Way to step up Massachusetts

[jamo]

I understand these points are the ones, along with the commerce & general welfare clauses of the US Constitution, are the most fundamentally used clauses to aid in the continued expansion, reach, and power of the federal government, but it doesn't make it right according to the basic reading and interpretation of the texts.

The problem with that is, this is how the Constitution has been read. Is there an expressed power saying Congress can "bust" trusts or create a welfare system? No, but the Constitution has been read to the extent that they both fall into the category of being within the general welfare clause.

I don't either of us is going to convince the other, our differences are more ideological beliefs about how loosely to read the Constitution.

[Shanks A Million]

The problem with that is, this is how the Constitution has been read. Is there an expressed power saying Congress can "bust" trusts or create a welfare system? No, but the Constitution has been read to the extent that they both fall into the category of being within the general welfare clause.

Not even experts agree about the necessary and proper clause, nor the tenth amendment's effect on it, and it's probably one of the most controversial parts of the constitution. The constitution is a living document, and is meant to be amended, and all who cling to it as divine have likely missed the point of it. Amendments to the constitution have brought about freedom for slaves, women, and many other groups who were once discriminated against. The whole idea of the United States was to be a nation founded on the ideal of progressing through time, changing with the times. When it was written, the idea that a black man could be president and a female house speaker was ludicrous. One day, gays, polygamists, and pagans will be as mainstream as blacks and women are today. Who knows, maybe our grandkids will aspire to be like President Alik Muntumbo, the first transgendered president born in Botswana?

[thrasher]

Let me start out by saying that I am a financial/data analyst and trainer at a major metropolitan hospital in the Twin Cities, which by the way resides in the state with the highest quality of health care in the US (Minnesota).

There are several factors contributing to the upward spiral of health care costs, in no particular order I guess:

-Lack of coverage for the uninsured.
What many people don't realize is that the uninsured are going to get the care they need, one way or another, which creates a multitude of financial problems in the long run. What happens quite often is they avoid regular PCP visits for preventative/wellness checks because they simply can't afford them. As a result, their health problems progress until they ultimately end up in Emergency Rooms, where they can't be turned away, and may be admitted for issues that would have been far less costly had they been dealt with earlier. Since they oftentimes can't pay for these costly visits, the facilities end up absorbing the costs and writing them off to either bad debt or to some community care write off program. In some cases we're talking about millions of dollars written off for a single patient. How do insurance providers and facilities stay afloat while absorbing these costs? Well, they negotiate higher payment rates with insurance companies in future contracts. Who do the insurance companies pass those costs along to? You guessed, all of the insured who are paying for private insurance, so your premiums go up.

-Overmedicating and overuse of unnecessary procedures
Providers and physicians are so afraid of being sued for misdiagnosis or for missing that one in a million diagnosis that they often order a battery of unnecessary, costly tests just to cover their butts in the future. In addition, a large percentage of physicians are paid by pharmaceutical companies to prescribe their medications, so the doctors make more money if they prescribe a specific medication. Obviously, both of these factors drive up costs as insurance companies are paying more for unnecessary tests and medication. Again, these costs are passed on to private insurance carrying consumers.

-Denial of coverage based on pre-existing conditions
Much like the uninsured, those with PEC very often lack the ability to get adequate coverage. Unfortunately, these people are already sick, and they WILL GET CARE regardless of their condition. Oftentimes, this care is very expensive and if there is no government program available to help cover expenses, the facilities are stuck with absorbing the costs. Premiums go up


Obviously, this is a multi-headed problem with no easy solution. I am of the opinion that both the Democrats and Republicans have important ideological contributions in the debate, and should be working together to get this HUGE problem resolved. My list of suggestions would be

-Cover the uninsured, PERIOD.
I have specific ideas about how that should happen, but whether it is a government run program or simply government funded, the uninsured have to be covered if we want to reign in costs. This includes the elimination of no pre-existing conditions disqualifications. If these people have regular access to preventative care as well as insurance coverage when they do need to be treated urgently/emergently, the domino effect on those who carry private insurance will be significantly reduced.

