Lizard King
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Post by Lizard King on Jan 21, 2014 16:09:05 GMT -5
There is a massive difference between catastrophic coverage or bond to offset the costs of uncompensated emergency room care, and comprehensive coverage or tax penalty to offset the costs of undercompensated chronic care. The Heritage Foundation floated the former possibility; Governor Patrick implemented the latter in Massachusetts after the legislature overrode Romney's veto on the matter.
Please, please, if you or anybody else is minded to talk about 'RomneyCare,' educate yourself about what Romney vetoed in the Massachusetts healthcare reform. What emerged in 2007 was PatrickCare; Deval Patrick implemented the reform, and did so on lines that suited the legislature more than his predecessor in the Governor's Mansion.
Then educate yourself about the truth that Massachusetts already had guaranteed-issue and community-rating; the reform championed by Romney was a response to the alarming inflation those measures created in the healthcare market.
What the ACA actually is, is a clumsy attempt to invert the logic of health insurance as a product and progressivism as a project - to redistribute funds from the asset-poor healthy young to the asset-rich sickly old. It is bad law and worse politics.
dj cited a NYT poll that showed majorities supported the Democrats over Republicans on healthcare policy - by a massive margin. That represented a longstanding policy edge for Democrats going back decades.
Recent polling shows a plurality of voters trust Republicans more than Democrats on healthcare. This is purely a consequence of PPACA - a law there was no pressure to pass, in the sense that the same poll dj cited showed more than three-quarters of respondents were broadly content with their existing healthcare options. "If it ain't broke, don't fix it," is a good rule of political thumb - with the understanding that it ain't broke if there ain't nobody thinks it's broke, or at least nobody who matters on polling day. That's why nobody reforms Social Security, for example.
Harry Reid claims 9 million Americans have healthcare because of PPACA. That includes an estimated 3 million 'pajama boys' piggy-backing on their parents' insurance (I await with interest the delayed impact of employer mandates on those families - it stands to reason that employer plans suddenly carrying extra beneficiaries are going to be more stretched than they would be otherwise, and that may make all the difference to employers deciding whether to drop those plans while they still can); an estimated 4 million on Medicaid (Harry said 3 million on Medicare, but clearly neither math nor familiarity with federal programs are desirable traits in a Senate Majority Leader) that Sean Trende's analysis suggests is probably closer to 200,000; and the 2 million plus that this administration - the ones that blamed Benghazi on a Youtube clip, Fast and Furious on George Bush, and IRS targeting of the Tea Party on rogue agents in Cincinnati - claim to have enrolled through the healthcare.gov portal, although 'enrolled' in this sense doesn't mean actually enrolled. It also discounts the self-evident truth that many of these enrollees, or 'enrollees,' had their plans dropped because of PPACA's insurer mandates.
And - I keep saying this because it's true and important - health insurance is not healthcare provision. The conditions for studying this don't arise often, but where they have, it has been repeatedly shown that, surprisingly, people who go from being uninsured to being insured don't show significantly better health outcomes. They are significantly less likely to file medical bankrupticies, but just as likely to die or be in poor health. And that's before we consider the very salient question of coverage networks and the real difficulties rural Americans face in receiving necessary medical care that qualifies for coverage under exchange policies.
AND -
A breakdown on that '47 million' figure. This was doing the rounds well before PPACA became law, and originates in a census report.
According to that census report, 10 million were illegal immigrants.
Around 17 million made better than median income, but chose not to have health insurance.
That gets us down to 20 million - a lot of people still, although I'm sure the President would be quick to put that in context as less than 10% of the population. Conservatively, half of these were eligible for Medicaid or SCHIP in 2009.
The real population of people economically barred from insurance is probably less than 10 million; the real population of people economically harmed in the insurance market by PPACA is an order of magnitude larger - and, to be clear, even PPACA's most sanguine projections still see millions of Americans uninsured.
