« Kofi Awoonor and Westgate | Main | Ezra Klein's unanswered question »

September 29, 2013

Comments

LJ, you're just envying us our freedom.

"The mind boggles."

I wonder how much tax money- paid by the citizens of those states - is going to the companies providing these entirely un-necessary and often outright-deceptive "services," rather than to services that actually benefit the people who have paid the tax dollars.

I also wonder how many of those companies won the contracts becuase they enjoy a mutually beneficial relationship with the state GOP.

You gotta hand it to the GOP: they manage to grift the ACA even as they orate about how it's the worst affront to FREEDOM ever.

This is what you do when you're Master Of The World and know your rule will endure forever. A thousand years from now, the ills you point to will be chapter headings in some future Gibbon's DECLINE AND FALL OF THE AMERICAN EMPIRE.

Don't forget that the ACA is just the disguised Holocaust 3.0* (Roe v. Wade being 2.1). What the GOP does is just what courageous German public servants did, delaying or 'accidentally' diverting trains headed for Auschwitz**. What else could they legally do to prevent the secret killing of all seniors, all black babies and all true Christians by order of of the Kenyan Muslim brotherhood were-mole in the WH?

*nobody scare-able would understand, if it was called Operation T4II ('Tea for two?'), i.e. Euthanasia 2.0
**I am not aware of any cases of that. the Reichsbahn meticulously 'did its job' without caring about morals.

Conservatives see a lot of sabotoge here, too: They see Obamacare ITSELF being a form of sabotoge. The program is so clearly unworkable, its effects so obviously destructive, (All those full time workers being demoted to part time, for instance.) that the conclusion becomes hard to avoid that it wasn't intended to work.

You're deliberately destroying the health care financing system, because too many people liked what they already had for it to be politically feasible for you to replace it with what YOU wanted them to have. But destroy what they had, and they've got no choice to opt for something new, and you figure you get to design that.

You're just destroying the health care financing system so you can build single payer on the ruins. That's the view from the right.

Brett:

All those full time workers being demoted to part time, for instance.

Do you have some statistics about that? Because in my observation this kind of thing has been going on for more than a decade: full-time workers being cut back to just under 35 hours a week, so the employer can avoid paying benefits. It's one of the "features" of employer-based insurance that the ACA is trying to get around, in fact.

Meanwhile, insurance rates in New York are already plummeting due to Obamacare.

The private, employment-based health care financing system you're mourning has been destroying *people*. Tens of thousands of Americans die every year for lack of health insurance.

Yes, the ACA is a kludge job. It's that way because so many people are invested (in every sense) in the destructive system we've had. If you're going to characterize any change to that system as "destruction", then yes, it's being destroyed. I see it as being *altered*, and yes, I hope it will *evolve* in the direction of single-payer. But there's no reason to think we'll have to go through a stage of "ruin" to get there, and we'll maybe stop ruining so many *lives* along the way.

it starts when you're always afraid

You're just destroying the health care financing system so you can build single payer on the ruins. That's the view from the right.

How I wish The Right was right, in that respect. The current US "health care financing system" is so incredibly stupid that even Brett might someday figure it out -- e.g. if he ever wants to start his own business.

But maybe Brett the Libertarian thinks that health insurance should only be available to good little drones who work for "job creators" like the Koch brothers.

Anybody that DOES want to unleash the creative energies of the US population -- anybody that actually wants people to be able to start small businesses without worrying about having to go without health insurance -- would be agitating for "the public option" as a bare minimum.

--TP

Conservatives see a lot of sabotoge here, too: They see Obamacare ITSELF being a form of sabotoge. The program is so clearly unworkable, its effects so obviously destructive,

Indeed, life in Massachusetts is an unimaginable hellscape. Doctors have totally fled the state and the health insurance system has completely collapsed. For example, within 5 miles of my home, I can only choose between 4 different level 1 trauma centers. I am so much worse off than the many people living in states in which there are zero such facilities.

"But maybe Brett the Libertarian thinks that health insurance should only be available to good little drones who work for "job creators" like the Koch brothers."

Or perhaps I think that the tax status of health insurance should be cut free from employement, so that you could get the same pre-tax advantage while purchasing health insurance through your credit union, block club, or individually, and employers would simply compensate you by offering money, not benefits. So that changing employers would not imply changing insurers, and a lot of the things Obamacare purports to fix would become moot.

Doc: Most 2013 job growth is in part-time work, survey suggests

"By Kevin G. Hall | McClatchy Washington Bureau


WASHINGTON — The July government employment report released Friday showed the job market treading water.

And a closer look at one of the two measures the Labor Department uses to gauge employment suggests that part-time work accounted for almost all the job growth that’s been reported over the past six months."

Exactly what you expect with employers splitting a stagnant amount of actual work among a larger number of jobs.

This last bit from lj's excerpt demonstrates how freedom-loving some people really are:

...more than a dozen states have passed measures subjecting health-exchange navigators to strict requirements: licensing exams, heavy licensing fees, insurance bonds. Florida has attempted to ban them from county health departments, where large numbers of uninsured people go for care. Tennessee recently adopted an emergency rule declaring that anyone who could be described as an “enrollment assister” must undergo a criminal background check, fingerprinting, and twelve hours of course work. The hurdles would hamper hospital financial counsellors in the state—and, by some interpretations, ordinary good Samaritans—from simply helping someone get insurance.

That's how you allow individuals to conduct their affairs without government intrusion, I guess. What a load of crap.

At least we'll get to see a state-by-state experiment - the sort of thing I've heard suggested as being an effective way of figuring out how things should be done - and we can compare the respective outcomes in full-implementation states and obstructionist states. One side or the other will finally have to "see the light," as it were. I how I'd bet on that one.

