theexorcist
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Post by theexorcist on Jul 17, 2009 8:24:06 GMT -5
Well...I mean, let's be honest here--our public schools are pretty crappy. Yes, there are plenty of public schools that are failing, but there are plenty others that are serving the nation's children quite well. But that's not even my point. My point is that there are plenty of things in our society that are "socialist," as in government-funded that I don't think many people would argue against. These include education, national parks, highways, and Medicare as previously mentioned. Simply waving the socialist flag at a public health care option does nothing. I think people need to stop treating socialism as a dirty word in this country. Call me un-American, but it is not always a bad thing. That's a canard - socialism is not just "government-funded". There are a variety of different definitons and levels, but socialism in its basic form believes that the government does things better than the market. And, with very few exceptions, it never has and it never will.
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TC
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Post by TC on Jul 17, 2009 8:50:29 GMT -5
There are a variety of different definitons and levels, but socialism in its basic form believes that the government does things better than the market. That's vague (how do you define "better"?) and completely incorrect. The state need not own anything for an enterprise to be socialist.
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TBird41
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Post by TBird41 on Jul 17, 2009 9:04:15 GMT -5
Right. And profit is a horrible way to motivate companies to produce a quality product. There are a variety of different definitons and levels, but socialism in its basic form believes that the government does things better than the market. That's vague (how do you define "better"?) and completely incorrect. The state need not own anything for an enterprise to be socialist.
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Boz
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Post by Boz on Jul 17, 2009 9:21:43 GMT -5
I'm really not all that concerned with the label we place on this.
My concern is whether it will work or not. Is it an effective and managable solution?
If you believe the Congressional Budget Office and Investor's Business Daily, the answer in the last 24-48 hours seems to be a resounding NO.
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Filo
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Post by Filo on Jul 17, 2009 20:34:57 GMT -5
Well, with the ever-decreasing payments that doctors* receive from insurers and the government (medicare/medicaid now, but who knows what plans in the future), the only way doctors will be able to earn a living is volume, volume, volume.
Of course, patients will just love being treated like they are in an assembly line.
* I am talking about GPs, OBs, and the like, not the surgical specialties, since I have no real knowledge in that area.
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Post by HoyaSinceBirth on Jul 17, 2009 23:30:08 GMT -5
I think they should start accepting more people into medschool - Person trying to get into medical school for 2010-2011 school year.
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CAHoya07
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Post by CAHoya07 on Jul 18, 2009 3:49:14 GMT -5
I'm really not all that concerned with the label we place on this. My concern is whether it will work or not. Is it an effective and managable solution? I don't agree with your answer, but I agree that this is question that we must try to answer. We can go off on different aspects and applications of "socialism" and its merits and pitfalls on another thread, if need be. My apologies for being one who helped produce this tangent.
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kchoya
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Post by kchoya on Jul 18, 2009 9:44:41 GMT -5
The last couple of posts have hit the head on as to a key problem that does not seem to be addressed by the proposals out there. In the 80's there was no shortage of doctors, so there were limits on the number of med school slots. Now, all the studies show severe shortage of doctors developing, especially in primary care areas. It's clear that we need more med school slots - especially if more work hour limits are imposed on residencies, which will require more doctors (either attendings or residents) just to cover the work load as it currently exists.
However, that's only part of the problem, as Filo hinted at. The shortages in primary care physicians, and in rural practitioners, is due, in significant part, due to the large differences compensation between specialties. My wife is in surgery because she loves surgery. But for a lot of people, it's huge consideration when a surgeon will average up to $150-$200K (and many make more than that) while many family practitioners may never sniff six figures. When you have to pay for college, med school and then do a residency (and possibly a fellowship), it's hard to ignore that difference when you may have $200K in debt and you don't start making "doctor money" until you're 33 or 34.
That's why Buff's concern is so valid. Now, it's not like those 45 million don't utilize our health care system - they just wait until they're really sick and go to the ER. However, if the goal is to get those people to the doctor sooner when the problem is lesser and can be treated easier, then it's going to take 4 weeks for you to see your family doctor instead of two. And it's not a matter of "volume, volume, volume" because there is little, if any, unused capacity in the system. How many primary care docs do you know that have said they're not taking any new patients because their practice is full already.
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EasyEd
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Post by EasyEd on Jul 18, 2009 9:48:08 GMT -5
One of the problems with the Federal Government being involved in health care is its penchant for using the program to advance various agendas. As a conservative this means I'm concerned they can (and ultimately will) mandate coverage of illegal aliens, same-sex unions, Viagra, contraceptives, abortions, in-vitro fertilization, face lifts, vacations in Cancun for mental therapy, etc. If the conservatives ever regain power they would be free to mandate that none of the above would be covered. In other words, once the Feds become involved the health care system WILL be used to foster political agendas.
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TC
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Post by TC on Jul 18, 2009 10:43:20 GMT -5
This legislation has the backing of the AMA, which is important because it lends some credibility to the impact on quality of care. Obama has clearly been lobbying them - in the ABC special, the AMA President was one of about 6 to get a question.
You start trying to dramatically increase the number of medical school slots and the number of medical schools out there and you lose the backing of the AMA. No one wants their wages eroded or benefits cut by the fact that they are essentially commoditized by a flood of new practitioners.
I think everyone agrees that we need more doctors - especially primary care physicians - but I don't think you can solve all the problems of health care in one bill. It'd be nice if we get something that attacks some of the problems of insurance (which the AMA will back) and then later attack the scarcity of Physicians problem (which will likely be backed by insurance).
