tvashtarkatena

The SC may well rule against the individual mandate; I think it should. That will require reform, which will likely move us closer to a public option. That would be a good thing. Most of the new law will stand constitutional muster, however. Healthcare was a step towards a finally becoming a civilized nation, not an end in itself. As for Gregoire, she's a powerful chick, so I guess you're duty bound to hate on her. Pretty decent governor in my book; excellent in terms of civil liberties protections.

Well, you don't know where my sympathies lie regarding Waco; a completely different situation than the one I just mentioned. Weird that you would try to conflate them, but hey, that's how you folks roll. Very broad brush. And regarding a raft of new domestic terrorism laws, the SC isn't going to touch them...but they're gonna touch a few militiamen pretty soon. You dumb cunts handed the keys to the kingdom over to Bush, now the weather has changed. Good luck.

Smart enough to get health care passed. Your right wing militia buddies just threatened to oust Gregoire by force. I think the FBI's gonna be spending a little extra time at the range this year. Fun! Wait till they get a taste of the new anti-terrorism laws. There's a new law in town, but I don't think they've quite realized just how much things have changed....

Well, I suppose the far right will continue to focus on every slip of the public tongue, as you are doing now. But they don't matter anymore politically, so, again, nobody really gives a shit. As the saying goes, the world has passed them by.

In the end, nobody gives a shit about that stuff, nor will they remember it. They'll remember the economy, health care, and Iraq, that's for fuck sure.

Obama had a rough first year. Should that come as a surprise, given the steaming pile he was handed? I think he's going to wind up being a fairly popular president in the end. Health care, while a bit of a kluge, will probably prove to be popular, despite the rantings of a few toothless idiots who seemed to have figured out where the Mr. Mikes are located at Walmart. Ditto on energy policy. Eventually, he'll pull our sorry asses out of certain failed states. The bail out was a relative success, particularly compared to doing nothing. The economy is improving, and he'll get the credit for that, deserved or not. Most of all, he's not the complete, utter, fucking moron his predecessor was, and he's finally learning how to step on the balls of the Right, which is the only kind of treatment they deserve.

It's easy for fall for a soundbyte taken out of context...if you a fucking idiot. Who buys that shit nowadays? Oh, wait.... The congressmen isn't a very good comedian. His concern, that of overwhelming a small island's limited resources with a substantial troop increase, remains a valid one, however. Right wing media's pretty much a one trick pony. It relies on manufacturing something that 'could' happen, or faking something that didn't, and throwing it out to the parroting zombie hordes, who then faithfully carry the momentum for a few days or weeks. No end to willing participants in that department, apparently.

During the drive back from CA talk radio was having a field day with this. The real nut of this story is that the congressman's obvious metaphorical joke, carefully edited into a soundbyte gaffe, was entirely lost on hosts and callers alike. I switched to an evangelical station, where I learned that the physical world was inherently evil. Just coming back from Yosemite, that seemed a bit strident.

