The Obama Presidency - 2008 & 2012

[JPhillips]

Originally Posted by Arles

It's not that all innovation occurs in the US, it's that the US population funds most of the innovation (partly because of our current health care system). As I said earlier, this isn't necessarily a good thing.

However, if the same UK/Europe/Canada system is setup in the States, the profit margins will go down for a lot of these pharm companies. Past activity shows when this occurs than money spent in R&D will decrease to keep the profit margin/share price higher. Now, maybe the US should stop being the financier of drug companies. But the reality is that once that happens, a lot of dollars currently going into R&D for new drugs will dry up.

I'm skeptical that R&D would dry up, but even if you're right, why should the American public subsidize drugs for the rest of the world?

[Flasch186]

WOW, just wow. Palin goes from being 'nuts' to being a possible leader in the movement.

GOP backs away from end-of-life counseling - Yahoo! News

By BEN EVANS, Associated Press Writer Ben Evans, Associated Press Writer – Fri Aug 14, 6:00 pm ET

WASHINGTON – Until last week, Republican Sen. Johnny Isakson was among the most enthusiastic backers of end-of-life counseling in government health care programs like Medicare.

That was before conservatives called it a step toward euthanasia and former Alaska Gov. Sarah Palin likened the idea to a bureaucratic "death panel" that would decide whether sick people get to live. And even though those claims have been widely discredited, the issue remains a political weapon in the increasingly bitter health care debate.

Now, Isakson and other Republicans who eagerly backed the idea are distancing themselves from it or lying low in the face of a backlash from the right.

"Until last week this was basically a nonpartisan issue," said John Rother, executive vice president for policy at AARP, the seniors lobbying group. "People across the political spectrum recognize that far too often people's wishes aren't respected at the end of life and there is a lot of unnecessary suffering."

The idea for government-backed end-of-life counseling — while delicate given the subject matter — has garnered significant consensus on Capitol Hill, fueled in part by cases such as that of Terri Schiavo, whose divided family fought for years over whether she would want to be kept alive in a vegetative state.

Just a year ago, Congress overwhelmingly approved legislation requiring doctors to discuss issues like living wills and advance directives with new Medicare enrollees. And the government already requires hospitals and nursing homes to help patients with those legal documents if they want support, under a 1992 law passed under Republican President George H.W. Bush.

Supporters say the current House proposal just goes one step further by paying for the counseling, with the idea that doctors and patients would spend more time on it instead of just having a cursory discussion in an initial Medicare visit. The counseling is voluntary.

Isakson and other Republicans such as Sens. Richard Lugar of Indiana and Susan Collins of Maine have co-sponsored legislation in recent years promoting the counseling, including in initial Medicare visits and through a proposed government-run insurance program for long-term care.

In the House, Republican Reps. Charles Boustany of Louisiana, Geoff Davis of Kentucky and Patrick Tiberi of Ohio co-sponsored legislation from Rep. Earl Blumenauer, D-Ore., that would authorize Medicare to pay for the counseling. That measure served as a model for the current House language.

Earlier this summer, Isakson sponsored an arguably more far-reaching measure that would have required that new Medicare patients have a living will or other advance directive.

But the Georgia conservative found himself in a storm of criticism when President Barack Obama said at a town hall meeting this week that Isakson was a chief architect of the House approach. Isakson quickly issued a statement repudiating the proposal.

"The House provision is merely another ill-advised attempt at more government mandates, more government intrusion and more government involvement in what should be an individual choice," he said.

Pressed later to explain his opposition, Isakson and his spokeswoman, Joan Kirchner, said he doesn't like the fact that the House bill would expand Medicare costs by paying for the consultations and giving doctors an incentive to conduct them. He also said the House bill is too specific in detailing what must be discussed in the sessions.

"There are similarities ... but there are substantial difference," Isakson said. "I'm not running away from anything but I'm not going to accept the president of the United States telling people I wrote something that I didn't."

Isakson, who initially called Palin's "death panel" characterization "nuts" in an interview Monday, declined later in the week to criticize Palin's statement, in which she said the measure would force people like her baby Trig, who has Down syndrome, "to stand in front of Obama's 'death panel' so his bureaucrats can decide ... whether they are worthy of health care."

"The best I can read she's applying the House bill and using her child with Down syndrome as an example," Isakson said. "I would never question anyone's defense of their child."

Spokesmen for Lugar and Collins — two other longtime proponents of end-of-life planning — declined to comment on the House bill.

Sen. Charles Grassley, an Iowa Republican and a lead negotiator on health care legislation, told constituents at a community meeting last week that they have good reason to fear the proposal.

"I don't have any problem with things like living wills, but they ought to be done within the family," he said. "We should not have a government program that determines you're going to pull the plug on grandma."

Grassley said Thursday that lawmakers negotiating on the Senate version of the health care bill had dropped the provision from consideration, citing how it could be misinterpreted.

Comments like Grassley's puzzle Rother, who said "it's been a little disappointing" that more Republicans haven't stepped forward to defend the legislation.

He and Jon Keyserling, a vice president at the National Hospice and Palliative Care Organization, say there is little difference between the current proposal and past legislation that Republicans have supported. The current bill specifies that the counseling would be covered only every five years to prevent people from overusing it, and describes what the consultations must include.

Keyserling said many people wrongly assume that end-of-life counseling is about terminating treatment. But it really is about making sure a patient's wishes are known, he said, including if that means continuing life-sustaining treatment in all circumstances.

He said he's been surprised at the backlash, particularly given the close attention that Congress paid to Schiavo's case, which he said clearly highlighted the need for better end-of-life planning.

Schiavo was removed from life support in 2005, though the Republican-led Congress and President George W. Bush had intervened in the family dispute in an effort to continue her care.

"I think the House bill is about as innocuous and helpful as possible," Keyserling said. "It's about making sure people are prepared and informed to make decisions."

