Getting it done: Obama's full-court press on health care

[Kraken]

The do-or-die date that keeps coming up lately is March 18, not even two weeks away. What do you think? Will the Dems pull it off? Or will they fail, and settle for some little Republican-friendly fig-leaf reform later on?

I see that business groups led by the health insurance companies have taken out up to $10 million in TV ads opposing reform. Several states are passing laws forbidding government from requiring people to buy insurance, setting up a constitutional showdown.

I would love to see Obama rally his party to do what's right instead of what's popular. But I have a hard time believing that enough of them will grow spines and risk their job security (dubious as it is anyway).

This could be Congress's last chance to take control of this problem for another generation. It's coming down to the wire. Will Obama even get his vote? Or will this baby-step reform die on the vine yet again?

No links because you guys all read more news than I do.

[Grundbegriff]

[GreenGoo]

My vote is that it will be a complete failure. No one can see past the word "socialism" or the dollar amount (especially given the economic climate).

Good luck next time guys. I wonder if I'll be dead before the next time comes around.

[GreenGoo]

Rosemary's Baby

Wait, this isn't the EBG movie thread?

[AWS260]

I don't know what will happen, but I know how I feel:

I'm appalled at how many of my fellow Americans seem willing to leave the uninsured hanging out to dry, out of fear of some mythical Red Menace. Access to decent healthcare is a fundamental human right (unlike many other sacred cows in the federal budget).

God, it's frustrating.

[Scuzz]

I think Obama's plan is dead........I would like some reform but the original plan galvanized the anti-government health care lobby group so much that nothing will slow them down now.

Incremental steps....some reform..tort reform...drug plans...insurance tax credits...something....but now all people see is black and white.

No pun intended.

[Little Raven]

Incremental reform literally can't work with health care...otherwise we would have done it a long time ago. Each step necessitates other steps, lest everything be thrown out of balance.

I'd like to think Obama can pull this off, but I'm deeply skeptical.

[LawBeefaroni]

You can't have no-prior-conditions without 100% buy-in. That's the bottom line. One side demands 100% no-prior-conditions, the other will not allow 100% forced participation.

Start with cost and we'll see what it looks like in 5 years. Of course they'll both spend the next 5 years blaming the other side for not fixing it today.

I heard part of Obama's speech yesterday. One of the things he was pitching (he was at a college) was coverage for adult dependents until 26-years-old. WTF? In comparison it's a non-issue. But it got him a rousing cheer from the < 26-year-old crowd. Still politics as usual.

[Kelric]

Universal health care for everybody. Cut back our ridiculous defense spending. Break even.

[Isgrimnur]

Universal health care for everybody. Cut back our ridiculous defense spending. Break even.

As someone whose family is part of the "ridiculous" defense spending, I respectfully disagree with your assessment.

[Kraken]

If this effort does fall apart, what are the prospects for Obama's next three years? Is this doomed to be a replay of the Clinton presidency (although hopefully without the bimbo eruptions)?

[Scuzz]

If this effort does fall apart, what are the prospects for Obama's next three years? Is this doomed to be a replay of the Clinton presidency (although hopefully without the bimbo eruptions)?

Clinton did go 8 years.....but the republicans are going to make in-roads in the next congressional elections if the polls mean anything

[GreenGoo]

Incremental reform literally can't work with health care...otherwise we would have done it a long time ago. Each step necessitates other steps, lest everything be thrown out of balance.

This is my feeling on the matter. And I don't think any modern 1st world country can tolerate the level of change required to make it work, if it makes anyone feel better about it's impending failure. It is just too big , too scary and too outside of most people's experience.

Hell, you guys can't even change your system of measurement without the country imploding. Health care? Fuggitaboutit.

[GreenGoo]

Universal health care for everybody. Cut back our ridiculous defense spending. Break even.

As someone whose family is part of the "ridiculous" defense spending, I respectfully disagree with your assessment.

And this is the problem. No one wants to pay for it.

I imagine that all the people who's families are part of the sick and uninsured would respectfully disagree with your disagreement. Plus plenty of average joes too.

