McConnell: Paul Ryan Medicare Plan 'On The Table' In Debt Ceiling Discussions

cpwill · Jun 8, 2011

Boo Radley said:
You continue to present false choices. The government doesn't decide when your care is cost effective.

that is, in fact, the purpose of the IPAB.

Like your insurance company they decide when effective efforts they will pay for.

except that your insurance agency is beholden to you by contract to provide a set of services or face legal suit. the IPAB isn't beholden to give you anything it decides it does not want to spend the money on, and was deliberately made immune from suit.

Your are not forbidden for paying for more through other means

that is true - you are free to pay out of pocket. which will be easier for some than others, and is why I support means-testing.

And there is no evidence a completely market driven system would lower prices or increase access.

completely? who is talking about completely?

as for introducing market pressure to drive down costs and expenditures?

Indiana offered HSA's, which have patients save money in tax-free accounts (where it grows and remains theirs forever and ever unless theys pend it) matched with high deductible plans to it's employees. Employees began to respond to price signals, and medical costs per patient were reduced by 33% and expenditures to the state were reduced by 11%.

Safeway has instituted a program that gave financial incentives to people who engaged in healthy behavior by allowing price signals in the insurance side of the market to work (Indiana worked on the medical side), and saw it's per-captia health care costs remain flat from 2005-2009; when most companies saw theirs jump by 38%.

Whole Foods instituted HSA's, and let's the employees choose what they want the company to fund. This institutes price pressure on the medical side (WF covers the high-deductible plan 100%), and their CEO points out that as a result Whole Foods' per-capita costs are much lower than typical insurance programs, while maintaining employee satisfaction.

Medicare Part D utilized market pressure on the insurance side, and saw expenditures come in at 40% UNDER expenditures - the only such government program in history to do so.

Wendy's instituted HSA's, and saw the number of their employees who got preventative and annual checkup care climb even as they saw claims decrease by 14% (in one year).

Wal-Mart's low cost clinics and prescriptions save us oodles of cash. Wal-Mart reports that "half of their clinic patients report that they are uninsured" and that "if it were not for [Wal-Marts'] clinics they would haven't gotten care - or they would have gone to an emergency room". Walmart - reducing costs and expenditures.

all of these utilize the markets to lower costs and expenditures; and they are just the begining. Not using insurance to pay for every procedure, checkup, etc. reduces administrative costs, which in turn reduces medical costs - and as HSA's catch on (assuming that Obamacare - which criminalizes them - is repealed) we will see the positive effects of that on costs and expenditures as well.

Dr Robert Berry runs a practice called PATMOS (payment at time of service). he doesn't take insurance at all - but simply posts the prices of his services. By removing the cost of dealing with mutliple insurance agencies, medicare, and medicaid, the prices he is able to list are one half to ONE THIRD of standard. That's huge.

what do all these programs have in common? They use market price pressure. People start to make better informed, and more conscious decisions once they are compensated for doing so.

That is more fanasty than anything else.[/QUOTE]

tlmorg02 · Jun 8, 2011

Then let us look at this another way, a scientific way. Should we even be attempting to prolong the lives of those who have inherited diseases? If we continue to treat those and prolong the life of those who are prone to diabetes and heart disease aren't we really ensuring that such traits are passed forward into the gene pool? Perhaps we should desire that those who need much medical attention due to their weak constitutions should simply die off and in the future their diseases will disappear with them.

Of course this would dramatically cut costs and we could all save money. Isn't that what is most important saving money? I think not. Yet if we create a system where people will indeed lose more access to medical care, as will certainly happen with Ryan's plan because once it is privatized and people have to make-up the difference in cost, the rising costs will prevent people from going and the deaths from treatable diseases and conditions will increase. Thus, lets just push it along and once the Baby Boomers are thinned out substantially, Medicare will once again be sustainable and may continue. Right?

Boo Radley · Jun 8, 2011

cpwill said:
that is, in fact, the purpose of the IPAB.

No, it isn't. You are factually incorrect.

except that your insurance agency is beholden to you by contract to provide a set of services or face legal suit. the IPAB isn't beholden to give you anything it decides it does not want to spend the money on, and was deliberately made immune from suit.

Yeah, that has slowed down insurance comapnies a lot. As evidenced by them continuely offering less while charging more.

that is true - you are free to pay out of pocket. which will be easier for some than others, and is why I support means-testing.