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djAdvocate
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Post by djAdvocate on Jan 21, 2014 16:30:26 GMT -5
you seem to know surprisingly little about our values. I don't know where you're pulling your "60% support single-payer" figure from. I did a search on polls. um.....i posted a link, Canadude.The most recent one I could find was from 2012, where 40% of Americans supported a single-payer system, and 44% opposed it. When Canada went through the costs and convulsions of overhauling our system in the 1960's, 70% of the public supported it. I'm telling you that you're going to need a heck of a lot better than 40% for, 44% against to do it in the US. Moreover, you're missing my point about the ACA. I agree with you that the ACA isn't universal healthcare. I'm saying that it's an ill-conceived half measure brought in because the Democrats knew perfectly well that they didn't have anywhere near the level of support they needed to bring in universal healthcare (what you call "single-payer"), oh, i assumed you meant "public support". they had that. did you mean "congressional support"? yes, that is true. the healthcare industry owns congress, so there is no way that was ever going to pass.and so they fudged the whole thing to look enough like single-payer and enough like the existing system to placate voters and keep the insurance companies happy. As far as I'm concerned, you guys are still 30% short popular-support-wise of where every other nation was when they bore the pain of overhauling their systems and gutting their insurance industries. That is a cultural difference. i am not interested in what concerns you. but the facts are that there is sufficient popular support to pass single payer in the US- or there was before the ACA, anyway. i am not sure now, because i have not seen any polling done on it since it passed.You don't agree with me, try sticking your head out of California and asking your countrymen what they think for once. they don't call me polldancer for nothing, bro. i am constantly asking. ask anyone here. ask bronco, for gosh sakes.
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Virgil Showlion
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Post by Virgil Showlion on Jan 21, 2014 16:47:02 GMT -5
I don't know where you're pulling your "60% support single-payer" figure from. I did a search on polls. um.....i posted a link, Canadude.The most recent one I could find was from 2012, where 40% of Americans supported a single-payer system, and 44% opposed it. When Canada went through the costs and convulsions of overhauling our system in the 1960's, 70% of the public supported it. I'm telling you that you're going to need a heck of a lot better than 40% for, 44% against to do it in the US. Moreover, you're missing my point about the ACA. I agree with you that the ACA isn't universal healthcare. I'm saying that it's an ill-conceived half measure brought in because the Democrats knew perfectly well that they didn't have anywhere near the level of support they needed to bring in universal healthcare (what you call "single-payer"), oh, i assumed you meant "public support". they had that. did you mean "congressional support"? yes, that is true. the healthcare industry owns congress, so there is no way that was ever going to pass.and so they fudged the whole thing to look enough like single-payer and enough like the existing system to placate voters and keep the insurance companies happy. As far as I'm concerned, you guys are still 30% short popular-support-wise of where every other nation was when they bore the pain of overhauling their systems and gutting their insurance industries. That is a cultural difference. i am not interested in what concerns you. but the facts are that there is sufficient popular support to pass single payer in the US- or there was before the ACA, anyway. i am not sure now, because i have not seen any polling done on it since it passed.You don't agree with me, try sticking your head out of California and asking your countrymen what they think for once. they don't call me polldancer for nothing, bro. i am constantly asking. ask anyone here. ask bronco, for gosh sakes. So how do you explain the 40% figure in the Rasmussen poll? The two 60% figures you presented were for whether the public believed government could keep costs down and whether the public would pay higher taxes for the government to insure the uninsured. "Single-payer" and "universal healthcare" appear nowhere in those numbers. Maybe you hoped I wouldn't notice. If it's between your gut and a Rasmussen poll from 2012, you'll have to forgive me for hanging my hat on the latter.
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djAdvocate
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Post by djAdvocate on Jan 21, 2014 16:52:27 GMT -5
they don't call me polldancer for nothing, bro. i am constantly asking. ask anyone here. ask bronco, for gosh sakes. So how do you explain the 40% figure in the Rasmussen poll? for the ACA?The two 60% figures you presented were for whether the public believed government could keep costs down and whether the public would pay higher taxes for the government to insure the uninsured. 64% said the government should guarantee coverage. what does that mean to you?"Single-payer" and "universal healthcare" appear nowhere in those numbers. Maybe you hoped I wouldn't notice. maybe i don't see any difference between "guaranteed government coverage", "universal coverage", and "single payer". maybe you should stop seeing everything as some sort of plot against you. maybe you should stop assuming the worst in others. maybe.....maybe......maybe.If it's between your gut and a Rasmussen poll from 2012, you'll have to forgive me for hanging my hat on the latter. if you had the same opinion of Rasmussen as i do, you would sooner hang your hat on a moving lorrie.
