|
The CEO sweetener is a fascinating exercise because the optics are awful, but it's the only thing they can come up with to try to distract health insurance companies from "we're going to tell anyone who's young and healthy to just not bother buying health insurance." This will be interesting mostly because I'm trying to wrap my head around who exactly this is supposed to appeal to.
|
#
¿
Mar 7, 2017 03:52
|
|
|
|
| # ¿ Apr 29, 2024 03:00 |
|
|
esquilax posted:nevermind Genuinely interested in your thoughts on this one, because I keep trying to figure out who the hell this is supposed to appeal to and not succeeding. The "murder the poor" provisions are insufficiently tough for the Tea Party caucus but sufficiently there to piss off the people who give a poo poo about them. Insurance companies are given a tax cut as apology for replacing the mandate with a sentence reading "young healthy people, if your insurance ever lapses, don't bother buying it back," which might be the worst imaginable answer. It is proving a difficult intellectual exercise to find a part of this spacecraft that's good.
|
|
#
¿
Mar 7, 2017 17:26
|
|
|
Pollyanna posted:Is this insanity going to pass, are we in for a huge blow to healthcare across the country, and will the GOP suffer any blowback from this? We're probably in for some kind of blow to healthcare across the country, but the bill as is is going to provoke some internal Republican rebellions from a few different directions.
|
|
#
¿
Mar 7, 2017 17:44
|
|
|
suburban virgin posted:I think this point is right at the heart of what's gone rotten in American healthcare, not just in Medicaid but generally. Too much time and effort being spent in the healthcare sector extracting every possible dollar from the old and insured (or Medicaid protected) and not enough keeping the population healthy throughout the majority of their lives. Naturally you're going to spend more on healthcare for the old and sick, that's just how people work, but a rational system would put a lot of resources into extending the healthy portion of peoples lives to save money later. It's a uniquely free-market issue where the healthcare industry wants to keep old, sick, brain-dead people alive on machine assistance and painkillers for as long as possible, but kicks young people out of the clinic to die of a treatable infection. It's called the capitation model. It's only ~minor~ problem is that it requires insurers and providers, two entities whose incentives are the polar opposites of each others', to play nice. Works like this: Insurers give providers a big sack of money, a big sack of patients, and say "this is for them. if you take care of them for cheaper you make more. if they get sicker you make less." Suddenly, providers have an incentive to try for preventative care as opposed to treating everything as a loss-leader on when your heart/hips/knees finally go and they can soak you for everything you've got. Elegant free market solution to the problem, right? Yeah, well, understandably, insurers have every incentive here to make the sack as tiny as possible and the patients as high-risk as possible, whereas the providers want it the other way around, and neither side has any reason to trust the other side's numbers in this negotiation. So you only really see it being rolled out where a hospital owns an insurance company or an insurance company owns a hospital, with all the accompanying inefficiencies: hospital-owned capitation models don't have profitable insurance divisions and insurance-owned capitation models don't have profitable hospitals. Outcomes are measurably better, of course, but nobody's pay is measured in human quality of life.
|
|
#
¿
Mar 7, 2017 18:09
|
|
|
Hieronymous Alloy posted:So how much time before this passes? How quickly is it being forced through? Great question. Ryan wants it fast-tracked as hard as possible because the longer people have to look at it, the longer they'll have to find the part of it that's a slap in the face to them personally. However, since Ryan doesn't have a lot of friends even within his own party, this is not an easy sell; the Freedom Caucus, among other things, know they were elected to grandstand about how Obamacare Must Die and aren't going to knock it off any time soon.