Yes it will, and I doubt there is much opposition to means testing accept among voters.

completely? who is talking about completely?

OK, so you acknowledge the need for forces other than the free market, like the government?

as for introducing market pressure to drive down costs and expenditures?

Indiana offered HSA's, which have patients save money in tax-free accounts (where it grows and remains theirs forever and ever unless theys pend it) matched with high deductible plans to it's employees. Employees began to respond to price signals, and medical costs per patient were reduced by 33% and expenditures to the state were reduced by 11%.

Safeway has instituted a program that gave financial incentives to people who engaged in healthy behavior by allowing price signals in the insurance side of the market to work (Indiana worked on the medical side), and saw it's per-captia health care costs remain flat from 2005-2009; when most companies saw theirs jump by 38%.

Whole Foods instituted HSA's, and let's the employees choose what they want the company to fund. This institutes price pressure on the medical side (WF covers the high-deductible plan 100%), and their CEO points out that as a result Whole Foods' per-capita costs are much lower than typical insurance programs, while maintaining employee satisfaction.

Medicare Part D utilized market pressure on the insurance side, and saw expenditures come in at 40% UNDER expenditures - the only such government program in history to do so.

Wendy's instituted HSA's, and saw the number of their employees who got preventative and annual checkup care climb even as they saw claims decrease by 14% (in one year).

Wal-Mart's low cost clinics and prescriptions save us oodles of cash. Wal-Mart reports that "half of their clinic patients report that they are uninsured" and that "if it were not for [Wal-Marts'] clinics they would haven't gotten care - or they would have gone to an emergency room". Walmart - reducing costs and expenditures.

all of these utilize the markets to lower costs and expenditures; and they are just the begining. Not using insurance to pay for every procedure, checkup, etc. reduces administrative costs, which in turn reduces medical costs - and as HSA's catch on (assuming that Obamacare - which criminalizes them - is repealed) we will see the positive effects of that on costs and expenditures as well.

Dr Robert Berry runs a practice called PATMOS (payment at time of service). he doesn't take insurance at all - but simply posts the prices of his services. By removing the cost of dealing with mutliple insurance agencies, medicare, and medicaid, the prices he is able to list are one half to ONE THIRD of standard. That's huge.

what do all these programs have in common? They use market price pressure. People start to make better informed, and more conscious decisions once they are compensated for doing so.

All within the context of existing aid and also limited. Take Dr. Berry. His program works because others take who he won't. If all followed suit, not only would prices overall not decrease enough to matter, but even more people would lack access, or be left with something truely inferior.

That is more fanasty than anything else.

Yes, the completely market driven system is prue fanasty. If you want elements incorporated in with other elements, we might agree. But that doesn't seem to be what you are really arguing.

Boo Radley · Jun 8, 2011

tlmorg02 said:
Who here has some consistent medical problem here? Diabetes, heart problems, etc...?

I have type 2 Diabetes, but it is well controlled by diet and exercise (very proud that I lost better than 150 lbs and need no medication).

However, my wife has a chronic issue with phobias that requires many meds. These are expensive, even with insurance. So, it is a chronic condition.

liblady · Jun 8, 2011

tlmorg02 said:
Then let us look at this another way, a scientific way. Should we even be attempting to prolong the lives of those who have inherited diseases? If we continue to treat those and prolong the life of those who are prone to diabetes and heart disease aren't we really ensuring that such traits are passed forward into the gene pool? Perhaps we should desire that those who need much medical attention due to their weak constitutions should simply die off and in the future their diseases will disappear with them.

Of course this would dramatically cut costs and we could all save money. Isn't that what is most important saving money? I think not. Yet if we create a system where people will indeed lose more access to medical care, as will certainly happen with Ryan's plan because once it is privatized and people have to make-up the difference in cost, the rising costs will prevent people from going and the deaths from treatable diseases and conditions will increase. Thus, lets just push it along and once the Baby Boomers are thinned out substantially, Medicare will once again be sustainable and may continue. Right?

hmm......and how do we develop cures if not for treating those with the disease?

i am becoming more and more fond of the idea of taking the entire medical profession out of the private market.

tlmorg02 · Jun 8, 2011

Boo Radley said:
I have type 2 Diabetes, but it is well controlled by diet and exercise (very proud that I lost better than 150 lbs and need no medication).