There's a difference between prices and costs. Government can enact legislation that puts caps on prices, but it can't control the gazillion factors beyond its control that determine what it actually costs to make things or bring services to the market. Government can cap the price of milk at 1$ a gallon, but hard as it may try, it can never control the real cost of all of the inputs that go into producing the said gallon of milk. When the real cost exceeds the price the government sets, then farmers stop producing it. If they're forced to keep delivering it they'll degrade the quality as much as possible in an effort to stay afloat you probably won't want to drink it. Health care is no different. Governments can control the price of delivering healthcare, but they can't control the cost of doing so, much less the demand for it. As of right now, something like 86% percent of all premiums are used to pay for goods and services, and the profit margins run around 2.2%. When you control for the real cost of Medicare, most of the efficiencies disappear. Even if there is a real margin there, the notion that it holds the key to making healthcare more effective is difficult to comprehend. The right way to value the efficiency of health care is to divide the benefit to the patient over the total cost of delivering it. What really matters is the numerator, and of the components that make up the denominator, the .1 to 0.05 that's in play in the "administrative efficiency" component aren't terribly significant. When you actually look at major drivers of total health costs, the obsessive parsing of marginal differences in administrative costs is even more puzzling. The nation is getting older and fatter, and the number of pills and devices at our disposal to address the health consequences of both is continuously expanding. You can scale administrative infrastructure pretty easily without spending much more money. This is not true for delivery - whether it's CT scanners or bariatric surgeons. I suspect that before long the illusion that it's private sector administrative expenses that are driving up the national tab for health-care will vanish, and then the conversation about how to best contain them will start to get very interesting. You've missed the cost savings entirely. Other countries are currently, right now, enjoying a 12% discount due to lower admin/billing costs. Right now. It's not theory, it's not idle CC chat, its reality. For the sake of argument - let's take your figure as granted. If all we were concerned with was administrative efficiency, the argument would be over. If we're concerned with what actually happens to patients, the analysis is more complicated. Then we have to look at what treatment the patient receives, and the net positive effect on their health. In a world where administrative costs trump all, there's no difference between no treatment, a treatment that makes the patient 0.1% better, and one that makes them 100% better. Once you start caring about the clinical efficacy of a given treatment, then you reduce administrative costs to a minor sub-component of the "cost" denominator in a true measurement of medical efficiency. E.g. Efficiency =(Health Benefit/cost of doctors+nurses+imaging+devices+drugs+etc, etc, etc, etc + administrative costs). Administrative costs trump all? Never said that, but idealize the argument (consider the spherical chicken...old engineer joke) to put it in a lab box if you need to. You seem to be ready to trot out the old 'you'd be dead in France' line. Spare us. And for the 30 + million Americans who aren't covered at all, none of what you just posted matters at all.

There's a difference between prices and costs. Government can enact legislation that puts caps on prices, but it can't control the gazillion factors beyond its control that determine what it actually costs to make things or bring services to the market. Government can cap the price of milk at 1$ a gallon, but hard as it may try, it can never control the real cost of all of the inputs that go into producing the said gallon of milk. When the real cost exceeds the price the government sets, then farmers stop producing it. If they're forced to keep delivering it they'll degrade the quality as much as possible in an effort to stay afloat you probably won't want to drink it. Health care is no different. Governments can control the price of delivering healthcare, but they can't control the cost of doing so, much less the demand for it. As of right now, something like 86% percent of all premiums are used to pay for goods and services, and the profit margins run around 2.2%. When you control for the real cost of Medicare, most of the efficiencies disappear. Even if there is a real margin there, the notion that it holds the key to making healthcare more effective is difficult to comprehend. The right way to value the efficiency of health care is to divide the benefit to the patient over the total cost of delivering it. What really matters is the numerator, and of the components that make up the denominator, the .1 to 0.05 that's in play in the "administrative efficiency" component aren't terribly significant. When you actually look at major drivers of total health costs, the obsessive parsing of marginal differences in administrative costs is even more puzzling. The nation is getting older and fatter, and the number of pills and devices at our disposal to address the health consequences of both is continuously expanding. You can scale administrative infrastructure pretty easily without spending much more money. This is not true for delivery - whether it's CT scanners or bariatric surgeons. I suspect that before long the illusion that it's private sector administrative expenses that are driving up the national tab for health-care will vanish, and then the conversation about how to best contain them will start to get very interesting. You've missed the cost savings entirely. Other countries are currently, right now, enjoying a 12% discount due to lower admin/billing costs. Right now. It's not theory, it's not idle CC chat, its reality.

A single payer government monopoly is just what we need to bring health care costs down. What we don't need is a clusterfuck of competing companies merging, going out of business, scamming their customers, and generally fucking us over any way they can to please their constituency, which isn't us. Private companies are great if you want a new widget. Health care billing is certainly not that, nor should it be. Health care billing should be standardized, predictable, boring, and largely invisible to providers and patients alike. Why this is a huge industry in this country and practically no where else is utterly beyond me.

