news for you, Sparky... even if you have healthcare, getting sick can kill you. In fact, none of us get out of this world alive.
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Old 01-13-2010, 01:24 PM   #7320
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Ask homeless people or illegal aliens how tough it is to get seen in an emergency room if they need it. Neither of those groups have any insurance.
I think that's one of the problems. When you don't have insurance, you pretty much have to go to the ER for everything. It would save a lot of money if the guy with an ear infection was able to see a doctor instead of having to go to the ER for some antibiotics.
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Old 01-13-2010, 01:27 PM   #7321
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I think that's one of the problems. When you don't have insurance, you pretty much have to go to the ER for everything. It would save a lot of money if the guy with an ear infection was able to see a doctor instead of having to go to the ER for some antibiotics.

You're assuming that most doctors will see patients with the new coverage. That doesn't even happen with some people who already have coverage. The reimbursement rates/timeframe will likely increase the number of people general practice doctors refuse to see. There's very little to no incentive to do so.
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Old 01-13-2010, 01:27 PM   #7322
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As for subsidy design, target direct measurable things with as straightforward an economic incentive mechanism as possible.

If health care costs are the problem, subsidize hospital costs in a way that operating costs or equipment is subsidized at the wholesale cost rather than 3 million people worth of retail pricing. Structure it such that efficient hospitals get to tack on a portion of the subsidy onto whatever profit margin (or offset against losses more likely) they may have, and slant it so continual improvement is rewarded disproportionately (so that wealthy hospitals don't get a huge chunk of subsidy straight to their profit line... more stressed hospitals with greater room to grow can get a faster share of the pie, but only if they stabilize and then make progress... also want to avoid subsidizing a hospital for being stupid, pure-welfare subsidies there is sometimes an incentive to deliberately be lazy since its the easiest way to maintain revenue certainty for effort made).

If the supply of doctors is the problem, bust the medical school monopoly for the public good. Subsidize residency costs to a greater extent, maybe go gangbusters and make it profitable for need hospitals to take on more positions (within reason).

Make more healthcare free. Flu shots potentially can save us X dollars in emergency room or doctor visits... have the government pay for everyone to get vaccinated for free. Mass produce the shit and who cares if the wealthy save 20 bucks, they probably don't, but I'm sure the working poor with a family of four would eat that up (working poor = you make enough to not qualify for anything, but you still are living paycheck from paycheck even if you have your costs under control). Subsidize emergency room better. Give out free weight watcher subscriptions, whatever!

I'm sure for the same trillion dollar pile of money we could come up with a group of projects that would make a noticeable dent in health care quality, availability, and affordability that would actually last into the future. I'd argue taking the massive money we spend now and actually structuring it to promote progress in cost reduction could probably do much of the same.

And as I've said before in another thread, if modern health-care is just impossible to pay for... figure out a standard that makes sense. I know this flies against Cover Your Ass principle, but it might be a good thing to cut down the amount of wasteful tests/procedures/paperwork that are involved in the treatment of most common illness. Maybe sponsor smaller specialization hospitals with lower costs since they focus on particular types of work to free up some of the needs of larger general hospitals.

So on and so forth... none of it easy, but I think work of that form will get more value out of any dollar spent than these supposedly grand sweeping legislative reforms.
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Old 01-13-2010, 01:39 PM   #7323
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I think that's one of the problems. When you don't have insurance, you pretty much have to go to the ER for everything. It would save a lot of money if the guy with an ear infection was able to see a doctor instead of having to go to the ER for some antibiotics.

yeah...seriously
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Old 01-13-2010, 01:44 PM   #7324
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Covering more people at the expense of increasing the rate at which people are getting impoverished and in need of help is not a solution to the problem. Covering more people and doing something that significantly affects the economics or reality of the situation... I could get behind that full heartedly.

Go ahead, cover 3, 5, hell 10 million more people with government subsidized care. But don't set it up so that if you are person 10 million and one you are about to see costs go up, quality go down, availability go down, taxes go up, and if you screw up a little bit having to face legal penalties.

In fact, take it out of individual perspective... my assumption is that subsidizing 10 million people without any structural change in an economy will create a change in the prices non-subsidized people pay. Its almost economics 101 if you want to break out your supply and demand curves with subsidies added into the mix. But even if we take it further, an admittably supply limited and broken distribution mechanism, and adding 10 million subsidized customers, and forcing everyone else to comply or face legal punishment? How can that not lead to a net increase in prices and arguably profit margins of provider companies?

I mean, if you are juggling at maximum capacity, will adding another patient just be handled at economies of scale so you get a marginal profit? Or will you take a marginal loss? In an economy where the latter is the case, a subsidy pushes prices. If the former is true, then maybe 10 million people will end up as a net stimulus to the health care economy.