Now we need just some solid data showing that the employers would not have done the same, if the ACA would not exist. The graphs I have seen until now show no correlation with any step of the passing of the ACA. And since those parts of the ACA that could have an effect there will not go into effect before next January, it seems to be mostly speculation right now.
As some GOPsters (including The Cruz) have stated publicy, the important thing is to stop the ACA before it goes into full effect or it would become in essence politically (not technically) impossible to repeal. The reason given for that can be interpreted in two ways:
1. The average citizen is a parasite and will be unwilling to give back the benefits paid for by money stolen from the makers. That's the standard argument against democracy itself since ancient Greece (the mob will always vote itself free meals)
2. If the ACA goes into effect it will prove superior to the previous system even before it has overcome its teething problems. Thus returning to the previous system would be seen as counterproductive and selfserving for the profiteers of the status quo that would loose under the new system.

Personally, both interpretations of their words are valid, although it depends on the individual, which carries more weight. Both are mutually exclusive with the claim that the ACA would be an instant failure because then the 'too popular to repeal once executed' argument would fall apart. As would the 'people prefer private death panels to public ones' argument btw.
---
I think the ACA will have significant teething problems but I attribute the vast majority of them to the concessions made to the profiteers of the status quo. And the 'improvements' or 'replacements' propsed by them are almost without exception poison pills, I would even say deliberate ones.
---
What I think of the GOPsters (plus their backers and some blue dogs) on this I could not express without committing a bannable offense. Let's just say that I think they would without hesitation sell their souls and their grandparents for short term gain, if they had not already done so long ago (except for those that could not yet find a buyer).

On the other hand, there's this.

And this.

Part of the rise in part-time employment may well be the spectre of Obamacare.

Part is also due to a generally crap economy.

What's a factor in both cases is a business model based on the premise that the way to maximize profit is to pay as little as you possibly can for labor.

What some folks are discovering, including some fairly significant players, is that that is a stupid, crappy, short-sighted, and counter-productive business model.

What I look forward to is the economy recovering enough that folks can tell all of the chiseling [email protected] bastards whose answer to every problem is to screw labor that they can take their crappy jobs and shove them.

To address this, briefly:

You're deliberately destroying the health care financing system, because too many people liked what they already had for it to be politically feasible for you to replace it with what YOU wanted them to have.

If you can look at the evolution of the ACA, from it's origins, through the various mutilations and deconstructions it went through, including having everybody on the planet with an interest in US health care tacking on their own personal favorite agenda items, and see anything like COHERENT INTENT, you're smoking something very very special indeed.

It starts when you're always afraid, buddy.

"And since those parts of the ACA that could have an effect there will not go into effect before next January, it seems to be mostly speculation right now."
Since there's up to a twelve month look-back to determine whether an employee is full-time or part-time, some employers made adjustments in work schedules some time ago.

I think Brett is right, at least as far as Cngressional Republicans go and quite a few Tea Partiers. I think they probably do see Obamacare as sabotage: sabotage of their sense of entitlement. Because, you see, only conservatives are entitled to be the recipients of government tax dollars or the beneficiaries of big government programs. It sabotages their self-concept as the real true responsible respectable Americans--not like those OTHER people-- to witness the formation of a plan to provide access to an essential service for people who they assume are the poors or at any rate not the entitled like the conservatives who get their healthcare through the VA or Medicare or current Medicare enrollment. Brett hit the nail on the head.

In the Senate the sense of conservative entitlement exists but I think Republican Senators, with some exceptions, of course, are more cynical than crazy. I think their opposition to Obamacare was partisan politics and that many of them would move on and accept Obamacare if they weren't afraid of the monster they created in their base.

The HOuse Repubicans, though..,you're talking some serous stupid there.

There was a time when quite a few Congressional Republicans saw Social Security, Medicare and Medicare as the end of the world. Or claimed to believe that. Hyperbole in defense of selfishness is a pattern with elected Republicans.

"Or perhaps I think that the tax status of health insurance should be cut free from employment, so that you could get the same pre-tax advantage while purchasing health insurance through your credit union, block club, or individually, and employers would simply compensate you by offering money, not benefits."

Why should purchasing health insurance or receiving medical care be tied to employment at all?

Unemployed and underemployed folks and those employees, mostly older, fired because of the rising costs of their coverage need medical attention as well.

With Obamacare repealed completely, folks with even trivial pre-existing conditions, just to choose one item, are shut out of the medical insurance market (market, they call it: the German Shepherds bark as you are instructed to stand to one side for the boxcar ride to death and penury) either through price or by outright rejection.

As the Republican "replacement" Death Palin insurance plan released last week reinstates.

Which makes the words "while purchasing health insurance through your credit union, block club, or individually ... a pointless exercise in murderous bullsh*t.

The word "simply", a gingrichian use of the language, is the dead-giveaway which cancels every other word in the paragraph, including and, of, the, and especially, block club.

My "block club", which can't organize a volleyball game, consists mostly of young, healthy folks, who will turn reptilian when the older folks with expensive medical maintenance plead to be let in on the medical pool.

"Block Death Panel", anyone? The government closest to the individual is the most likely to kill that individual.

And, please, who's interested in a lecture from a libertarian who would halt Medicare and Medicaid in a non-defibrillated heartbeat about destroying the health-care financing system?

Regarding the health-care navigators cited above, it is now easier in some states (let's guess which ones) to purchase a piece of weaponry and ammo than to qualify to become a navigator.

Which makes it obvious that what the would-be navigators should be doing BEFORE heading over to the Texas bureaucratic nest of f*cking repilian killers, is stop by the local gun show and gun and ammo-up to destroy the parts of government THEY find too inconvenient, and job-killing, and socialist, and taxing, and murderous.


Yes

http://talkingpointsmemo.com/livewire/sen-angus-king-conservatives-who-urge-people-to-avoid-obamacare-are-guilty-of-murder

Reinstate the death penalty for this crime.

By machete.

"Why should purchasing health insurance or receiving medical care be tied to employment at all?"

I don't suggest that it should be, I thought I was clear about that. Exactly the opposite: I think it's a bad idea that you have to get your health insurance through your employer for it to be paid out of pre-tax income. I think you should get the same tax status no matter HOW you obtain that insurance. Individually, block club, credit union, YMCA, you name it.

That would quite neatly abolish most of the issues with "pre-existing conditions" by allowing people to stay with the same insurer their entire lives if they wished.

I suspect your complaint actually revolves around my belief that getting a paycheck should have something to do with being employed, and that people actually should have to pay for health insurance, rather than having it provided by the government so that somebody else pays for it.