|
|
#
¿
Mar 7, 2017 23:26
|
|
|
silence_kit posted:Is being a doctor really like an episode of House, M.D. where you are constantly making judgement calls on esoteric diseases and oddball symptoms that only a veteran would be able to diagnose, or is there a lot of stuff that residents could do on behalf of the veteran doctors that would greatly enhance the veteran doctors' productivity? I suspect that reality is more like the latter than the former. And on the rock of "it seems to some rando on the internet," we shall rebuild our health care system. To lay this one out simply, silence_kit, when you gently caress up a diagnosis, people die. The difference between "take some aspirin and call me in the morning" and "that aspirin will in fact kill you because important bits of you have hosed up pH" is a series of small details that you have to know to look for, because the patient's unlikely to volunteer them. Courtesy of this, there is no doctor in primary care who has not, through making a mistake, killed a patient, whether through missing something critical or actively prescribing a course of treatment that kills someone. Seriously, they don't exist. It's a business where gently caress-ups are measured in human lives and nobody is perfect. You are correct in your guess that residents could do a lot of stuff without being checked by veteran doctors! For that matter, four times out of five, a reasonably bright high schooler could handle a primary care patient by dressing "eh, don't worry about it, you'll be fine" up in medicalspeak! That remaining 20%, you need someone who knows what the gently caress they are doing, or people die. And you don't know who that 20% are until you're talking with them. For understandable reasons, the principle "try not to kill patients" is kind of foundational to the design of medical education.
|
|
#
¿
Mar 10, 2017 21:46
|
|
|
Azhais posted:otoh people surviving medical emergencies is clearly not one of the current administration's priorities, so now's the time to change the rules! Fun fact: the major change in provider mechanics over the last several years has been a shift away from focus on highly specialized doctors- cardiologists and the like- back towards primary care. As it was charmingly summed up to me, having the biggest cardiology department in the state doesn't make you any money if all your prospective patients die of their heart attacks at home.
|
|
#
¿
Mar 10, 2017 21:59
|
|
|
Nissin Cup Nudist posted:What is the AMA saying this year? That there are too many doctors or not enough doctors? Both are true, entertainingly. Too many of the wrong kind of doctors, too few of the right kind. Turns out they'd been churning out as many high-tier specialists as they could for decades and then discovered whoopsie, without competent primary care docs to feed them cases they sit around very expensively doing nothing. For the last twenty years, primary care was where you shoved the bottom forty percent of your graduating med school class, who couldn't get a specialized position. This turns out to have been a problem. It's also why the muslim ban+derivatives is a particularly nuanced bit of bad news for health care: awful lot of kids from southeast asia went through med school, and for the usual the-people-making-hiring-decisions-at-the-desirable-positions-are-almost-invariably-old-white-guys reasons they're overrepresented in the list of people who couldn't get specialized positions. Long story short, whole lotta rural primary care docs with family in islamic-majority countries, and seriously weighing if sticking around in the States is a good idea at the moment.
|
|
#
¿
Mar 11, 2017 00:35
|
|
|
Fulchrum posted:Whereas Americans all just hate the rich and have never had any aspirations to be like them, right? That's just always been a winner. The wealthy of america stood united behind a candidate whose explicit-as-laid-out-by-the-currently-top-ranking-democrat-in-America campaign strategy was to abandon the working class in favor of picking up the votes of suburban republicans. Her opponent, a billionaire who has difficulty reading to the end of a sentence before getting bored and was caught on tape bragging about having sexually assaulted women, accused her of being a puppet of the rich. One of them is now president. Reconcile this with your theory that what the American people really want is to obey the whims of people with more money than them.
|
|
#
¿
Mar 13, 2017 20:50
|
|
|
HappyHippo posted:Unfortunately it looks like the report projects a decrease in the deficit. I was hoping it would increase as that would piss off the conservative wing even more; they don't give a poo poo about people losing coverage. Curious about the mechanism by which that works- mostly just cutting Medicare and company?
|
|
#
¿
Mar 13, 2017 21:21
|
|
|
HappyHippo posted:Medicaid, but yes. Cuts to Medicaid exceed the revenue lost in the tax cuts and credits. Surprised they could find that much in Medicaid to cut, tbh.
|
|
#
¿
Mar 13, 2017 21:30
|
|
|
PT6A posted:I'd actually say adopting the culture around food (not eating so loving much, and eating slower in general) is the most important change that could be made. God knows the French aren't avoiding butter or cream, and the Spanish are not avoiding red meats and/or cured meats, as we are commonly advised -- they just eat far less of it. there is a long version of this story, and a short version of this story, and one of the two of them is "corn subsidies".
