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Post by myrrh on Jul 4, 2020 14:42:39 GMT -5
If you think you can digest both sides & find the truth somewhere in the middle, that's like standing with one foot on a block of ice & the other on a blowtorch - on the average you would be comfortable - right? I agree with this for the most part. But painting both sides as equally bad is a false equivalency. The Democratic party platform fiscal policies are disruptive, they're annoying, and their social policies can be cringey. The GOP is supporting a man who turned a blind eye to a "friendly" state using bounties to encourage a terrorist organization to kill our soldiers, and has actively sabotaged the US reaction to Covid-19 so badly that recovery has gone from "when" to "if," and has been proving on a daily basis since before he was elected that he's a stone cold idiot. That's not a counter position to the Democratic party, that's just malicious narcissism. Supporting the GOP is indefensible; choosing to not actively oppose the GOP isn't centrism, it's complicity. One of the few places besides PD that I'm active online is a political forum where half of the discourse is just bitching about liberals. I've written dozens of angry letters to my state reps, all of whom are Democrats. But even though I roll my eyes at the woke cult, I'm able to recognize the fact that contemporary right wing politics has devolved to rancorous, state-sponsored ignorance. I would love to check out of politics and just, like, spend my time raising pygmy goats and listening to the morning news with calm detachment. But I work in the sustainability sector and every day I come face-to-face with the fact that we are in serious shit. Two years in a row, GOP representatives ran away and hid in a neighboring state so they wouldn't have to vote on anti-pollution legislation. They're bad actors and turning a blind eye is just not something I can do in good conscience.
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Post by mike on Jul 4, 2020 15:29:54 GMT -5
myrrh, evidently I was unclear. The suggestion wasn't that the right & left POLITICS are equally responsible, the suggestion was that left & right PRESS both distort the picture. If you derived the majority of your news from right wing press, your opinions might shift, but that would be driven by the distorted picture given to you. Likewise, if you derived your information mostly from left leaning press your opinions might also shift. It is more challenging to get a clear picture of what is actually going on, and I don't have a monopoly on insight. There have been other times when facts were unclear (Vietnam etc.), and only years after the fact did the lies become obvious. Trump is clearly controversial, but we have had controversial politicians before. For example, to liberals Bill (saint?) Clinton was a great guy, but to conservatives his name triggers the gag instinct. I am not trying to equate Trump with Clinton in terms of what they have done, but in terms of polarization of public opinion. Here is something that is apparent to me: the federal government clearly fumbled when dealing with Covid, and clearly fumbled with respect to Puerto Rico & hurricane Katrina. So why do the Bernie Sanders supporters want to turn our healthcare over to these same people? Would yet more power somehow make them more competent? Keep in mind that politics & science are not natural bedfellows. Science is driven by facts, politics is driven by wishful thinking.
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Post by darthoso on Jul 4, 2020 16:32:39 GMT -5
Here is something that is apparent to me: the federal government clearly fumbled when dealing with Covid, and clearly fumbled with respect to Puerto Rico & hurricane Katrina. So why do the Bernie Sanders supporters want to turn our healthcare over to these same people? Would yet more power somehow make them more competent? Keep in mind that politics & science are not natural bedfellows. Science is driven by facts, politics is driven by wishful thinking. Emergency Management in a federal system is extremely hard, it's why the federal government has devolved most of that power to the states to achieve better unity of command (dual status national guard commanders for example). Medicare For All is an expansion of Medicare, a health insurance program that everyone over 65 is on and functions extremely well by nearly every metric including patent satisfaction. A major component of that success is that the program is administrated by the federal government, not the states like Medicaid. I ask this in response, what's the alternative? Take a deep look at the healthcare system and you'll arrive at single payer. As someone who works in the healthcare industry I'd be happy to take you though it.