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Lizard King
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Post by Lizard King on Jan 21, 2014 17:13:28 GMT -5
dj, your own source shows 77% of the respondents were happy with the status quo. That is not a mandate for reform.
Do you have a source for the assertion that a majority has ever wanted single-payer healthcare in the US?
By the way - "does the government do a better job than BCBS of managing healthcare claims" is a question like "would you rather be stung by a scorpion or a stingray." It's possible to answer in the affirmative without thereby endorsing that option.
In other words, your cited poll doesn't say what you're saying it says.
And since when has the NYT had more psepholigical credibility than Rasmussen?
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Post by Virgil Showlion on Jan 21, 2014 17:15:40 GMT -5
To me it means that 64% of Americans would be willing to pay a bit more out of pocket to guarantee a baseline standard of care for the poor.
Nothing in that figure suggests that public support extends to getting rid of insurance companies, getting rid of employer-funded coverage, getting rid of the private right to choose an insurance provider and level of coverage, moving to a tax-based system of healthcare funding, and paying the hundreds of billions needed to properly overhaul the entire system, all of which would be necessary if the US government moved to a genuine universal healthcare model "just like the other industrialized nations".
The support lost between the two would appear to be 64% - 40% = 24%, or roughly a quarter of the US population, which is a large part of why you got the ACA rather than a single-payer system.
I very much do.
If you don't, why would you distinguish between the ACA and a single-payer system? The US government guarantees a minimum level of coverage for the poor via Medicaid. That minimum level of coverage was expanded to include everybody (including those who don't qualify for Medicaid or are uninsurable) under the ACA. That very reasonably meets the definition of "guaranteed government coverage", which you're now claiming is no different from "single payer".
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djAdvocate
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Post by djAdvocate on Jan 21, 2014 17:22:26 GMT -5
dj, your own source shows 77% of the respondents were happy with the status quo. That is not a mandate for reform. meaningless. 77% of respondents are covered. we are talking about the 23% that are not.Do you have a source for the assertion that a majority has ever wanted single-payer healthcare in the US? i use the term "universal" because most people don't know what single payer is. but further more, i don't care for single payer ONLY. i prefer a dual system which has a single payer AND a private system. single payer ONLY is not a reasonable alternative in the US, imo. so when i say "single payer" i am referring to a dual system with a single payer OPTION.By the way - "does the government do a better job than BCBS of managing healthcare claims" is a question like "would you rather be stung by a scorpion or a stingray." It's possible to answer in the affirmative without thereby endorsing that option. try not to overanalyze single polls, Virgil. we can spend all day discussing stuff like that, and get nowhere.In other words, your cited poll doesn't say what you're saying it says. And since when has the NYT had more psepholigical credibility than Rasmussen? www.electoral-vote.com/evp2012/Info/rasmussen.htmlNYT has not been shown to have systematic bias, Virgil. Rasmussen has. it is a house polling service for FOX. it USED to be a good, independent poll. in fact, before FOX got them, they were one of the best out there. now, they suck. i am not saying they are wrong. but i would certainly prefer just about anyone else. although there are worse, too.
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Post by djAdvocate on Jan 21, 2014 17:25:27 GMT -5
To me it means that 64% of Americans would be willing to pay a bit more out of pocket to guarantee a baseline standard of care for the poor. Nothing in that figure suggests that public support extends to getting rid of insurance companies, i favor that. but i didn't suggest that most Americans did, either. please read my later responses. i prefer to use the term "universal" to "single payer" coverage. i apologize for using those terms as if they were interchangeable, and whatever confusion that might have caused.
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Post by Virgil Showlion on Jan 21, 2014 17:29:42 GMT -5
To me it means that 64% of Americans would be willing to pay a bit more out of pocket to guarantee a baseline standard of care for the poor. Nothing in that figure suggests that public support extends to getting rid of insurance companies, i favor that. but i didn't suggest that most Americans did, either. please read my later responses. i prefer to use the term "universal" to "single payer" coverage. i apologize for using those terms as if they were interchangeable, and whatever confusion that might have caused. I use "single-payer" and "universal healthcare" interchangeably too. But it's a far cry above "guaranteed government coverage" such as offered by the ACA. See my previous post for the litany of differences.