I suspect your complaint actually revolves around my belief that getting a paycheck should have something to do with being employed, and that people actually should have to pay for health insurance, rather than having it provided by the government so that somebody else pays for it.

I suspect this particular suspicion of yours is, um, suspect, and I can't wait for the Count to demonstrate that by going all Daffy Duck on your @ss.

I suspect your complaint actually revolves around my belief

Maybe you should just assume that what people say is pretty much what they mean, and quit trying to construe their comments to mean whatever secret intents they harbor in their commie little hearts.

" ....Daffy Duck on your @ss."


https://www.youtube.com/watch?v=h0SNoIrm61w

And, if time permits:

https://www.youtube.com/watch?v=CVspg-K-rTw

Otherwise, I'm no longer in the giving vein.

It's tough to shoot at swiss cheese arguments that are all-hole.

Well, if that's not how I should read your complaint, you appear not to have read what I said, which is that insurance shouldn't be linked to employment.

Not linked, but having "something to do with employment".

Got it.

Here's a price quote from a few minutes ago on for the 10-year Treasury IOU, as George W. Bush called the debt that paid his salary and for his Soviet-style security apparatus.

10 Yr Note 98.80 +0.51 +0.52

Wall Streeters, mostly Republicans who want Obamacare decommissioned, are buying the very paper for which their wealthy patrons and the folks they elect to Congress clamor for default.

Regarding sabotage, this (via Drum from someone or other) is about right, but I'll append my edit:

"Thousands of employers will blame “ObamaCare” for whatever unpopular moves they impose their workers. It’s the obvious play. In many cases, this blame will be mostly or entirely misplaced. Other times, the blame will be justified, reflecting glitches or unintended consequences of the new law. Either way, many workers will believe what their employers tell them. Millions of workers with relatively modest incomes will see their lives getting a little worse when they were hoping that health reform would make their lives a little better. Other people—I suspect many more—will see their lives getting a little or a lot better. Some of the most deserving people will seek benefits and medical care–only to discover that no help is forthcoming because their states rejected Medicaid expansion. Republicans had better hope that this is a disorganized and politically marginal group."

Edit final sentence to read "Republicans had hope that this is a disorganized, unarmed, and politically marginal group."

I want that group armed with these:

http://www.youtube.com/watch?v=5GOwLGeWlrY

or these:

http://www.youtube.com/watch?v=p4ebtj1jR7c

... since Republicans want them in EVERY Americans' hands.

A Looney Tune, but you can dance to it.

What the hell, let's go full-Founder-guaranteed killing machine (equal to military firepower) and armored medical insurance:

http://www.youtube.com/watch?v=ZFjGbOyd2ek

quit trying to construe their comments to mean whatever secret intents they harbor in their commie little hearts.

which is to say, whatever secret intents *you think* they harbor etc.

where, for 'you', please read 'Brett'.

The mind boggles.

anyone besides me have fond memories of being told, ca. 2001, that 'elections have consequences'?

good times.

Well, if that's not how I should read your complaint, you appear not to have read what I said, which is that insurance shouldn't be linked to employment.

Continuing in the vein of not reading what you "said" (sic), I take it that you then are in favor of single payer, because otherwise I see some problems:

1. How will the purchase of private insurance through my book club be 'just the same' as the current tax treatment whereby the benefit is essentially part of one's wage?

2. To circumvent 'pre-existing conditions' entirely, would not the health policy have to be purchased at conception?

anyone besides me have fond memories of being told, ca. 2001, that 'elections have consequences'?

fonder still the memories, ca 2004, of being told to just shut the f$$$ck up and actually win an election....

Book club?

What if you belong to one of them Republican/Libertarian/Christian Fundamentalist Book Clubs where, on principle, you can't compromise on what book to read next month, the very concept of insurance (wherein costs are spread over a commie pool) is a touchy feeley, hippie experience worthy of gunfire, and by the way, we're reading Atlas Shrugged all year and next and anyone who suggests reading the banned "Lolita" is kicked out of the "club" to find out if your bladder infection last week was just that or maybe, according to the 27 insurance company Death Panels for whom you fill out insurance forms and whom deny you coverage, a suspicious ailment of unknown non-insurable origin?

Here's my non-negotiable demands on the Republican Party:

For them: http://www.break.com/video/russian-tsar-hydrogen-bomb-explosion-558915

or

For all of us: shut down the government in perpetuity and default on the national debt.

Let us review, so we're clear:

For the Republican Party and their children:
http://www.break.com/video/russian-tsar-hydrogen-bomb-explosion-558915

or

For all of us and our children: shut down the government in perpetuity and default on the national debt.

I'm willing to compromise on this sticky wicket by agreeing that the full terms of both demands go into effect this Friday one hour after cocktail hour commences to permit either side to stiffen their resolve and when my resolve is suitably stiffened, the Republican Party may stop sucking on it, the latter of which I call my middle ground.

Love,

Daffy Millhouse Lemay, but you may address me as General Rafael Cruz and his concubine Dagny Ryan


Or perhaps I think that the tax status of health insurance should be cut free from employement, so that you could get the same pre-tax advantage while purchasing health insurance through your credit union, block club, or individually, and employers would simply compensate you by offering money, not benefits.

Brett, this is such a lovely and rational idea! But can you point me to where, in which bill that has even be submitted, the House GOP has ever offered this as an alternative? Certainly I have seen no sign of them including that with the rest of the smorgasbord that they are trying to attach to either the CR or the debt ceiling increase.

And if that isn't an alternative on offer, why bring it up in this discussion? Unless it's just a matter of what should be done, with no reference to what either side is willing to do.

Speaking of Dagny Ryan, what would John Galt say about his fellatrix who blanches at the sight of stone-cold sadism:

http://blogs.marketwatch.com/capitolreport/2013/09/30/paul-ryan-is-awol-in-budget-battle/

Brett, this is such a lovely and rational idea! But can you point me to where, in which bill that has even be submitted, the House GOP has ever offered this as an alternative?

The glibertarian solution would result in over-priced insurance marketed only to healthy people (aka death spiral), widespread medical quackery, care rationing by ability to pay, and an explosion of lawsuits.