Not to mention no one is demanding the abolishment (firefox doesn't recognize abolishment as a word. ) of the military. There is no way that every single dollar of military spending is necessary for security and foreign policy. It's just not possible, and not the way the world works. That's like saying in a down economy that businesses that have to reduce spending should just go out of business instead.

Not to single you out Isgr, but Kelric said let's cut military spending to help pay for health care. Your response was "no". Not exactly room for negotiation there. And you're not alone. Plenty of people are unwilling to move or even consider moving a possibility.

[LawBeefaroni]

Incremental reform literally can't work with health care...otherwise we would have done it a long time ago. Each step necessitates other steps, lest everything be thrown out of balance.

It's not completely true. For example, common EHR can be implemented. It's already in progress and incentives are funded by ARRA2009. The problem is these incremental steps move at a snail's pace. Once EHR is implemented, the already in-place NPI Registry can be used in conjunction to cut down on fraud, cost, and reduce medical errors. We don't have to wait for that, but it's an example of an incremental step that isn't dependent on other reforms.

[GreenGoo]

Lawbeef, I was thinking costs could be attacked without complete reform, so I guess I change my position with regard to health care requiring a massive overhauling to make any progress at all.

[Little Raven]

It's not completely true.

Granted, but your examples are not what the populace at large considers reform. When the average person on the street thinks of health care reform, what they generally think of is removing pre-existing conditions. Sure, that's only one small part of absolutely massive system, but it's the one people think of because it's the one that's most obvious.

[LawBeefaroni]

It's not completely true.

Granted, but your examples are not what the populace at large considers reform. When the average person on the street thinks of health care reform, what they generally think of is removing pre-existing conditions. Sure, that's only one small part of absolutely massive system, but it's the one people think of because it's the one that's most obvious.

That's the problem. It's being sold to the average person as about single issues, usually the most contentious. Very few would have a problem with universal EHR standards. But it doesn't fire up the base at all so politicians don't use it.

The person on the street can be excused for their ignorance but our "leaders" cannot.

[Kraken]

Clinton did go 8 years.....but the republicans are going to make in-roads in the next congressional elections if the polls mean anything

His second term was just spent battling the vast right-wing conspiracy, though. He accomplished very little after Hillarycare went down. He had the good fortune to ride an economic boom. Maybe Obama will get so lucky.

(firefox doesn't recognize abolishment as a word. )

Because we already have "abolition".

Hell, you guys can't even change your system of measurement without the country imploding. Health care? Fuggitaboutit.

I see that the UK is proposing universal insurance for dogs. It would be a much better story if it were health insurance (it's liability).

[Arcanis]

As one of the unwashed masses without health care i don't want their health care reform. First off i don't trust the government to not completely fuck it up to the point that we will have to reinvent health care again in a century (it will take at least this long for them to admit it, see social security) and pay off a quintillion+ debt caused by this one. The current proposal 'works' over 10 years because they account for 13 years of taxes in it. All of their funding is accounting gimmicks like that or double counting 'cuts' in spending. Remember the CBO has to score it with the number the congress gives them so those numbers may not (read as "never are" for pretty much every bill) be grounded in reality.

I want a good healthcare system that is better than what we have and i think there are good ideas from both sides of the isle but nothing is remotely close enough to a complete plan. The Dems shouldn't have been arrogant enough to force it their way and galvanize the minority against it. I think they wasted a good chance to improve the country over the past year and the Reps are going to be too stubborn to try and make a viable plan now.

So in closing this is going to go down in flames and likely take Obama's pole numbers with it, congress' numbers were so low that they would have to start personally murdering people while punching babies and kicking puppies to get any lower.

[noxiousdog]

I don't know what will happen, but I know how I feel:

I'm appalled at how many of my fellow Americans seem willing to leave the uninsured hanging out to dry, out of fear of some mythical Red Menace. Access to decent healthcare is a fundamental human right (unlike many other sacred cows in the federal budget).

God, it's frustrating.

It's not fear of a mythical Red Menace, it's a very real fear of a blank check being written to health care providers of all types.

[Isgrimnur]

Universal health care for everybody. Cut back our ridiculous defense spending. Break even.

As someone whose family is part of the "ridiculous" defense spending, I respectfully disagree with your assessment.

And this is the problem. No one wants to pay for it.

