As Obamacare goes into effect, new criticisms leveled

[nismaratwork]

I emphasized "healthcare reform" because it's a joke (IMO). I don't believe a single piece of legislation (that nobody read) can address all of the issues. I'm for scrapping the legislation completely and moving forward with a real analysis of the existing problems and focused solutions. If that means we need to spend five or six years working through problems and solutions in a series of smaller Bills and reforms - fine. We need leadership at the highest levels - not political games and rhetoric. When Nancy Pelosi said they needed to pass the legislation first - before the details would be known - I said "enough".

I admit, this is the area we really do agree on. If it takes 2000 pages, FINE, but it seems insane to overhaul nearly half of our spending without READING it. I've been on both sides of this issue, but I can't think of a truly logical reason for the "don't read it" side. I can only conclude that it appeals to the element of my personality that wants reform NOW, and that screams, "political manipulation", or games as you say.

 

[Al68]

Since force is a meaningless word in this context, I'll say yes. Medicare plan D, won with much lobbying effort (force), explicitly forbids the government from negotiating bulk rates for prescriptions.

Lobbying isn't force. Force would be a meaningless concept if we accept that definition. I'm against that law, but it's a government action. You can't logically blame a lobby for its success because of a law passed by congress, who, unlike the lobby, is supposed to represent us.

In what way is taxation for roads, police and education fundamentally different than taxation for healthcare?

The means (taxation) is the same, which was my point. Using the same means for two different things does not equate those things.

 

[Al68]

You believe that the government is separate from and not made OF the people, and I don't.

Nope. Government is separate from, and made of the people.

Finally, you seem to think that pharmaceutical companies don't spank the USA on a regular basis, I'd just point you to Part D again.

That's government spanking itself. Government passed that law. Government is the spanker.

 

[ParticleGrl]

I emphasized "healthcare reform" because it's a joke (IMO). I don't believe a single piece of legislation (that nobody read) can address all of the issues.

I've read it. I'm sure at least a few others have. I don't think anyone argues that it covers all the issues, rather that it is a step in the right direction.

Further, why is it a joke? Your complaints are entirely general- specifically, what do you think this bill does wrong? "Its long" is not a reasonable complaint.

1. Is the focus on evidence based medicine a good idea? Will it reduce costs?
2. Should people with pre-existing treatments have some medical safety net? Should this safety net be a single-payer system, or a market system?

 

[ParticleGrl]

Lobbying isn't force. Force would be a meaningless concept if we accept that definition.

I was using force in the same broad sense in which you are using it.

The means (taxation) is the same, which was my point. Using the same means for two different things does not equate those things.

What is fundamentally different about health care vs. roads? Or police services?

 

[nismaratwork]

Nope. Government is separate from, and made of the people.That's government spanking itself. Government passed that law. Government is the spanker.

I disagree in principle with your first point, and the second is kowtowing to the pressure of lobbies. Lobbying isn't force, but it's effective, and it's inherently asymmetric for the average person.

Four score and seven years ago our fathers brought forth on this continent, a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal.

Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

But, in a larger sense, we can not dedicate -- we can not consecrate -- we can not hallow -- this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us -- that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion -- that we here highly resolve that these dead shall not have died in vain -- that this nation, under God, shall have a new birth of freedom -- and that government of the people, by the people, for the people, shall not perish from the earth.

Bolding mine.

 

[mugaliens]

I disagree in principle with your first point, and the second is kowtowing to the pressure of lobbies. Lobbying isn't force, but it's effective, and it's inherently asymmetric for the average person.

Bolding mine.

I like your bolding. I hate lobbying. I loathe the fact that SCOTUS gave the same fiscal rights to influence our government to corporations as we citizens used to enjoy, and I'll bet our founding fathers all turned over in their graves, en masse, on that one.

I'm pushing for a bill which would mandate all corporations provide quarterly and annual statements of all monies it's given in support of any local, state, or federal political effort, and to which person, party, or platform it's given those funds.

That we, we PEOPLE would know which corporations to boycott.

ETA: Lincoln's publically given Gettysburg Address is far more substantive evidence that corporations should not be considered as persons than Thomas Jefferson's private letter to the Danbury Baptists supports Separation of Church and State. Why did SCOTUS base it's decision on the latter while excluding the former?

 

[nismaratwork]

I like your bolding. I hate lobbying. I loathe the fact that SCOTUS gave the same fiscal rights to influence our government to corporations as we citizens used to enjoy, and I'll bet our founding fathers all turned over in their graves, en masse, on that one.

I'm pushing for a bill which would mandate all corporations provide quarterly and annual statements of all monies it's given in support of any local, state, or federal political effort, and to which person, party, or platform it's given those funds.

That we, we PEOPLE would know which corporations to boycott.

ETA: Lincoln's publically given Gettysburg Address is far more substantive evidence that corporations should not be considered as persons than Thomas Jefferson's private letter to the Danbury Baptists supports Separation of Church and State. Why did SCOTUS base it's decision on the latter while excluding the former?

I haven't the faintest... to me it's simply absurd, and appears to be a matter of party/ideology.

 

[Al68]

I was using force in the same broad sense in which you are using it.

