OT: Health Care Bill

[RkyMtn]

Here is the Health Care Bill for your reading pleasure, or if you are suffering from insomnia.

http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf

Notes of Interest:

Page 332, line 9: If your required health insurance premium exceeds 8 percent of (it appears) your gross income, you are exempt from participation and coverage. Well, that should help cover the 46 million, oh, I mean 32 million people without insurance. Instead of 32 million uninsured, it may be more after this bill is in effect.

Page 324, line 19: US citizen and Legal Immigrant minimum responsibility and penalties for not participating

Reading through selected sections, I see that the Federal Govt. is really not that involved, and that they are dictating that the state governments run all this. The federal Gov. will provide funding to the states for 2 years and then it is up to the state's to fund this new system, by feeing and charging the insurance companies, who will off-set the fees by raising our premiums.

It is interesting.

Best of luck to all of us if this passes.

Eric

[mjb266]

We gotta do something and I didn't see anything being done over the last 12 years. I like to remind myself that everything adopted can be amended. We can fix problems and we can ditch entire systems if need be.

Lets give it a chance and keep moving forward.

[rnhood]

I always favored getting it right the first time, so we don't have to redo it.

I'd rather see it go back to the drawing board.

[Ray]

I always favored getting it right the first time, so we don't have to redo it.

I'd rather see it go back to the drawing board.
Its a noble thought, but it'll take another 15 years and it'll be just as controversial and end up just as butchered up next time. No major legislation has ever been anywhere near the illusory "right" when its first passed - there are too many legitimately competing interests with their fingers in the pie for it to fully cohere. Getting it passed is a herculean task. Fixing the details once its in place is still difficult, but much more doable.

If you oppose it, oppose it. But many who are calling for going back to the drawing board oppose it and know that's a polite way of killing it. If you want it, they pretty much have to pass it and then continue to tweak it over the years.

Everyone opposed basically said the same thing when the Clinton bill went back to the drawing board.

In 1994.

Where we are now IS back to the drawing board. And in the meantime, how many people have remained uninsured and how many have died as a result?

-Ray

[hookookadoo]

I like to remind myself that everything adopted can be amended. We can fix problems and we can ditch entire systems if need be.

Uh like social security(SS) and many others? I cringe to think what my wife and I have contributed to SS and will continue to contribute in the future yet I know I will never see a dime. Its illogical but I have no choice.

It is a bipartisan fact - once given you cannot taketh away. I welcome examples where that is not the case.

[1centaur]

Many will die because this bill is passed too, since it's just another form of rationing. Many have died under Canadian and English national health care too, which ration in different ways that are viewed as appalling to Americans with private insurance. How many have lived under the current system because of fancy expensive tests and new drugs developed under the profit motive that would not have occurred under a belt-tightening government plan? How many Americans will pay more and get less under whatever this bill will turn into?

The fear of the average joes opposed to this bill is that the few will benefit at the expense of the many. I think the debate should have spent a lot of time on that issue because it was so obvious. The fact that it did not may be telling. Now I hear that a Hispanic group of Dems is threatening not to vote for the bill unless illegal immigrants get subsidized by US citizens to allow them to buy insurance. I hope that's not correct.

[RkyMtn]

And in the meantime, how many people have remained uninsured and how many have died as a result?

-Ray

But, as I am interpreting this bill, most of these folks will still be uninsured and those of us who will participate will be at the mercy of the health insurance companies pricing practices and coverage decisions. It is still mostly what we have now, but we are forced to pay. The insurance companies will still do what they do and require us to go to court to try to obtain a court order to get them to pay. I've seen this in action and the insurance companies just leverage their salaried lawyers to force you to pay your lawyer to try and get the insurance company to do what they should have done: Pay the coverage.

The winners in this bill are the lawyers and the insurance companies. I am sure that the major sponsors of this bill will be well-paid, future insurance company lobbyists.

- Eric

[Pete Serotta]

The Federal Programs for Medicare and Medicaid are in trouble and have been for years.

My fear is that adding a few million folks to a similar system that is broke and getting worse is an exercise in massive expenditures and a MUCH larger deficit - while at the same time making the medical support for folks more complicated, slower, and not an improvement.

I hope I am wrong but history does not support a pleasant experience.

[jhcakilmer]

I'm excited that we are finally starting to overhaul a system, that I consider nearly criminal....strong words....but it's just how I see it. We have so many "socialized" or "universal" systems already in the US, why not healthcare? So your guaranteed a basic education (K-12), but not basic healthcare? Does that really make sense? Or I'm guarenteed that the road in front of my house will be plowed of snow, but.....you get the ideal.

Don't get me wrong, I have little interest in the government running our healthcare system....they already mismanage many other wonderful programs, as others have pointed out.

"Many will die because this bill is passed too, since it's just another form of rationing." Seriously? Our system, as well as all systems have always been rationed....so what's your point? Many people die because of the system we have now, many of who would benefit greatly from just basic care. So how would making sure everyone has access to basic healthcare cause people to die?

I personally see the bill as being very weak, but atleast it's a start. We need to get something implemented, and work to refine it. I agree with Ray, going back to the drawing board is exactly what many want, just to impeded the process, or make any bill as ineffective as possible. Just keep the status quo...right?