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Post by devogirl on Jul 4, 2020 18:29:35 GMT -5
Putting yourself in the center of politics is comforting but I feel it is intellectually contradictory. Those in the center generally want this to calm down and return to a more normal "normal". That's fair, but the center has zero policy prescriptions that achieve that objective. The split in American politics, or more accurately the evacuation of the center, is a result of the failure of the center to offer policies that achieve any desirable outcome that releases the tension. The center is now occupied by those who are politically comfortable and feel they have something to lose if Left or Right is successful (economic if the Left wins, social if the Right wins. The center's failure to recognize the times is maddening since doing nothing just accelerates exactly what they fear. The Center is the Center's own worst enemy. I considered myself a moderate for years until I recognized the country was sick and that changes were needed to maintain political balance. My personal leaning towards FDR Progressivism is based on a historical record of what works to release the tension powering alternative political models, people forget the US had a legit Nazi movement too in the 30s. The 1990s are dead, welcome to the 1930s. I agree. Centrist positions support the status quo. People who have been radically marginalized need to push for radical change. Eventually those radical positions come to be widely embraced and seem obvious, like abolishing slavery or granting equal rights to women. In more recent history, most US politics used to be centrist--the sharp partisan division is relatively new, with an emptying out of the center. That change will not be reversed easily or quickly.
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Post by matisse on Jul 4, 2020 18:56:13 GMT -5
Here is something that is apparent to me: the federal government clearly fumbled when dealing with Covid, and clearly fumbled with respect to Puerto Rico & hurricane Katrina. So why do the Bernie Sanders supporters want to turn our healthcare over to these same people? Would yet more power somehow make them more competent? Keep in mind that politics & science are not natural bedfellows. Science is driven by facts, politics is driven by wishful thinking. Emergency Management in a federal system is extremely hard, it's why the federal government has devolved most of that power to the states to achieve better unity of command (dual status national guard commanders for example). Medicare For All is an expansion of Medicare, a health insurance program that everyone over 65 is on and functions extremely well by nearly every metric including patent satisfaction. A major component of that success is that the program is administrated by the federal government, not the states like Medicaid. I ask this in response, what's the alternative? Take a deep look at the healthcare system and you'll arrive at single payer. As someone who works in the healthcare industry I'd be happy to take you though it. Why not Medicare if you want it? If it's really that great, there should be no need to force it, it would naturally take over on its own. Another option is to cap profits on insurance companies. They may have served a function at some point, but now they are nothing more than middlemen squeezing both sides. They should function more like a co-op that returns excess profits to their members.
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Post by Corey on Jul 4, 2020 20:55:10 GMT -5
Those in the center generally want this to calm down and return to a more normal "normal". That's fair, but the center has zero policy prescriptions that achieve that objective. I dont think that is true. Matisse just gave a centrist policy that would greatly improve our healthcare system. (and is basically what Switzerland does) I think by 'centrist policy' you are thinking of the long line of policy compromises that typically are watered down versions of good bills that end up accomplishing very little. Obamacare is a great example. Democrats at the time had the house, the senate, and the executive. But the healthcare bill was very weak, because moderate Democrats were worried they would lose their seat so they compromised. What you ended up with was an expansion of Medicaid (okay...) and a government mandate to buy crappy insurance, from private companies, at very high prices (bad!). This is not what I call a centrist policy. If you were to ask the typical American with no strong affiliation to either party what their ideal health plan is, they will not say "whatever plan will make Cigna's stock go up by 300% in 7 years" This happens because our political system was designed to be inefficient. What we usually end up with as a result of all the compromises are bills that take the worst ideas from Democrats and the worse ideas from Republicans and mashes them together. I agree, they suck, but its not a centrist policy. A centrist policy is the opposite, when you take the best ideas from both sides. eg cut corporate taxes, but make them use the money to expand domestic capex. expand access to universities, but tie tuition to inflation. And so on...
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Post by mike on Jul 4, 2020 23:45:53 GMT -5
I somewhat agree with matisse - my version would be that IF YOU WANT you can buy your way into medicare. Medicare would be the competition that would force private insurance to become truly competitive. However, and this is my main concern, the lobbyists would derail any good ideas. My cynicism is that democrat or republican it makes little real difference, they just do what the lobbyists tell them anyway. Just like they distort any legislation that threatens profits. As long as there is money in politics, the big fish will eat the little fish every time.
