Will the Repub Health Care Plan pass the house

[Winston]

well, to be fair, both sides do this.



part of it is having legacy health insurance from a time when workers had more negotiating power.

Cognitive dissonance is powerful. I try to be as objective as my liberal bias allows. I just think liberals are right, that's why I self identify as liberal.


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[Helix]

Cognitive dissonance is powerful. I try to be as objective as my liberal bias allows. I just think liberals are right, that's why I self identify as liberal.


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i do try to check myself to avoid confirmation bias. however, i am far from perfect in this and in other areas.

 

[JasperL]

That's what so many do not take the time to understand. if we allow market forces to work, they ultimately work. That's why Subway sells sandwiches for about 7 bucks rather then 30 bucks.

There are many reasons why healthcare will never work in a truly 'free market' system. Just briefly with that Subway sandwich, you can say no to that and there are about 10,000 or more options for you to eat that will do the job of sustaining you for a few hours perfectly as well as that sammich. Food is extremely cheap - you can sustain yourself for a long time on a big jar of peanut butter, white bread, and water. It's predictable - we need roughly 2,000 calories per day and the source doesn't much matter for very long periods of time. No expertise required to choose food. Any child can do it.

Healthcare is none of those - it's unpredictable, there are few to no substitutes (if you need open heart surgery, aspirin isn't going to help nor will hip surgery), when you really need it the cost can easily reach well into the 6 or even 7 figures, almost no one can afford to self finance that kind of risk, so we all need a third party insurer to bear that risk, there is a massive amount of expertise required to deliver healthcare, in our system, it's expensive because of the incredible life saving equipment we've developed, etc......

Plus, in a real free market system, those who cannot pay are/must be denied goods or services. With healthcare, that means the poor just DIE if they get sick - so do their children. Meningitis? So sad but you can have more children ma'am. If we aren't willing to do that, every day, many times a day, markets will not work.

Anyway, those who say they want a 'free market' in healthcare haven't given it a lot of thought. There is a good reason why the ENTIRE industrialized world but the U.S has some sort of a single payer/UHC system, even those countries who are otherwise highly 'market' friendly, with low tax burdens and small government.

 

[Moderate Right]

That's the nature of data, as opposed to your anecdotes.

And I'm not sure on what basis you're claiming apples to oranges. At some levels, comparing healthcare in Alabama and Tennessee is apples and oranges, but we have to have some way to compare across cities, states and countries, and anecdotes don't cut it.

Generalized and averaged statistics don't cut it either. The US has higher rates of obesity than any of the countries with UHC so life expectancies and health outcomes are skewed against the US. That's just one example. For those in the US with good health insurance (and this often includes the poorer, depending on where they work) our quality of care is far superior to that of counties with UHC. But, that fact doesn't show up in generalized or averaged statistics. Stats are tools only, and that's all you can use them for. A nail isn't much good without a hammer.

 

[polisciguy]

There's a decent chance it will pass the House, though it may have a harder time in the Senate. I think it has a better chance of passing both houses the longer the process drags on. Similar to the Democrats with the ACA, the Republicans may find themselves pressured to pass it before they risk possibly losing the necessary seats to get it done.

 

[JasperL]

Generalized and averaged statistics don't cut it either. The US has higher rates of obesity than any of the countries with UHC so life expectancies and health outcomes are skewed against the US. That's just one example. For those in the US with good health insurance (and this often includes the poorer, depending on where they work) our quality of care is far superior to that of counties with UHC.

Often the poorer - 10s of millions of them - have no insurance or woefully inadequate insurance, which no doubt contributes to poor outcomes. Second, if you're going to claim that our quality of care is far superior to every other country on the planet, then you need evidence to back that up. Your phone calls with a few people in a few countries isn't evidence.

Furthermore, quality of care where in the U.S.? I can tell you from experience that the quality of care in a small county in lower Alabama is just awful, which is why we are forced to bring my mother in law to Tennessee where we can find better care. And it's going to be better in Boston than where I live. So how do you compare the "U.S." to anyone without averaged statistics?

But, that fact doesn't show up in generalized or averaged statistics. Stats are tools only, and that's all you can use them for. A nail isn't much good without a hammer.

But you're using an inferior and inadequate tool - your discussions with a few people in a few countries. I agree that something like longevity doesn't capture all we need to know about the quality of healthcare, but that stat works both ways. Just because someone makes it to 80 doesn't mean they lived a healthy life and had a good quality of life at the end.