[molson]

It's a very delicate matter. Once again the focus is on "Sarah Palin is insane", and the attempt there is to invalidate any opposition, but I think one can have reasonable concerns about this part of the bill.

The goal of Section 1233 is to pull the plug a little sooner on more people. There's no doubt about that. I have no problem with that in theory. And it does also does provide a "service", making sure people know more about their options. But the potential for abuse is there, and I definitely understand how this can freak some reasonable minds out (who unfortunately will be lumped in with Palin, whose continued relevance escapes my comprehension).

I think this is a pretty good article that separates the right-wing hysteria that many liberals are trying to make the center of this issue from the real concerns. It's too bad that the real concerns have so little place in this discussion. It's all fear-mongering and then responses to the fear-mongering.

Charles Lane - House Health-Care Reform Bill Oversteps on End-of-Life Issues - washingtonpost.com

[Flasch186]

Originally Posted by molson

The goal of Section 1233 is to pull the plug a little sooner on more people.

no its not, it is to allow end of life discussions, on a voluntary basis chosen by the patient and their family, to be covered as opposed to waiting until it is too late, like it was for my grandfather who died no semblance of the man I knew, in his awful painful sleepless night (I hope he got a few hours of real sleep) in a fight against pneumonia which was simply the last straw in a steep decline from a hip injury that saw him literally fight to recover eventhough the writing was on the wall. He was miserable, hated every second of it, but was in the machine and thus went through the rigors until the horrible, painful end.

There's no doubt about that.

yes there is

But is also does provide a "service", making sure people know more about their options. The potential for abuse is there.

I think this is a pretty good article that separates the right-wing hysteria that many liberals are trying to make the center of this issue from the real concerns:

Charles Lane - House Health-Care Reform Bill Oversteps on End-of-Life Issues - washingtonpost.com

please dont throw quotes around service to diminish it.

[JPhillips]

Originally Posted by molson

It's a very delicate matter. Once again the focus is on "Sarah Palin is insane", and the attempt there is to invalidate any opposition, but I think one can have reasonable concerns about this part of the bill.

The goal of Section 1233 is to pull the plug a little sooner on more people. There's no doubt about that. I have no problem with that in theory. And it does also does provide a "service", making sure people know more about their options. But the potential for abuse is there, and I definitely understand how this can freak some reasonable minds out (who unfortunately will be lumped in with Palin, whose continued relevance escapes my comprehension).

I think this is a pretty good article that separates the right-wing hysteria that many liberals are trying to make the center of this issue from the real concerns. It's too bad that the real concerns have so little place in this discussion. It's all fear-mongering and then responses to the fear-mongering.

Charles Lane - House Health-Care Reform Bill Oversteps on End-of-Life Issues - washingtonpost.com

And those concerns could easily be handled in the language of the bill if that was a real goal, but the people pushing the forced euthanasia line have no interest in actually solving any language problems in the bill. Don't blame the "hysteria" on liberals. When several Senators and Representatives make the death panel argument it's not the fault of a smelly guy in a coffee bar that has a Bush=Nazi sticker on his MacBook.

[molson]

Originally Posted by JPhillips

And those concerns could easily be handled in the language of the bill if that was a real goal, but the people pushing the forced euthanasia line have no interest in actually solving any language problems in the bill. Don't blame the "hysteria" on liberals. When several Senators and Representatives make the death panel argument it's not the fault of a smelly guy in a coffee bar that has a Bush=Nazi sticker on his MacBook.

Agreed. I called it fear-mongering. You might have missed that. Some liberals take advantage of the right's fear-mongering to frame it as THE opposition, which is completely unfair to those who have legitimate concerns. You have to go along with this, you can't have concerns, because if you do, you're no better than Sarah Palin. It's kind of creepy. It's a way to suppress dissenting speech. I agree that those concerns could potentially (I wouldn't say easily) be handled in the language of the bill, but that's not where the debate is. You're either for justice and against suffering people, or you're a right-wing crazy. There's no voice in this debate for reasonable concerns. They're just not allowed to be acknowledged - I get the same response from your or Flash as if I was talking about death counsels.

[JPhillips]

No, you can have concerns and they can be addressed, but those in a position to actually make decisions have no interest in working on the bill's language to make it better. Grassley is one of the lead negotiators for Republicans and he's been pushing the death panel idea. While you have legitimate concerns, the people making the decisions really aren't any better than Sarah Palin.

[molson]

Originally Posted by JPhillips

No, you can have concerns and they can be addressed, but those in a position to actually make decisions have no interest in working on the bill's language to make it better. Grassley is one of the lead negotiators for Republicans and he's been pushing the death panel idea. While you have legitimate concerns, the people making the decisions really aren't any better than Sarah Palin.

So what? Why is this always the response, what the Republican leaders are talking about? I'm not a supporter of Republican leadership. What about the people that will actually be subject to this bill? When I try to start a debate here about reasonable concerns, you keep throwing Palin, Palin, Palin, Palin, Republican leadership, Republican leadership, Republican leadership. That's a small but telling example of what's going on in this debate throughout the country.

Yes, if Republican leaders were smarter and cared more about the citizens and weren't only concerned with team politics, they'd turn down their rhetoric and express the concerns in a more reasoned way. But that ain't happening. So fuck the concerns, I guess. And for liberals who love responding to the right's rhetoric - as long as they can view is as the fault of the other side, as long as they feel like they're on the "winning team", they don't seem to be very sensitive to those concerns.

[JPhillips]

Nobody's called you out or lumped you in with all Republicans or Sarah Palin or whatever. The article Flasch posted was about elected officials and Republican leaders. When you posted concerns they were addressed without lumping you in with anyone else.

Ultimately what you think or I think has little relevance. In a representative democracy the most important opinions are those making the decisions. Of course we're going to talk about them.

