The Trump Presidency | Biden Inaugurated
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I can't shake the feeling that absolutely nothing will come of all this.
Me too. The least I can hope for is that it tanks his approval rating before the midterms.
That was the worst transfer window ever.
Hehehe
Also...
https://mobile.twitter.com/CheriJacobus
GOP strategist, columnist, etc. person who has turned on Trump.
That's because we won't be happy with little. Anything that doesn't end with him being removed from office will always sound like "nothing". And it will need to be something very very big to lead to that. So scepticism is natural at this stage.
Doesn't Obama follow like a billion people?
This is from the town hall I was talking about earlier...
Bit of a shouty mcshouterton but that simple minute or so shows how fundamentally stupid the american healthcare system is.
Now that's hitting the nail on the head
There's probably more, but this was happening at the same time as the senate hearing and I haven't searched it out. This popped up on my facebook.
I'm in the minority here, and don't support the Republicans because I wouldn't trust them to run a hot-dog stand and not corrupt it somehow. But not-for-profit healthcare (and health insurance which isn't exactly the same thing but got jumbled in as the means to achieve healthcare) is an open-ended liability. The question I pose to any proposal of government run healthcare is: will there be a limit to what value of care a patient can receive, how much is it and how is it determined?
Because morality is irrelevant when it comes to budgeting. I realize many countries have functioning single-payer systems that are not going around bankrupting the state (but cost a fair chunk of it). But there is always a limit to options of treatment, speed, etc. Every time I hear someone get so idealistic about what healthcare should look like I get the sense that it's a non-starter for me to make my point... because by their standards any limitation to the system will be 'immoral'.
To complement and clarify before I get predictably flamed, it's not in some form providing too much care to poorer people that "worries" me in terms of the cost. That's necessary and not that costly. It's the cross-subsidy of all sorts of people who would otherwise have the means to purchase private insurance. Same with Social Security, where the issue isn't that there are so many million people collecting disability or min income checks. The issue is the many millions more that have simply retired with enough assets, and yet draw their checks per their rights. It's the "for everyone" solutions I don't like.
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Chris Matthews and another journalist said there's no connection to Trump/Manafort/Stone and the person at the group that was raided. They both said this had been investigated previously and no connection was found. So the raiding is probably on other fronts discovered.
Any public healthcare initiative will have some level of cap on the quality of service simply due to budgetary constraints, I don't think that should take away from the fact that you can still have private health care in these states though. Public healthcare is good mainly for the people who can't afford care otherwise, if you're wealthy enough to have private healthcare/ work scheme then you should also be able to utilise that.
Is it fair? Probably not but then nothing is fair.
Spot on.
Income tax? Presumably single-payer will be funded by a progressive tax.
I don't agree that any national healthcare system should focus on the poor because that leads to awful standards and is politically vulnerable to cuts or abolition.
Was just about to post the vid:
It will genuinely be impressive if he manages to last four years without getting impeached, he's just an imbecile with no awareness of what he's saying and the implications.
It will genuinely be impressive if he manages to last four years without getting impeached, he's just an imbecile with no awareness of what he's saying and the implications.
I can live with that. But then a person can't tell me that the problem with the current system is that it's immoral, because a capped public system is too. At some point someone will be left to die because of a cap... So my original point is simply, probably don't make this a discussion about morality. As you essentially said, perfect fairness and real world constraints don't go along.
It doesn't really work necessarily like that. If I give you Portugal as an example, there is indeed public and private healthcare, but even the wealthy people will use public healthcare when they get seriously ill. They use private healthcare because for less urgent or important stuff they can have more comforts, luxuries, and, more importantly, shorter waiting times. But almost anyone who is seriously ill will end up in the public facilities, because that's where top-of-the-notch healthcare is available, and there's no limit to how much can be spent on a single patient. If you need a decade of expensive chemotherapy and multiple surgeries, or weeks at an ICU, you'll get them.
Of course, with the increasing costs of healthcare some sort of rationalisation is needed, but never something that would put someone's life at stake. As an example, not all patients with rheumatoid arthritis will be treated with the new biological medicines because they're absurdly expensive. Also, we had recent difficulties providing everyone who suffers from Hepatitis C with the new (and very expensive) medicines that can cure the disease definitely. Higher risk patients were prioritised, and eventually we got into a multi-country deal with some pharmaceutical companies to get the treatments for everyone at a reduced price.
Public systems don't have caps. Well, I can't speak for every public system, but in Portugal there isn't and I'm almost sure that's the case for most European countries with a NHS.
Exactly. A public NHS that works only for the poor will turn to shit very quickly, because they have no political bargaining power to demand better care. It will end up underfunded, with the best professionals running away to the private sector, among all other sorts of shortcomings.
If your insurance runs out they cap you too.
Healthcare should be a right not a privilege to the few that can afford it. My daughter broke her arm and it cost thousands. I broke my leg when I lived I England and it cost my parents nothing.
That gets into the tax simplification question too. I'd like everything to be just taxes and outlays. The cross subsidies I'm talking about is for example the fact that I'm mandated to have healthcare at risk of penalty, in order to make the entire business of insuring other higher risk people viable. And my employer gets a tax deduction for providing me part of that insurance, which makes it automatically the most viable option for all involved.
And to close this mess, I just mean: I'd rather face no incentives and restrictions when making my health insurance decisions, and the government straight pay from my takes for insurance or care for other people in need.
I know the feeling: each time you say to yourself "I shouldn't be shocked anymore", but then you find yourself shocked. It's unreal!
It cost someone something. That's my point. These things are noticeable in national budgets.