Obviously you can use whatever evidence you want to make decisions, but it's just illegitimate to conclude those of us using the data and evidence we have available to come to our own conclusions are using the wrong tool unless you have a better one to offer, which you do not.

 

[Ikari]

Hard to say if it will pass or not, even as we approach the looming deadline of the vote. There is a lot of grandstanding, but it may turn out to just be that and when it comes down to the vote, everyone falls into party line.

 

[Moderate Right]

Often the poorer - 10s of millions of them - have no insurance or woefully inadequate insurance, which no doubt contributes to poor outcomes. Second, if you're going to claim that our quality of care is far superior to every other country on the planet, then you need evidence to back that up. Your phone calls with a few people in a few countries isn't evidence.

Furthermore, quality of care where in the U.S.? I can tell you from experience that the quality of care in a small county in lower Alabama is just awful, which is why we are forced to bring my mother in law to Tennessee where we can find better care. And it's going to be better in Boston than where I live. So how do you compare the "U.S." to anyone without averaged statistics?



But you're using an inferior and inadequate tool - your discussions with a few people in a few countries. I agree that something like longevity doesn't capture all we need to know about the quality of healthcare, but that stat works both ways. Just because someone makes it to 80 doesn't mean they lived a healthy life and had a good quality of life at the end.

Obviously you can use whatever evidence you want to make decisions, but it's just illegitimate to conclude those of us using the data and evidence we have available to come to our own conclusions are using the wrong tool unless you have a better one to offer, which you do not.

I can back it up, using your very own generalized statistics and simple math and logic. I'll assume you know basic math. Let's take three numbers, 0, 50, and 100. The average of those numbers is 50. Now let's say the statistics for health outcomes in both the US and UHC countries averages out to 50, so they are similar other than the cost. Since all of the citizens in UHC countries are all about the same we'll say they are 50 on the statistics chart. In the US we'll say that many without good insurance or no insurance are at or near 0 on the chart and that people with great insurance are at or near 100 on the generalized averaged chart for the US, all of this averaging out to the same 50 compared to UHC countries, not accounting for cost. This logically means that a percentage of the US population gets far superior health outcomes than UHC countries and that a percentage of the US population gets far inferior health outcomes compared to UHC countries. These differences have more to do with where you work and their health care plans and less to do with your station in life. Therefore the health outcomes for some in the US are indeed far superior to those in UHC countries. Now I'm not rich by any means, I'm probably in the lower part of the middle class. But, I have always had great insurance and when I compare it to people in other countries with UHC, it is obvious to me how infinitely better my healthcare is to theirs.

 

[JasperL]

I can back it up, using your very own generalized statistics and simple math and logic. I'll assume you know basic math. Let's take three numbers, 0, 50, and 100. The average of those numbers is 50. Now let's say the statistics for health outcomes in both the US and UHC countries averages out to 50, so they are similar other than the cost. Since all of the citizens in UHC countries are all about the same we'll say they are 50 on the statistics chart. In the US we'll say that many without good insurance or no insurance are at or near 0 on the chart and that people with great insurance are at or near 100 on the generalized averaged chart for the US, all of this averaging out to the same 50 compared to UHC countries, not accounting for cost. This logically means that a percentage of the US population gets far superior health outcomes than UHC countries and that a percentage of the US population gets far inferior health outcomes compared to UHC countries. These differences have more to do with where you work and their health care plans and less to do with your station in life. Therefore the health outcomes for some in the US are indeed far superior to those in UHC countries. Now I'm not rich by any means, I'm probably in the lower part of the middle class. But, I have always had great insurance and when I compare it to people in other countries with UHC, it is obvious to me how infinitely better my healthcare is to theirs.

But you're making about a dozen assumptions in that little scenario. That all the citizens in UHC countries are about the same (false), that quality is uniform across the country in, say, France and in all other countries across the globe (false - it's no more likely to be uniform there as it is here), that the UHC is a one size fits all plan (false almost everywhere), and the $billionaires get the same care as the poor (false), that UHC in the U.S. will be one size fits all (almost surely false), with Jamie Dimon getting the same care as the grocery store clerk up the street (false), and much more.

And even if you accept your assumptions, most of them false or likely false, then it's still an inherent conclusion that the country - legislators and the POTUS - should be content with a health care system that fails something like 20% of the population pre-ACA (who were uninsured), and something like half the country if we exclude those non-seniors who were already on government plans, like the VA and Medicaid and SCHIP pre-ACA, just so long as it works very well for the minority of the country with a good healthcare plan at work.

