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Reid says Obamacare just a step toward eventual single-payer system[W:1539]

NIMBY said:
BTW, Ogilvie refused to sign the bill from the Dem. GA to allow the state to short the public pension funds. This went by the way-side in 1973 when Walker signed it after defeating Ogilvie. Edgar could have been great, but had a weak heart, and retired in 1995 for G. Ryan.
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Walker was awful. I remember Ogilvie complaining: "It's his good looks against our good record." Oh well, file it under "life lessons." Sometimes the good guy doesn't win.:peace
 
NIMBY said:
I seethe at his name. We used to talk before DP about means-testing on these pensions. How much is enough off the gov't teat? He has a highly successful attorney's office, even defended ex-con Gov. Ryan. His connections from gov't service should be enough.
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He gets what he gets. That's the law of the land.
 
And this line of discussion is why C. Christie cuts into Dem. demographics. Such as women, private union, even some public, ACA, etc--CC can make the case to Blue states he is one of them. Repubs are stuck with CC and will hold their nose and vote for him.
Kushinator said:
It should be noted that Illinois is a net federal taxpayer. Meaning, the amount of federal income taxes paid to the federal government is greater than the amount of federal tax expenditures allocated to the state. How much so? Between 1990 and 2009, Illinois net tax contributions to the federal government was equivalent to 111% of the states 2009 GDP, or approximately $700 billion.

This money goes to cover the state shortfalls in Kentucky, Tennessee, Alabama, Mississippi, Florida, Louisiana, New Mexico, Arizona, etc.... You know, for things like anti-poverty initiatives, civil service pensions, farm subsidies, nutritional aid, military spending, benefits, etc....
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Neomalthusian said:
There's something going on with this post that makes it difficult to understand.

From what I can gather, you are apparently trying to base public policy off of what we find psychologically acceptable or unacceptable, which usually makes sense, but sometimes it doesn't. When we see one person violating another's rights, we find it to be unacceptable, and it's reasonable to make laws against one person abusing another. When it comes to death and dying, we get really sensitive and sometimes not rational. For example, a dying person, or the loved ones of a dying person, might feel entitled to any and all amount of money and effort on the part of others to save the life, because they don't want to die or don't want the other person to die. This is psychologically somewhat normal (to cling to life), but that doesn't mean it's rational of financially workable.

We simply cannot entitle people to unlimited resources of others the moment they hit a desperate circumstance, and this is because 100% of us eventually hit a desperate circumstance.
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First, no one said anything about unlimited. Every system has limitations. No one pretends otherwise.

But, factually, we have proven as a people we won't allow denial of emergency care for example. Good policy or not, it's a fact that we've said no. So, we can plan to cover this and other such issues, or pretend that it's being covered. UHC allows us to better plan. Yes, some things are more elective. And everyone is free to buy what they can afford with those things. But basic care, needed care, we'd do better as a people to plan for it.
 
And it is one of the economic areas where we disagree. Public pensions should be means-tested. Millionaires don't need Social Security when those on the low end are losing money due to chained CPI.
Jack Hays said:
He gets what he gets. That's the law of the land.
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NIMBY said:
And it is one of the economic areas where we disagree. Public pensions should be means-tested. Millionaires don't need Social Security when those on the low end are losing money due to chained CPI.
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The amount of money involved is miniscule, and highly qualified individuals should be compensated for their opportunity cost in performing public service.
 
Boo Radley said:
I have. And I've even linked a version.


http://www.pnhp.org/publications/payingnotgetting.pdf
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Your link contains much voodoo math like we are "spending" what we do not currently tax:

health care–related tax subsidies and public employees’ health
benefits
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This counts what is now spent by employers (including gov't employers) on medical care insurance premiums as "really" being gov't money that can be redirected with no economic impact. In other words, money spent on insurance premiums (non taxed) is counted twice, once as "taken from the gov't" and again when it is actually spent on health care. Normally when you talk of removing the employer's "burden" of providing medical care then you, in turn, give that money (already a direct labor cost) to the employee as a raise - increasing their taxable income but NOT by the full amount, as this article implies. So only the portion of that money that is due in taxation (about 25% at most) would be available for ADDITIONAL gov't use - not 100% of it as this moron math asserts. SS alone takes 12.4% of that "extra".

