I Hate Dialysis Message Board
Off-Topic => Political Debates - Thick Skin Required for Entry => Topic started by: noahvale on November 11, 2014, 02:24:22 PM
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said that healthy people are going to pay in—you made explicit that healthy people pay in and sick people get money
Isn't this the basic definition of insurance? I've been in my job for 15 years, for 14 years I was subsidizing the other employees that were sick or had babies etc..., now for the past year I've been on the receiving end of those subsidies.
Same with Medicare Insurance, for say 20 years I've been paying in Medicare Insurance taxes, in two years Medicare Insurance will start picking up my dialysis (if I've not yet received a transplant) and I'll now be benefiting from other's Medicare Insurance payments.
I guess you could claim that people didn't realize that this mandatory insurance was insurance, but I'm sure that the anti-healthcare insurance folks claimed it was a tax and would cost everyone tons of money as a completely unworkable socialist state move etc...
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So, what's new? Politicians have been counting on the stupidity of the American voter for decades, and for good reason. WMDs, anyone?
Not only that, but they also count on our ambivalence. How many of you voted in the midterms?
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If people really care enough about this issue, they can educate themselves and then go and vote for candidates in 2016 who will repeal the whole damn thing.
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Gruber also points out that Obamacare’s individual mandate—the provision that requires most Americans to buy government-approved insurance, or pay a fine—was described in the law as a “penalty” instead of as a “tax” in order to hide the mandate’s effects. “I mean, this bill was written in a tortured way to make sure CBO did not score the [individual] mandate as taxes,” said Gruber. “If CBO scored the mandate as taxes, the bill dies. Okay, so [the law is] written to do that.”
Also of course they wrote it so that it would sound better, just as the other side promoted "obamacare death panels"! He had to work to get his medical insurance bill passed that includes being very sensitive about how it was worded so people didn't get riled up - same as the anti healthcare factions did their best to make it sound like the country would end as soon as it was enacted.
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Personally, I'd love to see the Supreme Court uphold that case just so that I can sit back and watch the likes of Paul Ryan and Marco Rubio follow through on their supposed plan to replace the ACA of something of their own making.
Not only that, but if the Supreme Court DOES restrict those tax credits, that decision will defy all legal precedent and the court will go down in history as being politically driven. It really will be a fascinating time. It's soap opera of the highest order!
I'm curious, Noahvale. Were you happy with the way medicine was being practiced before the ACA became law? Is "transforming one sixth of our economy" necessarily a bad thing?
I'm also curious, Noahvale, to know what you think would happen next should the ACA be repealed? What do you think the Republican-held Senate (and, let's say, all three branches of government come 2016) and Senate will/should do with the millions of newly insured?
It's all well and good to get lathered about the ACA, but until someone with authority and knowledge comes out with a workable alternative that our politicians will just put to a vote, I'm not listening to the outrage. I don't need the ACA, so I'm golden.
Regarding the Dr. Emanuel quote, I can't access that article because I'm not a Chicago Tribune subscriber. Can you access it and post it here for us to read? Thanks!
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Thank you for the link to The Atlantic; I was able to read Dr. Emanuel's article. I believe you may have gotten the wrong end of the stick as he is not "proposing policy" of any sort for the care of people over 75. In fact, he specifically writes:
And I am not advocating 75 as the official statistic of a complete, good life in order to save resources, ration health care, or address policy issues arising from the increases in life expectancy. What I am trying to do is delineate my views for a good life and to make my friends and others think about how they want to live as they grow older.
We've had many discussions here on IHD about how dialysis can undermine one's quality of life and whether or not further treatment is desirable. Dr. Emanuel writes about the same thing and points out that living longer doesn't always mean that those extra years are healthy ones. I don't understand your quarrel with his personal views.