Politically, it would lead to blood running in the streets-lampshade green in color. So I guess it wouldn't be all bad.

Why bring it up? Obviously, because somebody wrote this: "But maybe Brett the Libertarian thinks that health insurance should only be available to good little drones who work for "job creators" like the Koch brothers."

Granted, the current crop of Republican leadership would have no patience with the plan I suggest; The only people who'd like it less would be the Democratic leadership. But then, I'd frankly love to see the current Republican leadership replaced by people like Rand Paul, who actually WOULD be open to such a proposal.

Brett,

You're just destroying the health care financing system so you can build single payer on the ruins. That's the view from the right.

The health care financing system has been doing a pretty good job of destroying itself, not to mention lots of people.

the current crop of Republican leadership would have no patience with the plan I suggest; The only people who'd like it less would be the Democratic leadership

Sounds like you have a run for the House all lined up. Only question is, will there be any windmills left standing by the time you get there?

Brett, folks have already pointed out that the world does not revolve around your, er, beliefs, but if you want to get bent out of shape about this

Why bring it up? Obviously, because somebody wrote this: "But maybe Brett the Libertarian...

Maybe you got the blast because in the previous comment you wrote:

You're deliberately destroying the health care financing system, because too many people liked what they already had for it to be politically feasible for you to replace it with what YOU wanted them to have. But destroy what they had, and they've got no choice to opt for something new, and you figure you get to design that.

You're just destroying the health care financing system so you can build single payer on the ruins. That's the view from the right.

I realize that it can be a pain to try and separate the direct 2nd person pronoun with a pronoun meaning something like 'one', especially when you use it as wantonly as you did, but I'm afraid that words, like elections, continue to have consequences.

Just finished "Moby Dick" (avast, mateys, bring that book out of the head below decks and before the mast to be read aloud), and "the view from the right" like Ahab's, is that the great white (thar's a color the 27% should worship, not hate) whale -- Obamacare and Barack Obama -- must be destroyed and if the Pequod must be consumed in a whirlpool maelstrom in the process, so be it.

This, of course, does not count the other nine demands made last week by the terrorist Republican Party, which must be met in full or the Nation's debt will be defaulted on.

Those issues certainly can be "entertained" but destroying the country's credit under the gun by holding everyone hostage is not entertaining, it's cause for mutiny against the Republican Party and whatever killing needs to be done.

The demands are basically Mitt Romney's campaign platform from 2010 and would constitute a nullification of that election, since Romney and the Republican Party couldn't f*cking steal THAT election too, not to mention that the great white whale he wants destroyed was raised from guppy-hood in his aquarium, Massachusetts.

Elections have consequences, yes, but this attempt to nullify an election or else, if acquiesed to in any particular, will have consequences too.

You (whomever applies to that pronoun) don't think that can happen in this country?

people actually should have to pay for health insurance

so simple!

all they would need is money.

A mind is a terrible thing to boggle.

Much more of this:

http://talkingpointsmemo.com/livewire/rubio-reportedly-gets-earful-about-shutdown-on-flight-to-d-c

The pilot should have put the plane into a dive once it was discovered there was a terrorist on board.

Hell, all they need to buy food is money, but does the government order the grocery stores to sell food to the hungry below cost, and then order everyone else to buy over-priced groceries on a regular basis so the stores don't go bankrupt? No, the government gives poor people money with which to buy food, and lets the rest of us buy or not buy groceries as we choose.

Brett 0, windmills 1.

Which ones of you don't buy groceries?

Cause I'm thinking with what I pay for health insurance, I might need to cut other parts of the budget to zero.

"No, the government gives poor people money with which to buy food"

Money, is it? How come you didn't call it other people's money? What, did political correctness set in?

And actually, given the druthers of the elected ones in the Republican Party, giving poor people and one surfer money with which to buy food was just a subject of cutting last week.

And, you don't buy groceries as you choose.

You are forced at gunpoint to buy groceries that were inspected for disease, spoiliage, and free of lead, strychnine, mold, cooties, and sawdust created from the macerated pages of Das Kapital by the FDA, currently being furloughed, to allow you the choice of dumpster diving for that cheese steak with the greenish tinge.

....but does the government order the grocery stores to sell food to the hungry below cost, and then order everyone else to buy over-priced groceries on a regular basis so the stores don't go bankrupt?

ALL CAPS ALERT. ALL CAPS ALERT.

If one actually grasped the significant market failures that characterize the delivery of health care, one would not work so hard to construct a comparison OF SUCH NONPARIEL VAPIDITY.

"Mom and Dad, we're getting woefully short on groceries around here. Just wondering when the next trip to the [email protected] might be coming up?"

"Well, kiddo, your Mom and I have decided to go off the grid .... '''

" ... and grow our own food?"

" ...I didn't say that ...."

" ....hey, sis, they're going to buy a rice cooker!"

"Whoa, now, slow down, Chief. We're thinking we're NOT going to shop for groceries at all, as a choice ... lookee here, says so, that we're provided that choice by Natural Law and some clause in the Founders' meanderings through Montesquieu ...

"I'm hungry"

Well, now getting rid of child labor laws might be something we could do by choice as well and then you and your sister can shop for groceries, if you so choose."

Hey, look, Republican words, not mine:

GOP Rep. Calls Fellow Republicans 'Lemmings With Suicide Vests'

Rep. Devin Nunes (R-Calif.) sharply criticized his fellow House Republicans on Monday, saying it's "moronic" for them to let the government shut down over their opposition to Obamacare and calling them "lemmings with suicide vests."

“They have to be more than just a lemming," he said. "Because jumping to your death is not enough."

No, the government gives poor people money with which to buy food, and lets the rest of us buy or not buy groceries as we choose.

the count and bobbyp already got my back on this one, but i'll pile on nonetheless.

"the government" does subsidize groceries for poor people, and it does so by giving them *other people's money*. which seems to be the basis of your objection to ACA. so, i'm somewhat puzzled about your citing that as an appropriate strategy for dealing with groceries.

and, groceries and health care are really not comparable as consumer goods. the conditions necessary for an efficiently competitive market don't really exist for health care, and i doubt we'd want to reconstrue the delivery of health care in the ways that would be needed to change that fact.