The "new math" in this article also double counts Medicare, VA and Medicaid as if that is not simply part of total US medical care provider expenses. These people need exactly the same amount spent for their care under UHC as there is ZERO private insurance overhead/paperwork involved now. The only "savings" of UHC, without a reduction in care provided, is the small percentage now taken for "private" insurance company overhead (10%?) LESS whatever the paperwork costs for the gov't "single" payer are going to be. One must also consider what the immediate unemployment of all of these medical care insurance industry people will cost us - or will the gov't simply hire them all to staff UHC billing?

The bottom line is that efficiently running the UHC may reduce the total cost from 18% of GDP to 15% of GDP at best. Using that amount, 15% of GDP, as what must be collected in taxation is current US UHC reality.
 
Jack Hays said:
The amount of money involved is miniscule,
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This I don't know.
and highly qualified individuals should be compensated for their opportunity cost in performing public service.
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How much more compensation would you like to give the public pension golden parachuters? Do you know how many are grand-fathered above the new caps on pension just here in IL?
 
Conservative said:
No name calling, just reality. You can give everyone in the country healthcare coverage and not assure they can find a doctor or get into a doctor's office. that is the problem with UHC, total coverage but inability to service the people thus more ER usage
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One pundit has suggested that we want medical care that is affordable, accessible, and of high quality; we can have two out of three. I think he may be right. For those of us who live along the northern border, the Canadian health system is a real boon because medical professionals who are good enough to compete come here to practice, and Canadians wealthy enough to pay for their care come down here to get it.
 
NIMBY said:
This I don't know. How much more compensation would you like to give the public pension golden parachuters? Do you know how many are grand-fathered above the new caps on pension just here in IL?
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I'm not in a position to discuss individual cases or amounts.
 
Neomalthusian said:
It is nothing like you describe, although I understand the advocacy to turn it into this. It would be a revolutionary change to turn it into a communal service.

Emergency response to accident/injury may seem communal akin to police and fire, but the hundreds of billions spent on end of life comfort care, symptom management, prescription drugs, etc.? No that is not communal.

Health insurance is not even really insurance (ie it breaks all the rules that make insurance workable) and that is why it has failed.
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That is exactly right, although it wasn't always that way. We used to have policies that were good for catastrophic coverage, but Obama's Unavailable Care Act has outlawed them. If applied to car insurance, ObamaCare would require insurance to pay for gas, oil, tires, lube jobs, windshield wipers, and all sorts of other routine maintenance. Imagine what that premium would look like after you threw in the overhead for processing the claims and then doubled it for government oversight (including fancy conferences at luxury resorts, line dancing lessons, et al).
 
ttwtt78640 said:
Your link contains much voodoo math like we are "spending" what we do not currently tax:



This counts what is now spent by employers (including gov't employers) on medical care insurance premiums as "really" being gov't money that can be redirected with no economic impact. In other words, money spent on insurance premiums (non taxed) is counted twice, once as "taken from the gov't" and again when it is actually spent on health care. Normally when you talk of removing the employer's "burden" of providing medical care then you, in turn, give that money (already a direct labor cost) to the employee as a raise - increasing their taxable income but NOT by the full amount, as this article implies. So only the portion of that money that is due in taxation (about 25% at most) would be available for ADDITIONAL gov't use - not 100% of it as this moron math asserts. SS alone takes 12.4% of that "extra".

The "new math" in this article also double counts Medicare, VA and Medicaid as if that is not simply part of total US medical care provider expenses. These people need exactly the same amount spent for their care under UHC as there is ZERO private insurance overhead/paperwork involved now. The only "savings" of UHC, without a reduction in care provided, is the small percentage now taken for "private" insurance company overhead (10%?) LESS whatever the paperwork costs for the gov't "single" payer are going to be. One must also consider what the immediate unemployment of all of these medical care insurance industry people will cost us - or will the gov't simply hire them all to staff UHC billing?

The bottom line is that efficiently running the UHC may reduce the total cost from 18% of GDP to 15% of GDP at best. Using that amount, 15% of GDP, as what must be collected in taxation is current US UHC reality.
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10 % certainly helps. But care isn't hurt if needless test aren't done. Care is not hurt if minor things are handled by other care professionals.

Add to this a 6-10% increase in taxation, and I do believe we can much better manage adequate care. Of course the wealthy can buy more, as always.
 
