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Thread: Obama aide: Debt limit fight could be "catastrophic"

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Boo Radley View Post
    As I said, it is a national problem and not just a state problem. Remember, federal dollars are used by states right now. Ask your state about losing those dollars.

    But, I take you're conceding that you can't prove your claims. Accepted.
    yikes, i've been fretting that argument for a long time, but i suppose it was inevitable. yes the federal government will be bailing out the states (by design). this is the end of any perceived states rights, and the beginning of truly strong and centralized government. i suppose we can hope for the hyperinflation soon for a rejiggering that'll end it. but that's unlikely.
    Democracy is two wolves and sheep voting on what's for dinner. Liberty is a well armed sheep willing to contest the vote.

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Zyroh View Post
    Thanks. That's easier to read than the one J linked. Don't know why. I found a fact check on four of them that claimed they were quite as significant as painted here, but I'm still trying to find something more extensive.

    But always appreciate the help.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Boo Radley View Post
    Who am I? A reasonably intelligent human citizen who can look at all 50 states and see what is happening. Not one state has handle on all of this. Business has trouble competing internationally in part because of having to provide health care. Too many lack adequate access, and people getting care and can't pay run up cost everywhere.

    BTW, didn't I ask you somewhere if you were willing to deny care to people who need care if they couldn't pay? Even emergent care? If not, we have to seek a solution other than the individual.
    That gives you the right to state an opinion but since you don't know the finances of anyone else you have no right to tell someone else their costs are too high. I prefer having a bureaucrat in Austin, TX a three hour drive for me that I can actually get to than a bureaucrat in D.C. helping solve the healthcare problems. you claim no state can do it, but some have tried and as you seem to have no problem with the MA results then that destroys your argument over a national program. Your problem is you cannot sell it to your state or probably the 20+ others that are challenging Obamacare.

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Zyroh View Post
    yikes, i've been fretting that argument for a long time, but i suppose it was inevitable. yes the federal government will be bailing out the states (by design). this is the end of any perceived states rights, and the beginning of truly strong and centralized government. i suppose we can hope for the hyperinflation soon for a rejiggering that'll end it. but that's unlikely.
    Not sure I agree with that, but if this is true, that fight was lost long ago.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Have to go genetlemen. I'll continue this later.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Boo Radley View Post
    Thanks. That's easier to read than the one J linked. Don't know why. I found a fact check on four of them that claimed they were quite as significant as painted here, but I'm still trying to find something more extensive.

    But always appreciate the help.

    Strange....it's the exact same link.


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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Zyroh View Post
    this is exactly why no one, no matter what party, is for a smaller government until they're for cutting spending.
    We have the worst business tax climate in the nation, period. Our taxes are 66% higher than the national average. Upstate is truly an economic crisis. In real GDP, from 2001-2006, upstate New York grew about 1.7% per year while the average in the nation was 2.7%. The costs of pensions are exploding, 1.3 billion in 1998-1999, projected for 2013, 6.2 billion - a 476% increase and its only getting worse.

    The State of New York spends too much money, it is that blunt and it is that simple. Our spending has far exceeded the rate of inflation. From 1994-2009, inflation was about 2.7% per year; medicaid when up over 5% per year and education went up over 6% per year. We just can’t afford those rates of increase. State spending actually outpaced income growth. State spending increased just under 6%, personal income growth was only 3.8%.

    And most damaging, our expenses in this state far exceed revenue. We’ve been focusing on this year and the deficit this year, which is a very large deficit about $10 billion, and that is a problem and it is a major problem; what’s worse, is it’s not just about this year. Next year, the problem goes to $14 billion. The year after, the deficit goes to $17 billion. This is not a one year problem my friends. This is a fundamental economic realignment for the State of New York.

    Not only to we spend too much, but we get too little in return. We spend more money on education than any state in the nation and we are number 34 in terms of results. We spend more money on Medicaid than any other state in the nation and we are number 21 in results. We spend about $1.6 billion per year in economic development and we are number 50 in terms of results.

    And it’s not just State government – the proliferation of local government and special districts all across the State now over 10,500 driving that property tax rate up all across the State. And the large government we have is all too often responsive to the special interests, over the people of the State of New York. The proof is in the pudding. And New Yorkers are voting with their feet. Two million New Yorkers have left the State over the past decade.

    We currently have a government of dysfunction, gridlock and corruption. We are going to redesign our approach because the old way wasn’t working anyway, let's be honest.

