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Shear Modulus
Jun 9, 2010



Family Values posted:

Failing to vote is not an excuse IMHO. Also I don't think we have any voter suppression laws in CA; hell I'm registered for permanent absentee voting, it doesn't get much easier than having the ballot mailed to you and mailing it back whenever.

Nitpicking but it isn't super easy if you're homeless or don't have a permanent address.

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Bizarro Watt
May 30, 2010

My responsibility is to follow the Scriptures which call upon us to occupy the land until Jesus returns.

Shear Modulus posted:

Nitpicking but it isn't super easy if you're homeless or don't have a permanent address.

I would imagine not, but I think it'd have be shown that the numbers of people like that would actually alter election results in those areas if they did end up voting. I agree that it should be easier for them to vote, though.

etalian
Mar 20, 2006

Family Values posted:

Failing to vote is not an excuse IMHO. Also I don't think we have any voter suppression laws in CA; hell I'm registered for permanent absentee voting, it doesn't get much easier than having the ballot mailed to you and mailing it back whenever.

e: BTW, if you look at the statistics page on the Secretary of State site, it's kind of interesting that a majority of Californians now vote by mail in the general election, as of 2012. Neat. (Primaries have been that way for longer)

It's also fairly common in other western states since it saves the government big bucks.

nm
Jan 28, 2008

"I saw Minos the Space Judge holding a golden sceptre and passing sentence upon the Martians. There he presided, and around him the noble Space Prosecutors sought the firm justice of space law."
Prop 47 is the best idea since prop 36 (either of them).

Zeitgueist
Aug 8, 2003

by Ralp

nm posted:

Prop 47 is the best idea since prop 36 (either of them).

You're not kidding

Reztes
Jun 20, 2003

Family Values posted:

Failing to vote is not an excuse IMHO. Also I don't think we have any voter suppression laws in CA; hell I'm registered for permanent absentee voting, it doesn't get much easier than having the ballot mailed to you and mailing it back whenever.


Hey thanks for that link, I had no idea it was so trivially easy to do this (just a web form in my county). Now I have no excuse for ever missing an election again!

Craptacular!
Jul 9, 2001

Fuck the DH
As that map is per capita, it doesn't really discern whether those counties need more funding than most counties do (some do), or if they have a poorer population that needs the "safety net" (some do), or if they just happen to have low populations and a minimal level of government funding that's necessary puts them on that list.

There are issues of rural land VS developed land in California, such as the best use of available water, but that image isn't one of them. There are no answers for some counties unless you think their populations need to move to the already-dense areas of the coast and unincorporate.

Kaal
May 22, 2002

through thousands of posts in D&D over a decade, I now believe I know what I'm talking about. if I post forcefully and confidently, I can convince others that is true. no one sees through my facade.

Craptacular! posted:

As that map is per capita, it doesn't really discern whether those counties need more funding than most counties do (some do), or if they have a poorer population that needs the "safety net" (some do), or if they just happen to have low populations and a minimal level of government funding that's necessary puts them on that list. There are issues of rural land VS developed land in California, such as the best use of available water, but that image isn't one of them. There are no answers for some counties unless you think their populations need to move to the already-dense areas of the coast and unincorporate.

I'm going to go with the basic idea that there is a fundamental unfairness that urban liberals should be paying money hand over fist to prop up rural conservatives that shout down taxes and refuse to support their own programs, leaving the state to pick up the tab. The local Republican bigwigs who run these rural districts are the beneficiaries of massive government grants of all kinds, and yet they ensure that their counties don't come close to paying for their state services. They drain sorely needed money out of the pockets of hardworking people, and offer nothing but spite in return. That study showed that liberal areas like San Mateo were picking up six cents on the dollar in Med-Cal health benefits, while in Lake County it's 80 cents. It's not right. If they want to build their libertarian paradise, let them pay for the privilege of doing so rather than San Francisco and Los Angeles.

Kaal fucked around with this message at 07:36 on Sep 26, 2014

Trabisnikof
Dec 24, 2005

Kaal posted:

I'm going to go with the basic idea that there is a fundamental unfairness that urban liberals should be paying money hand over fist to prop up rural conservatives that shout down taxes and refuse to support their own programs, leaving the state to pick up the tab. The local Republican bigwigs who run these rural districts are the beneficiaries of massive government grants of all kinds, and yet they ensure that their counties don't come close to paying for their state services. They drain sorely needed money out of the pockets of hardworking people, and offer nothing but spite in return. It's not right. If they want to build their libertarian paradise, let them pay for the privilege of doing so rather than San Francisco and Los Angeles.

