Gingrich

[germloucks]

QUOTE As a Constitutionalist I have to follow the law. The States are free to do this, the Feds cannot. The Feds can, of course, pass laws to help ease the process, but they cannot be the providers of Medical insurance (as Medicare and Medicaid should not be Federal programs either).[/quote]

I'm going to ask you a couple of questions.


1) Do you think that healthcare reform is necessary?



2) Do you think that, legality aside, the healthcare provisions were a step in the right direction?



If you HONESTLY answered yes to the above question/s, i think it allows us to find a little common ground here that should be easy to see.

I think its important to find the point along the line that people start to disagree, because i think essentially healthcare reform is absolutely necessary and the current system is fuxored. Not many people are going to disagree there, but because the issue has also been extremely polarized, its totally relevant to find where exactly people start losing stomach on the issue and work from there.



QUOTE Passing laws at the Federal level does nothing but piss off half the country, doing so at lower levels of government will ensure that their programs are more tailored for their populace rather than just a blanket nation one. Hell some states may even figure out a way to unify the system without really doing much in the way of regulations.[/quote]

Well, we arent dealing with a local or geographical issue. We are dealing with a national issue. I think it makes total sense to propose national solutions to national problems. Plus, can you imagine the chaos in the system when each state starts making its own healthcare reform? I think that sort of nightmare scenario is exactly why we have public utilities and such. Services as important and vital to the people shouldnt just be allowed to be governed by the whims of a boom-bust market.

We decided a long time ago it didnt make sense to let 8 power companies run lines all throughout your neighborhood, or 10 phone companies all trying to hook wires up to your house, or 5 different road companies all charging for access to their highways and such. Can you imagine having to buy a pass that allowed you on certain highways but not others? Thats what free-market capitalism gets you in those kind of scenarios and its exactly why it makes sense to make healthcare a public trust as well.

Yep, i said it.

Heatlhcare should be a public trust, just like utilities and transportation. Take the extreme profit out of the system, and by proxy solve a great many problems at the same time.


Healthcare should not be a for-profit venture, it just ends up screwing the consumers in the end.



Include the price of healthcare in taxes people pay.... this does several things at once.


1) eliminates employer contributions to healthcare and benefits incentives, saving companies tons of cash (job creation)

2) allows public control and decision making on healthcare, allowing us to pool resources/eliminate subsidies and regulate.

3) allows us to reign in drug companies.

4) allows us to offer tax incentives on preventative healthcare and "healthy living" IE: charge less for insurance for people who arent overweight and dont smoke/chew/drink excessively

5) We can ELIMINATE medicare/medicaid!!!!!

6) other things i havent come up with yet, because im not smart enough

[Camaro]

QUOTE (germloucks @ Dec 6 2011, 05:44 PM) I'm going to ask you a couple of questions.


1) Do you think that healthcare reform is necessary?

Of course, our cost of healthcare is much higher than that of the rest of the world, driven by high medical inflation. This is an issue other countries have as well, though, but their rates are still low enough where it isn't quite as huge of an issue... yet...

2) Do you think that, legality aside, the healthcare provisions were a step in the right direction?

Some parts, as I've said before I dig the ACO and the private exchanges that are allowed/promoted. However, the bill was way to complex and essentially just had every single freaking idea thrown into it. It isn't cohesive and will probably work against itself in some aspects. However, its key provisions - Individual Mandate and expansion of Medicaid are outside of the scope of the Federal Government.

If you HONESTLY answered yes to the above question/s, i think it allows us to find a little common ground here that should be easy to see.

I think its important to find the point along the line that people start to disagree, because i think essentially healthcare reform is absolutely necessary and the current system is fuxored. Not many people are going to disagree there, but because the issue has also been extremely polarized, its totally relevant to find where exactly people start losing stomach on the issue and work from there.




Well, we arent dealing with a local or geographical issue. We are dealing with a national issue. I think it makes total sense to propose national solutions to national problems. Plus, can you imagine the chaos in the system when each state starts making its own healthcare reform? I think that sort of nightmare scenario is exactly why we have public utilities and such. Services as important and vital to the people shouldnt just be allowed to be governed by the whims of a boom-bust market.

I agree, however, on issues such as these, the law is the law. Would you rob someone to save another? Its morally ambiguous at best. However, with the States we have no such issue unless it is against that States Constitution.

We decided a long time ago it didnt make sense to let 8 power companies run lines all throughout your neighborhood, or 10 phone companies all trying to hook wires up to your house, or 5 different road companies all charging for access to their highways and such. Can you imagine having to buy a pass that allowed you on certain highways but not others? Thats what free-market capitalism gets you in those kind of scenarios and its exactly why it makes sense to make healthcare a public trust as well.

