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+---- Thread: ACA Repeal/Replace: Progressives Face Moral Dilemma (/thread-637.html)
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - pbrower2a - 01-18-2017
(01-15-2017, 10:58 PM)Warren Dew Wrote: Expecting welfare and entitlement recipients to have respect for taxpayers is like expecting slaveowners to have respect for their slaves.
I have gotten some food aid. I show enough respect for taxpayers to not buy sweets (unless you call strawberries, oranges, grapes, or bananas 'sweets') on that aid.
I am also starting vocational rehab even before I can collect SSDI... as a hedge. I might be able to do something compatible with Asperger's at my age. I would rather be a taxpayer.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - pbrower2a - 01-18-2017
(01-18-2017, 10:04 AM)Anthony Wrote: But if the Catholic Church gets involved in this - and remember that we have a Hispanic pope! - it has the potential to destroy the evangelical right's stranglehold on Christianity in American politics (and probably provoke a nasty anti-Catholic backlash not seen in America in nearly a century). Then, if progressives can merely tone down their reflexive fawning over all the freaks and geeks, there's your prescription - no pun intended since we're talking about health care here - for a Democratic landslide in 2020 (and what more do they want? They got what they wanted in Obergefell v. Hodges - and even if Roe v. Wade were to be overturned only about 1 out of 10 women live in states that would enact blanket bans on abortion).
I even have a catchy slogan for this campaign:
OUR JESUS IS THE SON OF GOD
THEIR JESUS IS THE SON OF JOHN GALT!
The Pope has some moral suasion beyond devout Catholics, and the Fundamentalist appeal is severely limited. "The Earth is only 5000 years old, and evolution is a fraud, plant your seed in the Wealth Cult..." I'd like some evolution-denier to tell me why Lake Superior has so little biodiversity in contrast to the oceans and even to small lakes in southern Michigan.
...The inauguration of Donald Trump has me thinking of a sick parody of the Hallelujah Chorus. Start with "He shall reign!" and turn it into "Greed shall reign!"
Hallelujah! Hallelujah! Hallelujah! Hallelujah! (etc.)
Mammon Omnipotent forever reigneth
Hallelujah! Hallelujah!
Greed shall reign! Forever! And Ever! Hallelujah! Hallelujah!
Cruel greed! (etc.)
Selfish greed! (etc.)
Wanton greed! (etc.)
Reckless greed! (etc.)
People of faith are going to come to realize that Donald Trump has but one God -- himself!
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - Anthony '58 - 01-18-2017
The right is in a much meaner place than in the 1980s/'90s, when Peggy Noonan wrote that "Thousand Points Of Light" speech for George H.W. Bush and Marvin Olasky, a favorite of the repulsive American Enterprise Institute, trumpeted a "charity revolution."
Now, it's throw people in jail for feeding the homeless, as was done in Fort Lauderdale recently - and just the other day, the president of a vocational school outside Kansas City got fired for letting a homeless student of the school sleep in his office on a zero-degree night.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 02:51 AM)Warren Dew Wrote:(01-16-2017, 09:50 AM)SomeGuy Wrote:Quote:Third, if we're going to have a major revamp of the system, why not move to a genuinely free market system, or at least closer to it?
I'd be curious to see what you had in mind. Not that I am necessarily opposed, mind you.
In an ideal world, the government - or the federal government, at least - would just get out of medical care entirely, limiting its role to safety regulations...
Been there. Done that. We have insurance now because the old model quit working when we stop using leeches for treatment.
Seriously, modern medical care is complex and necessarily expensive. To cover the costs by load sharing (i.e. insurance), everyone needs to be in the game. A totally voluntary system guarantees failure, because only the sick will want insurance but it will be unaffordable.
Why is this still being discussed at this late date? There is no magic pill to change this.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 03:37 AM)Galen Wrote:(01-16-2017, 03:31 PM)The Wonkette Wrote:(01-15-2017, 10:58 PM)Warren Dew Wrote: Expecting welfare and entitlement recipients to have respect for taxpayers is like expecting slaveowners to have respect for their slaves.
That is a very strong statement. I personally find it offensive to have taxpayers compared to slaves and welfare and entitlement recipients compared to slaveowners. Most people on welfare want to work, want to get off of welfare. And comparing taxpayers to slaves? Really???
Lets see, if someone should refuse to pay taxes then people with guns show up and take what they want. In effect by taking the earnings and property of another then the taxpayer in question is working for someone they would rather not. If the slave does not work then he is subject violence. Its a little more roundabout being one of the tax livestock but the results are much the same which is some form of involuntary servitude.
