I used to be disgusted, and now I try to be amused.

[Greedy,Greedy,Greedy]

Originally Posted by Tyrone Slothrop

DJT already has other people handling his relationship with the Kremlin, so Huntsman is just for show. Contrast the sort of person he sent to Israel.

Well, we now are getting a better answer as to where we'll be fighting our next wars. We dropped more bombs on Yemen last week than in the previous two years.

In other news, ground troops were greenlighted for Raqqa.

[Greedy,Greedy,Greedy]

Originally Posted by LessinSF

Serious question. Why am I wrong here?

The ACA was doomed the moment it added so many people with their conditions and costs without adequately adding premium and without reducing costs. The costs would have been reduced by limiting wasteful expenditures on end-of-life care. So called "death panels" would have decided - on behalf of taxpayer, not private money, - that paying millions for machines that go ping for a few weeks was asinine and cost ineffective.

But the Republicans in their fervor to be all things anti-Obama defeated the most fiscally responsible part of the Bill. Thus, it beacame a half assed project doomed to failure. We spend close to 20% of our GDP on health care, and over 75% of that on the last year of someone's life, i.e. the machine that goes ping when your grandparent is dying but may only add days to their life, but we added millions of sick patients without the ability to limit their care.

Do the math. Trump is right here about it expoding. Obama and Congress gave the doctors and insurance companies carte blanche to raise rates (or quit) 25% this year without recourse. And next year, etc. I may be wrong, but nothing I have read from either side - other than single payer - has proposed anything realistic on the cost side, so costs coninue to rise without equivalent revenues. Well, duh, Trump is right that that is unsustainable.

The principal cost reduction measures in ACA are just starting to take effect, including a move to outcome based payments. Most of the cost control efforts are nerdy and incremental, but cumulatively can have some significant impact. The rate of increase of healthcare costs has been steadily declining throughout the Obamacare period.

This is not to say something is not out of whack. A quick comparison of us to any other developed country says we aren't getting our money's worth as a society. But the Trump / Ryan solution is to make us less like countries that are getting more bang for their buck. Ah, yeh, sure, why not.

And what's your source for 75% being spent in the last year of life. The often-debunked statistic I'm used to seeing is one-third of healthcare costs being spent in the last year of life, a number that depends on some studies of the Medicare only population and so excludes that large group of working age folks covered by private insurance. There are other studies that look at ranges in the 12-20% range based on type of payor. 75%? Really? Seems like an alt-fact.

It would be a lot easier to fix healthcare expenses if the problem was so simple.

[Replaced_Texan]

Originally Posted by LessinSF

Serious question. Why am I wrong here?

The ACA was doomed the moment it added so many people with their conditions and costs without adequately adding premium and without reducing costs. The costs would have been reduced by limiting wasteful expenditures on end-of-life care. So called "death panels" would have decided - on behalf of taxpayer, not private money, - that paying millions for machines that go ping for a few weeks was asinine and cost ineffective.

But the Republicans in their fervor to be all things anti-Obama defeated the most fiscally responsible part of the Bill. Thus, it beacame a half assed project doomed to failure. We spend close to 20% of our GDP on health care, and over 75% of that on the last year of someone's life, i.e. the machine that goes ping when your grandparent is dying but may only add days to their life, but we added millions of sick patients without the ability to limit their care.

Do the math. Trump is right here about it expoding. Obama and Congress gave the doctors and insurance companies carte blanche to raise rates (or quit) 25% this year without recourse. And next year, etc. I may be wrong, but nothing I have read from either side - other than single payer - has proposed anything realistic on the cost side, so costs coninue to rise without equivalent revenues. Well, duh, Trump is right that that is unsustainable.

I still maintain that that keeping the 21-26 year olds out of the exchanges did the ACA no favors. Fuckers are adults. Throw them to the wolves.

[Did you just call me Coltrane?]

Originally Posted by Not Bob

Coltrane aka Young Sebby comes back, and you people are acting like it's no big deal? For shame!

So, Coltrane, you must be almost at the Swinging Free in the Hickey Freeman stage of development - how's that going? Do you like peaty single malt Scotch (excuse me, "Scots") yet? Catching the eye of the hot clerk at the Hyatt reception desk?

(Seriously, welcome back! Now we need Spanky to come by and talk about the Plantonic Ideal of Free trade.)

Hey NB! I'm drinking good tequila and mescal. So smooth and neither seems to affect me the next day.

If you have a Steinmart you can get HF ties for $25.

[Adder]

Originally Posted by sebastian_dangerfield

The people who are hurting Trump are the intel leakers, and Schumer, and Franken.

Should we look at recent poll numbers for this?

The Extreme Left/Protestor/Pussy Hat wing of the party is playing right into Bannon's hands.

Women are not the extreme left nor are they playing into Bannon's hands. That's dumb.

So would the majority of the country, which is comprised of fiscally moderate/socially tolerant Republicans and Democrats. The problem is, what solution could we reach? Neoliberal economics, the religion of the moderate wing of both the GOP and Democrats, is failing an enormous portion of the population, and we don't have a good Plan B.

The majority shares a political view and yet they can't win elections? Do you ever let evidence break into your world view?

