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Author Topic: government shut down  (Read 13011 times)

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Offline gaggedLouise

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Re: government shut down
« Reply #175 on: October 02, 2013, 10:22:21 AM »
Free public health care (in the sense that it's free at the point of delivery - you don't have to count up top dollar as you enter the hospital - and backed by the state) will often be more cost effective and a better guard of public health in the long run, but it's not something that runs like clockwork even where it's been established for many decades. It does depend on funding, and there is a definite tendency sometimes to grow large pieces of fat bureaucracy with low relevance to the health care mission. The county where I live - population a bit over one million people - has some of the tightest networks of both public hospitals and private practitioners in the country, but the large hospitals around here are constantly overbooked and some of the wards are run down (many of them were built fifty or sixty years ago and there's only so much renovation you can do on that kind of building).

Now, this town is projected to grow by at least 30.000 people in the next two decades, and there will be more and more old people. It's crystal clear they ought to set up a new general hospital in an expanding suburban/research region on the outskirts of town, and that's actually been under discussion, but due to political indecision and infighting it hasn't got on the drawing table. The situation in other towns nearby is similar. Likewise, there should be more doctors and nurses trained around here, I mean in this country as a whole, there's no shortage of willing and able students wanting to go that way and landing jobs is a near-secure thing, but for some reason the government refuses to fund an expansion of those programmes (we would have no trouble borrowing some of the money from abroad, or doing it by issuing state bonds). Effectively all universities and major tertiary colleges around here in Sweden are state-funded, so without public funds an addition of a few thousand student seats won't get off the ground. Meanwhile the patients are piling up and actually some doctors here have warned recently that this is going to lead to some squalid consequences. So yes, this kind of thing does depend on long-term funding and attention to what's really needed.
« Last Edit: October 02, 2013, 10:32:33 AM by gaggedLouise »

Offline mia h

Re: government shut down
« Reply #176 on: October 02, 2013, 10:23:16 AM »
i can understand all of the opinions expressed on here and none are wrong. The house has tried to compromised several times but the senate would not budge. My question is why? did they solely want nothing but all of obamacare  to to take affect today? did they want the house to crumble? do they even care about the people? so many questions and very few answers.

The house has tried to compromised several times all I can say to that is ha, haha, hahahahahaha!

The bill became law in 2010, the time for compromising was before it became a law not after it. This congress has tried to repeal the bill not once but 41 times, which  shows that the only compromise the Republicans are interested in is doing it there way. However as other people have pointed out funding for the ACA comes out the discretionary budget which Congress has no control over, so the Republicans can't defund the program or over turn it, so now they're resorted to holding their breath until the Senate gives into their little tantrum.

The entire US Government has been held hostage by the Tea Party, who refused to agree a proper budget last year and so the Government ended up with the sequester, which is exactly what the Tea Party wanted to see happen. But this time round the Senate and the President are doing the right thing in standing up to the right wing bullies

Offline Ebb

Re: government shut down
« Reply #177 on: October 02, 2013, 10:23:54 AM »
*coughs* well you link has its own bias. I was on Cigna for twenty years and lets not go into all of that it was a nightmare. So we can toss this ball back and forth forever. I am not utterly against ACA I am just skeptical and well we will see. But you articulated your stance well and I like to think I did the same. Imagine if something like that happened on a national political level?

I agree, it's been good talking with you. That blog you found seems to be a good source, and I'll have to read up on that. Best of luck to your relative who's grappling with this stuff for real, rather than just discussing it on a message board.

Offline kylie

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Re: government shut down
« Reply #178 on: October 02, 2013, 11:41:27 AM »
...  It seems to me that there are well-run programs, and there are really badly run programs. Since the ACA is such a political hot issue, I would expect it to come under far more scrutiny than most, which should help to keep things clean for the foreseeable future.

Medicare and Medicaid, for what it's worth, are generally considered to be two of the most efficiently run government programs in existence. They are administered by the Department of Health and Human Services, which is also in charge of ACA.

          I haven't followed it closely...  But my understanding so far, just from a little browsing:  There has already been so much wrangling involved in getting the law passed, and it has drawn so much resistance that it has been altered and perhaps, overcomplicated rather much as a result.   

I don't think it's dramatizing too much to say, this history even includes the difference between some early proposals -- where single payer was still being seriously considered -- and the final bill, which some say is still largely consistent with big corporate systems that even many Republicans (apart from the vocal "anti-government" wing we see driving the Party so much now?) once were, and still should be, quite happy with.