Blah, blah, blah. Give it a rest already. No, being a taxpaying part of a greater whole does not make you a slave.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 06:50 AM)Bronsin Wrote: Progressives really don't have to do anything at all. ObamaCare is going to die all on it's own once the remaining insurance providers can't keep up with the cost of providing coverage. One of them has dropped out already citing bankruptcy, and the biggest of the tax increases that will hit everybody is this year, right after Obozo has left office, just as we knew it would.
If it fails on Trump's watch, it will be replaced by the Democrats when (not if) they regain the entire government.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 02:51 AM)Warren Dew Wrote: Now, I'm not unsympathetic to David's argument about having paid into the Medicare system for a lifetime and deserving some return on that. If we take literally David's argument that intergenerational transfer is legitimate, of course, then it's legitimate to say, "okay, the GIs got the benefits but didn't pay in, and the boomers are going to pay in but not get the benefit". But from an individual fairness perspective, it's fair to give boomers Medicare coverage commensurate with what they (we) paid into the system, if not the current levels which amount to much more than they (we) paid into the system.
In order to limit costs to a reasonable level, it would probably be best to shift as many Medicare customers as possible over to Medicare Advantage type plans, where the customer gets a voucher to use toward traditional health insurance. These plans could then get less traditional, for example paying for certain beneficial supplements and possibly even for a healthier diet and lifestyle. The key is that the amount paid should be fixed, adjusted for inflation but not for "average" health care costs, and perhaps scaled to years in the system. You paid in a certain amount; you get out a certain amount.
If we wanted to keep a traditional form of Medicare as well, then costs on traditional Medicare would have to be limited to the same as that for the Medicare Advantage type plans. For example, we could seriously enforce the payment limits. Customers would then have to choose between using low end doctors and facilities, or making up the difference themselves.
Right now, today, Medicare Advantage is more expensive and less beneficial. People who use it do so to avoid the costs when young, but rue the day when they get older and sick. All that out-of-network stuff starts to kick in when illness enters the picture. Unfortunately, moving between standard and Advantage is not as easy as it appears. There are financial penalties.
Out of fairness, I should note that a few Advantage plans are actually pretty good. Most are in urban areas with plenty of providers.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 07:06 AM)SomeGuy Wrote: Am largely in agreement. I am not sure that it is politically feasible, though a "Medicare for all" option would probably look a lot more like Medicare Advantage for all once people actually grasp with the cost. Is largely what I meant earlier.
I mean, there are the equity issues that are politically powerful, and certain issues with health care versus other types of goods/services (that Dave touched on before), but it is still a rival, excludable good/service, and so it should be primarily handled by the private sector.
Medicare Advantage still has a providers list and out-of-network charges. Avoiding out-of-network is nearly impossible outside a major metropolitan area. The Advantage providers use cost shifting just like any other insurance provider. They also take profits, so the cost of the program is lot higher than Medicare in its traditional form. That's not to say that Medicare is fully realized as-is. Improvement is certainly possible, and should be pursued aggressively. It's just not the Advantage model that gets it done.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 07:47 AM)Mikebert Wrote:(01-16-2017, 03:09 AM)Classic-Xer Wrote: It would be nice if those developed nations weren't so reliant upon us for their national security and so forth.
Are they? We like to insist they are getting a benefit for US military spending. Do they agree? I think not. Trump is right, NATO is obsolete and has been since 1999. So is our security guarantee to South Korea and Japan. Hell we could eliminate three quarters of our military expenditures and probably be safer than we are now. Americans are just patsies. We pay way too much for defense just like we do for health care.
But the GOP Congress is chomping at the bit to spend more ... a lot more. We have this depleted military, you know.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 12:45 PM)Classic-Xer Wrote:(01-17-2017, 07:37 AM)Mikebert Wrote:(01-17-2017, 03:37 AM)Galen Wrote: see, if someone should refuse to pay taxes then people with guns show up and take what they want. In effect by taking the earnings and property of another then the taxpayer in question is working for someone they would rather not. If the slave does not work then he is subject violence. Its a little more roundabout being one of the tax livestock but the results are much the same which is some form of involuntary servitude.
And if tenant farmer doesn't pay his rent, men with guns show up and deprive him of his livelihood. What's your point?
The tenant farmer signed a legal agreement much like the legal agreements that I've signed with banks. You should be smart enough to get the point and understand the difference between legally committing oneself and being socially/legally committed by others without your consent. I'm pretty sure you would make a big stink and put up a fight if you were financially bound to an agreement that you didn't sign/authorize.