However, my wife has a chronic issue with phobias that requires many meds. These are expensive, even with insurance. So, it is a chronic condition.

Congratulations on maintaining your health without meds. I suffer no health issues, yet my wife suffers from both fibromyalsia and psoriasis. Her medical costs are quite extensive with the insurance as well.

My point is that I hear many complain about the costs being driven by sick people, however I do not think anyone would actually advocate letting these people die to save money. You would think that money is more important than people to many on this forum and it is ridiculous.

cpwill · Jun 8, 2011

tlmorg02 said:
Then let us look at this another way, a scientific way. Should we even be attempting to prolong the lives of those who have inherited diseases? If we continue to treat those and prolong the life of those who are prone to diabetes and heart disease aren't we really ensuring that such traits are passed forward into the gene pool? Perhaps we should desire that those who need much medical attention due to their weak constitutions should simply die off and in the future their diseases will disappear with them. Of course this would dramatically cut costs and we could all save money. Isn't that what is most important saving money? I think not. Yet if we create a system where people will indeed lose more access to medical care, as will certainly happen with Ryan's plan because once it is privatized and people have to make-up the difference in cost, the rising costs will prevent people from going and the deaths from treatable diseases and conditions will increase. Thus, lets just push it along and once the Baby Boomers are thinned out substantially, Medicare will once again be sustainable and may continue. Right?

putting aside the eugenics straw man... no. It will not be. Because medicare will not survive the Baby Boomers. Medicare will not even survive the next decade. This isn't a question of putting money over people - it's a question of whether we want to have Medicare survive to take care of the Boomers and the generation after them or not. Because on our current path, it doesnt'.

Ryan's plan does not "privatize" Medicare - you don't get a voucher from the government or any such thing. Under Premium Support, Medicare offers you a number of guaranteed plans, and you pick from among them which one you want - with Medicare picking up a chunk of the premium (hence: premium support), picking up more if you are poorer, and less if you are wealthier.

cpwill · Jun 8, 2011

liblady said:
hmm......and how do we develop cures if not for treating those with the disease?

i am becoming more and more fond of the idea of taking the entire medical profession out of the private market.

doing so has not proven as effective for "developing cures" or curing people with them.

tlmorg02 · Jun 8, 2011

liblady said:
hmm......and how do we develop cures if not for treating those with the disease?

i am becoming more and more fond of the idea of taking the entire medical profession out of the private market.

Not all diseases are genetic and thus would require research. However, if you simply allow certain populations to die of the diseases, those who are immune reproduce more and eventually the genetic prone trait dies out. For instance, 1% of the population of the world is immune to HIV, thus if we let the other 99% die from HIV, then HIV is cured.

My point is no one in their right mind would suggest such an option seriously. We need to save money sure, but the money is not more important that the lives.....well to some it very well maybe.

Boo Radley · Jun 8, 2011

tlmorg02 said:
Congratulations on maintaining your health without meds. I suffer no health issues, yet my wife suffers from both fibromyalsia and psoriasis. Her medical costs are quite extensive with the insurance as well.

My point is that I hear many complain about the costs being driven by sick people, however I do not think anyone would actually advocate letting these people die to save money. You would think that money is more important than people to many on this forum and it is ridiculous.

True. I remember a meeting long ago when we were negotiating insurance premiums. One person argued that sick people should be thrown off the rolls the minute they got sick in order to keep premiums low. I asked what would be the purpose of having insurance then?

But, people have to decide how they want to treat people with chronic and emergent needs. They cost. Few will ever be able to afford the cost. So, what do we do?

tlmorg02 · Jun 8, 2011

cpwill said:
putting aside the eugenics straw man... no. It will not be. Because medicare will not survive the Baby Boomers. Medicare will not even survive the next decade. This isn't a question of putting money over people - it's a question of whether we want to have Medicare survive to take care of the Boomers and the generation after them or not. Because on our current path, it doesnt'.

Ryan's plan does not "privatize" Medicare - you don't get a voucher from the government or any such thing. Under Premium Support, Medicare offers you a number of guaranteed plans, and you pick from among them which one you want - with Medicare picking up a chunk of the premium (hence: premium support), picking up more if you are poorer, and less if you are wealthier.