I imagine that all the people who's families are part of the sick and uninsured would respectfully disagree with your disagreement. Plus plenty of average joes too.

Not to mention no one is demanding the abolishment (firefox doesn't recognize abolishment as a word. ) of the military. There is no way that every single dollar of military spending is necessary for security and foreign policy. It's just not possible, and not the way the world works. That's like saying in a down economy that businesses that have to reduce spending should just go out of business instead.

Not to single you out Isgr, but Kelric said let's cut military spending to help pay for health care. Your response was "no". Not exactly room for negotiation there. And you're not alone. Plenty of people are unwilling to move or even consider moving a possibility.

Truly a discussion for another thread, but if you start making massive cuts to military spending, you're going to cripple the economy far worse than if GM went under. You going to train all the separated infantry to be candystripers? You going to retrain all those engineers to leverage weapons knowledge into CT scanners? All those fabricators and mechanics into hospital equipment manufacturers?

You want to trim military spending? I'll listen to reasonable ideas as to where to save money and reduce waste and inefficiencies while taking care of our servicemen and -women who so rarely get the good treatment they deserve and we maintain enough R&D in areas that will preserve our ability to protect our interests and the greater world security. But hearing someone advocate it in the language of "ridiculous defense spending" doesn't put me in a listening mood.

[GreenGoo]

They already train military for various health care jobs. I'm sure they will be more comfortable in a role where disobeying their boss only gets them fired, not put in jail.

Are you really saying that cutting military spending will hurt the economy if it was funneled into the health care industry? The 2 largest industries in the states? One industry would grow and the other would shrink. Oh well.

I'm not interested in random fear mongering or boogeymen. A solid analysis of both industries would need to be done. Without that, nothing you could say would stay me from continuing to suggest that the money can be found in the military industrial complex. The military regularly goes through cycles. What happens to all those engineers and weapons experts then? Mothballed and stored in lockers until they are needed again? There is a constant turn over in the military. Nothing new about the idea of members leaving with skills that can't be applied outside of killing people. And it's not like the cuts would all happen on the same day and 250,000 soldiers would be looking for work. Programs would be cut over time, and that money switched over to health care. It's not like if a check was cut today that health care reform would happen instantly.

Not being American, I see nothing sacrosanct about the military. And looking at the military spending in the states, I can not believe that there isn't room to cut, while still maintaining the best military in the world, and continuing vital programs to keep it that way into the future.

As Lawbeef says however, without controlling costs in health care, there is no point in any other changes. Not working in health care myself (although my wife does) I am amazed and appalled at how expensive it is to provide even basic health care in the states, compared to other 1st world countries. It is pretty clear just by looking at the numbers that something is seriously fucked up in your system. It doesn't take a whole helluva lot of analysis to see that something is out of whack.

For a competitive market that is supposed to keep costs down through competition, that doesn't appear to be happening. I thought litigation would be part of it, but someone provided stats awhile ago here that showed that malpractice insurance was only a tiny fraction of the overall cost of delivering health care.

[Kelric]

There is a hell of a lot of military spending that can be cut. How many super sonic jet radar buster missiles do we need? We are the preeminent military force on the planet. We will be for quite a while, even if we stop spending right now.

I haven't been to a doctor's office or a dentist's office in seven years, not counting the one emergency room visit last fall when I was having random dizzy spells that freaked me out. Why? Because it is too fucking expensive. Even in the last six months when I have been covered by the cheap Massachusetts insurance, I haven't gone. I didn't have much of a choice before this, because I was uninsured. This is a massive problem for the supposedly richest country on the planet. We have so many problems that nobody wants to account for. We have a large hunger issue despite producing a lot more food than we need. We have a large homeless issue despite having larger homes than anyone else on the planet. We have the largest criminal population despite being a 'free democracy.' We're a fucked up culture with serious issues that nobody wants to truly account for.

At some point we need to step up. Let us start here.

[Isgrimnur]

We are the preeminent military force on the planet. We will be for quite a while, even if we stop spending right now.

The Russians haven't stopped developing just because we're no longer in a cold war. And that video has at several references to arms sales to other countries. If you've seen Lord of War, you know that the permanent members of the UN Security Council are the biggest arms dealers in the world. We've got the Chinese developing weapons and one of these days they might decide to take Taiwan by force or invade another neighboring country. We may be called on to intervene in an Indian/Pakistan conflict. There's the Iran question.