 

[Moderate Right]

But you're making about a dozen assumptions in that little scenario. That all the citizens in UHC countries are about the same (false), that quality is uniform across the country in, say, France and in all other countries across the globe (false - it's no more likely to be uniform there as it is here), that the UHC is a one size fits all plan (false almost everywhere), and the $billionaires get the same care as the poor (false), that UHC in the U.S. will be one size fits all (almost surely false), with Jamie Dimon getting the same care as the grocery store clerk up the street (false), and much more.

And even if you accept your assumptions, most of them false or likely false, then it's still an inherent conclusion that the country - legislators and the POTUS - should be content with a health care system that fails something like 20% of the population pre-ACA (who were uninsured), and something like half the country if we exclude those non-seniors who were already on government plans, like the VA and Medicaid and SCHIP pre-ACA, just so long as it works very well for the minority of the country with a good healthcare plan at work.

And statistics that are all about averages and generalities make a ton of assumptions also. Not everyone is equal. That's why generalities and averages are only a good way to judge for generalities and averages.

 

[JasperL]

And statistics that are all about averages and generalities make a ton of assumptions also. Not everyone is equal. That's why generalities and averages are only a good way to judge for generalities and averages.

But when you conclude, as you did, that healthcare in the U.S. is FAR better than in every other country on the planet, we are more likely to see a doctor here than in all other countries, wait times here are shorter than in every other country on the planet, etc... you're making a claim based on "generalities and averages."

 

[Moderate Right]

But when you conclude, as you did, that healthcare in the U.S. is FAR better than in every other country on the planet, we are more likely to see a doctor here than in all other countries, wait times here are shorter than in every other country on the planet, etc... you're making a claim based on "generalities and averages."

The thing is, you guys claim that not one person in this country has better care than they do in other countries, unless that person is rich, and that's not even true. I'm not rich and I have better care than people in other countries and I know this because I have talked to thousands of them and I do have better care than they do for my pre-existing conditions. I wouldn't take any of their health systems with a ten foot pole. All you guys want to do is talk about generalities and averages so that you can claim everyone needs UHC. I don't want UHC and I'm saying that as a person with pre-existing conditions. Now, I would actually take UHC if it was good healthcare but so far I have seen no other UHC I would want. I find it hard to believe that you could develop a system that didn't suck. Now if you want to talk about just cost and it basically being "free" then that's one thing but don't sell me on a system with lower quality of care that would drive me nuts.

 

[JasperL]

The thing is, you guys claim that not one person in this country has better care than they do in other countries, unless that person is rich, and that's not even true.

I've never made such a claim because it's impossible to even describe such a claim in a way that can be demonstrated true or false. Who is the 'one person' in this country, care for what ailment, than who does in which country or countries? Which person is rich? What exactly is not true?

Just for example, many people in this country obviously receive world class care in this country - comparable to or better than every country on the planet. Similarly, many people in other countries ALSO receive world class care, comparable to or better to every other country on the planet. I wouldn't ever dream of making sweeping assertions about care here versus the rest of the entire world because it varies by country, person, ailment, etc.

I'm not rich and I have better care than people in other countries and I know this because I have talked to thousands of them and I do have better care than they do for my pre-existing conditions. I wouldn't take any of their health systems with a ten foot pole.

First of all, it's unclear how you conclude that and we don't know and shouldn't know your particulars but I'll assume your observation is accurate for those people in those countries. It's a big world and I'm sure you don't have anything like a representative sample of every country, and at best what you know is that for your particular ailment, and based on the care you get in your city and your healthcare team, you prefer the U.S. healthcare system over other options that you have examined. All we can possibly know is just your experience. If someone on a crappy plan in a rural county in Alabama compares his healthcare plan to someone of similar income in Paris, France and determines that the care his cohort gets in Paris is FAR superior to what's available to him in Backwater, AL - now what? How does a policy maker decide whether or not to adopt the French system or remain on our system? Better for you, worse for someone else....:doh

All you guys want to do is talk about generalities and averages so that you can claim everyone needs UHC. I don't want UHC and I'm saying that as a person with pre-existing conditions. Now, I would actually take UHC if it was good healthcare but so far I have seen no other UHC I would want. I find it hard to believe that you could develop a system that didn't suck. Now if you want to talk about just cost and it basically being "free" then that's one thing but don't sell me on a system with lower quality of care that would drive me nuts.

