Has U.S. Democracy Been Trumped?

[kenberg]

How important is it for people to "understand" this stuff in any detail? The taxation thing is no different from the income taxes that everyone already pays -- if you can't understand it you go to H&R Block.

 

Most people don't understand how a car engine works, but they still have no problem driving one.

 

Hardly anyone understands how computers and the Internet works, but they can Google and play Kandy Krush, that's all that matters.

 

The analogy gets tricky, analogies usually do. Cars: In 1980 I bought an Isuzu diesel. I don't need to know how a diesel works. but I do need to know how easy it will be to get diesel fuel whan I need it. I need to know if I might have problems with it in the winter if I move from Maryland to northern Minnesota.

 

Medical care has changed greatly during my lifetime, The possibilities for treatment have changed immensely, the mode of paying for it has changed immensely. I have seen enough variation, each with its own pluses and minuses, to be more than a little skeptical when I hear of how well it all would work if we would just do this or just do that.

 

The current system works well, very well, for me. I recognize that it does not work well for everyone. So I see the question as how to make it work better for others without screwing it up for myself. I am pretty sure that it is not easy.

[Vampyr]

btw it seems a bit weird that costs do not vary by person ....so a twenty year old pays just as much as a 70 year old

 

The 70 year old has, in a way, paid for her care by the premiums she paid between the ages of 20 and 69. I know this is over-simplified, but it is one way to think about the matter.

 

There are two more things that you might need to understand

 

1. The mindset of a person who believes that health care is a basic human rights not a commodity.

 

2. Empathy. Seeing a man suffering catastrophic injuries from a terrorist attack in a the heart of your city, a child born with cystic fibrosis, a woman diagnosed with breast cancer, and thinking, that could be me, that could be my child, that could be my wife.

 

As someone mentioned above, insurance companies are not going broke. In fact, they are among richest companies on the planet. Vast sums of money are being skimmed off rather than being used for medical treatment. A single-payer system is like an insurance company that does not intend to make a profit, and will in fact operate at a loss if necessary. There could be other models with this characteristic which might be more palatable for Americans, seeing as how they are so deathly afraid of socialised medicine. On the other hand I have not heard of large numbers of, or in fact one, senior refusing Medicare. There might be a few, but not enough to deny the fact that the majority of Americans are unwilling to put their money where their mouth is.

[barmar]

The analogy gets tricky, analogies usually do. Cars: In 1980 I bought an Isuzu diesel. I don't need to know how a diesel works. but I do need to know how easy it will be to get diesel fuel whan I need it. I need to know if I might have problems with it in the winter if I move from Maryland to northern Minnesota.

 

Medical care has changed greatly during my lifetime, The possibilities for treatment have changed immensely, the mode of paying for it has changed immensely. I have seen enough variation, each with its own pluses and minuses, to be more than a little skeptical when I hear of how well it all would work if we would just do this or just do that.

 

The current system works well, very well, for me. I recognize that it does not work well for everyone. So I see the question as how to make it work better for others without screwing it up for myself. I am pretty sure that it is not easy.

I've never been able to fully understand my healthcare options. Whether I've had employer-supplied insurance or I've been self-insured, they've always given me a menu of different plans to choose from. Employers generally just have a few options (HMO versus PPO, high or low deductibles), while the market place has lots of options. The websites have options to compare them, but figuring out the priority between feature A, feature B, and price is difficult. In the end I just guess.

[helene_t]

As a Dane (i.e. used to a single-payer system) living for a long time in the Netherlands, it astonished me how anybody in the Netherlands who is not on the pay list of the insurance lobby could support the insurance system.

 

The only argument I have heard is that it gives you choice. You can choose high or low co-payments, coverage of certain things are not in the basic package (like complementary medicine). In Denmark, you can of course also decide to pay for an extra insurance that lowers or eliminates co-payments so that's hardly an argument. But with respect to alternative treatments I suppose the insurance system has the advantage that if you take insurance for the more expensive options, you don't have to pay everybody else's cheaper options through the taxes at the same time.

 

Even in the Netherlands, you still have to pay for other people's chemotherapy even if you'd always chose Chinese herbs yourself if you got cancer. That's because standard cancer treatment is in the basic package. But I suppose one could find examples where the insurance system saves you from paying for the standard treatment which you don't get because you have chosen a more expensive alternative.

 

I find it difficult to believe that there are many people for whom that saving would be big enough to cancel out the extra costs of the expensive insurance system, compared to single-payer. I suppose I could be wrong.

