The Obama Presidency - 2008 & 2012

[Arles]

Originally Posted by JPhillips

I don't have much fear that businesses will start shedding their insurance plans, especially with all the restrictions on the public option. Why don't businesses shed health plans now when they don't face a fine?

It's a cultural requirement and it's needed to be competitive. If you are faced with having no insurance at job X or making less money in a worse environment with insurance in job Y, 90% of people will choose job Y.

If there is a public option companies can use for cover culturally/politically and save money by dropping care, many will look at that. A lot of companies would love to drop coverage right now but it's not a realistic option given the stigma attached to not having it.

A good point in MBBF's linked article is the fear that some current plans won't be "good enough" and it will cost even more to meet new government regulations. Depending on the scope of these requirements, some companies may just punt on providing health care as getting a short-lived penalty for not providing coverage is better than providing coverage and realizing you don't cover a certain thing and getting a fine/penalty for that.

[SteveMax58]

Originally Posted by JPhillips

I don't have much fear that businesses will start shedding their insurance plans, especially with all the restrictions on the public option. Why don't businesses shed health plans now when they don't face a fine?

But in theory...doesn't the public option need more businesses to actually be able to drive down costs? Otherwise...what leverage does a public option have to set rates and mitigate inflationary costs if it doesn't have a competitively large base of clients?

[Arles]

Originally Posted by SteveMax58

I understand that concern but similar to the way mant (most?) companies are incorporated in Delaware...why can't states also insist that insurance companies offering policies in their state must also adhere to their own regulations? Or if that isn't plausible enough (or loopholes still exist), why not federally mandate this?

I definitely see the issue with lack of competition but also don't see why we can't try this step first.

I think that must be a part of any state-to-state option. Still, I really see no downside to this and it won't cost much. This again comes down to why aren't we doing some very simple/cheap things to impact cost (opening state-to-state competition, looking into medical malpractice reform, improve health information technology and care-provider infrastructure). All these things are fairly simple to institute and will cost a fraction of any of these plans in congress. Plus, they would almost certainly amount to more cost savings than the $800 billion monster being bantered about.

[JPhillips]

Originally Posted by Arles

It's a cultural requirement and it's needed to be competitive. If you are faced with having no insurance at job X or making less money in a worse environment with insurance in job Y, 90% of people will choose job Y.

If there is a public option companies can use for cover culturally/politically and save money by dropping care, many will look at that. A lot of companies would love to drop coverage right now but it's not a realistic option given the stigma attached to not having it.

A good point in MBBF's linked article is the fear that some current plans won't be "good enough" and it will cost even more to meet new government regulations. Depending on the scope of these requirements, some companies may just punt on providing health care as getting a short-lived penalty for not providing coverage is better than providing coverage and realizing you don't cover a certain thing and getting a fine/penalty for that.

But the current public option restrictions will exclude many workers if they are dropped from their coverage, so those cultural requirements will still be in place.

[JPhillips]

Originally Posted by SteveMax58

I understand that concern but similar to the way mant (most?) companies are incorporated in Delaware...why can't states also insist that insurance companies offering policies in their state must also adhere to their own regulations? Or if that isn't plausible enough (or loopholes still exist), why not federally mandate this?

I definitely see the issue with lack of competition but also don't see why we can't try this step first.

I'd be fine opening up restrictions if there was also a trigger for a public option if cost increases aren't being effected.

[larrymcg421]

Originally Posted by Arles

A good point in MBBF's linked article is the fear that some current plans won't be "good enough" and it will cost even more to meet new government regulations. Depending on the scope of these requirements, some companies may just punt on providing health care as getting a short-lived penalty for not providing coverage is better than providing coverage and realizing you don't cover a certain thing and getting a fine/penalty for that.

The minimum standards for employer health insurance are necessary, because without it, employers would be able to avoid the fine for dropping coverage, by switching to cheap plans with insanely high deductibles that would result in basically no health care coverage at all.

[NewIdentity]

I am so glad I waited until now to vote.

Bad - sold us out


Where is our president when a convicted terrorist leader personally responsible for the death of hundreds if not thousands is allowed to go free!

I guess that big yellow streak running down his back is not paint. Grow a set Mr. President!!

I am kind of ashamed of my country right now.

[Ronnie Dobbs2]

I must have missed something, or am being stupid. Which convicted terrorist leader did Obama allow to go free?

[larrymcg421]

I'm assuming he thinks Obama is responsible for releasing the Lockerbie bomber?