Yet it will not be Medicare will it. It will be subsidized health insurance. How is this different from the Healthcare Reform Act in function? Does that bill not function exactly the same in that the goverment would subsidize a private insurance policy?

winston53660 · Jun 8, 2011

cpwill said:
doing so has not proven as effective for "developing cures" or curing people with them.

You might want to check into the National Institutes of Health

Yesterday, Today & Tomorrow: NIH Research Timelines

cpwill · Jun 8, 2011

Boo Radley said:
Yeah, that has slowed down insurance comapnies a lot. As evidenced by them continuely offering less while charging more.

so the man asserts - but the fact remains that insurance agencies are beholden to you by contract and can be sued should they choose not to cover that which they are obligated to. government is not beholden to you, and is immune from suit should it decide you are no longer worth the money.

Yes it will, and I doubt there is much opposition to means testing accept among voters.

:shrug: we shall see. the alternative is to harm the poor more - and I think that they will be fine with means testing when they realize that is their choice.

OK, so you acknowledge the need for forces other than the free market, like the government?

I'm a proponent for reforming Medicaid and Medicare so that they function well and don't drag the nation into a debt crises - not ending them.

as for introducing market pressure to drive down costs and expenditures?

All within the context of existing aid and also limited. Take Dr. Berry. His program works because others take who he won't. If all followed suit, not only would prices overall not decrease enough to matter, but even more people would lack access, or be left with something truely inferior.

:roll: you say you see no evidence, I provide it at length, and that is all you have to say.

"within the context of existing aid"? what does that even mean? how did "existing aid" make market pressure work for Indiana? for Whole Foods? how does "existing aid" let Wal-Mart provide cheap medication and clinic services.

and you are mistaking Dr. Berry for one with the incentives of an insurance agency. He wants sick people because they will be repeat customers. His program works because he operates in a market where you pay for goods instead of our current system where we try to get others to do that for us.

Yes, the completely market driven system is prue fanasty. If you want elements incorporated in with other elements, we might agree. But that doesn't seem to be what you are really arguing.

largely because that was a quote of yours that i accidentally left off the end

cpwill · Jun 8, 2011

tlmorg02 said:
Yet it will not be Medicare will it.

yes, it will be. Just as Medicare part D is Medicare.

It will be subsidized health insurance. How is this different from the Healthcare Reform Act in function? Does that bill not function exactly the same in that the goverment would subsidize a private insurance policy?

1. no individual mandate
2. no barriers - people are free to pick any plan that they choose, no punishment if they spend too much or too little. As I understand, they are also national plans, and thus not subject to state border restrictions.
3. we can afford this

structurally, though, there are indeed some similarities between how the plan will function.

Boo Radley · Jun 9, 2011

cpwill said:
so the man asserts - but the fact remains that insurance agencies are beholden to you by contract and can be sued should they choose not to cover that which they are obligated to. government is not beholden to you, and is immune from suit should it decide you are no longer worth the money.

You sound like a man who has never dealt with one. Getting money can be difficult even when you're right. Suing is hardly a sure thing, and you might actually have an easier time with the government. But the fact remains there isn't much difference between them.

:shrug: we shall see. the alternative is to harm the poor more - and I think that they will be fine with means testing when they realize that is their choice.

I think there are those who feel they are entitled, no matter how well off they are, I have heard the argument many times. But I hope you're right on that one. I just don't think you are.

I'm a proponent for reforming Medicaid and Medicare so that they function well and don't drag the nation into a debt crises - not ending them.

The devil is always in the details. If you change them so much that they really don't do anything, there is not much point. What Ryan does goes a long way towward giving seniors and others much less and toward reforming it in a way that is positive and meaningful.

:roll: you say you see no evidence, I provide it at length, and that is all you have to say.

"within the context of existing aid"? what does that even mean? how did "existing aid" make market pressure work for Indiana? for Whole Foods? how does "existing aid" let Wal-Mart provide cheap medication and clinic services.

and you are mistaking Dr. Berry for one with the incentives of an insurance agency. He wants sick people because they will be repeat customers. His program works because he operates in a market where you pay for goods instead of our current system where we try to get others to do that for us.

