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Paul Pless
11-07-2012, 04:28 PM
So what do you think might get cut out of the Patient Protection and Affordable Care Act as part of the forthcoming negotiations?

Who flinches first?

ccmanuals
11-07-2012, 04:34 PM
Nothing. It is law. I think the President is holding all the cards. In spite of the blustering by Boehner, McConnel and Cantor they will have to cave. I think they see the handwriting on the wall (at least I would hope they do) that the Amercian people are tried of the obstructionism. You would think McConnel would have at least got the word since he lost 6 seats.

Paul Pless
11-07-2012, 05:01 PM
Nothing. It is law.Obamacare is not exempt from the mandatory across the board cuts, should sequestration be the ultimate solution. . .

Ian McColgin
11-07-2012, 05:41 PM
NOTHING out of "Obamacare."

Health care costs were driving the real content of impossible private and public expenditures. There was no solution to our economic disaster without first containing insurance industry profits.

John Smith
11-07-2012, 06:33 PM
Nothing. It is law. I think the President is holding all the cards. In spite of the blustering by Boehner, McConnel and Cantor they will have to cave. I think they see the handwriting on the wall (at least I would hope they do) that the Amercian people are tried of the obstructionism. You would think McConnel would have at least got the word since he lost 6 seats.

According to what McConnell said this evening, he didn't get that memo.

Republicans who might want to compromise still live in fear of primary challenges. The Tea Party record on winning primaries is pretty good.

John of Phoenix
11-07-2012, 07:16 PM
Just wait until the Amercian people experience the full brunt of Obamacare and everything it entails.Yeah, there will be no turning back.

BTW, you being a true patriot and all, I'm sure you'd want to know that you misspelled "American".

mikefrommontana
11-07-2012, 07:26 PM
Well, if the Bush tax cuts are allowed to expire, would that indicate that the Republicans raised taxes--by failing to keep them from increasing? IOW, would every person that signed the pledge with Norquist have broken that pledge by letting the tax cuts run out? If so, would they then no longer be beholden to Grover Norquist?

No; I'm sure they'll spin their way to stay under Grover's thumb, but an out does present itself for some enterprising politicians who may have signed the pledge.

Gerarddm
11-07-2012, 08:32 PM
Harry Reid says he doesn't want to kick the can down the road.

One has to wonder at the effrontery of Republicans, who MADE THE SEQUESTRATION DEAL, and now want to welch on it. Nice. Abe Lincoln's father supposedly said words to the effect that if you make a bad deal, that's the one you have to hug all the harder.

Man up, McConnell.

TomF
11-07-2012, 08:43 PM
First thing I'd cut from Obamacare would be the Death Panels.

Shang
11-07-2012, 08:45 PM
You are mistaken. The American people elected them specifically to put the brakes on Obama's agenda. Just wait until the Amercian people experience the full brunt of Obamacare and everything it entails.

Hold onto your hats.....

Where exactly did you personally experience a similar health care system, that gave you such clarity of vision and predictive ability? I don't think you know what you are talking about.

Did you just see it on Fox News or hear it from Rush?

mdh
11-08-2012, 02:11 AM
First thing I'd cut from Obamacare would be the Death Panels.

That would be humane, but hardly practical. There's only so much money, and only so many doctors, and all these data processors. Decisions will have to be made.

We just elected two new rep's, their campaign platform? Repeal Obamacare.

mdh
11-08-2012, 02:15 AM
Where exactly did you personally experience a similar health care system, that gave you such clarity of vision and predictive ability? I don't think you know what you are talking about.

Did you just see it on Fox News or hear it from Rush?

If you'll excuse my hitchhiking in here, I'll tell you I did have a conversation with a Canuck who said "to hell with the gov't health care, if we want something done, we go black market, cash, no waiting."

Lew Barrett
11-08-2012, 02:24 AM
We just elected two new rep's, their campaign platform? Repeal Obamacare.

I'd be surprised if they were successful in their primary mission.

mdh
11-08-2012, 02:29 AM
Where exactly did you personally experience a similar health care system, that gave you such clarity of vision and predictive ability? I don't think you know what you are talking about.

Did you just see it on Fox News or hear it from Rush?

If you'll excuse my hitchhiking in here, I'll tell you I did have a conversation with a Canuck who said "to hell with the gov't health care, if we want something done, we go black market, cash, no waiting."

mdh
11-08-2012, 02:31 AM
I'd be surprised if they were successful in their primary mission.

One of them mentioned funding for the 16K new IRS agents.