[Zelandakh]

The usa has the best health care

You are joking right? Surely noone who has any idea about international healthcare can really believe something like this. :lol:

[PassedOut]

You are joking right? Surely noone who has any idea about international healthcare can really believe something like this. :lol:

If one can afford insurance and is selective, one can get good care here. Our family uses the Mayo Clinic for anything serious. But the overall statistics for outcomes in the US fall far below those of more advanced nations.

 

It was common when traveling to get questions or comments about US healthcare along the lines of WTF? Now though, the WTF questions are about Trump.

:(

[kenberg]

I've never been able to fully understand my healthcare options. Whether I've had employer-supplied insurance or I've been self-insured, they've always given me a menu of different plans to choose from. Employers generally just have a few options (HMO versus PPO, high or low deductibles), while the market place has lots of options. The websites have options to compare them, but figuring out the priority between feature A, feature B, and price is difficult. In the end I just guess.

 

Even in the relatively simple situation I inhabit right now, the benefits are confusing. I definitely did not say the system is understandable, mostly it isn't. But I have been happy with the care that I get, and one way or another most thinigs seem to get covered

 

It certainly would be nice to understand what I have. I don't. But it seems to work out.

[jogs]

The usa has the best health care

 

 

You are joking right? Surely noone who has any idea about international healthcare can really believe something like this. :lol:

For the 30% with cadillac plans that statement is probably true. At the top level for the top 1% the USA certainly has the best healthcare. For the 25% at the bottom the USA may have nearly the worst healthcare among the industrialized world.

[y66]

In the 25 years that I served in the United States Congress, Republicans never, ever, one time agreed on what a health care proposal should look like. Not once. And all this happy talk that went on in November and December and January about repeal, repeal, repeal — yeah, we’ll do replace, replace — I started laughing.

-- John Boehner, who handed off the Speaker's gavel to Paul Ryan on October 29, 2015 before resigning from Congress on October 31, 2015. Boehner currently works for Squire, Patton, Boggs the 3rd largest lobbying firm in the U.S. He also sits on the board of Reynolds American, the 2nd largest tobacco firm in the U.S.

[barmar]

It certainly would be nice to understand what I have. I don't. But it seems to work out.

That's basically my point. Except for people with special needs, the details don't make all that much difference. If you're generally healthy, you go with low premiums, high deductibles, and moderate reimbursement for routine care; if you expect to have significant medical expenses, you choose higher premiums that pay medical expenses in full.

 

It's like picking a college to go to or deciding where to live. People agonize over these decisions when they have to make them, but in most cases you'll be happy with whatever you choose -- you can usually weed out the choices that would be a really bad fit.

[kenberg]

That's basically my point. Except for people with special needs, the details don't make all that much difference. If you're generally healthy, you go with low premiums, high deductibles, and moderate reimbursement for routine care; if you expect to have significant medical expenses, you choose higher premiums that pay medical expenses in full.

 

It's like picking a college to go to or deciding where to live. People agonize over these decisions when they have to make them, but in most cases you'll be happy with whatever you choose -- you can usually weed out the choices that would be a really bad fit.

 

As I am now, it is all pretty simple. I am in generally good health but I can read the calendar. I have Medicare, and I have supplemental insurance that is partly subsidized as part of a retirement package. The coverage is such that I don't often have to pay much out of pocket, the combined cost of the two plans is such that I don't fret about it.

 

Life was not always that simple for me, and I try to stay aware of the fact that it is right now not simple for a lot of people. What to do requires thought. I absolutely agree that people have responsibility for themselves, but help can be very useful, and, for that matter, good for us all.

 

Back to Trump, this being the Trump thread. I see no evidence that Trump has given the health care issue five minutes of thought. Repeal and Replace apparently worked well for the campaign. Replace with what? It will cover everyone and be terrific; so he said. Whatever the merits of Ryan's plan, it was not going to cover everyone, far from it. But it was a Repeal and Replace bill, and for Trump that was enough. Who cares about details? This is totally irresponsible.

 

Worse, this stuff with health care reflects his general approach. I might well be more supportive of military spending than some on this thread. But surely building up the military, in itself, is not a viable approach for success in international matters. The man really seems to think that all he has to do is order how things are to be and then they will be that way. Solo flight, New York to Paris, worked out for Lindbergh, but that was quite a while ago. Generally I think we need our friends.

 

I fear that I am both repeating myself and stating the obvious.

 

Anyway, we have a mess on our hands.

