Medicare/Medicaid and some of the legitimate woes with them

Cynic · Post by **Cynic** » Fri Aug 21, 2009 1:04 am

So the Care and Caid family of governmental medicine are good on one end in that they deliver the most bare minimal of health coverage but when you go over to the more advanced and detailed care needed such as the care for Creutzfeld-Jacob or cancer, the C&C family are absolutely useless for a large degree. They provide relief but most of the specialists who might deal in C-J or Epilepsy or Cancer don't take medicare or medicaid.

The paperwork hassle itself is too huge for all doctors who deal in C&C unfortunately. This is only because of the draconic rules and regulations. There are specialist doctors out there who support the C&C programs and they work with their patients. But this is few and far between. The lack of coverage is too much unfortunately. I'm not saying that Medicare or Medicaid will not cover all diseases including highly degenerative ones but the quality of care decreases greatly because of system defect. The system keeps it hard. Family doctors have told me that there are also pressures from private insurance drug reps as to not participate in the program. KNowing that this is hearsay, I still write it.

--

Well that is it for now.

I plan on adding more on this topic as I keep researching it as it personally has bearing on my own healthcare these days. So I'll keep you all informed.

PhoneLobster · Post by **PhoneLobster** » Fri Aug 21, 2009 1:19 am

So... the problem with the public option is that the private option is rounding up specialist doctors and refuses to share them with those who need them?

That's a problem with the private option.

Or is the problem that the public option is loaded with draconian bullshit designed by anti public option legislators to prop up the private option?

Because again. That's a problem with the private option.

So I'm not seeing what your position here is.

Crissa · Post by **Crissa** » Fri Aug 21, 2009 1:20 am

It's a specious argument. The paperwork required by medicare is less than the paperwork by insurance companies, and they're more likely to pay.

It is true that since Congress sets the pay rate of medicare procedures, they're too low for doctors in some parts of the country - generally blue states - to take too many medicare patients.

And according to Medicare, they do pay for care of degenerative diseases. It just happens that's not the care you want. That's what the Right-wing calls 'choice'.

-Crissa

MGuy · Post by **MGuy** » Fri Aug 21, 2009 1:44 am

As for my concerns: its that whatever truly revolutionary ideas that might have come from health care reform will be hammered out of the final product. The best I think will come of all of it will be a horribly mangled and barely (if at all) functional final product that will be horribly underfunded then criticized by the media for being a failure.

Crissa · Post by **Crissa** » Fri Aug 21, 2009 4:40 am

The biggest part of the bill should be the new regulations of the Health Insurance industry - really a first at the national level. This is the part that normally has Republican support but the Blue Dogs and Neocons/wingers balk at.

The next biggest part is making sure then that everyone has insurance. That's the public option, and expansion of Medicare. This has majority support, but the Republicans want to filibuster it. The Blue Dogs are breaking up on which ones will support a filibuster and which will not; I predict they'll be split, actually.

The public option is a budget item. It can be passed in congress without the chance for filibuster, foiling the Republicans if they try to filibuster it. The regulation is not a budget item, but has wider support in the Republican caucus so a filibuster is less likely. So they could pass it normally by a majority as well.

We don't have a bill that has 60 of the same people supporting all features, which is needed to beat a filibuster. Also, one of the Democrats that supports it is still out with brain cancer, and while he's fine now, and may recover, he can't get to the floor to vote.

-Crissa

And I forgot to mention there are Republicans (and Blue Dogs) who have said they will vote against the bill that has all the things they asked for in it. Augh.

MGuy · Post by **MGuy** » Fri Aug 21, 2009 4:44 am

Excuse my ignorant question but because all of this is going to be part of the same bill at some point (paper clipped together so it counts as one item) won't the whole thing in danger of the aforementioned filibuster plan?

Crissa · Post by **Crissa** » Fri Aug 21, 2009 4:59 am

Like I said, yes. They're hoping to get ~60 votes so that doesn't happen. But there are other ways to pass it. It does not need to be only one vote, they can vote on it in any number of ways.