I imagine part of their libertarian paradise would involve charging for the water that San Francisco and Los Angeles uses that is piped from these rural counties. I don't think Inyo county would prefer to have the largest source of dust pollution in the US if they had any say in the matter. The big cities need the resources in the rural counties and the state is the mechanism through which the bill is balanced.

Also, I don't think that this has anything to do with counties leaving the state with the bill, but instead a truism of civilization that the money is always in the cities. Cities will always be a better tax base than the rural areas around the city supporting it.

Also the reason San Mateo has reduced Med-Cal spending compared to Lake county is that San Mateo has a median household income of $87,751 and Lake county has a median household income of $38,147. Its because San Mateo is rich not liberal.

Trabisnikof fucked around with this message at 07:40 on Sep 26, 2014

Kaal
May 22, 2002

through thousands of posts in D&D over a decade, I now believe I know what I'm talking about. if I post forcefully and confidently, I can convince others that is true. no one sees through my facade.

Trabisnikof posted:

I imagine part of their libertarian paradise would involve charging for the water that San Francisco and Los Angeles uses that is piped from these rural counties. I don't think Inyo county would prefer to have the largest source of dust pollution in the US if they had any say in the matter. The big cities need the resources in the rural counties and the state is the mechanism through which the bill is balanced.

Urban areas are never, ever going to come close to using as much water as rural counties, so that's a bit of a non-starter. Agriculture uses something like 80 percent of water in California. Beyond which, this line of thought always leads to the same absurdities that break apart any libertarian Mad Max society: If rural areas try holding resources hostage, who is going to pay for their roads to transport them on, or allow them free access to the markets, or equip their police to uphold their claims, if not the cities? The privileged rural elites don't hold the keys to the Social Contract - that power has always been vested in "the common people" and people live in cities these days.

quote:

Also, I don't think that this has anything to do with counties leaving the state with the bill, but instead a truism of civilization that the money is always in the cities. Cities will always be a better tax base than the rural areas around the city supporting it.

That's just a justification for why people living in rural areas should be treated as a permanent pseudo-nobility. I'm sure there's millions of hard-working poors in the cities who would love to get special treatment because they're the backbone of America. But because they aren't landowners they don't get special political access or financial assistance - they're just expected to make do. We treat land ownership as being synonymous with democratic legitimacy at every level of our government, but there's nothing democratic about it.

Trabisnikof posted:

Also the reason San Mateo has reduced Med-Cal spending compared to Lake county is that San Mateo has a median household income of $87,751 and Lake county has a median household income of $38,147. Its because San Mateo is rich not liberal.

That income difference doesn't come close to explaining how a San Mateo resident ends up paying something like five times more in taxes, and yet receives 1/3 the services. And even if you factored in all the differences of economies of scale, the inefficiencies of the political process, and the relative need of the people involved, you still come away with some really problematic numbers describing how liberal, urban people are consistently propping up the conservative, rural people at every level of our country.

If it was just San Mateo and Lake County, I could accept it; or even if this was something that existed only on a regional or even state-level. But the reality is that this is a problem that is endemic to our culture - we are paying exorbitant amounts of money to help prop up this wasteful dream that is rural/suburban culture. How long can we afford to keep on throwing money down to help people pretend they are cowboys that live in ranch-houses next to Walmarts? Because that subsidy is expensive and it's creating a dreamy bubble where conservatives think that there's tons of pork to be cut because they always get the fattiest slice. Our healthcare problems would be ended instantly if we could afford to give everyone $700 in annual state healthcare - but the reality is that most people have to get by on far, far less.

Kaal fucked around with this message at 08:18 on Sep 26, 2014

Trabisnikof
Dec 24, 2005

Kaal posted:

Urban areas are never, ever going to come close to using as much water as rural counties, so that's a bit of a non-starter. Agriculture uses something like 80 percent of water in California. Beyond which, this line of thought always leads to the same absurdities that break apart any libertarian Mad Max society: If rural areas try holding resources hostage, who is going to pay for their roads to transport them on, or allow them free access to the markets, or equip their police to uphold their claims, if not the cities? The privileged rural elites don't hold the keys to the Social Contract - that power has always been vested in "the common people" and people live in cities these days.


The reddest and most libertarian parts of the state aren't the agricultural land but the uplands, where the water comes from and where there is little agriculture. Take the theoretical state of Jefferson for example (either 6 Cali or original style), that'd be very conservative but with little agricuture compared to the valleys. However, they'd have the water that the Bay Area drinks and a good chunk of LA's water too (plus the water for the agriculture in the valleys).


