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On April 18 2016 23:44 Mohdoo wrote:
Predictions for today's immigration ruling? I think it's gonna go 4-4.
Do you mean the one on Obama's executive actions expanding DACA and DAPA? I think they are just doing hearings today, the decision won't be released until later in the summer.
I predict 5-3 though, with Roberts joining the liberals to throw out the case for lack of standing because:
1. Roberts really cares about the prestige of the Court, and a 4-4 split looks bad for them.
2. A 4-4 split could lead to a circuit split on the issue which would be a huge mess.
3. If the states have standing to sue in this case, it basically means that states can sue the federal government over pretty much any policy they don't like, which will clog up the federal courts, and make them even more political.
4. Deciding the case on lack of standing will allow Roberts to avoid these issues, without directly expanding the powers of the executive.
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United States42960 Posts
On April 18 2016 08:51 ticklishmusic wrote:Show nested quote +On April 18 2016 07:33 Ghostcom wrote:1) Why would the pay for a physician be lowered? A lot of the extra costs by having multiple payers is due to administration, not physician pay. There was an excellent article in TIME a couple of years ago about this exact issue. 2) I sincerely doubt physicians retire because ICD-codes are updated - and it's kind of a null-point, because that is going to happen regardless of whether or not you go universal healthcare or not. 3) Most MDs didn't become MDs to make money. If money was everything MDs would either not work in a practice/hospital but for the industry, or they would have taken another education. That is not to say that money doesn't matter - we all like to be compensated for long/shitty hours. 4) 10+ years of medical education is the norm for a specialist, regardless of country. What you are highlighting is that it is not only the US healthcare system that has issues, but also the US educational system. EDIT: On April 18 2016 07:30 cLutZ wrote:
Also, if you do 1:1 comparisons of Swedes in America, Germans, etc the QOL and healthcare outcomes are comparable or in America's favor.
As Milton Friedman once said, "That’s interesting, because in America, among Scandinavians, we have no poverty, either."
Out of curiosity would you mind linking some data for this? I do think you are correct, I could just use this for a presentation I'm working on  I think the explanation is extraneous to the healthcare system though. EDIT2: The lack of doctors is going to be an issue in all healthcare systems due to retirement and the increasing age of the population. It's really not an argument against universal healthcare. EDIT3; Don't get me wrong, I don't consider a universal healthcare system to be feasible in the current US political and social environment. 1. Insurers already have a medical loss ratio, so they have to spend 85%+ of premiums on care. The efficiencies that can be realized here are relatively small. Single payer's big cost savings would come from negotiating down price on basically every procedure. Less money in means less money for physicians.
You're assuming that there are no intrinsic efficiency gains when you have a big society picking up the tab for health decisions. That's not the case. At present healthcare costs are externalized which distorts rational planning, both for the individual and for the healthcare provider. It's not worth spending pennies to save dollars right now if the pennies are yours and the dollars are someone else's.
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On April 18 2016 23:15 m4ini wrote:Show nested quote +You guys keep changing the argument. Single payer is literally making the government pay for healthcare. I point out that it has problems X, Y and Z, you guys point out X, Y and Z can be fixed by A, B and C which are all viable solutions but all fall outside the scope of single payer. That just goes to show how convoluted our health system is and how much change would be necessary to make single payer work in the US.
So better stick with status quo? Oh, as a sidenote: solutions A, B and C, while "out of scope of single payer", are all better solutions for the existing systems too. Especially in regards to education. The only two things we agree on is that your health (and education) system is "convoluted", and that change won't happen overnight. But no "solution" would do that. It always literally boils down to either "takes too long to implement" or "too much hassle".
I'm not saying that all. My argument is that there are ways to get improved, universal coverage that aren't single payer. Get a public option first, then move onto multipayer or universal basic. Single payer as a goal in and of itself is stupid. It is a means to an end, not an end in and of itself. This is what I've said over and over again in this thread.
Education needs to be addressed, but tying the issue to healthcare is only making that more complicated.
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Cayman Islands24199 Posts
they can look at the group that need chronic care and provide a more centralized supply structure. part of the problem is that it is economically unviable for market to fund some of the rare drugs and devices, but research on these things is still done in academia etc. this pretty costly segment is really better served and at lower cost by a separate system like the VA.
a seirous issue with public healthcare systems is the geographically disperse nature of american society. when some patients choose to live in the middle of nowhere it is not a surprise when they have to wait a long time for an appointment. but it is unclear how a private system would solve this issue either.
yes va administration sucks government corruption blah blah but overall it is a good system for the money.
