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Here's the magic word, and i know it's a triggerword for many americans.
Imagine it being whispered.
+ Show Spoiler +
Here's the thing. Healthcare in the US is a business. As long as it stays that way, you will never have a decent system. That's why in any other country with a working healthcare system, regardless of what kind of system it actually is (NHS, Krankenkassen etc), the above is fundamentally what enables them to work.
Without above, it simply can't work. And that's why it doesn't, and probably never will, in the US.
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On January 23 2019 01:05 Plansix wrote: Hey, the compromise bill has a bunch of poison pill bullshit Democrats would get destroyed for supporting. I guess the Republicans don’t want to reopen the government if they can’t also fuck over refugees in some way while also building a wall.
Why negotiate at all when these are the tactics?
So when he said they CAN apply in their home country, it is a MUST apply....
Sneaky sneaky Trump
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Republicans poisoning a bill? totally unheard of. This is never what they usually do when they lose the public opinion battle and try to pin it on their opponents instead. /s
Why negotiate at all? Who said the Democrats should be negotiating? There is no reason to negotiate with the current set of Republicans, based on their past actions. Pass a clean CR, fold your arms and wait 2 more years. You can't get anything done with a majority in all 3 branches anyway.
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On January 23 2019 01:04 ticklishmusic wrote:Show nested quote +On January 23 2019 01:02 Gahlo wrote:On January 23 2019 01:00 ticklishmusic wrote:On January 23 2019 00:55 Plansix wrote:On January 23 2019 00:46 ticklishmusic wrote: the money certainly exists flowing through the system, the actual implementation of single payer is the real challenge. Logistically it will be a nightmare implement. 50 states with their own systems, costs and inefficiencies. Even if it started tomorrow, it would take years to iron out all the problems and have the system function efficiently. And that assumes we don’t have the special snowflake states that revolt every time someone changes and they can’t deal with someone moving their cheese. That is why single payer has to be a national movement with bipartisan support. Without that, every single bump in the road will be a vector for attack by the other party in their bid to retake power. that's basically why i'm generally opposed to single payer, vs. a public option/ hybrid system, or some sort of combination of government subsidies/ price caps (a little like the ACA subsidies + rate increase caps, but much more extensive). does single payer work in other countries? certainly yes - in some it works really well, in others maybe a little less so. but is it the best option for the US? that's a very different question. So you're against single payer because it might not work as well here as it does other places and instead choose to stay with the nightmare you know that continues spiraling out of control. you're completely misinterpreting what i said. the status quo is no good, especially with the extensive sabotage attempts of the ACA by republicans. however, single payer is not THE solution. there are many other strategies to improve/ solve healthcare in the US which would likely be much better than trying for single payer. there is a big misconception about single payer being the end all be all of solving healthcare in the US. it really isn't.
Whether or not it works a better or "a little less better" than in other countries... Single payer would work A METRIC FUCK TON BETTER than what we have :D
I'm not disagreeing with you, idk what is the "best option" ... but I think single payer would be really fucking good.
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Healthcare is a really hard problem to fix across 50 different states with varying levels if infrastructure and coverage. The problems of northern Maine are not the problems of Southern Florida. We are not going crack those problems in this thread and find the perfect solution. And admitting that no one system is going to work perfectly across the entire nation is not endorsing the status quo and doing nothing. We are not the boomers, so finding a single flaw in a proposal isn’t an excuse to do nothing.
On January 23 2019 01:16 Gorsameth wrote: Republicans poisoning a bill? totally unheard of. This is never what they usually do when they lose the public opinion battle and try to pin it on their opponents instead. /s
Why negotiate at all? Who said the Democrats should be negotiating? There is no reason to negotiate with the current set of Republicans, based on their past actions. Pass a clean CR, fold your arms and wait 2 more years. You can't get anything done with a majority in all 3 branches anyway. Dems need to make a show of being willing to work with any live body that is willing to help them, since people really want the government to re-open. I think the Republicans are going to be sadly surprised this also blows up in their face, because it is pretty easy to point out they added a bunch of stuff to this bill. This senate leadership has no experience working with anything but Paul Ryan’s useless House, so they are still trying the old bullshit that worked back then. They are acting like they control both chambers and are just trying to shame like 10 democratic senators into voting.