-Enact malpractice lawsuit caps
The LAST thing providers should be worrying about when treating patients is whether or not they will be sued if their patient is that one in a million. Mistakes are going to happen, providers are people and they're not perfect. This is as much a cultural change as it is a policy one, as people need to start accepting that medicine is NOT perfect. People are going to die, and it is rarely the provider's fault

-Incentivize positive health outcomes and promote wellness
The culture of medicine as a whole needs to change such that doctors are rewarded NOT for ordering tests and prescribing medication, but for acutally improving the health of patients. Holistic and naturopathic medicine needed to become more integrated into mainstream medicine, and the body as a whole needs to be treated preventatively to improve overall health and most importantly AVOID costly urgent/emergent procedures and hospital visits. Furthermore, there need to be financial incentives for consumers in the way of tax breaks and/or premium reductions for those individuals who show consistently strong health outcomes. After all, we WANT people to be healthy, right?

Whew, had to put in my 2 cents

[Fatphil]

Basically insurance companies are banks..they do not provide health care..they are not doctors. They are business' that take your premium invest it (with no interest to the policy holder) and make their profits and bonus' by doling out as little as possible. As a small business owner who pays ridiculous premiums and a huge deductable with NO guarentee of service should I need it, I am wholeheartedly in favor of the public option for one reason...to radically change the way insurance companies do business.

Denial of coverage and pre existing conditions..both of which Obama voted againt as a senator now he wants these in his bill OK great better late than never. Second...malpactice caps...never happen..however with the private option it is very difficult for some slim ball lawyer to pump out nuisance claims against the Fed's as they will actually defend the the ambulance chasers don't have the resources to fight. The dems realize they are in the pockets of the trial lawyers..this is a way to make it a moot point.

Had conversation with a vet the other day...he was railing about Obama and commies and such,,,I asked him how much he pays for heath care? He wouldn't answer...so I say I pay $900 a month w/ $5K deductable with 0 trust that when I need it they will pay or if they do they will either cut me or double my rate...I asked him if he thought 3 years in 'Nam is worth it to the taxpayer to provide him with 60 years of free medical care? Needless to say that ended the conversation and we went back to talking about Tiger.

[jamo]

Basically insurance companies are banks..they do not provide health care..they are not doctors. They are business' that take your premium invest it (with no interest to the policy holder) and make their profits and bonus' by doling out as little as possible. As a small business owner who pays ridiculous premiums and a huge deductable with NO guarentee of service should I need it, I am wholeheartedly in favor of the public option for one reason...to radically change the way insurance companies do business.

Does anybody have a good case against the public option? I have yet to think of one. Driving down healthcare costs is nice, as is paying off some of this gigantic deficit (again, please nothing about the deficit itself, i don't want to get into that argument).

[Shanks A Million]

Let me start out by saying that I am a financial/data analyst and trainer at a major metropolitan hospital in the Twin Cities, which by the way resides in the state with the highest quality of health care in the US (Minnesota).

Brilliant . This is something very few Americans understand well. I read the most fascinating article the other day: http://news.bbc.co.uk/2/hi/americas/8474611.stm From the article: Instead, to many of those who lose out under the existing system, reform still seems like the ultimate betrayal. Why are so many American voters enraged by attempts to change a horribly inefficient system that leaves them with premiums they often cannot afford? Why are they manning the barricades to defend insurance companies that routinely deny claims and cancel policies? It might be tempting to put the whole thing down to what the historian Richard Hofstadter back in the 1960s called "the paranoid style" of American politics, in which God, guns and race get mixed into a toxic stew of resentment at anything coming out of Washington. But that would be a mistake. Drew Westen argues that stories rather than facts convince voters If people vote against their own interests, it is not because they do not understand what is in their interest or have not yet had it properly explained to them. They do it because they resent having their interests decided for them by politicians who think they know best. What's funny is, this attitude is very real. The facts don't matter in this debate. We've pointed out many times that the United States pays the most, gets the least, and is the most unhealthy nation in the Western world. Yet, the people who oppose healthcare have a rationale for everything, "Oh, socialized medicine is terrible." Although no data exists to back that claim up (indeed, thousands upon thousands of studies prove otherwise), they cling to a false reality that somehow people in other countries are stacked in waiting rooms, bleeding to death. Indeed, it's Americans who often die because they cannot afford healthcare, and there have been several cases this year of people dying in waiting rooms, and merely being sidestepped by nurses as they lay dead on the floor. Our system is broken, and we pay three times as much as any other nation for this broken system. But not a single opponent of healthcare reform reading this right now cares about any facts I can tell them, they let their emotions rule the debate, instead resorting to name calling and inane accusations that somehow "Obamacare" (which has nothing to do with Barack Obama, yet receives that name because the opponents of this bill seek to demonize him) will put your grandmother to death. I could let fear run my life and be opposed to guns, but no study shows that more guns mean more violence, so I believe in the freedom to own guns. I know that outlawing abortion merely takes the procedure from the clinic to the back alley, so I oppose banning abortion. It's as simple as that, every issue. So, if you are opposed to a public option, and you know the facts, you are lying to yourself. You know there's no death panels, you know Europeans receive much better care than we do, for much cheaper, but you still fear it... Why?