The free market promoted the rail as a means of transportation and travel because it was the most efficient. BIG GOVERNMENT & the Military-Industrial Complex promoted the highway system (with no small push from automakers of course - but I digress).

Public utilities are hardly models of efficiency. A system where the STATE/LOCAL government controlled the lines and companies could establish power plants and pay small use fees or something would be better, IMO.

Lastly, entities such as CalPERS and Medicare/Medicaid are essentially public trusts. When Medicare/Medicaid make cuts, or small increases, they shift the costs to the Commerical sector and now entities such as CalPERS (which is the 2nd largest provider of health benefits after the Federal Government - I believe) have to have a larger increase to make it up. Whose fault is that? It doesn't make sense to blame the insurers, whose only other option would be to kick X provider out of their network to save costs... but that leads to "MMAAHHH CHHOOIICEEEEEEEEEEEEE... DAMN GOVERNMENT/INSURERS TELLING ME WHO I CAN AND CAN'T GO TO!!!!!1111oneone"

Yep, i said it.

Heatlhcare should be a public trust, just like utilities and transportation. Take the extreme profit out of the system, and by proxy solve a great many problems at the same time.


Healthcare should not be a for-profit venture, it just ends up screwing the consumers in the end.

Perhaps, but being for-profit or non-profit at the insurer level is irrelevant as they have to compete against one another. What is the issue is hospitals and providers of medical services, are they encouraged by the Fee-For-Service (FFS) system used by private and public insurers? Sure... but that cannot be the only cause because even non-profit closed systems like Kaiser Permanente (competitive in cost and better in quality when compared to the NHS of Britain) still experiences quick increases in rates. Our symptoms must be more deeply rooted in cultural causes.

Include the price of healthcare in taxes people pay.... this does several things at once.


1) eliminates employer contributions to healthcare and benefits incentives, saving companies tons of cash (job creation)

Increases cost of living for its employees, they will have to pay more for their employees - while they will ultimately see more savings than costs, this is a bit misleading. I agree with you on its face value however.

2) allows public control and decision making on healthcare, allowing us to pool resources/eliminate subsidies and regulate.

System is already ludicrously regulated by both private and government entities, hell even private systems use damn near communist era algorithms to determine their fee schedules. The market can pool its own resources when allowed... as evidenced by the large interest in PRIVATE exchanges that are allowed in Obamacare (a perfect example of how they just threw every single idea into the bill)

3) allows us to reign in drug companies.

What are we going to do against the German pharma giant Merck? The Pharmacy Benefit Management companies already have the capability to fight this, but they won't because CONSUMER OUTCRY will be immense. "YOU CANT TELL ME WHAT DRUG TO TAKE!"

4) allows us to offer tax incentives on preventative healthcare and "healthy living" IE: charge less for insurance for people who arent overweight and dont smoke/chew/drink excessively

You suggest additional spending on an item when less spending is more appropriate. What better way to get rid of unhealthy foods than to END THE GOD DAMN CORN SUBSIDIES AND OTHER FARM SUBSIDIES. Make food cost more, people eat less. People eat healthier because they can't get their $1 McDonalds Corn-Fed Beefburgers.

Also, "OH YOU CANT TELL ME HOW TO LIVE MY LIFE!!!!!!!!!1111oneone"

5) We can ELIMINATE medicare/medicaid!!!!!

YAY!!!! My proposed state led venture can as well.

6) other things i havent come up with yet, because im not smart enough

Responses in bold

[Sundance_]

Lets not forget that in talking about health care and health care reform.......



MEDICALE MALPRACTICE REFORM!!!!!


Limit judgements...

say... 30k in non-injury,
300k in serious injury,
under.... ~3 million in wrongful death lawsuits.




Medical Malpractice reform would DRASTICALLY reduce healthcare costs...
but NOT ONE F*CKING POLITICIAN WANTS IT 'CAUSE THEY'RE ALL CROOKED $#@!ING LAWYERS THEMSELVES


/endrant

[Sundance_]

Just the fact that an ENTIRE healthcare reform bill was passed without ONE F**KING WORD about malpractice reform in the ENTIRE bloated clusterf*ck shows that the goverment isn't smart enough to be trusted with healthcare.

[Camaro]

QUOTE (Sundance_ @ Dec 6 2011, 07:35 PM) //really big letters here//

Malpractice reform is a part of Obamacare, it gives funds to the various states to investigate and come up with malpractice reforms.

Like I said Obamacare has just about every single freaking idea thrown into it. Its too monstrously huge and unfocused.

[Sundance_]

QUOTE (Camaro @ Dec 6 2011, 10:38 PM) Malpractice reform is a part of Obamacare, it gives funds to the various states to investigate and come up with malpractice reforms.