[Flasch186]

yes.

Palin is forcing the people more like you in the GOP to slide her way and the fringe element is forcing the muting of the compromisers, maybe on both sides.

[molson]

Blame and political points seem more important than getting a good bill. To everyone, leadership on both sides. That's why this thing is going to fail. (I don't know if I mean this health care bill or America)

I tried to call something of a truce of sanity here - to back away from Palin and highlight the real concerns, but people have no interest in that. They want to win! They want to feel superior to the other side!

[Flasch186]

and I will then point you back to my "millions" post

OR

it will get shoved down some people's throats, bad facets and all

OR

we will have to wait for either the pendulum to continue its swing further left or back to the right.

The losers will be us.

[JPhillips]

Originally Posted by molson

Blame and political points seem more important than getting a good bill. To everyone, leadership on both sides. That's why this thing is going to fail. (I don't know if I mean this health care bill or America)

I tried to call something of a truce of sanity here - to back away from Palin and highlight the real concerns, but people have no interest in that. They want to win! They want to feel superior to the other side!

Again, your concern was addressed. But why isn't it a legitimate point to state that the minority party has no interest in making the bill better, but is instead focused on using whatever tactics are necessary to kill it? That's what is happening here and the legitimate concerns are being sidelined because they aren't as effective as the lies.

We can have a discussion about healthcare, and I think we have had a fairly productive discussion as long as Allah hasn't been involved. However, in the real world a very small group of people are going to be responsible for what does or doesn't get signed into law. To ignore the realities of the legislative process is to ignore the realities of our system.

[Flasch186]

...and I was thinking about it. Isnt that what the last facet of the debate in this thread was about (ignoring the Allah section)? The idea that the vocal are drowning out the middle? If it's happening in the news, happening in the talk shows, happening in here, isnt it incorrect for the parties in this thread before that tried to state that the town halls and the masses were lining up against this particular health care bill, when in reality it is as you say it is and the health care bill is truly secondary to many many real points of interest?

[RainMaker]

The irony in this mess is the people who who need health care reform the most are the ones against it.

[sterlingice]

Originally Posted by RainMaker

The irony in this mess is the people who who need health care reform the most are the ones against it.

Welcome to 2005 (and before)

Amazon.com: What's the Matter with Kansas?: How Conservatives Won the Heart of America (9780805077742): Thomas Frank: Books

SI

[Dutch]

Originally Posted by RainMaker

The irony in this mess is the people who who need health care reform the most are the ones against it.

I would be interested in some demographic breakdowns of who has and who doesn't have health care and what kind of jobs they have.

Does anybody have a good reference site for this stuff?

[SteveMax58]

Originally Posted by RainMaker

The irony in this mess is the people who who need health care reform the most are the ones against it.

While I think you were just throwing that out anecdotally...if in fact mostly true...then that would mean that the people pushing this legislation do NOT need it.

So I'll ask the stupid question of the day...why do we need this bill?

I liken this to the Bush tax cuts where rich people on the left were speaking out about how they felt they needed to be discontinued. Economic reasons for pro and con aside(I dont mean to dismiss them, it just isnt the point)...why have we become a country that seemingly
(a) looks out for somebody else's immediate interests more than our own
(b) cannot trust ourselves to donate (or payback) money into the government where it is needed
(c) became an entire nation of philanthropers right under our own noses?

[Arles]

Originally Posted by Flasch186

yes.

Palin is forcing the people more like you in the GOP to slide her way and the fringe element is forcing the muting of the compromisers, maybe on both sides.

So much for focusing on the arguments and not the messenger. If it will help move this discussion, I will gladly admit that I have little faith in the republican party to provide any reasonable solution to the health care crisis.

But that doesn't mean I'm going to jump off the Obama ledge because "something needs to be done". All we can do is keep the debate going until a more reasonable solution appears (if that ever happens). In the meantime, I will guarantee that some on the left will sound like fools and the right will have its own set of oddballs.

If people want to focus on the "my D- is better than your F" political party comparison - enjoy. You'll have plenty to banter as you explain why you are the tallest person at the midget convention.

[Flasch186]

The argument isn't accurate from that messenger. It is a scare tactic.

I guess Im not sure if your comment was directed at me or the idea in general that Palin is the spotlight instead of the message carrying weight...

[duckman]

Flasch, you just don't get it. We don't care about the messenger. We want to hear the message from BOTH sides of the debate. You cannot make an informed decision just hearing from one side of the argument because they have less 'spin.' The fact is that both sides are spinning the hell out of this debate. It's how they get people to pay attention to their message, right or wrong.

Instead of listening to the arguments and discussing their merits, you attack the messenger, thus negating any credibility on your part. You become a part of the spin machine of the Democratic Party. If you claim to be so independent, act like it for once! Use the thing in your skull that separates us from the rest of the animal kingdom.

[Flasch186]

youre wrong...IMO, I do get it just fine.

I believe that Palin is grabbing more of the neutral people to her side (on a graph it might be an extra 3% or something I guess, but that adds up). Eventhough the message she has put out there is false it is that 'win' that Arles mentioned that has trumped the vision of a solution. That is a bad thing, to win by misinforming.

For example, the moderate GOP member who was pushing for this that called her a name at first is now backpedaling. Why? Because of the pressure that even spun arguments are causing. This is not good for you or me since it will make finding a solution that much harder.

I agree with you in that this is occurring, right or wrong. I believe wrongly if one uses a scare tactic, or hyperbole as you'd liken it, to take those that maybe aren't as well read on the topic at hand and push them into a corner. This is why you see the debate taking on all sorts of deeper facets about things that have nothing to do with health care or their costs.

Now you say we, but look back in this thread alone and see that the scare tactics do have an effect, just from links alone.

