U.S. Politics: Russian Around

[Manhole Eunuchsbane]

53 minutes ago, Triskan said:

Yep, In non-for-profit hospitals there's a mantra of "No margin, no mission" implying there's got to be business savvy or the organization can't keep its doors open to patients.   The NFP status really just means no shareholders.  It does not mean that there isn't a lot of money involved and well-paid executives.  

Beyond that, the whole idea is that X percentage of profit has to be resunk into infrastructure, such as new medical equipment and technology and whatnot. It seems to me that much of X ends up spent on unneeded remodeling, or even building new facilities that seem to be underused or unnecessary. It's really kind of bizarre.

[Jo498]

9 hours ago, OldGimletEye said:

Oh yeah, here: "The serious conservative policy wonk" doesn't know what the purpose of insurance is:

http://www.msnbc.com/rachel-maddow-show/paul-ryan-flubs-the-basic-idea-behind-insurance

I feel the problem with car insurance is that the people who don't get into car wrecks end up paying for the people that do.

Also, let me just say, the problem I have with fire insurance is that the people's whose homes don't burn down, end up paying for the ones that do.

It's also the reason, I hate flood insurance. And life insurance too: I mean, the people who don't die end up paying for the ones that do.

While I certainly support public healthcare in the fashion of most European countries it is not wrong to point out that "health insurance" in these systems does work somewhat differently from car insurance. It really is not a typical insurance but something between a tax and an insurance (like obligatory pension plans etc.) because one is usually forced to pay into the system and does usually not have the freedom to take one's own risks and the people who are lucky enough to be healthy (and/or are in certain income brackets) would often have advantages in different healthcare systems.

But the most important difference from typical insurances is that people with bad risks usually do not pay more than healthy people. This is the solidarity element: You do not pay according to risk (like with a car insurance someone has to pay more if one has a history of accidents etc.) but according to ability (usually a fixed rate from one's income/salary/wage with some floors and caps). So "insurance" is a misnomer in several respects, I think, or at least there are salient differences to e.g car insurance.

[denstorebog]

http://www.cnbc.com/2017/03/09/the-republican-health-care-bill-threatens-trumps-voters.html

This may be a bit late, but I find myself wondering what the play is for the administration. I realize that Obamacare was always something they would have to deal with once the got the White House, and that the sudden popularity of Obamacare came a bit out of nowhere. But doesn't it seem a bit reckless for Trump to throw his weight so entirely behind Ryan's plan? Usually, some symbolic rewards for the base would be an immediate priority, and the muslim ban isn't going to cut it. The wall may never even happen. This, however, will have an actual impact on many of his own supporters.

A bit back to basics here, I guess, but maybe I'm just slow. What is the administration's rationale for going all in on pleasing a small subset of voters at the potential expense of a larger one?

[OldGimletEye]

Just now, Jo498 said:

While I certainly support public healthcare in the fashion of most European countries it is not wrong to point out that "health insurance" in these systems does work somewhat differently from car insurance. It really is not a typical insurance but something between a tax and an insurance (like obligatory pension plans etc.) because one is usually forced to pay into the system and does usually not have the freedom to take one's own risks and the people who are lucky enough to be healthy (and/or are in certain income brackets) would often have advantages in different healthcare systems.

But the most important difference from typical insurances is that people with bad risks usually do not pay more than healthy people. This is the solidarity element: You do not pay according to risk (like with a car insurance someone has to pay more if one has a history of accidents etc.) but according to ability (usually a fixed rate from one's income/salary/wage with some floors and caps). So "insurance" is a misnomer in several respects, I think, or at least there are salient differences to e.g car insurance.

Again, here is the quote:

Quote

Look at that quote again: “The whole idea of Obamacare is … the people who are healthy pay for the people who are sick.

This is is true in a private health insurance system too. The whole point of buying any insurance is to mitigate risk, whether that risk is getting in a car accident, your home burning down, or you getting sick. And if you buy health insurance, and then get sick, healthy people end up paying for your treatment.

It's fine to point out the redistributive nature of European healthcare systems or the ACA and that they don't allow actuarial adjustments, like other forms of insurance, and I get that. But, you know, it still doesn't change the basic point of insurance whether its provided by the government or through private markets.

