ACA Repeal/Replace: Progressives Face Moral Dilemma

[Kinser79]

I've used the VA in Orlando and in Daytona since I separated from the service. I was not impressed at all, thankfully it was for routine issues I have to deal with rather than anything major. I definately would not go to the VA for anything psychological like PTSD. Maybe you found a decent apple in a barrel of bad ones. It happens sometimes.

I would argue that Medicare for Everyone would not preclude the establishment of clinics and sundry providers. Ideally we should have the actual provision of services private while the insurance aspects would be public. This would bring us into line with counties like Germany which use the Bismarck Model.

[Bob Butler 54]

(08-21-2017, 01:33 PM)Kinser79 Wrote: I've used the VA in Orlando and in Daytona since I separated from the service.  I was not impressed at all, thankfully it was for routine issues I have to deal with rather than anything major.  I definately would not go to the VA for anything psychological like PTSD.  Maybe you found a decent apple in a barrel of bad ones.  It happens sometimes.

I would argue that Medicare for Everyone would not preclude the establishment of clinics and sundry providers.  Ideally we should have the actual provision of services private while the insurance aspects would be public.  This would bring us into line with counties like Germany which use the Bismarck Model.

Part of it is the notion that one should keep cutting domestic services.  There is only so much you can cut and still give the illusion of doing what one is supposed to be doing.  The VA wasn't always this bad.  There's nothing wrong with the model, but a lot wrong with the politicians that are crippling it. Some folk have economic values, and saving a buck is just more important than helping people.

It's different if your not the person saving a buck, but the person who needs help.

[Kinser79]

(08-21-2017, 06:09 PM)Bob Butler 54 Wrote:

(08-21-2017, 01:33 PM)Kinser79 Wrote: I've used the VA in Orlando and in Daytona since I separated from the service.  I was not impressed at all, thankfully it was for routine issues I have to deal with rather than anything major.  I definately would not go to the VA for anything psychological like PTSD.  Maybe you found a decent apple in a barrel of bad ones.  It happens sometimes.

I would argue that Medicare for Everyone would not preclude the establishment of clinics and sundry providers.  Ideally we should have the actual provision of services private while the insurance aspects would be public.  This would bring us into line with counties like Germany which use the Bismarck Model.

Part of it is the notion that one should keep cutting domestic services.  There is only so much you can cut and still give the illusion of doing what one is supposed to be doing.  The VA wasn't always this bad.  There's nothing wrong with the model, but a lot wrong with the politicians that are crippling it.  Some folk have economic values, and saving a buck is just more important than helping people.

It's different if your not the person saving a buck, but the person who needs help.

I think what cripples domestic services spending is the Empire and the Military Industrial complex.  If the state didn't have those expenses far more money could be spent on hospitals and schools, etc.  Eisenhower warned everyone about this in his farewell address.

As for the VA, well, there are veterans in every generation in my family less the youngest one (they aren't old enough yet).  Our collective memory of the VA and its services are almost universally poor.  My grandfather (a WW2 vet, deceased now) said that he wouldn't put his dog in a VA hospital.  My uncles (both Vietnam Vets, one Army the other USMC) refused to use those services unless they absolutely had to.  My cousins (Gulf War I vets) were thoroughly unimpressed with the VA.  And of course you have my impressions of it.

Could a model like the VA be used?  Yes.  Can it even be good?  Yes, the UK's NHS is fairly decent.  But in order to make it workable it would have to be universalized so as poor service, and lack of funding comes on the backs of the political class, as is the case in the UK.  The VA is as bad as it is, I suspect because a fraction of a fraction of the population use it and thus there isn't a powerful voting bloc to rail for necessary improvements.

[Kinser79]

Well it appears that my original proposal of kicking healthcare to the states is gaining traction. Rick Santorum is back on the Hill and has a plan to basically block grant funds to states to establish their own systems designed for their needs. An idea that I kicked around here for more than a little bit.

http://www.breitbart.com/big-government/...he-senate/

[David Horn]

(08-22-2017, 06:51 PM)Kinser79 Wrote: Well it appears that my original proposal of kicking healthcare to the states is gaining traction.  Rick Santorum is back on the Hill and has a plan to basically block grant funds to states to establish their own systems designed for their needs.  An idea that I kicked around here for more than a little bit.

http://www.breitbart.com/big-government/...he-senate/

Be careful what you wish for.  Considering who you have as a governor, living in Florida may be hazardous to you health.

