Elephants and Jackasses...

Does anyone support this bill?

 

Ask the Walton's and/or the Koch brothers how they feel about it...

 

I meant here, but yeah I guess they're pretty much the only people who matter.

 

I don't support Obamacare and I believe the government should get out of the business of healthcare (private sector knows better, capitalism, yada yada yada).

That whole if you like your doctor you can keep them? That was bullshit. I get that people will be out of coverage if Obamacare gets overturned. However, Obamacare is absolutely fucking up insurance for those who are covered. I find it extremely difficult to care about the people who are going to be uninsured without Obamacare if Obamacare has absolutely screwed up insurance for my own family.

So while I don't support the bill per se, and I think there is a happy medium somewhere, I do support us passing literally anything that replaces Obamacare.

Just fix my fucking insurance. It's that simple. I reserve the right to not give two shits about anyone else if I can't get my son, wife, or myself in to see the right doctor because obama thought a not broken system needed changing.

 

What in this current bill fixes the issues you have with your insurance?

 

Don't know what specifics are in the current bill, I fully admit to my ignorance. I just want it to go back to the way it was before Obamacare screwed it up.

Which I realize is the exact logic people used when they voted for trump. Fortunately, I didn't, and I'd trade any of my insurance problems in a second to get that national embarassment out of office.

 

Aside from ignorance being a HUGE part of the problem, I can't understand the logic behind shredding Medicare, one of the few entities in our healthcare landscape that's working on keeping costs low.

For the millionth time: qui bono, who does this bill benefit? From what I've read, the rich people whose tax burden increased under the ACA and the insurance companies who can now pressure the states to make them more profitable, and the states who will use a block grant to abuse Medicare and spend the funds more liberally on "health related initiatives".

The biggest economic problem behind healthcare is this: the strong subsidize the weak, and that only works if we are all in it together. Since we're not, the incentive is to push the weak (the people most likely to use their health benefits) into another insurance pool. There is no universal pool, but they cannot be refused coverage. We don't want to revoke the laws mandating that a medical provider must give care regardless of ability to pay, and we don't want to establish a baseline coverage for every US citizen for reasons that escape me (abortion, illegal immigrants and taxes seem to be the common objections that are pretty easy to refute and some constitutionalist nonsense about liberty from healthcare or something?).

I would argue the biggest issue is the ACA didn't go far enough in extending Medicare/Medicaid coverage into areas of higher need. I would also argue that the solution to our current problem is a bit of federal standardization: national standards of health, costs, and billing would greatly reduce the quagmire. Medicare provides a ready answer to our dilemma of high costs, bureaucracy perpetuated by insurance fuckery (again trying to push people into another pool) and damn-near universal coverage. There's nothing preventing you from double-dipping and having Medicaid to cover your knee surgery, cancer treatments and pregnancies, and private insurance to cover your plastic surgery, abortions and GP stuff. And in a battle of bureaucracy, the winner often has the shortest book and the biggest roster.

 

I don't understand why people believe they are entitled to Healthcare? I also don't understand why people believe we need a military to police the entire world? These things cost money. We can't afford both and some would say we can't afford either. I certainly don't want to pay for either but if I have to choose one I would prefer to try to take care of people. I have posted articles before about how broken the medicaid system is currently for doctors and hospital systems and how more and more are not accepting it because payments in some cases are years behind. I keep harping on this as someone who works in close proximity to the Federal Government and I won't stop saying it. The Federal Government cannot manage something like this in an efficient manner. The Federal Government today is synonymous with waste, ineptness and dysfunction. Why do you want them taking care of something as important as your health? Aside from the Right-Left, all or nothing approach, there must be a more sensible solution to this? I have no idea what it would look like but there has to be another option than: 1. Government Run 2. Government Subsidized or 3. Pure Private Care. We have seen examples where all three turn to shit before our very eyes.

 

I've seen this comment and others like it in regards to healthcare. My favorite is when people loudly declare that they have no moral obligation to pay for healthcare. I seriously have to ask if those that have this sentiment are sociopaths or not. Entitled to healthcare? Are you shitting me? The one fucking thing that you absolutely need in order to continue to live? Healthcare is way more important than education on just a logical level, but we just give that shit away. But healthcare? Shiiiiiiet. Fuck those people who have to choose between homelessness and fucking DYING, right? Or maybe it's a choice between homelessness or watching their kid die because they were born with a disease!

I cannot understand the mindset that makes it okay for people to think that the greatest country in the world shouldn't provide the most vital fucking service to humanity. Oooh, I don't like it when people I don't like get stuff from the government. Really? Well, I don't like it when assholes drive roads I pay for with my taxes, but you don't see me asking if roads are fucking necessary, do you? BUT MUH TAXES? Motherfucker, if everybody paid into the system, the system would be able to negotiate rates with pharmacies and hospitals! That huge pool of money that EVERYBODY would be paying into ensures that no matter how fucking stupid you're being, you won't be a burden not only on your family, but on the rest of society. But no, you don't want taxes. Never mind the fact that tax rates are already pretty fucking low for 98% of the population. But you keep that dream about winning the lottery as a basis for keeping taxes low on rich people, because you'd rather play Russian Roulette with your health and sticking the rest of us with the bill when the gun goes off.