[Horza]

50 minutes ago, denstorebog said:

http://www.cnbc.com/2017/03/09/the-republican-health-care-bill-threatens-trumps-voters.html

This may be a bit late, but I find myself wondering what the play is for the administration. I realize that Obamacare was always something they would have to deal with once the got the White House, and that the sudden popularity of Obamacare came a bit out of nowhere. But doesn't it seem a bit reckless for Trump to throw his weight so entirely behind a complete repeal? Usually, some symbolic rewards for the base would be an immediate priority, and the muslim ban isn't going to cut it. The wall may never even happen. This, however, will have an actual impact on many of his own supporters.

A bit back to basics here, I guess, but maybe I'm just slow. What is the administration's rationale for going all in on pleasing a small subset of voters at the potential expense of a larger one?

They're trapped.

They promised their base they would repeal Obamacare, but then the base realised that Obamacare was the same thing as the Affordable Care Act, which they either like or at least prefer to pure freedom. Now, they could backtrack and it would probably be no huge deal, because like the wall, this was sort of a totemic thing more than a serious commitment. But that will break the grand bargain Trump has with Ryan and McConnell, who are beholden to the other wing of the Republican coalition, the one that's packed with the 'healthcare is a business, not a right' types and their deep-pocketed pals, who will raise hell if they don't use their control of two and a half branches of government to rip up Obamacare. Both wings are now tying themselves in knots because the unfettered power they've been given by the collapse of the Democratic Party is forcing them to try and realise their deeply unpopular ideologies.

[denstorebog]

1 hour ago, Horza said:

They're trapped.

They promised their base they would repeal Obamacare, but then the base realised that Obamacare was the same thing as the Affordable Care Act, which they either like or at least prefer to pure freedom. Now, they could backtrack and it would probably be no huge deal, because like the wall, this was sort of a totemic thing more than a serious commitment. But that will break the grand bargain Trump has with Ryan and McConnell, who are beholden to the other wing of the Republican coalition, the one that's packed with the 'healthcare is a business, not a right' types and their deep-pocketed pals, who will raise hell if they don't use their control of two and a half branches of government to rip up Obamacare. Both wings are now tying themselves in knots because the unfettered power they've been given by the collapse of the Democratic Party is forcing them to try and realise their deeply unpopular ideologies.

Yes, true. However, I guess the crux of my question was why Trump seems to want to go all-in on Ryan's plan *personally*, holding campaign rallies and meeting with senators to bully it through. I figured there would be room for being a lot less aggressive and let Congress associate itself with the bill. I get the need for presenting a unified Republican front this early in the term, but Trump is really associating himself personally with this particular solution.

I guess the answer to my own question is that Trump doesn't want the public shame of being unable to push through another policy, but this really seems like a situation where getting it through will hurt his brand a lot more in the long run, if that article is on the money.

[Which Tyler]

1 hour ago, OldGimletEye said:

Again, here is the quote:

This is is true in a private health insurance system too. The whole point of buying any insurance is to mitigate risk, whether that risk is getting in a car accident, your home burning down, or you getting sick. And if you buy health insurance, and then get sick, healthy people end up paying for your treatment.

It's fine to point out the redistributive nature of European healthcare systems or the ACA and that they don't allow actuarial adjustments, like other forms of insurance, and I get that. But, you know, it still doesn't change the basic point of insurance whether its provided by the government or through private markets.

Be fair - Ryan seems unable to wrap his brain around the concept of young people becoming old people.

You may be expecting too much from him.

 

Presumably, that 40 year old with cancer; and that 50 year old man with heart disease have always been like that, and never were young and healthy - because if they were, then everything he said would have been directly self-contradictory.

[LongRider]

30 minutes ago, Which Tyler said:

Be fair - Ryan seems unable to wrap his brain around the concept of young people becoming old people.

You may be expecting too much from him.

 

Presumably, that 40 year old with cancer; and that 50 year old man with heart disease have always been like that, and never were young and healthy - because if they were, then everything he said would have been directly self-contradictory.

^^^^This!  I guess in Ryan's twisted world, a child who develops childhood diabetes is just a sick taker preying on healthy.  What a sick fuck he is.

[Which Tyler]

Yeah - those lazy blody asthmatics - can't even be bothered to learn how to breath properly!

[Fez]

2 hours ago, denstorebog said:

Yes, true. However, I guess the crux of my question was why Trump seems to want to go all-in on Ryan's plan *personally*, holding campaign rallies and meeting with senators to bully it through. I figured there would be room for being a lot less aggressive and let Congress associate itself with the bill. I get the need for presenting a unified Republican front this early in the term, but Trump is really associating himself personally with this particular solution.