Kaal posted:

That's just a justification for why people living in rural areas should be treated as a permanent pseudo-nobility. I'm sure there's millions of hard-working poors in the cities who would love to get special treatment because they're the backbone of America. But because they aren't landowners they don't get special political access or financial assistance - they're just expected to make do. We treat land ownership as being synonymous with democratic legitimacy at every level of our government, but there's nothing democratic about it.

What are you talking about? No one is saying enshrining people in rural areas. I'm making the economics point that to provide the same services to people in a less dense area requires more money. Rural communities by no means get better service than in the cities, they almost always get worse services.


Kaal posted:

That income difference doesn't come close to explaining how a San Mateo resident ends up paying something like five times more in taxes, and yet receives 1/3 the services. And even if you factored in all the differences of economies of scale, the inefficiencies of the political process, and the relative need of the people involved, you still come away with some really problematic numbers describing how liberal, urban people are consistently propping up the conservative, rural people at every level of our country.

Yes, actually it because San Mateo is a lot richer (people make 2x in San Mateo what they do in Lake) and providing service is more expensive per-person in small communities. That's just the facts of life, Lake county is 2x the size of San Mateo county with 1/10th the people it will cost more to provide the bare minimum of services.

Kaal posted:

If it was just San Mateo and Lake County, I could accept it; or even if this was something that existed only on a regional or even state-level. But the reality is that this is a problem that is endemic to our culture - we are paying exorbitant amounts of money to help prop up this wasteful dream that is rural/suburban culture. How long can we afford to keep on throwing money down to help people pretend they are cowboys that live in ranch-houses next to Walmarts? Because that subsidy is expensive and it's creating a dreamy bubble where conservatives think that there's tons of pork to be cut because they always get the fattiest slice. Our healthcare problems would be ended instantly if we could afford to give everyone $700 in annual state healthcare - but the reality is that most people have to get by on far, far less.

You're conflating a lot of things here. The people living in Lake county aren't "pretending to be cowboys that live in ranch-houses next to Walmarts" no more than people in San Mateo are all going to all night sex-orgies and pissing on the American flag. The suburban sprawl isn't happening in Inyo county, its happening in "liberal" San Mateo.

The rural poor are struck with the double burden of poverty and limited community resources. The idea that because servicing smaller communities is more expensive and we should just tell the poor to move to a big city is exactly the kind of argument turns the rural poor against so called anti-povery liberals.

Bizarro Watt
May 30, 2010

My responsibility is to follow the Scriptures which call upon us to occupy the land until Jesus returns.

Wow, it seems to have a lot of supporters too. What are the chances of this passing?

Edit: Didn't see that there was polling at the bottom. This is great.

Family Values
Jun 26, 2007


Trabisnikof posted:

Yes, actually it because San Mateo is a lot richer (people make 2x in San Mateo what they do in Lake) and providing service is more expensive per-person in small communities. That's just the facts of life, Lake county is 2x the size of San Mateo county with 1/10th the people it will cost more to provide the bare minimum of services.

People keep saying this, but I remain skeptical. MediCal doesn't operate facilities they simply pay for care. How do they adjust benefits to account for low density? Do rural healthcare providers charge higher rates? In fee-for-service there's a set amount that they'll pay for a given procedure, and I don't think that changes because you're in a rural area. I could be wrong of course but that's how I understood it.

The reason there's more spending in these areas is that they have high poverty rates.

pathetic little tramp
Dec 12, 2005

by Hillary Clinton's assassins
Fallen Rib

Bizarro Watt posted:

Wow, it seems to have a lot of supporters too. What are the chances of this passing?

Edit: Didn't see that there was polling at the bottom. This is great.

Yeah Shelley Zimmerman, chief of SD police is against it. That's all I really need to know.

edit: I hate that that's what politics has become, but it's gotten to the point that if I'm not quite sure, I just look at who's opposing it and if it's an rear end in a top hat, I know it must be a great idea.

pathetic little tramp fucked around with this message at 17:28 on Sep 26, 2014

Trabisnikof
Dec 24, 2005

Family Values posted:

People keep saying this, but I remain skeptical. MediCal doesn't operate facilities they simply pay for care. How do they adjust benefits to account for low density? Do rural healthcare providers charge higher rates? In fee-for-service there's a set amount that they'll pay for a given procedure, and I don't think that changes because you're in a rural area. I could be wrong of course but that's how I understood it.

The reason there's more spending in these areas is that they have high poverty rates.

Rural healthcare is often more expensive and there are fewer alternatives (such as free clinics). But yes, the poverty rate is the big reason (not evil Republicans like Kaal originally claimed)

For the original example of San Mateo, San Mateo is rich enough to afford its own local alternative to Med-Cal (http://www.hpsm.org) so that's another reason. The Health Care Plan of San Mateo covers more people than live in the Lake County, so I think economies of scale are important here.