To folks who are angry about the House obstructionism:

Time to write to your Reps to complain, and write to the President to express support for health care. The tea party won in 2010 because they were loud. We need to be louder.

I was at a client's house today and she had the TV on. CNN? I'm not sure. NOt Faux. Any way there was all the stuff about the shut down, basically presented like calling a boxing match. A listener would have no idea what it was about, only a vague idea that no one was winning.


Then there was a piece about the exchanges. Simplified, but clear. The talking head mentioned that no one could be turned down for a pre-existing condition. Repeated mention that the exchanges varied from state to state as they were organized at the state level. (Except for the red states where sulking and pouting predominates so the feds will organize the exchanges). The talking head said that people who already have insurance probably won't se much change.

In other words, the world will not end. Big government will not be messing with anyone's health care. What's the hysteria about?

Then the show went back to the boxing match coverage, but now it was clear what the fighting was about: will people who need it get insurance or not?
I know the thirty percenters will see what they want to see, but for the normal people who just aren't paying that much attention most of the time but are paying attention now, it looks an awful lot like the Republicans don't want people to have access to affordable insurance and are going to shut down the government to get their way.

In what reality does that kind of behavior get votes? Or respect?

What John Cole said:


How do “reasonable” Republicans still self-identify with this party?

So, Brett:

You and I agree that individual Americans should be able to buy health insurance based on their status as living human beings, not on their status as worker-bees. Good.

Now, would it be any skin off YOUR nose if I had the OPTION to buy my health insurance from the US government?

You'd have the option, too, of course -- an option you do NOT have now. Does your liberty increase or decrease when you have more purchasing options, I wonder?

--TP

Anticipating Brett's answer: When the government is involved, it will use its unfair advantage to push out the private insurers step by step and soon the private option would not exist anymore. The only way to prevent that is to legally ban the government from entering the market in the first place.
I would say in the case of the US this is not totally without merit but not because of the evil of the government but the unwillingness of the insurance sector to reform its business model accordingly (like putting primary emphasis on providing coverage at reasonable conditions instead of denying it in order to maximize the profit of CEOs and shareholders).
To be cynic: If the GOP ran the show from the start uninhibited, there would be the individual mandate (to deliver customers to the insurers aka donors) but all elements forcing the latter to actually provide any service would be left out (and quite a number of self-styled libertarians would not voice any protest. The Pauls would be ridiculed as usual).

Pretty much, Hartmut: No private insurer can compete with an 'insurer' which is not required to balance it's books, which has the power to pass laws requiring providers it 'negotiates' with to give it what it wants, can saddle competitors with burdensome rules, and can at any time force people who haven't contracted with it for insurance to provide it money.

To let the government participate in any market is to destroy that market, because the government, inherently, does not play by the same rules, barely plays by ANY rules.

Brett, I say this with all due respect, and in fact with no small amount of personal regard:

You are a nut.

By which I mean, your comments about anything touching on the public sphere are utterly dominated by an overpowering idee fixe, which appears to warp your thoughts the way massive objects warp space and time.

GOVERNMENT BAD. The rest is commentary.

To your point about "government destroying markets", this may not have occurred to you, but markets in anything like the actual social and economic context we live in could not exist without government involvement.

Ponder that, and you may see that it is so.

The problem with the free market and health care, as many folks have pointed out, is that the conditions necessary for an efficient and competitive market are not available.

If you can not name those conditions, or at least some of them, I'll ask you to stop reading this now, and go find out what they are before continuing on this thread.

As a somewhat related point, the costs of many medical goods and services are extremely high, such that absent insurance folks who find themselves in need of them are likely to face a choice between death and financial ruin. And there is no reliable way for folks to know if they are going to be the one on whom such bad luck falls.

The free market IS NOT a good model for most health care good and services, or the insurance that makes access those goods and services feasible.

Aspirin, ace bandages and bandaids, vitamins and other non-pharma supplements, maybe. Although even in the case of 'commodity' goods like aspirin and supplements, government intervention to guarantee purity and effectiveness has proven to be EXTREMELY useful.

As in, it was introduced, by popular demand and often with tremendous reluctance on the part of the government itself, to prevent people being killed, not hypothetically, but in real life.

Diagnostic services, surgery, manufacture of and/or prescription of dangerous drugs, no. I don't want the free market to weed out the sub-standard offerings. I don't want to have to know enough to evaluate whether I do, in fact, have a brain tumor or need bypass surgery. I don't want to receive health care services from someone who took up doctoring in a low-barrier-to-entry environment because the hours were better than opening a hardware store.

If you're going to flay me alive and poke around in my innards, I want somebody to have done the due diligence to make sure you know WTF you are about.

And I do not want that 'somebody' to be Mr Invisible Hand.

Health care ain't groceries.

The US Postal Service destroyed FedEx decades ago, and Princeton closed its doors shortly after Rutgers, just up the road a bit, became a public university. Let's also not forget that there are no health insurance companies in countries with public heath systems, of course.

All that aside, I like the idea of an insurer that doesn't have to balance its books. It would be more rational from a medical perspective, without finance interfering so much.

Can someone explain this to me? Why is it that insurance companies don't push for more preventive care, perhaps by requiring, as a condition of being insured, regular check-ups and such? Is it just so easy to dump people once they get sick enough to start costing a lot of money that it's not worth the up-front costs?

Health care ain't groceries.

I went to the store the other day, and there was a big pile of podiatrists next to the potatoes. I forget how much they were a pound.

Why is it that insurance companies don't push for more preventive care, perhaps by requiring, as a condition of being insured, regular check-ups and such?

I think they do...my insurance company is offering my spouse and I $250 each if we get a physical done and get the doctor to fill out a form for them.

Hartmut,
Good job "reading Brett's mind" :)

Brett,
Just reading your WORDS, one might conclude that you care more about the financial health of private insurance companies than about the financial health of your own family. I mean, if you could buy your insurance CHEAPER from a behemoth who "barely plays by any rules", would you pass up a good deal for your family on pure ideological principle?

