US Politics: 1950's edition

[Tsavong Lah]

no its not scarcasm. Kucinich was one of the only members of congress who stood up and said what a bad idea going to war with Iraq was. He voted against the Patriot Act (in his words "because I read it!"). I dont know anything about Kaptur, and she doesnt represent me, but I do like Kucinich, even though he is much more liberal than me. I also like that he filed articles of impreachment against GWB.

My problem with Kucinich is he is the epitome of "letting the perfect be the enemy of the good". He would vote against many bills because they weren't liberal enough, even though they were better than what existed and were realistically the best bill that could get passed. He was also a vain, spiteful man who did nothing to help the party. He is a man with no accomplishments who found his niche as being tied with Ron Paul for most anti-war member of congress.

[TrackerNeil]

My problem with Kucinich is he is the epitome of "letting the perfect be the enemy of the good". He would vote against many bills because they weren't liberal enough, even though they were better than what existed and were realistically the best bill that could get passed.

You've read my mind. He threatened to vote against the ACA for the same reasons, which was just crazy. I don't mind seeing the back of him.

[Former Lord of Winterfell]

Again, what on earth on you talking about? The vast majority of people who need chemotherapy will find a way to pay for it anyway. Does that somehow mean that it's okay for their health insurance policy to refuse to cover it?

First, it is directly relevant to Kalbear's argument. His argument was that covering birth control -- particularly with the "no-copay" rule but even without it-- actually saves insurance plans money because unwanted pregnancies cost more money than birth control pills. But if the vast majority of women will pay for their own BC regardless, those unplanned pregnancies due to lack of coverage (or no copay) really aren't happening very often at all. So insurance companies won't be incurring huge expenses for those pregnancies, and won't be paying for pills either.

Second, I don't consider the use of those pills for the purposes of birth control as on the same moral plane as chemotherapy. I do think the use of such pills for specific health care reasons is no different from other prescriptions, though, and if an insurer wrongfully denies coverage, that likely creates a claim for bad faith.

But I honestly can't understand the moral/policy-based argument for giving birth control pills being used for birth control purposes an even higher status via no co-pays than all sorts of life-sustaining treatments like chemotherapy, etc. for which copays are still required. That's what's bizarre. If you have a heart attack, cancer, life-threatening infection, ALS, AIDs, or condition of similar severity, you still have to pay your copays. But if you want birth control pills so you can have recreational sex without getting pregnant, well, those we'll spring for.

There are 10 categories of essential health benefits under the ACA - all of them must be covered to participate in the exchanges. Prescriptions are one of those categories. Furthermore, certain preventative health services identified by the United States Preventive Services Task Force have no cost-sharing - contraception is a preventative health service for the reasons Kalbear discussed above.

That's just a description of what the law is, not a moral defense of the underlying policy justifications. As for birth control being preventative, that was something that was not even defined in the law itself, but was left up to HHS. And there was a lot of behind the scenes politicking for various interest groups going on with that.

If you want to argue that contraception shouldn't be an expected benefit of a health care plan, than say so. I've never had one that didn't cover it, but if you think that's unusual, let's hear it.

No, that is not my point. I has said repeatedly that if an insurer and employer choose to define it as such, I don't care. Ah hell, actually, my preference would for it not to be covered if it raises my costs (I really do believe in the personal responsibility stuff for recreational activities), but that's not a political objection at all. And I have no objection at all to those students lobbying for such a policy given that they are paying into it. They're customers, and certainly are entitled to be heard. My objection is to the government stepping in and legally compelling coverage. And when you add in the requirement that there not even be a copay, we've moved well beyond any theory of "non-descrimination" to simply one of entitlement.

By the way, regarding the "cost of contraception" argument - it's really not hard to find data on this:

http://www.whitehous...us-institutions

There's no data there at all other than a conclusory reference to an unspecified study. It's just a puff piece on how great their policy is.

Note that the Guttmacher paper has a lot of detail if you're interested - things like 1.6 million pregnancies from those who could not obtain contraception themselves, 600,000 abortions, 700,000 children born below poverty each year. It's pretty detailed if you care to look it up and looks pretty definitive as far as an answer goes.

No it isn't. I'm not sure why this principle is so hard to understand. That study looks only at the universe of people who could not (supposedly) afford contraceptives otherwise. And, incidentally, points out that the pre-ACA world (the study is from 2008, right?) already contained mechanisms to ensure that women who couldn't afford contraceptives but needed them could get them.