The fucking delicious irony is that the poor uneducated shortsighted selfish assholes that would complain the loudest about this would be the ones that benefit the most while paying the least.

 

I kind of disagree, and this gets down to basic philosophy.

The government is wasteful, yes. It's not designed to run like a business because the government has a mandate focused on an outcome that's harder to define, like healthcare. A business' mandate is "shareholder value" and that's generally very easy to define. Part of the issue with this line of thinking is the assumption that those two are comparable. In other words, $2b spent on reproductive health by a FUNCTIONING government and $2b spent on condoms results in vastly different outcomes. One: generally speaking, fewer abortions, fewer STD's, better maternal health and healthier babies which results in lowering the costs downstream. Two: Cool trojan ads and an attempt to get to $2.2b.

Part of the issue is our government doesn't function as it should, and it's almost always held financially accountable. A business can declare bankruptcy, the LAPD doesn't have that legal protection. I think this is a big issue in our society today: liability and litigation. I went zip-lining (shut up), and the influence of the insurance companies was felt in all the procedures there because they had to protect against lawsuit. Why would someone sue? Because the cost of an injury is more than two year's salary for the average person and they can't pay for it. In the middle of the woods in Winchester, VA I would argue that a "free" society would find no purpose or indicator of the influence of an insurance company.

Another issue is the government's revenue now largely comes from us, but in the big-spending days it came from corporations (if we look back to the "golden age" we see an astounding corporate tax rate, such as a 95% tax on profit over $1m back in the 1950's). We are naturally more inclined to protest how the government spends OUR money as opposed to the company's money, because corporate circumstances aren't as tumultuous as individual's. In other words, the taxes used to be factored into the cost of doing business and now they are factored into the costs of existing in the US. I'm all for fiscal responsibility in this model, but I'm a bigger advocate for being fucking fair: I can't afford a team of people to wiggle me out of paying my fair share.

 

I hold a rather dim view for the net benefit of Globalization for America in it's current direction. Ending it or at least modifying it and with it the need to police shipping channels wouldn't be the worst thing in my book. Creating real GDP at home by actually making things here and putting people back to work should be of higher concern to America than the shipping lanes that send cheap Chinese stuff flooding our markets as the Asian markets aren't going to budge on making American goods too expensive as they are now. Again, I am all about lowering costs, put people to work, reduce the welfare programs and increase spending power...to include on healthcare of the individuals choosing, not the Government.

Is this an argument for healthcare or just a rant based on pure emotion? The one thing you need? Is healthcare? I would have gone with water first, personally.

I have no obligation to pay your healthcare, plain and simple. I would be fine if we just backed off all the taxes for now, send me a menu of the services available and I will pay for those I choose. If you don't have kids, don't pay for schools. Pay for highways with tolls instead of taxes, I'm fine with that too. Honestly, Uncle Sugar being your caretaker is not what America was founded on, is it? It's the exact opposite, people came here to get away from an all-powerful Government. If you want all of these services paid for by other people go where they have them, I won't stop you. I will wish you well on your journey. In the meantime, perhaps we can discuss means to fix the problem instead of just saying Government take care of it and raise my taxes because it doesn't work now and it won't in the future either.

This is not true. Ever go to a military base in September or October? You will never see so many new shiny pieces of equipment, fleets or news cars or warehouses full of toilet paper than at that time in those places. You know why? It's because it is the end of the FY. Funding is use it or lose it and if you don't use it all your budget is cut the next year. So you know what happens? Every single dollar in the budget gets spent regardless of need. That is not responsible. That is not a entity that you or a corporation should trust with your money because that is not being accountable to their customers.

In terms of healthcare, I agree with you, it's not as easy to define as shareholder value is and that is kind of what I was trying to say in my last post. Furthermore, we can all agree that the Government is not going to liquidate the healthcare and pharma industry because the people who could make that happen are all beholden to those same corporations. So how do you fix the problem if you aren't going to address the root cause? You aren't, that's the answer. In order to align all of the things that would need to change to correct our current course it would take a shake-up that would have chicken little's everywhere saying the sky is falling and in truth, 50% of the people would be happy and 50% unhappy with whatever was done because it will all be about partisan bullshit and protecting partisan-held turf and not what is best for all.

 

A healthy society benefits the whole society.

An educated society benefits the whole society.

A solid infrastructure benefits the whole society.

You reap benefit from all of those things even if you aren't directly consuming them.