I will not insult you by concluding that your answer is yes. I will indulge in a bit of mind-reading instead, and infer that your ideology does relate back to your own family's welfare. You and yours would be worse off with smaller insurance premiums than with larger ones, you must believe.

Being a logical fellow, you surely don't just "believe" that; you must have deduced it, based on history and logic. For instance, you might be looking at how thoroughly Medicare (the over-65 public option) destroyed both medicine and insurance in America over the last 50 years, and logically conclude that an under-65 public option would have exactly the same effect in the next 50. But that's just a guess on my part.

--TP

You must have a smarter insurance company than I do, or ever have had, Turb. I've never been offered anything like that.

Well, Rep. Crazy Eyes is happy today. And Rep. PuppyMill of Iowa, along with Reps Farm Subsidies but No Food Stamps are high-fiving each other because they finally got what they wanted. And Mr. Faux Moderate of Washington who votes like a crazy but has a mental reservation that makes him still moderate in his own eyes will head back home to tell his voters that he's a really a moderate because he doesn't really mean it when he votes like a crazy. And the Climate Denier Reps, the Cut Taxes for Rich People and That Solves Everything Reps and the Pro-life Reps who don't give a shit about the living--they'll all fan out to do what Republican politicians do: deny responsibility, babble slogans, and lie, lie, lie.
Hopefully people will finally get a clue and stop voting for them.

That might be a feature of living in MA. Even the crappy insurance I got for a few months when I was unemployed was offering me $100 to get a physical; of course I signed up for them on the MA exchange before the ACA was passed.

More generally though, there's a bit of a collective action problem. If your subscribers are going to be your competitors' subscribers in a few years, spending money now to reduce their future health costs doesn't necessarily make sense. Now, if every company decides to spend money now, everyone will be better off, but if one company doesn't, there's a free rider problem and they'll reap the benefits and get higher profits...

As with many other problems, single payer systems fix the incentives here.

"Can someone explain this to me? Why is it that insurance companies don't push for more preventive care,"

Because, unlike life insurance companies, you don't stick with the same health insurance company over your lifetime, and most preventative measures, while they pay off handsomely, pay off in the long term, when you're probably with a different insurer. So the company that pays for the preventative stuff gets the cost, and not the benefit.

Just one of the harmful effects of linking insurance to the employer, rather than the insured.

The GOP has passed a bill in the House with a long laundry list of demands. The Dems should respond in kind by passing a bill that offers some deals for "our" side:

You want the Keystone XL pipeline? Repeal the Law mandating a debt limit ceiling.
You want a one year suspension of the implimentation of the ACA? Repeal the Taft-Hartley Act.
You want to means test Medicaid? Revise the income tax bracket to those on the books in, say, 1952, adjusted for inflation.
You want to gut Dodd-Frank? Repeal the repeal of the Glass-Steagall Act.
You want to drill baby drill? Repeal any trade legislation passed since 1975 that was sold as a "free trade" measure.

Send it to the House, get it in a conference committee, and let the fur fly.

In yer dreams, bobbyp? Sigh. Yes, I know. One goes into political combat with the Democratic Party one has, not the one you wish you had.

"Repeal the Law mandating a debt limit ceiling."

That would be the Constitution. Article 1, Section 8, Paragraph 2.

This?

To borrow Money on the credit of the United States;

I don't see anything about a debt ceiling there. Am I missing something?

I went to the store the other day, and there was a big pile of podiatrists next to the potatoes.

Just wait until we can all print our own MRI machines with a 3D printer.

Brave new world!!

Offered without comment.

Am I missing something?

Absolutely not. Apparently, you are responding to one of those Constitutional "literalists" who have access to the "lost version" or "TRUE" Constitution to which only they are granted access to.

It seems the debt ceiling didn't exist before 1917, but whatever.

Brett,

I absolutely agree with you about the desirability of what amounts to a lifetime insurance policy. But there are some details here that need to straightened out.

First, if the insurer is free to raise your rates drastically if you get sick then the lifetime policy really doesn't protect aginst pre-existing conditions. I mean, technically you might still be able to get insurance, but if the premium is at bankruptcy level then in reality there is no such protection.

Second, not all insurers operate everywhere. If you move someplace where your current insurer doesn't operate, you have to find a new company. How will pre-existing conditions be handled then.

Third, you may have a break in coverage. Maybe you spedn time in the military, or live abroad for a few years, again raising the question of getting insurance anew.

Fourth, insurance companies go broke sometimes. Indeed, in a competitive national market it's likely that some will. Now what?

Fifth, if you have guaranteed lifetime insurer you might want to pay more than an actuarially fair premium when you are young, so you can pay less when you get older. That's just a common sense matter of matching your income to your expenses. But you can't do that if you might change insurers.

For these reasons, and others, it seems to me that it would be a good idea for your lifetime insurer to be the government, which would avoid many of these difficulties.

Of course, we could go with private insurers instead, but it's going to need an awful lot of rules to deal with all this.

my insurance company is offering my spouse and I $250 each if we get a physical done

It has often occurred to me that we could improve public health, at a tremendous saving to both our public and private wallets, if we would pay people to walk.

A dollar a mile. Set up checkpoints like they do for cross country bicycle races etc.

It wouldn't be that hard to game, but the amount of money on the table would make it hardly worth it. If you could keep the fraud down to about 10% or 15% of the total, it would be well worth it.

Two miles, five days a week, gets you ten bucks a week. Bump it up just a little bit, you get fifty bucks a month.

If you can fit in twenty miles a week, that's one large a year. Not bad for walking.

Take into account the general health benefits of lots of people walking ten to twenty miles a week, and it would pay for itself.

We would never, ever, ever, ever, ever, ever do anything like that, because FREEDOM.

We're damned lucky we're allowed to recycle.

I get my gold teeth cheaper by a third provided I have my dentist check my teeth once a year in the decade or so before.
The free rider problem on the insurer side is a bit mitigated over here by a bar one has to jump to change (statutory) insurers. And if one leaves the system to go fully private (potential better service but guaranteed much higher costs) the re-entry into statutory is very difficult (and one may be forced to go into AOK, i.e. minimum care and bad service). There is a system in place where insurers have to pay in to a fund to compensate those insurers of last resort that have to take the patients that the other insurers won't take. Not perfect but it gets for the most part rid of the standard problems of an unfettered market while putting only modest restriction on freedom(s) (at least as the majority sees it).