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Post by djAdvocate on Jan 21, 2014 17:29:49 GMT -5
I very much do. If you don't, why would you distinguish between the ACA and a single-payer system? because there is no guarantee of universal coverage with the ACA. in fact, the ACA never proposed anything even remotely approaching universal coverage.The US government guarantees a minimum level of coverage for the poor via Medicaid. That minimum level of coverage was expanded to include everybody (including those who don't qualify for Medicaid or are uninsurable) under the ACA. That very reasonably meets the definition of "guaranteed government coverage", which you're now claiming is no different from "single payer". i don't believe that the ACA includes everybody, via Medicaid or any OTHER mechanism. if it does, it is a way better law than i thought.
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djAdvocate
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Post by djAdvocate on Jan 21, 2014 17:30:45 GMT -5
i favor that. but i didn't suggest that most Americans did, either. please read my later responses. i prefer to use the term "universal" to "single payer" coverage. i apologize for using those terms as if they were interchangeable, and whatever confusion that might have caused. I use "single-payer" and "universal healthcare" interchangeably too. But it's a far cry above "guaranteed government coverage" such as offered by the ACA. See my previous post for the litany of differences. yeah, i am sorry, but i am not understanding that. care to explain it?>
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Post by Virgil Showlion on Jan 21, 2014 17:43:09 GMT -5
I use "single-payer" and "universal healthcare" interchangeably too. But it's a far cry above "guaranteed government coverage" such as offered by the ACA. See my previous post for the litany of differences. yeah, i am sorry, but i am not understanding that. care to explain it?> I had listed: ...getting rid of insurance companies, getting rid of employer-funded coverage, getting rid of the private right to choose an insurance provider and level of coverage, moving to a tax-based system of healthcare funding, and paying the hundreds of billions needed to properly overhaul the entire system, all of which would be necessary if the US government moved to a genuine universal healthcare model "just like the other industrialized nations". In this case "genuine healthcare model" = "universal healthcare" = "single-payer system". A truly socialist system where pay-in is tax based, so millionaires must (and do) pay in tens or hundreds of times as much money as paupers but get the same standard of care, the same priority in the waiting lines, the same access to treatments, etc. No such thing as employer coverage. No such thing as insurance companies. No markets for insurance. No choice as to level of coverage or insurance provider. From each according to his ability, to each according to his needs. A universal healthcare system administered on a national scale providing equal care for all, with rationing, prioritizing, vetting, funding all "built in" and centrally planned, not subject to market forces. This is a "single-payer system" = "universal healthcare". It's fair to call the ACA "guaranteed government coverage", but as a universal healthcare system a.k.a. single-payer, it most definitely does not meet the qualifications.
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Post by djAdvocate on Jan 21, 2014 17:58:39 GMT -5
yeah, i am sorry, but i am not understanding that. care to explain it?> I had listed: ...getting rid of insurance companies, getting rid of employer-funded coverage, getting rid of the private right to choose an insurance provider and level of coverage, moving to a tax-based system of healthcare funding, and paying the hundreds of billions needed to properly overhaul the entire system, all of which would be necessary if the US government moved to a genuine universal healthcare model "just like the other industrialized nations". In this case "genuine healthcare model" = "universal healthcare" = "single-payer system". A truly socialist system where pay-in is tax based, so millionaires must (and do) pay in tens or hundreds of times as much money as paupers but get the same standard of care, the same priority in the waiting lines, the same access to treatments, etc. No such thing as employer coverage. No such thing as insurance companies. No markets for insurance. No choice as to level of coverage or insurance provider. From each according to his ability, to each according to his needs. A universal healthcare system administered on a national scale providing equal care for all, with rationing, prioritizing, vetting, funding all "built in" and centrally planned, not subject to market forces. This is a "single-payer system" = "universal healthcare". It's fair to call the ACA "guaranteed government coverage", but as a universal healthcare system a.k.a. single-payer, it most definitely does not meet the qualifications. i don't think that the ACA is "guaranteed government coverage" tho, is it? that is the part i am not getting, Virgil. i would call it "mandated coverage". "guaranteed" implies that they are going to back it up, in the event you don't. i know of no such provision in the law. edit: sorry if you misunderstood me. i am still a little sick today, and not really....thinking well.....
