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Kristov
Jul 5, 2005

Gounads posted:

So, you're buying yours through the exchange, right?

No, my employer covers 75% so I only pay like $120. Just saying that the total amount payed to the insurance companies is more.

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Post 9-11 User
Apr 14, 2010

silvergoose posted:

What? McConnell is in the Senate, the gerrymandering is from state borders, no districts involved at all. Learn a bit more about the election system?

Yes, Senators are elected! Then, there is a vote within the Senate to see who gets to hold certain positions! Reading is fundamental. Did you have a single thought about how useless shits keep their positions within the House and Senate?

Brannock
Feb 9, 2006

by exmarx
Fallen Rib
Can you explain how gerrymandering affects Senate elections?

William Bear
Oct 26, 2012

"That's what they all say!"
From the front page of Fox News:



"drat it, Paul, it's the first day of the new Congress. Is it too much to shave?"

Fuckt Tupp
Apr 19, 2007

Science
Joementum is a drat liar.

Ryan didn't grow a beard, he's just turning into Teen Wolf.

amanasleep
May 21, 2008

Amergin posted:

The Dems never had to go anywhere NEAR Public Option. There are plenty of bogeyman to fight and those fights would all help reduce healthcare costs.

Make hospitals ACTUALLY non-profit and curb the earnings from hospital admins.
Allow US citizens to buy pharmaceuticals from Canada.
Limit the profitability of pharmaceutical companies, or tie their profit margins to their R&D costs.
Enact comparison studies on pharmaceutical companies' products and provide incentives for doctors/pharmacists to use cheaper drugs that have the same (or better) efficiency.
Enact some tort reform to reduce the over-testing of patients.
Limit profitability of medical device manufacturers or present incentives/disincentives for hospitals to stop buying equipment they don't need.
And although it doesn't necessarily tie too much to costs, try to reform/force insurance companies to simplify the language and layout of EOBs and other communication/billing.

NONE of this has anything to do with a public option but ALL of it (except the last item) would help reduce healthcare costs. What, of these items, was included in the ACA?

These items didn't need the Dems to stand up to the GOP and make "socialism" palatable, it required them to grow a loving spine and represent their constituents rather than their lobbyists. They failed, Obama failed, this legislation failed, and you're sitting here with a penny in your hand acting thankful because it was your team that did it.

If this was passed under a GOP executive + Congress you would be loving livid.

If the GOP had passed the ACA I would have been surprised, and some on the left would have been angry, but you are drawing a false equivalence here since the left would not behave like conservatives for passing legislation that improves the lives of Democratic voters.

The ACA is fundamentally insurance industry reform, so talking about a bunch of reforms to hospitals, pharmaceutical and med device companies is seriously moving the goalposts. All of those things sound pretty decent, but the lack of them doesn't weaken the significant insurance reforms that that are accomplished in the ACA and doesn't minimize the significance of the historic increase in health care access that was the prime liberal motivation for health care reform in the first place.

So get it through your head: Liberals want health care reform to expand access to affordable health care for all, and the liberal view of success or failure for the ACA is based on how well it achieves that vision. Cost cutting is also important (particularly if it accompanies breaking the political power of big companies) but it is secondary.

No liberal should be ashamed of the ACA.

Rygar201
Jan 26, 2011
I AM A TERRIBLE PIECE OF SHIT.

Please Condescend to me like this again.

Oh yeah condescend to me ALL DAY condescend daddy.


Brannock posted:

Can you explain how gerrymandering affects Senate elections?

The Senate is constitutionally gerrymandered to benefit less populous States. :ms:

zoux
Apr 28, 2006

Brannock posted:

Can you explain how gerrymandering affects Senate elections?

Well Texas used to be gerrymandered into Colorado...

Zeitgueist
Aug 8, 2003

by Ralp

amanasleep posted:

If the GOP had passed the ACA I would have been surprised, and some on the left would have been angry, but you are drawing a false equivalence here since the left would not behave like conservatives for passing legislation that improves the lives of Democratic voters.

The ACA is fundamentally insurance industry reform, so talking about a bunch of reforms to hospitals, pharmaceutical and med device companies is seriously moving the goalposts. All of those things sound pretty decent, but the lack of them doesn't weaken the significant insurance reforms that that are accomplished in the ACA and doesn't minimize the significance of the historic increase in health care access that was the prime liberal motivation for health care reform in the first place.