http://www.rand.org/blog/2012/08/socialized-or-not-we-can-learn-from-the-va.html
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On April 19 2016 00:40 oneofthem wrote:they can look at the group that need chronic care and provide a more centralized supply structure. part of the problem is that it is economically unviable for market to fund some of the rare drugs and devices, but research on these things is still done in academia etc. this pretty costly segment is really better served and at lower cost by a separate system like the VA. a seirous issue with public healthcare systems is the geographically disperse nature of american society. when some patients choose to live in the middle of nowhere it is not a surprise when they have to wait a long time for an appointment. but it is unclear how a private system would solve this issue either. yes va administration sucks government corruption blah blah but overall it is a good system for the money. http://www.rand.org/blog/2012/08/socialized-or-not-we-can-learn-from-the-va.html
Up here in Canada, with a population 1/10th the size but a bigger country geographically, we seem to do okay.
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Cayman Islands24199 Posts
im mostly talking about specialty care. that was the conclusion of a congressional report on the va system.
http://www.rand.org/news/press/2016/02/08/index1.html
However, waiting times are highly variable by location and type of care and some veterans in some facilities face very long wait times, such as almost 40 days for a primary care appointment at the extreme. In addition, surveys show that VA patients are less likely than private-sector patients to get appointments, care and information as soon as needed.
The RAND research also found that geographic access to care in the VA system is good for most veterans. Nearly 93 percent of enrolled veterans live within 40 miles of a VA medical facility, although veterans with specific health conditions may not live close to the type of care they need.
Veterans who live far from VA care also tend to live far from other health services. RAND research found that while 80 percent of enrolled veterans who live far from VA care have access to primary care in their community, less than 20 percent have access to specialty care, reflecting the challenges across the U.S. health care system of providing care in rural areas.
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On April 18 2016 21:26 m4ini wrote:Show nested quote +No, the "not enough doctors" complaint is very real. You could not simply hire more, because those people don't exist, instead you would have to hire people not currently considered doctors to do what doctors do.
Of course you can't just employ 200.000 doctors tomorrow. But to say "these people don't exist, so you can't hire more than we have" is just incredibly dishonest. Give out an incentive. Starting with subsidized loans (less debt after finishing study etc), or/and make it easier for foreign MDs to settle in the US. It's just such a dumb argument, "well we can't get it right 100% on day one, so lets stick with some shitty compromise or even better, lets scrap it altogether". Waiting times won't go up either. Why would they? You still have the same amount of MDs, they don't just magically disappear. If what you're saying is that they would have more work then, because people who formerly couldn't afford it would go.. Well. That shows you how urgent the whole situation is in the first place.
Its actually not about cost, its about exclusivity. There is a reason for the saying, "What do you call the person who finishes last in their class in medical school? Doctor." And that PhD's get called "not a real doctor" by people. There are very few medical schools that are accredited, and its very competitive to get in. The very fact that someone has been admitted to a US medical school means they are highly likely to be extremely competent.
By expanding the # of accredited schools, or expanding the number of foreign MDs you allow in, you are actually making people who, as I said, "Are not considered doctors" into doctors.
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An all-out internal power struggle has erupted at the Republican National Committee, just days before a critical party gathering in Florida, as the head of the RNC’s powerful rules committee has accused his own party leadership of a “major breach of trust” in trying to block a rule change that he said would make it harder to reopen the GOP nomination fight at a contested convention this summer.
At issue: a controversial proposal that would drastically alter how the convention would function, changing the underlying rule book for proceedings — and potentially affecting whether party insiders could draft a so-called white knight at a deadlocked convention.
Rules Committee Chairman Bruce Ash criticized RNC Chairman Reince Priebus and his allies in an email Saturday to his panel, accusing them of working to scuttle the proposal and prevent it from getting a hearing at this week’s RNC spring meeting in Hollywood Beach, Florida.
The proposal in question would switch the rule book governing the convention from the rules of the U.S. House of Representatives, which have been used at Republican national conventions for decades, to Robert’s Rules of Order, which is common in civic and organizational meetings.
“It became apparent to me during the discussions with Reince and others at the RNC that there might be an underlying political result that adherence to the House Rules achieved, and that Roberts made more difficult,” Ash wrote in the email, which was first reported by The Associated Press. “Reopening the nominations for President during the balloting to permit a more acceptable candidate to be nominated other than Donald Trump or Ted Cruz.”
The proposal, which is the brainchild of Solomon Yue, an RNC member from Oregon, would further empower delegates to determine the course of the convention’s proceedings — while diminishing the power of the convention’s presiding officer, a role that is expected to be filled by House Speaker Paul Ryan. Yue has said he’s looking to increase transparency by decreasing the influence of insiders.
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I wonder if Trump would run as independent if he was beaten at the convention. And right now it looks like the most plausible scenario, since he is not going to win straight out the primaries and that the republican establishment is so hostile to his candidacy.