Are your objections to the ACA based upon the law itself or upon your view that it was "rammed down your throat"? Do you sincerely believe that at the time of the law's passing there would have been enough Republicans who would have been eager to work with the President to improve the law? Even now, King vs Burwell doesn't HAVE to go before the Supreme Court. There has been plenty of time for Congress to revise/correct the wording to elucidate the law's intent, but would the Republican House be willing to do that? They haven't so far! I have a big problem knowing that Republicans would like to repeal the ACA, thus taking away insurance for millions, because they didn't get their egos stroked enough and got all stroppy because President Obama wasn't conciliatory enough for their liking. Oh, boo hoo.
And that's where legal precedent comes in. Should SCOTUS restrict the tax credits based on ONE WORD and not the intent of Congress, then yes, that would defy legal precedent.
Of course, if those states that refused to set up their own exchanges would only do so, then their residents who have enrolled would be able to keep their coverage.
Politically speaking, if SCOTUS sides with the plaintiffs, then those people who signed up on health.gov in states that refused to set up their own exchanges will see their premiums rise sharply, which makes me wonder if the governors in those states will feel the backlash.
In my mind, yes, it was worth changing the whole system to take care of three million people. That might not sound like a lot of people to you, but it does to me. Maybe a good number of those people have CKD but would never had known it before they had at least basic health care. And maybe a good number of THOSE people would be on dialysis now because their renal decline was never diagnosed. I'd happily change the whole system to keep any one soul off dialysis!
I'd be very happy to see all three branches of government work together to improve the ACA. I remember you sending me Tom Price's ideas and his introduction of his Empowering Patients First bill (is that the correct name). Did the House ever vote on it? Your post about it was the first and last time I've heard about it. My perception is that the Republicans have no real intention of improving health care for all Americans, rather, they are focusing on damning President Obama. I honestly would be very happy to see real cooperation AND real, substantive changes to the ACA if everyone agrees that those changes really will help bring down costs while at the same time expanding quality coverage.
So, yes, maybe we ARE all stupid because we are so bogged down in the politics of it all that we can't see the forest for the trees. I'm still wondering how many here on IHD bothered to vote in the midterms. Apathy is as costly as stupidity.
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Oh oh oh! I've just now found this piece on the NYT which gathers and expresses the myriad of thoughts I've had about this issue and of SCOTUS's decision to even hear this case. I'd be very interested to hear your thoughts, Noahvale! Like I've said, it's all quite the soap opera, filled with drama from many sources!
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Perhaps, Noahvale, it would add to your quality of life if you'd just ignore Dr. Emanuel.
He just wrote the piece. He didn't publish it. I disagree with your assessment. We can just leave it at that.
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So, what's new? Politicians have been counting on the stupidity of the American voter for decades, and for good reason. WMDs, anyone?
Not only that, but they also count on our ambivalence. How many of you voted in the midterms?
Umm, WMDs=BI-PARTISAN support. Easy to overlook that fact.
Totally irrelevant to MM's point, which was about policy-makers banking on the stupidity of the American public.
Sorry, if Obamacare - not only changing the way medicine would be practiced in the US, but also transforming one sixth of our economy - was so good, then smoke and mirrors shouldn't have been needed to get support.[/quote]
Exactly how has Obamacare changed the way medicine is practiced? We're entitled to our opinions, but we should strive to be careful with the hyperbole.
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The very fact as a dialysis patient I can choose a new carrier and I am not stuck keeping a job so I have insurance is a change for the better. And the methods used to pass the ACA are the very same ones used in 1965 to pass medicar over the republicans and AMA objections.
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My understanding is that there was a major effort to make medicare optional and there were attempts to amend the bill to reduce its effectiveness the democratic majority then put the bills up for a vote without the ability to add amendments this cut off attempts to neuter medicare and forced a vote. Yes liberal republicans (yes they used to exist) voted for it but the was a serious attempt to stop medicare from passing led by more conservative republicans. Re bet this is just after the A1964 republican presidential candidate voted against the landmark 1963 cival rights bill.
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Politics is about power, not service.
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OK, and so what? What do the opinions of any of these people have to do with you? Why the outrage? How you live your life as it is coming to an end is entirely up to you.
Again, stop reading the writings of these people with whom you so obviously disagree. It is not worth the upset it is apparently causing you. And you seem to be further weighing yourself down by posting these articles here. Do yourself a favor and just leave it.