So get it through your head: Liberals want health care reform to expand access to affordable health care for all, and the liberal view of success or failure for the ACA is based on how well it achieves that vision. Cost cutting is also important (particularly if it accompanies breaking the political power of big companies) but it is secondary.

No liberal should be ashamed of the ACA.

LOL your defense of the ACA being poo poo on pharma reform is that it it doesn't address pharma reform.

That's great, because I know drugs sure don't have anything to do with healthcare costs, ever.

Franco Potente
Jul 9, 2010

Post 9-11 User posted:

Yes, Senators are elected! Then, there is a vote within the Senate to see who gets to hold certain positions! Reading is fundamental. Did you have a single thought about how useless shits keep their positions within the House and Senate?

It's not silvergoose's fault your first post was so poorly worded/half-assedly sarcastic that he couldn't figure out what you were actually trying to say.

CaptainCarrot
Jun 9, 2010

Post 9-11 User posted:

Yes, Senators are elected! Then, there is a vote within the Senate to see who gets to hold certain positions! Reading is fundamental. Did you have a single thought about how useless shits keep their positions within the House and Senate?

They're not useless from the perspective of their colleagues. Hoyer kept his position as Majority Whip when Murtha challenged him a few years ago because despite Murtha being closer in ideology to much of the caucus, Hoyer helped them raise money for reelection.

Joementum
May 23, 2004

jesus christ

pathetic little tramp
Dec 12, 2005

by Hillary Clinton's assassins
Fallen Rib

America is now literally Who Framed Roger Rabbit

zoux
Apr 28, 2006


Mahogany and ivory...

Franco Potente
Jul 9, 2010

He's blushing :3:

Joementum
May 23, 2004

jesus christ
Meanwhile, in the World's Greatest Deliberative Body...

Gin and Juche
Apr 3, 2008

The Highest Judge of Paradise
Shiki Eiki
YAMAXANADU

Is this an edit? Did he hit her with the gavel?

sit on my Facebook
Jun 20, 2007

ASS GAS OR GRASS
No One Rides for FREE
In the Trumplord Holy Land

zoux posted:

Mahogany and ivory...

All that's missing is the harmony.

Joementum
May 23, 2004

jesus christ

Gravel Gravy posted:

Is this an edit?

No, but this might be.

zoux
Apr 28, 2006

Joementum posted:

Meanwhile, in the World's Greatest Deliberative Body...



Is that a hog balls cutter offer?

sit on my Facebook
Jun 20, 2007

ASS GAS OR GRASS
No One Rides for FREE
In the Trumplord Holy Land

Joementum posted:

Meanwhile, in the World's Greatest Deliberative Body...


Well that's actually kinda funny.

amanasleep
May 21, 2008

Zeitgueist posted:

LOL your defense of the ACA being poo poo on pharma reform is that it it doesn't address pharma reform.

That's great, because I know drugs sure don't have anything to do with healthcare costs, ever.

Dude the Civil Rights Act is even worse on Pharma Reform.

The ACA recognized that most cost cutting measures either needed more study, had significant political opposition, or both. So most of the cost-cutting measures in the ACA are focused on the Independent Payment Advisory Board, which investigates cost cutting measures for Medicare and Medicaid. And just that one provision almost tanked the entire bill by provoking the massive DEATH PANELS freakout of 2009.

duz
Jul 11, 2005

Come on Ilhan, lets go bag us a shitpost


Joementum posted:

Biden to Cory Gardner: "We got something in common: sisters who are better looking and smarter than you."

Is TPM going to do another highlight reel like last time?

For reference:
https://www.youtube.com/watch?v=iEu40xl7oCY

Gin and Juche
Apr 3, 2008

The Highest Judge of Paradise
Shiki Eiki
YAMAXANADU

Joementum posted:

No, but this might be.



"Hey everybody! We're all gonna get laid!"

Rhesus Pieces
Jun 27, 2005

Internet Webguy posted:

Joementum is a drat liar.

Ryan didn't grow a beard, he's just turning into Teen Wolf.

Yeah that beard needs work. The only excuse for that is if it's a Packers playoff beard with only a couple days growth.

Ghost of Reagan Past
Oct 7, 2003

rock and roll fun

Internet Webguy posted:

Joementum is a drat liar.

Ryan didn't grow a beard, he's just turning into Teen Wolf.
Impeach Joementum!

MaxxBot
Oct 6, 2003

you could have clapped

you should have clapped!!
EDIT: nvm misread

copper rose petal
Apr 30, 2013
Haha, yes, the public option was too hard to pass. Better to try and literally socialize hospitals and also keep medical companies from making too much profit, surely that is a reasonable alternative which will definitely be supported by even a single legislator.

