U.S. Politics: Feelings Trump Facts

[Mr. Chatywin et al.]

Continue....

[TrackerNeil]

So the solution for insufficient charity to cover the uninsured is more charity? I hate to seem really sharp here, but come now. Commodore, if you simply don't care about the uninsured, please say so and we can have an honest conversation. This fantasy about Goodwill or someone stepping up to solve the problem is just a waste of everyone's time. It didn't work before 2010 and it won't work now. Let's stop pretending that it will, yes?

[Rippounet]

The Washington Post at it again: https://www.washingtonpost.com/local/on-the-eastern-shore-a-mysterious-45-acre-russian-compound-is-being-shuttered-by-the-obama-administration/2016/12/30/b6a69c32-cea4-11e6-a747-d03044780a02_story.html?utm_term=.47a3824ef4c2

 

[Mlle. Zabzie]

52 minutes ago, TrackerNeil said:

So the solution for insufficient charity to cover the uninsured is more charity? I hate to seem really sharp here, but come now. Commodore, if you simply don't care about the uninsured, please say so and we can have an honest conversation. This fantasy about Goodwill or someone stepping up to solve the problem is just a waste of everyone's time. It didn't work before 2010 and it won't work now. Let's stop pretending that it will, yes?

I'll have that conversation with you, on a slightly modified basis.  I don't think that the government should impose the burden of equal care on all of its citizens.  We can talk about a basic level of care, but I'd honestly be all about the death panels deciding whether care for a particular individual was worth it given quality of life, life expectancy and similar concerns.  Then if the person could pay out of pocket or had private insurance for more, fine.

[OldGimletEye]

2 hours ago, TrackerNeil said:

So the solution for insufficient charity to cover the uninsured is more charity? I hate to seem really sharp here, but come now. Commodore, if you simply don't care about the uninsured, please say so and we can have an honest conversation. This fantasy about Goodwill or someone stepping up to solve the problem is just a waste of everyone's time. It didn't work before 2010 and it won't work now. Let's stop pretending that it will, yes?

Often the reasoning process is:

Quote

An extraordinary example of how, starting with a mistake, a remorseless logician can end up in Bedlam...

- J.M. Keynes

Now, I'd submit, the "mistake" is an absolutist view about property rights  and insisting that "freedom" is essentially about a defense of property rights. This ends up leading to all types of nonsense.

[A Horse Named Stranger]

8 minutes ago, Mlle. Zabzie said:

We can talk about a basic level of care, but I'd honestly be all about the death panels deciding whether care for a particular individual was worth it given quality of life, life expectancy and similar concerns

What?

Are we talking about nursing homes or healthcare. Either way you need to define what is a basic level of care. The death panels deciding about the quality of life, that is a road you do not want to go down. If you go through with it logically, you end up in places (or historic predecessors) you really do want. Hint, so why not cut cost and put down people with a low life quality, likesay people with Trysomy 21, their quality of life is not that great anyway, they will need care and nursing their entire life?

[Mlle. Zabzie]

5 minutes ago, Notone said:

What?

Are we talking about nursing homes or healthcare. Either way you need to define what is a basic level of care. The death panels deciding about the quality of life, that is a road you do not want to go down. If you go through with it logically, you end up in places (or historic predecessors) you really do want. Hint, so why not cut cost and put down people with a low life quality, likesay people with Trysomy 21, their quality of life is not that great anyway, they will need care and nursing their entire life?

I'm using "death panels" sarcastically here.  But though it sounds cold hearted, I don't think everyone should be entitled to spend taxpayer money on the $1 million/year experimental therapy that may or may not work.  And yes, quality of life goes into the calculus, just as it does now with transplant lists (to my understanding).  Scarce resources should be allocated, and that means sometimes people will die a little sooner than they would if they got the very last available therapy no matter the expense.  I'm not advocating state sponsored euthanasia and that isn't the logical conclusion of my suggestion.  And, hint, it's already happening to a greater rather than lesser extent inside insurance companies. ETA - quality of life can cut both ways.  A knee replacement may not be strictly necessary to preserve life, but may have a HUGE benefit in terms of quality of life and that should be taken into account.

[Rippounet]

21 minutes ago, Mlle. Zabzie said:

We can talk about a basic level of care, but I'd honestly be all about the death panels deciding whether care for a particular individual was worth it given quality of life, life expectancy and similar concerns.

I'm not sure I ever understood this thing about "death panels." I live in a country with socialized healthcare and there is no such thing as "death panels." You get sick, you get treated, period. There is no one who decides who gets to be treated and who doesn't.

It's more subtle than that. What Republicans used as a basis for this idea of "death panels" seems to be the fact that state health care systems like the NHS may have committees to decide whether some drugs can be reimbursed or not. If a pharmaceutical company is selling a drug at an exhorbitant price then the committee may refuse to provide the drug to patients. On the face of it, this does look bad, because it forces state officials to put a cap on how much an additional year of life is worth. But the point is to force pharmaceutical companies to sell their drugs at competitive prices rather than make tons of profit off sick people. I guess one could argue that sometimes, refusing to reimburse some very expensive drugs can be the same thing as letting individuals with specific terminal illnesses die. One should keep in mind however that it's unlikely that private insurers will reimburse such expensive drugs as well ; in fact, we know that private insurers are totally willing to let far more people die. And of course, people who can afford such expensive drugs will buy them anyway.

In a nutshell, what I'm saying is that the very term "death panel" does not describe anything close to reality and is essentially a term to attack socialized health care using fallacious arguments. One should be very careful about how it is used.