The salaries of all teachers and the public pensioneers above $75,000 a year are public record. Most of those 75ers are admins or rich repub suburban teachers. We have over 3,000 grandfathers, averaging $200,000 a year. These are not teachers. This is $0.6 billion a year and cannot be sustained.
Jack Hays said:
I'm not in a position to discuss individual cases or amounts.
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NIMBY said:
The salaries of all teachers and the public pensioneers above $75,000 a year are public record. Most of those 75ers are admins or rich repub suburban teachers. We have over 3,000 grandfathers, averaging $200,000 a year. These are not teachers. This is $0.6 billion a year and cannot be sustained.
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$75,000/year is not rich and I doubt most of those teachers are Repubs.
 
Boo Radley said:
First, no one said anything about unlimited. Every system has limitations. No one pretends otherwise.
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Okay, but the limitations tend to be avoided by UHC advocates, as far as I've seen around here. I.e., "we're not saying unlimited... just... whatever anyone needs... whenever they need it." :confused:

But, factually, we have proven as a people we won't allow denial of emergency care for example. Good policy or not, it's a fact that we've said no.
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That's true, but there are pitfalls of this, such as expensive diagnostic tests when malingerers show up pretending to be in pain, to have a headache, to be short-of-breath, dizzy, or depressed/lonely and suicidal. That gets expensive too. In many communities, police are required to filter public drunks through ERs before they can put them in the drunk tank. **** you not. How expensive is that, in total?

It's as though every ER in the nation needs a hyper-savvy and hyper-efficient triaging system. But as it is now, they're liability-averse, and over-admit the malingerers, drunks, etc.

The biggest problem with guaranteed emergency care is that people simply feign emergency to get immediate service. And if they don't pay for it, and because it's up and running 24/7, it becomes ripe for abuse.
 
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It is in Illinois and the Country I live in, the USA. 75K is 50% above the National average for households. My VT community last semester was 38K. Why do employers keep squeezing the bottom? Our economy is like you squeezing near the top of closed toothpaste. These suburbs are Repub. You linked repup to teacher.
Jack Hays said:
$75,000/year is not rich and I doubt most of those teachers are Repubs.
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Diogenes said:
That is exactly right, although it wasn't always that way. We used to have policies that were good for catastrophic coverage, but Obama's Unavailable Care Act has outlawed them. If applied to car insurance, ObamaCare would require insurance to pay for gas, oil, tires, lube jobs, windshield wipers, and all sorts of other routine maintenance. Imagine what that premium would look like after you threw in the overhead for processing the claims and then doubled it for government oversight (including fancy conferences at luxury resorts, line dancing lessons, et al).
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Agree, and the line dancing lessons comment reminded me of something: if you made a pitch to a liberal that health insurance should cover gym memberships and exercise class, claiming that people who can use the gym for free are healthier and so therefore it will reduce health care costs, what do you think the liberal would say? What do you think the exercise equipment and health/fitness club industries would have to say about these easy subsidies? They'd all be super excited about it, and we'd all pay for this giveaway too.

The sucking sound is our money and our personal responsibility being vacuumed up by the Federal Government Health Insurance Machine.
 
Neomalthusian said:
Okay, but the limitations tend to be avoided by UHC advocates, as far as I've seen around here. I.e., "we're not saying unlimited... just... whatever anyone needs... whenever they need it." :confused:



That's true, but there are pitfalls of this, such as expensive diagnostic tests when malingerers show up pretending to be in pain, to have a headache, to be short-of-breath, dizzy, or depressed/lonely and suicidal. That gets expensive too. In many communities, police are required to filter public drunks through ERs before they can put them in the drunk tank. **** you not. How expensive is that, in total?

It's as though every ER in the nation needs a hyper-savvy and hyper-efficient triaging system. But as it is now, they're liability-averse, and over-admit the malingerers, drunks, etc.

The biggest problem with guaranteed emergency care is that people simply feign emergency to get immediate service. And if they don't pay for it, and because it's up and running 24/7, it becomes ripe for abuse.
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Need is different than want.

Malingers show up now. And one way or another we pay for it now. But expensive test don't really have to be done. And filtering drunks through is so,etching we already do, and pay for that already. But it can be done cheaper. The ER not likely the best place.

And we can limit ERs to only emergencies, as they were intended.

We abuse it now. And it's not due to insurance. It's due to a mindset that we have to do more when less s often more effective. But many working poor go without care. Needed care. We can contain costs, give adequate care, and still allow the wealthy to be wasteful.
 
Reid says Obamacare just a step toward eventual single-payer system

Boo Radley said:
Need is different than want.