|
|
#
¿
Mar 21, 2017 06:01
|
|
|
Ogmius815 posted:Look man I know it's leftist dogma that the least popular presidential candidate ever losing by ~100,000 votes perfectly geographically distributed to gently caress her over means that all non-leftist democrats are doomed and Bernie is the Light, but those of us on planet earth see some problems with that conclusion. which is why Democrats currently control the Senate.
|
|
#
¿
Mar 21, 2017 15:49
|
|
|
evilweasel posted:The Senate is always going to be a problem for Democrats given that its setup favors rural areas over urban ones. But there's really not a solid argument that to take back the Senate what you need to do is move left because it requires capturing a number of seats in reddish states. The solid argument is that if you propose something that will actually improve the material conditions of voters, they will vote for you. In a world where centrists were arguing Democrats should actually try to do something- indeed, anything- you'd be right, there's no solid argument to move left. In a world where "do something for your constituents that might piss off some lobbyists" constitutes a profound deviation from establishment orthodoxy, i.e. this one, the story is quite different. Paul Ryan's trying to hand the democrats the entire 64+ demographic going forward, neatly wrapped with a bow on top, and they're busy yelling about Russia instead.
|
|
#
¿
Mar 21, 2017 16:35
|
|
|
evilweasel posted:on the other hand, what happened after the stimulus and obamacare was passed, both things that actually improved the material conditions of voters in pretty dramatic ways Fair line on the stimulus. After obamacare was passed, however, your average voter saw their premiums rise and their cheap doesn't-actually-cover-poo poo insurance get canceled. A strategic, pragmatic decision was made to screw over the average voter in favor of getting the health insurance industry onside, and it turns out the average voter faced with a change from "couldn't pay health costs in a million years" to "couldn't pay health costs in 30 years, also your premiums are higher now" bites back real fuckin' hard. "You and your children would be bankrupted trying to pay for your health care" is an improvement over "You and three more generations of your family would be bankrupted trying to pay for your health care" in only an abstract sense. To the voter on the ground? You are asking him for more money, and he still can't pay for the health care he needs. Obamacare 'helped' so many people that Democrats seeking reelection actively fled from any responsibility for helping pass it, and fled so successfully they managed to lose several state governments in the bargain.
|
|
#
¿
Mar 21, 2017 17:06
|
|
|
evilweasel posted:I don't really believe there's any way to pass major health reform without either losers or (more likely) people who fear they will be losers, and it's very difficult to get the benefits to people before the next election. Its not like it was unexpected that the delay in the law's effectiveness until 2014 was going to be a problem - the bill was revised to push as many benefits (children on their parent's plan, for example) as early as possible. And even then we all remember the healthcare.gov issues. You just can't reform 20% of our economy on a dime: even if you can wave a magic wand and get your preferred bill through congress you can't implement it immediately without more magic. So there's always going to be a time between when the bill passes (creating, at a minimum, the people who fear they will be losers under the new system) but the benefits aren't really real. Hell, people are really only waking up to how important the benefits are to them now that they're at risk. Yes. And the Democrats chose for the losers to be the average voter, and the winners to be health insurance companies. This was not an unforeseeable consequence. This was a decision, actively made, under the assumption that under a sufficient PR blitz the average voter would be more tractable than the health insurance lobby. Whoops. quote:And that was an "incremental" change rather than the sort of massive UHC change. Like, even if we just go to medicare for all, that is a lot of additional work. You have to build out all the systems to handle new people, transition people from their old insurance to medicare, get the doctors who previously weren't doing medicare doing it, wind down insurance companies, deal with the sure and certain republican sabotage and delay, etc. Paradoxically, incremental changes often require significantly more to make functional than sweeping changes. Being careful to make sure every established player doesn't have to change too