[Fatphil]

Does anybody have a good case against the public option?

the only people scared of the public option are the ones who ain't payin their health premiums. A vet who hasn't paid a dime in health costs in 30 years but still thinks Obama's a commie (...uh?), an employee of a corporation who has no idea what the company is paying...a congressman who has the cadallac of all plans...People are prisioners of their employer because of health care, they are scared to change jobs,,,scared to lose their jobs and scared to start a new business as an entrepenuer....all because of the way the insurance companies have gamed the system. Very sad.

Once again insurance companies are busniess' that cherry pick the least risk targets, collect premiums for years, deny claims, and schuffle you off to Medicare at 65. Ins companies are not doctors, medical labs, hospitals, or medical professionals they are middle men, admin staff and commission agents. If they went away tomorrow it would have no effect on the quality of american doctors or clinicians. What Obama needs to do however is come up with a good explaination of how much it will cost to join the public option (family or individual...waiting period, etc). You can't have people not paying for years and years and all of a sudden they get sick and sign up (even though that's what IS HAPPENING TODAY IN EMERGENCY ROOMS NATIONWIDE). Yes people will always be slimey and look to beat the system but the vast majority of americans (except Florida) are honest and forthright.

[jamo]

"Oh, socialized medicine is terrible."

This is what pisses me off the most. People use the word socialist like they think Obama is straight out of Stalin's USSR. Without socialism, there would be no police, no jails, no fire department, no public schools, no public universities (though those are state run). How ever you feel about the effectiveness of these, you must agree that they simply work. I'm in public schools, i learn just fine. Take Public colleges, for example. I'm currently applying to two of them, UMass Amherst and University of Delaware. Not coincidentally they are the least expensive colleges i am applying to, and tow top-notch schools. Without socialized police, laws would not matter, there would be no way to enforce them. You think privately owned fire departments would work?

People hear socialism and big government and think of George Orwells' 1984 (and yeah, i read that in school). Not even close. Note: It seems like most people (not thesandtrap specific) don't know that Obama can't pass laws (well, i guess an executive order acts as law, but you know what i mean). If you don't like healthcare, get mad at congress, not the president.

[Shanks A Million]

This is what pisses me off the most. People use the word socialist like they think Obama is straight out of Stalin's USSR.

The problem is most people don't understand the two dimensional political axis. Stalin was an extreme conservative and a communist. To most people, this would sound impossible, but it's not. The word socialism, therefore, is tainted by the authoritarian governments who professed to be socialist. Socialism has nothing to do with big brother, or a police state, these are actually extreme right wing policies. The problem is that these states don't fall on the traditional left/right political axis, and are therefore called extreme left.

I think if Americans were at least a little educated about politics, we'd see an end to such silly beliefs.

[Lefty-Golfer]

the only people scared of the public option are the ones who ain't payin their health premiums. A vet who hasn't paid a dime in health costs in 30 years but still thinks Obama's a commie (...uh?), an employee of a corporation who has no idea what the company is paying...a congressman who has the cadallac of all plans...People are prisioners of their employer because of health care, they are scared to change jobs,,,scared to lose their jobs and scared to start a new business as an entrepenuer....all because of the way the insurance companies have gamed the system. Very sad.

The bolded is soooo untrue. The people I know and hang out with are for the most part the owners of their companies or at least executives, they for the most part pay the insurance ocosts for the entire company, they have taken risks, been entrepenuers and made lots of money....they have seen what washington has done...the scams, the fraud, the waste and excess costs of everything they touch...They are wise enough to know that nothing good will come of it and it will certainly end up costing all of us more in the near future. Unless you are of the belief that taxing the rich and corporations more will not lower the pay scale and lessen the benefits of the workers...in that case LOL

[Fatphil]

what washington has done...the scams, the fraud, the waste and excess costs of everything they touch...They are wise enough to know that nothing good will come of it and it will certainly end up costing all of us more in the near future. Unless you are of the belief that taxing the rich and corporations more will not lower the pay scale and lessen the benefits of the workers.