[Kinser79]

(08-23-2017, 10:09 AM)David Horn Wrote:

(08-22-2017, 06:51 PM)Kinser79 Wrote: Well it appears that my original proposal of kicking healthcare to the states is gaining traction.  Rick Santorum is back on the Hill and has a plan to basically block grant funds to states to establish their own systems designed for their needs.  An idea that I kicked around here for more than a little bit.

http://www.breitbart.com/big-government/...he-senate/

Be careful what you wish for.  Considering who you have as a governor, living in Florida may be hazardous to you health.

Prior to DDT living in Florida was hazardous to one's health.  I'm no Rick Scott fan boy but he could have been a lot worse.  I'll probably vote for Baruff in the primaries again but in the general any Republican is preferable to any Democrat. Unless of course Augustus Sol Invictus runs again, then I'll vote for him even though he's third party.

https://en.wikipedia.org/wiki/Augustus_Sol_Invictus

[Warren Dew]

(08-21-2017, 09:20 PM)Kinser79 Wrote: As for the VA, well, there are veterans in every generation in my family less the youngest one (they aren't old enough yet).  Our collective memory of the VA and its services are almost universally poor.  My grandfather (a WW2 vet, deceased now) said that he wouldn't put his dog in a VA hospital.  My uncles (both Vietnam Vets, one Army the other USMC) refused to use those services unless they absolutely had to.  My cousins (Gulf War I vets) were thoroughly unimpressed with the VA.  And of course you have my impressions of it.

Could a model like the VA be used?  Yes.  Can it even be good?  Yes, the UK's NHS is fairly decent.  But in order to make it workable it would have to be universalized so as poor service, and lack of funding comes on the backs of the political class, as is the case in the UK.  The VA is as bad as it is, I suspect because a fraction of a fraction of the population use it and thus there isn't a powerful voting bloc to rail for necessary improvements.

I agree with your assessment of the VA.  However, I have some in laws in the UK, and the NHS is not any better.  It's just that most Brits have never known anything else, so they don't realize how bad it is.

It's simply not possible for mandatory monopolies to render good service.  Their internal incentive are wrong.

[Kinser79]

(08-24-2017, 10:19 PM)Warren Dew Wrote:

(08-21-2017, 09:20 PM)Kinser79 Wrote: As for the VA, well, there are veterans in every generation in my family less the youngest one (they aren't old enough yet).  Our collective memory of the VA and its services are almost universally poor.  My grandfather (a WW2 vet, deceased now) said that he wouldn't put his dog in a VA hospital.  My uncles (both Vietnam Vets, one Army the other USMC) refused to use those services unless they absolutely had to.  My cousins (Gulf War I vets) were thoroughly unimpressed with the VA.  And of course you have my impressions of it.

Could a model like the VA be used?  Yes.  Can it even be good?  Yes, the UK's NHS is fairly decent.  But in order to make it workable it would have to be universalized so as poor service, and lack of funding comes on the backs of the political class, as is the case in the UK.  The VA is as bad as it is, I suspect because a fraction of a fraction of the population use it and thus there isn't a powerful voting bloc to rail for necessary improvements.

I agree with your assessment of the VA.  However, I have some in laws in the UK, and the NHS is not any better.  It's just that most Brits have never known anything else, so they don't realize how bad it is.

It's simply not possible for mandatory monopolies to render good service.  Their internal incentive are wrong.

Sounds like a reason to keep provision of services private while making most of the insurance public.

[David Horn]

(08-24-2017, 10:19 PM)Warren Dew Wrote:

(08-21-2017, 09:20 PM)Kinser79 Wrote: As for the VA, well, there are veterans in every generation in my family less the youngest one (they aren't old enough yet).  Our collective memory of the VA and its services are almost universally poor.  My grandfather (a WW2 vet, deceased now) said that he wouldn't put his dog in a VA hospital.  My uncles (both Vietnam Vets, one Army the other USMC) refused to use those services unless they absolutely had to.  My cousins (Gulf War I vets) were thoroughly unimpressed with the VA.  And of course you have my impressions of it.