As I talk to physicians, I've noticed a trend.....the higher ones salary, the more opposition they have to reform. This is subjective, and simplistic, but it's what I've notice from talking to many attendings. As a student I usually don't argue, I understand my place on the food chain... ;)

I'll stop ranting, I could go on for hours. Anyway, here is a program that I saw a couple years ago...it's obviously not totally inclusive, but does a good job at pointing out the pros and cons of other health systems. You can watch the entire program online.

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

[93legendti]

http://hr.blr.com/HR-news/Benefits-Leave/Healthcare-Insurance/Virginia-OKs-Preemptive-Strike-Against-Healthcare-/


March 10, 2010
Virginia OKs Preemptive Strike Against Healthcare Reform
The General Assembly in Virginia has approved legislation that would prohibit any requirement for residents to obtain and maintain healthcare coverage.

The legislation also would exempt Virginia residents from any penalty for failure to obtain health coverage. The legislation goes to Governor Bob McDonnell, who is expected to sign the legislation into law.

The legislation is a direct response to proposed healthcare reform on the federal level. Both chambers of the U.S. Congress have approved bills that would require individuals to maintain healthcare insurance and would impose a penalty on those who fail to do so. The U.S. Senate and U.S. House have approved different versions of healthcare reform, which is the reason neither bill has reached the desk of President Barack Obama.

Lawmakers in other states have proposed similar legislation to that approved by the Virginia General Assembly. There's at least one state that won't approve similar legislation: Massachusttes, which already requires individuals to carry healthcare insurance.

[jhcakilmer]

http://hr.blr.com/HR-news/Benefits-Leave/Healthcare-Insurance/Virginia-OKs-Preemptive-Strike-Against-Healthcare-/


March 10, 2010
Virginia OKs Preemptive Strike Against Healthcare Reform
The General Assembly in Virginia has approved legislation that would prohibit any requirement for residents to obtain and maintain healthcare coverage.

The legislation also would exempt Virginia residents from any penalty for failure to obtain health coverage. The legislation goes to Governor Bob McDonnell, who is expected to sign the legislation into law.

The legislation is a direct response to proposed healthcare reform on the federal level. Both chambers of the U.S. Congress have approved bills that would require individuals to maintain healthcare insurance and would impose a penalty on those who fail to do so. The U.S. Senate and U.S. House have approved different versions of healthcare reform, which is the reason neither bill has reached the desk of President Barack Obama.

Lawmakers in other states have proposed similar legislation to that approved by the Virginia General Assembly. There's at least one state that won't approve similar legislation: Massachusttes, which already requires individuals to carry healthcare insurance.

I'm not categorically in favor of forcing individuals into doing anything, but on the other hand are you willing to pick up the bill when they get hurt, and come to the hospital? The system is most efficient when we all contribute to it!

[dmurphey]

Who needs police, firemen, schools or health care. Lets get the gobment out of all of this. Let's move to Mexico. Wait they already have socialized medicine there. Come to think of it there is no where to go to avoid people asking for help to provide the public with health care.
Really, folks, we can't afford to give everyone free stuff that is expensive, but we have to provide some sort of basic human right to safety, education and health care. Give the poor Medicare, and let the rich buy insurance. Let the poor go to public school and let the rich go to elite private schools. Provide good services for all, but let the rich live in private enclaves with barbed wire fences.

[BCS]

How about letting physicians get a tax write off for providing indigent care? I would be happy to see (more) uninsured patients if this were the case.

[93legendti]

I'm not categorically in favor of forcing individuals into doing anything, but on the other hand are you willing to pick up the bill when they get hurt, and come to the hospital? The system is most efficient when we all contribute to it!
I agree. The problem is THIS bill:

"... will hit the wallets of 1/4 of all Americans making less than $200,000 per year, according to an analysis by the nonpartisan Joint Tax Committees.
The committee also determined that the bill would subsidized insurance premiums for 7% of... taxpayers -- about 13 million people -- while some 73 million people would face higher costs from the new fees and taxes.
The potential tax increases in the bill could pose significant problems for Obama as he makes his final push for health care reform because he promised to protect middle-class Americans from any tax hikes.

Republicans already are pouncing on the committee's analysis."For every family that gets some benefit from this program, in other words, a premium subsidy, three families are going to get a tax increase and those three families obviously include the bulk of people you'd call middle class America..."

How about letting physicians get a tax write off for providing indigent care? I would be happy to see (more) uninsured patients if this were the case.
This makes perfect sense-which explains why Washinton hasn't proposed it.

[SamIAm]

Question:

Ok, I haven't read the proposed bill, which puts me in the same category as congress, the white house and most of my fellow americans. Having said that, my question is when this bill ruins the best healthcare system in the world (yes it is) and we all know it will, do I and others with the means have the option of paying for the kind of healhcare that we receive today?

[93legendti]

When will Washington spend the required time and effort on jobs? When did health care become more important than jobs?

[gdw]

Jobs, we don't need no stinkin jobs.... we're getting change we can believe in.

[2LeftCleats]

When they make me King, I will:

Eliminate Medicare, Medicaid, Veterans system. Private health insurance companies may exist to provide Lexus-level care for those willing to pay.

Replace them with a universal healthcare system.

Everyone is entitled to appropriate care. Inappropriate/unnecessary care is on your own dime through the private companies.