For some reason I think perhaps youre seeing the word "Palin" and insinuating something from the word alone. On the otherhand I view her as a leader not just of the GOP but of many people out there who look up to her for right or wrong, good or bad thus IMO she is being very untruthful in her statements but strategic and smart for her goal which is why I do believe in this case, due to her stature to her fans, the messenger is somewhat more important than average joe.

As my sales partner just said after a short re-read, "If celebrity backing didnt mean anything people wouldnt get paid millions to do it." and she's a Republican.

I think I get it just fine.

[molson]

Is there one Democrat, on the planet earth (or at least FOFC) that has ANY concerns at all about this plan? Is there any Democrats that would change anything, or think that any of the plan is misguided? I haven't seen that here, and I haven't much of it anywhere else. It would seem that this plan is absolutely perfect in every way, in their view.

Any plan, anything that was devised, would be supported by the same old regular people. If we had an alternative reality where there was a different plan out there, it would still be supported by the same people. So how can the arguments of these supporters have any credibility?

Obviously, it's not everyone. There's certainly tons of Democrats I respect and it's easy to see whose opinion is worth something - they don't blindly support everything that their team spits out.

That's yet another problem with team politics. The plan doesn't have to be good. You can't question your team. You have to go along with your team, and attack the other team.

[Flasch186]

Originally Posted by molson

Is there one Democrat, on the planet earth (or at least FOFC) that has ANY concerns at all about this plan? Is there any Democrats that would change anything, or think that any of the plan is misguided? I haven't seen that here, and I haven't much of it anywhere else. It would seem that this plan is absolutely perfect in every way, in their view.

yes I have concerns. As I mentioned above in my "millions of people" post there are a million different concerns including their costs.

Any plan, anything that was devised, would be supported by the same old regular people. If we had an alternative reality where there was a different plan out there, it would still be supported by the same people. So how can the arguments of these supporters have any credibility?

Unfortunately right now there isnt 1 bill I support in its entirety and there are a bunch of different facets of multiple bills being bantered about. I have great concerns over cost BUT I will say this, as Ive said before:

"If you dont trust the mouthpiece's words, than what is there to talk about?"

If Obama says it must be Self Sufficient and you scoff and say, "Well thats a pipe dream." than what is left to talk about? Same as during the campaigns, if you dont take someone for their word than you can tune out and just vote for the person you wanted to anyways. Same thing here.

Obviously, it's not everyone. There's certainly tons of Democrats I respect and it's easy to see whose opinion is worth something - they don't blindly support everything that their team spits out.

That's yet another problem with team politics. The plan doesn't have to be good. You can't question your team. You have to go along with your team, and attack the other team.

That is unfortunate about the 'win' thing we have been talking about. I think whomever on both sides wants to see 'win' at all costs OR let the other 'team win' so that they'll fall on their sword and we can 'win' later, is really aborting the welfare of the people and our country.

[molson]

Originally Posted by Flasch186

yes I have concerns. As I mentioned above in my "millions of people" post there are a million different concerns including their costs.

I wish the Democrats didn't give a shit about appeasing the Republicans. The Democrats should be debating amongst themselves in Congress. That's where productive disagreement and improvement might be possible. But they're apparently too afraid. One Democratic voice v. One Republican voice sucks. We need the Democrats to start mixing it up in their own party.

Why are they giving Palin power at all? Everyone complains about her mouthing off, but how much power does she have? We're not bringing this plan to a general vote. Maybe some Republicans will complain that the bill isn't "bi-partisan" but who the fuck cares - isn't that why we have elections? I'd rather have a plan that involves Democrat disagreement and compromise than anything that's "bi-partisan". If they believe in the plan, they need to stake their political careers on it. If they're not willing do to that, then you have nobody to blame for Palin's influence.

What's the end game goal of this crusade by the Democrats - to get Palin to change her mind? To get Republicans to stop following her and start following them? I don't care how many websites they set up or town halls they have. People's feet are DUG IN on this. Even if you can convince someone that there won't be a "death counsel", there's not going to up and join your party the next day. They'll disagree on some other basis. This entire barnstorming for support strategy has been a disaster. It hasn't increased support, it's increased resistance. The fact that the resistance is perceived as "wrong" is irrelevant.

[Flasch186]

Well I think the debate is healthy if it stays on topic no matter the parties involved. I think the Blue Dogs have done a good job of being a concerned voice as well as some of the members of the GOP. I just hope the opposition is opposed to the bill based on the bill's pros and cons and not issues on the periphery or a broader 'win' strategy. If so than their voices should be heard. Fringe voices tend to get the headlines and thus more sheep but its the more moderate heads behind closed doors that'll get a solution put forth that people can then truly talk about. Honestly, I think talking about the bills now is somewhat of a fruitless endeavor. PS my GOP friend here agrees with that.

Since you added the death panel part let me answer in this edit my stance:

Im not trying to change anyone's mind on anything. I simply want the rhetoric to be truthful, that is all and leaders, be it in politics or not, to realize that their words carry more weight than average Flasch, or Molson, or MBBF and thusly they have a duty to be more deliberate in their choices. If she's read up on the topic and is against the bill than she should voice that opinion but simply leave out misinformation. That is all. If people disagree with a facet of the many bills being talked about based on that facet than I say more power to them. The resistance isnt "wrong" by any means as long as theyre resisting what is actually in the bill itself as opposed to the grander conversation or misinformation being spun. heck, dissent is what I was clamoring for for all the years of the Bush administration after I turned against the war in Iraq so I would be a hypocrite to be against it now. Dissent is good. Dissent that is based on lies (just like support based on lies) is dangerous.

On that note, I have heard some great cases both for and against the bills and their facets on CNBC since this started and rarely are the scare tactics involved. It can be done.

[KWhit]

Originally Posted by SteveMax58

While I think you were just throwing that out anecdotally...if in fact mostly true...then that would mean that the people pushing this legislation do NOT need it.