I guess the answer to my own question is that Trump doesn't want the public shame of being unable to push through another policy, but this really seems like a situation where getting it through will hurt his brand a lot more in the long run, if that article is on the money.

I have two theories, and I could see either being correct.

The first is that Trump is getting played by some of the people in his administration; through either outright lying or just not fully revealing the truth. He doesn't have an interest in policy, they tell him this is a good policy, and that's the end of it.

The second is that Trump is hoping to break Ryan, and he is counting on either the House Freedom Caucus or the Senate moderates to block the bill. Trump knows that he can escape blame from his supporters by just throwing Ryan under the bus, and if Ryan is embarrassed badly enough he won't have the clout to block any Trump-supported bills on immigration or the border.

The first is more likely if Trump is listening to Mulvaney/Price and the second is more likely if he's listening to Bannon.

Also, whoever convinced him that it'd be okay to move up the Medicaid cuts to 2018 gave him some really bad advice. Massively cutting services for their own voters right before the midterms will be a disaster for Republicans.

[Maithanet]

3 minutes ago, Fez said:

The second is that Trump is hoping to break Ryan, and he is counting on either the House Freedom Caucus or the Senate moderates to block the bill. Trump knows that he can escape blame from his supporters by just throwing Ryan under the bus, and if Ryan is embarrassed badly enough he won't have the clout to block any Trump-supported bills on immigration or the border.

I don't know about this.  If his goal is to cow Ryan, it seems like it would be better to make his unhappiness with the bill known early and often.  He could stick with his populist talking points "Why no sales across state lines?  Why so many handouts to insurance companies?  Ryancare is Obamacare Lite!"  That way he could make sure everyone knows this is Ryan's bill (not Trumpcare), and that it sucks.  If Trump were to do that, there's no question it fails, the far right in the House and moderates in the Senate would have all the cover they need to torpedo it.  Congressional Republicans would look ineffectual, but Ryan would obviously be brought to heel.  Then Trump could move on to important work he actually cares about, like upper class tax cuts, a national Right to Work bill, and removing environmental regulations. 

But he isn't doing that.  Trump has said he doesn't want this bill to be called Trumpcare, but he is going to bat for it pretty hard thus far.  If he doesn't start backing away pretty soon, he's going to own it.

[OldGimletEye]

Just now, Horza said:

They're trapped.

We’re caught in a trap

We can’t walk out

Because we want to cut taxes so badly

 

Why can’t they see

What they’re doing to the conservative party

When they don’t believe a word we say

 

We can’t get along together

With suspicious minds

And we can’t build our tea party dreams

On suspicious minds

 

So, if an old conservative kook we know

Stops by to say hello

Would we still see suspicion in their eyes

 

Here we go again

Asking where’s our plan

They can’t see these conservative tears are real

We’re crying

 

We can’t get along together

With suspicious minds

And we can't build our tea party dreams

On suspicious minds

 

Oh let our tax cuts survive

Or there will be tears in our eyes

Let’s not let tax cuts die

When guys, you know

Republicans have never lied to you

Mmm yeah, yeah,

 

We’re caught in a trap

We can’t walk out

Because we want to cut taxes so badly

[Jaxom 1974]

41 minutes ago, Fez said:

 

The second is that Trump is hoping to break Ryan, and he is counting on either the House Freedom Caucus or the Senate moderates to block the bill. Trump knows that he can escape blame from his supporters by just throwing Ryan under the bus, and if Ryan is embarrassed badly enough he won't have the clout to block any Trump-supported bills on immigration or the border.

The first is more likely if Trump is listening to Mulvaney/Price and the second is more likely if he's listening to Bannon.

Actually, this was my thought too.  I'm not sure if Trump plays things correctly. Ever. But the goal seems to be reducing, eventually, Ryan.  If this act fails spectacularly, Ryan is essentially neutered. If it somehow succeeds, Trump gets to take all the credit and he marginalizes Ryan, likely making him more vulnerable as he'll be expending massive amounts of political capital to sway the Senate.

[Mr. Chatywin et al.]

44 minutes ago, Fez said:

I have two theories, and I could see either being correct.

The first is that Trump is getting played by some of the people in his administration; through either outright lying or just not fully revealing the truth. He doesn't have an interest in policy, they tell him this is a good policy, and that's the end of it.

The second is that Trump is hoping to break Ryan, and he is counting on either the House Freedom Caucus or the Senate moderates to block the bill. Trump knows that he can escape blame from his supporters by just throwing Ryan under the bus, and if Ryan is embarrassed badly enough he won't have the clout to block any Trump-supported bills on immigration or the border.