Just because our current enemies like hiding in caves and have nothing more technologically advanced than an RPG does not mean that this is always the case. Ask André Maginot how well it works to prepare for the next war based solely on the lessons of the last one.

[Kelric]

We don't need to be an international police force. Ask the Romans how well that worked out for them.

While development is important, do we really need to be spending $680 BILLION (20% or so of our total budget) when the rest of the world COMBINED barely spends that much?

We are not God's Gift to Peace Amongst Mankind. We are one country. We should look after our own first. That does include defense. That does not include being able to obliterate mankind several times over while our own people starve, shiver and suffer.

[Kraken]

Not being American, I see nothing sacrosanct about the military.

It is our last claim to great power status, and so it will be the last thing we give up.

That does not include being able to obliterate mankind several times over while our own people starve, shiver and suffer.

We are a warrior people. We scorn the social democracies with their universal healthcare and their 6-week vacations because they are a bunch of lazy pansies.

Like it or not, if we gave up the capability to obliterate everyone else three times over we'd have fewer "friends" than those cheese-eating surrender monkeys in France. Health care is for the weak.

[Kelric]

That does not include being able to obliterate mankind several times over while our own people starve, shiver and suffer.

We are a warrior people. We scorn the social democracies with their universal healthcare and their 6-week vacations because they are a bunch of pansies.

Like it or not, if we gave up the capability to obliterate everyone else three times over we'd have fewer "friends" than those cheese-eating surrender monkeys in France. Health care is for the weak.

And we don't need them. We can provide more than enough food to feed our own country. We have enough resources to keep our population at a solid standard of living (though we can't keep growing, but we can't keep growing even with the world's resources at hand) for a while to come. Other than nuclear war and the random terrorist attack, I can't see us being at risk in any other way any time soon. Both of those are risks now anyways, and does anyone here honestly believe that our destruction of our own constitution has led us to be a safer country under Bush and Obama anyways? Our priorities are skewed, our politicians are stereotypical politicians and nothing gets done on a continual base to honestly help our own citizens.

[Arcanis]

For a competitive market that is supposed to keep costs down through competition, that doesn't appear to be happening. I thought litigation would be part of it, but someone provided stats awhile ago here that showed that malpractice insurance was only a tiny fraction of the overall cost of delivering health care.

It isn't a competitive market. The insurance companies don't have to compete with anyone outside of their state. Don't forget each state can tell insurance companies that they have to offer only Cadillac plans too. The bigger issue is one that can be expressed best by what a friend of mine told me once (he worked at an auto insurance company at the time) "The difference is that people won't make a car claim unless they have to, where as if i get the sniffles i'm going to the doctor."

Everyone expects to have the world stop because they have a runny nose. They can't deal with the fact that you get sick some times. They also forget that in the end we all die, just like everything else people never think it will happen to them. I will freely admit that me and my whole family have a colored view about medical care due to the circumstances of one of my grandfather's death. He went from a healthy rice farmer to bead ridden within 2 years and was dead another 2 after that with no explanation until after his death. I don't recall much as he first got sick shortly after i was born, i do remember being told it was something in his spinal fluid and he was only the 50th confirmed case of it ever.

[Little Raven]

You want to trim military spending? I'll listen to reasonable ideas as to where to save money and reduce waste and inefficiencies while taking care of our servicemen and -women who so rarely get the good treatment they deserve and we maintain enough R&D in areas that will preserve our ability to protect our interests and the greater world security.

I've found that whenever someone says 'I'm willing to listen, but...' and then attaches a paragraph worth of conditions, they probably aren't very willing to listen.

Everyone has their berserk button. The military is yours. Despite the fact that America spends 9 times as much on defense as the next largest spender, you always insist we can't make any meaningful cuts. That's complete puppies, and you're smart enough to know it.

