The Obama Administration thread

[Bodhi]

I have a question I forgot to ask some of  you guys.  Say someone decides not to get health insurance.  As of right now the fine for not getting health insurance is far lower than actually paying for health insurance.  Say that person gets sick with lets say cancer, then they decide to go get coverage because they can due to prexisting conditions not preventing you from getting coverage.  Say they get better, then decide to stop paying for insurance again since they are not sick and the fine is relatively low.  What is stopping people from only "using" insurance companies when they need them?  Wouldnt that put insurance companies out of business?  Its like me not having car insurance and getting in an accident then calling up Geico to fix it, then dropping them.  How is this not bad for insurance companies?

[Smoking Guns]

The bill in the short term will seem good, in the long term the money must come from somewhere, and it will come from us.  It is a very unpopular bill...

[Smoking Guns]

I hope this bill delivers more than the stimulus package that was supposed to keep unemployment to 8.5% and below.  The bill does have some good things, its a "start", but there are some issues that nobody is sure what will happen...

[Vicious Wishes]

I have a question I forgot to ask some of  you guys.  Say someone decides not to get health insurance.  As of right now the fine for not getting health insurance is far lower than actually paying for health insurance.  Say that person gets sick with lets say cancer, then they decide to go get coverage because they can due to prexisting conditions not preventing you from getting coverage.  Say they get better, then decide to stop paying for insurance again since they are not sick and the fine is relatively low.  What is stopping people from only "using" insurance companies when they need them?  Wouldnt that put insurance companies out of business?  Its like me not having car insurance and getting in an accident then calling up Geico to fix it, then dropping them.  How is this not bad for insurance companies?

If you can get insurance on the day you need it(as in after you went to the doctor and found out you had cancer), and not pay for it before then, why wouldn't you?

If the penalty for not having insurance is cheaper than having it, why have it?

[Axl4Prez2004]

nowhere near the same as having to pay for a 16 year old slut in high school who can't keep her legs closed. 

I'd rather pay the small cost for the abortion than the huge bill down the line to pay for that kid's welfare and prison stay.  Just sayin'.

 If she's that fucking irresponsible, why on earth would you want her carrying and conceiving a child?  Do u think she's eating the right foods while carrying?  Do you think she's getting adequate pre-natal care?  Fuck no!  Then, when the kid requires all sorts of special ed., increased healthcare costs, and don't forget to factor in the future crimes/prison stays, etc., then what?  Fuck, we should offer irresponsible people checks for a thousand bucks just to have their tubes (female) balls (males) tied/soddered/made into silly string for all I care.  Now THAT'S saving money.  
  (tongue firmly in cheek)

btw, Pilferk is best at handling the questions...the man knows his shit.  Fuck Robert Gibbs, Obama needs Pilferk up there answering questions!   

[pilferk]

As I am getting ready to graduate and enter the medical field, i know a lot of people are concerned with this..

maybe i am naive or making it too simple, but to me, if MORE people are covered, MORE people can go to the Dr. thus all medical fields should make MORE money, correct?

Or am i totally missing something?

Less unit profit, more total profit.

In other words, you'll make less revenue on each patient, pill, whatever...but the increase in volume should more than counteract the differences on a per unit basis.

I don't know how I feel about the huge cut to medicare though. I know Heath Shuler voted against it, due to 500 billion being cut from it...


in the PT field, i know Medicare is huge for the business.

Let me help out here:  The cuts are mostly to the MEDICARE MANAGED CARE program, not the stock Medicare program.  Trust me, I deal with the managed care (Advantage my ass) stuff all the time.  The payors are SOAKING the Fed for their premium, and not doing a thing to earn it.

Essentially, for every $1.00 the Fed spends on direct medicare, they're paying the insurance companies somewhere between $1.10 and $1.20 to do the same thing.  That's a 10% to 20% premium.  You realize a pretty big savings when you scale back (or eliminate all together) that premium.

In addition, there's the possibility of seeing people come OFF the Medicare rolls (not the elderly, which makes up most of the users) and transitioning to "something else" within the confines of this program.  If you're not paying for them via Medicare, but paying for them "somewhere else", that, too, is a "cut" to medicare.

I'm not worried.  Not yet.

