GeorgiaDon

Fixed it for you. Obama IS the President of the US, much as some people wish he wasn't. Sometimes that job requires the President to be an advocate for US interests. kbordson is absolutely correct. It's interesting that right-wingers always bring up the "community organizer" job when they want to characterize Obama's previous life. Why not mention "Professor of Constitutional Law at the University of Chicago", or "President of the Harvard Law Review"? Those are also things he has been/done. I guess they don't have quite the taint that "community organizer" does in certain circles. Makes him sound too respectible and accomplished. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Do you really think it's very hard to get a fake ID? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Here in Georgia the state legislature has had a lot of trouble passing/enforcing a requirement to show photo ID to vote. It seems a sizeable segment of the poor/elederly population don't have a drivers license or any other form of photo ID, so the law was interpreted as an attempt to disenfranchise that population. Even when the state set up a mechanism for people to go to DMV and get a photo ID for on'y $5 that was challenged (successfully) in court as a "poll tax". Now if you're poor you can get a photo ID for free, and people (including all these professional "advocates for the poor") are still complaining that it's too much of an imposition. Still, the law is now likely to stand up in court. I can't understand why it's such a big deal to show a photo ID to vote (or to register for gov't benefits either). That being said, there is actually zero evidence of a problem with fraudulent voting. If people were pretending to be someone else in order to vote, the problem would immediately be apparent when the authentic voter showed up at the polls only to be told they had already voted (or the reverse if the imposter arrives second). So the law (as reasonable as it seems) truely is a law in search of a problem. As far as health insurance is concerned, the existing bill already requires proof of birthplace (which effectively includes citizenship), name, and social security number. If someone is willing to fake those documents to register for benefits, do you really think a photo ID will be an insurmountable barrier? Around here (college town, lots of underage would-be drinkers), fake ID is a major cottage industry. It seems to me that photo ID is much like 90% of what the TSA does, window dressing to look like you're "protecting the taxpayers" but really accomplishing squat. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

But, the issue in the WHO report is how well the health care system is serving the needs of the whole population. It is quite possible that hospitals and doctors provide excellent service to those patients who get in to see them, so by that measure (which seems to be the one you are focused on) the system is first-rate. But wouldn't you agree that if a significant portion of the population was excluded from getting in the hospital door because they can't afford to pay (not saying that that is happening in the US, just a "hypothetical" for discussion), the health care system is not doing a good job of meeting the needs of the whole population? Access certainly is a relevant component of how well the system is functioning. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Perhaps that is an argument to decriminalize most of those drugs. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Private insurance companies exist to make a profit, not to provide health care to anybody and everybody. Obviously they can maximize profits by signing up young, healthy customers and purging those likely to cost them money (older people, those with pre-existing conditions). Additionally, pressure on share prices from investors feeds the need to drop "unprofitable" customers. For large-enrollment group plans, people are largely shielded from these forces as insurance companies will accept some money-losers to get access to the large pool of profitable customers. For small businesses, a single employee with a pre-existing condition can cause premiums for the whole business to climb several-fold, so often the business owner must either get rid of that employee or drop coverage for everybody. If you are looking for an individual policy and you have had a bout with cancer or a heart attack, the premium will have to cover expected medical expenses, administrative costs, and profit, with no healthy people in the pool to dilute the cost. It isn't necessarily a matter of anti-trust or price fixing, it's just that no insurance company can cover those costs and make a profit if they can't "bundle" the high-risk person with several low-risk people. Market forces on their own work to ensure that such people will never be attractive to private insurance. Since private insurance is not interested in those people, covering them in some manner through a government-operated plan would not actually compete with private insurance. This is the same as the argument that insuring the elderly through medicare has not wiped out private insurers, because private insurers don't want those customers in the first place. I am suspicious of the idea that a new bureaucracy is needed, though, as it seems to me these people could be accommodated in medicare just as the disabled currently are. Even if they were to pay an additional premium on top of regular medicare payroll deductions (if they are working), their coverage could be more cost-efficient as they would not be contributing to the (very large) profit and administrative expenses charged by private insurers. To enroll, people would have to demonstrate that private coverage is not available for a reasonable premium (say 10% of their annual income). I do not favor a single-payer system, as I think that puts too much power in the hand of the insurer and doctors tend to get screwed. I do favor the idea that routine costs should be paid by the patient, ideally with funds from a tax-exempt medical savings account that could accumulate from year to year. Insurance should only kick in to cover extraordinary expenses that otherwise would threaten to wipe out the patient financially. On the other hand, doctors and hospitals should be more transparent about what they charge so patients can be informed consumers. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Insurance companies have had many decades to come up with affordable plans that cover people with pre-existing conditions, including the universal pre-existing condition of getting old (happens to all of us). So far, they have not expressed any interest in competing for this "market". The same applied to retired people, which led to the introduction of Medicare. At the time the insurance industry, and conservatives, decried the "government takeover" and claimed that it was the beginning of the end of the private insurance industry. Obviously that hasn't happened. Why not? Because there isn't really any competition, private industry never had any interest in the elderly market, it just doesn't pay enough. So, why would a plan that would cover people who private insurance won't touch with a ten-foot pole (those with pre-existing conditions) be a threat to the insurance industry? And, how long do we give the industry to come up with their solution to the problem? 50 years? 100? Forever? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Maybe, they were working?? A few days off to go to DC for a protest means days of lost business. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

