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Awesome republican reactions, part <ranoutofnumbers>

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dotsla...@gmail.com

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May 3, 2017, 6:20:27 PM5/3/17
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http://www.cnn.com/2017/05/03/politics/jimmy-kimmel-conservatives-pre-existing/index.html

"After his slobbering wet kiss to federal bureaucracy, Mr. Kimmel then went squealing on about Obamacare and how insurance companies, the government and your neighbors should all be forced to pay for everybody else's health care," the conservative wrote. "Easy thing to say for a gazillionaire from Hollywood."

"I mean, really, Jimmy, does your newborn child not mean more to you than petty politics? How do you look at the miracle of your child and think — partisan politics?" Hurt added.

Cheers.

The Cheesehusker, Trade Warrior

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May 4, 2017, 12:50:32 PM5/4/17
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This whole Jimmy Kimmel thing brings up some interesting philosophical points - such as how much should be pay of our health care - and should the rich, like Mr. Kimmel - pay more - especially since they're able to.

You often hear of parents saying "I'd die trying to protect my children" - and yet....will they spend money?

dotsla...@gmail.com

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May 4, 2017, 12:58:32 PM5/4/17
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In my experience, absolutely. Parents will take on additional jobs and/or spend themselves into enormous debt to keep their kids healthy and alive, even when cold logic (spending 100k on the mere chance of a few extra months) would suggest the benefit doesn't meet the cost.

Cheers.

The Cheesehusker, Trade Warrior

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May 4, 2017, 1:00:22 PM5/4/17
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On Thursday, May 4, 2017 at 11:58:32 AM UTC-5, dotsla...@gmail.com wrote:
> In my experience, absolutely. Parents will take on additional jobs and/or spend themselves into enormous debt to keep their kids healthy and alive, even when cold logic (spending 100k on the mere chance of a few extra months) would suggest the benefit doesn't meet the cost.
>

I'd like to agree with you on this - but this is very much not the take I'm getting from the whole Kimmel thing - which seems to be "yay insurance" for someone making $10 large year.

this is why, if I were king, there'd be a minimum deductible of 10% AGI

dotsla...@gmail.com

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May 4, 2017, 1:24:47 PM5/4/17
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Do you think that dude making 10k a year just doesn't want to make 200k a year? But once their child is sick that'll be enough motivation?

I interpret what he's saying a little differently. Like "imagine a society where a schoolteacher doesn't have to go 100k in debt (which we're never gonna recover anyways, which results in higher hc costs for you and I and said teacher filing for bankruptcy) and pick up night shifts at piggy wiggly because their child was born with a heart condition".

Also "and that child won't spend the rest of their lives paying 10x what you or I spend on insurance because they happened to be born with a heart condition".

Which is something pretty much every other affluent country seems to manage. Don't know why it's so hard for us to figure out.

I think the same principles around capitalism often pushing companies to over value short vs long term planning is at play here. It's absolutely beneficial (imo) to make sure the vast majority of our kids grow up with great hc and educational opportunities. But the net result - having a strong pool of applicants 20 years out - doesn't improve this quarters statements, even though the costs are on there in red.

Anyways... I don't really care what happens today and I don't really care that conservatives simply cannot abide public support systems like ss, medi*, or obamacare. I think y'all are fighting the tide of history and trend just as much as, say, white nationalist parties. Only you're also fighting the trend that's elbowing like crazy - per capita production.

As we become wealthier and wealthier, I just don't see the "but it's cost prohibitive" argument standing up.

Cheers.

The Cheesehusker, Trade Warrior

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May 4, 2017, 1:38:02 PM5/4/17
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On Thursday, May 4, 2017 at 12:24:47 PM UTC-5, dotsla...@gmail.com wrote:
> Do you think that dude making 10k a year just doesn't want to make 200k a year? But once their child is sick that'll be enough motivation?

Eh? Wrong spin - think Kimmel/upper middle class bashing - people who already HAVE money not willing to spend it - NOT incentive for the poor.