Look, I'm not a fan of government entitlement programs, but if you're going to have Medicaid, I don't oppose covering BC pills for those women who can't afford it otherwise because as taxpayers, we'd picking up that tab anyway. That is the issue the Guttmacher paper addresses. I have issues with some of the assumptions in the Guttmacher paper, such as how they determined the number of pregnancies that would have occured (which I strongly suspect proceeds on the assumption that recipients would not have changed their sexual habits or used alternative methods such as condoms if they hadn't obtained birth control), but it's not worth arguing.

But the ACA does not have that "inability to pay" limitation. It requires both coverage and no copay (essentially subsidization) for all those tens of millions of women who can afford that out of pocket expense. Those are all folks who would not become pregnant without the subsidy because they'd be getting BC on their own anyway. Yet when you mandate coverage and no co-pay even for those who could afford it otherwise, you are driving up plan costs with absolutely no financial benefit to the plan. There is nothing in the Guttmacher article that addresses that cost issue at all, and that's the situation that applies to the vast majority of women.

Now just to reiterate, if an employer and plan choose to do that, I've got no problem with it. Not my problem. But since we're talking about a government mandate, they've made it my business as a voter/taxpayer.

[Shryke]

I think Santorum is more likely to drop out than Gingrich. Santorum is a young-ish guy in good standing with the party, and he's not going to want to ruin himself just to poison the well for Romney. I think that, when the time comes, he'll allow himself to be bought off in exchange for getting out of the race and letting the inevitable happen.

Gingrich, however, is much older, despised by party elites, and has little incentive to turn off his self-aggrandisement machine. In fact, the longer this race goes on the more publicity he gets, which could translate into future book sales, cushy speaking engagements, etc.

Gingrich ain't going nowhere so long as his pet billionaire keeps dropping cash on his head. The minute the well runs dry, he's gone.

Dems, IMO, have trouble playing to win though. Obama's record seems spotty and in some cases (Solyndra) kinda weak.

Really? Solyndra is a weakness now? The hell?

[Shryke]

no its not scarcasm. Kucinich was one of the only members of congress who stood up and said what a bad idea going to war with Iraq was. He voted against the Patriot Act (in his words "because I read it!"). I dont know anything about Kaptur, and she doesnt represent me, but I do like Kucinich, even though he is much more liberal than me. I also like that he filed articles of impreachment against GWB.

Kucinich was useless. He's all talk, no action and basically did nothing with his 15 years in the House.

Whatever you think of the man, his loss is no great loss for anybody else.

[Kalbear]

But the ACA does not have that "inability to pay" limitation. It requires both coverage and no copay (essentially subsidization) for all those tens of millions of women who can afford that out of pocket expense. Those are all folks who would not become pregnant without the subsidy because they'd be getting BC on their own anyway. Yet when you mandate coverage and no co-pay even for those who could afford it otherwise, you are driving up plan costs with absolutely no financial benefit to the plan.

That's not necessarily the case. You get increased ability to purchase, you now get to be on the 'must sell low cost birth control' rule, and for the vast majority of plans this does not affect them since, well, they already cover this.

And this also means that it won't be a cost to you anyway since these are private plans. None of these are subsidized by taxpayer dollars any more than a car having a seatbelt in it is subsidized by taxpayer dollars.

Put it another way, FLOW: without a mandate tehre is no requirement that these are subsidized, which means that at that point you are dealing with a large number of people who will not take BC because they can't afford it - and that means the Guttmacher thoughts come into play. So you either get the mandate - and the savings to the tax base that come from that - or you don't, and you pay a lot more personally.

[Former Lord of Winterfell]

My problem with Kucinich is he is the epitome of "letting the perfect be the enemy of the good". He would vote against many bills because they weren't liberal enough, even though they were better than what existed and were realistically the best bill that could get passed. He was also a vain, spiteful man who did nothing to help the party. He is a man with no accomplishments who found his niche as being tied with Ron Paul for most anti-war member of congress.

In fairness to Kucinich on this issue, he usually cast such votes when the bill was certain to pass anyway. When you guys really needed his vote, he went your way.