Could a model like the VA be used?  Yes.  Can it even be good?  Yes, the UK's NHS is fairly decent.  But in order to make it workable it would have to be universalized so as poor service, and lack of funding comes on the backs of the political class, as is the case in the UK.  The VA is as bad as it is, I suspect because a fraction of a fraction of the population use it and thus there isn't a powerful voting bloc to rail for necessary improvements.

I agree with your assessment of the VA.  However, I have some in laws in the UK, and the NHS is not any better.  It's just that most Brits have never known anything else, so they don't realize how bad it is.

It's simply not possible for mandatory monopolies to render good service.  Their internal incentive are wrong.

H-m-m-m.  Apparently you have rich in-laws in the UK, because 90+% of Brits love the service.  And your comment on mandatory monopolies also applies to the police, fire services and, not coincidently, the military.

[Warren Dew]

(08-25-2017, 11:41 AM)Kinser79 Wrote:

(08-24-2017, 10:19 PM)Warren Dew Wrote:

(08-21-2017, 09:20 PM)Kinser79 Wrote: As for the VA, well, there are veterans in every generation in my family less the youngest one (they aren't old enough yet).  Our collective memory of the VA and its services are almost universally poor.  My grandfather (a WW2 vet, deceased now) said that he wouldn't put his dog in a VA hospital.  My uncles (both Vietnam Vets, one Army the other USMC) refused to use those services unless they absolutely had to.  My cousins (Gulf War I vets) were thoroughly unimpressed with the VA.  And of course you have my impressions of it.

Could a model like the VA be used?  Yes.  Can it even be good?  Yes, the UK's NHS is fairly decent.  But in order to make it workable it would have to be universalized so as poor service, and lack of funding comes on the backs of the political class, as is the case in the UK.  The VA is as bad as it is, I suspect because a fraction of a fraction of the population use it and thus there isn't a powerful voting bloc to rail for necessary improvements.

I agree with your assessment of the VA.  However, I have some in laws in the UK, and the NHS is not any better.  It's just that most Brits have never known anything else, so they don't realize how bad it is.

It's simply not possible for mandatory monopolies to render good service.  Their internal incentive are wrong.

Sounds like a reason to keep provision of services private while making most of the insurance public.

It's reason to keep provision of services private, anyway.  It doesn't really say anything about who should provide the insurance.

[Warren Dew]

(08-25-2017, 12:51 PM)David Horn Wrote:

(08-24-2017, 10:19 PM)Warren Dew Wrote:

(08-21-2017, 09:20 PM)Kinser79 Wrote: As for the VA, well, there are veterans in every generation in my family less the youngest one (they aren't old enough yet).  Our collective memory of the VA and its services are almost universally poor.  My grandfather (a WW2 vet, deceased now) said that he wouldn't put his dog in a VA hospital.  My uncles (both Vietnam Vets, one Army the other USMC) refused to use those services unless they absolutely had to.  My cousins (Gulf War I vets) were thoroughly unimpressed with the VA.  And of course you have my impressions of it.

Could a model like the VA be used?  Yes.  Can it even be good?  Yes, the UK's NHS is fairly decent.  But in order to make it workable it would have to be universalized so as poor service, and lack of funding comes on the backs of the political class, as is the case in the UK.  The VA is as bad as it is, I suspect because a fraction of a fraction of the population use it and thus there isn't a powerful voting bloc to rail for necessary improvements.

I agree with your assessment of the VA.  However, I have some in laws in the UK, and the NHS is not any better.  It's just that most Brits have never known anything else, so they don't realize how bad it is.

It's simply not possible for mandatory monopolies to render good service.  Their internal incentive are wrong.

H-m-m-m.  Apparently you have rich in-laws in the UK, because 90+% of Brits love the service.  And your comment on mandatory monopolies also applies to the police, fire services and, not coincidently, the military.