So I'll ask the stupid question of the day...why do we need this bill?

I liken this to the Bush tax cuts where rich people on the left were speaking out about how they felt they needed to be discontinued. Economic reasons for pro and con aside(I dont mean to dismiss them, it just isnt the point)...why have we become a country that seemingly
(a) looks out for somebody else's immediate interests more than our own
(b) cannot trust ourselves to donate (or payback) money into the government where it is needed
(c) became an entire nation of philanthropers right under our own noses?

I don't know how you can argue that A and C are accurate. I think we overall are a country of individuals that looks out for their own interests much more than for others'. See the economic meltdown for evidence.

[KWhit]

Originally Posted by molson

Is there one Democrat, on the planet earth (or at least FOFC) that has ANY concerns at all about this plan? Is there any Democrats that would change anything, or think that any of the plan is misguided? I haven't seen that here, and I haven't much of it anywhere else. It would seem that this plan is absolutely perfect in every way, in their view.

Any plan, anything that was devised, would be supported by the same old regular people. If we had an alternative reality where there was a different plan out there, it would still be supported by the same people. So how can the arguments of these supporters have any credibility?

Obviously, it's not everyone. There's certainly tons of Democrats I respect and it's easy to see whose opinion is worth something - they don't blindly support everything that their team spits out.

That's yet another problem with team politics. The plan doesn't have to be good. You can't question your team. You have to go along with your team, and attack the other team.

I see a lot wrong about the health care bill. We need a single-payer system like the rest of the world seems be able to make work, but that will never happen because it's (gasp!) "socialism."

[molson]

Originally Posted by KWhit

I see a lot wrong about the health care bill. We need a single-payer system like the rest of the world seems be able to make work, but that will never happen because it's (gasp!) "socialism."

If Democrats want to do that, and they're so sure it's going to work, they have the numbers to do it. I'd love to see a Democratic single-payer v. multi-payer debate be the center of this thing right now. Instead we have a debate over the existence of death counsels, and how best to mitigate Republican influence. Hey, I know how to do the latter - ignore them!

Why is everybody even complaining about Palin and town hall reactions if this thing is going to work? The Republicans are at their lowest point in decades, and they're still wielding all this power somehow.

[KWhit]

Originally Posted by molson

If Democrats want to do that, and they're so sure it's going to work, they have the numbers to do it. I'd love to see a Democratic single-payer v. multi-payer debate be the center of this thing right now. Instead we have a debate over the existence of death counsels, and how best to mitigate Republican influence. Hey, I know how to do the latter - ignore them!

Why is everybody even complaining about Palin and town hall reactions if this thing is going to work? The Republicans are at their lowest point in decades, and they're still wielding all this power somehow.

But the Democrats aren't all the same. The Blue Dogs won't go for a single-payer system because their constituents won't let them (will not re-elect them if they support it).

[molson]

Originally Posted by KWhit

But the Democrats aren't all the same. The Blue Dogs won't go for a single-payer system because their constituents won't let them (will not re-elect them if they support it).

Exactly - Democrats aren't the same. That's what I'm still hopeful for - I want to see them fight it out amongst themselves and come up with the best plan possible. Not lob missiles at Sara Palin.

Maybe there's not the support for a single-plan right now, but this is definitely the opportunity for the supporters of that idea to gain some ground.

Maybe this debate does go on behind the scenes, for all I know. But I'd love to see Democrats publicly disagreeing with Democrats, same with Republicans. That would warm my heart. Everyone's more concerned with having a unified front for some reason.

[JPhillips]

The problem is a lot more complicated than a simple numbers game. Look at Baucus. He's got enormous power in all of this because he's the chair of the Finance Committee and he's decided that instead of only worrying about how it's financed, he wants to have control of the bill. If the Dems didn't stick to seniority in committee assignments a bill would have gotten to a floor vote weeks ago.

But the general point that the Dems are too chickenshit won't get any argument from me. Despite your belief that I'm all for the Dems, that just isn't true. I have policy goals that often align with the Dems, but the elected officials often piss me off. That's why I don't give money to them.

Personally I think there's a lot wrong with the bills being discussed and the longer Grassley has veto power the shittier they get. I'll stick with what I've believed from the beginning, without real cost controls the final bill will likely be worse than doing nothing. Then we can revisit this in ten or fifteen years when Medicare is really busting the budget.

[Arles]

Originally Posted by molson

Exactly - Democrats aren't the same. That's what I'm still hopeful for - I want to see them fight it out amongst themselves and come up with the best plan possible. Not lob missiles at Sara Palin.

It's no secret that I normally vote republican, but I think this would be extremely interesting. I think that initial steps can be taken (as I've stated numerous times in this thread) and that the democrats are the only ones who have a chance at doing this.

It's fine to have an ultimate goal of a single-payer system, but even if I could wave a magic wand and make it happen - it would be a disaster. We don't have anything remotely close to a needed infrastructure for the medical needs, financial needs and patient needs for a single-payer system to work.

In fact, if I was an extremely cynical republican team-first guy - I'd be all in favor of a single-payer system passing. It will bomb horribly, the democrats will lose a ton of seats (and maybe the presidency in 2012) and the single-payer dream will be dead.

Instead, the democrats need to be smart if this is their goal. Do a bill that slowly improves on the infrastructure with tax incentives, setup a "poverty single-payer plan" for those under 30K, extend unemployment coverage for those who lose their jobs and provide additional tax incentives for small business owner to buy private health care. Leave the 70+% of people with solid employer-provided coverage alone. This won't cost a ton and there will be some small victories (more people covered, more protection for those that lose their job, improved infrastructure,...). Plus, it takes the boogie man argument away from the republicans.