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On January 23 2019 01:12 IyMoon wrote:Show nested quote +On January 23 2019 01:04 ticklishmusic wrote:On January 23 2019 01:02 Gahlo wrote:On January 23 2019 01:00 ticklishmusic wrote:On January 23 2019 00:55 Plansix wrote:On January 23 2019 00:46 ticklishmusic wrote: the money certainly exists flowing through the system, the actual implementation of single payer is the real challenge. Logistically it will be a nightmare implement. 50 states with their own systems, costs and inefficiencies. Even if it started tomorrow, it would take years to iron out all the problems and have the system function efficiently. And that assumes we don’t have the special snowflake states that revolt every time someone changes and they can’t deal with someone moving their cheese. That is why single payer has to be a national movement with bipartisan support. Without that, every single bump in the road will be a vector for attack by the other party in their bid to retake power. that's basically why i'm generally opposed to single payer, vs. a public option/ hybrid system, or some sort of combination of government subsidies/ price caps (a little like the ACA subsidies + rate increase caps, but much more extensive). does single payer work in other countries? certainly yes - in some it works really well, in others maybe a little less so. but is it the best option for the US? that's a very different question. So you're against single payer because it might not work as well here as it does other places and instead choose to stay with the nightmare you know that continues spiraling out of control. you're completely misinterpreting what i said. the status quo is no good, especially with the extensive sabotage attempts of the ACA by republicans. however, single payer is not THE solution. there are many other strategies to improve/ solve healthcare in the US which would likely be much better than trying for single payer. there is a big misconception about single payer being the end all be all of solving healthcare in the US. it really isn't. Can you lay out some things other than single payer you think would benefit the US to the extent single payer would?
Here are some examples of systems in place that aren't single payer around the world we could copy:
1. Nationalized healthcare a la the UK NHS - probably wouldn't work, nationalizing the US healthcare system is even more of a lift than single payer 2. German multipayer - anyone under a certain income threshold is auto enrolled (this is much better than an opt in system) into government funded healthcare (think of it like super Medicaid). People above the threshold can opt for private insurance, employers may also offer additional health insurance benefits. 3. Swiss hybrid - everyone must have insurance (individual mandate). Expenditure is capped at 8% of income via cash subsidy. Insurance is provided by private entities, but they are not allowed to make profit on this basic insurance, and they make money on supplemental plans. I like this one a lot. 4. Japan government rate setting - no more crazy secret fee schedules where how much you pay depends on who is your insurer, etc. basically everyone would get Medicare pricing. 5. Public option - afaik what was proposed in 2009-2010 isn't actually implemented anywhere in the world (though the public insurance in Germany is quite similar, albeit with income requirements) but it would be relatively easy to implement.
Apart from the price side of things, the US also suffers from a pretty big supply issue due to a variety of factors, like a rather more unhealthy population, really spread out geography, and just a dearth of medical professionals (especially GP-type doctors). That's another facet which we need substantial investment in regardless of the approach we end up taking.
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My wife’s company not only has a shortage of nurses, but the company is reluctant to hire more nurses because they are not seeing “growth”. They provide nursing services for the elderly and disabled. Her company’s shareholders refuse to accept that market is finite. And their company is one of the “good ones”.
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Caring for the increase in numbers of the elderly is forseen as one of the biggest problem everhwere else in the developed world. Why do you live that doesn't see an increase in the proportion of the elderly?
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On January 23 2019 02:14 Dangermousecatdog wrote: Caring for the increase in numbers of the elderly is forseen as one of the biggest problem everhwere else in the developed world. Why do you live that doesn't see an increase in the proportion of the elderly? Because they got them all. They provide healthcare for people staying with family over being placed into a nursing home. That is a subsection of the overall elderly population. And it is only in one state. They reached their peak in saturation like 3 years ago. The company is profitable. But every year their stockholders are looking for growth because they are to stupid to realize they invested in elderly healthcare, not cell phones.
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Ironically cell phones are have reached a plateau in growth a while ago I beleive.
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apple has been growing mostly by juicing prices. but it seems they may have hit a wall with that strategy. also see, planned obsolescence.