That being said, I'm glad to see the filthy little troll (he really needed to take more showers) lose his seat. He was my representative, and don't think I miss the humor in that. My only fear is that he'll pop up in local politics now, which is about the last thing we need.

[Former Lord of Winterfell]

That's not necessarily the case.

Yes it is. The ACA mandate applies regardless of income. That's indisputable.

And this also means that it won't be a cost to you anyway since these are private plans. None of these are subsidized by taxpayer dollars any more than a car having a seatbelt in it is subsidized by taxpayer dollars.

But....but....I have a private plan. And because of this mandate, the cost of my plan will increase.

[Shryke]

But....but....I have a private plan. And because of this mandate, the cost of my plan will increase.

How will it increase?

[Sci-2]

Heh, my sister used to joke that when people argued with Kucinich about aliens or whatever, he'd say, "Guys, come on. Look at my wife."

[Kalbear]

Yes it is. The ACA mandate applies regardless of income. That's indisputable

That's true, but I wasn't disputing that. I was disputing the notion that this will cost anyone any more money.

FLOW, there is zero evidence your plan's costs will increase and many points of evidence that it will decrease. We've shown that already with insurance plans that added contraception to their benefits; their costs did not increase to either themselves or to their payers. You think that it'll increase because adding something should increase some value, but evidence is against you.

[IheartTesla]

It looks as if almost anything causes an increase when it comes to health care costs. According to some dude on an Atlantic, free contraception would raise the cost of contraception (from $9 to $20 for generic birth control was his number). ACA will raise health care costs. Illegal alien anchor babies will raise health care costs. The price of tea in China will raise health care costs.

Apparently the only thing that wont raise health care costs is the status quo.

[Shryke]

In fairness to Kucinich on this issue, he usually cast such votes when the bill was certain to pass anyway. When you guys really needed his vote, he went your way.

That being said, I'm glad to see the filthy little troll (he really needed to take more showers) lose his seat. He was my representative, and don't think I miss the humor in that. My only fear is that he'll pop up in local politics now, which is about the last thing we need.

You guys know what this means right?

In November, FLOW will be voting for Joe the Plumber.

I shit you not.

[Crazydog7]

Yes it is. The ACA mandate applies regardless of income. That's indisputable.

But....but....I have a private plan. And because of this mandate, the cost of my plan will increase.

Really? Will it? And what News Network did you hear that on I wonder?

[Ser Greguh]

I'd be curious to know what his position is on the death penalty, and other such issues where the RCC is pretty hardline.

Given that I haven't heard it brought up I'm going to go with "Pro." If he were opposed to it it surely would have been used to undermine his hate cred by now.

[drawkcabi]

You guys know what this means right?

In November, FLOW will be voting for Joe the Plumber.

I shit you not.

:rofl: :rofl: :rofl:

I can see Solyndra as an issue that the GOP can use as a weakness to sway independents (the more wishy washy ones) and shore up conservatives but Obama can use to his benefit with the more progressive left as doing good in implementing alternative energy research. Even though Solyndra went bust, other alternative energy programs of the President's did not.

Re: Romeny getting the nomination.

Even with last nights anyone-but-Romney showing and even if it causes (another) change in momentum, the mathematics of the delegates are on Romney's side.

IMHO, there's more chance of a brokered convention than Santorum getting the nom and there's not that great a chance of that. However, the more weak Romney looks the chances of a brokered convention do go up and Santorum stays the least likely of these choices.

[Mlle. Zabzie]

First, it is directly relevant to Kalbear's argument. His argument was that covering birth control -- particularly with the "no-copay" rule but even without it-- actually saves insurance plans money because unwanted pregnancies cost more money than birth control pills. But if the vast majority of women will pay for their own BC regardless, those unplanned pregnancies due to lack of coverage (or no copay) really aren't happening very often at all. So insurance companies won't be incurring huge expenses for those pregnancies, and won't be paying for pills either.

Second, I don't consider the use of those pills for the purposes of birth control as on the same moral plane as chemotherapy. I do think the use of such pills for specific health care reasons is no different from other prescriptions, though, and if an insurer wrongfully denies coverage, that likely creates a claim for bad faith.

But I honestly can't understand the moral/policy-based argument for giving birth control pills being used for birth control purposes an even higher status via no co-pays than all sorts of life-sustaining treatments like chemotherapy, etc. for which copays are still required. That's what's bizarre. If you have a heart attack, cancer, life-threatening infection, ALS, AIDs, or condition of similar severity, you still have to pay your copays. But if you want birth control pills so you can have recreational sex without getting pregnant, well, those we'll spring for.