[RainMaker]

Originally Posted by Arles

It's a cultural requirement and it's needed to be competitive. If you are faced with having no insurance at job X or making less money in a worse environment with insurance in job Y, 90% of people will choose job Y.

If there is a public option companies can use for cover culturally/politically and save money by dropping care, many will look at that. A lot of companies would love to drop coverage right now but it's not a realistic option given the stigma attached to not having it.

A good point in MBBF's linked article is the fear that some current plans won't be "good enough" and it will cost even more to meet new government regulations. Depending on the scope of these requirements, some companies may just punt on providing health care as getting a short-lived penalty for not providing coverage is better than providing coverage and realizing you don't cover a certain thing and getting a fine/penalty for that.

Most people with a decent job would not qualify for the public option anyway. This idea that the public option would steal people away from the private option is just silly since the requirements are so high to qualify. The public option is really setup for those who can't get or can't afford insurance, something that isn't stealing precious customers away from the private health care monopoly.

[NewIdentity]

Originally Posted by larrymcg421

I'm assuming he thinks Obama is responsible for releasing the Lockerbie bomber?

That is correct. We should have taken him at the airport. He should never have been allowed to fly home to a hero's welcome.

Very sad day for America.

[Ronnie Dobbs2]

That's what I figured, but I wanted to cover my bases.

NewIdentity, your take on the situation is reasonable and factual.

[flere-imsaho]

Originally Posted by SteveBollea

As a result, it's becoming more and more clear the compromise will be between Democrats and Conservadems/Snowe & Olympia. In other words, people who actually have incentives to pass a bill, rather than incentives to kill the bill.

I think you mean Senators Olympia Snowe and Susan Collins, both R-ME.

I agree. In fact, I'm willing to predict that getting a bill to pass the Senate will more-or-less require getting Olympia Snowe to agree to it. Go Maine!

Originally Posted by molson

Did any of the European countries have to cover, what, 40 million new people overnight?

West Germany springs to mind.

[larrymcg421]

Originally Posted by NewIdentity

That is correct. We should have taken him at the airport. He should never have been allowed to fly home to a hero's welcome.

Very sad day for America.

At Glasgow airport? We should commit an act of war against one of our allies? Or perhaps at Tripoli, so we could get into another skirmish with a Middle Eastern country?

[DaddyTorgo]

NewIdentity = missed the boat

[DaddyTorgo]

i wonder if newidentity thinks he was being held in an American prison under American law?

[Autumn]

Originally Posted by DaddyTorgo

i wonder if newidentity thinks he was being held in an American prison under American law?

Don't our laws supersede that of the rest of the world? That was the impression I got ;-)

[Autumn]

Originally Posted by flere-imsaho

I think you mean Senators Olympia Snowe and Susan Collins, both R-ME.

I agree. In fact, I'm willing to predict that getting a bill to pass the Senate will more-or-less require getting Olympia Snowe to agree to it. Go Maine!

Yay me!

[RainMaker]

While it's absolutely retarded to blame Obama, why were we not able to extradite him to the United States to stand trial?

[DaddyTorgo]

Originally Posted by RainMaker

While it's absolutely retarded to blame Obama, why were we not able to extradite him to the United States to stand trial?

i'm sure the decision was made way back then to let scotland do it...probably some version of "international double jeopardy" or something applies now...

[larrymcg421]

Originally Posted by RainMaker

While it's absolutely retarded to blame Obama, why were we not able to extradite him to the United States to stand trial?

I have strong doubts that we could've gotten a conviction or that it would have held up on appeal.

[molson]

Originally Posted by Autumn

Don't our laws supersede that of the rest of the world? That was the impression I got ;-)

When it comes to terrorism against U.S. citizens, they certainly should.

[molson]

Kind of an interesting news coverage observation

The stop story on FoxNews.com:

Report: Obama to Increase 10-Year Deficit Estimate $9 Trillion - Political News - FOXNews.com

So he was about 2 trillion off the last projection.

Meanwhile, neither CNN.com, nytimes.com, nor MSNBC.com have this anywhere on their front page.

So is FoxNews too conservative for telling us this, or are CNN.com, nytimes.com, and MSNBC.com too liberal for not telling us?

[JPhillips]

It was a leak to Fox o a report to be issued next week. When the report's issued then you can wonder if there's media bias.

[molson]

The AP has it too:

AP sources: $2 trillion higher deficit projected

And I initially read it on Boston.com (where it's the headline story). Boston.com doesn't credit FoxNews, but says, "senior administration official told Reuters Friday..."

[JPhillips]

Either way I think the real story is the report, not leaks about the report. I'd prefer if news organizations didn't run so many single anonymous source stories regardless of what they're about.