Yeah! You should move to ... no place I guess.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 01:05 PM)Warren Dew Wrote: ... budgets for big pharma companies show most of the cost being the trials necessary for FDA approval. That's what the Japanese bargain not to pay, but if everyone bargains not to pay them, the drugs won't be developed. (Which would be fine with me, but not so fine with the people that use them.)
Do you know what orphan drug subsidies are? They are guarantees against competition for "developing" drugs to treat ailments that affect fewer than 200,000 (?) people. Big Pharma uses this law as an ATM. Some drugs, widely in use for years, get cited as a treatment for some other illness. For example, Remicade has numerous orphan cites -- it was originally developed for rheumatoid arthritis. The rest are free riders..
Don't cry crocodile tears for the pharmaceutical industry; they don't deserve it.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - David Horn - 01-18-2017
(01-17-2017, 03:38 PM)Classic-Xer Wrote:(01-17-2017, 02:41 PM)Mikebert Wrote:(01-17-2017, 01:05 PM)Warren Dew Wrote: I'm willing to accept it because I don't pay for the drugs; my employer or the government does.
No they don't. They pass it along to you as lower salary.
No they don't. They add it to his hourly cost and mark it up accordingly and pass it on to the costumer. I think he's service related. Service related people aren't viewed as corporate overhead.
Every HR professional will tell you, the total cost of an employee to a company is based on pay and benefits. Nothing gets passed on, That's nonsense. Customers have no vested interest in paying for employee benefits.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - The Wonkette - 01-18-2017
(01-17-2017, 01:47 PM)Warren Dew Wrote:And if they are out of work? Or if their employer doesn't offer insurance? Or they are part time? What then?(01-17-2017, 12:38 PM)The Wonkette Wrote:(01-17-2017, 02:51 AM)Warren Dew Wrote: In an ideal world, the government - or the federal government, at least - would just get out of medical care entirely, limiting its role to safety regulations.How do you handle the affordability issue? Most Americans don't have a couple grand lying around that they can use to procure routine preventive care such as colonoscopies or managing chronic conditions such as diabetes or asthma, common medical emergencies such as broken legs or pregnancy. (I'm assuming that the catastrophic coverage would cover things such as heart attacks, strokes, cancer, and postnatal care for preemies.) And do you really want people having to pay out of pocket for public good items like vaccinations?
The big problem with our present system is the economic distortion introduced when the beneficiary of a product is different from the payer of the product. That's a recipe for overconsumption and overcharging - or at least overpricing - and is what causes health care expenses to keep going up and up. And we have that distortion both with government provided medicare and with employer provided health insurance, which together include the vast majority of the market.
What that means is that we spend too much on medical care, and that takes away from the money we could be spending for things like a higher quality diet that would be a more cost effective path to good health.
Return the money and control to the people, and we'll see a more rational health care system and better health. And yes, people will likely start paying for doctors' visits and drugs out of pocket and medical insurance will likely be limited to relatively inexpensive policies that only cover catastrophic needs.
For people at the age where colonoscopies are common, health insurance typically costs $500-$1000 per month, or $6000-$12000 per year. If you get that money back - for example if it's paid by an employer now and instead they pay that money to you as wages - you can easily afford the colonoscopy.
Alternatively, people who don't do money management well could continue to just buy the same health insurance they have now, at the same price - though the price will come down as going rates are reduced from the competitive effects of people who choose to buy their medical care a la carte.
I would expect catastrophic coverage to cover broken legs.
Vaccinations might be a special case where the government - the state government, not the federal government - might choose to pay for them due to the general public benefit from people being vaccinated. Vaccinations tend to be cheap anyway. I do have to say, though, that I presently pay for my own vaccinations under Obamacare.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - Warren Dew - 01-18-2017
(01-18-2017, 10:12 AM)pbrower2a Wrote:(01-15-2017, 10:58 PM)Warren Dew Wrote: Expecting welfare and entitlement recipients to have respect for taxpayers is like expecting slaveowners to have respect for their slaves.
I have gotten some food aid. I show enough respect for taxpayers to not buy sweets (unless you call strawberries, oranges, grapes, or bananas 'sweets') on that aid.
I am also starting vocational rehab even before I can collect SSDI... as a hedge. I might be able to do something compatible with Asperger's at my age. I would rather be a taxpayer.