much puts a tremendous amount of financial and tactical overhead on a project. The question is whether the costs of preserving extant inefficiencies will outweigh the new inefficiencies, and that is a question Obamacare was very carefully designed to avoid answering. quote:So at the end of the day if you want to do heath care you can't rely on "do good things for people and you will be rewarded". Maybe Obamacare could have been sold better - but I question if any messaging that needs to explain a new system to people can ever beat fearmongering based on fear of the unknown. It's always going to be simpler to attack any heath care plan than to support it. And at the end of the day, even if we go back to the pre-Obamacare disaster of 50 million uninsured, that's still a minority of the population. Even if you double that to assume 100 million people have health care that is nonexistent or is - in their own minds - effectively nonexistent so they will support any improved plan, you've still got the 200 million people who have a level of health care they are afraid to lose. So you've always, always, got the problem of the "middle class" who would be better off under UHC done right, but are afraid that their workable insurance will be replaced by UHC done wrong. You can, in fact. And indeed must. Obamacare was wholly reliant on doing good things for the health insurance lobby being rewarded by them having the system's back going forward, a bet that its architects lost both publicly and hilariously in the case of Aetna, but that looks to be being rewarded right now, as the health insurance lobby makes its displeasure with this new bill known. You're right when you say there will always be a great deal of fear of the unknown. Quite a bit will turn out to be justified. The calculus is how many people you can rely on having your back thanks to the new changes, and if you can expect to balance them out. quote:The only real solutions I see to those problems are (a) incrementalism: create a parallel public alternative (expanded medicare/medicaid, public option) and let people transition to it slowly as they become comfortable with it or (b) wait for the reaganites to die out and younger generations who don't share the assumption that the government fucks things up take power and reverse the cultural assumption government fucks stuff up Republicans have managed to instill. Neither are quick options. And as we're seeing now, you have to keep power after you implement the changes long enough to make them stick: you can't just get power, ram them through, then lose power because then it's all for naught. B is a non-starter, as we both well know; it is astonishing how quickly anyone's definition of 'attainable change' twists into 'profits me, personally.' You will never lack for Reagans. As for A, I don't disagree that your definition of incrementalism is correct. i would only challenge it to increase the increments in question. There is no way to improve the American health care system that does not involve pharmaceutical companies and health insurance companies losing, and losing big. The sooner plans that try to mollify entities whose structural interests are reliant on the system remaining broken are a thing of the past, the better.
|
|
#
¿
Mar 21, 2017 19:23
|
|
|
EugeneJ posted:So if it dies today, Obamacare survives until at least 2019, right? Nothing stopping them from repeating this process, either; awful lot of year left to take another shot at it. Well, Paul Ryan's pride, maybe.
|
|
#
¿
Mar 23, 2017 15:26
|
|
|
Rhesus Pieces posted:I thought they could only do a budget reconciliation bill once per year and anything else they try this year would need 60 in the senate. Am I wrong here? They can only pass one budget reconciliation bill. If they want to spend the rest of the year failing to pass this one, that would be okay by me, mind.
|
|
#
¿
Mar 23, 2017 16:00
|
|
|
Craig K posted:i legitimately don't know who the gently caress this bill as is WOULDNT royally piss off Very wealthy old people. ...that appears to be the list, in its entirety.
|
|
#
¿
Mar 23, 2017 23:27
|
|
|
Rad Valtar posted:As someone who only has affordable insurance because of the ACA what are the realistic chances of it surviving? I'm guessing the GOP will just keep drawing up new plans until something gets passed? In an ideal-for-them world, yes, but while the House Freedom Caucus remains at large and unwilling to compromise on feeding Grandma into a wood chipper you're going to be hard pressed to find a bill that doesn't fail, embarrassing the speaker repeatedly. Paul Ryan wants to sit in the big chair someday, being the Guy Who Obamacare Humiliated will not aid him in this cause.