[pilferk]

Also I saw a few of you use the whole pacifist having to pay for war analogy in order to justify the abortion that is STILL in this bill as of right now.  It is not the same.  Having to pay for national defense to keep you and your fellow countrymen alive is nowhere near the same as having to pay for a 16 year old slut in high school who can't keep her legs closed.  In theory you guys are right, but I don't think they are the same.

It's a moral objection, rather than a legal one, over how your money should be spent.  It's the same thing.  The outcomes of not paying are different, but the principal is the same.

And the executive order ALREADY put in place by the President (which carries the force of law) says that Hyde superceeds the bill, and that no federal funds can be spent to pay for abortions.

Like I said I will wait until all the lawsuits that have been filed today and all the red tape clears before really commenting on this bill.  It is chaos in the streets today.  Political careers will be finished over this, and there is guaranteed to be a huge change in the House and Senate this fall, thats not me talking, thats the polls.  So I think we are a long ways away from this really going anywhere.  I imagine the republicans tying this up for a while.

Actually, the polls aren't showing anything of the sort.  At least not the ones I've seen.  Dems and Repubs are polling about equal in terms of Congressional approval.  Obama's numbers have fallen slightly, but aren't nearly in the toilet (AND, remember, there's the economy to factor in to all this).  I haven't seen a recent, huge swing in the projections for the 2010 Senate Races...they're about where they have been (showing the Repubs have a good shot at picking up about 4 to 5 seats).  Nothing is showing a huge backlash, YET.

I'm assuming maybe you're talking about the CNN poll, recently released, that the Repubs are trying to spin as showing this will have huge repurcussions come November.  There's one problem with that.

The Repubs are pointing to the poll and saying: Hey, look 57% of the population don't like this bill and you're voting for it.  We're going to make you pay.

But the breakdown is a lot more interesting.  About 46% of the populace think the bill is good, about 44% of the populace think the bill is too liberal, and about 13% of the populace DON'T THINK THE BILL IS LIBERAL ENOUGH.

Now, really look at those numbers.  Because they don't really seem to indicate what the Repubs are trying to infer that they do.

[pilferk]

im talking about the back door deals and payoffs to certain states for their votes, Lousiana, Florida etc...  What was the final count on how much money members of the House pocketed for their own interestes?

The "fix it" bill, unless I'm mistaken, strips out almost all of them.  Right?

[pilferk]

I have a question I forgot to ask some of  you guys.  Say someone decides not to get health insurance.  As of right now the fine for not getting health insurance is far lower than actually paying for health insurance.  Say that person gets sick with lets say cancer, then they decide to go get coverage because they can due to prexisting conditions not preventing you from getting coverage.  Say they get better, then decide to stop paying for insurance again since they are not sick and the fine is relatively low.  What is stopping people from only "using" insurance companies when they need them?  Wouldnt that put insurance companies out of business?  Its like me not having car insurance and getting in an accident then calling up Geico to fix it, then dropping them.  How is this not bad for insurance companies?

From my understanding, the fine is able to be applied YEARLY AND cumulatively.  Sort of like paying the punitive fines for not filing your taxes.   I'm not sure if it allows for interest on those fines, too...it might.   In addition, like with car insurance, your premiums are going to be higher if you can't provide proof of insurance over some previous time period (with auto, I think it's 5 years)...which means waiting will cost you more $$ twice.  You'll pay the cumulative fine for however many years you were without insurance AND you'll pay an increased premium when you go to get insurance.

In addition, while you can't be DENIED coverage for pre-existing conditions, I do think the bill allows that you have to pay a higher premium if you have one.  It limits what that additional amount is, but there IS an increase.

[pilferk]

The bill in the short term will seem good, in the long term the money must come from somewhere, and it will come from us.  It is a very unpopular bill...

See, I don't get that impression.  At least not completely.

It's wildly unpopular with the right, with the Repubs, and with the Tea Party sect.

But overall?  I think it's split pretty close to down the middle....it sure seems that way from the recent polls I've seen (especially the breakdown polls....65% unhappy doesn't mean much when 20% of those voters are "unhappy" because the bill isn't LIBERAL enough).  If anything, the Dems and Libs main gripe is it didn't go far enough.....