Does the new health care cover remedies for insomnia?

I think the best strategy for most pressing problems is to ignore them until the perfect solution suddenly appears. Unless, of course, that solution comes from France.

You save 12% off the top in admin/billing costs. We already have the IRS...no addditional cost in collections there. As for paying the providers; everybody uses the same system (per the French model): huge economies and simplification there. I would think that would make dollars and sense to you.

Limbaugh pulls down over 30 million a year. He's not dumb. He's an entertainer who knows his audience. None of what he says needs to make a lick of sense...fortunately for him, because little of it does. It just has to pander to his apparently substantial audience.

Well, you're not penalized if you don't have kids. You're not fined. Or jailed if you don't pay the fine. You are subsidized if you have kids. It's a big difference. Furthermore, this isn't a tax, or 'like a tax'. Congress has never before mandated that you buy a commercial, for profit product. It's power to do so will now be tested in the courts. This isn't speculation: there are already legal challenges in the works. The ability of congress to regulate interstate commerce seems to be a weak argument for taking this fairly significant step, in my view. Once this happens, what other commercial products will Congress see fit to force all of us to purchase for the general good? The way to do this right is to tax us (which Congress clearly has the power to do), and make single payer healthcare available to all of us. That would remove an instant 12% or more out of our overall health care costs; the part consumed by the billing clusterfuck we currently enjoy.

This bill extends federal power into uncharted territory, particularly the individual mandate clause. Never before has congress mandated penalties for NOT buying something. It will certainly run into serious legal challenges, and perhaps even at the supreme court level. Personally, I find the mandated purchase of a for profit, commercial product a disturbing precedent, to say the least. Is the new health care constitutional? Still, in the balance, I'm very glad the bill passed. A failure here would have sent any health care reform into another decade of oblivion; we can't afford to do that anymore as a country. In addition, the passage of this bill with zero republican votes indicates that bipartisanship is over; a welcome change in my book. I believe it also signals the long term death of the Republican Party, something long overdue as far as the good of the country is concerned. At least now the country will be trying reform which can, of course, be amended along the way. And as far as the individual mandate, my main worry, is concerned; there's a significant chance it will be shot down in the courts and by the states, anyway.

Fast forward to the present: similar 'everybody-must-be-armed' laws have failed in the courts in recent years.

BTW, here's a summary of what's in the New Health Care: linky We'll need to go to a single payer system eventually...this new law is a muddled bandaid. I don't, for the life of me, know why the Dems bothered to include 400 RFuck amendments in this bill, when not a single one of the cunts voted for it. Next time they'll know not to bother.

Celebrating another's suffering. Classy.

Suck it, half-assed constitutional "scholars". Both points of this analysis are flawed. Re: point one, congress can regulate interstate businesses, but this involves individual persons, not businesses. Re: the 2nd point; congress can fine businesses for polluting, which constitutes a past and present harm. It's unclear whether or not congress can fine a person for a future harm that may or may not happen(consuming health care resources if uninsured IF the person gets sick). States may force citizens to buy insurance as a requirement for using public infrastructure; driving on roads, for example, but it remains unclear whether or not the feds can force citizens to buy insurance simply to live. There will undoubtedly be one or more court challenges to the mandatory health insurance requirement, which I personally think was a very bad idea. Whether the issue makes it to the supreme court remains to be seen. If it does, the defeat of such a challenge is far from a foregone conclusion. Past courts have show deference to the legislature, but the Roberts court has proven to be unusually activist.

GooDDay Wayne! Very pleased to have the favor of your consideration regarding a business matter of utmost import!

One look at the teabaggers and it becames painfully clear that their biggest problem with The New Healthcare involves the wellness provisions.

At least you'll be covered for medical while you guys are trying to kill each other.