The system will be run by a semi-autonomous body insulated from the whims of politicians---something like the Federal Reserve. It's charge will be to ration responsibly. There's no getting around some form of rationing given finite resources. But it can be done fairly by identifying care that's proven and that which is questionable or worthless; pay for the former and not the latter. (It's an evolving science and not perfect. But it beats falling in love with every expensive technology that hasn't been subjected to careful evaluation before lining the pockets of drug/device companies, hospitals, and physicians). It will be a centralized repository of the nation's health data, will be able to spot trends more easily, and direct reseach money efficiently to do the most good for the most people. (I admit this idea isn't mine--comes from a book, "Critical Condition")

The body above will have taxing authority within budgetary guidelines set by the government, which otherwise will have no say in how money is directed. There will be no burden on business to pay for employees' healthcare and citizens will not have to be employed to receive coverage. It will be portable everywhere.

Patients will see whatever practitioner they want and go to whatever hospital they choose.

Physician groups will be paid based on number of patients cared for and for the outcomes of care--rewarded for efficiency and quality.

Drug companies will be encouraged to innovate but not duplicate. The governing body will assist in funding basic research in partnership with the companies. In exhange for relieving them of some of their research burden and some immunity from liability, they will be subject to price controls and refrain from advertising. Same with device manufacturers.

Obviously not a free-market approach but that one has only succeeded in enriching a few, impoverishing many, and producing an exorbitantly inefficient and, by most measures, very mediocre system of care. And it's current trajectory will bankrupt us all.

There is clearly a need for a method of covering everyone so that the increasing severity of illness in the uninsured doesn't drag down the rest of us. (One might venture the quaint idea that it's immoral not to cover everyone at some basic level). Tax write-offs for unreimbursed care just shift the tax burden elsewhere.

But universal coverage by itself won't control the ever-increasing costs. There has to be sensible rationing. In other words, the basic health coverage will provide everything you need, not necessarily everything you want.

For those who decry this as 'socialized medicine', I'm not opposed or offended by that label. There are few complaints about 'socialized' military, police and fire departments. As a physician I get a lot of complaints about private health insurance, but damn few about Medicare with it's 3% overhead. The closest thing we have to Britain's system is the Veteran's system. The hospitals are government owned and the physcians are government employees. It has a stigma attached from the past, but despite being underfunded it does great work and has pioneered electronic health records. I don't hear politicians or others criticizing that system--they wouldn't dare. I do suggest abolishing it mainly to have a simplified universal system, but the system I propose could adopt some of its methods.

[jhcakilmer]

Question:

Ok, I haven't read the proposed bill, which puts me in the same category as congress, the white house and most of my fellow americans. Having said that, my question is when this bill ruins the best healthcare system in the world (yes it is) and we all know it will, do I and others with the means have the option of paying for the kind of healhcare that we receive today?

"best" is a surprisingly subjective term.....define for us. IMO, our system is "best" at acute technical procedures and treatments....believe me, we're not the "best" in disease prevention, or chronic care. Our system benefits from sick people....I'm not saying anyone is purposely malicious, but there aren't really any incentives to prevent illness in our system.

[jhcakilmer]

When will Washington spend the required time and effort on jobs? When did health care become more important than jobs?

Since the begining of time.....it's cliche, but if you don't have your health, does anything else really matter?

[Ahneida Ride]

The Federal Reserve Act was passed on Dec. 23 1913, when most of
Congress was away on Christmas vacation, creating a private central
banking corporation.

It has been tinkered and amended countless times.

The fed reserve (non) note has lost 98% of it's original purchasing power.
The national debt now exceeds 100 Trillion fed reserve notes according to
the chairman of the Dallas fed.

100 years of tinkering and it still ain't right.

[Dekonick]

Who needs police, firemen, schools or health care. Lets get the gobment out of all of this. Let's move to Mexico. Wait they already have socialized medicine there. Come to think of it there is no where to go to avoid people asking for help to provide the public with health care.
Really, folks, we can't afford to give everyone free stuff that is expensive, but we have to provide some sort of basic human right to safety, education and health care. Give the poor Medicare, and let the rich buy insurance. Let the poor go to public school and let the rich go to elite private schools. Provide good services for all, but let the rich live in private enclaves with barbed wire fences.

How about Washingon state that just passed legislation of 18.5% estate tax on top of the 55% estate tax that is in effect next year - oh that stimulates the economy... right? So any successful small business will have to be dissolved to pay this tax (almost 75%!) when the owner dies - what happens to the employees of these businesses?

I guess is is ok as they just live in enclaves....

[JeffS]

Somewhere along the line I forgot what we're trying to fix.


We're a country with horrible health practices, horrible eating habits and taking way too many prescription drugs. Since when do we care about health care?


My idea of health care reform would be the ability to walk into a hospital, pay in cash and get charged exactly what it costs to perform the service.


This whole things feels like a bad soap opera. Both sides have sold out to the drug and insurance companies and they're both grandstanding. The end result is the same...

[Dekonick]

Question:

Ok, I haven't read the proposed bill, which puts me in the same category as congress, the white house and most of my fellow americans. Having said that, my question is when this bill ruins the best healthcare system in the world (yes it is) and we all know it will, do I and others with the means have the option of paying for the kind of healhcare that we receive today?