 

I'm very familiar with the concept of government spending and again, our government isn't functioning properly. I think in part this is because we equate spending with priorities, which is a business-centric view that falls short. What would you rather have: $1b worth of security or healthcare? Well, how in the fuck does one qualify that and make them comparable? It's a logical fallacy the media deploys constantly: "If we'd spent X dollars on food/health/babies/what ever rather than on that plane we'd snuggle the globe 8 times and have ten billion left over for chocolate pudding". Those two objectives aren't the same thing and I don't want a cheap-ass, starved for resources military. Why? Because I've been in those countries, and those assholes topple the government and rob the fucking citizens...and they can't win a fucking war.

Same thing for healthcare: some things I do not want done on the cheap. This isn't a luxury or superfluous spending, some things do not need to be skimped on. YOU might run your life based on the cheapest possible thing that achieves an outcome, but our government does not because we can afford to invest in achieving the "best" outcome (again, when it functions properly).

I would argue that the incentives are misplaced. I'll also point out that the practice of "use it or lose it" funding is well-mirrored in the private sector. Military spending is a fucking atrocious black hole. Why? Because if it was publicly known who spent what where, our enemies would have a very good idea of our capabilities. Again, the analogy breaks down in the outcomes: security isn't accountable in the same way as Wal-Mart is. I grant you some things the government does are objectively stupid and can be improved, and "use it or lose it" is likely one of them.

This reeks of "I don't get it, so it's wrong!" thinking. Not saying government isn't wasteful, I'm saying it functions differently than how a "good" organization in the private sector or non-profit realm works and that's why it's given a different mandate. It's also why taxes aren't fucking optional: you're not a customer, you're a citizen. You don't "invest" in the bits you like, you vote or propose a better option, or move to another country.

Again: who benefits from this thinking? Why do you believe government is evil and you shouldn't be beholden to it (in the richest civilization in history that's so incredibly free from war and violence our ancestors didn't believe it was possible)?

I get you detest the government, and there is no "fuck it" button. We have to fix it or move to Somalia and find out exactly how fun it is to live in a place with NO functioning government.

 

Stop being willfully obtuse. I was talking about services the government should provide.

Just because you have no obligation to pay for someone else's healthcare, that doesn't mean you're not already doing it with inflated insurance premiums. The more people that don't have insurance, the higher the premiums will be for people that are taking some responsibility for their lives. Letting the free market dictate who lives or dies because it will upset shareholders is morally fucking repugnant. This is no different than shrugging your shoulders when Mylan makes epipens prohibitively expensive because...reasons?

As to the rest of your tax idea, you are effectively enacting a flat tax against everybody. While this is great for people that have money, forcing poor people to choose between paying a toll to get to work or schools so their kids might escape the cycle of poverty they were born into is no way to live. In addition, places where the poor work and live will fall into disrepair because the tax base won't be able to fix anything. But I guess letting parts of the country turn into Escape from New York is okay because it'll incentivize poor people to pull themselves up by their bootstraps, right?

I was partially railing against the callousness that people apparently feel for their own countrymen and the fact that people have to choose between life or destitution.

In any case, the US already has government health insurance in the form of Medicare and Medicaid. You say it's not at easy as flipping a switch. Clearly it isn't. But doesn't expanding those programs make sense? Medicaid expansion and insurance subsidies are already paid for by taxing people making more than $250,000 a year. Why not just get rid of insurance subsidies and just fund Medicaid instead? At least this way, there's an option for coverage that's already accepted by a large majority of providers. If people want to get private insurance to supplement Medicaid or not use it at all, that's on them. This would still require a mandate that you get some kind of coverage. If insurers were allowed to sell health insurance anywhere like they do with car insurance, being forced to compete with each other and Medicaid would drive prices down. Medicaid's massive purchasing power would allow it to negotiate lower drug prices.

I pay $450 a month for pretty standard coverage for me, my wife and kid. I would be happy paying less than or up to that amount as a tax for universal healthcare and knowing that no matter what happens to me, my family is still cared for.

 

I'll get to Medicare/Medicaid in a second.

Wouldn't this be solved by closing the exchanges, moving people to Medicaid and allowing insurers to sell health insurance like car insurance? This way there is no tax hit to the insurer for refusing to play ball in the exchanges and prices go down. If a person opts out of Medicaid, the tax they would have spent paying into it could be used for buying private insurance. This would allow those that are better off to get their own insurance. Insurers would have to compete with Medicaid, which would keep prices down.

I would rather see everybody on Medicaid and Medicare shut down. Having one system with one standard for forms and codes would increase efficiency and those formerly working on Medicare could now help protect against fraud and misuse. Forcing all government employees, including the military/VA and Congress would incentivize fixes for Medicaid, while removing multiple healthcare systems that support these different entities. If they aren't interested in being on Medicaid, then they can spend their own money on their own insurance, just like everybody else. It's not perfect, but at least with a system like this, people are still covered regardless of their socio-economic status while still having the option of purchasing their own insurance from companies that are competing with each other.