So it's not dead yet.

-Crissa

Koumei · Post by **Koumei** » Fri Aug 21, 2009 7:12 am

I have a question on it, if people will forgive my ignorance of how the passing of bills works in America: if Obama woke up one day and discovered he had nineteen testicles, could he say:

"I gave you fucks the chance to compromise but you still opposed it. Now this is the socialist commie health care plan I'm putting through, in its original glory with no compromise to the right. Suck my nuts, teabaggers."

?

erik · Post by **erik** » Fri Aug 21, 2009 7:22 am

It'd never get passed unless he also found the balls to make it politically unsuitable for people to oppose it.

He would have to get on T.V., papers, radio, and internets to identify who the representatives are who are fighting for more poor people dying. Let their constituents know that the real death panels are the ones being held already by insurance companies, and that those representatives are their evil lackeys.

Basically put everything on the line and make it a serious fight, not some sissy fight where he proposes something and they add things onto the bill just so they can rail against the very things they added.

People should be enraged at the douchebaggery going on by the people opposing this bill, but the supporters of the health care plan are not doing enough to go out and make it known. If the local papers won't publish letters to the editor from their local representatives then burn them too on online reports and go to the local TV stations who would hopefully be excited to feature their representative frothing with fury. I'd watch that shit any day of the week over the usual shitty infotainment.

TavishArtair · Post by **TavishArtair** » Fri Aug 21, 2009 7:25 am

He could put that into the system, but he won't, because he knows that he needs more votes than what he'd get in order to pass it through Congress. If the Democrats do not vote as a bloc... and the Blue Dogs make that VERY hard... then it swings on Republican votes.

MGuy · Post by **MGuy** » Fri Aug 21, 2009 8:19 am

Actually, and this may be my anger over how incompetently this issue is being handled talking, I think turning this whole debate into a flame war is the way to go. If Obama could actually organize the Dems and get the liberal loons in on this, spamming the actual truth instead of made up garbage (showing a few clips from the daily show and Colbert Report en masse would do the trick) and rallying people (like they did with the whole vote or die craze) I think we'd see some real traction. hell where are all the protesters for the war? They can start protesting against these damn protests for god sake.

Crissa · Post by **Crissa** » Fri Aug 21, 2009 8:44 am

Technically, it is unsuitable for the Blue Dogs to oppose anything the President says. When the sitting president (of the same party) is unpopular, they lose their jobs, period. No matter how against the president they were.

Fifty House Democrats lost their jobs in 1994. It wasn't the liberal left that was hurt, no, they were safe in their blue states.

So why the wishy-washy opposing the president? Because they have to pretend to oppose him, and go back to their right-wing voters. But if they actually Waterloo the president, there's no way the Blue Dogs will be here in 2011.

Strange, then, that they keep doing this, yes?

-Crissa

PS, the president cannot apply programs and law outside of 'discretionary spending' which is really miniscule (about a hundred million dollars). And the Republicans could totally filibuster and stop it; it literally takes sixty senators in the chamber voting yes to override a veto. If 41 Senators want to stay home, they merely only have to leave one of their number in congress to vote against Cloture.

tzor · Post by **tzor** » Fri Aug 21, 2009 1:53 pm

MGuy wrote:Excuse my ignorant question but because all of this is going to be part of the same bill at some point (paper clipped together so it counts as one item) won't the whole thing in danger of the aforementioned filibuster plan?

Once a bill is passed in the Senate it goes to the "reconciliation" committee to work with a compromise with the House. In a bizarre math A + B sometimes yields C where C contains items that are not in either A or B and does not contain things that are in both A and B. This reconciliation bill isn’t up for “debate” and doesn’t require a motion to close debate; thus it cannot be filibustered and only needs a 50% majority in the senate.