Take into account the general health benefits of lots of people walking ten to twenty miles a week, and it would pay for itself.

And the reduction in emissions. Maybe pay double if the walking is to work/school.

I read a few weeks ago that treadmills are now selling like hot cakes (fewer hot cakes might help to shed some pounds) for the office, as in the once sedentary "bureaucrat" standing and walking behind's ones desk.

This seems a peculiarly American way of killing two birds with one stone and multitasking.

I love to walk .... outside .. and when I have paperwork I like to do it inside. Mixing the two is like fruit flavoring in my beer -- that's two things ruined.

Personally, I would find it a little alarming to have a receptionist lead me into someone's office for a meeting and be greeted by the sight of a person hot-footing it in place while speaking into their cellphone.

What is the etiquette? Do I hop on with them and stride in tandem as we do our business or should I run in place next to their machine, as if keeping up?

This raises questions about other professions too.

What about those guys who pull rickshaws in the city? They are getting plenty of exercise but must be short of rest. Maybe they could rig up a contraption on which they lie down as they locomote via pulling the passengers with their hands along the street.

Or maybe, the "puller" could place himself on a treadmill, thereby getting his walking in, but the treadmill could be on wheels powered by an electric motor, which would pull the passenger carriage.

And what of the passengers physical conditioning. It can't be healthy to just sit their on their asses rubbernecking the sights; maybe instead of a cart with seating, the rickshaw puller could pull a two man treadmill on which the passengers would walk as they ride.

The power-generation possibilities of hooking up all this kinetic energy to the power grid seems promising as well, though I expect the Republican Party will insert an additional demand into the budget negotiations that the hippie notion of treadmill renewable energy shall be disallowed (in cahoots with their campaign financiers in the oil industry) across the country or the government will be shut down and the Treasury will be forced to default.

Maybe we could have Republican politicians and their media whores run on treadmills (we'll tell them it's for their health) each of which would be engineered to explode in a mushroom cloud when a random level of speed or distance is achieved, killing the lot of them.

Apparently, self-driving cars are just around the corner, as are self-driving 18-wheel rigs. Since the truck drivers will be unemployed and without health insurance (or else the government will be shut down and the debt defaulted on) and have nothing better to do, they could run beside their trucks to stay in trim.

The trucking companies could outfit them in thick wool trucking mascot uniforms as additional advertising.

Hup, hup

Maybe at the airports, instead of those people movers, you could convert all of the floor surfaces into a gigantic treadmill device. Folks would be in great shape, though I guess they might be late for their flights, huh?

Alright then, instead of seating on planes (I'll bet you're way ahead of me here) install treadmills but with only enough room to take very tiny steps and every time you over strode, you'd clip a knee on a pointy hard surface.

Combination treadmills/toilets for the person who wants to achieve two movements at once.

You'd think a guy could find a youtube video of Homer Simpson with his new boss at some New Age tech company (the one where he gets the job as a "manager" and finds success by telling his workers to work a little harder), riding the conveyor belt/people mover through the corporate complex to the gym to go for a walk on a treadmill.

Maybe the treadmill was first, then the people mover. Either way.

The murder begins:


"At the National Institutes of Health, nearly three-quarters of the staff was furloughed. One result: director Francis Collins said about 200 patients who otherwise would be admitted to the NIH Clinical Center into clinical trials each week will be turned away. This includes about 30 children, most of them cancer patients, he said. (From behind the WSJ paywall via the Atlantic) (h/t a tweet from science writer extraordinaire Steve Silberman aka @stevesilberman.)"

Hey look, that magic 27% once again. So we know who the murderers are. They always give themselves away:

"According to a CNN/ORC poll, 68% of Americans think shutting down the government for even a few days is a bad idea, while 27% think it’s a good idea.

And it appears most Americans would blame congressional Republicans for a shutdown: Sixty-nine percent said they agreed with the statement that the party’s elected officials were acting like “spoiled children.”

"Spoiled children", not "children denied experimental cancer treatment".

Since the NSA is not protecting us from the 27% of the Republican Party (the most dangerous, murderous organization on the face of the Earth) that identify themselves as child-killers (you know, saving the fetus so thay can butcher the born child), who is going to have to hunt down the terrorists and kill them like Obama killed Osama bin Laden?

Someone has to do it.

Perhaps some of the kids being denied experimental cancer treatment will survive, in spite of the efforts to kill them, and grow up, join the NRA, buy heavy weaponry while skirting background checks, and hunt down the Republican "spoiled children" and use their heavy weaponry for what it was intended for by the Founders, butchering anti-American sadistic terrorist vermin and THEIR children.

They could do all of that while jogging on a treadmill.

Walking? I say give these f*cking vermin (to borrow a term) a good old fashioned tongue lashing. The use of real whips* would not be discouraged either.

*Steny Hoyer

Thanks, bobbyp.

"When is it about it that drives you Republicans crazy?" "What is the price that the workers have to pay?"

Need to bring that rhetoric back, on the phone, to any Republican representative's office we can reach.

[D]irector Francis Collins said about 200 patients who otherwise would be admitted to the NIH Clinical Center into clinical trials each week will be turned away. This includes about 30 children, most of them cancer patients, he said.

Well, you or I or any random normal person would be enraged by that.

But we're talking about Republicans. 20 kids gunned down at an elementary school, and the bastards didn't even blink or pause before whipping up their supporters to make damn sure there was no legislative response to the slaughter.

30 kids dying of cancer? P'shaw. Just another ritual sacrifice to whatever foul excrescent Thing the GOP worships.

I suppose we should be grateful those loathesome savages in the House GOP caucus don't do a victory dance and high-five each other...at least, not out where anyone can see them. By all reports, they're "giddy" over their great victory in shutting down the government, with no few of their supporters figuring there's no reason to ever end the shut-down.

Indeed, the murder begins, but you're perhaps a little unclear about who's committing it.