It would look like him to do so, and in a weird way he would probably be right; he really doesn't own anything to the party, that has treated him like s...
That would also be kind of hilarious.
I also don't believe Paul Ryan's word that he wouldn't accept a nomination. The guy has changed his mind one month after declaring something like that in the past. And he is the least trustable person in the universe. I think he would be the biggest threat to democrats, for he has somewhat mysteriously managed, against all odds, to build himself an image of serious responsible republican.
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Trump has been sort of semi hostile during the entire process and always moments from denouncing the party and its process. They made the pledge early one that he wouldn’t run as an independent. This was always going to be the end result. Anyone can run any party’s primary, but even the popular vote does not mean other members of that party will work with you if you are a raging asshole. Trump is the exact candidate the GOP deserves for leaning so hard into the tea party to pick up the house.
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Trump probably won't run third party. Hw's shown himself to be cheap and incompetent, he won't devote the time or money needed. He'll just whine if he loses and all his rabid followers will blame the RNC instead of their hero.
Edit: probably
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On April 19 2016 01:31 oneofthem wrote:im mostly talking about specialty care. that was the conclusion of a congressional report on the va system. http://www.rand.org/news/press/2016/02/08/index1.htmlShow nested quote +
However, waiting times are highly variable by location and type of care and some veterans in some facilities face very long wait times, such as almost 40 days for a primary care appointment at the extreme. In addition, surveys show that VA patients are less likely than private-sector patients to get appointments, care and information as soon as needed.
The RAND research also found that geographic access to care in the VA system is good for most veterans. Nearly 93 percent of enrolled veterans live within 40 miles of a VA medical facility, although veterans with specific health conditions may not live close to the type of care they need.
Veterans who live far from VA care also tend to live far from other health services. RAND research found that while 80 percent of enrolled veterans who live far from VA care have access to primary care in their community, less than 20 percent have access to specialty care, reflecting the challenges across the U.S. health care system of providing care in rural areas.
I'm generally loathe to get into specifics for topics that I haven't researched, but usually in Canada if specialty care is not available in a remote region then people just travel to get it (still for free, although I can't recall if travel costs are covered; I believe that in serious cases much of the expense is) at a different geographic location. Also, the example you cited might be a product of the fact that veterans are only eligible to get the free care at VA hospitals; if everyone was able to get care at any hospital, then this probably wouldn't be an issue, especially in a relatively population-dense country like the US (you're not like Europe, but you're nowhere even close to Canada's population density, although ours is higher than it seems because most of our population lives in the southern part of the country). Functionally, the VA system *seems* like it's artificially creating what you're describing; a geographically spread out population where remote inhabitants might not have close access to a hospital. There might be a hospital close by, it's just not a VA one. By limiting/forcing that subset of the population to go to a specific subset of hospitals, you're functionally in a situation where you have a (very) low-density population (veterans in the US) with a set of hospitals that cater to them exclusively (also at a low density). If you had single-payer with universal access this would be a non-issue.
This is just off the top of my head, though. The situation might be a bit more nuanced (i.e. can non-veterans go to VA hospitals? What is the rate at which veterans attend non-VA hospitals?), but my guess is what I described is generally accurate.
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Cayman Islands24199 Posts
there are special arrangements for people to receive care with non-va providers but yes a larger scale system is going to resolve the problem a bit. i'm arguing FOR at least a partial public system though so there's not much to disagree with
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On April 19 2016 03:35 Biff The Understudy wrote:
I wonder if Trump would run as independent if he was beaten at the convention. And right now it looks like the most plausible scenario, since he is not going to win straight out the primaries and that the republican establishment is so hostile to his candidacy.
It would look like him to do so, and in a weird way he would probably be right; he really doesn't own anything to the party, that has treated him like s...
That would also be kind of hilarious.
I also don't believe Paul Ryan's word that he wouldn't accept a nomination. The guy has changed his mind one month after declaring something like that in the past. And he is the least trustable person in the universe. I think he would be the biggest threat to democrats, for he has somewhat mysteriously managed, against all odds, to build himself an image of serious responsible republican.
Ryan will not accept the nomination because he knows he would lose the general. Unless he got tipped off about some serious Hillary weakness he is too saavy to run in that way knowing he would lose 50% of the Trump supporters and probably 20% of Cruz supporters.
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On April 19 2016 04:00 cLutZ wrote:Show nested quote +On April 19 2016 03:35 Biff The Understudy wrote:
I wonder if Trump would run as independent if he was beaten at the convention. And right now it looks like the most plausible scenario, since he is not going to win straight out the primaries and that the republican establishment is so hostile to his candidacy.