[OldGimletEye]

Just now, Mlle. Zabzie said:

I'm using "death panels" sarcastically here.  But though it sounds cold hearted, I don't think everyone should be entitled to spend taxpayer money on the $1 million/year experimental therapy that may or may not work.  And yes, quality of life goes into the calculus, just as it does now with transplant lists (to my understanding).  Scarce resources should be allocated, and that means sometimes people will die a little sooner than they would if they got the very last available therapy no matter the expense.  I'm not advocating state sponsored euthanasia and that isn't the logical conclusion of my suggestion.  And, hint, it's already happening to a greater rather than lesser extent inside insurance companies. ETA - quality of life can cut both ways.  A knee replacement may not be strictly necessary to preserve life, but may have a HUGE benefit in terms of quality of life and that should be taken into account.

I don't disagree with your fundamental premise here. No matter what we do, there will have to be "rationing" of healthcare. I'd note though, that I do not think the ACA mandated that everyone get the same level of healthcare. It did mandate a basic level though.

Secondly, I'd note that compared to other countries, at least before the ACA, the US system was largely inefficient. I don't hear this much anymore, but I do recall conservatives going around claiming that "The United States Had The Best Healthcare System in the World", which was an extremely dubious statement, to say the least. Also, I think there is still a lot of stuff that can be done to drive cost out. Thinking about Patent laws might be a start.

[A Horse Named Stranger]

So no bone marrow transplants for leukemia patients? Or do you consider that non-experimental? Afterall it may or may not work. It's not a 100%.

What about psychotherapy? Covered or not? Covered for what disorder? 

I am not going into organ donations, because that's a different story.

 

[Mlle. Zabzie]

2 minutes ago, Notone said:

So no bone marrow transplants for leukemia patients? Or do you consider that non-experimental? Afterall it may or may not work. It's not a 100%.

What about psychotherapy? Covered or not? Covered for what disorder? 

I am not going into organ donations, because that's a different story.

 

I'm not medically qualified to make those decisions, but someone who is should.  Healthcare should be rationed.  

[The Wedge]

1 minute ago, Mlle. Zabzie said:

Healthcare should be rationed.  

It already is. To those that can afford insurance packages that cover more than others.

Haves get treated, have nots get the shaft.  And the disparity grows.

[Rippounet]

8 minutes ago, The Wedge said:

It already is. To those that can afford insurance packages that cover more than others.

Haves get treated, have nots get the shaft.  And the disparity grows.

Exactly. Decisions based on medical reasons are much better than any based on individual wealth.

[Mr. Chatywin et al.]

If this podcast is correct, it sounds like the U.S. is going to have a horrific retirement crisis in the next few decades:

http://www.wbur.org/onpoint/2017/01/04/401k-retirement-pension-problems

[OldGimletEye]

Just now, Tywin et al. said:

If this podcast is correct, it sounds like the U.S. is going to have a horrific retirement crisis in the next few decades:

http://www.wbur.org/onpoint/2017/01/04/401k-retirement-pension-problems

Part of the problem here is management fees that eat into peoples returns. A lot of these investment guys just aren't that good at beating the market.

[Manhole Eunuchsbane]

2 minutes ago, Tywin et al. said:

If this podcast is correct, it sounds like the U.S. is going to have a horrific retirement crisis in the next few decades:

http://www.wbur.org/onpoint/2017/01/04/401k-retirement-pension-problems

Yeah that whole switchout to 401ks in lieu of traditional pensions is going to hit the fan. Many of the folks who advocated the change are now apologizing...

http://www.slate.com/blogs/moneybox/2017/01/03/even_the_people_who_pushed_the_401_k_think_it_s_been_a_huge_mistake.html?utm_source=fark&utm_medium=website&utm_content=link&ICID=ref_fark

[Ser Scot A Ellison]

39 minutes ago, Rippounet said:

I'm not sure I ever understood this thing about "death panels." I live in a country with socialized healthcare and there is no such thing as "death panels." You get sick, you get treated, period. There is no one who decides who gets to be treated and who doesn't.

It's more subtle than that. What Republicans used as a basis for this idea of "death panels" seems to be the fact that state health care systems like the NHS may have committees to decide whether some drugs can be reimbursed or not. If a pharmaceutical company is selling a drug at an exhorbitant price then the committee may refuse to provide the drug to patients. On the face of it, this does look bad, because it forces state officials to put a cap on how much an additional year of life is worth. But the point is to force pharmaceutical companies to sell their drugs at competitive prices rather than make tons of profit off sick people. I guess one could argue that sometimes, refusing to reimburse some very expensive drugs can be the same thing as letting individuals with specific terminal illnesses die. One should keep in mind however that it's unlikely that private insurers will reimburse such expensive drugs as well ; in fact, we know that private insurers are totally willing to let far more people die. And of course, people who can afford such expensive drugs will buy them anyway.

In a nutshell, what I'm saying is that the very term "death panel" does not describe anything close to reality and is essentially a term to attack socialized health care using fallacious arguments. One should be very careful about how it is used.

"Death Panels" is a hyperbolic term for triage, the decision about who gets treated when.

[Mr. Chatywin et al.]

4 minutes ago, OldGimletEye said:

Part of the problem here is management fees that eat into peoples returns. A lot of these investment guys just aren't that good at beating the market.

That's one of the troubles they highlight, but I was shocked to hear that 50% of people between the ages of 50 and 64 have no savings at all.

[Mlle. Zabzie]

3 minutes ago, Ser Scot A Ellison said:

"Death Panels" is a hyperbolic term for triage, the decision about who gets treat when.

Which I am totally in favor of.  And if you can pay more more and/or earlier, so be it.

[Rippounet]

14 minutes ago, Ser Scot A Ellison said:

"Death Panels" is a hyperbolic term for triage, the decision about who gets treated when.

Sure. But the fallacy is that it's not about who gets treated when: in a socialized system, everyone gets treated all the time, but some specific treatments are not deemed cost-effective enough to be paid for by society.