|
|
#
¿
Mar 24, 2017 20:59
|
|
|
Pizdec posted:Speaking as an European who is way out of the USPOL loop - How was the Trumpcare proposal different from the pre-Obamacare status quo? "good news, your health insurance no longer has to cover medical treatments"
|
|
#
¿
Mar 24, 2017 23:24
|
|
|
Accretionist posted:This makes me wonder if Medicaid buy-ins are feasible. You have just described the nightmare scenario of every insurance executive in America. That is precisely the boogeyman they fear every time a national discussion of health care policy comes around, and they have spent a GREAT deal of money to make it known that anyone who so much as suggests it will have them willing to prop up any and all primary challengers to them going forward. That poo poo would hit the American health insurance industry like Chixculub and kill the dinosaurs a hell of a lot faster this time around. A few descendants would make it through, much smaller and much less powerful, but you are not going to make any friends telling the CEO of AETNA "hey, only making one million a year instead of ten million a year would still make you pretty damned rich." You would demonstrably improve the lives of millions of people, mind, but nobody gets paid by the life saved.
|
|
#
¿
Mar 25, 2017 03:40
|
|
|
Brainiac Five posted:Wow, looks like someone was only exulting in death and suffering ironically. Twain said it better quote:“I come from the Throne — bearing a message from Almighty God!” The words smote the house with a shock; if the stranger perceived it he gave no attention. “He has heard the prayer of His servant your shepherd, and will grant it if such be your desire after I, His messenger, shall have explained to you its import — that is to say, its full import. For it is like unto many of the prayers of men, in that it asks for more than he who utters it is aware of — except he pause and think. “God’s servant and yours has prayed his prayer. Has he paused and taken thought? Is it one prayer? No, it is two — one uttered, and the other not. Both have reached the ear of Him who heareth all supplications, the spoken and the unspoken. Ponder this — keep it in mind. If you would beseech a blessing upon yourself, beware! lest without intent you invoke a curse upon your neighbor at the same time. If you pray for the blessing of rain on your crop which needs it, by that act you are possibly praying for a curse on some neighbor’s crop which may not need rain and can be injured by it.
|
|
#
¿
Mar 28, 2017 15:13
|
|
|
A big flaming stink posted:In a surprise shocker no one knows anything about how the legislature actually operates. nah, in this particular case it's quite clear: the history of single-payer health proposals in California is particularly instructive. While Republicans are in power, Democrats will produce a dozen single-payer requests monthly. The split second they get the power to actually pass one, they will immediately return to whining about how it is ~haaaaard~ to make health insurance companies unhappy, and how their constituents are so ~unreasonable.~ You may recognize elements of this dynamic from recent history.
|
|
#
¿
Mar 29, 2017 16:56
|
|
|
Boon posted:I feel like you're taking the wrong lesson from recent history though. Are you? Your feelings re: asking politicians to do things for their constituents being morally suspect behavior are a matter of record, yes. Quorum posted:That's the joy of being in the minority, you can produce pie in the sky magic wand legislation that maybe isn't exactly practical, or you know, CBO-scored. It is literally harder to frame legislation when you think it might be able to pass, as perhaps a certain party has recently learned. Yes, yes, the bill explicitly designed from moment one by its architects to gently caress over the average american voter in the name of keeping health insurance companies from sinking it was Sabotaged By Lieberman. Whatever you need the origin story to be. The moral of this story remains that "elect democrats if you want single-payer" is at best a facile elision of the whole truth, and at its worst a self-serving lie. Electing democrats is not sufficient; you also need to put the fear of god into them that if they do not help their constituents out, they are going to lose the next election.
|
|
#
¿
Mar 29, 2017 17:17
|
|
|
Boon posted:The GOP got it's face smashed recently because they promised their constituents something that they could not deliver for purely political reasons. So if I'm following you, you want the Democrats to do the same thing but somehow magically deliver? That you consider the idea of a political party representing the will of its constituents to be a work of incomprehensible sorcery is remarkably illustrative of the rot in the democratic party, to my mind. Understand: we got tremendously lucky that Paul Ryan is a wet-behind the ears nobody as far as the House Republicans are concerned, and that the Trump administration hasn't gotten around to purging the CBO yet. A Speaker who has any kind of alliances among the disparate factions of these caucuses could have produced a bill that would pass the House and Senate both. An even remotely functional Republican party would be celebrating the ACA's repeal now. Fortunately for us the ruling party is currently a tremendously dysfunctional mess. If a political party actually wants to do something with popular support, it takes a colossal gently caress-up to make it not happen. If you argue that the Democratic Party cannot be made to do an unambiguously good thing with popular support, I have to ask what your rationale for supporting them even is.