Thus when the President was waving his trial balloon about how the “public option” wasn’t required for the final package, skeptics knew that he was really saying “you pass what you want and then it can be added back in reconciliation.”

violence in the media · Fri Aug 21, 2009 2:11 pm

Koumei wrote:I have a question on it, if people will forgive my ignorance of how the passing of bills works in America: if Obama woke up one day and discovered he had nineteen testicles, could he say:

"I gave you fucks the chance to compromise but you still opposed it. Now this is the socialist commie health care plan I'm putting through, in its original glory with no compromise to the right. Suck my nuts, teabaggers."

?

A caller posed a similar question to Obama on his recent radio interview. He essentially espressed the left's frustration that, even with overwhelming majorities in the government and repeated obstinance at any sort of compromise from the Republicans, that the Democrats have not closed ranks and told them to fuck off and go home. Sadly, I missed what Obama said in response to that, but I think the information is available on NPR or a general search.

Hopefully, that sentiment continues to build.

Crissa · Post by **Crissa** » Fri Aug 21, 2009 4:21 pm

All bills only need 50+% to pass in the House and Senate, tzor.

The filibuster was intended to allow the minority some leverage on things they found repugnant.

I might point out that the Republicans have used Reconciliation to pass multiple things every year they were in power, and since they've been out of power, they apparently find running the government repugnant - they've filibustered more things last year than everyone in the prior twenty.

-Crissa

tzor · Post by **tzor** » Fri Aug 21, 2009 4:26 pm

My general complaint with the reconciliation process is that it can be used to add things that were not in the original bills and remove things that were in both bills and then require an up or down vote without chance for amendment. It’s a trick that’s been used by both parties and I hate it whenever it is done.

Crissa · Post by **Crissa** » Fri Aug 21, 2009 4:48 pm

That's my problem with it, as well. But in this case, the final product will get an up or down vote, making it fine.

Currently the Republicans are filibustering everything by default, making the system not work as it should.

-Crissa

mean_liar · Post by **mean_liar** » Fri Aug 21, 2009 5:19 pm

PhoneLobster wrote:So... the problem with the public option is that the private option is rounding up specialist doctors and refuses to share them with those who need them?

That's a problem with the private option.

It is not "refusing to share" as if insurance companies were preventing participation, this is a problem with private providers not wanting to be paid percentages less than what they could get through non-Medicare.

This problem is directly attacked either by having public providers so that care has mandated participation or by having public insurance pay out more lucratively.

http://www.cga.ct.gov/2009/rpt/2009-R-0242.htm

Participation in Medicare is a provider choice, not an insurance choice. Mucking about with private insurance will only affect Medicare participation if it makes private insurance pay out less for care.

tzor · Post by **tzor** » Fri Aug 21, 2009 6:25 pm

Crissa wrote:That's my problem with it, as well. But in this case, the final product will get an up or down vote, making it fine.

Currently the Republicans are filibustering everything by default, making the system not work as it should.

-Crissa

O' RLY? Filibustering has been going on since forever; the increase was started in this decade and is generally increasing, a result of the greater and greater divide between the parties.

In 1917, a rule allowing for the cloture of debate (ending a filibuster) was adopted by the Democratic Senate at the urging of President Woodrow Wilson. From 1917 to 1949, the requirement for cloture was two-thirds of those voting.