TomF
11-08-2012, 06:40 AM
If you'll excuse my hitchhiking in here, I'll tell you I did have a conversation with a Canuck who said "to hell with the gov't health care, if we want something done, we go black market, cash, no waiting."And as a Canadian health care planner, I say great. Universal health care is, unhm, all but universally perceived up here as the single most important, and most desired service provided by Government. If a few want to buy their own care to get faster "customer service," fine. They're paying twice ... as they don't get a tax refund. And by not taking a spot in the public system, they're freeing up a space for someone else who hasn't the opportunity to make the same choice.

As incredibly rare as it is that folks do as your acquaintance said, you'd notice almost nobody opts out of our system when it comes to the truly high cost services. Or maybe you wouldn't.

TomF
11-08-2012, 06:47 AM
That would be humane, but hardly practical. There's only so much money, and only so many doctors, and all these data processors. Decisions will have to be made.Tone is so hard to follow, without cues like "smilies."

There are, to my knowledge, no "death panels." That's why I think they should be cut first. You're confusing the type of triage that all systems use, with something akin to what happened in Nazi experimentation camps.

Flying Orca
11-08-2012, 08:21 AM
If you'll excuse my hitchhiking in here, I'll tell you I did have a conversation with a Canuck who said "to hell with the gov't health care, if we want something done, we go black market, cash, no waiting."

Funny - I've lived in Canada for forty-five years and never heard of black market health care. I call BS.

Ian McColgin
11-08-2012, 09:50 AM
It's not black market. Just off the national plan free market. The market forces drive the prices down such that there are some proceedures where for US patients it's cheaper to pay the clinic in Montreal than to deal with the incredible co-pays and ancillary uncovered costs of some older US insurance plans.

The totality of health care costs - insurance inefficiencies (includes malpractice as well as customer costs) and rampant over-capitalization of private hospitals and semi-hospital clinics and excess numbers of high cost specialists compared to GPs - has been a huge drain on the GDP. We could not get control of the economic free-fall triggered by decades of Wall Street malfeasance without also getting a grip on health care finance. ObamaCare is a bare start and there's much more to be done. ObamaCare contributes significant savings at the national level, which is why both Obama and the R's could propose the same dollar number for Medicare but with ObamaCare it's savings at no loss of service while the Republican plan was quite bluntly and honestly written as diminished service. ObamaCare is already part of the solution.

The major part of the solution will be if the R's do what Boehner has said is not on the table - to wit repudiate the Norquist pledge. When Boehner said yesterday that the pledge still holds, he was actually saying that he is not in a position to bring any level of compromise to the table. He was admitting while trying to hide it that the Republicans remain the party of no compromise, the party of NO.

Concordia 33
11-08-2012, 10:08 AM
So what do you think might get cut out of the Patient Protection and Affordable Care Act as part of the forthcoming negotiations?

Who flinches first?

No more kicking the can down the road. Lets have a full budget (for the first time in a few years) or go into sequestration. No more temporary measures. You can run a government on extensions and temporary measures. If the Dems and the GOP hate Sequestration so much than maybe it will force them to actually do their jobs and enact a real budget.

Ian McColgin
11-08-2012, 10:18 AM
For those who believe the right wing myth but are willing to actually study the issue, start with:

CBO: ‘Obamacare’ cuts deficit
By Jay MacDonald Bankrate.com
Tuesday, July 31, 2012
Posted: 10 am ET

You may have seen a few election-year TV ads that claim President Obama's landmark health care reform, aka "Obamacare," will add "trillions" to the federal deficit.

Turns out they're off by, well, trillions.

The latest estimates from the nonpartisan Congressional Budget Office indicate the Affordable Care Act will actually cut rather than increase the national debt over the next decade.

In its first budget projections since the Supreme Court upheld most of the health care reform law last month, the CBO adjusted its cost estimate down slightly to reflect the one provision of the ACA that the court struck down: the requirement that states expand Medicare to provide health insurance to lower-income residents.

Since states now have the option to accept or reject the government's offer to pay 100 percent of the initial cost to expand Medicaid, the CBO estimates that 3 million fewer Americans than previously expected will gain health insurance coverage under health care reform.

As a result, taxpayers will save about $84 billion between 2012 and 2022, when an additional 30 million Americans will have been added to the health insurance pool.

While the CBO offered no exact estimate on how much health care reform will shrink the federal deficit, it said that the law's spending cuts and tax increases would more than compensate for the federal outlay to cover the uninsured.

As for those efforts in Congress to repeal the Affordable Care Act? The CBO estimates they would boost the federal deficit by $109 billion between 2013 and 2022.