LOL, of course the data indicate that there are lots of excellent UHC systems, all over the globe, but you disregard the evidence so we're at sort of an impasse. It's worse because you're claiming that there can be no evidence that you'd trust to demonstrate that in fact people get excellent, outstanding, care in much of the rest of the world.

 

[Jack Hays]

Not discounting your opinion. I referred to what we as a society consider to be a just society.

Justice does not require equality of outcomes, only equality of opportunities.

 

[Jack Hays]

Debunking Canadian health care myths – The Denver Post

I don't recall referring to Canada.

 

[JANFU]

Justice does not require equality of outcomes, only equality of opportunities.

And i differ on that. How we as a society care for the weak, those that need help, those that need medical care, the elderly, and so on. If we as a society throw these people to the side, that is not my idea of what a just society is.
I have no issue with tax dollars being used for this, in fact I support it.

 

[Jack Hays]

And i differ on that. How we as a society care for the weak, those that need help, those that need medical care, the elderly, and so on. If we as a society throw these people to the side, that is not my idea of what a just society is.
I have no issue with tax dollars being used for this, in fact I support it.

You assume use of taxation improves outcomes. That's not necessarily so.

Who Really Cares: The Surprising Truth About ... - Amazon.com

https://www.amazon.com/Who-Really-Cares-Compassionate.../dp/0465008232


We all know we should give to charity, but who really does? In his controversial study of America's giving habits, Arthur C. Brooks shatters stereotypes about ...

 

[JasperL]

Justice does not require equality of outcomes, only equality of opportunities.

LOL, when you find that world where there exists 'equality of opportunities' please let us know so we can join you there. It sure as hell isn't the U.S. in 2017.

So the question is in a reality where there are VAST differences in opportunities, what does justice require?

 

[JANFU]

You assume use of taxation improves outcomes. That's not necessarily so.

Who Really Cares: The Surprising Truth About ... - Amazon.com

https://www.amazon.com/Who-Really-Cares-Compassionate.../dp/0465008232


We all know we should give to charity, but who really does? In his controversial study of America's giving habits, Arthur C. Brooks shatters stereotypes about ...

Look to the EU, western democracies, their percentages of poor, health care for all to name a few.
But truth be told, we have opposing positions on this.

 

[Jack Hays]

LOL, when you find that world where there exists 'equality of opportunities' please let us know so we can join you there. It sure as hell isn't the U.S. in 2017.

So the question is in a reality where there are VAST differences in opportunities, what does justice require?

I have not claimed there is justice now, but I see no reason to invest in a feckless pursuit of equal outcomes.

 

[Jack Hays]

Look to the EU, western democracies, their percentages of poor, health care for all to name a few.
But truth be told, we have opposing positions on this.

And yet net immigration is from there to here.

 

[JANFU]

And yet net immigration is from there to here.

True to a point. I am not sure of the levels. I am aware of many farmers in Western EU countries emigrating to Canada, as land is cheaper, privacy is easy, and you are not living on top of each other.

 

[JasperL]

I have not claimed there is justice now, but I see no reason to invest in a feckless pursuit of equal outcomes.

So you meant nothing with your statement about what justice requires? That's odd. :doh

And equal outcomes is a straw man. I'm not aware of anyone pursuing 'equal outcomes' - on healthcare access or anything else. That would be feckless because it's impossible. All that any "UHC" system can be expected to accomplish is a higher floor on access to healthcare by the poor, sick and old, which is pretty much all it accomplishes in the rest of the industrialized world.

 

[Jack Hays]

So you meant nothing with your statement about what justice requires? That's odd. :doh

And equal outcomes is a straw man. I'm not aware of anyone pursuing 'equal outcomes' - on healthcare access or anything else. That would be feckless because it's impossible. All that any "UHC" system can be expected to accomplish is a higher floor on access to healthcare by the poor, sick and old, which is pretty much all it accomplishes in the rest of the industrialized world.

The fact that justice requires equal opportunities does not mean justice has been achieved, anywhere. The reference is aspirational.

 

[JasperL]

The fact that justice requires equal opportunities does not mean justice has been achieved, anywhere. The reference is aspirational.

What I'm asking is given vastly unequal opportunities in this country, what your version of justice requires. Besides, if equal opportunity is the goal, then it's certainly impossible to meet that goal if roughly half the country cannot reliably access our healthcare system without government assistance. The stress and financial burdens, as well as the practical difficulties, of succeeding while you or a loved one is ill and cannot afford basic treatment are obviously immense and a large burden that falls only on the poor.