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Virgil Showlion
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Post by Virgil Showlion on Jan 21, 2014 18:20:17 GMT -5
I had listed: ...getting rid of insurance companies, getting rid of employer-funded coverage, getting rid of the private right to choose an insurance provider and level of coverage, moving to a tax-based system of healthcare funding, and paying the hundreds of billions needed to properly overhaul the entire system, all of which would be necessary if the US government moved to a genuine universal healthcare model "just like the other industrialized nations". In this case "genuine healthcare model" = "universal healthcare" = "single-payer system". A truly socialist system where pay-in is tax based, so millionaires must (and do) pay in tens or hundreds of times as much money as paupers but get the same standard of care, the same priority in the waiting lines, the same access to treatments, etc. No such thing as employer coverage. No such thing as insurance companies. No markets for insurance. No choice as to level of coverage or insurance provider. From each according to his ability, to each according to his needs. A universal healthcare system administered on a national scale providing equal care for all, with rationing, prioritizing, vetting, funding all "built in" and centrally planned, not subject to market forces. This is a "single-payer system" = "universal healthcare". It's fair to call the ACA "guaranteed government coverage", but as a universal healthcare system a.k.a. single-payer, it most definitely does not meet the qualifications. i don't think that the ACA is "guaranteed government coverage" tho, is it? that is the part i am not getting, Virgil. i would call it "mandated coverage". "guaranteed" implies that they are going to back it up, in the event you don't. i know of no such provision in the law. edit: sorry if you misunderstood me. i am still a little sick today, and not really....thinking well..... I suppose there is the ability to opt out and remain uninsured, but there are fees and penalties to pay for uninsured persons of means. Depending on how high those fees are, we could argue that the only sensible option is to buy subsidized coverage. And if a government both i) guarantees coverage for persons without means, and ii) effectively eliminates all but one sensible option for persons with means, the two collectively constitute "guaranteed coverage" in my book. Yes, there will be hold-outs who refuse to buy insurance, but they'll pay fees anyway, and how is that any different from a Canadian who refuses to go to a doctor even though he has to pay a part of his income tax to the government for the purposes of healthcare. I'm not going to call him "not covered" just because he refuses to use the system. I don't know how high the penalty is with the ACA, but I can tell you that whatever it ends up as will be punitive enough to discourage Americans from buying insurance when they get sick and getting rid of it when they're healthy again. I don't think a love of Richard Simmons will be enough to secure their loyalty.
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Lizard King
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Post by Lizard King on Jan 21, 2014 21:03:47 GMT -5
dj #1440,
I think you're getting a little caught up in the momentum of the argument.
For starters you were replying to me, not Virgil. He and I don't see exactly eye to eye on almost anything, although we stand close enough on most things that anybody less nitpicky than either of us might not think so.
Also, if you really believe that 77% of the respondents were insured, and 100% of insured respondents were happy with the status quo, then (1) it's going to be hard to trust your interpretation of any poll ever, because that's a radical misconception of the data; (2) your case is actually weaker than I was making it out to be, because according to your source literally nobody who had insurance thought the government could do better, or at least not sufficiently better to justify making the change.
I'm prepared to accept "universal" and "single-payer" essentially refer to the same system in the universe of discourse. I don't see why the US is uniquely ill-suited to single-payer healthcare, and for example even in the UK around 8% of people with free access to NHS 'care' choose to carry private health insurance (have a guess which income quintile they belong to). Single-payer options already exist in the US for designated populations. The Obamacare reforms increase the size of one of those designated populations, without building in a funding stream to pay for the expansion. But the bulk of what they do is an ignorant rearranging of incentives in the private market. They are not a step on the road toward government-run single-payer universal-healthcare options - unless you can plot a tangled course that takes in discrediting government as an agent of any remotely competent service delivery system.