Read more: CBO: ‘Obamacare’ cuts deficit Bankrate, Inc. http://www.bankrate.com/financing/insurance/cbo-obamacare-cuts-deficit/#ixzz2Be1sFPpN

ccmanuals
11-08-2012, 10:41 AM
You could fill in those gaps in your knowledge by doing a little googling for "Independent Payment Advisory Board". It will require some thought on your part to understand the potential 2nd and 3rd order effects of the authority this board has been given.

seems like a good thing to me.


IPAB is tasked with developing specific proposals to bring the net growth in Medicare spending back to target levels if the Medicare Actuary determines that net spending is forecast to exceed target levels, beginning in 2015.
According to official records, the proposals made by IPAB should not include any recommendation to ration health care, raise revenues or increase Medicare beneficiary premiums, increase Medicare beneficiary cost sharing (deductibles, coinsurance, or co-payments), or otherwise restrict benefits or modify eligibility criteria.[10] (http://forum.woodenboat.com/#cite_note-10) The Department of Health and Human Services (http://forum.woodenboat.com/wiki/Department_of_Health_and_Human_Services) (HHS) must implement these proposals unless Congress adopts equally effective alternatives. The board is also required to submit to Congress annual reports on health care costs, access, quality, and utilization. IPAB must submit to Congress recommendations on how to slow the growth in total private health care expenditures.[11] (http://forum.woodenboat.com/#cite_note-Jost-11)
Every year on September 1, IPAB must submit a draft proposal to the Secretary of Health and Human Services. On January 15 of the next year IPAB must submit a proposal to Congress. If IPAB fails to meet this deadline, the HHS must create its own proposal. Congress must consider this proposal under special rules. Congress cannot consider any amendment to the proposal that does not achieve similar cost reductions unless both houses of Congress, including a three-fifths super majority in the Senate, vote to waive this requirement. If Congress fails to adopt a substitute provision by August 15, HHS must implement the proposal as originally submitted to Congress.[11] (http://forum.woodenboat.com/#cite_note-Jost-11)
With regard to IPAB's recommendations, the law says "The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and co-payments), or otherwise restrict benefits or modify eligibility criteria."[12] (http://forum.woodenboat.com/#cite_note-12)

Shang
11-08-2012, 11:28 AM
I've lived in three different countries besides the US (Belgium, UK and Hong Kong) and traveled extensively to many others. How about you?

What are you so angry about? Can't we have a discussion without you folks getting so cranky?

Angry? Cranky? Naugh, it's just that I grew up on a farm...


You are mistaken. The American people elected them specifically to put the brakes on Obama's agenda. Just wait until the Amercian people experience the full brunt of Obamacare and everything it entails.
Hold onto your hats.

...and I get emotional when I hear a jackass.

Other countries? I've lived in, or traveled in: India, Canada, France, England, Belgium, the Netherlands, Czechoslovakia (before the Czech Republic), Yugoslavia (before it was reshuffled), Germany, Austria, Switzerland, Italy, Greece, and a few others I may have forgotten.

However, the issue is the Affordable Healthcare Act. I find it difficult to believe that, "the American people elected them to put the brakes on Obama's agenda," in light of the U.S.'s low standing on public health care.

(Reuters) - Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.

The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.

"As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it," Commonwealth Fund president Karen Davis told reporters in a telephone briefing.

http://www.reuters.com/article/2010/06/23/us-usa-healthcare-last-idUSTRE65M0SU20100623

wardd
11-08-2012, 11:48 AM
the american people at large don't elect representatives, that is done in local well selected constituencies

so yea it may be possible that a few loonytoons elect representatives to do that

John Smith
11-08-2012, 11:55 AM
You are mistaken. The American people elected them specifically to put the brakes on Obama's agenda. Just wait until the Amercian people experience the full brunt of Obamacare and everything it entails.

Hold onto your hats.....

We've passed lots of "brunts" of Obamacare. So far they've all been good. Which bad ones do you believe are still coming? You guys are like the boy who cried, "Wolf" on in the story there was a wolf. Where's the wolf here?

John Smith
11-08-2012, 11:57 AM
Harry Reid says he doesn't want to kick the can down the road.

One has to wonder at the effrontery of Republicans, who MADE THE SEQUESTRATION DEAL, and now want to welch on it. Nice. Abe Lincoln's father supposedly said words to the effect that if you make a bad deal, that's the one you have to hug all the harder.

Man up, McConnell.

How many members of Congress tell us they don't want to kick paying the debt down the road, but don't want to ask anyone to pay more taxes to prevent doing just that?

wardd
11-08-2012, 11:59 AM
That's fine by me.

When the Tea Party wins in the Primaries, the Democrats win the election.