> I interpret what he's saying a little differently. Like "imagine a society where a schoolteacher doesn't have to go 100k in debt (which we're never gonna recover anyways, which results in higher hc costs for you and I and said teacher filing for bankruptcy) and pick up night shifts at piggy wiggly because their child was born with a heart condition".

Which gets back to my question - we talk a good game about sacrifices for our kids....

> Also "and that child won't spend the rest of their lives paying 10x what you or I spend on insurance because they happened to be born with a heart condition".
>
> Which is something pretty much every other affluent country seems to manage. Don't know why it's so hard for us to figure out.

Every other country ends up rationing - which we don't. And I'm pretty sure that most kids get taken care of anyway - and yes, you and I pay the bills.

> I think the same principles around capitalism often pushing companies to over value short vs long term planning is at play here. It's absolutely beneficial (imo) to make sure the vast majority of our kids grow up with great hc and educational opportunities. But the net result - having a strong pool of applicants 20 years out - doesn't improve this quarters statements, even though the costs are on there in red.
>
> Anyways... I don't really care what happens today and I don't really care that conservatives simply cannot abide public support systems like ss, medi*, or obamacare. I think y'all are fighting the tide of history and trend just as much as, say, white nationalist parties. Only you're also fighting the trend that's elbowing like crazy - per capita production.
>
> As we become wealthier and wealthier, I just don't see the "but it's cost prohibitive" argument standing up.

B/c the cost is prohibitive w/o rationing somewhere/somehow

dotsla...@gmail.com

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May 4, 2017, 1:46:28 PM5/4/17
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You'll have to explain this bit to me:

"Every other country ends up rationing - which we don't."

Pretty sure many or most of those other countries have private options available - if you have the money, you can get whatever expensive procedure you want.

Which is all we're guaranteed - emphasis on the if you have the money part.

I mean, seriously - give me the low down - how is healthcare rationed in Germany in a way that's different from the US?

Cheers.

The Cheesehusker, Trade Warrior

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May 4, 2017, 1:54:40 PM5/4/17
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On Thursday, May 4, 2017 at 12:46:28 PM UTC-5, dotsla...@gmail.com wrote:
> You'll have to explain this bit to me:
>
> "Every other country ends up rationing - which we don't."
>
> Pretty sure many or most of those other countries have private options available - if you have the money, you can get whatever expensive procedure you want.

Right - but there's rationing for everyone *else* - and we're back to square 1 of the rich getting more

> Which is all we're guaranteed - emphasis on the if you have the money part.
>
> I mean, seriously - give me the low down - how is healthcare rationed in Germany in a way that's different from the US?

Can't speak to Germany b/c I'm not familiar with it - but England and Canadia have some nice lines - and even here in the US w/ our "state insurance" parts - aka the VA system, we see this.

michael anderson

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May 4, 2017, 1:56:33 PM5/4/17
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On Thursday, May 4, 2017 at 12:46:28 PM UTC-5, dotsla...@gmail.com wrote:
when my uncle needed a rather technical(and semi-urgent but not "have this now or die immediately" eye surgery) he was seen by a retina subspecialist within a couple days and surgery was scheduled and done on very short notice.

My guess is that those sorts of things in the european models you adore don't work like that.


>
> Cheers.

dotsla...@gmail.com

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May 4, 2017, 2:23:51 PM5/4/17
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And if your uncle was poor he would have just made due without the surgery in the conservative US model you adore.

Hmm. Have to wait too long or have to wait forever... hold on, I'm weighing those options carefully.

Cheers.

dotsla...@gmail.com

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May 4, 2017, 2:30:16 PM5/4/17
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Dude the rich will always get more. That doesn't mean we should just throw up our hands and say - hey, they're gonna get more, so why change a system where they get waaaay more?

Just don't see that as a valid criticism - don't see "well the rich will still get more" as being back to square 1 - the if you're poor you get next to nothing square.