On a side note, do these projections assume the Bush tax cuts expire or are renewed? I can't find that info in any story.

[molson]

Originally Posted by JPhillips

Either way I think the real story is the report, not leaks about the report. I'd prefer if news organizations didn't run so many single anonymous source stories regardless of what they're about.

On a side note, do these projections assume the Bush tax cuts expire or are renewed? I can't find that info in any story.

Fair enough, it will be interesting to see how it's covered next week.

It's interesting to see it has the lead story on Boston.com (the Boston Globe's website- not exactly a bastion of conservative journalism), but isn't mentioned on the mainstream news sites. It could very well represent signficant differences of opinions about single-source news.

[RainMaker]

IT'S ALL LIBERAL MEDIA BIAS. EVERYONE EXCEPT FAIR AND BALANCED FOX NEWS CHANNEL!!!!!!!!!11

[molson]

Originally Posted by RainMaker

IT'S ALL LIBERAL MEDIA BIAS. EVERYONE EXCEPT FAIR AND BALANCED FOX NEWS CHANNEL!!!!!!!!!11

And Boston.com, Rueters, and the AP apparently.

Isn't it funny how (in general) liberals can't acknowledge liberal bias, and conservatives can't acknolwedge conservative bias?

Am I the only one that can see that both FoxNews and MSNBC have pretty notable bias?

[Radii]

Originally Posted by molson

And Boston.com, Rueters, and the AP apparently.

Isn't it funny how (in general) liberals can't acknowledge liberal bias, and conservatives can't acknolwedge conservative bias?

Am I the only one that can see that both FoxNews and MSNBC have pretty notable bias?

nope! I can't speak for anyone else on the left(I like to say center but its pretty obvious when I do lean its clearly left), but its a bit difficult wading through this mess to actually get to the point of posting

There are definitely some things that fox seems notorious for doing that seem of a lower standard(Mark Sanford-D-South Carolina... Larry Craig-D-Idaho happens just a little too often to be an accident... does that happen with frequency with CNN/MSNBC? If so then I take it back), but on most claims of bias it seems impossible to make a claim without being blatantly hypocritical. I can't really turn on any of the 3 major news networks for more than 10 minutes without becoming seethingly angry or dying a little inside at what I see at this point. Honestly CNN annoys me the most by now... if I want to see what some random asshole on twitter has to say, I'll turn off my TV and load up twitter. I don't want to turn on CNN to see some pseudo-journalist-newsman randomly reading comments from twitter and facebook.

Errm, anyway, end rant


As far as the story itself, assuming its accurate, it still does point out its a long term projection and extremely volatile based on short term results. There will be more than enough data over the next 4 years to figure out how we're doing fiscally, so this isn't at the top of my list of concerns, but its a concern. At this point, with a dem controlled house, senate, and executive branch, all this stonewall up in the air bullshit is pissing me off. DO SOMETHING.

If reducing the deficit is a top priority and god knows everyone everywhere said it was during their campaigns on all sides, then do something about it. Make some tough choices somewhere... anywhere. The easiest thing any politician can do at this point to lose my vote is to just have nothing happen between now and the next election. You assholes have a majority everywhere, its going to look pretty shaky when you try to blame the other side of the aisle if all these grand plans for healthcare reform, alternative energy/lesser dependence on oil, and fiscal responsibility all go nowhere.

End that rant too I suppose

[RainMaker]

I never really saw a massive liberal media bias. I mean they do have their favorites and punching bag, but it generally seems to be about public perception and momentum. I don't think any of the major networks are anywhere near as liberal as Fox is conservative. If you've ever seen those Fox News memos from years ago, it was essentially the GOP talking points being passed down to their reporters.

[SteveMax58]

Originally Posted by molson

Isn't it funny how (in general) liberals can't acknowledge liberal bias, and conservatives can't acknolwedge conservative bias?

Am I the only one that can see that both FoxNews and MSNBC have pretty notable bias?

There is a definite bias in both networks...with CNN committed to giving a voice to those who should never speak.

I like to consider myself a centrist for the most part...but am probably right of center. I am probably 50/50 on social issues(maybe even 60L/40R), mostly right on fiscal policy and role of government, and probably right of center on foreign policy (though I believe in cohesive foreign policy more than any philosophy).

I also find Fox News to be blatantly right leaning. I can't watch the morning show or Hannity, but will watch the occassional Beck and O'Reilly. I recognize when they make blatantly silly right wing accussations...but can stomach these because the rest of the show is typically ok.