That's just a description of what the law is, not a moral defense of the underlying policy justifications. As for birth control being preventative, that was something that was not even defined in the law itself, but was left up to HHS. And there was a lot of behind the scenes politicking for various interest groups going on with that.

No, that is not my point. I has said repeatedly that if an insurer and employer choose to define it as such, I don't care. Ah hell, actually, my preference would for it not to be covered if it raises my costs (I really do believe in the personal responsibility stuff for recreational activities), but that's not a political objection at all. And I have no objection at all to those students lobbying for such a policy given that they are paying into it. They're customers, and certainly are entitled to be heard. My objection is to the government stepping in and legally compelling coverage. And when you add in the requirement that there not even be a copay, we've moved well beyond any theory of "non-descrimination" to simply one of entitlement.

There's no data there at all other than a conclusory reference to an unspecified study. It's just a puff piece on how great their policy is.

No it isn't. I'm not sure why this principle is so hard to understand. That study looks only at the universe of people who could not (supposedly) afford contraceptives otherwise. And, incidentally, points out that the pre-ACA world (the study is from 2008, right?) already contained mechanisms to ensure that women who couldn't afford contraceptives but needed them could get them.

Look, I'm not a fan of government entitlement programs, but if you're going to have Medicaid, I don't oppose covering BC pills for those women who can't afford it otherwise because as taxpayers, we'd picking up that tab anyway. That is the issue the Guttmacher paper addresses. I have issues with some of the assumptions in the Guttmacher paper, such as how they determined the number of pregnancies that would have occured (which I strongly suspect proceeds on the assumption that recipients would not have changed their sexual habits or used alternative methods such as condoms if they hadn't obtained birth control), but it's not worth arguing.

But the ACA does not have that "inability to pay" limitation. It requires both coverage and no copay (essentially subsidization) for all those tens of millions of women who can afford that out of pocket expense. Those are all folks who would not become pregnant without the subsidy because they'd be getting BC on their own anyway. Yet when you mandate coverage and no co-pay even for those who could afford it otherwise, you are driving up plan costs with absolutely no financial benefit to the plan. There is nothing in the Guttmacher article that addresses that cost issue at all, and that's the situation that applies to the vast majority of women.

Now just to reiterate, if an employer and plan choose to do that, I've got no problem with it. Not my problem. But since we're talking about a government mandate, they've made it my business as a voter/taxpayer.

FLOW - I find your constant reiteration that birth control should not be covered to the extent that it is only being used so that the person taking the birth control can have "recreational sex" intellectually unsatisfying.

1. Take the following example - person has painful, irregular periods. Person could certainly live with them (with some unpleasant disruption to life) but a hormonal pill makes the periods both regular and, while not pain free, at least not at a level causing vomiting. Does that person get covered? I'm thinking under your example the answer is "no" even though I think that person would be comparable to, for instance, a person with a non-crippling auto-immune disease who takes a prescription anti-inflammatory every morning to help manage stiffness (except for the fact that, it is true, the person who takes the anti-inflammatory, I guess, has to swing for their own birth control, which, I suppose means that dual purpose drugs shouldn't be allowed - if you get a nice side effect, whammo, you pay twice).

2. What about a person for whom pregnancy, except under specifically monitored conditions, would be dangerous? Ok? What about that same person, or you know, any person, getting her tubes tied. Covered? How is it different? In both cases the goal is recreational sex (though in the first its allowing it while preserving a chance for fertility).

[awesome possum]

Dems, IMO, have trouble playing to win though. Obama's record seems spotty and in some cases (Solyndra) kinda weak.

How so? The investment in Solyndra was 1.3% of the total amount spent in green energy loans. It was a very minor failure that Republicans turned into a major controversy, as both sides are apt to do. It really was and is inconsequential.

Whatever you think of the man, his loss is no great loss for anybody else.

The major loss came when the GOP in Ohio used their redistricting to merge two Democratic districts, hence killing a Dem's seat.

[Kalbear]

Soylndra was pretty bad. It's not whitewater bad, but hundreds of millions in money lost on something that looked fairly fishy and doubled down after it was shown to pretty well suck is not a great mark no matter how you spin it.