It would look like him to do so, and in a weird way he would probably be right; he really doesn't own anything to the party, that has treated him like s...
That would also be kind of hilarious.
I also don't believe Paul Ryan's word that he wouldn't accept a nomination. The guy has changed his mind one month after declaring something like that in the past. And he is the least trustable person in the universe. I think he would be the biggest threat to democrats, for he has somewhat mysteriously managed, against all odds, to build himself an image of serious responsible republican. Ryan will not accept the nomination because he knows he would lose the general. Unless he got tipped off about some serious Hillary weakness he is too saavy to run in that way knowing he would lose 50% of the Trump supporters and probably 20% of Cruz supporters.
Why do you think he would? Genuine question. He seems to me like a winning synthesis: he looks like a wonk (even though he is not) and could convince moderates voter who haven't been following, and he has always acted the way he is, as a total extremist that tea party people seem to like.
I don't see anyone more qualified to run.
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On April 19 2016 03:44 Introvert wrote:
Trump probably won't run third party. Hw's shown himself to be cheap and incompetent, he won't devote the time or money needed. He'll just whine if he loses and all his rabid followers will blame the RNC instead of their hero.
Edit: probably
I doubt he'd give up after a year of campaigning if he leads in votes but someone else gets the nomination.
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NEW YORK — Ted Cruz on Monday acknowledged he's concerned about how a contested convention might “fracture” the party ahead of the general election, especially if Donald Trump lashes out should he lose the primary.
“There is no doubt, we are likely headed to a contested convention,” the Texas senator told a private gathering of Republicans here in Manhattan, according to audio of the meeting obtained by POLITICO. “One of the greatest risks of a contested convention is, if you come out with a party fractured, it potentially makes you vulnerable going into the general election. I believe, in a contested convention, we’ll have a strong advantage and we will earn the majority of the delegates and unify the party. But in that circumstance it’s not difficult to imagine Donald Trump getting very upset, and making his upsetness [known].”
Trump currently leads Cruz in delegates and in state victories, and he looks poised for a big victory in the New York primary on Tuesday. The Texas senator is highly unlikely to win the 1,237 delegates needed to clinch the nomination outright and is working to do so on a second ballot at a contested convention.
But Cruz downplayed the threat of Trump running as a third-party candidate should he lose the GOP primary. Cruz cited so-called “sore loser” laws that, through ballot access requirements, make it very difficult in some states for candidates to mount an independent bid late in the cycle.
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United States42960 Posts
On April 19 2016 04:11 Biff The Understudy wrote:Show nested quote +On April 19 2016 04:00 cLutZ wrote:On April 19 2016 03:35 Biff The Understudy wrote:
I wonder if Trump would run as independent if he was beaten at the convention. And right now it looks like the most plausible scenario, since he is not going to win straight out the primaries and that the republican establishment is so hostile to his candidacy.
It would look like him to do so, and in a weird way he would probably be right; he really doesn't own anything to the party, that has treated him like s...
That would also be kind of hilarious.
I also don't believe Paul Ryan's word that he wouldn't accept a nomination. The guy has changed his mind one month after declaring something like that in the past. And he is the least trustable person in the universe. I think he would be the biggest threat to democrats, for he has somewhat mysteriously managed, against all odds, to build himself an image of serious responsible republican. Ryan will not accept the nomination because he knows he would lose the general. Unless he got tipped off about some serious Hillary weakness he is too saavy to run in that way knowing he would lose 50% of the Trump supporters and probably 20% of Cruz supporters. Why do you think he would? Genuine question. He seems to me like a winning synthesis: he looks like a wonk (even though he is not) and could convince moderates voter who haven't been following, and he has always acted the way he is, as a total extremist that tea party people seem to like. I don't see anyone more qualified to run.
People qualified to run know better than to run in today's toxic environment. They'll get hate and abuse from their own side, lose to a unified opposition and then be blamed for Hillary. Just because Ryan could run doesn't mean it'd be a good move for him.
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Running 3rd party if someone else gets formally nominated seals Trump in the talk radio and GOP mediasphere as the man who handed an "easily winnable" election after the "catastrophic disasters of the Obama presidency" to Clinton. All his power, gone.
I use quotes because I can almost guarantee those words would be spoken in the punditsphere ad nauseam.
Also Paul Ryan can't run until people have forgotten how utterly forgettable, vapid, and ineffectual he was as Romney's VP pick, it's just a waste of his time.
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Export led growth will lift everyone out of poverty. Why try the long arduous path of ISI when we can burn fossil fuels until fusion gets here?
A bit ambivalent anyway on that IP regime right? Internal contradictions between lifting everyone out of poverty and benefitting the free flow of (American) capital.
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EPT