[jogs]

 

 

Back to Trump, this being the Trump thread. I see no evidence that Trump has given the health care issue five minutes of thought. Repeal and Replace apparently worked well for the campaign. Replace with what? It will cover everyone and be terrific; so he said. Whatever the merits of Ryan's plan, it was not going to cover everyone, far from it. But it was a Repeal and Replace bill, and for Trump that was enough. Who cares about details? This is totally irresponsible.

 

 

There is little evidence that any plan from any politician from either side of the aisle is any good.

 

Gavin Newsom's health plan is the best I've seen. Unfortunately egotistic Jerry Brown refused to step aside and allow Newsom to run for governor of California.

[kenberg]

There is little evidence that any plan from any politician from either side of the aisle is any good.

 

Gavin Newsom's health plan is the best I've seen. Unfortunately egotistic Jerry Brown refused to step aside and allow Newsom to run for governor of California.

 

This is true. But wait. Jamie Raskin, my Representative in Congress, did not run on repealing the ACA and replacing it by something really terrific. Trump did. I don't know if Raskin thinks NATO is obsolete, but if he does I hope he has the good sense to shut up about it. And so on.

 

To put this in still another way, it is true that I also do not have a great idea, even a concept let alone the details, of just how we should structure. health care. But then I had the good sense to not run for president, and if I had run then I assume people would have had the good sense not to vote for me.

 

For Trump to now say something like "my goodness, it's complicated", I don't recall exactly his words, does not really work for me. His business model seemed to be to just give anything a shot and if it doesn't work out well there are always the bankruptcy courts and good lawyers, Maybe that's NY real estate, but it is one hell of a way of conducting the presidency.

[jogs]

Newsom's Healthy San Francisco only had to cover 8% of San Francisco. His plan is really only for those who didn't have access to good employer based health insurance.

Healthy California may include as many as 30% of Californians. Would Newsom be able to design a creative way to fund such a large system?

 

I have heard no plan from Trump or any republican which seems sound or workable.

[cherdano]

Say what you want about Trump, at least he made an ausholen his press secretary. Or he made his press secretary be an asshole.

 

https://www.washingtonpost.com/news/the-fix/wp/2017/03/28/sean-spicer-loses-his-cool-stop-shaking-your-head/?hpid=hp_hp-more-top-stories_fix-spicer-325pm%3Ahomepage%2Fstory&utm_term=.227c43836da7

 

Make assholes great again.

[jogs]

http://www.foxnews.com/politics/2017/03/27/sessions-takes-aim-at-dangerous-sanctuary-cities-warns-on-funding.html

Attorney General Jeff Sessions fired a broadside at so-called "sanctuary cities" Monday, telling reporters local policies of noncooperation with immigration authorities are "dangerous" and will cost communities federal funding.

 

Sanctuary cities fight back.

 

http://www.npr.org/sections/thetwo-way/2017/03/28/521771752/sanctuary-cities-promise-legal-fight-after-sessions-threatens-funds

 

How does the progressive left justify giving illegal aliens more rights than ordinary Americans? There is no right to immigrate into the USA.

The dishonest left loves to cite flawed studies which claim immigrants commit crimes at a lower rate than average Americans. 300 sanctuary cities will not allow law enforcement to ask a criminal of their immigration status. Their crime total is clearly undercounted. Legal immigrants, especially those from Asia and Europe who come to America for university studies, commit crimes at a extremely low rate. The Trump administration is only deporting illegal immigrants who are also violent criminals. Any honest study would not group legal and illegal immigrants into a single large group. It is the uneducated illegal immigrants who are committing crimes at an extremely high rate.

 

http://www.cnn.com/2017/03/21/us/maryland-undocumented-student-rape/

 

18-year-old Henry Sanchez-Malian arrested and accused of rape. Sanchez is an illegal immigrant who can't speak English. He isn't even fluent in his native tongue. These are the people who should be deported.

Every advocate of placing illegal immigrants into public schools should be required to send their children, grand children, and great grand children of K-12 age into the public school system.

[cherdano]

For Trump to now say something like "my goodness, it's complicated", I don't recall exactly his words, does not really work for me.

 

I think everyone, but especially Trump, deserves to be quoted accurately.

 

"We have come up with a solution that's really, really I think very good," Trump said at a meeting of the nation's governors at the White House.

 

"Now, I have to tell you, it's an unbelievably complex subject," he added. "Nobody knew health care could be so complicated."

http://edition.cnn.com/2017/02/27/politics/trump-health-care-complicated/

[kenberg]

I think everyone, but especially Trump, deserves to be quoted accurately.