They don't need the republicans to do any of this stuff, but for some reason it's either all or nothing with this crew in congress. It's almost like the attitude is that if we can't help all 30 people in a room without insurance, we will do nothing. Even if there's a very solid initial attempt that could help 18 of the 30, they want no part of it. All or nothing. The problem with this is even if you win, you lose as we are not capable of supporting such a shift if it's passed (esp before the next set of elections).

[JPhillips]

There is no movement in Congress for a single payer system. What's being proposed is a small step, largely what you've stated support for with the addition of a public option to force competition in the insurance market. All the talk of nationalized healthcare is going way beyond what's currently being discussed.

But again, the real problem is the rising costs of healthcare. If the curve isn't flattened to some degree we'll be in a real crisis in a couple of decades when the only options are large tax increases or severe cuts in Medicare. I don't think this bill will do enough to cover costs as too many Senators seem inflexible on any costs reductions, but that's the real problem. We could cover all the uninsured tomorrow if we wanted, but that still won't solve the impending budget crisis.

[Flasch186]

Originally Posted by molson

If Democrats want to do that, and they're so sure it's going to work, they have the numbers to do it. I'd love to see a Democratic single-payer v. multi-payer debate be the center of this thing right now. Instead we have a debate over the existence of death counsels, and how best to mitigate Republican influence. Hey, I know how to do the latter - ignore them!

Why is everybody even complaining about Palin and town hall reactions if this thing is going to work? The Republicans are at their lowest point in decades, and they're still wielding all this power somehow.

I think that that is a good thing. When the GOP was in office I was upset that they didnt listen to the Democratic minority to the point of changing the rules sometimes to keep them in the closet, so to speak. I dont want to trample on the GOP's voice either. FWIW, Im not complaining about Palin simply the verbiage she, and other people in role model positions, are using.

[RainMaker]

Originally Posted by SteveMax58

While I think you were just throwing that out anecdotally...if in fact mostly true...then that would mean that the people pushing this legislation do NOT need it.

So I'll ask the stupid question of the day...why do we need this bill?

I liken this to the Bush tax cuts where rich people on the left were speaking out about how they felt they needed to be discontinued. Economic reasons for pro and con aside(I dont mean to dismiss them, it just isnt the point)...why have we become a country that seemingly
(a) looks out for somebody else's immediate interests more than our own
(b) cannot trust ourselves to donate (or payback) money into the government where it is needed
(c) became an entire nation of philanthropers right under our own noses?

It's an odd setup in this country. I can understand people not liking this particular plan, but it seems like many on the right are just against health care reform.

I bring it up because the red states are for the most part the unhealthiest with the lowerst life expectancy. When you're life expectany is almost 5 years lower than someone living in another state or country, you'd think you'd be about getting some change.

[RainMaker]

Originally Posted by SteveBollea

Also, I'd point out to Arles that in every other nation that single-payer or universale health care has passed, it's extremely popular and no major politician supports it's repeal or even major reforms to it. I'm sure many Republicans in 1935 were saying, "heh, Social Security will fail and we'll kick this Rossevelt out of office!" or were saying in 1965, "heh, Medicare will fail and we'll kick LBJ out of office!"

That's the funny thing. I lived in Canada and no one really complained about their system. I think the biggest gripe I saw was that you'd sometimes have to go in at odd times to get tests done. I remember hearing about people having to go in at like 5am for MRIs.

There is no pressure in these other countries to reform health care and go back to a private system. I mean if all these other countries are happy with what they have and live longer, you'd think people here would take notice.

[Arles]

Originally Posted by SteveBollea

If you guys want to see a Democratic vs. Democratic argument about single-payer versus Obama's plan, go to any major liberal blog.

Also, I'd point out to Arles that in every other nation that single-payer or universale health care has passed, it's extremely popular and no major politician supports it's repeal or even major reforms to it. I'm sure many Republicans in 1935 were saying, "heh, Social Security will fail and we'll kick this Rossevelt out of office!" or were saying in 1965, "heh, Medicare will fail and we'll kick LBJ out of office!"

It's a different world than in 1935 or 1965. We also had the stomach for Normandy, World War I, dropping the bomb on Japan and numerous other actions that would not fly today. The extremely critical press combined with a 24 hour news cycle means one month passes like a year did in 1935.

Social Security and Medicare also provided options to people who didn't have any. 80% of US citizens have some form of health care, with many people having fairly cost-effective (for them) and quality plans provided by their employer. If these 80% start seeing longer waits, rationed care and more difficult access to doctors (combined with higher taxes), there will be a pretty big outcry. I think most people are fairly ambivalent on this issue unless it starts costing them a lot more or their health service/wait times/access worsens. That, IMO, is why the democrats want a lot of cover with this bill. They know it will get worse until it gets better and this isn't the 1940s where Americans will sit and listen to thousands of soldiers dying abroad and not bat any eye. We don't have the stomach for any kind of pain in 2009 (war, health care, economy, you name it).

Originally Posted by RainMaker

There is no pressure in these other countries to reform health care and go back to a private system. I mean if all these other countries are happy with what they have and live longer, you'd think people here would take notice.

They live longer in Europe because they have better diets and healthier lifestyles (virtually no one eats fast food and foot/bike travel is much more prevalent).

If happiness is all that counts, 89% of Americans are happy with their own personal medical care according to June poll here: EDITORIAL: Health care's big secret - Washington Times

There's no reason to nationalize health care because most Americans are happy with the coverage they receive -- including most of those who don't have health insurance.

Eighty-nine percent of Americans are satisfied with their own personal medical care, according to an article in Regulation magazine this week. Of those with insurance who had suffered a serious illness during the last year, 93 percent were satisfied; 95 percent of those who suffered chronic illness were satisfied with their health care.