Craziness appeals to some, but it doesn't have broad appeal.

that may hold true for the senate but not the house

John Smith
11-08-2012, 11:59 AM
One of them mentioned funding for the 16K new IRS agents.

That was another lie. Can't cut agents that aren't there.

John Smith
11-08-2012, 12:04 PM
Can you expand on this? Which insurance companies do you believe are "too profitable" and what should be done to fix this "problem"?

I could explain it, but you'll not listen. A couple of things: the great bulk of the money being cut from Medicare comes from the taxpayer overpayment legislated into the Part D program. This is language in the ACA to encourage lower costs and lower premiums. Based on my personal experience, it is working. My private Blue Cross premiums whent down $1 a month last year and are increasing only $3 a month next year.

The CBO scored the overall health reform as SAVING MONEY. That's because it costs you, as a taxpayer, less to have people insured so they go to a doctor rather than not insured and go to the ER.

Since this ACA was first proposed, Republicans have told us many things we should hate about it. So far, not a single one of those things they told us have been true.

You really need to find new sources of data.

John Smith
11-08-2012, 12:07 PM
No more kicking the can down the road. Lets have a full budget (for the first time in a few years) or go into sequestration. No more temporary measures. You can run a government on extensions and temporary measures. If the Dems and the GOP hate Sequestration so much than maybe it will force them to actually do their jobs and enact a real budget.

Don't bet on it. Car insuance in NJ is hated by the drivers, the insurance companies, and the doctors. There is no group fighting for the status quo, but we can't get it changed.


As to our coming cliff, I hope the democrats don't blink.

John Smith
11-08-2012, 12:08 PM
That's fine by me.

When the Tea Party wins in the Primaries, the Democrats win the election.

Craziness appeals to some, but it doesn't have broad appeal.

The problem is those would be sane Republicans fear the primary they'll lose.

Osborne Russell
11-08-2012, 12:14 PM
First thing I'd cut from Obamacare would be the Death Panels.

That's right, go ahead and ignore the War On Christmas.

Osborne Russell
11-08-2012, 12:22 PM
You are mistaken. The American people elected them specifically to put the brakes on Obama's agenda. Just wait until the Amercian people experience the full brunt of Obamacare and everything it entails.

A remarkable conception.

1. They were not elected by the American people.
2. The purpose of the people who did elect them, whatever it might have been, is irrelevant to what powers they possess, and what powers are forbidden them.
2. Executing the law is "on the President's agenda" in the sense that it is his sworn duty.
3. The only legitimate way the Congress can "put the brakes on", or do anything at all, is by legislating. Anything else is a usurpation of power and a violation of their oaths.

Flying Orca
11-08-2012, 02:42 PM
Why won't you people stop lying?

Oh, oh, I know the answer to that one: 'cause fear, hate, and lies are all they've got.

Tom Hunter
11-08-2012, 02:53 PM
@Ian "Health care costs were driving the real content of impossible private and public expenditures. There was no solution to our economic disaster without first containing insurance industry profits."

Health insurance profits are equal to a tiny fraction of healthcare expenditures. You can't fix a problem if you can't correctly identify it. If all the health insurers immediately gave their profits back to patients it would do almost nothing.

As for the sequester, I think Obama has all the cards. If nothing happens he gets a tax increase and budget cuts, and likely a recession, but maybe not. Then the economy recovers and he gets three years with smaller budget deficits, higher tax revenue and a better fiscal situation. Ronald Reagan did that in 1980, we had a steep recession and by the time the election came around in 1984 we were booming.

The Republican house boxed themselves in with the fiscal cliff, and all thier choices are bad. Obama really can't lose at this point.

mdh
11-08-2012, 07:20 PM
Why won't you people stop lying?

It's just not true. And worse yet.... it's so easy to check.

http://www.factcheck.org/2010/03/irs-expansion/



Don't say stuff that isn't true!

Yet.

ccmanuals
11-08-2012, 07:34 PM
Yet.

Ol lonesome Glen says it's true so it must be! Right mdh. :)

John Smith
11-08-2012, 07:37 PM
@Ian "Health care costs were driving the real content of impossible private and public expenditures. There was no solution to our economic disaster without first containing insurance industry profits."

Health insurance profits are equal to a tiny fraction of healthcare expenditures. You can't fix a problem if you can't correctly identify it. If all the health insurers immediately gave their profits back to patients it would do almost nothing.

As for the sequester, I think Obama has all the cards. If nothing happens he gets a tax increase and budget cuts, and likely a recession, but maybe not. Then the economy recovers and he gets three years with smaller budget deficits, higher tax revenue and a better fiscal situation. Ronald Reagan did that in 1980, we had a steep recession and by the time the election came around in 1984 we were booming.