Now, it's true that we can't make meaningful cuts and continue to be the world's #1 cop all around the globe, build super-jet fighters that outperform our competitors at a 10 to 1 ratio, and develop that missile shield that will no doubt be working any day now. But frankly, we probably can't keep that up anyway. It's bankrupting us - and the damage is accelerating every year. We're being played for suckers by ever more countries around the world, including most of our European pals. This simply can't continue. We can scale back easy, like Britain, or we can scale back hard, like Russia. But sooner or later we will scale back, whether we want to or not.

[AWS260]

I don't know what will happen, but I know how I feel:

I'm appalled at how many of my fellow Americans seem willing to leave the uninsured hanging out to dry, out of fear of some mythical Red Menace. Access to decent healthcare is a fundamental human right (unlike many other sacred cows in the federal budget).

God, it's frustrating.

It's not fear of a mythical Red Menace, it's a very real fear of a blank check being written to health care providers of all types.

[noxiousdog]

I don't know what will happen, but I know how I feel:

I'm appalled at how many of my fellow Americans seem willing to leave the uninsured hanging out to dry, out of fear of some mythical Red Menace. Access to decent healthcare is a fundamental human right (unlike many other sacred cows in the federal budget).

God, it's frustrating.

It's not fear of a mythical Red Menace, it's a very real fear of a blank check being written to health care providers of all types.

Why are you banging you head? Where are the cost controls in this bill?

[LordMortis]

The do-or-die date that keeps coming up lately is March 18, not even two weeks away. What do you think? Will the Dems pull it off? Or will they fail, and settle for some little Republican-friendly fig-leaf reform later on?

I don't know about the 18th but something will happen. It will cost obscene amounts of money. The democratic faithful will call it a victory. It won't do much. The republican faithful will call it a travesty. They will be right but for the wrong reasons. We will be paying obscene amounts of money for some sort of crap that is meaningless to 99.99% or more of Americans and will be distinctly not what is being called for by the vast majority who are in favor of health care reform.

Is that fail or is that success?

I would love to see Obama rally his party to do what's right instead of what's popular. But I have a hard time believing that enough of them will grow spines and risk their job security (dubious as it is anyway).

I still don't know what is right. But if Obama can find it, define it, and get it passed, he'll convert me again despite the tons of things I really hate about his presidency.

This could be Congress's last chance to take control of this problem for another generation. It's coming down to the wire. Will Obama even get his vote? Or will this baby-step reform die on the vine yet again?

I don't think that is the case. I think health care is much closer to destroying this country than were the crisises pointed at by either Bush or Obama's stimulus packages. The Boomers are retiring and finding the medical pensions collapsing and medicare not holding up. This is happening while the next generations are growing into medical coverages that are way worse than what they grew up with in their Boomer parents households. If we don't deal with it this year, then next year it gets worse. If we don't deal with it next year then the following year it gets worse. You either solve medical care problems or you put the country back in to stupid unsustainable running in to a brick wall growth mode, so you can hide medical costs.

[Isgrimnur]

I've found that whenever someone says 'I'm willing to listen, but...' and then attaches a paragraph worth of conditions, they probably aren't very willing to listen.

Everyone has their berserk button. The military is yours. Despite the fact that America spends 9 times as much on defense as the next largest spender, you always insist we can't make any meaningful cuts. That's complete puppies, and you're smart enough to know it.

Now, it's true that we can't make meaningful cuts and continue to be the world's #1 cop all around the globe, build super-jet fighters that outperform our competitors at a 10 to 1 ratio, and develop that missile shield that will no doubt be working any day now. But frankly, we probably can't keep that up anyway. It's bankrupting us - and the damage is accelerating every year. We're being played for suckers by ever more countries around the world, including most of our European pals. This simply can't continue. We can scale back easy, like Britain, or we can scale back hard, like Russia. But sooner or later we will scale back, whether we want to or not.

It's not a berserk button, and you're not listening to what I say. I don't like people indiscriminately attacking an area of the economy that I happen to have ties to. I won't debate with people who obviously aren't interested in one. I have that issue with any topic.

You want cuts? Let's start with the "Extra" F-35 engine. The Pentagon and mmilitary don't want it, but Congress won't let them kill it.

The Air Force is flying Bombers that were new before Vietnam. The tanker fleet is over 40 years old. The M1 Abrams is 30 years old. How old was your last car when you got rid of it? As the video shows, other technologic powers aren't ceasing weapons development. Again, these weapons and aircraft may be sold to people involved in the next regional conflict. When we went into Iraw the first time, they were flying Tupolev Tu-22s, MiG-25s and Mig-29s.