Trying to get off is good, and not rubbing it in their faces is good. It would be nice if there were some equivalent to the "thank you for your service" that vets get, but I'm not sure how that would work.
You might try learning a computer scripting language like PHP or Python. They are relatively easy to learn, and Asperger's is a big plus for programming, due to the perfectionistic tendencies and the ability to focus. Java is higher end but takes more training.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - Warren Dew - 01-18-2017
(01-18-2017, 01:16 PM)David Horn Wrote:(01-17-2017, 03:38 PM)Classic-Xer Wrote:(01-17-2017, 02:41 PM)Mikebert Wrote:(01-17-2017, 01:05 PM)Warren Dew Wrote: I'm willing to accept it because I don't pay for the drugs; my employer or the government does.
No they don't. They pass it along to you as lower salary.
No they don't. They add it to his hourly cost and mark it up accordingly and pass it on to the costumer. I think he's service related. Service related people aren't viewed as corporate overhead.
Every HR professional will tell you, the total cost of an employee to a company is based on pay and benefits. Nothing gets passed on, That's nonsense. Customers have no vested interest in paying for employee benefits.
Or, to put it another way, everything gets passed on including pay.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - Warren Dew - 01-18-2017
(01-18-2017, 01:11 PM)David Horn Wrote:(01-17-2017, 01:05 PM)Warren Dew Wrote: ... budgets for big pharma companies show most of the cost being the trials necessary for FDA approval. That's what the Japanese bargain not to pay, but if everyone bargains not to pay them, the drugs won't be developed. (Which would be fine with me, but not so fine with the people that use them.)
Do you know what orphan drug subsidies are? They are guarantees against competition for "developing" drugs to treat ailments that affect fewer than 200,000 (?) people. Big Pharma uses this law as an ATM. Some drugs, widely in use for years, get cited as a treatment for some other illness. For example, Remicade has numerous orphan cites -- it was originally developed for rheumatoid arthritis. The rest are free riders..
Don't cry crocodile tears for the pharmaceutical industry; they don't deserve it.
You might want to follow the thread. I'm arguing to permit reimportation, which would completely undercut big pharma's market splitting strategy. I agree we should get rid of orphan drug subsidies too - another Bush idea that was bad.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - Warren Dew - 01-18-2017
(01-18-2017, 12:38 PM)David Horn Wrote:(01-17-2017, 02:51 AM)Warren Dew Wrote:(01-16-2017, 09:50 AM)SomeGuy Wrote:Quote:Third, if we're going to have a major revamp of the system, why not move to a genuinely free market system, or at least closer to it?
I'd be curious to see what you had in mind. Not that I am necessarily opposed, mind you.
In an ideal world, the government - or the federal government, at least - would just get out of medical care entirely, limiting its role to safety regulations...
Been there. Done that. We have insurance now because the old model quit working when we stop using leeches for treatment.
Seriously, modern medical care is complex and necessarily expensive. To cover the costs by load sharing (i.e. insurance), everyone needs to be in the game. A totally voluntary system guarantees failure, because only the sick will want insurance but it will be unaffordable.
Why is this still being discussed at this late date? There is no magic pill to change this.
To the contrary, as discussed before, there are "magic pills" in the sense of inexpensive supplements and dietary and lifestyle strategies that would remove the need for much of the treatment. But you're uninterested in them because you can get as much treatment as you want at others' expense ... for now.
At least pbrower uses the cancer preventive.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - Eric the Green - 01-18-2017
(01-18-2017, 10:27 AM)pbrower2a Wrote:(01-18-2017, 10:04 AM)Anthony Wrote: But if the Catholic Church gets involved in this - and remember that we have a Hispanic pope! - it has the potential to destroy the evangelical right's stranglehold on Christianity in American politics (and probably provoke a nasty anti-Catholic backlash not seen in America in nearly a century). Then, if progressives can merely tone down their reflexive fawning over all the freaks and geeks, there's your prescription - no pun intended since we're talking about health care here - for a Democratic landslide in 2020 (and what more do they want? They got what they wanted in Obergefell v. Hodges - and even if Roe v. Wade were to be overturned only about 1 out of 10 women live in states that would enact blanket bans on abortion).
I even have a catchy slogan for this campaign:
OUR JESUS IS THE SON OF GOD
THEIR JESUS IS THE SON OF JOHN GALT!
The Pope has some moral suasion beyond devout Catholics, and the Fundamentalist appeal is severely limited. "The Earth is only 5000 years old, and evolution is a fraud, plant your seed in the Wealth Cult..." I'd like some evolution-denier to tell me why Lake Superior has so little biodiversity in contrast to the oceans and even to small lakes in southern Michigan.