My assumption is the latter... and from there I think this is a mathematically provable disaster, while appearing to be kumbayah public policy for the greater good. If the margins are all negative than its more likely to create more people who need government assistance than anything.

Thats the simplest way to put it, and that assumes optimal government management and everything just fitting perfectly into place... not the highly suboptimal clusterfuck we know is really going to happen.
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Old 01-14-2010, 09:25 AM   #7325
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I've got news for you, Sparky... even if you have healthcare, getting sick can kill you. In fact, none of us get out of this world alive.

The subtlety of the argument that lack of access to healthcare makes one more likely to die from preventable and treatable conditions is clearly lost on some.
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Old 01-14-2010, 09:34 AM   #7326
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The subtlety of the argument that sarcasm is undetectable on 98% of message boards is clearly lost on some.

Fixed.
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Old 01-14-2010, 09:45 AM   #7327
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Fixed.

Your inability to work with numbers has already been well-documented in this thread and others.
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Old 01-14-2010, 09:53 AM   #7328
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Your inability to work with numbers has already been well-documented in this thread and others.

Duly noted. But I'll stick with that 98% of all message boards.
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Old 01-14-2010, 10:24 AM   #7329
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The subtlety of the argument that lack of access to healthcare makes one more likely to die from preventable and treatable conditions is clearly lost on some.

It's not lost on me... it's just not a winning argument as far as I'm concerned. I think it's hopelessly naive and simplistic... which of course makes it incredibly popular as a liberal argument.
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Old 01-14-2010, 10:27 AM   #7330
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It's not lost on me... it's just not a winning argument as far as I'm concerned. I think it's hopelessly naive and simplistic... which of course makes it incredibly popular as a liberal argument.

i'd counter that your counter was far more simplistic
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Old 01-14-2010, 11:10 AM   #7331
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Originally Posted by CamEdwards View Post
It's not lost on me... it's just not a winning argument as far as I'm concerned. I think it's hopelessly naive and simplistic... which of course makes it incredibly popular as a liberal argument.

Kind of like "guns don't kill people, people kill people". AMIRITE?


Seriously, though, people who have access to healthcare tend to get sick and die less from preventable and treatable diseases.
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Old 01-14-2010, 11:11 AM   #7332
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i'd counter that your counter was far more simplistic

When in Rome...
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Old 01-14-2010, 11:18 AM   #7333
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Seriously, though, people who have access to healthcare tend to get sick and die less from preventable and treatable diseases.

Unless you're a middle age man and you skip all your checkups (as middle age men are prone to do).
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Old 01-14-2010, 11:34 AM   #7334
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Unless you're a middle age man and you skip all your checkups (as middle age men are prone to do).

Thank you, Captain Obvious. What's the next part of your argument? That insured patients who develop a terminal, untreatable disease die just as often as uninsured patients who develop a terminal, untreatable disease? Oh, the failure of the health care system, writ large!!!

Anyway, when taken on aggregate, and when referring to actual data you are, once again, wrong: http://jama.ama-assn.org/cgi/content...ct/298/24/2886
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Old 01-14-2010, 12:26 PM   #7335
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Thank you, Captain Obvious. What's the next part of your argument? That insured patients who develop a terminal, untreatable disease die just as often as uninsured patients who develop a terminal, untreatable disease? Oh, the failure of the health care system, writ large!!!

Your sarcasm meter just got the blue screen of death.
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Old 01-14-2010, 12:34 PM   #7336
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The use of is great. It means one can make one's point, but then not be required to provide support for said point because one was "just kidding".

Maybe if Sarah Palin had been able to put after everything she said we'd all now be celebrating her subtle and sophisticated humor.
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Old 01-14-2010, 12:44 PM   #7337
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Thank you, Captain Obvious. What's the next part of your argument? That insured patients who develop a terminal, untreatable disease die just as often as uninsured patients who develop a terminal, untreatable disease? Oh, the failure of the health care system, writ large!!!

Anyway, when taken on aggregate, and when referring to actual data you are, once again, wrong: http://jama.ama-assn.org/cgi/content...ct/298/24/2886

thanks for picking up the discussion flere - i'm swamped at work and don't have time to refute their shallow counters with actual facts and links today
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Old 01-14-2010, 12:50 PM   #7338
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That was Palin's mistake. She used when clearly the appropriate closing statement was .
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Old 01-14-2010, 01:08 PM   #7339
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Originally Posted by flere-imsaho View Post
Thank you, Captain Obvious. What's the next part of your argument? That insured patients who develop a terminal, untreatable disease die just as often as uninsured patients who develop a terminal, untreatable disease? Oh, the failure of the health care system, writ large!!!

Anyway, when taken on aggregate, and when referring to actual data you are, once again, wrong: http://jama.ama-assn.org/cgi/content...ct/298/24/2886

I will freely admit to not being able to understand this.