I've bolded the part that already addresses your first point.

Let's see, what about the other monopolies you mention?  Police - disavow any duty to protect the citizenry; only go after criminals after the fact and leave many cases unsolved.  Fire services - some areas have private fire services and it seems to work.  The military - mistakenly invade entire countries based on false reports about stockpiles of weapons of mass destruction.  Yes, looks like my comment applies.

[Mikebert]

(08-18-2017, 07:23 AM)Kinser79 Wrote: If I were to suggest a model, I would suggest that it be as follows:

1.  Abolish medicaid, SCHIP, VA Hospitals (and yes I'm a "vet" too--I just served during a time of relative peace in a service unlikely to see action except in "big ones") and other sundry programs.
2.  Expand medicare to cover everyone and cover any procedures deemed by doctors to be medically necessary. 
3.  Allow private insurance to cover elective procedures
4.  Reduce total qualification age of medicare to birth.

Problem solved.  It will never be implemented of course because it makes too much sense.  Also this is the very ideas that have been pushed by Dennis Kuchinich since forever.

That's close to Canadian-style Medicare, which your side strenuously opposes and has opposed for 70 years.

[Bob Butler 54]

(08-26-2017, 06:11 AM)Mikebert Wrote:

(08-18-2017, 07:23 AM)Kinser79 Wrote: If I were to suggest a model, I would suggest that it be as follows:

1.  Abolish medicaid, SCHIP, VA Hospitals (and yes I'm a "vet" too--I just served during a time of relative peace in a service unlikely to see action except in "big ones") and other sundry programs.
2.  Expand medicare to cover everyone and cover any procedures deemed by doctors to be medically necessary. 
3.  Allow private insurance to cover elective procedures
4.  Reduce total qualification age of medicare to birth.

Problem solved.  It will never be implemented of course because it makes too much sense.  Also this is the very ideas that have been pushed by Dennis Kuchinich since forever.

That's close to Canadian-style Medicare, which your side strenuously opposes and has opposed for 70 years.

It seems Kinser is favoring single payer on health care, is not toeing the Republican / Conservative line at all in health care.  I'm not sure why, but I'm not complaining.

[Kinser79]

(08-26-2017, 06:11 AM)Mikebert Wrote:

(08-18-2017, 07:23 AM)Kinser79 Wrote: If I were to suggest a model, I would suggest that it be as follows:

1.  Abolish medicaid, SCHIP, VA Hospitals (and yes I'm a "vet" too--I just served during a time of relative peace in a service unlikely to see action except in "big ones") and other sundry programs.
2.  Expand medicare to cover everyone and cover any procedures deemed by doctors to be medically necessary. 
3.  Allow private insurance to cover elective procedures
4.  Reduce total qualification age of medicare to birth.

Problem solved.  It will never be implemented of course because it makes too much sense.  Also this is the very ideas that have been pushed by Dennis Kuchinich since forever.

That's close to Canadian-style Medicare, which your side strenuously opposes and has opposed for 70 years.

Mike, I seriously doubt you actually know what side I'm on. I actually opposed Obamacare on the grounds of "It doesn't go far enough".

(08-26-2017, 06:23 AM)Bob Butler 54 Wrote:

(08-26-2017, 06:11 AM)Mikebert Wrote:

(08-18-2017, 07:23 AM)Kinser79 Wrote: If I were to suggest a model, I would suggest that it be as follows:

1.  Abolish medicaid, SCHIP, VA Hospitals (and yes I'm a "vet" too--I just served during a time of relative peace in a service unlikely to see action except in "big ones") and other sundry programs.
2.  Expand medicare to cover everyone and cover any procedures deemed by doctors to be medically necessary. 
3.  Allow private insurance to cover elective procedures
4.  Reduce total qualification age of medicare to birth.

Problem solved.  It will never be implemented of course because it makes too much sense.  Also this is the very ideas that have been pushed by Dennis Kuchinich since forever.

That's close to Canadian-style Medicare, which your side strenuously opposes and has opposed for 70 years.

It seems Kinser is favoring single payer on health care, is not toeing the Republican / Conservative line at all in health care.  I'm not sure why, but I'm not complaining.