Also using Med-Cal spending as example of the "dreamy bubble" is weird since you must qualify as disabled, a child, pregnant, a senior or a refugee to receive it. So its not like Republicans in rural counties can artificially increase those numbers somehow.

Leperflesh
May 17, 2007

Kind of missing the point, here, guys.

Rural communities are undoubtedly poorer, and poorer people live in rural communities. The point is that those poorer rural communities vote Republican, and Republicans consistently vote to cut taxes and cut services. Cutting taxes does not help poor people much (because they don't pay much in taxes anyway) but cutting services hurts poor people disproportionately (because they rely more on services).

The disparity of tax vs. service is a natural consequence of this process once the political divide is formed.

Poor people in rural counties, if they voted out of economic self-interest instead of voting based on other issues (abortion, perception of support for military, religion, social issues such as gay marriage, immigration, etc.), ought to vote for the politicians that are most inclined to support and expand the services and infrastructure they rely on.

At the very least, simply acknowledging the fact that poor people everywhere in America rely on services funded by taxes levied on people who live in the higher-property-value urban centers would be a step in the right direction. Nobody's asking for rural poor folks to kowtow to city dwellers or act like they owe some kind of debt. We all recognize that rural workers provide critical products and services to the country, most prominently farm production, natural resources such as lumber and mineral products, and of course a disproprotionately high percentage of youth that join and serve in the military. Not to mention providing locations for us to keep our enormous prison population conveniently out of sight.

It's just the political dissonance in which rural poor vote for politicians that want to cut funding for the services that are relied-upon more by the rural poor that is worthy of regular and repeated mention, because it's such a giant goddamn fuckup on the part of America's rural poor voters that can only be improved by repeating the facts again and again (utilizing the same techniques that the Republican party convinces people to believe things that are not true).

computer parts
Nov 18, 2010

PLEASE CLAP

Leperflesh posted:

Kind of missing the point, here, guys.

Rural communities are undoubtedly poorer, and poorer people live in rural communities. The point is that those poorer rural communities vote Republican, and Republicans consistently vote to cut taxes and cut services. Cutting taxes does not help poor people much (because they don't pay much in taxes anyway) but cutting services hurts poor people disproportionately (because they rely more on services).

Are the poor people themselves voting Republican though?

Just as a cursory example, Kings County (one of the ones on the map) had 41% of their voting population* vote for Obama in 2012. That's a pretty significant percentage and could be indicative of other things happening than just "dumb rural hicks voting against their interests".



*Which, incidentally, was only 30% of the entire population of the county, and the county itself is majority Hispanic. That doesn't sound like "rah dumb white people".

e: Based on the above figures, only 18% of the county actually voted for the Republicans, though something like 12% of the county are inmates alone and ~6% are immigrants.

computer parts fucked around with this message at 16:42 on Sep 27, 2014

Leperflesh
May 17, 2007

Low voting turnout is common everywhere in the US, that's hardly surprising. And a 60/40 split is considered a landslide victory for the party getting 60. Of course not everyone in the area votes republican, but the majority of the people who show up to vote do.

And I would not characterize them as "dumb hicks." The republican party machine has been extremely good at utilizing all the tools of advertising and human psychology to capture voters. I don't think you have to be dumb to be misled.

Hog Obituary
Jun 11, 2006
start the day right
I haven't been following the district 17 race, but I was surprised to see the SF chronicle endorse Ro Khanna. Is that a big deal?

Jerry Manderbilt
May 31, 2012

No matter how much paperwork I process, it never goes away. It only increases.

Hog Obituary posted:

I haven't been following the district 17 race, but I was surprised to see the SF chronicle endorse Ro Khanna. Is that a big deal?

Well for what it's worth they also endorsed Fiorina four years ago

computer parts
Nov 18, 2010

PLEASE CLAP

Leperflesh posted:

Low voting turnout is common everywhere in the US, that's hardly surprising. And a 60/40 split is considered a landslide victory for the party getting 60. Of course not everyone in the area votes republican, but the majority of the people who show up to vote do.

Voter suppression is also not a new concept.

Leperflesh posted:


And I would not characterize them as "dumb hicks." The republican party machine has been extremely good at utilizing all the tools of advertising and human psychology to capture voters. I don't think you have to be dumb to be misled.

I think the people that use these services are not the ones that are voting.

Proust Malone
Apr 4, 2008



There's snow in the Sierra. Please let it rain this year.

Leperflesh
May 17, 2007

computer parts posted:

Voter suppression is also not a new concept.