The Republican house boxed themselves in with the fiscal cliff, and all thier choices are bad. Obama really can't lose at this point.

To put this is more simple terms: Healthcare is 1/6 of our economy. Our healthcare system was broken. How are we to fix the economy if we leave 1/6 of it broken?

John Smith
11-08-2012, 07:42 PM
Yet.

Let me repeat my challenge that no one seems to wish to respond to. Go back to '92 and Whitewater, which Starr CLEARED both Clintons in. Go to the '93 budget that all the Republcans voted against and warned it would destroy our economy. Recall the Republcans all telling us that they would not impeach Bill Clinton if Starr's report only contained Monica. FF to the WMD's, the "yellow cake", the origin of the Mission accomplished banner, the oil paying for the war, that we wouldn't use our military for nation building, or any item of your choice and show me a single thing the Republcians have presented as a matter of fact or predicted as an outcome that has turned out to be true.

I ask this because I cannot think of one. Not one. They have been wrong/lying continually for at least 2 decades.

So far, everything they've predicted about the ACA has proven false or wrong.

skipper68
11-08-2012, 07:48 PM
Snuck outa my politics bunker- Geez..http://i1135.photobucket.com/albums/m622/cvan6856/387838_4258814626163_1003657178_n.jpg

Keith Wilson
11-08-2012, 10:15 PM
As for the sequester, I think Obama has all the cards.Exactly. All he has to do with the House Republicans is smile and say "no" until his tongue bleeds.

George Jung
11-08-2012, 10:31 PM
A poll - how many believe ol' numbnutz and mdh actually believe the crap their posting, vs just doing a lil' trolling? (or.... how stupid?)

Cuyahoga Chuck
11-08-2012, 11:42 PM
Wha' happen to PLess? He ducked out on his own thread at post #3 and hasn't been back since!

Durnik
11-09-2012, 01:16 AM
Angry? Cranky? Naugh, it's just that I grew up on a farm...



...and I get emotional when I hear a jackass.



Priceless! ;-)

enjoy
bobby

John Smith
11-09-2012, 06:49 AM
I think party loyalty overcomes logic for far too many voters.

Flying Orca
11-09-2012, 08:21 AM
Health insurance profits are equal to a tiny fraction of healthcare expenditures. You can't fix a problem if you can't correctly identify it. If all the health insurers immediately gave their profits back to patients it would do almost nothing.

This could be true, as far as it goes, but it does not address the fact that a multi-payer, insurance-based scam - sorry, scheme - adds huge overhead costs required to run the insurance companies themselves, and to comply with their paperwork requirements. Don't take my word for it, look it up.

George Jung
11-09-2012, 08:38 AM
Perhaps Mr. Hunter can identify for us all - since American expenditures per capita for healthcare is 2X more, give or take, than what other countries with NHC spend (and with better outcomes) - where's the divergence? Where are those 'extra' dollars going?

Tom Hunter
11-09-2012, 10:04 AM
Flying Orca has a very important part of it: administrative expenses. Ian did not, because the corporate profits are not that big a number. This graph shows a total of $750 billion in waste:

http://cdn.theatlantic.com/static/mt/assets/food/chart_1-3.png


Its from an article in the Atlantic, published on Sept 7 2012. The most recent profit figure I could find in a quick web search was $12 billion across all health insurers in 2009. The Kaiser family foundation puts US healthcare spending at a total of $2.6 trillion in 2010.

I'm not defending the health insurance companies or thier profits. I'm just saying that $12 billion is a tiny fraction of $2.6 trillion if you focus there you are not going to accomplish much. If you focus on unnecissary care and stop a small fraction of it you will easily save more than $12 billion.

For example we might all be better off if we offered the health insurers and increased profit if they could cut the administrative waste from its current $180 billion down to $120 billion. We might also tell them that if it stays at $180 billion we will cut thier profits to $6 billion, or perhaps cut Aetna's CEO pay from $tens of millions to single digit millions.

Regardless of what we do, we will not do the right thing if we fail to understand what drives the huge waste of money in our healthcare system.

Keith Wilson
11-09-2012, 10:06 AM
You mean 2.6 trillion, I presume? The ACA has statutory limits on administrative expenses; a good start, but not enough.


Where are those 'extra' dollars going?That's the $1 trillion dollar question, and you'd think the answer would be well-known, and would be front and center in any discussion of US heath care. I think we'd better find out. A fair percentage is administrative expenses, both insurance companies and heath care providers, all the effort that goes into getting paid and dealing with hundreds of different private insurance firms, each with their own procedures.