It seems that way because I don't.

Ideally we'd take an existing program that has most of the bugs worked out (Medicare), and expand it to cover the middle aged, young adults and children as well as the elderly. Once that is done then other problems with the medical system can be addressed, such as the AMA restricting the number of doctors and nurses put into circulation.

ETA:

I also support implementing a program to encourage people to write out living wills and DNR orders. The most expense in health care comes from the end of life. A lot of the time that is spending more and more money for less and less return.

[David Horn]

(08-25-2017, 03:49 PM)Warren Dew Wrote:

(08-25-2017, 12:51 PM)David Horn Wrote:

(08-24-2017, 10:19 PM)Warren Dew Wrote: I agree with your assessment of the VA.  However, I have some in laws in the UK, and the NHS is not any better.  It's just that most Brits have never known anything else, so they don't realize how bad it is.

It's simply not possible for mandatory monopolies to render good service.  Their internal incentive are wrong.

H-m-m-m.  Apparently you have rich in-laws in the UK, because 90+% of Brits love the service.  And your comment on mandatory monopolies also applies to the police, fire services and, not coincidently, the military.

I've bolded the part that already addresses your first point.

Let's see, what about the other monopolies you mention?  Police - disavow any duty to protect the citizenry; only go after criminals after the fact and leave many cases unsolved.  Fire services - some areas have private fire services and it seems to work.  The military - mistakenly invade entire countries based on false reports about stockpiles of weapons of mass destruction.  Yes, looks like my comment applies.

You have no way of personally knowing how good or bad the NHS is unless you've tried it yourself.  The WHO lists it as far preferable to our disastrous system, and among the world's best.  And you also failed to address the issue of public service by public agencies.  The police are not armed guards, so they act as they should -- responding when called.  Likewise, the military acts as the strong arm of government, but makes no policy on its own.  What you ignored is the comparison of private companies doing the same on a for-profit basis ... like Blackwater in Iraq.  Not a good model for "foreign policy by other means".

I would enjoy a link to private fire services, though.  Other than volunteer fire departments, which serve as de facto arms of mostly rural governments, I can't think of any such cases.

[Bob Butler 54]

(08-26-2017, 02:46 PM)Kinser79 Wrote: I also support implementing a program to encourage people to write out living wills and DNR orders.  The most expense in health care comes from the end of life.  A lot of the time that is spending more and more money for less and less return.

Both my parents had living wills and DNR, as do I myself.  I'm not aggressively pushing it though to individuals, though.  Some decisions should be made personally or in family.

[Kinser79]

(08-31-2017, 11:15 AM)Bob Butler 54 Wrote:

(08-26-2017, 02:46 PM)Kinser79 Wrote: I also support implementing a program to encourage people to write out living wills and DNR orders.  The most expense in health care comes from the end of life.  A lot of the time that is spending more and more money for less and less return.

Both my parents had living wills and DNR, as do I myself.  I'm not aggressively pushing it though to individuals, though.  Some decisions should be made personally or in family.

Precisely why I used the word encourage. I'm going to assume you are using the same definition of that word I am:

Dictionary Wrote:b :  to attempt to persuade :  urge they [i]encouraged him to go back to school[/i]

Perhaps an example from my own life will illuminate my views.  My grandmother lived to be into here late 80s and eventually died of a combination of massive stroke and heart attack.  We chose to not continue treatment after it became clear that she wouldn't survive with her mental faculties and ability to live outside of a full time nursing home or hospital.

Needless to say we had to make the perhaps cold calculation that she would not have wanted to continue on in that way.  I feel that this was the morally correct decision.  It didn't make it easy to make it.  I was lucky that my mother and my uncles agreed that their mother wouldn't want to basically be chained to a hospital bed unable to communicate or even live in her own house.

She did not have any living will or DNR.  I shudder to think what would have happened had one of my relatives objected.  That Terri Shivo woman was needlessly kept existing, despite all indication by the best available medical advice that she would not recover to functionality.