Indeed, the murder begins, but you're perhaps a little unclear about who's committing it.

Indeed. If only Obamacare were repealed, estate taxes were eliminated, the top tax rate were reduced to 10%, and Obama would resign, the House would end the shutdown. Is that your point?

"Indeed, the murder begins, but you're perhaps a little unclear about who's committing it."

Oh, he's a clever boots, that one is.

And here I thought I was cocooning.

http://www.youtube.com/watch?v=qeDTc2dPsD0

If I thought at least most of the Republicans trying to sabotage the ACA really thought it was a horrible travesty worth defeating at all costs, I'd be more sympathetic to Brett's notion that there's credit and blame to be shared somewhat equally by both sides. But I don't think that.

I think what's really got them in a bunch is that the ACA will turn out to be acceptable, at least, perhaps even somewhat successful and popular, in the eyes of the public. That would give credit to Obama and the Democrats, while discrediting the Republicans. It's just politics, not looking out for the public interest in good faith, even if wrongheadedly, IMO.

(Not that I think I'm writing something novel or especially insightful. I just thought it needed repeating, right about now.)

One million uninsured Americans communicated with the ACA yesterday before 7:00 am to shop and sign up for health insurance.

It was like folks lining up for an I-Phone.

Except that if the murderers in the Republican Party decided to halt funding for the I-Phone, or else, on pain of shutting down the government and defaulting on the debt, no one would die.

"20 kids gunned down at an elementary school, and the bastards didn't even blink or pause before whipping up their supporters to make damn sure there was no legislative response to the slaughter."

Yes, see the answer to our current confederate problem, the solution, has been right front of our eyes, placed there by the NRA and the other anti-American gun lovers, and by the likes of Ted Nugent cavorting double-gunned on stage threatening the murder of Obama and Clinton (and yet unscathed he yaps on FOXnews, the cuntcock), and by the Republican Party-armed and enabled mass murderers previewing very other month or so what the Republican Party, of which al Qaeda is merely an affiliate, has in store for the rest of us.

This:

Hello, Kitty!

and this:

Belt fed

Links all broken like a GOP promise of compromise.

Not done, I guess.

I personally am not entirely confident that the ACA will turn out to be reasonably successful. It's too complicated and touches on many issues beyond my expertise. But there are people, who are considered to be experts, who come down both sides on the potential success of the ACA.

What this leaves us with is a difference of opinion on a complex policy isssue. This isn't some obvious moral outrage. For example, people aren't being tortured or thrown in jail without charge under the ACA. We aren't invading countries that pose no threat to us, killing innocents and putting our troops in mortal danger unnecessarily.

What we're talking about is a piece of legislation passed properly according to the law and that attempts to solve, or at least mitigate, an obvious and longstanding problem. Not everyone likes it, for reasons political and otherwise.

What it isn't is something you can justify taking extraordinary measures to defeat, measures outside the usual legislative process of repealing or modifying prior legislation. We're not talking about a law passed by Democrats, when they had the power to pass laws unilaterally, outlawing the Republican party.

The House Republicans are being a$$holes, hurting people to stop something they can't know with a reasonable degree of certainty will be harmful enough to justify what they're doing. It's horsesh1t, plain and simple.

You don't have to like the ACA. You don't even have to agree to fund it. But shutting down the government over it, even if you can, is wrong.

Links work for me. :)

Is it ok if I just fix those links, Count?

Fix away, unless you mean disappear the links, but that's O.K too.

I'm in the giving vein for the moment.

I tried, but I somehow obliterated a link.

Sorry!

That's O.K. Thanks.

No one likes overkill, except for those that do.

Being an engineer, I am appreciative of just exactly the right amount of kill.

It occurs to me that there's a simple solution to the whole ACA / Obamacare / government shutdown / debt ceiling game of chicken mess.

The ACA is basically Heritage's Consumer Choice Health Plan. In particular, the individual mandate, which is the point that most folks find so objectionable, was Heritage's solution to the free rider problem associated with mandating that hospitals provide care to people without requiring payment.

Some more history.

My suggestion is as follows:

1. repeal the ACA
2. let Ted Cruz re-introduce the ACA, except this time call it Heritagecare. Or, even better, Reagancare. Get Paul Ryan to pronounce it conservatively holy, that should help.
3. pass it, sign it, let the SCOTUS reaffirm it.

For (3), we will need to insure that the SCOTUS affirms the new plan for reasons other than their rationale for affirming the ACA, so that the new plan doesn't end up with any ACA cooties on it.

And then, carry on.

Russell, that Heritage proposal: did it ever get voted on?

I am guessing no.

I am guessing that it got little popular support on the Right.

The second "history" link I included has some of the legislative history. There were two bills introduced in the Senate in approximately the same timeframe that the Heritage papers were published.

Both were introduced by (R)'s. I don't think either came to a vote. I don't know what level of broader conservative support they received.

In any case, ain't nobody gonna be taking up my proposal.

Guns and opposition to insuring Americans go hand in hand -- They themselves link the two all the time -- defund the ACA and meet all our other demands, or:

http://www.providencejournal.com/breaking-news/content/20131001-r.i.-gop-under-fire-for-gun-raffle-even-in-own-ranks.ece

If you see a Republican carrying this weapon, shoot first, ask questions later. Aim at the head because they are most likely wearing armored vests and mean to do supporters of the ACA harm.

If you see a liberal carrying that weapon, lend them some ammo.

If you suspect a Republican is carrying a concealed weapon and they make a false move, shoot first and ask questions later, because, as their elected representatives and the their 27% base have made clear, they are going to water the tree of liberty with our blood, so they may have been reaching to kill a supporter of the ACA.

You can't be too careful when there are tens of millions of murderers on the loose, terrorists on the innocent and average person.

Erectile dysfunction can occur suddenly or gradually. Some men slowly lose the firmness of their erections or how long the erections last.

"Erectile Dysfunction" is a name I would probably want to change as soon as I reached the age of 18, if not before.

So.

Also, don't click the link, please. I'll try and make it go somewhere amusing, later.

I thought the implication was that I was shooting blanks.

The comments to this entry are closed.

Blog powered by Typepad