A stupid effortpost for some loving reason will follow.

Amergin posted:

Make hospitals ACTUALLY non-profit and curb the earnings from hospital admins.
Non-profit is just a tax designation, it makes no difference whether or not a hospital is non-profit or for-profit in terms of how much actual profit they make, or how much they charge insurance companies for procedures. Those charges are based on negotiated network pricing, a hospital doesn't charge less because they are non-profit. Non-profit hospitals are still rolling in cash, not sure why changing this would have any meaningful impact on the cost of healthcare. What's more, the ACA actually included a provision to review the non-profit status of these hospitals who may not be doing as much community services as they are letting on.

quote:

Allow US citizens to buy pharmaceuticals from Canada.
You mean the ones notorious for selling counterfeit medications? Yeah, let's get more of that. There's nothing doctors love more than having the additional dimension of "maybe all the drugs on this patient's list aren't actually the labeled med" when trying to figure out why you suddenly have liver failure for no discernible reason.

quote:

Limit the profitability of pharmaceutical companies, or tie their profit margins to their R&D costs.
Most initial R&D on potential drugs is done by the NIH, the bigger expense is in the drug approval process and LOL if you think the US government is ever going to pass legislation to forcibly limit the profitability of any company. Since that will never, ever happen, demand-side mechanisms have to take its place. That's what negotiated pricing is for, and why Medicare Part D was such a huge slobbering blowjob to the drug industry because it revoked Medicare's ability to negotiate drug pricing for Medicare recipients.

quote:

Enact comparison studies on pharmaceutical companies' products and provide incentives for doctors/pharmacists to use cheaper drugs that have the same (or better) efficiency.
There's already a pretty good base of information on comparative efficacy (which I assume you meant), but it could be expanded, sure. That'll require a few billion dollars to the NIH over the next 10+ years or so. Right now, drug formularies already act as a mechanism to force doctors to prescribe first line therapies, and why drug formularies are tiered. These incentives exist within the for-profit insurance industry, at the patient level. When a non-preferred drug gets kicked back at the pharmacy, the insurer gives a list of preferred first-line therapies that have to be tried before the more expensive drug will be covered and if step-therapy isn't done, the doctor has to convincingly document the medical necessity for skipping the cheaper alternatives.

quote:

Enact some tort reform to reduce the over-testing of patients.
A number of studies have shown that tort reform doesn't actually decrease the cost of care, and a number of states that have enacted tort reform and limited physician liabilities have continued to see consistent growth in healthcare costs. Over testing is done for a number of reasons. 1) You usually don't know what is considered "over" testing because you are not a clinician. 2) Our medical system is fee for service, there is an incentive to do any medically justifiable test simply because you'll get paid for it, and it helps recoup the costs of services that were not paid for either by insurance rejection or patient inability to pay. 3) Some defensive medicine is actually GOOD because it doesn't allow hospitals to cheap out on care because the threat of a lawsuit is actually effective.

quote:

Limit profitability of medical device manufacturers or present incentives/disincentives for hospitals to stop buying equipment they don't need.
Once more, putting profit caps on medical companies is never, ever going to happen. You might as well ask for the defense contracting industry to be nationalized or for us to go back to a cap on CEO salaries that is based on astrology, it's pie in the sky for any political party and I'm not sure that's even going to do very much to help cut healthcare costs. But on a serious note, there are already incentives/disincentives for hospitals to stop buying equipment they don't need, it's called "not being able to bill for any procedures using the new fancy machine". Hospitals aren't incentivized to buy equipment they can't bill out to use.

quote:

And although it doesn't necessarily tie too much to costs, try to reform/force insurance companies to simplify the language and layout of EOBs and other communication/billing.
The ACA did this. EOBs aren't hard to read.

quote:

These items didn't need the Dems to stand up to the GOP and make "socialism" palatable, it required them to grow a loving spine and represent their constituents rather than their lobbyists. They failed, Obama failed, this legislation failed, and you're sitting here with a penny in your hand acting thankful because it was your team that did it.
What you're arguing for here is so much worse than advocating for the public option, FYI. Capping corporate profits, allowing Americans to buy drugs outside of any reliable supply chain, and the mythical "tort reform" don't actually do much to maintain any quality of healthcare while also driving down costs.

quote:

If this was passed under a GOP executive + Congress you would be loving livid.
Yeah, because most this is a weird patchwork of "stuff that's already happening" and "poo poo that will literally never happen" without much evidence for how it will reduce the cost of healthcare without radical changes to both our economy and the way our entire medical system is structured on top of the recommended changes. Putting restrictions on the biggest actor in the healthcare transaction system, health insurers, has downstream effects. That's why Medicare is efficient at wrangling doctors, hospitals, and patients, whatever you happen to think of Medicare either as a patient or a provider. They pay less, but they pay on time, and they can (could) negotiate with a larger patient base than any of the major insurers.