Guess we agree to disagree...but to answer your question in this instance; Yes, I do believe the govt can do a cheaper job than private insurance companies are doing. Better, probably not but the HHS and SS will oversee private admin companies so my guess is the admin side will be largely unaffected.

My reasoning is this (somewhat twisted but here it is)....the dems are in the pockets of the trial lawyers,,,the repubs are in the pockets of the insurance companies so what to do…what to do?....the critical issues are: Tort Reform Lack of competition Portability Pre existing conditions. All these are capitalistic objectives. IMO the public option (yes it must be an option) will create competition & reduce nuisance lawsuits, (suing the Feds ain’t easy). Since the basis of Obama care is Portability & Pre-existing Conditions that will force any pvt company to offer the same to keep competitive. Without the public option you will never break the monopoly. As Teddy Roosevelt, this is trust busting at its best…(Note what happened after Teddy…we de-regulated oil and up it went to $150/barrel) Anyone want to start a thread on that one I’m in!!! The emotional issue is also difficult…folks have come to think of insurance companies as “health providers” this is an insane twist,,,spin.,,,misrepresentation…they are middle men, commission agents and paper pushers…Not doctors…American doctors will not get stupid overnight if Obama care becomes and option. If you look at value added they provide a service worth 2% but they earn 20% and spend it on football stadiums and bonus’. Will you pay a guy 20% commission to go buy supplies for your business when you know all the vendors and can hire a clerk for $25K/yr? Or better yet just drive over to home depot and buy ‘em yourself? Obama needs to lay out how much this will cost a family of 4 or an individual, what’s covered and what’s the waiting period. I guarantee you your current agent will take his (or better yet her) pants down to keep your business. And yes I agree with you higher taxes result in lower wages and benefits.

[wannabe]

Not even experts agree about the necessary and proper clause, nor the tenth amendment's effect on it, and it's probably one of the most controversial parts of the constitution. The constitution is a living document, and is meant to be amended, and all who cling to it as divine have likely missed the point of it. Amendments to the constitution have brought about freedom for slaves, women, and many other groups who were once discriminated against. The whole idea of the United States was to be a nation founded on the ideal of progressing through time, changing with the times. When it was written, the idea that a black man could be president and a female house speaker was ludicrous. One day, gays, polygamists, and pagans will be as mainstream as blacks and women are today. Who knows, maybe our grandkids will aspire to be like President Alik Muntumbo, the first transgendered president born in Botswana?

I agree, Shanks. Amend away under the constitutional amendment process, but until that happens, don't legislate outside the enumerated powers, of which healthcare is not included. And liberty and justice for all.

[wannabe]

This is what pisses me off the most. People use the word socialist like they think Obama is straight out of Stalin's USSR. Without socialism, there would be no police, no jails, no fire department, no public schools, no public universities (though those are state run). How ever you feel about the effectiveness of these, you must agree that they simply work. I'm in public schools, i learn just fine. Take Public colleges, for example. I'm currently applying to two of them, UMass Amherst and University of Delaware. Not coincidentally they are the least expensive colleges i am applying to, and tow top-notch schools. Without socialized police, laws would not matter, there would be no way to enforce them. You think privately owned fire departments would work?

My view is that when people talk of socialism in the US, they're talking about (1) the federal government, not local gov't, and (2) it's the federal gov't owning and running every aspect of our lives. Recently, the federal government through the bailouts has taken major ownership stakes in AIG, GM (a car company?), etc. This country, above all things, was founded on the principles of individual rights, individual freedom & individual liberty. Every year, little by little, freedoms, rights, & liberties are being replaced by page after thousandth page of legislation telling us how we're do to everything. The US Constitution is a document intended to limit the powers of the federal government, not give license to it, so that individuals can freely act to pursue happiness in this land of opportunity, not gov't controlled & enforced wealth & property distribution.

I actually believe and practice socialism, sometimes even a dictatorship, in my home and local community, and it works great, mainly because of the joint efforts and accountabilities we can share amongst those we encounter on a daily basis. But taken to a large faceless scale, socialism deteriorates. It's been proven time and time again historically. My overall answer to you, therefore is locally provided services shared by a community is great; on a grand scale, though, it fails, and that's where basic protection of rights & freedoms is all that's warranted. And you're correct; probably not gonna convince each other here, and that's ok. Hey, it's a golf site; we're supposed to be getting away from the cares of the world, right? :)

[wannabe]

Does anybody have a good case against the public option?