[pilferk]

Some interesting "stuff" on the bill:

http://www.politifact.com/truth-o-meter/article/2010/mar/19/top-5-lies-about-health-care/

http://www.politifact.com/truth-o-meter/article/2010/mar/18/top-10-facts-know-about-health-care-reform/

http://www.nytimes.com/2010/03/23/us/politics/23repubs.html

[pilferk]

Like I said I will wait until all the lawsuits that have been filed today and all the red tape clears before really commenting on this bill.  It is chaos in the streets today. 

The lawsuits are likely to fail.  Their argument is that the commerce clause isn't broad enough to allow the Fed to mandate purchase of goods or services an individual might not want.  Given precedent, I can't see the SC agreeing with them.

Now, the avenue the State's COULD go down is instituting amendments to their own constitutions.  They could also simply try state legislation, but that's less likely to work..but amendments might actually catch the SC's eyes, and be allowed to stand.

The flip side, though, is the fed can simply decide (as they did with Transportation funding and the drinking age) to tie all Medicare and Medicaid funding to whether or not your state chooses to participate in the federal law.  If the state opts out...by doing so they eschew all rights to federal funding for healthcare. In other words: You get all of it, or you get none of it.

I can tell you right now...that would essentially bankrupt the states choosing not to pariticpate, especially those with a balanced budget amendment already on the books.  It would be a dangerous game of chicken....

[freedom78]

Like I said I will wait until all the lawsuits that have been filed today and all the red tape clears before really commenting on this bill.  It is chaos in the streets today. 

The lawsuits are likely to fail.  Their argument is that the commerce clause isn't broad enough to allow the Fed to mandate purchase of goods or services an individual might not want.  Given precedent, I can't see the SC agreeing with them.

Now, the avenue the State's COULD go down is instituting amendments to their own constitutions.  They could also simply try state legislation, but that's less likely to work..but amendments might actually catch the SC's eyes, and be allowed to stand.

The flip side, though, is the fed can simply decide (as they did with Transportation funding and the drinking age) to tie all Medicare and Medicaid funding to whether or not your state chooses to participate in the federal law.  If the state opts out...by doing so they eschew all rights to federal funding for healthcare. In other words: You get all of it, or you get none of it.

I can tell you right now...that would essentially bankrupt the states choosing not to pariticpate, especially those with a balanced budget amendment already on the books.  It would be a dangerous game of chicken....

Yeah...a $2.5 trillion industry NOT being interstate commerce...that really just defies logic.

[Jdog0830]

I am just getting tired of hearing the same old crap from people who clearly don't understand any of this. All over my facebook i'm seeing this is communism or socialism. This is a government takeover they're taking away our freedoms. We're being forced to buy in to a certain plan or be fined. Your free to buy ANY plan you want. As pilf said you should be required to take care of YOURSELF. The plan also has a hardship exemption for poorer americans. I'm starting think many people aren't even reading a damn thing about this bill and are just making wild accusations and repeating the right wing crap.

Its a prime example of the right wing using fear to control there masses.
Its a sad thing to see.






Joe

[Bodhi]

I have a question I forgot to ask some of  you guys.  Say someone decides not to get health insurance.  As of right now the fine for not getting health insurance is far lower than actually paying for health insurance.  Say that person gets sick with lets say cancer, then they decide to go get coverage because they can due to prexisting conditions not preventing you from getting coverage.  Say they get better, then decide to stop paying for insurance again since they are not sick and the fine is relatively low.  What is stopping people from only "using" insurance companies when they need them?  Wouldnt that put insurance companies out of business?  Its like me not having car insurance and getting in an accident then calling up Geico to fix it, then dropping them.  How is this not bad for insurance companies?

From my understanding, the fine is able to be applied YEARLY AND cumulatively.  Sort of like paying the punitive fines for not filing your taxes.   I'm not sure if it allows for interest on those fines, too...it might.   In addition, like with car insurance, your premiums are going to be higher if you can't provide proof of insurance over some previous time period (with auto, I think it's 5 years)...which means waiting will cost you more $$ twice.  You'll pay the cumulative fine for however many years you were without insurance AND you'll pay an increased premium when you go to get insurance.