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On January 22 2019 18:17 Simberto wrote:Show nested quote +On January 22 2019 14:33 RvB wrote:On January 22 2019 13:46 KwarK wrote:On January 22 2019 13:35 Sermokala wrote:On January 22 2019 12:15 Introvert wrote:On January 22 2019 11:40 Lazare1969 wrote:On January 22 2019 11:12 Introvert wrote: However, neither she, nor any other Democrat, is willing to talk about the massive tax hikes required for her ideas. For all the "bravery" of this new crop of Democrats, they still can't come out and say what is needed to fund what they want.
The other method is to just print more money, aka quantitative easing, like Reagan did to expand the military budget by almost 50%. She is going to be criticized from the left for proposing ideas that will lead to less federal revenue. I assume you mean the right or centre, because the left generally doesn't scaremonger over the federal deficit. no, they aren't debt hawks most of the time, but they act like tax revenue is the government's by right, and so generally oppose anything that leads to less of it. On January 22 2019 11:28 KwarK wrote: The US gov could afford single payer with the payroll taxes it currently takes in, if costs were comparable to the NHS. This idea that Single Payer will require massive tax hikes is absurd, it’s cheaper than what you already have. found your problem. doesn't matter the organization, they all say it would cost an additional ~30 T over ten years, in a best case scenario. and we can't junk what we have all at once anyways. For some period of time, most people would be paying way more in taxes. No Democrat will say this, so I don't want to hear about how brave they are. You can make your argument all you want, but no politician will make it. The cost that people pay for health insurence now would be less then the tax they would pay for health insurance with single payer. Thats probably what kwark is trying to say. What I said is probably what I'm trying to say. The Federal government already spends more on healthcare than the cost of government healthcare, before you even consider the huge amount individuals pay towards health insurance, deductibles, copays, and so forth. There's not really any way that healthcare costs can't go down. There's nowhere else for them to go. Americans are paying the full cost of single payer, and then also the full cost of private healthcare, and somehow have managed to get neither working well. That's just wishful thinking. Single payer won't make US healthcare magically cheaper. There have been numerous studies about Sanders initial plan of Medicare for all and it's associated costs. They were all in the trillions. Changing a system doesn't automatically make it more efficient. So, is this american exceptionalism again? Because other countries can have full healthcare for less than the public money that the US spends on their broken shit. https://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-global-perspective?redirect_source=/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspectiveJust compare the numbers in the right half of exhibit 2. The numbers are slowly getting more and more dated since i have started posting them years ago, but they still show a very clear picture. US healthcare costs similar amounts of public money than a real healthcare system, also costs a lot of other money, and produces worse results plus lots of stress for everyone. And if you don't like single payer because you are scared of the government, take a look at the german system. We have lots of different health insurers, but they must obey to a lot of laws, including not being able to make a profit, and set payrates. We also have additional private health insurers, which may turn a profit, but also sometimes have other advantages that some people choose. My point is that the US healthcare is incredibly inefficient. It has a huge amount of structural issues. Changing the healthcare system to a single payer one isn't going to solve these structural issues. Single payer isn't going to make the healthcare more efficient overnight.
On January 22 2019 23:42 Plansix wrote:Show nested quote +On January 22 2019 14:33 RvB wrote:On January 22 2019 13:46 KwarK wrote:On January 22 2019 13:35 Sermokala wrote:On January 22 2019 12:15 Introvert wrote:On January 22 2019 11:40 Lazare1969 wrote:On January 22 2019 11:12 Introvert wrote: However, neither she, nor any other Democrat, is willing to talk about the massive tax hikes required for her ideas. For all the "bravery" of this new crop of Democrats, they still can't come out and say what is needed to fund what they want.