...The inauguration of Donald Trump has me thinking of a sick parody of the Hallelujah Chorus. Start with "He shall reign!" and turn it into "Greed shall reign!"
Hallelujah! Hallelujah! Hallelujah! Hallelujah! (etc.)
Mammon Omnipotent forever reigneth
Hallelujah! Hallelujah!
Greed shall reign! Forever! And Ever! Hallelujah! Hallelujah!
Cruel greed! (etc.)
Selfish greed! (etc.)
Wanton greed! (etc.)
Reckless greed! (etc.)
People of faith are going to come to realize that Donald Trump has but one God -- himself!
Hallelujah!
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - Eric the Green - 01-18-2017
(01-18-2017, 09:59 AM)Warren Dew Wrote:(01-18-2017, 07:56 AM)Odin Wrote:(01-16-2017, 03:31 PM)The Wonkette Wrote:(01-15-2017, 10:58 PM)Warren Dew Wrote: Expecting welfare and entitlement recipients to have respect for taxpayers is like expecting slaveowners to have respect for their slaves.That is a very strong statement. I personally find it offensive to have taxpayers compared to slaves and welfare and entitlement recipients compared to slaveowners. Most people on welfare want to work, want to get off of welfare. And comparing taxpayers to slaves? Really???
I had to respond.
It's the whole white identity politics thing. A lot of conservatives associate public assistance with the myth of the "black welfare queen" and think "hard working white people" are being "exploited" by lazy minorities on welfare.
Consiidering we were talking about Medicare, it obviously nothing to do with race. As to welfare, most conservatives dislike the use of welfare as a style of life irrespective of race.
I agree with Odin on that one. Anti-welfare is the dog-whistle for white identity racism. Conservatives often claim otherwise, but your own posts Warren earlier revealed this. So do Classic's posts.
"Welfare as a style of life" is a revealing phrase too. The claim is that welfare creates a dependent style of life. Even though that kind of welfare went away in the 1990s, it is still the leading conservative talking point. Because it scores political points with closet racists and libertarian ideologues.
No, welfare is a protection for all of us against the greedy bosses, who will stop at nothing to fire us over nothing or take away our jobs. We will need it ever-more greatly, and as the Republican power grows, we have less and less protection from the greedy bosses who run our country. And now our new president (whom you voted for) is the leading exponent of this behavior, as exemplified by his favorite phrase, "you're fired!" Not to mention the leading practitioner of race-baiting.
RE: ACA Repeal/Replace: Progressives Face Moral Dilemma - pbrower2a - 01-18-2017
(01-18-2017, 01:55 PM)Warren Dew Wrote:(01-18-2017, 10:12 AM)pbrower2a Wrote:(01-15-2017, 10:58 PM)Warren Dew Wrote: Expecting welfare and entitlement recipients to have respect for taxpayers is like expecting slaveowners to have respect for their slaves.
I have gotten some food aid. I show enough respect for taxpayers to not buy sweets (unless you call strawberries, oranges, grapes, or bananas 'sweets') on that aid.
I am also starting vocational rehab even before I can collect SSDI... as a hedge. I might be able to do something compatible with Asperger's at my age. I would rather be a taxpayer.
Trying to get off is good, and not rubbing it in their faces is good. It would be nice if there were some equivalent to the "thank you for your service" that vets get, but I'm not sure how that would work.
You might try learning a computer scripting language like PHP or Python. They are relatively easy to learn, and Asperger's is a big plus for programming, due to the perfectionistic tendencies and the ability to focus. Java is higher end but takes more training.
How about vacations to interesting places, food such as steak and lobster, wine instead of diet colas, nice clothes, a really-good sound system, better housing, and maybe a better car....not to mention being more desirable to women if a straight male? That's how capitalism rewards middle-class and skilled-labor success. I doubt that anyone has a problem with that. Ostentatious display? I'd rather have money in a brokerage account, thank you.
I did some programming years ago in college and loved it. I went to the computer lab around 11PM and left when the computers got shut down for maintenance... and I was surprised that it was 3 AM. That was BASIC. That's how long ago it was. I was able even to create images for a mock-up call-sign screen and such a game as Yahtzee (really simple).
The poor will always be with us, and how we treat them (or any other vulnerable people) will say more of our character than will any possessions that we ever get. Anyone of base character can kiss up to the rich-and-powerful. Showing genuine compassion for poor people? Such is the true measure of us all.