The first is more likely if Trump is listening to Mulvaney/Price and the second is more likely if he's listening to Bannon.

Also, whoever convinced him that it'd be okay to move up the Medicaid cuts to 2018 gave him some really bad advice. Massively cutting services for their own voters right before the midterms will be a disaster for Republicans.

It could honestly be both. Trump, not caring about the details and wanting to claim a policy victory, is listening to those around him suggesting he stump for Ryancare even though it looks like a giant mess, and Bannon, hoping it crashes and burns, could want to use that as a means to throw both Ryan and Priebus under the bus for it's failure.

[Mlle. Zabzie]

24 minutes ago, OldGimletEye said:

We’re caught in a trap

We can’t walk out

Because we want to cut taxes so badly

 

Why can’t they see

What they’re doing to the conservative party

When they don’t believe a word we say

 

We can’t get along together

With suspicious minds

And we can’t build our tea party dreams

On suspicious minds

 

So, if an old conservative kook we know

Stops by to say hello

Would we still see suspicion in their eyes

 

Here we go again

Asking where’s our plan

They can’t see these conservative tears are real

We’re crying

 

We can’t get along together

With suspicious minds

And we can't build our tea party dreams

On suspicious minds

 

Oh let our tax cuts survive

Or there will be tears in our eyes

Let’s not let tax cuts die

When guys, you know

Republicans have never lied to you

Mmm yeah, yeah,

 

We’re caught in a trap

We can’t walk out

Because we want to cut taxes so badly

Great.  Thanks.  Now I have that song stuck in my mind.

[OldGimletEye]

Just now, Mlle. Zabzie said:

Great.  Thanks.  Now I have that song stuck in my mind.

Sorry about that. I just really couldn't help myself as the urge to get a bit goofy was just too strong.

[Fragile Bird]

1 hour ago, OldGimletEye said:

We’re caught in a trap

We can’t walk out

<snip>

Hey, I was singing along! Great stuff!

[TerraPrime]

5 hours ago, OldGimletEye said:

Again, here is the quote:

This is is true in a private health insurance system too. The whole point of buying any insurance is to mitigate risk, whether that risk is getting in a car accident, your home burning down, or you getting sick. And if you buy health insurance, and then get sick, healthy people end up paying for your treatment.

It's fine to point out the redistributive nature of European healthcare systems or the ACA and that they don't allow actuarial adjustments, like other forms of insurance, and I get that. But, you know, it still doesn't change the basic point of insurance whether its provided by the government or through private markets.

I'd quibble that for most of us, we pay more in premium than the value of care we receive. So, when I get sick, you're not paying for my care - I did, through my previous years of premium. The balance shifts if I use more health care services than what my premium covers in value. At that point, my healthcare is paid for by contribution from others. In other words, if I break my leg and need to have my bones screwed back together, that's probably not going to cost more than what I paid for. On the other hand, if I get type C hepatitis and end up with complications from viral sirrhosis and need a liver transplant, then yes, the amount I contribute through my premium is not going to cover all of it. 

[OldGimletEye]

Just now, TerraPrime said:

I'd quibble that for most of us, we pay more in premium than the value of care we receive. 

In most cases, people pay more for premiums than what they receive from insurance. That's true of all insurance.

The reason you buy insurance is because you're sufficiently risk averse that you are willing to give up a little consumption in one state to avoid a catastrophic loss in another state. If everyone got more out of their insurance than what they paid in premiums insurance wouldn't work.

[Kalbear]

7 hours ago, denstorebog said:

http://www.cnbc.com/2017/03/09/the-republican-health-care-bill-threatens-trumps-voters.html

This may be a bit late, but I find myself wondering what the play is for the administration. I realize that Obamacare was always something they would have to deal with once the got the White House, and that the sudden popularity of Obamacare came a bit out of nowhere. But doesn't it seem a bit reckless for Trump to throw his weight so entirely behind Ryan's plan? Usually, some symbolic rewards for the base would be an immediate priority, and the muslim ban isn't going to cut it. The wall may never even happen. This, however, will have an actual impact on many of his own supporters.

A bit back to basics here, I guess, but maybe I'm just slow. What is the administration's rationale for going all in on pleasing a small subset of voters at the potential expense of a larger one?

Because alienating voters doesn't matter that much when voters are incredibly polarized and almost every single republican congressional seat is safe due to gerrymandering.

The most dangerous thing to a Republican right now is compromise with a democrat, which can be used against them in their primary elections.