Zogby had a similar finding in June of 2009:
http://www.zogby.com/news/wf-healthcarereform.pdf

505. How Satisfied are you with your health care?
Very satisfied - 46.2%
somewhat satisfied - 37.3%
somewhat unsatisfied - 8.8%
not at all satisfied - 6.8%

83.5% either very or somewhat satisfied

[RainMaker]

Originally Posted by Arles

They live longer in Europe because they have better diets and healthier lifestyles (virtually no one eats fast food and foot/bike travel is much more prevalent).

Same for babies who have better mortality rates? At some point you have to judge health care by the actual health of people.

Originally Posted by Arles

If happiness is all that counts, 89% of Americans are happy with their own personal medical care according to June poll here: EDITORIAL: Health care's big secret - Washington Times

Zogby had a similar finding in June of 2009:
http://www.zogby.com/news/wf-healthcarereform.pdf

They are happy with the care they receive. We have great doctors and great technology. The issue has never been the quality of care that our doctors and hospitals offer. The issue has always been the cost and whether those who are uninsured are able to access doctors on a regular basis.

We've also never lived under a different system. Ask people on Medicare if they'd like to switch to a private system. I'd be interested to see a poll of people who have lived in countries like Canada or the UK and the U.S. As someone who has lived in both, Canada's system is just better for the country.

[Arles]

Originally Posted by SteveBollea

Most people are satisfied with the actual _care_ they get. What people get pissed about is having to deal with insurance companies multiple times just to get a procedure paid for and/or the costs involved in getting that care. That to be blunt is a pointless poll.

From a CNN poll, "But satisfaction drops to 52 percent when it comes to the amount people pay for their health care, and more than three out of four are dissatisfied with the total cost of health care in the United States."

If you ask people if they are happy with their house, most say 'Yes'. If you ask them if they're happy with their mortgage payment, that numbers drops a great deal. No one is "happy" to be paying for anything.

My point was that most people with health care are happy with the quality of service they are getting. So, coming up with a solution that had a high chance of impacting that service (wait times, rationing, ...) should be a last resort after other things (ie, targeting cost/uninsured) have been tried.

Also, the idea that 80% of people already have health care, so no real change to be needed is sort of silly. A lot of people who have health insurance get screwed over by their insurance companies at the end of the day.

Polls don't show that. No one likes the cost of insurance (and no one ever will), but the above quote has 90+% of insured people with chronic illnesses being happy with their own insurance quality. Again, this whole thing reeks of throwing the baby out with the bath water.

As far as your argument about the American people not having the stomach, I don't believe that. I just think nobody has challenged the American people in generations. To quote John Edwards, "we need to be patriotic about more than just war."

Well, the trillions in stimulus and the massive drop in the war approval after less than 5,000 deaths says otherwise. We don't have the stomach for any pain in the US because the minute it happens, we see it 24/7 on our TVs - making it seem 100-times worse.

Originally Posted by RainMaker

Same for babies who have better mortality rates? At some point you have to judge health care by the actual health of people.

That's mostly hereditary (ie, obesity) and class oriented. The reality is that we have a much higher number in poverty than Europe or Canada (partly because we have 300 million people). It's not like the US has parents who can't afford to give birth and hire a bunch of mid-wives while the great European health care system allows for births on golden chairs. Mortality rates reflect poverty levels/obesity, not health care systems. If these countries had to support populations at nearly a third of what the US is, their mortality rates would skyrocket as more would be in poverty.

I'd be interested to see a poll of people who have lived in countries like Canada or the UK and the U.S. As someone who has lived in both, Canada's system is just better for the country.

I'd be interested in that too, I doubt it would end up as you think (my guess is 50-50). My neighbors and their family are from the UK and despise British health care. Here's a recent quote of hers on facebook:

Big fat British NO to Government run health plans - do we really think Politicians on Capitol hill have the experience and expertise to run healthcare as well as manage fiscal policy, foreign affairs and the list goes on. Jack of all trades, master of none!

To site some very personal experience living in and being affected by 'social medicine' - my sister diagnosed with ankylosingspondilitus was left untreated, very poorly and unable to walk at age 14 or so to wait for an appointment with a specialist who once she visited got her on the right medication, treatment plan and rehabilitation to now be an avid runner among many other sporting activities and running the NY marathon this year. She would never have been left that long to suffer through great pain in this country. Secondly, watching my Dad diagnosed with Stage 4 cancer in September to die 3 months later, because his family practitioner didn't have the b&@% to tell him he had cancer, and after months of extraneous tests to try.

and find out what was wrong, all going down the wrong path. Again, would never have happened here and perhaps could have been diagnosed earlier and lived a bit longer.
I'd rather have the 'corporate suits' with a bottom line incentive to deliver efficient, affordable healthcare focusing on wellness and prevention than my political leaders wrapping it up in red tape.
Oh, and did I mention the massive, british-size increase in taxes we'd all see and that the NHS was on the brink of complete collapse NO THANKS!

[Arles]

For those wondering about the British NHS, here's an article on the major issues it faces moving forward:

The NHS is on the brink of collapse and cannot be saved unless Gordon Brown intervenes when he becomes prime minister to give doctors the authority to organise a recovery, the leader of Britain's 33,000 hospital consultants will claim today.

Jonathan Fielden, chairman of the British Medical Association's consultants committee, will tell Mr Brown: "Political meddling has brought the NHS to its knees. Unshackle the profession, give us back the health service, and we will rebuild it. Fail to do so and you will rightly be condemned for destroying the best piece of social capital the country has ever had."

http://www.guardian.co.uk/uk/2007/ju...ealth.politics

Seriously ill patients are being kept in ambulances outside hospitals for hours so NHS trusts do not miss Government targets. Thousands of people a year are having to wait outside accident and emergency departments because trusts will not let them in until they can treat them within four hours, in line with a Labour pledge.