I didn't say anything about a "doctor czar". "Market forces" have had a long time to "take care " of the supply problem, and so far they haven't. Part of the reason is apparently that the AMA has lobbied to keep the supply of doctors relatively low. I'm not entirely sure that that really is the case. Another, probably bigger problem is that it's incredibly expensive to start up a new medical school. Building the thing is the smallest part, and that can easily be 20-30 million or more. Then you need to attract good faculty, which means competing with private practice to get the best people in each specialty. On top of that good medical schools all have active research programs, which generates the "cutting edge" medicine and keeps faculty up-to-date with the latest advances in their field. To equip a modern biomedical research lab costs about $500,000+ in startup costs, per faculty member, on top of a salary of at least a couple of hundred thousand/year (plus they have their private practice based at the school/teaching hospital). When you're talking about $60-80 million in up-front costs before the first student is even admitted, it's no suprise that no large private medical schools have opened in a long time. It really does require government input to get these things off the ground. Since they are tax exempt, in a real sense all HSAs are taxpayer subsidized already. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

kbordson, Casting pearls before swine, I'm afraid. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

After some pondering, I find myself agreeing with pretty much everything he has to say. Just a couple of things that might also help: 1) Increase the supply of doctors. Currently the medical profession restricts the number of med school slots, so doctors are in short supply especially in certain disciplines. More doctors will mean more competition, more being attracted to underserved areas (general practice, geriatrics, etc), and lower prices. This must include opening more medical schools, and maybe subsidizing the cost to expand the pool of candidates. Both are inherently expensive propositions, but perhaps cost-effective in the long run. As some in the medical profession who post here have pointed out, such reforms could screw doctors who have gone through the existing system and are now saddled with huge student loans. Some loan forgiveness mechanism may also be needed. 2) Allow people to accumulate money in medical savings programs for more than one year. The system we have now only allows for a year at a time, and money in the account at the end of the year is lost. This should be a simple and non-controversial matter of "tweaking" the existing law. 3) Malpractice reform to lower premiums, while still allowing for appropriate restitution for real victims of medical malpractice. I don't think simple-minded caps on awards will work. That has been done here in Georgia and in other states; premiums have continued to rise, insurance company profits have risen, and it is now economically unfeasible for low-income people to seek restitution. The reason for that is awards are limited to $250,000 plus actual economic damages. A big chunk of economic damages is loss of future income, which is pretty small for most people. Since expert witness fees, court and legal fees, etc have to be paid out of the award, the maximum payment under the caps won't even cover legal costs unless you make a 6-figure income. I wonder if it would be cheaper for the AMA or the various medical professional societies to "self-insure". The society would maintain a cadre of "special masters", who would be qualified to examine malpractice claims. If they decide the case is malpractice, they could negotiate a settlement. If they feel the case is frivolous, the society would contact with lawyers to fight tool and nail. Cost savings could be realized, because the profit skimmed off by the insurance company would be eliminated. Insurance companies often settle "smaller" claims because they can be expensive to contest, and anyway they can recover their payment to the "victim" by ratcheting up premiums. This feeds a "malpractice claim is like winning the lottery" mentality. If frivolous claims were contested instead of automatically paid, the incentive to sue frivolously would decrease. By "frivolous" I mean claims related to normal (and often temporary) side effects of treatment, which patients are told about in advance, and things of that nature. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