If you think I was using it in that sense, you misunderstood my post. I was referring to real, physical force, such as that used by government to enforce laws.

What is fundamentally different about health care vs. roads?

I don't even know how to answer that without just stating the obvious. Public roads are built and maintained by government by billing those that use them via fuel tax and/or tolls. My health care is none of government's business whatsoever. But I must be misunderstanding your question, since the differences are obvious.

 

[Al68]

I disagree in principle with your first point, and the second is kowtowing to the pressure of lobbies. Lobbying isn't force, but it's effective, and it's inherently asymmetric for the average person...

...government of the people, by the people, for the people...

Bolding mine.

I'm not sure why you disagree that government is separate from the people. That's the obvious assumption in the phrase "of the people, by the people, for the people". It would make no sense to make such a statement about the people: "The people are of the people" is illogical, and so is Lincoln's quote unless government is an entity separate from the people.

As far as lobbying, I never said it wasn't effective, or asymmetric. But congressmen, not lobbyists, are responsible to the people for their votes.

 

[Gokul43201]

But congressmen, not lobbyists, are responsible to the people for their votes.

In the modern era of electoral history, one could argue that Congresspersons are responsible to their lobbies to a significant extent (possibly even a greater extent than to which they feel responsible to their constituents), since money largely determines a campaign's ability to rally the electorate.

 

[Al68]

In the modern era of electoral history, one could argue that Congresspersons are responsible to their lobbies to a significant extent...

One could argue that a congressperson may "feel" responsible to lobbies, but they are not. They are responsible to the people via the constitution for their votes.

 

[nismaratwork]

One could argue that a congressperson may "feel" responsible to lobbies, but they are not. They are responsible to the people via the constitution for their votes.

The legislative evidence supports Gokul's assertion AFAIK. In theory you're right, but we live in practice...

 

[WhoWee]

I've read it. I'm sure at least a few others have. I don't think anyone argues that it covers all the issues, rather that it is a step in the right direction.

Further, why is it a joke? Your complaints are entirely general- specifically, what do you think this bill does wrong? "Its long" is not a reasonable complaint.

1. Is the focus on evidence based medicine a good idea? Will it reduce costs?
2. Should people with pre-existing treatments have some medical safety net? Should this safety net be a single-payer system, or a market system?

I have not read or heard a single argument against finding a way to cover pre-existing conditions - anywhere - have you?

 

[ParticleGrl]

So then, again, what specific problems do you have with the law?

 

[Al68]

The legislative evidence supports Gokul's assertion AFAIK. In theory you're right, but we live in practice...

You seem to have misread my post, again. My point was that congressmen are responsible to the people instead of lobbyists. I made no assertion about who had more influence.

 

[nismaratwork]

You seem to have misread my post, again. My point was that congressmen are responsible to the people instead of lobbyists. I made no assertion about who had more influence.

I'd argue that given the history of lobbying and legislation, while in principle you're right, in practice they are in fact responsible to their lobbies. It's not legal, but it is reality, and that's all I've ever been arguing about here.

 

[WhoWee]

So then, again, what specific problems do you have with the law?

I've posted an estimated 200 times in the discussion of healthcare legislation reform on a variety of PF threads. With this noted, my primary concern is the legislation does not address the current problems - instead - it overlays a new set of regulations on top of a failing system.

 

[Al68]

I'd argue that given the history of lobbying and legislation, while in principle you're right, in practice they are in fact responsible to their lobbies. It's not legal, but it is reality, and that's all I've ever been arguing about here.

It seems you're using a non-standard definition of "responsible". I have to assume you do not believe they are responsible to lobbyists instead of the people using the standard definition.

 

[nismaratwork]

It seems you're using a non-standard definition of "responsible". I have to assume you do not believe they are responsible to lobbyists instead of the people using the standard definition.

Correct, I'm talking about their practical interests and actions, not their legal and (if you believe in it) moral responsibilities to those who elected them. Of course, you could argue that the largest participents in elections are not people voting, but external factors such as money, which case their constinuancy truly isn't the people.

 

[ParticleGrl]

I've posted an estimated 200 times in the discussion of healthcare legislation reform on a variety of PF threads. With this noted, my primary concern is the legislation does not address the current problems - instead - it overlays a new set of regulations on top of a failing system.

Believe it or not, I've read every word of this thread. I don't have the time or inclination to revisit every thread on healthcare legislation.

Be specific- what current problems aren't being addressed by the law? I think most would agree that the single greatest current problem is the runaway growth in cost, which is largely at the hospital/treatment end of things. Using scientific methods to identify effective treatment is, in my mind, the best long term way to reduce cost. This is a big part of the law. Do you feel this isn't an effective way to address cost? What is it about this area of the law that you dislike?

The other major problem, most would agree, is the high percentage of uninsured. Luckily, much of the legislation is involved in expanding the number of insured by making it easier to get individual insurance. Of course, this only will work if the individual mandate to purchase is upheld by the courts. We will have to see. Do you feel this doesn't effectively address the problem? Is it too market driven? Would you prefer a sweeping expansion of medicade or medicare to cover these people?