    We are going to start by transforming New York’s economy. Because what made New York the Empire State was a not a large government complex, it was a vibrant private sector that was creating great jobs in the State of New York. We get it. And this is going to be a business friendly State.

    Competition works.

    Next, we are going to have to confront the tax situation in our State. The property taxes in New York are killing New Yorkers. Thirteen of the sixteen highest tax counties are in New York when assessed by home value. In absolute dollars, Westchester County the highest property taxes in the United States of America. Nassau County the second highest property taxes in the United State of America. It has to end, it has to end this year.

    We have to hold the line on taxes for now and reduce taxes in the future. New York has no future as the tax capital of the nation. Our young people will not stay. Our business will not come. This has to change.

    Put it simply the people of this state simply cannot afford to pay any more taxes, period.

    In 1938 a reform was passed, a constitutional amendment, that said there could be only 20 executive departments – 20 - so what has happened since then. Well we couldn’t create any more departments but the law didn’t say anything about creating councils, advisory panels, working groups, facilities, offices, task forces, institutes, boards and committees.

    The Department of Health is only one department in compliance with the law, however there are 87 other organizations that have been added to the Department of Health, 46 councils, 6 committees, 17 boards, 6 institutes, 2 task forces, 5 facilities; it’s time to organize the government make it professional. We need to transform our budget. We have to start with an emergency financial plan to stabilize our finances we need to hold the line and we need to institute a wage freeze in the State of New York. We need to hold the line on taxes, we need a state spending cap and we need to close this $10 billion gap without any borrowing.

    GOVERNOR ANDREW M. CUOMO STATE OF THE STATE ADDRESS, 1-5-11 | Governor
    Last edited by The Prof; 01-14-11 at 09:10 PM.

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Boo Radley View Post
    You claim there are no doctors to see them. Please support that.
    of course there are some doctors to see em, just not enough

    it's been known for years---patients go to er (hence all the links reporting increased er traffic and costs) cuz they simply can't find a doctor to make an appt

    http://health.usnews.com/health-news...alone?PageNr=1:

    During a long struggle with recurring stomach pain, Meiwes got used to waiting three weeks to get in to see a doctor—and then being hustled back out in mere minutes. "They had way more patients than they really can see," says Meiwes, 29, of Piedmont, Okla. "They would say, Take an antacid and go home." When she fell ill on weekends, her only options were an after-hours clinic or the emergency room. It took three years of office visits and ER visits before she got a diagnosis: inactive gallbladder. "I got to the point where I wouldn't even go to the doctor anymore."

    Twenty-nine percent of people with Medicare said they had trouble finding a doctor who would take that insurance in 2007, up from 24 percent the year before. That's 11.6 million people.

    In California, almost half of emergency department patients surveyed in 2006 by the California HealthCare Foundation said they thought their problem could have been handled by a primary-care physician. Two thirds of those people said they couldn't get an appointment with their doctor.

    In Texas, 24 counties now have no primary-care doctors at all.

    In Alaska, not one of the 749 private-practice physicians was taking new Medicare patients for primary care in November 2007.

    "The waiting list to get a physical with me is 14 months," says Kate Atkinson, a family-practice physician in Amherst, Mass., who does home visits, answers patients' E-mails within a few hours, and prides herself on being the kind of doctor she'd like to go to. Atkinson sees 25 to 30 patients a day, yet she's barely staying afloat, largely because of the cost of staff she needs to keep up with insurance paperwork and Massachusetts's combination of low insurance reimbursements and a high cost of living. "It's very frustrating," she says. Her salary is supposed to be $110,000. But one month last year, she wasn't able to pay herself at all.

    Yet Bay State docs are so busy that just 51 percent of internists were accepting new patients in 2007, down from 66 percent in 2005—this in the state that in July 2007 became the first to require that residents have health insurance. Bruce Auerbach, president-elect of the Massachusetts Medical Society and head of the emergency department at Sturdy Memorial Hospital in Attleboro, often sees people coming in with out-of-control asthma or with severe dehydration due to stomach problems. When he asks them, "Why did you wait so long?" the answer is almost always that they couldn't get in to see their doctor or that they have no primary-care physician at all.