As matters stand, we have a problem with illegal immigration because we provide jobs to people who are not entitled to work here. Certain industries in particular benefit from hiring illegals, as they can pay them less than Americans would demand for the same services. We need: 1) A fast, easy-to-use, and highly accurate system to verify social security numbers (including matching numbers to names. The E-verify system is supposed to do this, but accuracy and ease of use are apparently problematic. However I recently heard a program on NPR where HR people said that they could get verification routinely in under 3 minutes, which seems pretty good to me. In the same program, the American Council of Business (or something like that) was whining about the cost imposed on business (which is trivial, especially compared to criminal background checks); basically their attitude was to let someone else take care of the problem. 2) Require all employers to verify employees social security number. 3) Police businesses to ensure checks are made, ideally before beginning employment. Severely fine both businesses who fail to check, and illegals who obtain employment without legal status. Remove the financial incentive to hire illegals. If it is nearly impossible to get a job here as an illegal immigrant, very few will come here (illegally) and the ones already here will lose their jobs and have to leave. Of course, if down the road we discover that we really don't have the people to pick crops or pluck chickens or whatever, we will have to create legal mechanisms for people to come here to do those jobs. As it stands now, either there are no existing mechanisms to obtain visas to work in certain industries, or those visas are prohibitively expensive. If an industry needs to bring in foreign workers, perhaps they should pay the visa costs, just as high-tech industries pay H1 visa costs for immigrants with needed technical skills. On the down side, the cost of food is likely to rise some. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Thanks for that. Much to ponder. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Good luck Wendy. They never answer those questions, I'm pretty convinced by now that it's because they can't. It's worth noting that, when an illegal alien's emergency treatment is reimbursed by Medicaid, the money goes to the hospital/doctors that provided the service, not to the illegal alien. The real outcome of not "covering" illegal aliens (keeping in mind that at the time of the emergency, there isn't any timely way to figure out who is and who is not a citizen, often you have to treat first and ask questions later) will only be to screw the doctors and hospitals, who are certainly good US citizens/corporations. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Hey dsandreas, Are you going to answer the questions I asked of you earlier (post 194) in the thread? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Tom, I'm watching a retrospective of the 9-11 attacks, and wondering if you are really saying that after that attack, we should have responded by doing NOTHING??? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

OK, so I have asked these questions of several "right-wing" posters, and no-one has ever bothered to respond. Wendy asked earlier in this thread, and no-one responded to her. I hope you will do me the courtesy of an answer. Enforcement means that US citizens have to be able to prove citizenship. 1) What proof of US citizenship do you think would be adequate? A birth certificate is not an adequate document, as they are easily forged. In fact, the only real proof of citizenship that I have is a passport. 2) Would you support a law that required all citizens to have a passport? How do you feel about a "national identity card"? If you do not, then how can you reconcile "enforcement" with the fact that most US citizens do not actually have the ability to prove citizenship? 3) Suppose a US citizen is injured in a car accident, and is transported to the hospital. The victim is critically ill, and must receive immediate treatment or they will die. However, their identification was left at the accident scene when EMS transported them, so they arrive at the hospital without ID including proof of US citizenship. (This is not an imaginary scenario; according to a former student of mine who works EMS about 20% or more of critical patients don't have ID when they are transported). Would you really demand that the hospital refuse to treat them, and instead allow them to die, because they can't be sure of the persons citizenship status? How many US citizens would it be OK to allow to die, each year, just to ensure that no tax dollars were ever spent to treat an illegal alien? I hope you will be able to explain to me how all this is supposed to work. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

You make your wife stand in the corner? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Out of curiosity, do you also object to mandatory auto insurance, or do you think that too should be a matter of personal responsibility? Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Agree 100%. When I've tried to explain this approach to very conservative/religious types, I've found most to be hostile to the idea, at least at first. They think it involves taking something away from them. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Which is, of course, the appropriate thing to say in the first place. As it is a totally untestable proposition, it lies entirely within the realm of faith, which is the proper place for religious statements. Everyone can choose for themselves to believe it or not. It is when religion conflicts with science, the realm of actual observation, measurement, and experiment, that religion comes off looking silly, because it then requires us to deny what we can actually observe as "false", and substitute a fairy world that is unobservable and capricious. The evidence for evolution is overwhelming, but evolution is just a process. The process says nothing, one way or the other, about "God". There aren't any obvious "God fingerprints" in the working of the process, but there is no evidence that there isn't a "God" (albeit a wasteful, cruel, and very patient one) either. There are certainly many more people who believe in "theistic evolution" (evolution guided in some way by a "God") than there are people who hold the atheistic view. Of course, reality is not determined by the point of view that holds the most adherents. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

There is a difference between calling a specific person a liar, and saying that people who knowingly spread falsehoods about health care reform, so as to sow fear and gain political advantage, are telling lies. Obama did not "name names", he called out a behavior, and the only people who are tarnished as liars are the ones who have engaged in that behavior. If the shoe fits, as the saying goes. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

With all due respect, since humans and chimpanzees diverged more recently than the gorilla/(chimp + human) split, if we were to run into that common ancestor we would see an animal that would be immediately recognizable as an "ape". It would not be any currently living ape species (or even genus) of course, but it would be an ape, likely looking like a mix of chimp and gorilla. In fact, humans, chimps, gorillas, and orangutans all belong to the same taxonomic family (the Hominidae, or "great apes"), and the most recent common ancestor is necessarily also Hominidae. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

It's sad that that anyone is comfortable with the idea of executing people for crimes they did not commit. Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)

Just curious about when this happened. My youngest daughter graduated this year from a public school in Georgia with nearly a year's worth of advanced college credit courses, which were taken at the high school but count for university credit. As a result she should be able to finish a 4-year degree in 3 to 3 1/2 years. I personally had an experience like the one you describe, but that was back in the paleolithic (early 1970's). Don _____________________________________ Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996) “Education is not filling a bucket, but lighting a fire.” (Yeats)