Pointing out the flaws in your expressed interpretation of data may, to your mind, constitute 'overanalysis' - evidently, it's analysis you considered unnecessary in making your argument - but I'll choose to differ with you on that. I disputed your findings based on a single poll, because you only presented a single poll. And it didn't say what you said it did. It basically said the grass is greener on the other side of the fence, and Aesop beat the New York Times to that gem by millennia.
And leveling whatever accusations you like against Rasmussen doesn't, in and of itself, make the New York Times any more reliable as a pollster. Neither does it invalidate the finding in the particular poll Virgil cited, which seems to be pretty consistent with the mean of polls on the question.
There isn't a popular clamor in this country for government-run healthcare - quite the reverse. Nobody wants grandma to die for lack of access to healthcare provision, but I guarantee you nobody wants grandma to die because a bureaucrat determines the lifesaving operation doesn't add enough QALY to justify the outlay from the commons. People who want a public option are for the most part either people who don't understand what it costs, or people who can afford to carry something more efficient and flexible for themselves. I say that as somebody who believes healthcare ought to be a part of the social contract, but who follows that to the logical conclusion to see why it isn't.
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Post by Virgil Showlion on Jan 21, 2014 21:12:47 GMT -5
Weren't you the one who proffered exactly this theory a few weeks ago? Something about "Classic Alinski. Create the problem to create the solution."?
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Post by djAdvocate on Jan 21, 2014 21:44:04 GMT -5
dj #1440, I think you're getting a little caught up in the momentum of the argument. For starters you were replying to me, not Virgil. He and I don't see exactly eye to eye on almost anything, although we stand close enough on most things that anybody less nitpicky than either of us might not think so. phoenix, i have to leave right now. but you are right, i mistook your argument for Virgil. i have been sick this last week, and it is hurting my focus. but i did realize that i applied to you AFTER i posted, and decided just to let it stand.... as to the rest of my reply, treat it hypothetically. polling questions are funny. for example, i might reply that i am satisfied with my health insurance. i might also reply that i am happy with my medical care. but as you will know, i think the entire insurance industry is a racket, and i think we are grossly overcharged in this country for services, particularly elder care. so, as you can see, using my own case, the fact that 77% are satisfied doesn't really say ANYTHING. it is not a meaningful question. it doesn't get to the root of things. and it says nothing about whether or not a person thinks the system, as a whole, needs improvement.
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Post by Lizard King on Jan 22, 2014 0:44:59 GMT -5
Weren't you the one who proffered exactly this theory a few weeks ago? Something about "Classic Alinski. Create the problem to create the solution."? Classic Mojo. Suggest a theory that appears at first blush to be speciously consistent with some evidence from an assumed perspective, in order to later ridicule either the theory, the perspective, the evidence, or some combination of the three... In this case, the implementation has been so cack-handed that the exact opposite effect has been evinced. Far from making the status quo seem worse, the leaden-footed maneuvers of the G have made government intervention seem worse - ironically, the notion that government should get out of healthcare altogether, a fringe belief at best, has been made more popular by the hamfisted rollout of Obamacare. It's certainly believable to me that a cadre of the elite wanted single-payer from the get-go and would have signed onto some reform that highlighted the vagaries of the alternative - it's consistent with the explicit energy policy of raising the cost of fossil fuels to make alternative fuels more competitive in the marketplace, for example. But the evidence is instead of far pettier motivations: individuals in transitory positions of leadership grasping too hard for a legacy, and strangling the fruits on the vine. Almost all of the predictable problems confronting Obamacare were announced in advance during debate preceding its passage; none of them were addressed because the Democratic leadership were obliged to sidestep conference and deem a pre-conference version of a mammoth bill. No wonder the president has found it necessary and appropriate to extra-legally and unconstitutionally amend the legislation from the Oval Office. Nobody said Alinskyites had to be competent, or free from hubris, or for that matter untainted by other objectives less noble than the manufacture of revolutions.
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Post by Lizard King on Jan 22, 2014 0:47:14 GMT -5
dj,
I agree with you that psephology is a shill game, and interpreting the answers delivered to the pollsters on any question more complex than "do you choose THIS or THAT" is a fraught and often redundant exercise.
That's precisely why I knock polling statistics when people rest arguments on them, and precisely why I cherry-pick polls that support what I'm trying to argue.