The federal government is always more inept at spending taxpayers' money than the taxpayers are.

[Shanks A Million]

My view is that when people talk of socialism in the US, they're talking about (1) the federal government, not local gov't, and (2) it's the federal gov't owning and running every aspect of our lives. Recently, the federal government through the bailouts has taken major ownership stakes in AIG, GM (a car company?), etc. This country, above all things, was founded on the principles of individual rights, individual freedom & individual liberty.

The problem is, people who argue this point then turn around and say the government has every right to take our money to fight wars (42% of your tax dollar goes to military, more than anything else), they also say the government has every right to tell gays they can't get married, they agree the government should ban abortions, and is capable enough to censor television and radio. The problem with the modern neo-conservative and labor "liberal" groups is they cherry pick what they like, and discount the rest. The only two groups in this country who have clout are the green party, and the libertarians. Both of these parties have a belief, and stick to it. They don't cherry pick what they like and don't like. It's not just the Republicans who do the cherry picking, although they tend to go for the lowest fruit. Plenty of Democrats are responsible as well, look how many Democrats voted for the Patriot act and the Iraq war, two of the largest mistakes in American history (and both directly counteract the constitution).

Here's the irony. The largest single economic entity on the entire planet is the United States Military, a government agency that is supported whole heartedly by the same Republicans who decry other government groups. The U.S. Military has more funding than every other military on earth, and then some. In fact, if you were to cut the military budget just enough so that we merely equal every other nation combined, you'd have enough money to fully fund about f major government programs (welfare, special ed, madicaid, and a few others). Here's a list of military budgets in order of size: U.S. - 965,000,000,000 China - 84,900,000,000 France - 65,700,000,000 U.K. - 65,300,000,000 Russia - 58,600,000,000 (The U.S. spends 607 billion on current military budget alone, and the rest goes to the cost of veterans care, and other military purposes that are not related to currently enlisted personnel, like defense contractors, etc.) So, here you have a group that declares that a healthcare option would be absolute socialism, yet they continually vote to build missile systems that can hit a camel in the ass from a thousand miles away, cost is not a concern. Despite all of this funding, we still lose soldiers nearly daily in wars we have no business being a part of. This should be our biggest concern. The next should be debt. In 2008, 10% of our tax dollar went to debt interest. Combine these, and you have 52% of every tax dollar that goes to Republican causes. This is quantified by looking at presidential budgets from 1976-2006. Republican presidents increased spending by about 12%, while Democrats increased it by 10%. It is true that Obama will skew these numbers, but the problem is what will happen if he doesn't. The bailouts started in 2008, not January 21st, 2009. If McCain were in office today, he'd be spending just as much as Obama, but instead of healthcare, we'd be getting even better missiles that could hit a flea in the ass from 10,000 miles.

[wannabe]

^I'm on the same page with ya there pretty much.

[Lefty-Golfer]

The problem is, people who argue this point then turn around and say the government has every right to take our money to fight wars (42% of your tax dollar goes to military, more than anything else), they also say the government has every right to tell gays they can't get married, they agree the government should ban abortions, and is capable enough to censor television and radio. The problem with the modern neo-conservative and labor "liberal" groups is they cherry pick what they like, and discount the rest. The only two groups in this country who have clout are the green party, and the libertarians. Both of these parties have a belief, and stick to it. They don't cherry pick what they like and don't like. It's not just the Republicans who do the cherry picking, although they tend to go for the lowest fruit. Plenty of Democrats are responsible as well, look how many Democrats voted for the Patriot act and the Iraq war, two of the largest mistakes in American history (and both directly counteract the constitution).

Maybe you should start writing speeches for Barak, you would do better then the clowns that wrote his state of the Union speech!! You at least believe what you are saying. I will give you credit for that...granted it is naive but at least it has passion…someday you will grow to be fiscal conservative and see the error of your ways!! Notice I didn’t say Republican…fiscal conservative!!!

Based on the cost of our military, why would you think our govenment is going to save us money on healthcare??

[Fatphil]

they also say the government has every right to tell gays they can't get married, they agree the government should ban abortions, and is capable enough to censor television and radio.

YO let's discuss gay marriage! That really pissed me off....