|
|
#
¿
Mar 29, 2017 17:35
|
|
|
evilweasel posted:There is not much more to say besides you have stupid opinions that are not borne out by the facts, and when faced with facts that conflict with your preconceived notions of reality you will disregard the facts. You are massively, massively ignorant, the things you say are based on misunderstandings of the relevant facts/flat out incorrect beliefs, and you generally are unable to conceive of the concept that moving towards, but not getting to, a goal is a positive step or the idea that sometimes you can't get everything you want. Anything more complex than Good and Evil gets rejected by your brain and you produce dumb poo poo like this. That you interpret any steps toward the common goal more dramatic than the ones you, personally, are comfortable with at the moment as a personal attack is a strange pathology, but fortunately irrelevant! You're an important part of the process: you are a reliable defender of progress achieved. When you are whipped and cajoled into leaving your comfort zone to defend an actual advance towards a common goal, you will only try to trade it away in a Grand Reasonable Bargain two or three times per decade. We're both believers in incrementalism, evilweasel. You just find the idea of increments larger than your own morally suspect, for whatever reason.
|
|
#
¿
Mar 29, 2017 17:49
|
|
|
Quorum posted:If anyone purges the cbo it will be Ryan, not Trump, because the cbo is literally the Congressional Budget Office. That's what I thought, prior to reading that Trump replaced the director but not anyone underneath that. Maybe someone got confused between the CBO and the OMB. Odd. quote:More to the point: one of the reasons the GOP is failing miserably here (among a lot of reasons) is that they're trying to change a lot with just one bill, which is ridiculous. They're doing it because of a quirk in our legislative procedures, when practically speaking big changes require many bills, some addressing flaws in earlier ones. Ultimately ensuring universal health care (whether or not it is single payer in the end!) will be, and was always going to be, that way as well. Even most Medicare For All proposals do not create universal single payer, but rather the public option that ACA should have contained, which can gradually grow until it becomes effectively a single payer system. Lieberman is -a- reason. Not, unfortunately, -the-. The strategic vision that brought you Obamacare was in its entirety predicated on bringing health insurance onside from moment one, and that meant they got an awful lot of veto power. There's a reason the Max "A Wholly Owned And Operated Subsidiary Of Blue Cross/Blue Shield" Baucus's version of the bill was the one that finally saw daylight, and it sure as hell wasn't the involved parties thinking it was the best of the available bills. The public option was dead from the moment that the opening strategic decision was made, Lieberman's existence just provides a convenient cover for that fact going forward.
|
|
#
¿
Mar 29, 2017 18:22
|
|
|
To elaborate, the explicit strategic decision was to, wherever the interests of the average american voter and the interests of health insurance companies conflicted, to privilege the interests of health insurance companies, on the assumption that one of the two was a more reliable ally going forward. This is Sound Centrist Logic. Insurance companies have an immediate impact on your reelection prospects. The average voter has a much more abstract one. There was still plenty of good done for the average american voter! Health insurance companies have no issue whatsoever with the government promising to give them money they otherwise would not get from poor people! It's just on issues like "do literally anything about rising premiums" where they produced a great deal of friction. Whiiiiich brings us to now, and that strategic decision coming back to bite in a big fuckin' way.