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EasyEd
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Post by EasyEd on Jul 18, 2009 13:15:29 GMT -5
The AMA backs the bill means the head honchos of AMA back the bill but there is no assurance they represent the membership. Heads of organizations often take positions against the opinions of their member, like the AARP does all the time.
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EasyEd
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Post by EasyEd on Jul 21, 2009 10:05:57 GMT -5
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TC
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Post by TC on Jul 21, 2009 10:14:48 GMT -5
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kchoya
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Post by kchoya on Jul 21, 2009 10:45:04 GMT -5
All that does it prove the point that we're trying to rush through a bill that' thousands of pages long that would dramatically alter many aspects of the economy and daily life when no one knows everything that's in there.
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Post by hoyawatcher on Jul 21, 2009 10:46:19 GMT -5
IMHO this bill is a boondogle that doesn't fix the major things wrong with the current system but puts at risk many of the things that are good about the system. Specifically:
Employer based HC - If GM taught us anything it is that US companies competing in a now flat world cannot continue to absorb the cost of healthcare for their employees and still compete with the rest of the world. Especially when US companies can avoid the costs by shipping jobs overseas. Radical change in philosophy but we need to get rid of this relic from WWII wage and price controls. Make health insurance a personal responsibility like auto insurance.
Personal Accountability/Cost control - with the program proposed, the only option for cost control is rationing of health care and reductions in reimbursement. To be clear some of that is needed. But Safeway and others showed us that putting the cost of bad behavior (ie obesity and smoking) on people changes behavior and outcome. Also making people shop for care instead of being in a zero cost environment changes both patients and providers - as an alternative to socialized medicine. Making insurance a personal policy also gets rid of portability issues.
Tort reform - Well documented that a huge amount of costs are associated with defensive medicine due to concerns about being sued. That isn't addressed at all in this plan to my knowledge.
To be clear, we need to move some of our spending from extroadinary end of life care to earlier broad based primary care. And that is rationing pretty much any way you slice it. It is what the Europeans do now. This will also include some incentives to go into primary care instead of specialty.
But the Europeans and Canadians have a political consensus that allows them to get away with the rationing and other deficiencies to their HC system. We don't have that consensus - shoot we went nuts when managed care tried to ration million dollar procedures with minimal if any cure rates. Right now we don't have that consensus and as such I expect this to fail. Could be wrong but we shall see.
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TC
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Post by TC on Jul 21, 2009 11:23:19 GMT -5
All that does it prove the point that we're trying to rush through a bill that' thousands of pages long that would dramatically alter many aspects of the economy and daily life when no one knows everything that's in there. Oh please, it's a blatantly disingenuous argument about one clause in the document - and it's malicious misrepresentation at best. I don't mind anyone arguing that the system will be overloaded, that taxing the rich isn't the way to fund it, or that it doesn't solve the personal accountability angle (people need to be incentivized to make healthy choices). Those are all good, legitimate arguments. Stuff like this is BS.
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Boz
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Post by Boz on Jul 21, 2009 11:39:57 GMT -5
Can I ask what I hope will be a non-partisan question at this point?
Who in the F%^# writes these freaking bills?
I've gone through about 20 pages of this and it is the most ridiculous, convoluted nonsense I have ever read. And I've read Joyce!
Who has a "definitions" section wherein you are referred to a completely different section for the definition of a term?? WTF is that?
I swear to Christ, you frakkin' lawyers are ruining the world.
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kchoya
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Post by kchoya on Jul 21, 2009 12:58:16 GMT -5
All that does it prove the point that we're trying to rush through a bill that' thousands of pages long that would dramatically alter many aspects of the economy and daily life when no one knows everything that's in there. Oh please, it's a blatantly disingenuous argument about one clause in the document - and it's malicious misrepresentation at best. I don't mind anyone arguing that the system will be overloaded, that taxing the rich isn't the way to fund it, or that it doesn't solve the personal accountability angle (people need to be incentivized to make healthy choices). Those are all good, legitimate arguments. Stuff like this is BS. Ok, you read the whole thing and then tell us what's in it.
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Nevada Hoya
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Post by Nevada Hoya on Jul 22, 2009 11:42:28 GMT -5
I think we can all agree that we have to have a system that allows all US citizens in this country some kind of health care. My sister was a self employed (stained glass artist), who was diagnosed with ovarian cancer in 1999. She struggled to pay her health premiums (about $500/month). About two years before her death her health insurer dropped her because of a "business decision." She had to spend the rest of her life battling both her disease and trying to get some kind of health care. End of story!
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Boz
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Post by Boz on Jul 22, 2009 13:26:14 GMT -5
Well, abortion is now being debated as part of this issue, so I think it's pretty safe to say that these bills are not going to get done soon.
And it goes to, I think it was bin's point. When the government gets involved, there is no maybe about it...it WILL get political.
To Nevada, that is a tragic story and I'm very sorry. I think increasing coverage and reform of the current system (particularly as it relates matters like to dropping invidivuals from coverage) ARE things that everyone can agree on. Certainly there are large principled disagreements on how those things can and should be accomplished, but I think everyone does want to accomplish them.
EDIT: Well, there's an hour of my life I'll never get back. Hell, when even the folks at MSNBC are skeptical about his performance, I think it's safe to say that the President didn't really move the ball at all tonight. Maybe even lost a yard or two.
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