          That being said...  I am still betting it's better than the next to nothing we have had in the past.  Which I am still "paying for" after just one, hardly uncommon procedure.  Or, it's just possible that I might might never actually pay for all of it in cash, but it was a major factor in changing my whole lifestyle and leaving the country.  We'll see.  Once it's reached that point, the amount of money isn't even so nagging in the long run (it's really nothing compared to people with chronic illnesses) -- as compared to, whether it's really benefitting me (or anyone but certain very bloated companies, really) to go back and pay any money for the consequences of such a ridiculous system.  Look at how many other things I've already changed, soooo....  Who knows.

          I'm not sure about Medicare etc. either actually -- I've heard it does fairly well...  Which should not be taken lightly!  But I'm not sure what part of that means relatively well e.g. 'for a government program that faces some resistance -- but could be still better if people had never tried to limit it so much' etc., or absolutely well in some more objective measures of actual efficiency. 

One can say, oh but there is no government program that exists without some social pressure and resulting inefficiency...  But I think that US politics have made a particularly grand mess with conservatives sniping at these programs in particular as examples of "big government."  By which they generally seem to mean -- if you look at what they want instead?  A sizable allocation of tax money and work, blah blah which they would rather hand directly and with less oversight, to big corporate backers!
« Last Edit: October 02, 2013, 11:42:44 AM by kylie »

Offline TheGlyphstone

Re: government shut down
« Reply #179 on: October 02, 2013, 12:03:37 PM »
American Politics confuse my so much, but skimming this thread actually helped me understand a lot!

Yay for getting up to date on international news through E!

As you can see through this thread, American politics often confuse Americans too, so don't feel bad. ;D

Online Callie Del Noire

Re: government shut down
« Reply #180 on: October 02, 2013, 01:21:54 PM »
*coughs* well you link has its own bias. I was on Cigna for twenty years and lets not go into all of that it was a nightmare. So we can toss this ball back and forth forever. I am not utterly against ACA I am just skeptical and well we will see. But you articulated your stance well and I like to think I did the same. Imagine if something like that happened on a national political level?

My take on this... it's a start. There are some industries and issues that should have the government involved. When the health insurance arena turned into a 'for profit first' area, I was wary. When I saw two fellow co-workers come back into the military because they couldn't cover family members with commercial plans that the HMOs pushed. I had one chief who literally had to sell THREE homes he'd spent years buying to help cover his kid's health issues because the HMO ruled it 'pre-existing' and not covered. I don't expect health insurance providers to be perfect, I don't like it when they push their profit before their client's needs. And when a man has to sell 3 houses at a loss to help his son and then give up an otherwise excellent job to commit another six years to the Navy.. it's wrong.

Offline Retribution

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Re: government shut down
« Reply #181 on: October 02, 2013, 01:40:28 PM »
My take on this... it's a start. There are some industries and issues that should have the government involved. When the health insurance arena turned into a 'for profit first' area, I was wary. When I saw two fellow co-workers come back into the military because they couldn't cover family members with commercial plans that the HMOs pushed. I had one chief who literally had to sell THREE homes he'd spent years buying to help cover his kid's health issues because the HMO ruled it 'pre-existing' and not covered. I don't expect health insurance providers to be perfect, I don't like it when they push their profit before their client's needs. And when a man has to sell 3 houses at a loss to help his son and then give up an otherwise excellent job to commit another six years to the Navy.. it's wrong.

If you are waiting for me to argue against that you are going to have a horribly long wait  :-)

Online Callie Del Noire

Re: government shut down
« Reply #182 on: October 02, 2013, 02:08:35 PM »
If you are waiting for me to argue against that you are going to have a horribly long wait  :-)

I didn't expect it. I imagine that we share some points in common and some we differ on. I do like we're doing what the GOP reps in the House can't.. we dialog.

My issue is that it shouldn't be so damn easy to reduce a person's life to a number.. I understand that there is a certain measure of cold arithmetic involved but as one of the richest and largest countries in the world we shouldn't have consistently the highest cost for care in the world. It is a bloated system where the insurance companies game the system, the medical companies and drug companies do as well. I know friends who lived in Mexico or Cananda whose costs were literally HALF what my friend's costs were a mere 10 miles up the road from them.