But I don't see it as some giant thing that will kill him.

[Guest Raidne]

Does anyone have any data on where people voting for The Thing Called Newt would go if he dropped out? I assume it's overwhelmingly to Santorum, but I don't have any data. If that's so, think how much Newt is bailing Romney out.

Romney's people think it's them, which would be a good assumption except that I think the people who are voting for Newt want a candidate that is like Romney generally, but not Romney personally. Newt is the least popular candidate in the general population, however, which I find surprising, but apparently a lot of people find him to be personally distasteful as well. Americans don't like egomaniacs unless they are really, really charismatic.

Voting for Santorum -> Is this the last gasp of the social conservatives? I mean how many years does this movement have left?

I hope so, and I do kind of think so. If not the last gasp, getting there. Does getting the social conservative vote cost you a greater number of moderate votes? If so, they are done and relegated to the status of fringe third party, like true socialists in the United States.

Kalbear's...argument was that covering birth control -- particularly with the "no-copay" rule but even without it-- actually saves insurance plans money because unwanted pregnancies cost more money than birth control pills. But if the vast majority of women will pay for their own BC regardless, those unplanned pregnancies due to lack of coverage (or no copay) really aren't happening very often at all.

This is theoretically true, but empirically untrue because apparently a significant number of women don't pay for their BC regardless, or don't get the most effective method of BC for their purposes, or skip a month here or there, etc. I can see that - BC becomes a regular regimen in the lives of women who are not in a committed relationship when it's covered and obtained in the regular method that they get their other prescriptions, but only women who know they need it are going to go to the extra effort when it's not - you are acting as though you don't have to get a script written by someone to obtain it, and a script for the one you can afford out of pocket, from a doctor who doesn't know which is cheapest out of pocket, or have an appointment that includes a gynecological examination from a provider you are not familiar with (which some Planned Parenthoods require), etc.

Second, I don't consider the use of those pills for the purposes of birth control as on the same moral plane as chemotherapy. I do think the use of such pills for specific health care reasons is no different from other prescriptions, though, and if an insurer wrongfully denies coverage, that likely creates a claim for bad faith.

It's not a moral issue - it's about essential health benefits as a descriptive issue. What these are were and are determined by what most plans currently cover - it's about consumer expectations: what people assume is in their health care plans.

With regard to copays, it's about prevention - decreasing overall costs through cost-saving preventive care. When something meets that empirical test, as shown by the commission, it is added to the fully covered list of health services because it decreases costs, and not for any other reason.

As for birth control being preventative, that was something that was not even defined in the law itself, but was left up to HHS. And there was a lot of behind the scenes politicking for various interest groups going on with that.

Precisely, because it's an empirical question that requires expertise to answer, which is what the administrative state is for. If you think there is politicking at the agency level, imagine what would happen if that level of detail was carved out by non-experts in Congress with the full involvement of lobbyists and campaign money.

My objection is to the government stepping in and legally compelling coverage. And when you add in the requirement that there not even be a copay, we've moved well beyond any theory of "non-descrimination" to simply one of entitlement.

There are a few premises implicit to this decision that I would like to know if you accept or not:

(1) Health care plans are too complicated for the average reasonable person to understand.

(2) It is good for people to be able to understand their health care plans

(3) Mandating certain coverage that people have been empirically shown to assume they have and is commonly actually present in most health care plans is a good way to ensure that people are buying the coverage that they think they are buying.

There's no data there at all other than a conclusory reference to an unspecified study. It's just a puff piece on how great their policy is.

Then go look for the study. And no - there is an empirical claim about federal employee benefits there. Since, as per usual, you cannot be arsed to use Google yourself, here is a summary from FactCheck:

http://www.factcheck.org/2012/02/cloudy-contraception-costs/

Overall, the data looks inconclusive, but the type of data varies widely and a lot of the negative evidence seems to be premised on the theoretical argument that you raised, and I answered, above, and not empirical evidence. The data pertaining to FEHB is hard data, and conclusive. I think the agency had an empirical call to make, and made it, like they would for any other preventative service they are charged with evaluating.

If you have an issue with the agency's fact-finding, then you should do what you are supposed to do and find a way of raising it during the notice and comment period, or, at the very least, read the federal register summary of the comments and agency deliberations before you decide the whole process was hijacked by NOW.