Lol - it always comes back to that increasing gap between the really rich and the rest of us - either you see that as a problem or you don't. (I feel like I could do a pretty good job of predicting a whole range of political opinions for a person just by showing them that graph and asking - "cause for concern, yea or nay?")

Cheers.

The Cheesehusker, Trade Warrior

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May 4, 2017, 2:37:22 PM5/4/17
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But that's what this has all been about! The "rich" having better health insurance than everyone else....

so where we do draw the line? What is the "minimum acceptable standard" for healthcare for everyone?

this is not a simple question, is it?

Should it be unlimited and unfettered or should it be limited - and to what/where? And where do "life style" choices come into play? When do we account for certain conditions being far more costly to pay for than others?

etc etc etc etc

I could easily say we HAD this prior to gov't insurance - everyone has the right to health care limited only by either their willingness to pay for it and/or have an insurer pay for it. That' pretty far in one direction - so.....what's "acceptable"? heart surgery for all infants? free diabetes care for fat rednecks sucking down sonic limeades? free cancer treatment for smokers?

darkst...@gmail.com

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May 4, 2017, 2:42:49 PM5/4/17
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On Thursday, May 4, 2017 at 10:24:47 AM UTC-7, dotsla...@gmail.com wrote:
> Do you think that dude making 10k a year just doesn't want to make 200k a year? But once their child is sick that'll be enough motivation?
>
> I interpret what he's saying a little differently. Like "imagine a society where a schoolteacher doesn't have to go 100k in debt (which we're never gonna recover anyways, which results in higher hc costs for you and I and said teacher filing for bankruptcy) and pick up night shifts at piggy wiggly because their child was born with a heart condition".
>
> Also "and that child won't spend the rest of their lives paying 10x what you or I spend on insurance because they happened to be born with a heart condition".

There's an easy solution, say animals like Irish Mike and Hugh: The kid never lives outside the hospital, and is properly disposed of so we don't have to pay for them.

Mike

dotsla...@gmail.com

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May 4, 2017, 2:52:03 PM5/4/17
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I could easily say we HAD this prior to gov't insurance - everyone has the right to health care limited only by either their willingness to pay for it and/or have an insurer pay for it. That' pretty far in one direction - so.....what's "acceptable"? heart surgery for all infants? free diabetes care for fat rednecks sucking down sonic limeades? free cancer treatment for smokers?


No, though. Not limited by their *willingness* to pay for it. In most cases, limited by their *means*.

But yeah to your general point. That's exactly it. We should be working out where those lines are, not throwing our hands up and saying we can't afford for everyone to get three mris a month, so fuhgeddaboudit.

I'm seriously searching for what the argument here is, but I keep coming back to "we can't get to 100% so we should stick with zero".

Cheers.

tim.vanwa...@gmail.com

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May 4, 2017, 4:36:10 PM5/4/17
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You know, you don't have to actually guess. The make this thing called Google. It's really cool and you can get all educated about stuff so you don't have to look foolish when you repeat fake facts or just make stuff up to fit your worldview.

Average wait times for primary care in the US is some of the worst in the first world. http://www.commonwealthfund.org/~/media/files/publications/in-the-literature/2013/nov/pdf_schoen_2013_ihp_survey_chartpack_final.pdfs

Average wait times for specialists is one of the best, as expected, but actually behind the NHS.

Oh, and one should point out that the U.K. Spends half of what we do with better overall health outcomes and patient satisfaction. But we do have much prettier buildings and our employee parking lots have much nicer cars in them, so we have that going for us.

Eric Ramon

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May 4, 2017, 6:08:38 PM5/4/17
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evidence in my favor: scientific
evidence in your favor: anecdotal or "fake"

Can we just split the country in two already? We could do it like India and Pakistan so that one country is filled with a certain type (those who think we're all in this together) and the other one filled with a different type (psychopaths who have some sick need to feel "superior" and who really should be shunned).