Like I said Obamacare has just about every single freaking idea thrown into it. Its too monstrously huge and unfocused.

Oh?

That's a bull@#(! cop-out so the lawyers that passed the bill don't have to cut the legs out from under their ambulance chaser friends.

[Jimen]

QUOTE (Raveen @ Dec 6 2011, 11:21 AM) Speaking as a pinko leftie liberal, wouldn't it be a good idea for the republicans to nominate a centrist candidate in the hope of attracting swing voters rather than someone who appeals to the grass roots (who will vote republican anyway)?

I've seen the same mistake made by opposition parties in the UK over the last 30 years and it makes for poor democracy as you have a 2 party system with 1 unelectable party.

The Republican grassroots won't vote Republican anyway, that's the problem. After eight years of Bush followed by an economic meltdown, the right wised up to the fact that Republican politicians were taking their votes for granted and not giving them what they wanted, so they rebelled. In many places, relatively new Republicans who had clean enough records to change their political persona jumped on the Tea Party bandwagon and pulled those votes back into the Republican fold, but in others, radical candidates from third-parties such as the Constitution Party almost unseated Republican incumbents with challenges from the right! By threatening to abandon the Republican boat, the so-called "fiscal conservatives" have gotten more of what they wanted during three years of Obama than they got from eight years of Bush.

Right now, it's the Democratic grassroots that are falling in line while their candidates trend right to grab conservative swing votes. Well, that's how it was in 2008 and 2010, anyway. Occupy is a sign that the left is now the ones getting fed up!

[Duckwarrior]

QUOTE Kaiser Permanente (competitive in cost and better in quality when compared to the NHS of Britain)[/quote]

This is interesting. Could you link me to a source please?

[Lindy_Hop]

@Sundance.

Medical malpractice tort reform by the numbers is a stupid boogey man political issue and not an actual cost saver. I actually took a class that covered the matter in detail a couple years back and here is the simple English report you want to read if you would like to educate yourself on the matter.

http://www.citizen.org/documents/NPDB_Report_200907.pdf

The TLDR summary with spin removed. Malpractice premiums and payouts constitute less than 1% of healthcare costs and payouts, are not responsible for the rise in healthcare costs, and are generally made on a rational basis with the biggest awards going to the worst injuries.

The source does downplay that with healthcare cost so high, even cutting a fraction of a 1% to a smaller fraction of 1% is some nice savings. But really, this is not a magic bullet to reign in costs by any means. The source also has an axe to grind with preventing common medical errors so be aware that they have spin directed that way. They do make a relatively compelling case in other papers that the money that could be saved by taking proper steps to prevent these common errors would save multiple times the money tort reform would save.

[germloucks]

Camaro, despite your objections being too numerous and off topic to adequately address, a unifying theme seems to be that the states can do what the fed can;t (and shouldnt)


Do you really believe the states will see the need, find the money, and find the votes to pass meaningful healthcare reform? Even if ONE STATE (MA) did it, what makes you think that the majority (or even a small minority) could ever expect to see those benefits. ESPECIALLY with the cash-strapped budgets the states are facing.

I feel like you keep kicking the can down the road with no real solutions here. Let the states deal with it, in my opinion, is a cop out. Essentially, they wont, and really dont have an incentive to. The people expect the FED to fix the healthcare system, not the states. Although you may feel/act very libertarian, most people blame the president and the congress when problems hit... not their state legislature. Who can even name one freakin person in their state legislature? I know i cant, and dont bull@#(! me and say that you do just for the sake of argument. The Fed is where the impetus for change is being focused. For good or ill.

And you still havent explained why the interstate commerce clause, and general welfare cause arent good enough constitutional justifications either. I know you can give me a very conservative interpretation worthy of Glen Beck, but can you really give me something meaningful and mainstream that HONESTLY has some depth and weight? I dont want to hear some partisan crap, i can watch Fox news for that.

If you want to start the discussion of the bill with a prior assumption that its not even legal in the first place, please do tell.


I am, however, very interested to see how the supreme court is going to rule in 2012 on this issue. More interesting than the decision itself is going to be the rationale, as that is going to have a HUGE influence on the interstate commerce/general welfare clause in the future.


EDIT:

In fact, expecting the states to handle healthcare in terms of cost/availability/effectiveness is a total denial of reality, in my opinion. But i challenge you to show me a way that it WOULD work, then show me how that is going to get passed in any state legislature. You criticize Ron Paul for proposing good, but unpassable ideas. Lets see you come up with something effective, AND politically viable.

My ideas only need to be passed once, yours need to be passed 50 times.