|
|
#
¿
Mar 29, 2017 19:00
|
|
|
Boon posted:Did you become politically conscious in November? Do you know who John Boehner is or Ted Cruz or how stupid this statement sounds? Medicare Part D. Just as transparent a shitshow, just as transparently a horrible waste of money, just as transparently a blatant handout to private industry, just as abominably stupid an idea. The Republican Party passed it without so much as blinking. I understand if you became politically aware in the last four years, but I'm afraid your vision of it being impossible for a party to make broad changes to the American health care system is a lie you tell yourself to feel better. quote:The world isn't that simple. Like, full stop. This 'popular support' that you think is some kind of universal, single-issue block quickly fragments the moment you go, "Alright, let's look at the various details of this extremely broad and ill-defined talking point of a policy" You support a political party which you gladly accept is unwilling at best and incapable at worst of representing its constituents. While your support of anything with a -D on the end of its name makes the recipe for getting your support for progressive policy pretty simple, I really do have to ask what you think you're getting out of this arrangement.
|
|
#
¿
Mar 29, 2017 19:14
|
|
|
Lockback posted:I literally used his terminology Yeah, imprecise wording, my bad. Better to have said wherever a choice had to be made between loving you and loving insurance companies, the architects of the ACA made the explicit strategic decision that option 1 is the default.
|
|
#
¿
Mar 29, 2017 19:17
|
|
|
Boon posted:Your implication is that your mythical constituents understand the difficulty of shifting 1/6 of the economy and impacting 325 million people. They don't. Sure! And some people voted for Hillary Clinton because they thought she'd declare war on Russia. Does their stupidity mean electing Hillary Clinton is a bad idea?
|
|
#
¿
Mar 29, 2017 19:27
|
|
|
Boon posted:Because the realities of cost are this: Americans want expensive things and good health but are unwilling to pay for them or change their ways. ...what a curious statement to make. Of course I would like UHC, and of course I am well aware of the fact implementing in one stroke from the current system would result in a tremendous tax increase! To say nothing of the total collapse of the American private health insurance industry overnight, good god, the spike in unemployment alone would make the incoming self-driving-truckpocalypse look like a regular round of layoffs. The public option is the simplest way to move towards that from here. Unfortunately, as Xae can attest, the idea of a public option is already something that makes any health insurance exec's blood run cold in primal terror, as they (quite rightly!) see one being launched as the end of their industry as it currently stands. The trick is to move the Overton window far enough that the slow death of public option is an acceptable compromise for them versus the very quick and extremely painful death of UHC.
|
|
#
¿
Mar 29, 2017 19:36
|
|
|
BarbarianElephant posted:I never heard of anyone who did this, but plenty of people who voted Trump because they were afraid Hillary would declare war on Russia. Yup. Their opposite numbers were far fewer, and utterly deluded, but they did exist. Support of a good thing being ill-informed is not a disqualification for the good thing, to my mind.
|
|
#
¿
Mar 29, 2017 19:40
|
|
|
Boon posted:Not really. Medicare/Medicaid is already primarily administered by private insurers in partnership with CMS. It represents the main strategic thrust for UHG (the world's largest health insurer) Yes. The health insurance industry is entirely accepting of being forced to compete with an entity with no profit motive, a far larger datapool to base its rates on, and the ability to mandate pharmaceutical prices in what is, at the moment, the definition of a captive market. Your political awareness started during the Bush years. This is understandable. Do yourself a favor. Look up the history of Hillarycare. The short form of which, I regret to inform you, reads as follows: 
|
|
#
¿
Mar 29, 2017 19:43
|
|
|
Boon posted:That's great! Except htat's still not good enough because, and this is the thing that might blow your mind, popular opinion doesn't actually mean a goddamn thing. If you think Congress does anything in this country, now or at any time in the past based soley on popular opinion, then you should perhaps take a break from these threads. Moreover, it's not clear that popular opinion SHOULD form policy, after all, it's popular opinion that is leading the UK to shoot itself in the economic face. And so we arrive at the feeble, quivering organ that serves as the technocratic argument's heart: that a government that represents the will of its constituents is not only an impossible, magical dream, the very concept is a monstrosity that must be opposed wherever it presents itself. "Popular opinion doesn't actually mean a goddamn thing." One hell of a democratic party slogan you've got there, my man.