No, you didn't. I know you think that any old thing you throw up is overwhelming, but it isn't. And I make no mistake at all with Dr. Berry. There are more than enough sick people, wealthy sick people. He doesn't have to lower anything much. I know the profession fairly well. Going this route universally will never lower the costs enough to make it affordable for a all, or even a majority, and will leave a large number outside without adequate care.

cpwill · Jun 10, 2011

Boo Radley said:
You sound like a man who has never dealt with one. Getting money can be difficult even when you're right.

no doubt. but getting money out of government in this instance is impossible'

Suing is hardly a sure thing, and you might actually have an easier time with the government

that is incorrect - the law is written so that even Congress has a hard time overturning their decisions.

I think there are those who feel they are entitled, no matter how well off they are, I have heard the argument many times. But I hope you're right on that one. I just don't think you are.

Americans are generally good hearted people.

I refuse to give up hope.

The devil is always in the details. If you change them so much that they really don't do anything, there is not much point. What Ryan does goes a long way towward giving seniors and others much less and toward reforming it in a way that is positive and meaningful.

this is incorrect. yes, the Ryan plan gives people less - but he also gives them what we can afford to give, and he makes sure that those who have difficulty making up the difference get more support to help them. Medicare still offers guaranteed coverage, and it still takes care of the elderly. but we can no longer afford the plans we have been giving.

No, you didn't. I know you think that any old thing you throw up is overwhelming, but it isn't. And I make no mistake at all with Dr. Berry. There are more than enough sick people, wealthy sick people

apparently you missed the part where the prices he charges range from one-half to one-third that of the market.

He doesn't have to lower anything much. I know the profession fairly well.

given your schooling by Jeezy where you claimed that state-funded research could match private research.... I would say maybe not as much as you think

Going this route universally will never lower the costs enough to make it affordable for a all, or even a majority, and will leave a large number outside without adequate care.

i never said universally. but it is an option, and the more it is implemented the more prices across the board will be driven down.

Boo Radley · Jun 10, 2011

cpwill said:
no doubt. but getting money out of government in this instance is impossible'

Sounds like an insurance company to me.

that is incorrect - the law is written so that even Congress has a hard time overturning their decisions.

Hard is not impossible.

Americans are generally good hearted people. I refuse to give up hope.

All for hope. But it won't trump reality. Sadly.

this is incorrect. yes, the Ryan plan gives people less - but he also gives them what we can afford to give, and he makes sure that those who have difficulty making up the difference get more support to help them. Medicare still offers guaranteed coverage, and it still takes care of the elderly. but we can no longer afford the plans we have been giving.

No, it actually doesn't, not even means testing. It doesn't keep up and in the end it is reasonable to foresee them getting less.

apparently you missed the part where the prices he charges range from one-half to one-third that of the market.

Nope, didn't miss that at all. And it changes nothing I said. Remember, he is alone, only one, and cannot represent what would happen overall, and for a number, even this would be too much. As his is based on no one having insurance, and not accepting government money, that is how we have to frame it as a future cost saving measure. It simply would not do the job.

given your schooling by Jeezy where you claimed that state-funded research could match private research.... I would say maybe not as much as you think

There's been no schooling and frankly your comment suggests you have no understanding of what has been argued. You're going to the j school of debate, which is slightly better than the Prof school. And I do know the profession quite well.

i never said universally. but it is an option, and the more it is implemented the more prices across the board will be driven down.

But that's the premise, without going universally, you have what you have now. A few here and there with no effect at all.

cpwill · Jun 10, 2011

Boo Radley said:
Sounds like an insurance company to me.

then you need to get your hearing checked - people get money out of insurance agencies all the time.

flippancy does not become this debate.

Hard is not impossible.

that is correct - any time they can work up the same percentage that it takes to overturn a Presidential Veto they can overturn a decision by the IPAB. Now, given that that is the hurdle you have to jump over, what do you think the odds are that you will see more success out of that than you would suing an insurance company that is in breach of contract.

All for hope. But it won't trump reality. Sadly.

:shrug: well if you think reality is that Americans are too greedy to try to protect the poor then we are just going to have to disagree.

No, it actually doesn't, not even means testing

in fact it does - the coverage is guaranteed by law.

Nope, didn't miss that at all. And it changes nothing I said. Remember, he is alone, only one, and cannot represent what would happen overall, and for a number, even this would be too much.

cutting healthcare costs by 1/2 to 1/3 is pretty impressive - and you offer precisely zero evidence that this wouldn't work for anyone other than him.