Sure - if you leave the USA for care....

[RPS]

Somewhere along the line I forgot what we're trying to fix.


We're a country with horrible health practices, horrible eating habits and taking way too many prescription drugs. Since when do we care about health care?
My thought exactly. I’d love to know how many people buy cigarettes, alcohol, too much red meat, and illicit drugs but don’t buy health insurance. Or why so many can’t pay for insurance but can pay for cell phones and other non-life-supporting essentials.

The argument being used for every person being entitled to basic health care can also be used – if extrapolated – to other necessities. Why not also include basic food, basic shelter, etc…. ?

What’s “basic” anyway? And who decides?

[I Want Sachs?]

We got it wrong the first time, that is why we need to pass this bill now. We know whatever we have now is not working. Back to the drawing board is just advocating current failed system.

If healthcare is just paying for what one used. Why can't physicians and hospitals charge maximum amount they can get out of you? Especially in emergency situation? There is a cost in maintaining shop that no one wants to pay for. Guess what, we need to pay for it otherwise there is no incentive for hospital to serve with losses.

[Ray]

When will Washington spend the required time and effort on jobs? When did health care become more important than jobs?
You keep saying that, but please tell me WHAT Obama could do on the jobs front that you wouldn't trash him for? Lower taxes? I mean OTHER than turning into another Republican with Republican priorities. Pretty much every mainstream economist I've read agrees that both the TARP and the stimulus were necessary and effective in keeping us out of total collapse. The recession seems to have bottomed out and is beginning to improve. Job losses have finally flattened and even conservative economists expect job growth to start pretty much now. It's gonna take years to replace the whole 6-8 million jobs we're in the hole, but the trend is finally looking to be going in the right direction. Could we slip back into recession? Sure. Things might still get a lot worse.

But anything that's done to create jobs other than slashing even more taxes is met with scorn around here. You all want the government out of the economy and let every business rise or fail on its own - fine, no problem. You're conservative. I get it. But how does that square with these constant calls for Obama to drop health care and focus on jobs? What exactly do you mean when you say Obama should be focussing more on jobs?

-Ray

[1centaur]

"Drug companies will be encouraged to innovate but not duplicate. The governing body will assist in funding basic research in partnership with the companies. In exhange for relieving them of some of their research burden and some immunity from liability, they will be subject to price controls and refrain from advertising. Same with device manufacturers."

Price controls without monopoly are a recipe for problems and always have been. Look at rent controlled apartments. Electric utilities have monopolies and are allowed what, 9% profits? Medical device companies without monopolies should therefore earn what, 20% profits? But no, the politicians cry, health care is a "right" but we'll be sports and grant 12% profits because medical devices are more competitive than utilities (though of course, you can't advertise). The consequences are obvious.

Medicare is provided below cost (i.e., the high health care costs we pay are subsidizing Medicare which makes it part of the problem). No wonder people who get subsidized care don't complain about it. That does not make it a model for a general system, unless the Chinese will subsidize it as a "right" for their biggest customers.

Really bottom lining it, countries with strong national health care tend to have no real military and/or have VAT of 15% plus. For many people in this country, they'd take that trade-off, and for many their care would get worse at the same cost due to resource spreading, even assuming people are allowed private insurance on top of socialized medicine, which is not universally true out there. That debate has not really happened because the pro forces want to win the issue on "oh the poor uninsured, how can you be so selfish you fat cat corporatists." That argument is so vapid that it's losing in the polls even though most people really have no clue on economics. We need to make the trade offs much more clear and openly acknowledged, or we'll be in for a decade or more of bill passing and repeal and reworking. Broad societal agreement (75% poll approval) is possible if the real trade-offs are turned over in the light. And let's start by examining why costs are rising so fast and how we're really going to get them down as a national priority; note that I said costs, not prices.

[Climb01742]

whether we have "the best heathcare in the world" depends on who you are. if money is no object and you have the resources, we do have some awfully good doctors, hospitals and gizmos to fix what ails you.

but if you don't have unlimited funds, i don't believe ours in the best. it is a valid and necessary debate for america to define what our "healthcare" system should strive to do. to be "the best" should:

it be universal "universal", or as 1centaur has suggested, be universal at the two ends, for preventive care and castastrophic care?
it be geared toward prevention rather than sickness-care?
it lead to so many personal bankruptcies?
it pay for effective care rather than the amount of care?
it have financial disincentives to discourage personal behavior that is injurious to your health, like smoking, overeating and lack of exercise?
it try to find a way to take so much litigation out of the system?
it try, somehow, to address the global competitive imbalance that exists between u.s. companies that bear the burden of "private" healthcare, and companies in other developed countries that have national healthcare?

the list could go on much longer, but the point is...we've never defined what a "good" healthcare system is, much less "the best".

and beyond that is a deeper and bigger question. as a nation we're living beyond our means. what do we truly want to spend our finite budget on? without addressing spending on the military, social security and medicare -- and the inherent priorities those reflect -- can we really define what we as a nation value? nothing exists in a vacuum.

can we honestly address what we spend on healthcare without addressing what we spend on bombs, bridges, schools, prisons, and laboratories?

america can do ANYthing. we just can't do EVERYthing. we have so many legacy "priorities" that may have outlived their meaning. until we truly know what we value as a nation, how can we honestly decide what to spend our money on? and is any party or politican willing to have this debate?