Take care.
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Dr Emanuel has consistently opposed any form of euthanasia during his entire career. Michelle Bachman started this line of pure trash and Sarah Palin jumped on this libel bandwagon and ever since these sisters of stupidity started this line of BS conservative writers have just continued writing about this fairy tale ever since.
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Ah but you see, Noahvale, I don't need to heed my advice because I am not outraged like you are. I've had a lovely weekend so far, thanks very much. Had lunch at a Japanese café, purchased a lovely Islay single malt scotch and then went to the theater. Ok, so Emanuel wrote, submitted and maybe even singlehandedly published this article. Again, so what? I'm not sure I even understand why you'd disagree so vehemently with the idea that people should be able to decide for themselves how much "treatment" they want to endure as their life comes to an end.
Color me baffled.
Oh, and tomorrow I'm making potato soup with parsley, butter and cream, and my husband is making an apple pie with Calvados. And then we're watching the NFC/AFC Championships followed by Downton Abbey. Any article written by Dr. Emanuel will be the furthest thing from my mind. I hope the same will be true for you.
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I found very few patients who just wanted to let it go at the age of 75. In fact, I have met enough 90 and 100 year old folks still active, bright and enjoying life that I must question which planet Emanuel comes from.
I will quite gladly ignore his comments, however the problem is he is setting health care policies that will have an impact on those over 75. That is where the outrage lies. If this man wants to let it go at 75, so be it, but what right does he have to make those choices for everyone else?
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If this man wants to let it go at 75, so be it, but what right does he have to make those choices for everyone else?
Bingo!!!
Those of us user 75 can guess, however, one doesn't really know if they will want to go until getting there.
I upset the transplant clinic by telling them I decided to quit dialysis. When they asked for details, I told them "sometime after age 85, but I haven't figured out the exact date yet" and they became somewhat less concerned.
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For those who believe this dribble please go to factcheck.org and search for Dr. Emanuel . This line of bunk originated from the ex lieut. Gov. Of NY and was picked up by Michelle Bachman and Sarah Palin. None of which have been known as being able to find there massive butts with one hand on the best day they ever had. Just because something is repeated over and over does not make it true.
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I found very few patients who just wanted to let it go at the age of 75. In fact, I have met enough 90 and 100 year old folks still active, bright and enjoying life that I must question which planet Emanuel comes from.
I will quite gladly ignore his comments, however the problem is he is setting health care policies that will have an impact on those over 75. That is where the outrage lies. If this man wants to let it go at 75, so be it, but what right does he have to make those choices for everyone else?
He doesn't have any right at all to make those choices for anyone else. In which way is he setting health care policies that will have an impact on those over 75?
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There is no doubt that Emanual wrote a paper suggesting the use of age in determining the allocation of scarce medical treatments such as kidney transplants. That is a rather large jump from there to no care after 75. Western survival traditions have always been women and children first. Taking.that principle to the transplant arena is just a logical method for allocating scarce organs. However in no way shape or form does that translate into death panels. Accusing a man who has always advocated for patients rights of supporting this kind of final solution is a disgrace. In not to far past hospitals ran panels to decide who went on dialysis and who would die. It is people like Dr. Emanuel who helped push for the expanded dialysis facilities that keep a half million Americans alive today.
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For those who believe this dribble please go to factcheck.org and search for Dr. Emanuel . This line of bunk originated from the ex lieut. Gov. Of NY and was picked up by Michelle Bachman and Sarah Palin. None of which have been known as being able to find there massive butts with one hand on the best day they ever had. Just because something is repeated over and over does not make it true.
Sorry, I am referring not to any alleged euthanasia issues my friend, but of denying care. Two separate issues so just go ahead and retract your statement that does not apply whatsoever to my comment about Ezekiel. There are many policy changes Obama has enacted in part by Zeke's recommendations. As a physician myself, I am in complete disagreement with his philosophies. I have not in any manner referred to euthanasia.
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Hemodoc, which of Obama's policies as set out in the ACA would result in the denial of care for people over 75? If a physician had to deny care because of said policies, does that physician have any recourse? It's hard to imagine that a physician would deny his patient care just because of "policy".