My apologies, it's probably my fault but I can no longer tell what point you're trying to make, or even whether we actually disagree.

quote:

I think the people that use these services are not the ones that are voting.

Social Security and Medicare are overwhelmingly used by retirees and the elderly; these are the Republican Party's strongest base.

I also don't think voter turnouts are strongly related to the republification of rural america.

From this WSJ article

quote:

The U.S. divide wasn't always this stark. For decades, rural America was part of the Democratic base, and as recently as 1993, just over half of rural Americans were represented by a House Democrat, according to a Wall Street Journal analysis. Conservative Democrats often represented rural districts, including Ms. Hartzler's predecessor, Ike Skelton, who held the seat for 34 years before she ousted him in 2010.

Unless poor people in rural areas that used to vote in the 80s and 90s have stopped voting now, a significant fraction of them have switched from D to R, enough to change the outcomes of elections.

quote:

In 1992, Mr. Bush won the 50 least-dense counties—the most rural in the country—by 18 points. In 2012, Mr. Romney's advantage there had roughly tripled, to 53 points.

That cannot be explained entirely or even mostly by voter suppression or increasing apathy among rural liberals (that for some reason isn't mirrored by apathy among urban liberals). I think moderate rural voters, which includes large swathes of rural poor, have been pulled to the right by relentless and pervasive campaigns focusing on issues like abortion, immigration, creating a perception of persecution of christians, and most recently, racism. Fox News is part of that campaign. Rural moderates aren't stupid, they've just been exposed to a lot of propaganda and misinformation and outright lies, and are not exposed to a population density that would force them to interact with a lot of people who don't share the same views and values.

computer parts
Nov 18, 2010

PLEASE CLAP

Leperflesh posted:


Social Security and Medicare are overwhelmingly used by retirees and the elderly; these are the Republican Party's strongest base.

We were talking about the state programs.

Jerry Manderbilt
May 31, 2012

No matter how much paperwork I process, it never goes away. It only increases.
The whole swath of the valley from San Joaquin County all the way down to Fresno County went pretty overwhelmingly for Bush in 2004 before swinging increasingly to Obama in 2008 and 2012. Then again Obama's done much better in the cities there than Kerry did.

ChipNDip
Sep 6, 2010

How many deaths are prevented by an executive order that prevents big box stores from selling seeds, furniture, and paint?

Leperflesh posted:

Unless poor people in rural areas that used to vote in the 80s and 90s have stopped voting now, a significant fraction of them have switched from D to R, enough to change the outcomes of elections.

The generation that came of age during the Depression is mostly gone now. They tended to vote reliably Democratic thanks to the positive influence of the New Deal.

Telesphorus
Oct 28, 2013
Got my voter information booklet the other day. I haven't read the whole thing but I have initial opinions on these:

1. The Proposition that makes punishment for non-violent felonies less harsh is a "Yes", due to prison overcrowding and people's lives being ruined for stupid mistakes.

2.The Proposition that enables a Commissioner to review and approve health cost increases is also a "Yes", despite the buckets of money being poured into what appears to be a fear-based campaign against it.

Any thoughts?

nm
Jan 28, 2008

"I saw Minos the Space Judge holding a golden sceptre and passing sentence upon the Martians. There he presided, and around him the noble Space Prosecutors sought the firm justice of space law."
Besides the criminal justice one, the most interesting one to me is the med mal one.
For those who don't know, CA capped med mal damages a few decades ago and hasn't moved the cap since.
Accidentally cut off the wrong leg? Sorry, you're capped a 250k. Or worse. It is pretty screwed up. Before the caps, a partner at my dad's law firm was in a terrible car accident and went way off the freeway. This was before cell phones.
He crawled a mile to the nearest ER7, where they refused to treat him because they thought he was drunk (he was black) and called the police.
Due to the delayed treatment, he never worked a day again and died after 20 years of pain and round the clock treatment. The should be no cap for that poo poo.
On the other hand, I hate the idea of forcing drug tests on doctors (or anyone) when they aren't working.

etalian
Mar 20, 2006

nm posted:

Besides the criminal justice one, the most interesting one to me is the med mal one.
For those who don't know, CA capped med mal damages a few decades ago and hasn't moved the cap since.
Accidentally cut off the wrong leg? Sorry, you're capped a 250k. Or worse. It is pretty screwed up. Before the caps, a partner at my dad's law firm was in a terrible car accident and went way off the freeway. This was before cell phones.
He crawled a mile to the nearest ER7, where they refused to treat him because they thought he was drunk (he was black) and called the police.
Due to the delayed treatment, he never worked a day again and died after 20 years of pain and round the clock treatment. The should be no cap for that poo poo.
On the other hand, I hate the idea of forcing drug tests on doctors (or anyone) when they aren't working.