[hookookadoo]

Since the begining of time.....it's cliche, but if you don't have your health, does anything else really matter?

Keep in mind we are not talking about taking away people's health we are talking about whose pocket the money comes out of to pay for people's health who can't afford it(some legitimately others not), how much will it cost the people/entities that subsidize/pay for the rest, and do we trust the fudiciary(aka the govt) to spend that money correctly.

This is not the only govt program that raises these same conceptual questions. It is one of many that are already in place so when I think about it (and I believe others do to) think about it as "yet another program" vs. an isolated situation.

TGIF - Spring break next week. :banana:

[zap]

snipped

I like to remind myself that everything adopted can be amended. We can fix problems and we can ditch entire systems if need be.



Like AMT?

It appears the proposed tax on Cadillac plans has the same problem.

One can discuss the moral issue of providing quality care for all and paying for it but the proposed Health overhaul does not look convincing.

[Ray]

can we honestly address what we spend on healthcare without addressing what we spend on bombs, bridges, schools, prisons, and laboratories?

america can do ANYthing. we just can't do EVERYthing. we have so many legacy "priorities" that may have outlived their meaning. until we truly know what we value as a nation, how can we honestly decide what to spend our money on? and is any party or politican willing to have this debate?
To reiterate, here's another perspective check:

-Ray

[zap]

ray-source?

[Ray]

ray-source?
http://voices.washingtonpost.com/ezra-klein/2010/03/the_health-care_bills_spending.html#comments

There are any number of arguments about where the numbers COULD go from here, but it was a back of the envelope calculation just to put it in perspective. And I think its legit for that limited purpose.

-Ray

[sg8357]

Many will die because this bill is passed too, since it's just another form of rationing.

We aren't getting the NIH here, we are keeping our for profit insurance
companies, our hospital trusts, you are still going to pay for the uninsured
and subsidize Fortune 500 and Union health care with your inflated premiums.
You can still go bankrupt, trial lawyers and idiot doctors are still protected
species. We already having rationing aka pre-existing conditions, rescission and
yearly or lifetime spending limits.

[zap]

http://voices.washingtonpost.com/ezra-klein/2010/03/the_health-care_bills_spending.html#comments

There are any number of arguments about where the numbers COULD go from here, but it was a back of the envelope calculation just to put it in perspective. And I think its legit for that limited purpose.

-Ray

Ray maybe you are right but gosh-ezra and an intern!

[rugbysecondrow]

Regarding the individual mandate penalty on Page 340:

In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.

Also:

the Health and Human Services secretary shall not

file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty … or levy on any such property with respect to such failure.

So, there is an individual mandate which requires coverage, but a loophole written in that doesn't provide any teeth for enforcement.

I am not going to get into the merits of whether their should or should not be health care reform since that has turned into an abortion style debate where nobody really listens, but just talks and talks and talks and talks...

What I will say is that 2074 pages of legistlation that is of questionable value (based on comments made by both Republicans and Democrats), that has no clear direction nor lends itself to being understood in any meaningful way should not be what is settled for.

It is a document that can't even be read by a reasonable person...this is not acceptable. Even my health care prospectus is only 100 pages and that is hard enough to read, but 2074 is unreasonable. Dem or Repub, we deserve better than this crappy legistlation.

[Ray]

Ray maybe you are right but gosh-ezra and an intern!
Hell, Ezra's a liberal, but he knows his ****. He knows how to separate the policy differences from the technical analysis. Check out his on-going discussions with Paul Ryan - they disagree on most of the policy underpinnings, but they're able to agree on the reality of the technical issues pretty effectively. So I tend to trust his numbers when I agree with him and when I don't, even if they're back of the envelope. Particularly when he acknowledges that's what they are.

-Ray

[mjb266]

It is a bipartisan fact - once given you cannot taketh away. I welcome examples where that is not the case.

Ummm....maybe the 18th and 21st amendment.

[RPS]

but if you don't have unlimited funds, i don't believe ours in the best. it is a valid and necessary debate for america to define what our "healthcare" system should strive to do. to be "the best" should:

Great point Climb, but before enumerating what makes a better “health” system, I’d like us to step back and address a fundamental divide I keep observing between liberals and conservatives.

"There is one language, one people, one nation, the strong do not victimize the weak, ..."

The above is a line from a favorite movie where the alien is contrasting his civilized planet against our intelligent but savage Earth. The highlighted part can be interpreted at one extreme as meaning the strong shouldn’t intentionally harm or prey on the weak, and at the other extreme that we have the responsibility and obligation to help and provide for the weak.

If voluntary the answer should be very easy. However, when “mandated” it can take on a completely different life of its own. And that’s the problem I see here. Liberals first have to establish that they have the right to “MANDATE” anyone (other liberals and conservatives alike) to help those in need. It’s in the nature of good people to help each other, but does anyone have the right to force us under duress to help the weak? It's not about should we, but must we.

Helping the weak is indeed the right thing to do – of that there is no doubt. My question is whether it is right to force anyone to help. For me that’s a totally different issue and the road block we face. And I don't ever see liberals and conservatives agreeing on this.

[JeffS]

Jobs, we don't need no stinkin jobs.... we're getting change we can believe in.