Ultimately for other people what they consider to be the correct and moral course of action is different, however, if the person who is dying has a legal document with written instructions as to their wishes it makes things far easier.  Especially when there are competing agendas within a family as with the Shivo case.

I think my objection to the involvement of politicians into that matter needs not be stated.

[Mikebert]

(08-26-2017, 02:46 PM)Kinser79 Wrote: Mike, I seriously doubt you actually know what side I'm on.  I actually opposed Obamacare on the grounds of "It doesn't go far enough".

As for where you are ideologically I have no idea.  You might have been like David Horowitz, once on the extreme left and then shifted to the extreme right without spending anytime in the region in  between.  You may be an intelligent man with shit economic prospects with ideas of how things could be better who has a weakness for authoritarian figures. Or something else.  Whatever.

But that doesn't really matter. You have rhetorically embraced Trump in a way you used to embrace Stalin. By side you're on I meant the side you have chosen to embrace, that is, Trump's side. And Trump's side is 100% opposed to single payer health insurance.

[Kinser79]

(09-01-2017, 11:31 AM)Mikebert Wrote:

(08-26-2017, 02:46 PM)Kinser79 Wrote: Mike, I seriously doubt you actually know what side I'm on.  I actually opposed Obamacare on the grounds of "It doesn't go far enough".

As for where you are ideologically I have no idea.  You might have been like David Horowitz, once on the extreme left and then shifted to the extreme right without spending anytime in the region in  between.  You may be an intelligent man with shit economic prospects with ideas of how things could be better who has a weakness for authoritarian figures. Or something else.  Whatever.

But that doesn't really matter. You have rhetorically embraced Trump in a way you used to embrace Stalin. By side you're on I meant the side you have chosen to embrace, that is, Trump's side. And Trump's side is 100% opposed to single payer health insurance.

   You really are completely clueless.  I don't exactly support single payer either as I would actually prefer a Bismarck model as those have proved more stable and less prone to political pressure.  (Seriously the UK Parliment spends a month every year on their NHS budget and it is always messy.  Germany has no such issues.)  As for single payer and Daddy:

http://www.breitbart.com/big-government/...n-wealthy/

And in before you go "hurr breitbart is evil nazi publication, durr" the report is pointing out he stuff he said, in public, on the mainstream media program 60 Minutes.  As far as the president I don't think he's too concerned about the form that the replacement takes so long as everyone is covered and it actually works.  That leaves us with two viable models really, single payer or Bismarck.

As for my weaknesses, I would say that I have a certain attraction to strong men. Both Stalin and Trump fit that model. It is natural for someone who is himself strong to seek out leadership from someone who is stronger than himself. Weaklings have nothing on offer.

[Kinser79]

(09-01-2017, 01:08 PM)X_4AD_84 Wrote:

(09-01-2017, 11:31 AM)Mikebert Wrote:

(08-26-2017, 02:46 PM)Kinser79 Wrote: Mike, I seriously doubt you actually know what side I'm on.  I actually opposed Obamacare on the grounds of "It doesn't go far enough".

As for where you are ideologically I have no idea.  You might have been like David Horowitz, once on the extreme left and then shifted to the extreme right without spending anytime in the region in  between.  You may be an intelligent man with shit economic prospects with ideas of how things could be better who has a weakness for authoritarian figures. Or something else.  Whatever.

But that doesn't really matter. You have rhetorically embraced Trump in a way you used to embrace Stalin. By side you're on I meant the side you have chosen to embrace, that is, Trump's side. And Trump's side is 100% opposed to single payer health insurance.

Duginism / National Boshevism / Eurasianism is a pathway for someone like Kinser79 to embrace Trumpism, or other related or emergent isms. It is also a pathway for Fascists, Nazis, and others of those nether regions. It is the Red-Brown Axis.

Duginism doesn't exist anymore than Kissingerism does.

National Bolshevism is a joke even in Russia a country where political movements that are considered jokes elsewhere are often taken seriously.

Eurasianism only really can work in Eurasia.  The US isn't in Eurasia.  Now North-Americanism may have some merits.  I wouldn't mind liberating our Canadian brothers from their communist regime which is now arresting people for having the audacity to call dick girls 'he'.