In addition, while you can't be DENIED coverage for pre-existing conditions, I do think the bill allows that you have to pay a higher premium if you have one.  It limits what that additional amount is, but there IS an increase.

ok cool thanks.  I figured there had to be some way to avoid people blatantly taking advantage of the system.

[oldgunsfan]

I will wait to see what the final bill looks like with whatever revisions take place before I really comment on it, but as of right now I dont like how you are forced to buy health insurance or face fines. 

You mean, like being forced to carry auto insurance?

Yes, the difference is you can choose to have a car or not...while having a body is sort of required, but the principal remains the same.  Not having someone pay your medical bills means we ALL have to pay your medical bills.  It's funny...Repubs are all about personal responsibility yet this is the ULTIMATE in personal responsibility, in the whole bill, and it seems to get some of the loudest objections from them.  The goverment is REQUIRING you to be able to take care of yourself if you get sick, rather than making the rest of the population pay your way through increased costs.  I don't have a single problem with that.

I dont like how the taxpayers will be forced to pay for abortions even if its against their religious beliefs, that is wrong.

It's also not true.  First off,  there is a concession that WILL BE adopted by the Senate that will change that language.  Second, Obama has issued an executive order stating that NO federal funds will be used to pay for elective abortions. 

That being said: I have no issue, given the findings of our Supreme Court, with how my tax money is used, so long as it's legal.  Your objection is akin to a pacifist complaining his taxes are being used to fund our national defense (and thus, war).  Taxes are spent on our SOCIETY, not any particular individual.  If the Courts and Roe V. Wade uphold Freedom of Choice.....then saying the federal government can't fund premiums for insurance that MIGHT be used to fund an abortion would be just as illegal, IMHO, as preventing the abortion itself.

  I also want to see what kind of coverage people who are here illegally will be getting, and who is going to pay for that, cause we already know they wont. 

I think there is a reason you're now hearing strong cries (and agreement from the White House) about the need for strong immigration reform.  On this, though, we agree.  If you're illegal, and you get sick, hurt, whatever....we treat you, turn to your government for payment (since, remember, pretty much everyone else has single payor) and go from there.  If that means you get shipped back home, so be it. 

Other than that, I like how people with pre-existing conditions wont have trouble getting coverage etc... so we will see.  But if social security, the post office and the public school system are any indication of what happens when the government runs things, lets just say I'm a little skeptical on how this will pan out.

The beauty of THIS system is...the government actually ain't gonna be running anything.  Private industry will still exist.  There are 2 differences:

1) There are some strong consumer protection laws that will force that private industry to do business in a specific, regulated way
2) There will be someone else (in some cases...specifically the government) paying the insurance premiums.

Really, this isn't nearly, if you read the bill, any kind of government take over of healthcare.  They are not operating any specific segment of the industry EXCEPT the marketplaces people can go to buy insurance...and even then, only for awhile.  They're basically going to function as "insurance e-bay" until they can transition that process off.

The rest of what they'll do is actually what they do best: Regulate and enforce.

Also that is ignoring the fact of how they actually achieved the 219 votes which is disgusting, but it is the government we are talking about, so its not even worth mentioning.

How is that, exactly?  Looks like a lot of the fat is getting trimmed in reconcilliation, most of the pet project amendements are going to get stripped.....it looks like they did pretty much what they've always done (Dems and Repubs).

i got to hear someone today say how happy they were cause they got free healthcare; and I wanted to bash his fucking skull in so he would have to use it;

i have healthcare as well but I work my ass off it for and pay a portion of the freight as does my company

[pilferk]

i got to hear someone today say how happy they were cause they got free healthcare; and I wanted to bash his fucking skull in so he would have to use it;

i have healthcare as well but I work my ass off it for and pay a portion of the freight as does my company

So will they.  Unless, of course, they're making less than 14k a year (as an individual, or about 20k a year for a family of 4).  That's about 133% of the Federal Poverty Level.  THOSE folks will get the government to pay most, if not all, of their health insurance premiums (if they don't, already, through Medicaid or some other program).  There's subsidies for people ABOVE those levels, but they'd still pay something.