The Romans weren't interested in policing the world, they were interested in subjugating and ruling it. On the world stage, we will either be hated because we go to help or hated because we do not help. Either way will lead to people seeking us out to target us. The UN is as close to useless as a military organization as there is. The interests of the security council are so diametrically opposed that they can't even agree to sanction rogue states when they violate previous resolutions. I feel much better living in a country that can take care of itself than have to rely on a coalition of neighbors to defend their own borders against people that want to take us down.

[Little Raven]

The Pentagon and mmilitary don't want it, but Congress won't let them kill it.

You and I have long been in agreement that the process by which military funding is handed out is in need of reform. But that doesn't mean the absolute numbers don't need to come down. They do. They need to come WAAAAY down. I'm all for cutting the extra F-35 engine. That's 2.5 billion dollars over the next 5 years. If our current spending levels hold for the next 5 years, (and we both know they won't) we'll be spending 3 trillion dollars in that time. 2.5 billion isn't a drop in the bucket....it's a drop in the ocean. We need to cut at least a hundred billion a year to really make an impact. Will that be painful? Absolutely. So will the necessary adjustments to SS and Medicare. But just because something is painful doesn't mean it isn't necessary.

As the video shows, other technologic powers aren't ceasing weapons development.

Nobody's saying we have to stop either. We just can't keep spending almost as much as the rest of the world combined. If the Russians and the Chinese weapon research can be a credible threat to us while spending 85 billion a year each, don't you think we can maybe make do with just 400 billion a year? Is that absurdly high ratio still not enough for you?

I feel much better living in a country that can take care of itself than have to rely on a coalition of neighbors to defend their own borders against people that want to take us down.

How on earth does going from spending 41% of the world's military budget to 31% translate to us being unable to defend ourselves? Nobody's saying we can't have a military. Nobody's saying we can't have the biggest, baddest, best military on the planet. We just need to tone it down a bit (say, a fifth) from the level it's at. We're a tiny percentage of the global population. We can't possibly continue to pump out almost half of the global military budget. It's literally bankrupting us.

[noxiousdog]

It's a fair argument to say that in order to wield as big a stick as we do, it's not enough to be near the other guys, it has to be completely dominate. When putting the tech ($$$) into equipment that we do, the kill ratios have to be completely weighted in our favor.

It certainly seems like you could cut back, but isn't that how global instability always starts?

[Little Raven]

It's a fair argument to say that in order to wield as big a stick as we do, it's not enough to be near the other guys, it has to be completely dominate.

Absolutely. And if we really, really pruned the military, (say, 20%...which I honestly can't imagine happening) we'd still be spending over 3 times as much as China and Russia combined. That's pretty damn dominate.

Now granted, I don't think we could cut 20% and still do everything that we currently do. But we're not going to be able to keep up what we're doing with the military, any more than we're going to be able to keep up what we're doing with entitlements. We simply can't afford it....and if we try, we'll ultimately end up like Russia. Gradually cutting back and carefully re-evaluating where our limited assets are best spent seems the more prudent course.

[LawBeefaroni]

It's a fair argument to say that in order to wield as big a stick as we do, it's not enough to be near the other guys, it has to be completely dominate. When putting the tech ($$$) into equipment that we do, the kill ratios have to be completely weighted in our favor.

I've long said that if that's the goal, it should be embraced. None of this "we don't want to be the policeman to the world." We should say, "We are the policeman, we can kick your ass, and you will get in line." And the cost of doing so should be mitigated by the economic support of grateful nations that don't have to spend double digit percentages of their GDP to defend themselves.

If we don't like that role, we shouldn't fill it.

[Little Raven]

Lawbeef makes a good point. If we start 'taxing' Europe, Japan, Taiwan, Saudi Arabia and South Korea to offset the cost of their defense, I'm up for keeping military spending levels where they are. (or even raising them, depending on the numbers)

If not, well, something's gotta give.

[Freezer-TPF-]

Protection money FTW. "Nice multinational interest you got there. Be a shame if something happened to it."