As his is based on no one having insurance, and not accepting government money, that is how we have to frame it as a future cost saving measure. It simply would not do the job.

he's not. he's basing it on people paying cash for service. this sort of thing would work splendidly with high-deductible plans.

There's been no schooling and frankly your comment suggests you have no understanding of what has been argued. You're going to the j school of debate, which is slightly better than the Prof school. And I do know the profession quite well.

lol, once upon a time, boo, i might have even agreed with that last line.

since then...

Boo Radley · Jun 14, 2011

cpwill said:
then you need to get your hearing checked - people get money out of insurance agencies all the time.

flippancy does not become this debate.

No, my hearing is fine, and i wasn't flippant. Is see little difference.

that is correct - any time they can work up the same percentage that it takes to overturn a Presidential Veto they can overturn a decision by the IPAB. Now, given that that is the hurdle you have to jump over, what do you think the odds are that you will see more success out of that than you would suing an insurance company that is in breach of contract.

And you have to jump over major hrdles concerning an insurance conmpany as well, who have much more money and lawters, and a maze of rules and such to get through.

:shrug: well if you think reality is that Americans are too greedy to try to protect the poor then we are just going to have to disagree.

Wow, what a leap. This is the definition of a strawman. Seriously, dude. :coffeepap

in fact it does - the coverage is guaranteed by law.

No, limited coverage.

cutting healthcare costs by 1/2 to 1/3 is pretty impressive - and you offer precisely zero evidence that this wouldn't work for anyone other than him.

Yes, I have offered evidence through logic. For all to do this, you ahve to end government aid and healthcare, as that is what he did. So, this means, that some would be left outside of care, as it was before insurance.

he's not. he's basing it on people paying cash for service. this sort of thing would work splendidly with high-deductible plans.

Right., Cash and not insurance. Now add the two. Link the logic.

lol, once upon a time, boo, i might have even agreed with that last line. since then...

And that is whn you would have been right. Your ideology blinds you to reality and the profession, of which you ahve very limited knowledge.

donsutherland1 · Jun 14, 2011

Sgt Meowenstein said:
McConnell is refering to the Ryan budget. The budget that effectively ends Medicare. There is no way in hell Dems will go along with that. Therefore; there will be no deal if McConnel insists on those terms. Get back to me when you have a clue.

Senator McConnell almost certainly knows that the Democrats will not accept Congressman Ryan's proposed solution for Medicare. It's an opening position. Notice that with respect to a deal, Senator McConnell stated "Medicare will be a part of it" but did not get more specific than that. That broad statement is not accidental. It leaves a lot of flexibility for both the magnitude and type of Medicare reforms that he could possibly accept.

American · Jun 14, 2011

Sgt Meowenstein said:
McConnell is refering to the Ryan budget. The budget that effectively ends Medicare. There is no way in hell Dems will go along with that. Therefore; there will be no deal if McConnel insists on those terms. Get back to me when you have a clue.

The Hyperbole King!

cpwill · Jun 19, 2011

Boo Radley said:
No, my hearing is fine, and i wasn't flippant. Is see little difference.

you see little difference between a private entity against whom suit can be brought, and who pays out money on a constant basis...

...and a board of bureaucrats against whose decisions cannot be contested and who by law will thus pay out nothing at all.

this is like your north/south korea thing, Boo - you are testing the limits of reality here in your desire to defend a poorly chosen argument.

And you have to jump over major hrdles concerning an insurance conmpany as well, who have much more money and lawters, and a maze of rules and such to get through.

yes, and you have to run a gamut of hurdles to get a McDonalds Cheeseburger, from finding the place, to getting to the place, to getting through the door, to waiting in line....

it's not a matter of whether or not one has to work for it - it's a matter of scale. to get money out of an insurance agency you fill out the right forms and if they try anything funny you hire a lawyer. to get money out of the government in this case you have to get the equivalent of a Constitutional Amendment passed.

Wow, what a leap. This is the definition of a strawman. Seriously, dude.

I said that Americans would support means-testing as a way to protect the poor, you argued that they wouldn't because that would entail a loss of benefits for upper and middle class Americans, I disagree that I don't think Americans are that greedy and your only response is to try to pretend like you don't have to respond.....