Don't pretend it would be any different with another president.

There's be a few less green tax incentives, and a little more mining and drilling on public lands. The economy would still be in the crapper and the govt. would still be under the control of the same banks and corporations.

[Climb01742]

Helping the weak is indeed the right thing to do – of that there is no doubt. My question is whether it is right to force anyone to help. For me that’s a totally different issue and the road block we face. And I don't ever see liberals and conservatives agreeing on this.

the question you pose could be, and perhaps must be, examined from nearly every angle: economic, political, religious, philosophical and finally, personally. i can't even begin to craft an answer that doesn't begin with my world view. but interestingly, this from today's nytimes, in a piece about glenn beck (who is a mormon convert for contextual reference):

"Mr. Barlow said that Mr. Beck’s comments were particularly ill-timed because just this year, the church’s highest authority, the Quorum of the Twelve Apostles, issued a new “Handbook of Instructions” to church leaders in which they revised the church’s “three-fold mission” and added a fourth mission statement: care for the poor."

and this from the dalai lama, "be kind whenever possible. it's always possible."

[RPS]

Indeed Climb, but as I’ve stated before Jesus’ version of Christianity is similar to socialism and/or communism with one incredible difference – it’s based on a voluntary good, not mandated (except maybe as required by God if that’s your belief).

Mix religious and legal requirements and we are one step closer to a train wreck.

[soulspinner]

Don't pretend it would be any different with another president.

There's be a few less green tax incentives, and a little more mining and drilling on public lands. The economy would still be in the crapper and the govt. would still be under the control of the same banks and corporations.

+1-I find it amusing that somehow we think one person in that office will make a night and day change.

[gdw]

"Don't pretend it would be any different with another president.

I'm not pretending anything and am aware that Obama inherited a mess. I'd just like to see him put the effort into job creation that he has wasted trying to sleaze through a questionable bill which lacks support from the majority of people he was elected to serve. The phony deadlines, us vs them badmouth the opposition shtick is pathetic and something one expects from an arrogant inexperienced used car salesman and not the president of our country. Of course that's just my opinion and I'm in bad mood because most of my day will be wasted trying to deal with the VA. Government run healthcare is really wonderful.

[Ray]

Indeed Climb, but as I’ve stated before Jesus’ version of Christianity is similar to socialism and/or communism with one incredible difference – it’s based on a voluntary good, not mandated (except maybe as required by God if that’s your belief).

Mix religious and legal requirements and we are one step closer to a train wreck.
But isn't that the thing with all government and all societies? There are laws/rules/regulations/requirements. Not everyone is in favor of any of them, but they got passed through whatever form of democracy or theocracy or totalitarianism or whatever is in place. But even in the most theoretically democratic society we could imagine, a lot of people will disagree strenuously with every stipulation of that society (and in those with free speech, they'll yell about it). But that doesn't mean they don't have to go along with it.

Every society collects taxes for some form of "the common good". Some of that is spent on roads and bridges, which something close to 100% of us agree on. Some is spent on national defense, which may include actions that a significant percentage of people do not agree with, but they're forced to support those actions financially. Some may be spent on disaster relief - that money was also "taken" in the form of taxes, not volunteered on an individual action by action basis. That's a case specific example of social welfare, no - taking from those who can pay to help those who can't help themselves? Some may be spent on agricultural subsidies which a lot of us don't agree with - should we have to pay?

And some may be spent on various sorts of public welfare programs that, no, are not voluntary. So, if these other societal choices, which all include collecting taxes and spending the funds on actions that only a percentage of the populace approves of, are ok, why not Social Security, Medicare, Medicaid, and possibly now health care? How are these things different. Money "confiscated" from me and from you are used for things that I might not approve of and other things that you might not approve of. How is social welfare different than other priorities in this fundamental sense?

-Ray

[MassBiker]

If health care reform makes the US system anything like the Canadian system it will be a disaster and I have had substantail experience with both.

:beer:

[1centaur]

We aren't getting the NIH here, we are keeping our for profit insurance
companies, our hospital trusts, you are still going to pay for the uninsured
and subsidize Fortune 500 and Union health care with your inflated premiums.
You can still go bankrupt, trial lawyers and idiot doctors are still protected
species. We already having rationing aka pre-existing conditions, rescission and
yearly or lifetime spending limits.

You are making my point. Rationing leads to death. All health care plans involve rationing. All health care plans kill people. It's almost funny that people objected to the Death Panels concept - talk about denial.

My quote was very specific - passing this bill will.....I am not saying THIS bill will because I did not want to belabor, but now I will:

How many on the left wish this to be the first step to single payor or some approximation thereof? How many people on the right think this IS the first step to single payor? Exactly. Single payor will mean government Death Panels while the current system means insurance company Death Panels (although one is MUCH more appealable/influenceable than the other, don't forget).

climb's right that the debate is about bigger principles - what kind of society do we wish to be and how do we get there? I suppose there is no politician capable of leading that debate who both appreciates capitalism and has sympathy for the poor (and can communicate really well). I wish that was not the case. Where's Jimmy Stewart when you need him?