It's the classic bundling trick were something random like drug testing for doctors get included with the change of medical malpractice caps.

Telesphorus posted:


2.The Proposition that enables a Commissioner to review and approve health cost increases is also a "Yes", despite the buckets of money being poured into what appears to be a fear-based campaign against it.

Any thoughts?

It's mainly focused on giving the state commissioner of insurance more oversight over medical rate increases similar to auto and home insurance. To get a rate increase they have to go through a process which involves justifying to the public and also state government all the fiscal reasons behind the rate increase.

Naturally the medical insurance industry doesn't like the idea leading to corporations like Blue Cross and Kaiser spending millions of dollars against the proposition.

The state exchange also doesn't like it either since it adds in more state involvement into the insurance oversight process, basically state turf war fight since Obamacare already has some provisions to protect against insurance rate increases

etalian fucked around with this message at 21:45 on Sep 28, 2014

VikingofRock
Aug 24, 2008




For the interested, here are the 2014 ballot propositions.

Edit: looking over these, my mind is pretty well made up on all of them except the Native American Casino one. I'm for helping the native population in any way we can, but Environmental Quality Act exemption gives me pause. What are your thoughts on this?

VikingofRock fucked around with this message at 22:15 on Sep 28, 2014

Telesphorus
Oct 28, 2013
To be honest, I often use the frequency of political ads on the radio as a bullshit detector. Usually it's the people with the power that bombard TV/radio/media while the underdog's position is drowned out. What can I say, I'm an underdog kind of guy - generally!

(the healthcare industry's ad lately describes the proposition as a scam meant to enrich lawyers)

etalian
Mar 20, 2006

Telesphorus posted:

To be honest, I often use the frequency of political ads on the radio as a bullshit detector. Usually it's the people with the power that bombard TV/radio/media while the underdog's position is drowned out. What can I say, I'm an underdog kind of guy - generally!

(the healthcare industry's ad lately describes the proposition as a scam meant to enrich lawyers)

Also helps to look up how the ad campaign is funded:

Guy Farting
Jul 28, 2003

has vegetable salty
Healthcare costs will increase by an unpredictable amount if that bill goes through. Malpractice premiums are not an effective way of ensuring quality of care. Ultimately the cost of all those extra "defensive medicine" tests will be passed along to you via higher premiums and copays.

FRINGE
May 23, 2003
title stolen for lf posting
New malpractice practice: Cut off someones leg "by accident"? 20 years minimum in prison for negligence and medical torture-equivalence for everyone involved.

Suddenly people read charts more carefully.

nm
Jan 28, 2008

"I saw Minos the Space Judge holding a golden sceptre and passing sentence upon the Martians. There he presided, and around him the noble Space Prosecutors sought the firm justice of space law."

Guy Farting posted:

Healthcare costs will increase by an unpredictable amount if that bill goes through. Malpractice premiums are not an effective way of ensuring quality of care. Ultimately the cost of all those extra "defensive medicine" tests will be passed along to you via higher premiums and copays.
They're not removing caps, they're indexing them to inflation.
Also, I don't disagree that it isn't an effective method for ensuring quality of care, but I don't give a poo poo. I care about the people who get damaged in terrible ways and only get $250k for not being a function human anymore. Not everyone gets economic damages -- a college student who can not work after his injury essentially gets nothing under the current law.

Med mal premiums have gone up anyhow, despite a cap that has been decreasing in real terms anyhow. It amazes me how doctors understand just how hosed up medical insurers are and then believe the same companies when they blame lawsuits for the cost of malpractice insurance going up.

Now, I would actually support the cap going away. Caps don't protect good doctors. Good doctors are scared of frivolous suits that tend to be in the tens of thousands in non-economic damages (and the number of these suits are much smaller than claimed -- those that pass the early phases of litigation are even smaller). Those people don't care about the cap. It doesn't stop them.
The caps hurt the people who are seriously injured. Those with life long pain and loss of happiness due to gross malpractice. Those doctors and those who insure them deserve no protection. And those who are injured deserve to be made whole and have something to try to make up for the pain.

nm fucked around with this message at 00:06 on Sep 29, 2014

computer parts
Nov 18, 2010

PLEASE CLAP

FRINGE posted:

New malpractice practice: Cut off someones leg "by accident"? 20 years minimum in prison for negligence and medical torture-equivalence for everyone involved.

Suddenly people read charts more carefully.

Or at least it would discourage the practice of 30 hour shifts.