We let drug companies sell people medicine here for HUNDREDS of times what the same medicine costs oversears. Same meds, only 10 miles difference in distance.

Offline Oniya

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Re: government shut down
« Reply #183 on: October 02, 2013, 02:12:49 PM »
In some cases, the cost of buying a plane ticket and lodging to get treatment in another country is cheaper than getting the treatment here in the US.

Offline Retribution

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Re: government shut down
« Reply #184 on: October 02, 2013, 02:19:34 PM »
Well here for example like I said earlier I was on Cigna for twenty years. As is obvious from my posts I am a government employee. I had always paid more out of pocket for Cigna as well as more in  copay because I liked to be able to go to whatever doc I like and not worry about preferred provider. Of course all of these kept going up and my last straw with Cigna was when I had a large bill that went unpaid for two years and I ended up paying out of pocket and waited another six months for reimbursement. I at last went kicking and screaming into HMO land. So things like this make me skeptical.

As for drug companies, hospitals, so on I honestly feel rampant law suits are just as responsible as them. It all is a really ugly circle when it comes to someone needing medical help just plain getting screwed. I get it I just look at how badly we mess up so many things with bureaucracy and I cringe. Hell, on a professional level I have to do things that I feel like a moron over but I have been ordered....

I just so many possibilities for this in ACA.

Online Callie Del Noire

Re: government shut down
« Reply #185 on: October 02, 2013, 02:22:43 PM »
In some cases, the cost of buying a plane ticket and lodging to get treatment in another country is cheaper than getting the treatment here in the US.

And by another country..we're not talking a flight from New York to Calgary right?


Found an interesting little speech by a Republican on the issues of shutting down the Government over an issue.

Quote from: A Republican
Your purpose, then, plainly stated, is that you will destroy the Government, unless you be allowed to construe and enforce the Constitution as you please, on all points in dispute between you and us. You will rule or ruin in all events. [...]

Under all these circumstances, do you really feel yourselves justified to break up this Government unless such a court decision as yours is, shall be at once submitted to as a conclusive and final rule of political action?

But you will not abide the election of a Republican president! In that supposed event, you say, you will destroy the Union; and then, you say, the great crime of having destroyed it will be upon us! That is cool. A highwayman holds a pistol to my ear, and mutters through his teeth, "Stand and deliver, or I shall kill you, and then you will be a murderer!" [...]

A few words now to Republicans. It is exceedingly desirable that all parts of this great Confederacy shall be at peace, and in harmony, one with another. Let us Republicans do our part to have it so. Even though much provoked, let us do nothing through passion and ill temper.

This was of course Abraham Lincoln. Concerning Slavery and it's status. The entire speech is Here.

Offline Oniya

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Re: government shut down
« Reply #186 on: October 02, 2013, 02:23:50 PM »
And by another country..we're not talking a flight from New York to Calgary right?

More like transatlantic.  *nods*

(And I'd probably aim for Toronto if I was considering Canada from New York, anyways.  Close enough to drive that one.)
« Last Edit: October 02, 2013, 02:25:56 PM by Oniya »

Offline Torch

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Re: government shut down
« Reply #187 on: October 02, 2013, 02:45:26 PM »
We lived in San Antonio, Texas for seven years. It was very common practice for folks to make the drive to Nuevo Laredo, just across the border in Mexico, for cheap surgical procedures. Usually plastic surgery, but other procedures as well.

Nuevo Laredo has the reputation of being the face-lift capital of South Texas.  ::)

Offline Ephiral

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Re: government shut down
« Reply #188 on: October 02, 2013, 03:38:59 PM »
There are a couple things I don't get in the healthcare debate:

1. It seems to be just an accepted fact that no level of government can possibly do anything more efficiently than the current system. Why, exactly? What is it about every level of the US government that makes it manifestly less capable than pretty much every other industrialized nation in the world?

2. In discussions of "efficiency", why is profit never mentioned once? Considering that we're talking about how to get the most care to the most people for the least dollars, profit itself is a huge inefficiency - dollars taken from the system without delivering a single iota of care - and one I've never seen factored in when discussing the efficiency of the private sector.

Offline mia h

Re: government shut down
« Reply #189 on: October 02, 2013, 03:48:42 PM »
2. In discussions of "efficiency", why is profit never mentioned once? Considering that we're talking about how to get the most care to the most people for the least dollars, profit itself is a huge inefficiency - dollars taken from the system without delivering a single iota of care - and one I've never seen factored in when discussing the efficiency of the private sector.