I also watch MSNBC for the morning shows (Scarborough is good in my book), but cannot stomach Olberman or Madow at night.

Unfortunately...this is pretty much all we have to choose from.

[SteveMax58]

Originally Posted by RainMaker

I never really saw a massive liberal media bias. I mean they do have their favorites and punching bag, but it generally seems to be about public perception and momentum. I don't think any of the major networks are anywhere near as liberal as Fox is conservative. If you've ever seen those Fox News memos from years ago, it was essentially the GOP talking points being passed down to their reporters.

I agree with this in general...though I think the "liberal bias" is more of a historical thing before cable news became what it is today.

[rowech]

9 trillion.......wonder when our money turns into wallpaper?

[Ronnie Dobbs2]

Originally Posted by SteveMax58

There is a definite bias in both networks...with CNN committed to giving a voice to those who should never speak.

I think this is pretty much it.

Just sayin'.

[Dutch]

Originally Posted by RainMaker

I never really saw a massive liberal media bias. I mean they do have their favorites and punching bag, but it generally seems to be about public perception and momentum. I don't think any of the major networks are anywhere near as liberal as Fox is conservative. If you've ever seen those Fox News memos from years ago, it was essentially the GOP talking points being passed down to their reporters.

I think we all agree that nobody can make an opinionated article or report without some degree of bias. If you agree with the slant, it's very difficult to see, if you don't agree, it's more obvious.

So when you look for bias, it's easier to see which networks, newspapers, magazines, news organizations are biased *against* you than for you. But I can assure you, that once you have identified those that are leaning away from your point of view...the rest more than likely lean with you.

[Mizzou B-ball fan]

This is definitely not going to help the health care push by the Democrats or the cries of 'fear mongering'. They're in the process of reinstating a guide to veterans that 'assists' them with end of life decisions. Some senators are calling for a review. It's an interesting read to say the least. Here's the "guide".........

http://www1.va.gov/pugetsound/docs/ylyc.pdf

[JPhillips]

Ah good, we're back to the outrage of the day. Here's a look at Jim Towey's op-ed in the WSJ that stated this round of manufactured outrage.

They failed to mention that the so-called "death book" contains the same advance-care planning required of all health care organizations under federal law, has been in use since 1997 and was developed with the input of interfaith ministers. [...]

The VA's policy is in accordance with the 1990 Patient Self Determination Act, which requires all institutions receiving Medicare funds to provide information to patients regarding end of life, living will and other advance directives. During the Bush administration, the VA changed its regulation to extend the act to cover all VA facilities.

In 2007, after Towey complained that the so-called "death book," "Your Life, Your Choices - Planning for Future Medical Decisions," was biased against the right-to-life viewpoint, the VA convened an outside panel of experts to assess and update the booklet.

In his op-ed, Towey stated that this panel did not include any representatives of faith groups or disability rights advocates. In fact, according to the VA, the panel included a priest, a rabbi, a renowned disability rights advocate, and the president of the organization that produces "Five Wishes," the alternative advance care planning document that Towey is promoting and selling.

The panel supported the use of the "Your Life, Your Choices" booklet but included some suggestions for revising its content. The plans to update and release the booklet were developed under the Bush administration and it is due for release in 2010.

[fpres]

Originally Posted by Mizzou B-ball fan

This is definitely not going to help the health care push by the Democrats or the cries of 'fear mongering'. They're in the process of reinstating a guide to veterans that 'assists' them with end of life decisions. Some senators are calling for a review. It's an interesting read to say the least. Here's the "guide".........

http://www1.va.gov/pugetsound/docs/ylyc.pdf

I'm just going to comment on the guide itself (mainly with respect to its very existence).

This is already the standard of care in the United States. It may not have been routinely taught in U.S. medical schools years ago, but end-of-life issues (i.e., advance directives, etc.) are now part of the curriculum which ensures that physicians are competent when it comes to being able to address these topics with their patients.

One of the most frustrating things, personally, has been seeing someone who is incapacitated in the ICU (already having coded once or multiple times, on multiple pressors, on a ventilator, with diagnostic evidence of severe quality-of-life-altering brain damage)...who does not have an advance directive of any kind, and has a room full of family members who are ripping each other to shreds over conflicting ideas about what their loved one "would have wanted."

Unless we go out of this world in a quick and unexpected way, most of us will one day reach that point. For those of us who are clear on our wishes (and who have family and friends who understand those wishes), that's great. Many of us don't want to think about that sort of thing. It's human nature. Maybe it should be though.