|
|
#
¿
Mar 29, 2017 22:34
|
|
|
Boon posted:I love that you think your idea of a singular, lock-step united party is possible when the very fact we are arguing about how to accomplish a common goal lies in opposition to the idea. Have you ever worked in an organization, any organization, where you have had to 'herd the cats' to get something done? Magnify that by multiple orders of magnitude and you have the Democratic party. For gently caress's sake. Who said anything about a lock-step, united party? You're the one who said a party actively ignoring the will of its constituents, as repeatedly expressed was the correct approach, on the grounds that popular opinion, and I quote, "doesn't actually mean a goddamned thing." This is a democracy. The Democratic Party has lost over a thousand seats in the last decade, and is currently the weakest it has been since Reagan, thanks to the horrifying discovery that popular opinion does, in fact, mean a goddamned thing. You will never structure a healthcare proposal such that everyone supports it, sure, given. The most you can hope to do is structure things such that the largest number of people support it. In the Democratic Party's previous shot at a healthcare bill, they explicitly rejected that philosophy, in favor of making sure the largest number of health insurance companies supported it, on the grounds that popular opinion didn't actually mean a goddamn thing. At minimum, this strategy is part of the reason why we are currently discussing precisely how Republican total dominance over government will sabotage this healthcare policy going forward. This strategic error is avoidable in the future. You just have to remember that in democracies popular opinion does things.
|
|
#
¿
Mar 29, 2017 22:52
|
|
|
Boon posted:You refuse to do any critical thought on this eh? I guess it's my fault because I just assumed that these things are common knowledge. I'll do the work for you - here's a recent study on it. I have seen no work to significant contradict these findings, but I'll welcome any that you are aware of The Democratic Party that based its healthcare strategy- the sole major policy achievement of said party in the last eight years, through not entirely their own fault- around the premise popular opinion would have no influence on policy going forward has lost over one thousand seats in the last ten years, and as a result has zero voice in healthcare policy for at least the next eighteen months, more likely the next forty-two. Evidence provided.
|
|
#
¿
Mar 29, 2017 23:12
|
|
|
evilweasel posted:this is a wrong and stupid thing to say, it's at the foundation of all of the things you believe, and it is wrong, and stupid Max "Single payer was never even on the table" "The public option will hold back meaningful reform" "two point five million in donations from the insurance industry" Baucus might disagree, but hey, what would he know, he's just the guy who wrote it. I will leave the accusation of counterrevolutionary behavior for saying that popular will has an impact on ability to enact policy in a democracy where it lies, as I believe it speaks for itself. Yeowch!!! My Balls!!! fucked around with this message at 23:49 on Mar 29, 2017 |
|
#
¿
Mar 29, 2017 23:44
|
|
|
|
| # ¿ Apr 29, 2024 03:00 |
|
|
evilweasel posted:The Democratic Party's philosophy on the ACA was very simple: get as much done as possible in a bill that will become law. To do that, they needed as many stakeholders on board as possible, and pretty much nailed exactly the outer limits of what could get passed. You are fundamentally incapable of thinking about things in that way because it's complex thinking instead of just trying to declare Good and Evil in some way that lets you comfortably feel like you've explained the world in simple terms and no ambiguity is left. So, to be one hundred percent clear, you are in agreement that the Democratic Party's philosophy on the ACA was to, wherever possible, defer to health insurance companies over the american people wherever the interests of the two did not coincide ("needed as many stakeholders on board as possible-" excellent euphemism!) but object to that acknowledged reality being presented as a thing that hurt the Democratic party. You protest that is all that could have been done at the time, and that waving away even the pretense of negotiation for them before the discussion began was the only way to get what we ultimately got. That this defense can be unfalsifiably applied to literally any change, in any policy, at any point in human history, no doubt bugs you only a little. I suggest to you, o acolyte of pragmatism, that if your definition of political victory involves losing every single level of government after the people the victory was supposedly for get a taste of it, your definition of "victory" needs some work.
|
|
#
¿
Mar 30, 2017 02:01
|
|