Ken Olson

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May 4, 2017, 6:15:56 PM5/4/17
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Democrats are the latter group, correct?

Eric Ramon

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May 4, 2017, 6:24:31 PM5/4/17
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I thought about whether it could be interpreted that way but if you look at the first group ("we're all in this together") it'd be a stretch for that to be Republicans. But it doesn't matter which is which. There's clearly a philosophical divide that degrades the enjoyment of life for both.

Ken Olson

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May 4, 2017, 6:39:39 PM5/4/17
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Actually, I can see parts of both being owned by parts of both. I see
to breaking down to 2 main issues. What is the purpose of government
and what is money. Is it (govt) a framework or a nanny? Is it (money)
tangible or intangible?

dotsla...@gmail.com

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May 4, 2017, 7:38:16 PM5/4/17
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Here's the thing I think you're missing from that analysis, Ken.

Money has its own gravity. It's easier to make your tenth million than it was to make your first.

I won't add a judgement around how much easier it is. Yes, it isn't a zero sum game. It also isn't an infinite pie. Take whatever "best case possible" rate of growth you want, it's still possible for a small group to eat that growth plus some extra. That ratio - growth vs consumption by the already wealthy - is, imo, a key indicator of the overall health of a society.

It's possible, over time, to concentrate wealth in the hands of a really small but powerful minority. Inheritance is a bitch. Generational wealth is, more than any other factor, the invisible finger on the scale. The tilt in the floor.

The right is correctly wary of the power of government. The left is correctly wary of the power of the monied class. Nobody seems to get the full picture.

So the government's role is to somehow minimize the ramifications of the inevitable, over a span of generations, consolidation of wealth and power in the hands of a few.

Those few have to safeguard against populism expressed by government action to seize what they have and a whole lot more (true capital S grab the means of production and destroy the engine of wealth creation Socialism - not the safety net stuff many of us support, the real deal).

The best most of us can hope for is to keep them balanced against each other. Cuz if they join forces (hostile takeover of one by the other) we're all screwed.

Final point - we're a hell of a lot closer to the wealthy running the guv than the guv taking over the economy, in this country. So siding with the wealthy folks (R) is counterproductive. :)

Cheers.

The Cheesehusker, Trade Warrior

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May 4, 2017, 8:52:56 PM5/4/17
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On Thursday, May 4, 2017 at 1:52:03 PM UTC-5, dotsla...@gmail.com wrote:
> I could easily say we HAD this prior to gov't insurance - everyone has the right to health care limited only by either their willingness to pay for it and/or have an insurer pay for it. That' pretty far in one direction - so.....what's "acceptable"? heart surgery for all infants? free diabetes care for fat rednecks sucking down sonic limeades? free cancer treatment for smokers?
>
>
> No, though. Not limited by their *willingness* to pay for it. In most cases, limited by their *means*.

That was poorly written by me - in general, yes to your point - yes, willingness.

And I'm shocked you haven't pointed out I want the rich to pay moar! What kind of capitalist swine am I?

> But yeah to your general point. That's exactly it. We should be working out where those lines are, not throwing our hands up and saying we can't afford for everyone to get three mris a month, so fuhgeddaboudit.

Yup

> I'm seriously searching for what the argument here is, but I keep coming back to "we can't get to 100% so we should stick with zero".

Very fair point. In a sense we were "there" before all this started - but now it seems we've moved "the line" dramatically in the far broader coverage direction.

Is this good or bad? Dunno. Health care's a tricky issue - w/o it, we die. OTOH, we're gonna die anyway. So much care and so much spending seems....wasted either by overconsumption, overcosting (!) and/or CYA.

The lack of pricing transparency really really really bugs me.

michael anderson

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May 4, 2017, 10:22:02 PM5/4/17
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Well I really like the car I'm going to buy in that parking lot with all the nice cars, and most people seem to like our current system(would be better without obamacare though)....so let's get back to market principles and go from there.