No, limited coverage.

coverage for which those who can afford it pick up more of the premium is not "limited coverage"

Yes, I have offered evidence through logic.

no you haven't, you've just offered a series of just-so statements.

For all to do this, you ahve to end government aid and healthcare, as that is what he did.

no you don't. you simply have to have people willing to pay in cash. people on an HSA, for example.

Right., Cash and not insurance. Now add the two. Link the logic.

the logic is not "ergo, there can be no insurance".

And that is whn you would have been right.

yup; once upon a time.... even then you were slippery, but at least you were quality when you staked out a position. it all started to go downhill for you, I think, when the war in Iraq turned around.

cpwill · Jun 19, 2011

donsutherland1 said:
Senator McConnell almost certainly knows that the Democrats will not accept Congressman Ryan's proposed solution for Medicare. It's an opening position. Notice that with respect to a deal, Senator McConnell stated "Medicare will be a part of it" but did not get more specific than that. That broad statement is not accidental. It leaves a lot of flexibility for both the magnitude and type of Medicare reforms that he could possibly accept.

perhaps they will accept the Simpson-Bowles proposal - that would be good.

Boo Radley · Jun 21, 2011

cpwill said:
you see little difference between a private entity against whom suit can be brought, and who pays out money on a constant basis...

...and a board of bureaucrats against whose decisions cannot be contested and who by law will thus pay out nothing at all.

this is like your north/south korea thing, Boo - you are testing the limits of reality here in your desire to defend a poorly chosen argument.

Your tactic is alwys to tery andf take it where it isn't so you can make such silly claims. The fact is, actually winning anything is difficult to impossible with both. This is the point.

yes, and you have to run a gamut of hurdles to get a McDonalds Cheeseburger, from finding the place, to getting to the place, to getting through the door, to waiting in line....

Another silly comparison that is not remotely the same. How do you expect someone to address something so silly?

it's not a matter of whether or not one has to work for it - it's a matter of scale. to get money out of an insurance agency you fill out the right forms and if they try anything funny you hire a lawyer. to get money out of the government in this case you have to get the equivalent of a Constitutional Amendment passed.

And the scale isn't that different. If it were as small as you example, you would be correct. But as they are much closer, it comes across as just stupid. If you're going to make the scale argument, show me how they are not closer than your example.

I said that Americans would support means-testing as a way to protect the poor, you argued that they wouldn't because that would entail a loss of benefits for upper and middle class Americans, I disagree that I don't think Americans are that greedy and your only response is to try to pretend like you don't have to respond.....

Means testing will effect more than the poor. It isn't as much about greed as it is about feeling entitled and seeing their need as different than the standards the testing will likely have. For example, some see $14,000 a year as the standard for help for a family of four. Would you argue someone at $16,000 year didn't see it differently? It's not greed as much as not accepting the standard the government is likley to present.

coverage for which those who can afford it pick up more of the premium is not "limited coverage"

Just so we don't get lost in your diversions, we're speakign about the entire program, which will decrease benefits, apart from means testing, which will mean in fact limited coverage. Picking more is only possible if you really can pick up more. Otherwise, it will be limited.

no you haven't, you've just offered a series of just-so statements.

Yes, and if you add the series of statements together, you know, reading the whole to see what it adds up to instead of mindless breaking it down to parts as if they were separate, you might see what I'm saying.

no you don't. you simply have to have people willing to pay in cash. people on an HSA, for example.

I'm sorry, that makes no sense. To pay cash, you have to have cash. Are you suggesting we hand people cash?

the logic is not "ergo, there can be no insurance".

If you are paying cash, there is no insurance to cover to cover it.

yup; once upon a time.... even then you were slippery, but at least you were quality when you staked out a position. it all started to go downhill for you, I think, when the war in Iraq turned around.

Turned around? Even there your view is through some weird colored glasses.

CP, long before now, long before Bush went with any surge or anything, your tactics angered even people who shraed your ideological bent. I orignally started speaking to you about it back then because so many spoke of it, people who liked you like I do. You're no where near as good as you think you are. Few of us are. But before you can critize someone's logic you have to understand it and when you look only at parts, removed from the whole, and don't connect them, you simply don't have the understanding to comment.

cpwill · Jun 23, 2011

Boo Radley said:
Your tactic is alwys to tery andf take it where it isn't so you can make such silly claims. The fact is, actually winning anything is difficult to impossible with both. This is the point.

yes, i get what you are trying to say. the problem is that what you are trying to say isn't connected to reality. people can and do get money out of their insurance companies all the time. I have done so on multiple occasions.