In 1946, Southern Senators blocked a vote on a bill proposed by Democrat Dennis Chavez of New Mexico (S. 101) that would have created a permanent Fair Employment Practices Committee (FEPC) to prevent discrimination in the work place. The filibuster lasted weeks, and Senator Chavez was forced to remove the bill from consideration after a failed cloture vote even though he had enough votes to pass the bill. As civil rights loomed on the Senate agenda, this rule was revised in 1949 to allow cloture on any measure or motion by two-thirds of the entire Senate membership; in 1959 the threshold was restored to two-thirds of those voting. After a series of filibusters led by Southern Democrats in the 1960s over civil rights legislation, the Democratic-controlled Senate[13] in 1975 revised its cloture rule so that three-fifths of the Senators sworn (usually 60 senators) could limit debate. Changes to Senate rules still require two-thirds of Senators voting. Despite this rule, the filibuster or the threat of a filibuster remains an important tactic that allows a minority to affect legislation. Senator Strom Thurmond (D/R-SC) set a record in 1957 by filibustering the Civil Rights Act of 1957 for 24 hours and 18 minutes, although the bill ultimately passed. Thurmond broke the previous record of 22 hours and 26 minutes which Wayne Morse (I-OR) had established in 1953 protesting the Tidelands Oil legislation.

The filibuster has tremendously increased in frequency of use since the 1960s. In the 1960s, no Senate term had more than seven filibusters. One of the most notable filibusters of the 1960s was when southern Democratic Senators attempted, unsuccessfully, to block the passage of the Civil Rights Act of 1964 by making a filibuster that lasted for 75 hours. In the first decade of the 21st century, no Senate term had fewer than 49 filibusters. The 1999-2002 Senate terms both had 58 filibusters. The 110th Congress broke the record for cloture votes reaching 112 at the end of 2008, though cloture votes are increasingly used for purposes unrelated to filibusters.

Don't you just love all those great Democratic filibusters against CIVIL RIGHTS?

Maxus · Post by **Maxus** » Fri Aug 21, 2009 7:02 pm

Actually, Tzor, I saw a graph of the amount of filibustering going on.

Since 2006, when the Republican party became a minority, there's been a marked increase in the number of filibusters going on. And they're almost always called by the Republican Party, to make it harder for something to get passed.

http://farm4.static.flickr.com/3137/298 ... 500da4.jpg

Or, hell, just google "Filibuster Graph" and look at that spike on the end.

Oh, and get this: Nevermind that the rule is 51 votes, or 60 votes if someone thinks it's important. Now some Republican senators are claiming the Health Care bill should be a bill that 75 or 80 senators would vote for.

violence in the media · Fri Aug 21, 2009 7:03 pm

tzor wrote:Don't you just love all those great Democratic filibusters against CIVIL RIGHTS?

So, tzor, why don't you tell us which party modern Southern racists typically associate with?

erik · Post by **erik** » Fri Aug 21, 2009 7:13 pm

Hey! Stop treading on his rights to ignore facts when supporting the party that is delighted to leave poor people to die through lack of health care!

Facts have no place in that agenda and shame on you for bringing them up.

Caedrus · Post by **Caedrus** » Fri Aug 21, 2009 7:47 pm

tzor wrote: Don't you just love all those great Democratic filibusters against CIVIL RIGHTS?

What does that have to do with the modern parties? Both parties do not really resemble their older selves. This just seems like a shoddy red herring to say "hey, look, once a democrat filibustered something!" as if one example compares to the staggering deluge of (modified so that they don't actually have to keep going to do it anymore) filibusters abused by the modern Republicans.

Crissa · Post by **Crissa** » Fri Aug 21, 2009 10:15 pm

Yeah, gosh, does tzor even know the names of those lawmakers who filibustered CIVIL RIGHTS? If he did, then he'd know they became Republican party leaders later in their careers, or embraced civil rights support.

-Crissa

Username17 · Post by **Username17** » Fri Aug 21, 2009 10:47 pm

That is impressive amounts of bullshit there Tzor. Someone points out (the true fact) that Republicans are filibustering more than any caucus ever has. And your response is that a couple of people in different eras filibustered some legislation that shouldn't have been. Why does your head not explode?

Your argument is that anecdotally filibusters are bad things. You don't refute or even address the fact that this group of Republicans are filibustering more than ever before. You're conceding that point and showing some examples where filibusters have been a bad thing!

You're way off the deep end into crazy hat there Tzor. If you don't have an argument that won't just make you and your team look even worse, just don't make an argument.

-Username17