BTW, if I'm paying for poor people to go to the doctor, I'm not paying for them to buy Ding Dongs. That's part of the who we are national debate. If 70% of us are supposed to pay for 100% of our health care costs, no food stamps for anything that's not nutritious, mandatory exercise 5 days a week, penalties for significant weight gain, government advertising in many media pointing the finger at fatties and telling them they're hurting our economy, no more "I like my curves;" I hope not mandatory statins for high cholesterol but I bet the medical establishment would vote for that. Funny how when "rights" are increased, freedom can decline.

[SamIAm]

"Don't pretend it would be any different with another president.

I'm not pretending anything and am aware that Obama inherited a mess. I'd just like to see him put the effort into job creation that he has wasted trying to sleaze through a questionable bill which lacks support from the majority of people he was elected to serve. The phony deadlines, us vs them badmouth the opposition shtick is pathetic and something one expects from an arrogant inexperienced used car salesman and not the president of our country. Of course that's just my opinion and I'm in bad mood because most of my day will be wasted trying to deal with the VA. Government run healthcare is really wonderful.


Nailed it. For me it's not as much about a health care bill as much as it's about this ill-conceived, we'll fix it after the fact, we'll read it later, we'll stop at nothing, including the people's will to push the piece of trash through. If something is worth doing, it's worth doing right. This ain't right, not by a long shot.

[jpw]

A United States, a united population, no?

There has to be a line below which no one citizen should be allowed to fall by his/ her fellow citizens.

[sg8357]

How many on the left wish this to be the first step to single payor or some approximation thereof? How many people on the right think this IS the first step to single payor?

Single payor is not a common system around the world, private health insurance is the dominant system, wingnuts, left & right use single payor
as a boogie man.

You are already paying for the medicare, medicaid, veterans both through
taxes and higher rates on your insurance, since medicaid et al under pay
your doctor/hospital. Small business employers & employee pay higher rates,
that make up for the discounts given to Unions and Fortune 500 companies.
So you are already paying for your neighbors health care.

[Climb01742]

Indeed Climb, but as I’ve stated before Jesus’ version of Christianity is similar to socialism and/or communism with one incredible difference – it’s based on a voluntary good, not mandated (except maybe as required by God if that’s your belief).

Mix religious and legal requirements and we are one step closer to a train wreck.

RPS, you will find no stronger adherent to the separation of church and state than i am, but the urge, indeed the responsibility, to care for others springs from our humanity. for some, it is expressed religiously as morals. for others, like me, it is more philosophical/spiritual and is expressed as ethics. two sides, i think, to the same human coin.

but perhaps you feel about paying for healthcare as i do about paying for the military. i wish i had a choice. but don't the military and healthcare protect the same thing, and aren't both our duty as part of a civilized society--to protect the well-being of our fellow citizens?

[MattTuck]

Ummm....maybe the 18th and 21st amendment.

To be fair the order is wrong, that was taken away, AND THEN, giveth back.

[pbbob]

[QUOTE=Climb01742]RPS, you will find no stronger adherent to the separation of church and state than i am, but the urge, indeed the responsibility, to care for others springs from our humanity.

+1.
Moral decisions are made unconsciously and then emotional and rational justifications are made for it.
Moral Minds by Marc Hauser a good read.

[hookookadoo]

To be fair the order is wrong, that was taken away, AND THEN, giveth back.

And that underscores the point. It was allowed, disallowed and then allowed again....oh yeah and then it was taxed. :p ....Once given you cannot taketh away..... at least our politicians are predictable.

I forgot....regarding the graph. While, if correct, it provides some good perspective, but what it does not show is how much of the incremental $100BN health reform expenditure is funded from debt. The answer is 100%. We are operating under the largest deficits in the history of this country and every incremental dollar we spend is funded by debt. Not only this year, but the next year and the next year and so on.

If other programs were cut to at least make room for the incremental $100Bn it would at least be deficit neutral but we don't see that happening.

[RkyMtn]

If this Health Bill is SOOOooo good and should be passed, then why aren't all the congressional members giving up their current Platinum Plan for it?

If they want us to buy into it, it would be best if they did first!!!

I am tired of this system where the people who decide our fate don't participate in it.

It's getting to be Revolution time, again!

As for the Health Bill, just let me bleed out on the side of the road. I'd rather be dead than fund this mess.

Eric

[Ray]

If this Health Bill is SOOOooo good and should be passed, then why aren't all the congressional members giving up their current Platinum Plan for it?
Section 1312 of the bill:

(D) MEMBERS OF CONGRESS IN THE EXCHANGE—

(i) REQUIREMENT—Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are—

(I) created under this Act (or an amendment made by this Act); or

II) offered through an Exchange established under this Act (or an amendment made by this Act).

BTW, another Republican amendment, proposed by Charles Grassley.

[RkyMtn]

[I] Section 1312 of the bill

BTW, another Republican amendment, proposed by Charles Grassley.

Thank you, Ray, for pointing me to this! I wonder if Nancy Pelosi has read this (LOL)!

Cheers and thanks again!

Eric

[happycampyer]

I wonder if Nancy Pelosi has read this (LOL)!It's the first thing that Congress will "fix" after the fact if the bill passes....