Quote:
Compared with previously insured adults, previously uninsured adults reported significantly improved health trends after age 65 years for the summary measure (differential change in annual trend, +0.20; P = .002) and several component measures. Relative to previously insured adults with cardiovascular disease or diabetes, previously uninsured adults with these conditions reported significantly improved trends in summary health (differential change in annual trend, +0.26; P = .006), change in general health (+0.02; P = .03), mobility (+0.04; P = .05), agility (+0.08; P = .003), and adverse cardiovascular outcomes (–0.015; P = .02) but not in depressive symptoms (+0.04; P = .32). Previously uninsured adults without these conditions reported differential improvement in depressive symptoms (+0.08; P = .002) but not in summary health (+0.10; P = .17) or any other measure. By age 70 years, the expected difference in summary health between previously uninsured and insured adults with cardiovascular disease or diabetes was reduced by 50%.

Serious question (I guess this means I should use the smiley here)... how big an improvement are we talking about?
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Old 01-14-2010, 01:11 PM   #7340
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thanks for picking up the discussion flere - i'm swamped at work and don't have time to refute their shallow counters with actual facts...

Why start now? And yes, on this one I'm 55% joking. not sure if there's a proper smiley for that. perhaps?
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Old 01-14-2010, 02:20 PM   #7341
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Serious question (I guess this means I should use the smiley here)... how big an improvement are we talking about?

I'd recommend reading the full text (which isn't really that long), but a good summary of the findings relevant to this can be found at: http://jama.ama-assn.org/cgi/content...886/JOC70139F1

Essentially, people who were uninsured before 65 and had some health issues had their decline in overall health sharply slowed after qualifying for Medicare (and being able to use medical resources). This in a marked contrast to the rate of decline in overall health after 65 for the uninsured without previous medical issues prior to 65.

This seems consistent with the Kaiser Family Foundation's conclusion that having insurance could reduce mortality rates for the uninsured by 10-15%.

Another author claims, based on past studies and newer census data that an estimate 22,000 people died in 2006 due to a lack of insurance.

Then there's this: Hospital reports shows higher death rate for uninsured - Sacramento Business Journal:

Quote:
Patients who pay their own tab at California hospitals are 80 percent more likely to die there than patients with private insurance, according to a report released Tuesday by the Office of Statewide Health Planning and Development (OSHPD).

Poor patients covered by Medi-Cal, the government program for the poor, are 60 percent more likely to die in the hospital than folks with private insurance, concludes the report on hospital mortality rates in 2006.

The first in a series of research briefs about the quality and safety of health care in California, the report offers no theory about why the death rates for these groups are higher.

The fact that people without insurance and poor patients on Medi-Cal are less likely to get preventive care and therefore show up at the hospital in worse shape than others is a logical explanation for the trend an agency spokesman said.

And this: http://www.childrenshospital.org/new...blevel577.html

Quote:
A study led by Heather Rosen, MD, MPH, research fellow in the Department of Plastic Surgery at Children's Hospital Boston and Harvard Medical School, found that uninsured children were over three times more likely to die from their trauma-related injuries than children who were commercially insured, after adjustment for other factors such as age, gender, race, injury severity and injury type in an analysis of data from the National Trauma Data Bank. Moreover, publicly-insured children were 1.19 times more likely to die from trauma when compared with commercially-insured children.


So, there's some pretty demonstrable data to back up the relatively common sense conclusion that people with health insurance live longer than people without health insurance. As Cam points out, though, this is not necessarily a "winning argument". So, what would be a winning argument?
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Old 01-14-2010, 02:40 PM   #7342
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So, what would be a winning argument?

I got mine, so fuck you?
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Old 01-14-2010, 02:44 PM   #7343
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Just saw GOP Rep. Shadegg is retiring. Does this men the GOP can see the writing on the wall?
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Old 01-14-2010, 02:44 PM   #7344
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Why start now? And yes, on this one I'm 55% joking. not sure if there's a proper smiley for that. perhaps?

I try to bring out the facts when I have the time / there's stuff easily at hand / i know my way around the data. But honestly (no offense meant to anyone) it's pretty far down on my list of things "to do" - whether I'm at work or not. Digging up facts to support a discussion on an internet messageboard that will inevitably turn off-topic fairly soon anyways just isn't high on my list of priorities.
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Old 01-14-2010, 03:04 PM   #7345
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I got mine, so fuck you?

I did some more digging, to get to the bottom of this "winning argument" thing.

According to the CDC there were roughly 30,000 gun-related deaths in 2006. Given that we can assume Cam won't view this as a "winning argument" for gun control, we can understand why he'd not view 22,000 deaths from a lack of insurance as a "winning argument".

So, what's the number?

Well, given that Cam, in gun control threads, has suggested banning cars because more people die from them than guns, I looked up this. According to the NHTSA, almost 39,000 people died from "motor vehicle traffic crashes" in 2006.