Some dued

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May 4, 2017, 10:36:57 PM5/4/17
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I hate our system, it requires WAY too much interaction between me and insurance companies.

dotsla...@gmail.com

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May 4, 2017, 10:46:57 PM5/4/17
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On Thursday, May 4, 2017 at 7:52:56 PM UTC-5, The Cheesehusker, Trade Warrior wrote:
> On Thursday, May 4, 2017 at 1:52:03 PM UTC-5, dotsla...@gmail.com wrote:
> > I could easily say we HAD this prior to gov't insurance - everyone has the right to health care limited only by either their willingness to pay for it and/or have an insurer pay for it. That' pretty far in one direction - so.....what's "acceptable"? heart surgery for all infants? free diabetes care for fat rednecks sucking down sonic limeades? free cancer treatment for smokers?
> >
> >
> > No, though. Not limited by their *willingness* to pay for it. In most cases, limited by their *means*.
>
> That was poorly written by me - in general, yes to your point - yes, willingness.
>
> And I'm shocked you haven't pointed out I want the rich to pay moar! What kind of capitalist swine am I?
>

Dude, the first rule of dark-sidin' is you never point out the dark-sidin'.

> > But yeah to your general point. That's exactly it. We should be working out where those lines are, not throwing our hands up and saying we can't afford for everyone to get three mris a month, so fuhgeddaboudit.
>
> Yup
>
> > I'm seriously searching for what the argument here is, but I keep coming back to "we can't get to 100% so we should stick with zero".
>
> Very fair point. In a sense we were "there" before all this started - but now it seems we've moved "the line" dramatically in the far broader coverage direction.
>
> Is this good or bad? Dunno. Health care's a tricky issue - w/o it, we die. OTOH, we're gonna die anyway. So much care and so much spending seems....wasted either by overconsumption, overcosting (!) and/or CYA.
>

Yeah. A lot of that is driven by culture, I guess. People here have pretty high expectations. And I'm gonna assume that even though there might be a reasonable expectation of things going sideways for any surgery (for instance), I'm also gonna assume that when it does go sideways, here, it almost always gets litigated. How could *I* fall outside the well-documented 98% success rate!

Where in some cultures, that just isn't a reasonable reaction.

> The lack of pricing transparency really really really bugs me.

100%.

Cheers.

michael anderson

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May 5, 2017, 9:34:45 AM5/5/17
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I don't get the lack of transparency complaint. Prices are plenty transparent. It's like when you go to an auto body shop- Geicos contract is going to reimburse different than progressives contract which are both going to reimburse a good bit lower than someone who wants a quote on a repair who doesn't have full coverage(bc otherwise Geico would just lower their contract to that). It's the same concept in health care and many other fields. If you call up any office just about and ask what the out of network fee will be(from providers standpoint) they will give you a price.

Con Reeder, unhyphenated American

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May 5, 2017, 10:26:28 AM5/5/17
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Are you serious? If you have to call for a price, it isn't
transparent. And none of that flows to the customer in an easily
comprehensible way. On the margins, of course, when you are in
deductible land, there is some incentive to select a lower cost
provider. But you are rarely in a position where you can easily
choose.

If hospitals and clinics advertised prices, people could choose
which they prefer on a regular basis.

And when every man-jack is sending you a different bill for an x-ray
ordered by a doctor, or a seperate fee for anesthesia, and you had
no input as to the price and method of selection for that vendor, it
is not transparent. And that is the way it is in many situations
involving hospital stays.

Until you can get providers advertising all-in prices for an
angioplasty or a knee replacement, and you can select any of them
that meet certain underwriting criteria, it isn't transparent.

That is the key; there has to be incentive to shop. For example, you
get people signing up for HMOs knowing that they will have less
choice, just so they can get a lower insurance payment. And if people
can make choices for who they get to do procedures, based on price
and consumer ratings, the tendency will be to try and compete for
that business.

--
Nature, to be commanded, must be obeyed. -- Francis Bacon
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