Another silly comparison that is not remotely the same

it is, in fact, more comparable than your own. the nature of the two are the same - it is merely the degree that differs. whereas the comparison you are attempting to draw is between two items of opposing nature.

but I don't expect you to address it at all.

you have consistently demonstrated yourself unwilling to do so, preferring to be dismissive rather than try to actually engage.

And the scale isn't that different.

really. You think that filling out a piece of paperwork or hiring a lawyer... is the equivalent of passing a Constitutional Amendment.

like the North/South Korea thing, Boo, you are beyond rationality here in your attempt to defend a stupid point. There is a reason even Democrats are turning on the IPAB.

Means testing will effect more than the poor.

it will effect both the poor and the well-off, that is correct.

It isn't as much about greed as it is about feeling entitled

see - "feeling entitled" to someone else's money... that's what we call greed.

and seeing their need as different than the standards the testing will likely have.

you are saying everyone always wants more. I am saying in a zero-sum distribution; people will accept shifting the support that is currently weighted towards the wealthy towards the impoverished instead.

For example, some see $14,000 a year as the standard for help for a family of four. Would you argue someone at $16,000 year didn't see it differently?

that depends entirely on the family, place, and time. when I was bringing in about $24000 a year with a family I didn't think I needed any help, and a family in most nations around the world would consider themselves solid middle class or even wealthy on $16,000 a year. As an American today I'm fully willing to extend such people more aid when it comes to the entitlements.... and I'm willing to cut the entitlements to someone bringing in $70K to do it.

It's not greed as much as not accepting the standard the government is likley to present.

specifically with regards to themselves?

here's a question: do you even know at what point the means-testing begins to tilt extra support to the senior? or are you just throwing out randomness desperately attempting to dodge the point?

Just so we don't get lost in your diversions, we're speakign about the entire program, which will decrease benefits, apart from means testing, which will mean in fact limited coverage. Picking more is only possible if you really can pick up more. Otherwise, it will be limited.

:shrug: in that sense coverage is already limited due to the constant of scarcity of resources. as for Reduced Benefit - I'm less sure. We will definitely see decreased expenditures; but if we see anything like the success story we saw the last time we put into play something like this we may see not nearly the kind of benefit reduction that worry us enough to impose means-testing.

I'm sorry, that makes no sense. To pay cash, you have to have cash. Are you suggesting we hand people cash?

do you know what a "high deductible plan" is? are you aware of what an "HSA" is? I ask this in honesty because you say that the notion of people paying in cash makes no sense - yet if you knew about those two items, then the only way that such a concept couldn't make sense to you would be if you were mentally deficient; and so I must assume lack of knowledge rather than assume idiocy. or perhaps it was just an oversight? a missed connection?

If you are paying cash, there is no insurance to cover to cover it.

or you have chosen not to have your insurance cover it, or you are on a high-deductible plan.

Turned around? Even there your view is through some weird colored glasses.

says the man who kept changing the goal posts. well the election hasn't gone off well. well it went off well but the sunni didn't participate. well the election went off well, and now the sunni are now participating but violence is still high. the elections have gone off well, the Sunni are participating, and violence is decreasing, but violence still isn't below 2005 (no idea why you picked that year) levels. Well, the elections have gone off well, the Sunni are participating, violence is below 2005 levels, but we always knew this would happen and the Surge troops haven't left yet. How many times did you predict massive civil war?

and all the while you are loudly proclaiming that Afghanistan is the "good" war, that that is where we should be "surging" and that is where we should be sticking it through.... and so did nearly everyone else on the anti-Iraq side of the aisle, throwing out support for Afghanistan as their shield to charges that they were weak on national security and willing to lose the war.....

.... now, let me see if I can recall... When McCrystal asked for another 40,000 troops and a surge to stick it through your response was.....
.... and your reaction to Obama deciding to go for what is politically popular rather than necessary to finish that conflict will be.....

and the faux-support you and your compatriots pretended to have for Afghanistan shrivels up minus the need to use it as a cover.

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