I bring up the end-of-life discussion with all of my patients the first time I do a "routine physical" with them. I don't promote any personal biases when I do so. No health care provider should, although I'm sure there are plenty who do. Reading that VA guide, I think the only message conveyed is that the discussion is one that needs to take place.

[JonInMiddleGA]

Originally Posted by fpres

I don't promote any personal biases when I do so.

Then I'll tip my hat to you.

No health care provider should, although I'm sure there are plenty who do.

I can most definitely vouch for that. I've lost count of how many doctors we've encountered over the past decade who had a very clear & highly inappropriate agenda in those conversations.

[larrymcg421]

Originally Posted by Mizzou B-ball fan

This is definitely not going to help the health care push by the Democrats or the cries of 'fear mongering'. They're in the process of reinstating a guide to veterans that 'assists' them with end of life decisions. Some senators are calling for a review. It's an interesting read to say the least. Here's the "guide".........

http://www1.va.gov/pugetsound/docs/ylyc.pdf

Huh? What's your problem with this? You don't think planning for end of life decisions is a good idea?

[fpres]

Originally Posted by JonInMiddleGA

I can most definitely vouch for that. I've lost count of how many doctors we've encountered over the past decade who had a very clear & highly inappropriate agenda in those conversations.

Having experienced that type of thing from the patient's family side of things, I make a conscious effort to never do that sort of thing myself.

I've signed off on a 90-year-old who wants a "full-court press" and I've signed off on a 30-year-old who wants no extraordinary measures taken...and I can say that I've done so with no reservations. That is the person's right, and nobody else has a better understanding of their circumstances than the person himself/herself.

[larrymcg421]

When did "end of life decisions" become such a boogeyman word? You would think after the Terri Schiavo ordeal that you would want people to be more educated and prepared about end of life situations, no matter where you stand on that issue.

[RainMaker]

Originally Posted by Mizzou B-ball fan

This is definitely not going to help the health care push by the Democrats or the cries of 'fear mongering'. They're in the process of reinstating a guide to veterans that 'assists' them with end of life decisions. Some senators are calling for a review. It's an interesting read to say the least. Here's the "guide".........

http://www1.va.gov/pugetsound/docs/ylyc.pdf

I'm lost on what you're outraged about with this document. It seems like a resource full of options and questions that people can ask when dealing with themselves or someone they love who has to make serious decisions.

If anything, it seems like a preparation guide so that you don't get stuck in a situation where doctors are doing something against your wishes. If you had strong religious beliefs on how you want to be treated at the end of life, I think this would be beneficial.

What is it in this document that you don't like or did Michelle Malkin not cover that yet?

[RainMaker]

Originally Posted by larrymcg421

When did "end of life decisions" become such a boogeyman word? You would think after the Terri Schiavo ordeal that you would want people to be more educated and prepared about end of life situations, no matter where you stand on that issue.

It is more of a religious issue. Many in that movement want to dictate how others have to live their life.

[rowech]

Originally Posted by RainMaker

It is more of a religious issue. Many in that movement want to dictate how others have to live their life.

It's not that at all. It's the fear of the government being involved in those decisions and influencing those decisions based upon a cost-benefit analysis. The facts are that financially, people over the age of 65 become more a of a drain on society than they offer. People fear a government that can direct people to certain decisions because of such an analysis.

[miked]

Originally Posted by rowech

It's not that at all. It's the fear of the government being involved in those decisions and influencing those decisions based upon a cost-benefit analysis. The facts are that financially, people over the age of 65 become more a of a drain on society than they offer. People fear a government that can direct people to certain decisions because of such an analysis.

It's probably so meddling religious right people don't try and legislate medical decisions either (see: Schiavo, Terry). There is much benefit to end of life counseling (even for people my age, i.e. living wills) for all.

[rowech]

Originally Posted by miked

It's probably so meddling religious right people don't try and legislate medical decisions either (see: Schiavo, Terry). There is much benefit to end of life counseling (even for people my age, i.e. living wills) for all.

As long as it remains neutral counseling, I agree completely.

[Grammaticus]

Why does this end of life stuff have to be in a health care bill? If it is just normal discussions that happen during routine care, then doctors will do it like they have been right? Why do you have to legislate that the conversation has to happen at the following x intervals?

[JPhillips]

Originally Posted by Grammaticus

Why does this end of life stuff have to be in a health care bill? If it is just normal discussions that happen during routine care, then doctors will do it like they have been right? Why do you have to legislate that the conversation has to happen at the following x intervals?

They aren't legislating when it happens, but if and how often a provider can be paid for it. This had broad bipartisan support until the past few weeks when some on the right figured out they could get a lot of people riled up by lying about death panels.