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Post by darthoso on Jul 5, 2020 11:59:37 GMT -5
Emergency Management in a federal system is extremely hard, it's why the federal government has devolved most of that power to the states to achieve better unity of command (dual status national guard commanders for example). Medicare For All is an expansion of Medicare, a health insurance program that everyone over 65 is on and functions extremely well by nearly every metric including patent satisfaction. A major component of that success is that the program is administrated by the federal government, not the states like Medicaid. I ask this in response, what's the alternative? Take a deep look at the healthcare system and you'll arrive at single payer. As someone who works in the healthcare industry I'd be happy to take you though it. Why not Medicare if you want it? If it's really that great, there should be no need to force it, it would naturally take over on its own. Another option is to cap profits on insurance companies. They may have served a function at some point, but now they are nothing more than middlemen squeezing both sides. They should function more like a co-op that returns excess profits to their members. The issue with a Medicare Buy In is that it doesn't do anything to address the underlying problem: price. Not the cost of the insurance, the cost of care. I don't know a lot about the Swiss system but I'd bet money that all of their insurance plans operate off a system wide fixed price model. A hip replacement costs your insurance X regardless of where you get your coverage. I know that sounds commie but there is no other method to do price discovery since free market economics and healthcare don't mix. The current system of providers and insurance companies pulling numbers out of their ass is bankrupting the country, we can't keep spending nearly 18% GDP on healthcare. Here's an example of the insanity: Biogen sells Spinraza to Duke for $125,000 per dose, Duke then bills Blue Cross $765,709 which gets "negotiated" down to $365,306.03. Putting Biogen aside (at least they kinda invented something), that's a quarter million dollar profit for Duke every 4 months per patient. Labs, doctor fee, PT eval, procedure, and recovery are billed separately. All Duke did for that profit is fax the doctor's letter and PT eval to Blue Cross for preauth, then Biogen to order the drug. NC Medicaid only pays Duke a $10,000 profit. These numbers are made up by Duke and BC, they are based on nothing. Medicare for All would establish a fixed price schedule, which means that providers could greatly reduce their overhead since they don't need an army of admins to file insurance. We easily could see a 40% premium increase in 2021 post COVID. We already have caps on % of premiums that go towards overhead and profit and insurance is barely cheaper in states with multiple companies competing. Premiums largely reflect costs. 18% GDP is $3.6 trillion, health insurance overhead is only ~$275 billion of that, that's nothing. Doesn't matter what system we use unless we fix provider cost first. What's even more insane is that even with $3.6 trillion, a lot of rural hospitals are collapsing. So I don't get where that money is going beyond outright waste and inefficiency. The other issue with Medicare Buy In is exactly what mike said. The Medicare Buy In will be sabotaged to make it noncompetitive. Medicare for All can't be sabotaged just like traditional Medicare can't be sabotaged, because everyone is on it. Now if you want to build private coverage on top of Medicare, like Medicare Advantage, at least you're operating on top of the Medicare system.
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KingRichard
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Post by KingRichard on Jul 5, 2020 12:26:03 GMT -5
The only real joy I get out of politicians nowadays is when there get owned or get called out on their bullshit from both sides in my opinion both sides are just as bad as each other the right cut too much and the left spends too much money this is why I am in the middle when it comes down to politics and don't pick the left side or the right side of politics both sides always say that there can fix things but 90% of the time there just make things worse not better
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Post by Dr. BiPAP Sachin on Jul 5, 2020 13:38:50 GMT -5
I'm still waiting to be bashed by progressives, conservatives, Trumpians, and centrists for being a moderate libertarian who is an ardent Tulsi Gabbard supporter.
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Post by myrrh on Jul 5, 2020 13:50:57 GMT -5
I'm still waiting to be bashed by progressives, conservatives, Trumpians, and centrists for being a moderate libertarian who is an ardent Tulsi Gabbard supporter. Would you say you're.... present?
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quadversation
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Post by quadversation on Jul 5, 2020 14:40:58 GMT -5
People are generally intelligent Some people truly are dumbasses though 50% of people are below average intelligence. Imagine trying to have a reasonable conversation with this person: God bless America!!! Yeah there are plenty of nuts out there.