The other method is to just print more money, aka quantitative easing, like Reagan did to expand the military budget by almost 50%. She is going to be criticized from the left for proposing ideas that will lead to less federal revenue. I assume you mean the right or centre, because the left generally doesn't scaremonger over the federal deficit. no, they aren't debt hawks most of the time, but they act like tax revenue is the government's by right, and so generally oppose anything that leads to less of it. On January 22 2019 11:28 KwarK wrote: The US gov could afford single payer with the payroll taxes it currently takes in, if costs were comparable to the NHS. This idea that Single Payer will require massive tax hikes is absurd, it’s cheaper than what you already have. found your problem. doesn't matter the organization, they all say it would cost an additional ~30 T over ten years, in a best case scenario. and we can't junk what we have all at once anyways. For some period of time, most people would be paying way more in taxes. No Democrat will say this, so I don't want to hear about how brave they are. You can make your argument all you want, but no politician will make it. The cost that people pay for health insurence now would be less then the tax they would pay for health insurance with single payer. Thats probably what kwark is trying to say. What I said is probably what I'm trying to say. The Federal government already spends more on healthcare than the cost of government healthcare, before you even consider the huge amount individuals pay towards health insurance, deductibles, copays, and so forth. There's not really any way that healthcare costs can't go down. There's nowhere else for them to go. Americans are paying the full cost of single payer, and then also the full cost of private healthcare, and somehow have managed to get neither working well. That's just wishful thinking. Single payer won't make US healthcare magically cheaper. There have been numerous studies about Sanders initial plan of Medicare for all and it's associated costs. They were all in the trillions. Changing a system doesn't automatically make it more efficient. We already pay trillions and have shitty healthcare. This is the problem with the healthcare discussion, it is that people look at the cost to the government and omit the fact that we are already paying that amount to healthcare companies that are more concerned with returns for their shareholders than the quality of our healthcare. Not really. The argument is that single payer will cost even more than it does now. It adds to the healthcare bill. There's nothing wrong with providing healthcare for all (I'm in favour of it myself) but it's important to be clear about its associated costs so the right trade offs can be made. Pretending like single payer won't cost a dime for the US tax payer falls into the same category as Republicans pretending that the tax cuts will pay for themselves in added tax dollars.
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On January 23 2019 02:24 Dangermousecatdog wrote: Ironically cell phones are have reached a plateau in growth a while ago I beleive. Yes, but if you invent a better, magic cell phone, that will make everyone throw away their old one, then you will get amazing growth. So capture lightning in a bottle a second time and then you can have huge growth again.
On January 23 2019 02:31 RvB wrote: Not really. The argument is that single payer will cost even more than it does now. It adds to the healthcare bill. There's nothing wrong with providing healthcare for all (I'm in favour of it myself) but it's important to be clear about its associated costs so the right trade offs can be made. Pretending like single payer won't cost a dime for the US tax payer falls into the same category as Republicans pretending that the tax cuts will pay for themselves in added tax dollars. No one was pretending that it would. But I'm not convinced that it is going to be this staggering increase that will break my bank account more than the garbage that is the current system. Right now if I broke my arm at work I would still consider having someone drive me to the ER because I'm not dropping + $1000 for ambulance ride.
On January 23 2019 02:27 ticklishmusic wrote: apple has been growing mostly by juicing prices. but it seems they may have hit a wall with that strategy. also see, planned obsolescence. I'm still impressed that they were never raked over the coals for programming their phones to slow down the CPU along side battery life and never like customers know. Only in America can Apple design a product to break right after you finish paying it off and not get the hammer dropped on them.
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United States42014 Posts
My understanding of the Apple thing is that users continually demand more of the OS and the only reason new phones have any battery life at all is because battery tech has advanced a huge amount. Battery lives appear constant because supply and demand are increased in tandem. But on older phones supply can’t keep up and therefore Apple bottlenecked demand to keep the battery running. If the phone didn’t run slowly it would lose charge quickly.
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On January 23 2019 04:50 KwarK wrote: My understanding of the Apple thing is that users continually demand more of the OS and the only reason new phones have any battery life at all is because battery tech has advanced a huge amount. Battery lives appear constant because supply and demand are increased in tandem. But on older phones supply can’t keep up and therefore Apple bottlenecked demand to keep the battery running. If the phone didn’t run slowly it would lose charge quickly.
Maybe I'm the exception, but I'd rather have a good phone that works for 6 hours than a shit phone that lasts 10. There are chargers EVERYWHERE.
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I’m sure there is a very reasonable justification for Apples CPU gating that sounds great. My main issue is that they didn’t tell customers they were doing it and it caused people to buy new phone rather than simply replace their batteries. After all, Apple sells a $1000 device that was designed to never have the battery replaced.
Edit: Apparently McConnell plans to have a vote on the poison pill bill on Thursday, so expect complaining about the filibuster from Trump. And due the Supreme Court’s decision to not take up a DACA case, the president’s offer of DACA protections is pretty worthless since they can’t be deported for another year(aka, the next Supreme Court session).