So, once more. Insurers are already incentivized to cut the poo poo out of healthcare costs and negotiate down reimbursements for procedures that don't maximize their own profitability, i.e. better outcomes for less money spent. The problem is that they are also incentivized to cut out patients that consume too much healthcare, which is the primary thing the ACA was intended to rectify. It wasn't supposed to be an overhaul on the entire healthcare industry, because frankly changing that much all at once would have had a disastrous effect. While a lot of the things you mention are already being done by the insurance companies who have more leverage to negotiate the pricing of those medical services than an individual person would in a price-controlled market, medicine doesn't exist in a vacuum where you can just base the price of everything off what people should be able to pay and call it good.

Joementum
May 23, 2004

jesus christ

Aerox posted:

Someone please give Biden a cameraman and a reality show where he just walks around different places talking to people.

Ask, and the White House YouTube account shall answer.

https://www.youtube.com/watch?v=e3OFJlwig74

Aerox
Jan 8, 2012

Joementum posted:

Ask, and the White House YouTube account shall answer.

https://www.youtube.com/watch?v=e3OFJlwig74

THANKS OBAMA!

Zeitgueist
Aug 8, 2003

by Ralp

amanasleep posted:

Dude the Civil Rights Act is even worse on Pharma Reform.

The ACA recognized that most cost cutting measures either needed more study, had significant political opposition, or both. So most of the cost-cutting measures in the ACA are focused on the Independent Payment Advisory Board, which investigates cost cutting measures for Medicare and Medicaid. And just that one provision almost tanked the entire bill by provoking the massive DEATH PANELS freakout of 2009.

Pharmaceuticals: Roughly as relevant to healthcare as they are to civil rights.

Are you for real?

Joementum
May 23, 2004

jesus christ
Daniel Webster has been removed from the Rules Committee. That's the committee that controls what bills move to the floor. It's members are directly selected by the Speaker. :commissar:

Radbot
Aug 12, 2009
Probation
Can't post for 3 years!
loving LOL at the idea that if death panels weren't the bogeyman of the day that some other provision of the bill wouldn't have been

Mc Do Well
Aug 2, 2008

by FactsAreUseless

Radbot posted:

loving LOL at the idea that if death panels weren't the bogeyman of the day that some other provision of the bill wouldn't have been

Obama wants to punish successful drug companies! Why make new medicines if all your profit is going to be taken away by the government?

Zeitgueist
Aug 8, 2003

by Ralp
We can't have good reform because if we do the other party will say mean things about them.

Because this won't happen otherwise.

Trabisnikof
Dec 24, 2005

Let us not measure bills by how much they changed the world but instead by how far away from heaven the world is after they pass.

Sulphagnist
Oct 10, 2006

WARNING! INTRUDERS DETECTED

Joementum posted:

Ask, and the White House YouTube account shall answer.

https://www.youtube.com/watch?v=e3OFJlwig74

He says they're "re-enacting" it with the families present. Does that mean they do some sort of real swearing in beforehand, like with all the senators together?

Joementum
May 23, 2004

jesus christ

Antti posted:

He says they're "re-enacting" it with the families present. Does that mean they do some sort of real swearing in beforehand, like with all the senators together?

Yes, they do it four-at-a-time on the Senate floor and each Senator is led up by the other Senator from their state. Then they do the ceremonial version later in the Old Senate Chamber so that families can join and take pictures.

Zeitgueist
Aug 8, 2003

by Ralp

Trabisnikof posted:

Let us not measure bills by how much they changed the world but instead by how far away from heaven the world is after they pass.

It's really important that we pass bills if they make any positive difference at all, don't let the good be the enemy of the anything.

There's a little timer and if you don't pass them as soon as you have something positive in them the table will shake and you'll lose all the pieces.

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ReidRansom
Oct 25, 2004


Is there a blindfold involved? If not, there should be. Also threats of masonic level punishments for breaking the rules; tongue pulled out by its roots, that sort of thing.

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