The hold-ups mean ambulances are not available to answer fresh 999 calls. Doctors warned last night that the practice of "patient-stacking" was putting patients' health at risk. Figures obtained by the Liberal Democrats show that last year 43,576 patients waited longer than one hour before being let into emergency units.

A&E patients left in ambulances for up to FIVE hours 'so trusts can meet government targets' | Mail Online

The London Telegraph reported Tuesday that the British government has a "plan to save billions of pounds from the NHS budget." But it won't come without enormous pain.

"Instead of going to a hospital or consulting a doctor, patients will be encouraged to carry out 'self-care' as the Department of Health tries to meet Treasury targets to curb spending," the Telegraph explained.

http://www.ibdeditorials.com/IBDArti...84257033287107

Hospital waiting times are longer than under the Conservatives, despite £90billion being ploughed into the health service this year alone.

But doctors said patients with serious illnesses were among those still waiting too long, while those with comparatively minor problems were being fast-tracked to meet the Government's 18-week target.

Many of the big falls in waiting have been seen in conditions such as cataracts and dermatitis and eczema.

Yet the figures, obtained by the BBC from the NHS Information Centre which collates statistics on health and social care, show that for some cancers average waiting has increased slightly.

Jonathan Fielden, chairman of the British Medical Association's consultants' committee, said: "All that has happened is that the Government has put an end to the really long waits and the really short waits.

"Doctors have been stopped from using their clinical judgment and pushing people through the system when they need to.

"Of course, it is good that the really long waits have gone, but it is wrong to say that all patient care has improved because of shorter waits."

Katherine Murphy, of the Patients' Association, said: "These figures make us really question whether patients are getting a better deal.

"What concerns me is that patients with serious conditions may be waiting longer than they used to. That is wrong."

Average NHS waiting times have RISEN under Labour - despite £90bn investment | Mail Online

Yeah, sounds like a plan we should all be envy of in the States.

[JPhillips]

Originally Posted by Arles

For those wondering about the British NHS, here's an article on the major issues it faces moving forward:

http://www.guardian.co.uk/uk/2007/ju...ealth.politics



A&E patients left in ambulances for up to FIVE hours 'so trusts can meet government targets' | Mail Online


http://www.ibdeditorials.com/IBDArti...84257033287107


Average NHS waiting times have RISEN under Labour - despite £90bn investment | Mail Online

Yeah, sounds like a plan we should all be envy of in the States.

Again, there is no plan in Congress that would create anything remotely like the NHS. Whether or not NHS is good or bad is irrelevant to the discussion.

[Dutch]

Originally Posted by JPhillips

Again, there is no plan in Congress that would create anything remotely like the NHS. Whether or not NHS is good or bad is irrelevant to the discussion.

I keep hearing how "everybody else's is better", how is it not relevant???

[JPhillips]

Well the NHS may be the worst example of a single payer system and their big problem is that they don't spend enough money on it. Did you know that the US already spends more tax dollars per capita on healthcare than the UK? If the UK matched our total spending per capita on healthcare I'd expect the NHS to be fantastic. The NHS gets trotted out because it's the easiest to find flaws with, but if you look at other European systems you can find single payer that works very well.

[RainMaker]

Originally Posted by Arles

If you ask people if they are happy with their house, most say 'Yes'. If you ask them if they're happy with their mortgage payment, that numbers drops a great deal. No one is "happy" to be paying for anything.

But we have reason to gripe about health care. We pay twice as much as other countries and are not getting back more in return. With a mortgage it's our choice, with health care we have no choice in what we pay.

We have great doctors and great medical technology. No one in this health care debate is arguing that. The poll has nothing to do with what's being debated. The issue is costs and access. Our health care system is great if you are healthy, have money, and have health insurance.

Originally Posted by Arles

That's mostly hereditary (ie, obesity) and class oriented. The reality is that we have a much higher number in poverty than Europe or Canada (partly because we have 300 million people). It's not like the US has parents who can't afford to give birth and hire a bunch of mid-wives while the great European health care system allows for births on golden chairs. Mortality rates reflect poverty levels/obesity, not health care systems. If these countries had to support populations at nearly a third of what the US is, their mortality rates would skyrocket as more would be in poverty.

There are some extremely poor countries with better infant mortality rates than us. Obesity is also an issue that needs to be addressed with doctors and patients. The overall goal for health care is to live longer and healthier. You can't keep throwing the end results out the door because it doesn't fit your argument.

It's akin to saying your football team is faster and stronger than everyone else but not caring whether they win more games.

Originally Posted by Arles

I'd be interested in that too, I doubt it would end up as you think (my guess is 50-50). My neighbors and their family are from the UK and despise British health care. Here's a recent quote of hers on facebook:

Your neighbors prefer corporate suits to decide the fate of their health. That's fine, but at least with a politician I'm getting someone who has a vested interest in me being happy and getting better (votes).

[SteveMax58]

Out of curiosity...why wasn't France on that list?

[RainMaker]

Originally Posted by Arles

For those wondering about the British NHS, here's an article on the major issues it faces moving forward:

http://www.guardian.co.uk/uk/2007/ju...ealth.politics


A&E patients left in ambulances for up to FIVE hours 'so trusts can meet government targets' | Mail Online


http://www.ibdeditorials.com/IBDArti...84257033287107


Average NHS waiting times have RISEN under Labour - despite £90bn investment | Mail Online

Yeah, sounds like a plan we should all be envy of in the States.

And despite these horror stories of having to wait, they seem to find a way to live longer than us. They also get by paying a much smaller amount as to what we pay.

[rowech]

I continue to love how we bring up countries that have 60 million or less people and expect a system for 300 million to go just as smoothly. Most of these countries are similar in size to California and we've seen how well they run things.

[RainMaker]

I'm assuming those against the national health care system are opposed to having Medicare too, right?

[Flasch186]

looks like the Co-op option is gaining traction. Lets see if the other side of the debate wants to come to compromise too.