[soulspinner]

RPS, you will find no stronger adherent to the separation of church and state than i am, but the urge, indeed the responsibility, to care for others springs from our humanity. for some, it is expressed religiously as morals. for others, like me, it is more philosophical/spiritual and is expressed as ethics. two sides, i think, to the same human coin.

but perhaps you feel about paying for healthcare as i do about paying for the military. i wish i had a choice. but don't the military and healthcare protect the same thing, and aren't both our duty as part of a civilized society--to protect the well-being of our fellow citizens?


+1

[Ray]

It's the first thing that Congress will "fix" after the fact if the bill passes....
Sorry, didn't mean to confuse you with facts.

-Ray

[93legendti]

You keep saying that, but please tell me WHAT Obama could do on the jobs front that you wouldn't trash him for? Lower taxes? I mean OTHER than turning into another Republican with Republican priorities. Pretty much every mainstream economist I've read agrees that both the TARP and the stimulus were necessary and effective in keeping us out of total collapse. The recession seems to have bottomed out and is beginning to improve. Job losses have finally flattened and even conservative economists expect job growth to start pretty much now. It's gonna take years to replace the whole 6-8 million jobs we're in the hole, but the trend is finally looking to be going in the right direction. Could we slip back into recession? Sure. Things might still get a lot worse.

But anything that's done to create jobs other than slashing even more taxes is met with scorn around here. You all want the government out of the economy and let every business rise or fail on its own - fine, no problem. You're conservative. I get it. But how does that square with these constant calls for Obama to drop health care and focus on jobs? What exactly do you mean when you say Obama should be focussing more on jobs?

-Ray
Right. Because we use can't any Republican ideas.

Go read what Pres. Reagan did.

Every Obama idea involves rasing taxes to pay for his new/expanded gov't program. The "mainstream economists" you have been reading say that raising taxes creates jobs?

It will be an interesting debate argument/political ad: "I did what every mainstream economist said I should have done".

I get it, you are a progressive. Taxes have to be high because the gov't knows how to spend our money better than we do?

Obama's ideas have created an atmosphere where companies aren't expanding and businesses aren't hiring.

It's an interesting strategy. The WH said it was "going to pivot to jobs" this year. If I undrestand your post, the pivot would only be a pr campaign because the WH has done all it can do/intends to do. Got it.

[Ray]

Right. Because we use can't any Republican ideas.

They've used a TON of Republican ideas, they just didn't abandon their entire approach for a primarily Republican approach. Actually, on health care they did, the Republican approach from 15 years ago. Incorporating Republican ideas is called bi-partisanship. Abandoning your principles and using the entire Republican approach is called capitulation/surrender. Your guys would never do that and shouldn't - its not what they got elected for. Our guys wouldn't and shouldn't either. But if that's what it takes to be called "bipartisan", you can keep it.

-Ray

[Kirk007]

Obama's ideas have created an atmosphere where companies aren't expanding and businesses aren't hiring.

.

Why is it that it is always someone else's like the Presidents fault? So often we hear the refrain that businesses need this that and the other thing from government and that without these things - lower taxes, less regulation yada yada - they will fail? Aren't these factors at the margins? In my experience companies don't hire because they aren't competitive - a quality that has much more to do with failed leadership, failed vision, fear of embracing change, a less "motivated" work force and failed strategies. Evolve or die. Compete better or be replaced. This has always been the way, and you can't escape that by blaming the latest straw man.

[Elefantino]

Before this thread gets locked, a couple of thoughts:

1) If all we get from this bill is wiping out pre-existing conditions, great.

2) If the bill doesn't pass, we are screwed.

3) If the bill passes, we are screwed.

4) We are screwed either way. Does anyone actually think things will change? Look at Wall Street. Look at the banks. Look at CEOs in general.

C'mon, all. We need to stop deluding ourselves. Try to stay as healthy as you can, ride lots, enjoy life and buy lots of stock in health-care companies.

It's all good.

[Kirk007]

Before this thread gets locked, a couple of thoughts:

1) If all we get from this bill is wiping out pre-existing conditions, great.

2) If the bill doesn't pass, we are screwed.

3) If the bill passes, we are screwed.

4) We are screwed either way. Does anyone actually think things will change? Look at Wall Street. Look at the banks. Look at CEOs in general.

C'mon, all. We need to stop deluding ourselves. Try to stay as healthy as you can, ride lots, enjoy life and buy lots of stock in health-care companies.

It's all good.

Dang, a does of reality : )

[Ray]

Before this thread gets locked, a couple of thoughts:

1) If all we get from this bill is wiping out pre-existing conditions, great.

2) If the bill doesn't pass, we are screwed.

3) If the bill passes, we are screwed.

4) We are screwed either way. Does anyone actually think things will change? Look at Wall Street. Look at the banks. Look at CEOs in general.

I believe that if the bill passes, a lot more people are a lot less screwed than if nothing passes. Otherwise, there would be absolutely no point. And, yeah, I know there are other opinions and everyone's entitled to them.

Yeah, I think things will change. Not all for the better for everyone all the time, but for the people who need it most, things will change for the better. Some of the rest of us will pay more, some will pay less. But almost nobody will end up paying more in ten years than they would have in ten years if nothing passes.

Yeah, life is a losing proposition and you don't get out of it alive. And yeah, taking care of yourself and enjoying life is the best medicine. But that's a lot easier for those of us with good health care to say than for those who have none.

-Ray

[Pete Serotta]

Yep, I was also guilty on this one..