Guy Farting
Jul 28, 2003

has vegetable salty

nm posted:

They're not removing caps, they're indexing them to inflation.
Also, I don't disagree that it isn't an effective method for ensuring quality of care, but I don't give a poo poo. I care about the people who get damaged in terrible ways and only get $250k for not being a function human anymore. Not everyone gets economic damages -- a college student who can not work after his injury essentially gets nothing under the current law.

Med mal premiums have gone up anyhow, despite a cap that has been decreasing in real terms anyhow. It amazes me how doctors understand just how hosed up medical insurers are and then believe the same companies when they blame lawsuits for the cost of malpractice insurance going up.

Now, I would actually support the cap going away. Caps don't protect good doctors. Good doctors are scared of frivolous suits that tend to be in the tens of thousands in non-economic damages (and the number of these suits are much smaller than claimed -- those that pass the early phases of litigation are even smaller). Those people don't care about the cap. It doesn't stop them.
The caps hurt the people who are seriously injured. Those with life long pain and loss of happiness due to gross malpractice. Those doctors and those who insure them deserve no protection. And those who are injured deserve to be made whole and have something to try to make up for the pain.

You don't think increasing caps will increase the number of frivolous lawsuits from predatory lawyers? Increased caps = increased settlement amounts from hospitals and insurers who don't want to fight these edge cases that you describe. The number of cases will increase.

These costs will absolutely be passed onto the consumer and hidden in the overall cost of healthcare. As a bonus it will increase defensive medicine testing with likely no additional benefit to quality of care, and also probably reduce transparency because they will be punished that much more for making an error.

What I have seen proposed is a "health court" independent of an adversarial legal system, composed of lawyers and healthcare professionals and actuarials, who would convene when a patient suffers harm, and determine appropriate compensation. I have not seen this idea take off because nobody wants to champion this idea (because nobody stands to get rich from it).

nm
Jan 28, 2008

"I saw Minos the Space Judge holding a golden sceptre and passing sentence upon the Martians. There he presided, and around him the noble Space Prosecutors sought the firm justice of space law."

Guy Farting posted:

You don't think increasing caps will increase the number of frivolous lawsuits from predatory lawyers? Increased caps = increased settlement amounts from hospitals and insurers who don't want to fight these edge cases that you describe. The number of cases will increase.

These costs will absolutely be passed onto the consumer and hidden in the overall cost of healthcare. As a bonus it will increase defensive medicine testing with likely no additional benefit to quality of care, and also probably reduce transparency because they will be punished that much more for making an error.

What I have seen proposed is a "health court" independent of an adversarial legal system, composed of lawyers and healthcare professionals and actuarials, who would convene when a patient suffers harm, and determine appropriate compensation. I have not seen this idea take off because nobody wants to champion this idea (because nobody stands to get rich from it).
I don't think it will because the frivolous lawsuits are never in danger of getting more than $250k. Also, the number of them is much, much lower than people think.

You know what costs us all a whole lot of money? Defending lawsuits against police officers alleged to have committed police brutality. There's even more money in it, and potential for settlement because 1983 suits award attorney fees to a party who brings a suit and wins.
These lawsuits are paid for by all of us, by tax dollars. They take money that could go to rehabs, school, and community oriented policing. Mean while, these lawsuits could cause police officers to be slow to react, leading to more injured police officers, leading to increased workers comp billing.

Yet, no one proposes caps on those types of lawsuits.
Not even lawyers have been ballsy enough to propose caps on their malpractice.
And again, this doesn't make the awards unlimited, just tied to inflation (with a one time bigger adjustment). Even if you're in favor of caps, you should agree that they should increase with inflation. In real terms, when the caps were imposed, the cap was over 1 million 2014 dollars.

I am willing to risk paying more to make sure that people injured by very damaging malpractice get what they are due.

nm fucked around with this message at 04:55 on Sep 29, 2014

FRINGE
May 23, 2003
title stolen for lf posting
Lawsuits are less of a problem for healthcare costs than predatory billing, but there isnt a political machine pushing to address that so most of America thinks "frivolous lawsuits" are a serious issue, because there is a political machine pushing the idea that that is a serious issue.

edit: This is the one I was looking for: http://www.thesleuthjournal.com/scam-alert-hospitals-america-wildly-inflating-medical-bills/

quote:

All over America, doctors are popping into surgeries or are stopping by to talk to another doctor’s patients for a few minutes and are charging thousands of dollars for this “assistance”.

...

Another thing that needs to be stopped is the practice that many hospitals have of billing patients for emergency medications at a rate that is thousands of times over cost.

http://www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?_r=0

quote:

... an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives

...