+ a gajillion

how is making profit from people being ill not something so immoral that it doesn't carry hard time?

Online Callie Del Noire

Re: government shut down
« Reply #190 on: October 02, 2013, 04:25:36 PM »
There are a couple things I don't get in the healthcare debate:

1. It seems to be just an accepted fact that no level of government can possibly do anything more efficiently than the current system. Why, exactly? What is it about every level of the US government that makes it manifestly less capable than pretty much every other industrialized nation in the world?

2. In discussions of "efficiency", why is profit never mentioned once? Considering that we're talking about how to get the most care to the most people for the least dollars, profit itself is a huge inefficiency - dollars taken from the system without delivering a single iota of care - and one I've never seen factored in when discussing the efficiency of the private sector.


I had an online friend who lived up north, Atlanta if I recall. He died in part to the inability to pay for AIDs treatment drugs that cost a truckload here but elsewhere in the world cost next to nothing.  You know why?

Because the Drug industry continues to mandate drug policy and protection measures that they can not damn near everywhere else. 'Generic' drugs are bad for US business we are told but I don't see these same companyies dropping out of ANY of the overseas markets due to loss of funds. Quite the contrary. I bought meds in Spain for 1/10th the cost those meds cost me here. Same company, same brand.

I would rather my government consider my well being a little more and the bank balance of Pfizer a little less.

Offline Dashenka

Re: government shut down
« Reply #191 on: October 02, 2013, 04:37:22 PM »
+ a gajillion

how is making profit from people being ill not something so immoral that it doesn't carry hard time?

Just for the sake of an argument...

You can't make money from people being ill but the government CAN make money from people who work hard and have a lot of responsibilities and make a lot of money?

Again, just for the sake of the argument in relation to rising taxes for the higher incomes. Isn't that just as immoral?

Offline Vekseid

Re: government shut down
« Reply #192 on: October 02, 2013, 04:50:42 PM »
Alright not sure how good a source this is http://healthaffairs.org/blog/2011/08/09/is-medicare-more-efficient-than-private-insurance/  It was the one that simply seemed the best written after a plain old Google search so I am not making any claims as to it's accuracy or lack of bias. My point though is that efficiency and government really do not go together.

And charging me a hundred thousand dollars a year for insurance - which will cost at most ~$4k now, is efficient?

What's with people forgetting that corporations are centrally planned, too? Only with less accountability.

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Re: government shut down
« Reply #193 on: October 02, 2013, 05:37:52 PM »
As someone who works for the government... nothing they do is efficient. Absolutely nothing. Even the things that SEEM efficient to the "end user" IE: people using the ACA (which I'm all for, btw, this is just an example) aren't really as efficient as they should be.

Offline Dashenka

Re: government shut down
« Reply #194 on: October 02, 2013, 05:43:18 PM »
Democracy and efficiency never work together. Because democracy means bureaucracy as well.

Offline TheGlyphstone

Re: government shut down
« Reply #195 on: October 02, 2013, 06:23:05 PM »
Democracy and efficiency never work together. Because democracy means bureaucracy as well.

Government means bureaucracy, whatever flavor you prefer. China is communist/totalitarian, and has a horrendously large and cumbersome (and corrupt) bureaucracy.

Offline Oniya

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Re: government shut down
« Reply #196 on: October 02, 2013, 06:42:05 PM »
As I recall, the bureaucracy even extends to Chinese mythology.

Offline Kythia

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Re: government shut down
« Reply #197 on: October 02, 2013, 06:45:57 PM »
And why the automatic assumption that a bureaucracy is a necessarily bad thing?

Offline Oniya

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Re: government shut down
« Reply #198 on: October 02, 2013, 06:49:58 PM »
Ask me that after the next time you have to fill out a governmental form.  I'd link you to some of the US forms online, but I don't know if they can be accessed outside of the country.

Offline gaggedLouise

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Re: government shut down
« Reply #199 on: October 02, 2013, 06:50:19 PM »
Democracy and efficiency never work together. Because democracy means bureaucracy as well.

And transparency.

Democracy sometimes is a slow-moving animal. But preferably not a giant sloth animal.

(the word for sloth in my tongue, is literally "latewalker, slowopede")