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Post by djAdvocate on Jan 22, 2014 1:29:59 GMT -5
dj, I agree with you that psephology is a shill game, and interpreting the answers delivered to the pollsters on any question more complex than "do you choose THIS or THAT" is a fraught and often redundant exercise. That's precisely why I knock polling statistics when people rest arguments on them, and precisely why I cherry-pick polls that support what I'm trying to argue. polls are fine, as long as you understand what they are asking. if you don't, then buyer beware.
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Virgil Showlion
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Post by Virgil Showlion on Jan 22, 2014 2:08:07 GMT -5
Weren't you the one who proffered exactly this theory a few weeks ago? Something about "Classic Alinski. Create the problem to create the solution."? Classic Mojo. Suggest a theory that appears at first blush to be speciously consistent with some evidence from an assumed perspective, in order to later ridicule either the theory, the perspective, the evidence, or some combination of the three... In this case, the implementation has been so cack-handed that the exact opposite effect has been evinced. Far from making the status quo seem worse, the leaden-footed maneuvers of the G have made government intervention seem worse - ironically, the notion that government should get out of healthcare altogether, a fringe belief at best, has been made more popular by the hamfisted rollout of Obamacare. It's certainly believable to me that a cadre of the elite wanted single-payer from the get-go and would have signed onto some reform that highlighted the vagaries of the alternative - it's consistent with the explicit energy policy of raising the cost of fossil fuels to make alternative fuels more competitive in the marketplace, for example. But the evidence is instead of far pettier motivations: individuals in transitory positions of leadership grasping too hard for a legacy, and strangling the fruits on the vine. Almost all of the predictable problems confronting Obamacare were announced in advance during debate preceding its passage; none of them were addressed because the Democratic leadership were obliged to sidestep conference and deem a pre-conference version of a mammoth bill. No wonder the president has found it necessary and appropriate to extra-legally and unconstitutionally amend the legislation from the Oval Office. Nobody said Alinskyites had to be competent, or free from hubris, or for that matter untainted by other objectives less noble than the manufacture of revolutions. *lol* So bad things happen when Alinskyites screw up their own engineered chaos.
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Lizard King
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Post by Lizard King on Jan 22, 2014 2:14:01 GMT -5
Revolutions would work great if they weren't managed by people.
When we have sentient toasters and they can plot a New World Order, that's when the trains start running on time again.
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Virgil Showlion
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Post by Virgil Showlion on Jan 22, 2014 2:22:59 GMT -5
Revolutions would work great if they weren't managed by people. When we have sentient toasters and they can plot a New World Order, that's when the trains start running on time again. A toast to Mussolini?
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Lizard King
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Post by Lizard King on Jan 22, 2014 9:52:21 GMT -5
Virgil. In more good news for fans of fascist government manipulation of markets, a DC district judge has dismissed the argument that policies sold on federal rather than state exchanges cannot be subsidized under PPACA (which would also mean tax penalties can't be levied in those states which didn't set up their own exchanges). Judge Friedman decided the case on the merits, which bolsters the chance of the other three cases attacking the same provision of the law. He also accepted that "the plain language" of the act supported the plaintiff's argument, before going on to offer a creative interpretation of that plain language allowing him to ignore it. The case will be appealed to the 9th circuit court of appeal - happily, thanks to Harry Reid's jettisoning of parliamentary procedure, Dems have been able to stack it, so the decision should be upheld (there is a conspiracy theory that the probability Friedman might find in favor of Halbig et al. was sufficiently scary for Democratic leaders that the nuclear option was deemed a lesser risk; that would make them immensely reckless and short-sighted, but we are talking about a Senate Majority Leader under whom more than half the entire national debt of the United States has accumulated). ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2013cv0623-67Keep an eye out for Coons v Lew - oral argument is scheduled for next week on that one. It takes aim at one of the least popular elements of PPACA - the unaccountable bureaucrats of IPAB, the infamous 'death panel' who will have the power to circumvent the legislative process and set reimbursement rates for Medicare, essentially nullifying 'doc fix' legislation. The argument that this represents a power grab by the executive and an undermining of the coequal legislature can be expected to have resonance down the line, given the tone of questioning from SCOTUS in the recent case of Noel Canning v NLRB.