What's funny is that people in the US say "healthcare is a right". Fine, the country is fairly wealthy, it could probably be pulled off.
Then you go to Brazil, 30% of the wealth or so... people say "healthcare is a right". Sure, but do you expect the same level as developed country? And if by logic you do not, will you therefore agree that these "rights" are actually quite relative since they are constrained by resources?
So much for the "law and order president". It's funny that that was the slogan of Richard Nixon in 1968...
Obviously poor countries cannot aspire to the same services, but you can get a pretty good idea at the ineffectiveness of your system when you consider that:
- Portugal has a GDP per capita about one third that in the US
- We spend, as a % of the GDP, little more than half what the US does
- These two aspects combined mean that we actually spend, per citizen, between one-fifth to one-sixth of what you spend in the USA (irrespective if that spending comes from taxes or your pocket).
- We have the same high-standard of care. Our guidelines for treatments are almost all imported from American or European Medical Associations who are the leading ones in their fields. I.E., if you have an heart attack or cancer in Portugal your protocol for treatment will be exactly the same you would get in the US with no cap at all
- This covers everyone, including the nearly half of the country that doesn't pay taxes (children, unemployed, retired)
- I should add that in terms of healthcare Portugal occupies a higher position than we do in almost any other areas, i.e., we are a truly developed country in that regard. In fact, in many health indicators we are among the top of the world, such as child death rate, vaccination and primary care coverage, access to family planning, etc. So the comparison with a country like the UK or the US is valid in this regard. In some of these indicators we outright embarrass a country like the USA (you should be ashamed of your infant death rate - it's on par with the likes of Slovakia, Mexico, etc. More than twice what we have in Portugal, or thrice the rate in Japan)
You may question how this is possible, well.
- First, at low level stuff, the service quality may lag a bit, particularly in non-urgent stuff. So say you have an inguinal hernia, with no complications attached, you may have to wait a long time for a surgery, because the system operates at full capacity in these areas, which leads to savings. The law determines how much you can wait. If the public system cannot keep up with those deadlines, they'll pay the private institutions to take care of you.
- Second, the system isn't profit oriented. So there is no incentive for anyone to make an extra buck by ordering unnecessary exams, prolonging your stay, etc. I can imagine this being a problem in the US, with hospitals trying to milk insurers for how much they can get away with, etc. Here, every doctor knows he has a responsibility for the sustainability of the system.
- Third, well, we're a poorer country. We pay a lot less to doctors, nurses... Everything is less expensive, the brutal logistics of running a big hospital...
- Fourth, the lack of a litigation culture, which from what I know puts a big strain in American doctors in the form of civil responsibility insurances, whose costs obviously trickle down to the patients.
- Fifth, I don't know, but there are certainly more reasons
This is not to say there are no immense challenges to keep it sustainable and working. Ageing population, more expensive health innovations, etc, all put a strain on the system, which needs to continuously adapt to new challenges. But so far it works excellently.
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Satire is just fecking pointless these days 
You're an American Republican aren't you?
Also @MTF my explanation of how our NHS works isn't directly related to the post of yours I quoted, it was more because I got the perception that you were a bit puzzled about how can a system like this provide the same level of care for more people and still cost less. This is actually a situation where the "for everyone" solution is the better solution for everyone, to the point that even people who could afford a private insurance chose not to do so and keep their money for other things. Many people will indeed have private insurance, but they are usually there for the small stuff, i.e., to dodge waiting lists for simpler problems, etc, so they are a lot cheaper than what an insurance with full coverage for everything would cost. For serious illness, the sort that can bankrupt even a middle class family, people just use the public system.
Something is better than nothing though. I live in a resource poor country but we still have free healthcare. As a medical student every single day I see people who I know fully well was healthcare not free, they wouldn't be able to afford a trip to the hospital. Even if your resources may limit you to not being able to provide the cutting edge care in the newest medical guidelines, you still provide adequate enough care that the people can survive, and you try to help them as much as you can. And no there is no cap for how much treatment one patient gets. Once its available in the public sector they get it, from tests all the way to surgery and post operative chemotherapy for example. That's the way it should be in my opinion.
The public system does have its constraints yes, in terms of availability of certain medications, procedures and especially the waiting times. That's what the private sector is for. If you can afford it then you go and get your treatment done privately, but massive amounts of people wouldn't be able to do that, and so they need the free healthcare. The point being if your resources prevent you from providing the absolute best, then you provide as best care as you can, you don't say "well this system can't work because we can't afford to give everyone the best"
Healthcare is a right. You don't deserve to be doomed to death because you aren't rich.
@Donovan_red7 - I wish I could get you over here to explain to folks how you were still driven to join the medical profession even though you're in a system where you're not gonna make $1m a year providing medical care.
One argument we get here is that there won't be any doctors if we go to single payer because they won't be able to get rich off of it.
One argument we get here is that there won't be any doctors if we go to single payer because they won't be able to get rich off of it.
Another argument I've seen peddled is that single payer healthcare is basically resigning a doctor to a life of slavery
I really love America. Each time I went I always enjoyed it, and I always met loads of great people, but there's something wrong with the mentality of too many people in America when it comes to helping out others. I'm talking more on a bigger scale here. Not many things seem to really be about helping other people, all it ever seems to be about is money and maximizing profits. I know money is the most important thing to live in the world today, but there's something about America seems to drive that to new levels.
The best example of it is of course every time the healthcare topic comes up. "I can afford health insurance for me and my family, so balls to whoever can't."
If you read carefully you'd notice that I'm neither.
The last President who fired and pissed off intel heads got whacked...just sayin.
Look up Cuba's healthcare
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