Malingers show up now. And one way or another we pay for it now. But expensive test don't really have to be done.
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Tell that to the liability-averse ER doc who has no idea if the guy with the .180 BAC is telling the truth about his dizzying migraine or is making it up to avoid another transfer to the drunk tank. They'd rather do the CT scan just to be safe.

And filtering drunks through is so,etching we already do, and pay for that already. But it can be done cheaper. The ER not likely the best place.

And we can limit ERs to only emergencies, as they were intended.
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How? Tort reform? If an ER doc says scram and the guy dies, does the pissed grieving family have a winning case?

I have worked in the ER, so anecdotally I can say they almost always opt toward that which minimizes liability, even though it tends to maximize cost.

We abuse it now. And it's not due to insurance. It's due to a mindset that we have to do more when less s often more effective.
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It's more basic than that, we abuse it because it's 1) paid for by others and 2) guaranteed to provide 24/7.

But many working poor go without care. Needed care. We can contain costs, give adequate care, and still allow the wealthy to be wasteful.
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You make it sound so easy when it is not. It will cause major disruption to contain costs. We have yet to come to terms with what cost containment really requires, and as a result this health care issue is making us all poorer, fast.
 
Neomalthusian said:
Tell that to the liability-averse ER doc who has no idea if the guy with the .180 BAC is telling the truth about his dizzying migraine or is making it up to avoid another transfer to the drunk tank. They'd rather do the CT scan just to be safe.
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I will. If procedures are clear established, back by law, he has nothing to fear. UHC helps him with this as well.

How? Tort reform? If an ER doc says scram and the guy dies, does the pissed grieving family have a winning case?

I have worked in the ER, so anecdotally I can say they almost always opt toward that which minimizes liability, even though it tends to maximize cost.
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I too ave worked the ER. Married an ER nurse. Together, we have 50 years of experience in ERs. If the rules are clearly defined, no one need fear law suits. Like I said, UHC helps here as it codifies these procedures.
It's more basic than that, we abuse it because it's 1) paid for by others and 2) guaranteed to provide 24/7.
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It's not really guaranteed. Only emergencies are covered by law. And others pay for it and will no matter what you do unless you deny service. As I said, we've been unwilling to do this.

You make it sound so easy when it is not. It will cause major disruption to contain costs. We have yet to come to terms with what cost containment really requires, and as a result this health care issue is making us all poorer, fast.
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Don't know why you think it sounds easy. I don't see it that way. But I do believe it can be done if we stop the nonsense and go to wrk doing it. And no, we don't at all have to be poorer. Taxes will not equal what we spend right now on insurance premiums. So working people will likely see more money in their checks. Businesses will be more equal to the rest of the world. It has several benefits.

Our biggest problem will be an aging population. But eventually that tide will turn. And if we quit fighting needless wars, bailing out businesses, and redistributing wealth to the wealthy, we can create a very workable system.
 
Reid says Obamacare just a step toward eventual single-payer system

Boo Radley said:
I will. If procedures are clear established, back by law, he has nothing to fear. UHC helps him with this as well.



I too ave worked the ER. Married an ER nurse. Together, we have 50 years of experience in ERs. If the rules are clearly defined, no one need fear law suits. Like I said, UHC helps here as it codifies these procedures.

It's not really guaranteed. Only emergencies are covered by law. And others pay for it and will no matter what you do unless you deny service. As I said, we've been unwilling to do this.

Don't know why you think it sounds easy. I don't see it that way. But I do believe it can be done if we stop the nonsense and go to wrk doing it. And no, we don't at all have to be poorer. Taxes will not equal what we spend right now on insurance premiums. So working people will likely see more money in their checks. Businesses will be more equal to the rest of the world. It has several benefits.

Our biggest problem will be an aging population. But eventually that tide will turn. And if we quit fighting needless wars, bailing out businesses, and redistributing wealth to the wealthy, we can create a very workable system.
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Well comparatively speaking you have fairly well reasoned arguments, but realize the pro-UHC crowd in general seems really geeked about universal access and not really aware of a need for cost-control or how to achieve it. Even as a libertarian I'd rather have a cost-controlled government system than our cost-uncontrollable status quo. What we have right now is disastrous, with or without PPACA.
 
Neomalthusian said:
Well comparatively speaking you have fairly well reasoned arguments, but realize the pro-UHC crowd in general seems really geeked about universal access and not really aware of a need for cost-control or how to achieve it. Even as a libertarian I'd rather have a cost-controlled government system than our cost-uncontrollable status quo. What we have right now is disastrous, with or without PPACA.
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And that last part we can certainly agree on.
 
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