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AgeOfEnlightenmentSCP
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Post by AgeOfEnlightenmentSCP on Jan 22, 2014 20:34:29 GMT -5
The legal challenges have to proceed- but what will doom ObamaCare is the math. It doesn't work- it's one of those rare blessings like the Medicare Catastrophic Coverage Act- an INSTANT liberal failure. No waiting. And repeal will take place as I've said- probably dressed up as "reforms"- that will amount substantively repealing the law.
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Lizard King
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Post by Lizard King on Jan 23, 2014 8:57:17 GMT -5
Megan McArdle made the same point in a recent debate with Jonathan Chait - not that there'd be anything called outright repeal, but that the continuing temporary administrative fixes would evolve into permanent administrative adjustments.
The end result of 'Obamacare' is going to be that:
1) People who were formerly excluded for pre-existing conditions won't be any more. This does genuinely look like progress.
2) People who were formerly able to afford the care they want will now have to be subsidized by the taxpayer for the care they're allowed to have. This is a backward step.
3) The pressure on private insurers and healthcare providers to increase prices will be magnified by numerous provisions in the PPACA law; at the same time, mechanisms built into the law to ease those pressures either have been or will be scrapped by the administration as simply too politically dangerous to retain.
4) Despite these wanton ravages to the structure of PPACA, the cost borne by the public of the bill Obama once promised would add 'not one dime' to the deficit will remain a stick with which to beat Democrats for a long time - Democrats, for example, still beat the long-departed President Bush for Medicare Part D and Medicare Advantage, and both of those had Dem fingerprints all over the legislation and enactment.
5) In quite large parts of the country, availability of healthcare provision will be reduced. Adequate healthcare provision will be more a privilege of the wealthy after PPACA than it was before PPACA. It will still be cheaper to have the expensive subsidized insurance, pay the high out-of-pocket costs associated both with traveling to an in-network provider and covering deductibles and coinsurance on exchange plans than it would be to go uninsured and pay out of pocket for all healthcare costs; but it will be too expensive for even median-income Americans to manage without some form of taxpayer subsidy, direct or indirect. When more than half the population needs partial or total subsidy for the provision of a service, you're at a point of economic non-viability.
[You'll notice I never even alluded in there to the 'death spiral,' although whatever the Kaiser Foundation's sanguine estimates might be, evidence is mounting that it's under way.]
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Virgil Showlion
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Post by Virgil Showlion on Jan 23, 2014 9:50:28 GMT -5
If you like your dime, you can keep your dime...
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djAdvocate
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Post by djAdvocate on Jan 23, 2014 12:50:37 GMT -5
the promise was based on cost savings. if cost savings don't happen, then yes, that will be an albatross for Democrats.
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Lizard King
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Post by Lizard King on Jan 23, 2014 13:13:53 GMT -5
Which means that Democrats are going to argue, without a lot of credibility in my view, that health insurance would have been even more expensive without their ignorant ("what we're also discovering is that insurance is complicated to buy" ~ Barack Obama, Nov 2013) tinkering.
What will be interesting is how far the consensus in the media will support that self-serving nonsense. It's reminiscent of the parsing of "saved and created" jobs and that unemployment projection back when ARRA was still the dumbest bit of legislation Obama had signed.
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djAdvocate
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Post by djAdvocate on Jan 23, 2014 13:18:07 GMT -5
Which means that Democrats are going to argue, without a lot of credibility in my view, that health insurance would have been even more expensive without their ignorant ("what we're also discovering is that insurance is complicated to buy" ~ Barack Obama, Nov 2013) tinkering.
they won't be able to make that argument if the "inflation curve" for healthcare is not "bent". of course, it will be. there is no way it could continue. it is a bubble. it had to burst. so, they are going to win the argument on paper, but not in reality. in reality, time itself would have fixed this problem.
What will be interesting is how far the consensus in the media will support that self-serving nonsense. It's reminiscent of the parsing of "saved and created" jobs and that unemployment projection back when ARRA was still the dumbest bit of legislation Obama had signed.
they will go all the way. if there is one thing i have learned over the years, it is that the media is woefully undereducated in terms of economics. ie- they have been repeating supply side arguments for decades without a sliver of proof to support them.
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