Are there other problems you feel aren't being addressed by the law? What are they?

 

[Al68]

Correct, I'm talking about their practical interests and actions, not their legal and (if you believe in it) moral responsibilities to those who elected them.

Like I said, non-standard definition. The word "responsible" means the latter, not the former. It's an adjective, not a verb, and doesn't refer to any actions or interests of its subject.

The only way "responsible" is effectively a verb is as an adverb with a modifier, such as "acting responsibly" or "accepting responsibility", neither of which was used.

Man, I hate arguing semantics.

 

[nismaratwork]

Like I said, non-standard definition. The word "responsible" means the latter, not the former. It's an adjective, not a verb, and doesn't refer to any actions or interests of its subject.

The only way "responsible" is effectively a verb is as an adverb with a modifier, such as "acting responsibly" or "accepting responsibility", neither of which was used.

Man, I hate arguing semantics.

I made it pretty clear in this thread and elsewhere what my beliefs are... I'm not sure why you're surprised. I don't think it is semantics, I think it's a profoundly different view of the world.

 

[WhoWee]

Believe it or not, I've read every word of this thread. I don't have the time or inclination to revisit every thread on healthcare legislation.

Be specific- what current problems aren't being addressed by the law? I think most would agree that the single greatest current problem is the runaway growth in cost, which is largely at the hospital/treatment end of things. Using scientific methods to identify effective treatment is, in my mind, the best long term way to reduce cost. This is a big part of the law. Do you feel this isn't an effective way to address cost? What is it about this area of the law that you dislike?

The other major problem, most would agree, is the high percentage of uninsured. Luckily, much of the legislation is involved in expanding the number of insured by making it easier to get individual insurance. Of course, this only will work if the individual mandate to purchase is upheld by the courts. We will have to see. Do you feel this doesn't effectively address the problem? Is it too market driven? Would you prefer a sweeping expansion of medicade or medicare to cover these people?

Are there other problems you feel aren't being addressed by the law? What are they?

The individual mandate - enforced by the IRS - is a concern.

 

[ParticleGrl]

The individual mandate - enforced by the IRS - is a concern.

Why? be specific. Should people with pre-existing conditions be coverable by insurance? How is that possible without an individual mandate? How else would a mandate be enforced?

Is an individual mandate preferable to a sweeping overhall of medicare/medicaid? Either the public or private sectors have to pick these people up. What is the alternative?

 

[nismaratwork]

The individual mandate - enforced by the IRS - is a concern.

Not being trite, but how is it different from mandating car insurance? If this is a state's rights issue, there are ways to make this less than a mandate, and use funding as a cudgel instead. Nasty, but legal and common (drinking age for example).

 

[WhoWee]

Not being trite, but how is it different from mandating car insurance? If this is a state's rights issue, there are ways to make this less than a mandate, and use funding as a cudgel instead. Nasty, but legal and common (drinking age for example).

There are two points. First, you are not required to have a car or a drivers license. Second, you are required to purchase the insurance to protect other people and their property - not yours.

 

[WhoWee]

Why? be specific. Should people with pre-existing conditions be coverable by insurance? How is that possible without an individual mandate? How else would a mandate be enforced?

Is an individual mandate preferable to a sweeping overhall of medicare/medicaid? Either the public or private sectors have to pick these people up. What is the alternative?

There are 4 reasons people don't purchase individual health insurance currently:
1.) don't want it
2.) don't need it
3.) can't afford it
4.) can't have it - pre-existing

Next, other than the mandate, this legislation does not address all of the "gaps" in coverage. The most significant problem is long term care. Medicare does not cover nursing homes. Nursing home care is expensive, it consumes assets (houses) and places a major burden on Medicaid.

 

[nismaratwork]

There are two points. First, you are not required to have a car or a drivers license.

...and just like that, I feel like an idiot. You have a free "duh" to use on me anytime you wish.

Second, you are required to purchase the insurance to protect other people and their property - not yours.

Hmmm... all of that being true... is it still not possible to use federal funds as a goad to induce states to "volunteer"? Again, much like the drinking age and higheway funds. I'm not arguing the morality of it, just the legality.. would that have potential?

 

[ParticleGrl]

There are 4 reasons people don't purchase individual health insurance currently:
1.) don't want it
2.) don't need it
3.) can't afford it
4.) can't have it - pre-existing

Next, other than the mandate, this legislation does not address all of the "gaps" in coverage.

I've never in my life met a "don't want it", and further "don't need it" is naive and irrational. An accident can wrack up millions of dollars of medical fees. I think we can agree that these two groups are at most a trivial percentage of the uninsured.

Three and four are certainly the largest group of uninsured. The bill certainly covers 4, you agree? Now, how well it covers 3 is a matter of debate- but certainly the hope is that as more people are required to enroll, everyone's premium will go down.

The most significant problem is long term care.

The CLASS section of the health care bill does address long term care. Do you have a problem with the voluntary long-term-care insurance type solution?

I'm still not hearing actual, specific complaints from you. You have a vague issue with the individual mandate but you haven't outlined why. Even in this post- you say that the insurance doesn't address gaps in coverage, without outlining why you think that.