 

 

http://edition.cnn.c...re-complicated/

 

Continuing on from your cited source:

 

"We have a plan that I think is going to be fantastic. It's going to be released fairly soon," Trump said Monday. "I think it's going to be something special ... I think you're going to like what you hear."

 

Well, a guy can hope. I wonder just who the "you" was in "I think you're going to like what you hear".

[helene_t]

ausholen

German autocorrection will make the English language great again

[cherdano]

German autocorrection will make the English language great again

LOL my phone uses bilingual autocorrelation. But apparently my phone is less profane than I am.

[WellSpyder]

I think everyone, but especially Trump, deserves to be quoted accurately.

"Now, I have to tell you, it's an unbelievably complex subject," he added. "Nobody knew health care could be so complicated."

Ha, ha, ha! You almost got me there. For a moment I was worried that the fate of the western world really was in the hands of a complete ****** idiot. Then, fortunately, I realised this had to be an example of the "false news" we hear so much about these days. I mean, nobody could really be so stupid as to spend a whole election campaign believing it was just a simple problem that they would be able to sort out to everybody's satisfaction as soon as they thought about it properly, could they? And if somebody did really believe this, nobody would want to vote for them, would they?

[barmar]

Well, a guy can hope. I wonder just who the "you" was in "I think you're going to like what you hear".

Most of his supporters could be expected to "like" anything that isn't called "Obamacare".

 

A significant number of people don't realize that Obamacare and the Affordable Care Act are the same law, particularly among groups that are most likely to take advantage of it.

 

https://www.nytimes.com/2017/02/07/upshot/one-third-dont-know-obamacare-and-affordable-care-act-are-the-same.html?_r=0

[barmar]

Back to Trump, this being the Trump thread. I see no evidence that Trump has given the health care issue five minutes of thought. Repeal and Replace apparently worked well for the campaign. Replace with what? It will cover everyone and be terrific; so he said. Whatever the merits of Ryan's plan, it was not going to cover everyone, far from it. But it was a Repeal and Replace bill, and for Trump that was enough. Who cares about details? This is totally irresponsible.

I like the way many comedians put it: The GOP is like the dog who chases a car -- they don't know what to do if they actually catch it. They've been talking about killing Obamacare ever since it was enacted. But because they knew they couldn't actually achieve it, they never gave serious thought to what they'd put in its place. Then when it actually became politically achievable, they had to throw something together incredibly quickly (because Trump said this would be done on Day 1), and of course it was a total mess.

 

As for Trump's "plan", that was just the usual campaign rhetoric. He's just a better BS artist than typical politicians. His entire campaign was just saying what people wanted to hear in broad strokes -- he never fleshed it out with any details. But the public was so hungry for a change from business as usual that they ate it up and elected him.

 

Trump also seems to have no notion of "unintended consequences". His executive orders have been making sweeping changes without any regard for the impact other than the primary goal.

[gwnn]

All this about "tried to understand but couldn't" from people who are generally (at the risk of flattering y'all) very smart and well educated, all this shows how stupid someone like Rand Paul's idea is of "people should be allowed to choose what healthcare they want!". I mean, yes, within some limits they should be allowed to do it. But in practice many/most folks will just go for the cheapest possible and never read the fine print or even the large print (it is not actually an insurance but a scam. for small stuff you pay yourself and for large stuff they only pay a fraction - or something). Someone should set those limits and if that means that some of the cheapest options (that actually shouldn't be called health insurance as they don't insure you) are eliminated, so be it. I guess this is all pretty obvious but I just got reminded of this by this discussion.

[kenberg]

All this about "tried to understand but couldn't" from people who are generally (at the risk of flattering y'all) very smart and well educated, all this shows how stupid someone like Rand Paul's idea is of "people should be allowed to choose what healthcare they want!". I mean, yes, within some limits they should be allowed to do it. But in practice many/most folks will just go for the cheapest possible and never read the fine print or even the large print (it is not actually an insurance but a scam. for small stuff you pay yourself and for large stuff they only pay a fraction - or something). Someone should set those limits and if that means that some of the cheapest options (that actually shouldn't be called health insurance as they don't insure you) are eliminated, so be it. I guess this is all pretty obvious but I just got reminded of this by this discussion.

 

Well, I am also often too dumb to figure out how to use my smart phone. So we want to be cautious about drawing conclusions from an education. Back when I used to drive long distances to tournaments we stopped for a snack and chatted with the server. She commented that my training as a mathematician must be very useful for bridge. The lady at my side observed that a certain amount of good sense is also useful.

 

But generally yes, I take your point.