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Post by darthoso on Jul 5, 2020 15:09:31 GMT -5
Those in the center generally want this to calm down and return to a more normal "normal". That's fair, but the center has zero policy prescriptions that achieve that objective. I dont think that is true. Matisse just gave a centrist policy that would greatly improve our healthcare system. (and is basically what Switzerland does) I think by 'centrist policy' you are thinking of the long line of policy compromises that typically are watered down versions of good bills that end up accomplishing very little. Obamacare is a great example. Democrats at the time had the house, the senate, and the executive. But the healthcare bill was very weak, because moderate Democrats were worried they would lose their seat so they compromised. What you ended up with was an expansion of Medicaid (okay...) and a government mandate to buy crappy insurance, from private companies, at very high prices (bad!). This is not what I call a centrist policy. If you were to ask the typical American with no strong affiliation to either party what their ideal health plan is, they will not say "whatever plan will make Cigna's stock go up by 300% in 7 years" This happens because our political system was designed to be inefficient. What we usually end up with as a result of all the compromises are bills that take the worst ideas from Democrats and the worse ideas from Republicans and mashes them together. I agree, they suck, but its not a centrist policy. A centrist policy is the opposite, when you take the best ideas from both sides. eg cut corporate taxes, but make them use the money to expand domestic capex. expand access to universities, but tie tuition to inflation. And so on... The issue is that that good centrist policy has massive problems that'll cause it to become a bad policy, as I laid out above. The ACA is, on paper, a good policy but was doomed because it requires regular congressional updates and careful executive management. Good policy is like good engineering, simple and built to last. Medicare runs on nothing from congress and even a willfully neglectful executive can't mess it up. Same with Social Security. Centrist policy only works if the politics can support it, it can't in today's environment, it's like trying to build on quick sand. To make it worse the ACA was watered down because of scared moderates, that watering down helped make the ACA worse which led to them losing their seats anyway. As I said, they are their own worst enemy.
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Post by Dr. BiPAP Sachin on Jul 5, 2020 16:11:01 GMT -5
People are generally intelligent Define "intelligent."
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Post by matisse on Jul 5, 2020 17:00:53 GMT -5
Why not Medicare if you want it? If it's really that great, there should be no need to force it, it would naturally take over on its own. Another option is to cap profits on insurance companies. They may have served a function at some point, but now they are nothing more than middlemen squeezing both sides. They should function more like a co-op that returns excess profits to their members. The issue with a Medicare Buy In is that it doesn't do anything to address the underlying problem: price. Not the cost of the insurance, the cost of care. I don't know a lot about the Swiss system but I'd bet money that all of their insurance plans operate off a system wide fixed price model. A hip replacement costs your insurance X regardless of where you get your coverage. I know that sounds commie but there is no other method to do price discovery since free market economics and healthcare don't mix. The current system of providers and insurance companies pulling numbers out of their ass is bankrupting the country, we can't keep spending nearly 18% GDP on healthcare. Here's an example of the insanity: Biogen sells Spinraza to Duke for $125,000 per dose, Duke then bills Blue Cross $765,709 which gets "negotiated" down to $365,306.03. Putting Biogen aside (at least they kinda invented something), that's a quarter million dollar profit for Duke every 4 months per patient. Labs, doctor fee, PT eval, procedure, and recovery are billed separately. All Duke did for that profit is fax the doctor's letter and PT eval to Blue Cross for preauth, then Biogen to order the drug. NC Medicaid only pays Duke a $10,000 profit. These numbers are made up by Duke and BC, they are based on nothing. Medicare for All would establish a fixed price schedule, which means that providers could greatly reduce their overhead since they don't need an army of admins to file insurance. We easily could see a 40% premium increase in 2021 post COVID. We already have caps on % of premiums that go towards overhead and profit and insurance is barely cheaper in states with multiple companies competing. Premiums largely reflect costs. 18% GDP is $3.6 trillion, health insurance overhead is only ~$275 billion of that, that's nothing. Doesn't matter what system we use unless we fix provider cost first. What's even more insane is that even with $3.6 trillion, a lot of rural hospitals are collapsing. So I don't get where that money is going beyond outright waste and inefficiency. The other issue with Medicare Buy In is exactly what mike said. The Medicare Buy In will be sabotaged to make it noncompetitive. Medicare for All can't be sabotaged just like traditional Medicare can't be sabotaged, because everyone is on it. Now if you want to build private coverage on top of Medicare, like Medicare Advantage, at least you're operating on top of the Medicare system. Can this be solved by requiring providers to accept Medicare with no balance billing? That would inherently give Medicare power over how much they pay.
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