    In some places where Medicare reimbursements have slid below those of commercial insurers, particularly in the South and West and in rural areas, more and more doctors are refusing to take new seniors—and even dropping longtime patients when they turn 65. In Oregon, for example, the number of primary-care doctors who no longer accept Medicare almost doubled in two years, from 13 percent in 2004 to 22 percent in 2006.

    When friends and family ask to become patients at his practice, David Dale says he most likely will reply that he can't take on new patients. But Dale, who is in a group practice at the University of Washington (where he used to be dean of the medical school), allows that "you might get in because you're in our hospital or because people want to be nice." So, as a last resort, begging might help.
    http://www.tampabay.com/news/health/...r-care/1117932:

    Hospital emergency rooms are busier than ever, filled with patients who are sicker and poorer than ever.

    But it's not just the uninsured who end up there. Now, people with Medicaid or other government insurance plans for the poor are making up a large share of the increased traffic, according to the latest federal numbers released this month.

    It's a worrisome trend for both patients and health care providers. Emergency physicians say Medicaid patients must go to the ER because they can't get appointments with private physicians. Many doctors say Medicaid reimbursement is so low — about half that of the Medicare program for seniors in Florida — they lose money on each patient.

    Emergency department visits are up sharply at many Tampa Bay area hospitals. Brandon Regional saw its ER traffic increase by 21.6 percent from 2008 to 2009. At St. Joseph's in Tampa, which runs the busiest ER in the area, adult visits were up 11.3 percent, to 95,000 in 2009, while children's ER visits went up 23.5 percent, to more than 50,000 in 2009.

    ER visits have increased at twice the rate of U.S. population growth.

    Tampa General's ER traffic increased 7.6 percent from 2008 to 2009. Morton Plant Hospital in Clearwater saw a 12.2 percent increase. Community Hospital in New Port Richey was up 5.3 percent.

    At the same time, enrollment in Medicaid ballooned from 28.5 million in 1999 to 42.6 million in 2008, U.S. Census figures show.

    But the number of physician offices that accept Medicaid — and the volume of patients each can take — is decreasing. Nationally, about 62 percent accept it, down three percentage points from last year, according to SK&A, a health care information company.

    The low Medicaid rates make it tough for practices with significant Medicaid caseloads to cover costs.

    It's a situation Bonnie Mack of St. Petersburg knows all too well. The 72-year-old, who has both Medicare and Medicaid, said that even physicians who accept Medicaid patients will only take a limited number.

    "A lot of times when you call, they've filled their quota and say they're not taking new Medicaid patients at this time," said Mack, who has diabetes and severe arthritis. "Some of them will put you on a list for when they get an opening, but often you don't get an opening for a long time."

    To avoid the ER, Mack schedules her regular doctor visits well in advance and hopes nothing unexpected happens. "When I'm at the doctor's office, I always make my next appointment before I leave," she said.

    Doctors say few patients with alternatives would choose the hassle of a hospital visit over a regular physician appointment.

    "People don't necessarily want to come to emergency departments," said Dr. Amy Conley, an emergency physician at University Community Hospital in Tampa, which saw a 6.4 percent increase in ER visits last year. "But we're the safety net."

    Conley, who is president of the Florida College of Emergency Physicians, said people with chronic conditions such as coronary artery disease who can't get in to see their doctors may ignore symptoms such as shortness of breath or chest pains, or allow their medications to run out, worsening their condition.

    "They can end up costing the health system much more," she said.

    People are not going to the ER for minor issues, the latest data show. Less than 8 percent of ER visits were deemed nonurgent in 2007, down from 12 percent the year before.

    Doctors worry that the new health overhaul law may make matters worse, because while the law aims to provide health coverage to more people, it does not address the Medicaid reimbursement problem.
    Last edited by The Prof; 01-14-11 at 09:50 PM.

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Boo Radley View Post
    But always appreciate the help.
    well, then, here ya go

    ER doctors sue state, say emergency room system near collapse | L.A. NOW | Los Angeles Times

    State: Florida emergency rooms can't find enough doctors

    http://www.nytimes.com/2009/04/02/bu.../02health.html

    Why people overuse the E.R. - By Zachary F. Meisel and Jesse M. Pines - Slate Magazine

    you don't know what you're talking about, you talk too much, and you don't read (it appears) at all

    to each his own

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    Re: Obama aide: Debt limit fight could be "catastrophic"

    Quote Originally Posted by Boo Radley View Post
    Have to go genetlemen. I'll continue this later.
    well, that should be good for a few laughs

    LOL!

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