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On January 23 2019 05:34 Plansix wrote: I’m sure there is a very reasonable justification for Apples CPU gating that sounds great. My main issue is that they didn’t tell customers they were doing it and it caused people to buy new phone rather than simply replace their batteries. After all, Apple sells a $1000 device that was designed to never have the battery replaced.
Edit: Apparently McConnell plans to have a vote on the poison pill bill on Thursday, so expect complaining about the filibuster from Trump. And due the Supreme Court’s decision to not take up a DACA case, the president’s offer of DACA protections is pretty worthless since they can’t be deported for another year(aka, the next Supreme Court session).
I will love the whole "Dems are filibustering!" while mitch refuses to let the dem bill see the floor. God I love the GOP rule
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On January 23 2019 06:18 IyMoon wrote:Show nested quote +On January 23 2019 05:34 Plansix wrote: I’m sure there is a very reasonable justification for Apples CPU gating that sounds great. My main issue is that they didn’t tell customers they were doing it and it caused people to buy new phone rather than simply replace their batteries. After all, Apple sells a $1000 device that was designed to never have the battery replaced.
Edit: Apparently McConnell plans to have a vote on the poison pill bill on Thursday, so expect complaining about the filibuster from Trump. And due the Supreme Court’s decision to not take up a DACA case, the president’s offer of DACA protections is pretty worthless since they can’t be deported for another year(aka, the next Supreme Court session). I will love the whole "Dems are filibustering!" while mitch refuses to let the dem bill see the floor. God I love the GOP rule I just read up on the vote and the house bill to reopen the government will also be put to a vote that day. I suspect that Mitch knows he has to votes to assure it won’t get to 60. But maybe we will finally get to see Trump’s first veto.
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On January 23 2019 06:26 Plansix wrote:Show nested quote +On January 23 2019 06:18 IyMoon wrote:On January 23 2019 05:34 Plansix wrote: I’m sure there is a very reasonable justification for Apples CPU gating that sounds great. My main issue is that they didn’t tell customers they were doing it and it caused people to buy new phone rather than simply replace their batteries. After all, Apple sells a $1000 device that was designed to never have the battery replaced.
Edit: Apparently McConnell plans to have a vote on the poison pill bill on Thursday, so expect complaining about the filibuster from Trump. And due the Supreme Court’s decision to not take up a DACA case, the president’s offer of DACA protections is pretty worthless since they can’t be deported for another year(aka, the next Supreme Court session). I will love the whole "Dems are filibustering!" while mitch refuses to let the dem bill see the floor. God I love the GOP rule I just read up on the vote and the house bill to reopen the government will also be put to a vote that day. I suspect that Mitch knows he has to votes to assure it won’t get to 60. But maybe we will finally get to see Trump’s first veto.
Wait, Mitch is going to let the house bill come to the floor? He is really going to give up the whole "the dems filibustered it but filibustering the dems package?"
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On January 23 2019 06:33 IyMoon wrote:Show nested quote +On January 23 2019 06:26 Plansix wrote:On January 23 2019 06:18 IyMoon wrote:On January 23 2019 05:34 Plansix wrote: I’m sure there is a very reasonable justification for Apples CPU gating that sounds great. My main issue is that they didn’t tell customers they were doing it and it caused people to buy new phone rather than simply replace their batteries. After all, Apple sells a $1000 device that was designed to never have the battery replaced.
Edit: Apparently McConnell plans to have a vote on the poison pill bill on Thursday, so expect complaining about the filibuster from Trump. And due the Supreme Court’s decision to not take up a DACA case, the president’s offer of DACA protections is pretty worthless since they can’t be deported for another year(aka, the next Supreme Court session). I will love the whole "Dems are filibustering!" while mitch refuses to let the dem bill see the floor. God I love the GOP rule I just read up on the vote and the house bill to reopen the government will also be put to a vote that day. I suspect that Mitch knows he has to votes to assure it won’t get to 60. But maybe we will finally get to see Trump’s first veto. Wait, Mitch is going to let the house bill come to the floor? He is really going to give up the whole "the dems filibustered it but filibustering the dems package?" I think you might be over estimating how committed Mitch is to the shut down and his ability to control the other GOP Senators. The entire FBI has gone unpaid for nearly a month now. Food Stamps are going to run out shortly, including in his very poor state. Closings nationwide are being kicked out because HUD does not exist. Either he knows it is going to fail, he wants Trump to veto it or he knows he can’t stop it from coming to a vote.
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