The thing is, though....we're (and by that, I mean everyone who is using the system now and either IS paying out of pocket or has insurance) paying for it now.  Those folks who are at or just above the poverty level, if they don't have insurance through their work place, are what we call "Self Pay" patients.  That's a nice way of saying they're responsible for their bills...but they rarely get paid.  Which means the costs of their care are passed along to the rest of us, who can pay....through increased costs of care.  Because SOMEONE has to pay for the labor, materials, etc used in the care, just to break even on it....and that's the only manner, currently, to cover those losses/costs.

By increasing the number of people coverer, and taking what you can get from those that can afford it, you actually would reduce the "pass off" of costs to the consumer....you just pay for it out of your tax dollars which subsidizes or pays for the coverage of those who can't afford it.  And since, SO FAR, the plan is estimated to more than pay for itself (meaning, no increase in what you're paying for taxes)......it's just a redirection of your existing tax dollars. 

[freedom78]

i got to hear someone today say how happy they were cause they got free healthcare; and I wanted to bash his fucking skull in so he would have to use it;

i have healthcare as well but I work my ass off it for and pay a portion of the freight as does my company

That person's beliefs about "free" healthcare are likely erroneous.  It may be subsidized, but there would still be a premium involved for most people, except those in fairly serious poverty. 

Anyone else watching the reactions to all of this?  Glen Beck comparing it to Pearl Harbor, Republicans believing, based on poll data, that this is akin to "what Hitler did". 

We've gone off the fucking deep end. 

[pilferk]

The rhetoric (from both sides, but particularly from the Repubs) is getting a little crazy.  Armegeddon?  Equating the passage of this bill to 9/11?  BABYKILLER???  Really???   C'mon!  I get that the Repubs disagree, politically (you can't even say "in principal" because there's a lot of stuff in this bill that jives with Conservative principals).  But there comes a point where hyperbole actually kills your case...and I think they're quickly approaching that point.

I know it works to lather up the more radical base (and, honestly, the Radicalization of the Republican party should be concerning to the party leadership).  And when it's occasional, or coming from a more junior member of the House....I sort of expect it.  But this is beginning to smack of a temper tantrum, rather than a principaled disagreement.  

I agree, the bill is not perfect.  I would have liked to have seen more cost control measures, measures to increase competition (and incentives to actually COMPETE), the incorporation of torte reform (because now I feel it's going to get forgotten...especially given the bickering going on), and some other provisions (like fixing the Medicare Payment cut that goes into effect this year...THIS year.  They fix it, sort of, but not for a while into the bill's life) and some other things.  That being said, it's a perfectly functional bill who's costs we're going to have to monitor.  IF the CBO is right (and it's interesting that the Repubs are calling their numbers into question given they, themselves, have used the CBO consistently to back their cases), or at least CLOSE to right, we're in good shape.  If, as the Repubs suggest, they're off by over a trillion dollars (something I find hard to believe given history....they're usually off, which is understandable when you're working with projections, but not by such a significant margin), then the CBO should be shuttered and we're in trouble.

Also "Repeal and Replace"?  Really?  Because...well...I don't think many people, once they see the actual law at work (and not the rhetoric laced, baby killing, socialist, Armegedon inducing description being bandied about), will want the ENTIRE law repealed.  And they're going to have a hard time repealing ANYTHING til after 2012, at least.....given who's holding the veto power.  Do you REALLY want to campaign on a platform like that?   Short term rhetoric?  Maybe...but they're setting themselves up for failure.

[pilferk]

Anyone else watching the reactions to all of this?  Glen Beck comparing it to Pearl Harbor, Republicans believing, based on poll data, that this is akin to "what Hitler did". 

We've gone off the fucking deep end. 

LOL...great minds and all that.

I honestly don't think the ratcheting up of the rhetoric is going to do the Repubs any favors.  They're beginning to border on the edge of "crackpot" territory.  You can disagree, and not engage in such rampant hyperbole that it begins to make you look like one of those guys on the street corner talking about the end of the world.

I know, they lost...and they need to spin this loss into "something".  But the way they're going about it....I'm not sure it's going to do them any favors.  The part of their party they're catering to.....I'm not sure that's the mobilization they want, because I'm not sure it's the element that will get them elected, or pick them up seats.   The moderates and indies aren't going to respond well to this kind of talk....and if they lose them, they're not going to make up much ground come November.  And if they don't pick up significant seats in the House and Senate in November, the Repubs are in serious trouble.