So it must be somewhere between 30,000 and 39,000. Let's say 35,000. Thus, if something causes more than 35,000 deaths per year in America, it should be acted upon.

Well, I'm glad we've cleared that all up. So, how about that Michelle Obama on Iron Chef, eh?
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Old 01-14-2010, 03:08 PM   #7346
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So, there's some pretty demonstrable data to back up the relatively common sense conclusion that people with health insurance live longer than people without health insurance. As Cam points out, though, this is not necessarily a "winning argument". So, what would be a winning argument?

I understand the statistics on basic health things (uninsured far less likely to seek treatment until too late), but I don't get the trauma one. Hospitals have to treat uninsured patients now, so in what way do they fail to receive treatment? Are hospitals providing sub-standard care to uninsured patients? Is it an issue with follow-up visits?
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Old 01-14-2010, 03:16 PM   #7347
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So it must be somewhere between 30,000 and 39,000. Let's say 35,000. Thus, if something causes more than 35,000 deaths per year in America, it should be acted upon.

Cool. Does that mean I can finally bring shampoo and wear shoes on the plane after disbanding TSA since terrorism is still killing less than lightning strikes? Or does that mean we need to turn off Cobra Commander's weather dominator so lightning strikes can't kill people?

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Old 01-14-2010, 03:23 PM   #7348
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I understand the statistics on basic health things (uninsured far less likely to seek treatment until too late), but I don't get the trauma one. Hospitals have to treat uninsured patients now, so in what way do they fail to receive treatment? Are hospitals providing sub-standard care to uninsured patients? Is it an issue with follow-up visits?

From the article:

Quote:
Because the study was retrospective, the researchers cannot say definitively why insurance status may affect mortality rate in spite of EMTALA. "This paper provokes more questions than it answers," says Rosen, who is currently doing her residency in general surgery at the University of Southern California's Keck School of Medicine. "Should we be more vigilant about investigating whether EMTALA laws are being violated? Is this happening more often than we care to admit?"

The researchers speculate about several possible explanations for their findings. One is that trauma patients with public insurance or no insurance may be transferred from one hospital to another, causing a delay in definitive treatment. Uninsured patients may also undergo fewer medical tests, leading to inadequate diagnoses or missed injuries. In addition, if uninsured patients do not speak English as their first language or are less educated overall, they may be less able to communicate with medical providers about their medical history and quality of care after sustaining an injury.

Another article I read (but can't find the link to now, argh) also speculated that the uninsured weren't going to follow-up appointments (because they couldn't afford them), which contributed to the mortality rate (i.e. dying of complications from the injuries after discharged from the hospital).

Last edited by flere-imsaho : 01-14-2010 at 03:25 PM.
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Old 01-14-2010, 10:10 PM   #7349
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Originally Posted by flere-imsaho View Post
From the article:



Another article I read (but can't find the link to now, argh) also speculated that the uninsured weren't going to follow-up appointments (because they couldn't afford them), which contributed to the mortality rate (i.e. dying of complications from the injuries after discharged from the hospital).

Do you think it may be that people who choose to purchase insurance are generally making better decisions on average? Basically they are more responsible and make less high risk decisions in life.
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Old 01-14-2010, 10:39 PM   #7350
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I did some more digging, to get to the bottom of this "winning argument" thing.

According to the CDC there were roughly 30,000 gun-related deaths in 2006. Given that we can assume Cam won't view this as a "winning argument" for gun control, we can understand why he'd not view 22,000 deaths from a lack of insurance as a "winning argument".

So, what's the number?

Well, given that Cam, in gun control threads, has suggested banning cars because more people die from them than guns, I looked up this. According to the NHTSA, almost 39,000 people died from "motor vehicle traffic crashes" in 2006.

So it must be somewhere between 30,000 and 39,000. Let's say 35,000. Thus, if something causes more than 35,000 deaths per year in America, it should be acted upon.

Well, I'm glad we've cleared that all up. So, how about that Michelle Obama on Iron Chef, eh?

LOL. I think I've actually suggested that if we're going to ban guns because of 30,000 deaths, then we might as well ban cars (since more people die in car accidents). I guess the same argument could be made about spending a trillion dollars to prevent the deaths of 22,000 individuals, but honestly I haven't really thought much about it in that regard... though now that I'm thinking about it I'm recalling a statistic about the number of deaths due to medical mistakes in this country. According to this study, it's 195,000 a year.

hxxp://www.medicalnewstoday.com/articles/11856.php

Now I'm not suggesting that because 195,000 people died every year because of medical mistakes we go back to a system of midwives and witch doctors, but I think it's reasonable to wonder if the increased number of deaths (due to increased patients being served) would be more than the 22,000 people who are dying because of a lack of insurance.

Wouldn't it be a kick in the pants if insuring these folks actually led to more deaths?
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