The phenomenon can take many forms. In some instances, a patient may be lying on a gurney in the emergency room or in a hospital bed, unaware that all of the people in white coats or scrubs who turn up at the bedside will charge for their services. At times, a fully trained physician is called in when a resident or a nurse, who would not charge, would have sufficed. Services that were once included in the daily hospital rate are now often provided by contractors, and even many emergency rooms are staffed by out-of-network physicians who bill separately.

Patricia Kaufman’s bills after a recent back operation at a Long Island hospital were rife with such charges, said her husband, Alan, who spent days sorting them out. Two plastic surgeons billed more than $250,000 to sew up the incision, a task done by a resident during previous operations for Ms. Kaufman’s chronic neurological condition.

In the days after the operation, “a parade of doctors came by saying, ‘How are you,’ and they could be out of network or in network,” Mr. Kaufman said. “And then you get their bills. Who called them? Who are they?”

http://www.forbes.com/sites/peterubel/2012/08/21/its-physician-pay-stupid/

quote:

Why does hip replacement in the United States cost $4,000, while costing less than half that amount in Australia, hardly a medical backwater? Why does such an operation cost six times as much in the United States as it does in Canada?

The price of medical services is significantly higher in the United States than other parts of the world. Primary care physicians in the United States make $186,000 per year on average versus $131,000 in Germany. Orthopedic surgeon pay ranges from a high of $442,000 in the United States, to $324,000 in the UK, to a relatively parsimonious $187,000 per year in Australia, that according to analysis by the United Health Group Foundation.

http://careandcost.com/2013/11/17/predatory-health-care/

quote:

If Medicare had been the payor in this case, the hospital’s total reimbursement would have been a little less than $2,000. But the lithotripsy and associated costs were billed at $33,160, or just under 17 times the Medicare rate. After the patient applied for financial assistance, a 30% contractual adjustment was applied, reducing her bill to just under 12 times the Medicare rate.

If the health system had asked her to pay 190 percent of Medicare – typically the upper end of commercial insurance rates – her bill would have been about $3,800. By the time I was contacted, the patient and her husband – responsible people trying to make good on their debt – had already paid the health system $5,700 or 285 percent of Medicare. The hospital insisted they owed an additional $16,000.

...

That’s the core point. Most health system executives have, at some time in their careers, released a friend or acquaintance from egregious pricing. Many have forgiven a debtor they didn’t know because the issue was raised and they knew how unfavorable it would look in the local media. In other words, most know that, while these practices are lucrative and mostly hidden, they are also disgraceful.

http://www.ncbi.nlm.nih.gov/pubmed/15209592

quote:

CONCLUSIONS:

Aggressive debt retrieval for medical care appears to be indiscriminately applied with a negative effect on subsequent health-seeking behavior among those least capable of navigating the health system.

http://www.examiner.com/article/medical-billing-advocates-can-help-fight-billing-abuse

quote:

80 percent of medical bills contain *errors, accounting for as much as 49 percent of total charges, according to Christie Hudson, of Medical Billing Advocates of America, an organization based in Salem, Virginia. The organization’s website claims that billing abuse costs consumers upwards of $10 billion per year.
* I would say that they are not "errors" or they would not consistantly drivethe price higher, instead the "errors" would include some under-billing.

FRINGE fucked around with this message at 05:11 on Sep 29, 2014

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Trabisnikof
Dec 24, 2005

Next we're going to have the Suede Denim Secret Police:

http://arstechnica.com/tech-policy/2014/09/california-cops-dont-need-warrants-to-surveil-with-drones/

quote:

California Gov. Jerry Brown vetoed legislation that would have required the police to obtain search warrants to surveil the public with unmanned drones.

Brown, a Democrat facing re-election in November, sided with law enforcement and said the legislation simply granted Californians privacy rights that went too far beyond existing guarantees. Sunday's veto comes as the small drones are becoming increasingly popular with business, hobbyists, and law enforcement.

"This bill prohibits law enforcement from using a drone without obtaining a search warrant, except in limited circumstances," the governor said in his veto message (PDF). "There are undoubtedly circumstances where a warrant is appropriate. The bill's exceptions, however, appear to be too narrow and could impose requirements beyond what is required by either the 4th Amendment or the privacy provisions in the California Constitution."

At least 10 other states require the police to get a court warrant to surveil with a drone. Those states include Florida, Idaho, Illinois, Indiana, Iowa, Montana, Oregon, Tennessee, Utah, and Wisconsin.

As Slate described it, "California's drone bill is not draconian. It includes exceptions for emergency situations, search-and-rescue efforts, traffic first responders, and inspection of wildfires. It allows other public agencies to use drones for other purposes—just not law enforcement."

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