The majority isn't paying attention and doesn't give a damn. Minority that consistently vote have various motivations, including lots of things that are not tolerant (opposition to gay marriage for example) that matter more to them than fiscal responsibility. The game of politics is finding the right package of those motivations to turn out more voters than the other guy.

And we just learned that hating Muslims and immigrants is a big winner there.

Actually, we knew that but we'd been relying on the character of individual GOP candidates to restrain themselves.

[Adder]

Originally Posted by sebastian_dangerfield

Consider for a moment what will occur in this country if Trump were to be removed from office.

Perhaps there's a smooth transition to Pence. That's possible, maybe even likely.

But a just as likely scenario is a bit more disturbing...

What happens to the "movement" -- and yes, Trump has created a movement -- which would view his ouster as a coordinated attack by elites, or the "deep state," or the Establishment? And what happens to those last vestiges of trust in institutions existing in the population?

I'm sure you think we have ample enforcement to keep control under any circumstances. And on the surface, we do. Demonstration of brute force can compel the population to refrain from a certain narrow category of behaviors we all agree should be prohibited. But actual, meaningful control is very fragile, and the slide toward something like Brazil -- a govt that has power over perhaps half of its population, at best -- isn't a long one.

Our govt's coercive power is a lot like credit. It's all based on confidence, and in reality, much of it is a bluff. We are already destabilized. I'm not sure I want to know the wages of another Watergate ("Russiagate") occurring in our current tenuous position.

Oddly, this fear is receding in my view, as his evidence of his corruption and incompetence is mounting.

I also think evidence of a real movement is fading too. The Chan troll culture isn't going to stay with him as he actually has to do more than bloviate.

[Adder]

Originally Posted by Did you just call me Coltrane?

Are you saying I can't carve out his corporate plan from his individual plan?

Segue: I do find it interesting that people always talk about poor rural whites voting against their self interest (which they do), when many urban/suburban upper-middle class voters do the exact same thing (I know I do). Trump's tax plan would benefit both of us significantly more than Clinton's would have.

You're assuming we see our interests as lower taxes.

[Greedy,Greedy,Greedy]

Originally Posted by Adder

Oddly, this fear is receding in my view, as his evidence of his corruption and incompetence is mounting.

I also think evidence of a real movement is fading too. The Chan troll culture isn't going to stay with him as he actually has to do more than bloviate.

You're arguing with a man who didn't know who Abby Huntsman is. He pays no attention.

[Adder]

Originally Posted by sebastian_dangerfield

Come on... We do not have anything close to fiscal moderation. Both parties spend like drunks. Medicare part d, defense budget, subsidies for ACA, countless administrative agencies... It's a fuckshow in terms of govt breadth and expenditure. .

16 years of Clinton & Obama and you still say this crap? Facts do not enter your thoughts.

[Adder]

Originally Posted by Greedy,Greedy,Greedy

You're arguing with a man who didn't know who Abby Huntsman is. He pays no attention.

I don't know who Abby Huntsman is.

[Did you just call me Coltrane?]

Originally Posted by Adder

You're assuming we see our interests as lower taxes.

No I'm not. There's no dispute that under Trump's proposed tax plan, high earners will see a financial benefit. But maybe your interests are purely altruistic. If so, welcome back Jesus.

[Adder]

Originally Posted by Did you just call me Coltrane?

No I'm not. There's no dispute that under Trump's proposed tax plan, high earners will see a financial benefit. But maybe your interests are purely altruistic. If so, welcome back Jesus.

It's not altruism, it's thinking past the next tax bill.

[Tyrone Slothrop]

Originally Posted by LessinSF

Serious question. Why am I wrong here?

The ACA was doomed the moment it added so many people with their conditions and costs without adequately adding premium and without reducing costs. The costs would have been reduced by limiting wasteful expenditures on end-of-life care. So called "death panels" would have decided - on behalf of taxpayer, not private money, - that paying millions for machines that go ping for a few weeks was asinine and cost ineffective.

But the Republicans in their fervor to be all things anti-Obama defeated the most fiscally responsible part of the Bill. Thus, it beacame a half assed project doomed to failure. We spend close to 20% of our GDP on health care, and over 75% of that on the last year of someone's life, i.e. the machine that goes ping when your grandparent is dying but may only add days to their life, but we added millions of sick patients without the ability to limit their care.

Do the math. Trump is right here about it expoding. Obama and Congress gave the doctors and insurance companies carte blanche to raise rates (or quit) 25% this year without recourse. And next year, etc. I may be wrong, but nothing I have read from either side - other than single payer - has proposed anything realistic on the cost side, so costs coninue to rise without equivalent revenues. Well, duh, Trump is right that that is unsustainable.

Costs were rising before the ACA was passed, and it has slowed the rate of increase. If you compare what we spend on healthcare to other countries, it definitely seems like we pay too much. If you compare what we spend to what we used to spend, it also seems like we pay too much -- but in some ways we get better care than we used to, and there is no doubt that what we spend money on changes over time.

[Pretty Little Flower]

Originally Posted by Adder

It's not altruism, it's thinking past the next tax bill.

Typical son-of-God modesty. Don't worry, JC, your secret is safe with us!

[Did you just call me Coltrane?]

Originally Posted by Adder

It's not altruism, it's thinking past the next tax bill.

There's no reason we can't kick this can down the road in perpetuity.

Although for the son of God, perpetuity probably isn't nearly as long as it is for us humans.