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He doesn't have any right at all to make those choices for anyone else. In which way is he setting health care policies that will have an impact on those over 75?
Choices are being made for others when the government says "Yes, we will force person A to pay for person B's treatment". It's not so much an issue of denying someone the ability to purchase whatever treatment (s)he can afford, but one of denying the person in need of treatment a transfer payment to cover the cost.
The issue is not "withholding treatment" by "withholding funds" (which have pretty much the same effect), except in cases of rare supply, and a governmental prohibition on market based solutions (ie, transplants)
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Choices are being made for others when the government says "Yes, we will force person A to pay for person B's treatment". It's not so much an issue of denying someone the ability to purchase whatever treatment (s)he can afford, but one of denying the person in need of treatment a transfer payment to cover the cost.
The issue is not "withholding treatment" by "withholding funds" (which have pretty much the same effect), except in cases of rare supply, and a governmental prohibition on market based solutions (ie, transplants)
I'm sorry, but I don't understand what you mean by "denying the person in need of treatment a transfer payment to cover the cost." What is a "transfer payment"?
If the issue is not "withholding treatment" by "withholding funds", then what IS the issue? I'll ask again; which policies are promoted in the ACA that deny care for people over 75? Truly, I am not trying to be confrontational. I am trying to understand and would appreciate more specifics and fewer sweeping statements. Thanks!
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Interesting article with which I happen to agree. Thanks for posting the link.
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Well then, how do you account for his advocacy for including annual exams as a component of Obamacare, especially when the info he quoted in the op-ed was readily avaiable at that time?
People should be responsible for how they use healthcare. They should be free to decide for themselves whether or not they would benefit from an exam. Someone who is 40 years old and who has never had/does not have any medical issues should be free to decide not to have an exam. People who are getting older and who feel anxiety about their state of health or who have a chronic condition should be able to have an annual exam if they so choose.
Whether or not an annual exam is of benefit to everyone has been a subject for debate for a long time. We are STILL being given ever-changing advice on whether or not to have annual pap smears and mammograms. At this point in time, the general consensus is that the benefit of annual paps/mammograms depend upon a woman's individual risk factors. Men and woman of all ages are surely smart enough to make their own decisions. It appears that Dr. Emanuel has made his own decision based upon his own assessment of his own health status, and you are surely free to do the same. I see nothing in any of his articles whose links you have posted that prevents you from doing as you see fit for yourself.
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I'm sorry, but I don't understand what you mean by "denying the person in need of treatment a transfer payment to cover the cost." What is a "transfer payment"
A transfer payment is when wealth is transferred from Party A to Party B, even though Party B has not rendered any goods or service to Party A.
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A transfer payment is when wealth is transferred from Party A to Party B, even though Party B has not rendered any goods or service to Party A.
OK, thanks for that. But isn't this what insurance does, anyway? Many people paid for my transplant and all that goes with it even though I have not rendered to them any goods or services.
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A transfer payment is when wealth is transferred from Party A to Party B, even though Party B has not rendered any goods or service to Party A.
OK, thanks for that. But isn't this what insurance does, anyway? Many people paid for my transplant and all that goes with it even though I have not rendered to them any goods or services.
There is a nice writeup on transfer payments at http://en.wikipedia.org/wiki/Transfer_payment. Insurance is a different matter, since one contracts for the service. Govt run insurance programs that operate on a political, rather than actuarial, basis have both elements of insurance and transfer payments. That is not to say that all transfer payments are bad; I am simply recognizing them for what they are.
If you bought insurance, you supplied goods (i.e., cash) in return for a service (assumption of risk). But, with the constraints of the affordable care act, even private sector insurance has an element of transfer payment (for example, by requiring insurance companies sell policies to ESRD patients on the organ list)
A private sector example is the games colleges play with who pays full price and who gets a deal.
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@noahvale why have you gone through and deleted the content of many of your posts? (Not just in this thread but may other threads as well)
If Epoman were still here you'd of been banned by now