shutdown

[zk]

All this debate about the ACA is well and good. But it’s not really the issue here. The issue is how congress should go about changing a law that some of them don’t like. The sensible answer to that is to get the votes you need and then change it. If you don’t have the votes, well then that’s how “democracy” works. Tell the people what you want and, if they agree with you, you’ll have more votes next term.

To basically grab the country in a headlock and say, “change this law that we don’t like or we won’t let go” is astonishingly childish, expensive, selfish, destructive, poorly-planned, and downright stupid.

I truly don’t understand why people aren’t angrier about this. I don’t understand why people are debating the finer points of this law when they should be excoriating the tea-party republicans and the house speaker responsible for this.

[zk]

To respond to their tactic with debate validates their position. It makes their tactic seem normal and acceptable. First, let go of your headlock, then we’ll talk. And if you can’t get anything done after that, then a) your ridiculous shut-the-government-down-and-hope-they-say-uncle strategy wasn’t going to work, anyway and b) again, that’s how democracy works. Continue the debate and, if the American people agree with you, you’ll have your chance to change it.

[livinincali]

[quote=SK in CV][quote=livinincali][quote=SK in CV]
No. ER’s utilization will go down, but revenues will go up because the number of patients with coverage will go up. Staffing may go down, but long waits at ER’s should go down. If anything, charges can be reduced for the reduced number of uninsured because less cost sharing will be necessary.[/quote]

Do we measure total health care spending in the country based on invoiced amounts or payments actually received?[/quote]

Payments actually made.[/quote]

So if hospital revenues go up because the people that come in actually have insurance to pay doesn’t that mean as a nation we’ve just increased the total cost of health care. More revenue for hospitals means higher spending on health care and we haven’t even gotten to the increased demand for general practitioner or the overhead associated with running the state exchanges.

How is this going to make health care more affordable again, if we are indeed going to be spending more per capita on health care.

[FlyerInHi]

We have to wait about a decade to see if health spending as a share of GDP goes down. I think it will because of a healthier population and lower end of life care.

But as zk said, Obamacare is not the issue here.

Easy way to end the shutdown. Bring the bill already passed by the senate to a vote in the house.

Problem with republicans is that is they don’t like something, they won’t let the democratic process work and put it to a vote.

[paramount]

[quote=UCGal][quote=paramount]

But to clarify – It’s not just sending federal workers home.
* It’s WIC (formula and milk for low income children)
* It’s IRS call centers (which are pretty busy right now because if you filed for extension – that deadline is 10/15.)
* It’s VA call centers. And applications for VA disability are on hold.
* The NIH has halted research.
* It looks like if you’re a green card applicant – your visa app is on hold, even though the clock is still ticking on your application. (I work with several VERY concerned folks.)
* New applications for small business loans aren’t being accepted.
* Locally – Miramar air base is shutting down the commissary, the day care, the youth sports programs, etc. This impacts a lot of families in San Diego. I would imagine it’s similar at North Island.[/quote]

And it can be argued that many of those federal govt functions are unconstitutional anyway…

BTW, most are able to walk through the woods perfectly fine without govt help.

[scaredyclassic]

did someone mention “unconstitutional? you can get a free reference volume on the constitution plus cases normally costing 290$ free! now as an APP. might want to read some before declaring one thing or another unconstitutional, though…the annotations get mighty tricky…

New app, released in honor of Constitution Day, has the document and the case law
Posted Sep 20, 2013 5:50 AM CDT
By Debra Cassens Weiss

The Constitution Annotated runs 2,860 pages, weighs 10 pounds and costs $290.

But the document is now available for free in an app released on Tuesday in honor of Constitution Day, the Washington Post reports. The app, available from iTunes for iPhones and iPads, includes case law and analysis. An Android version is also being developed.

The app was released by the Senate Committee on Rules and Administration, the Library of Congress, and the Government Printing Office, according to a news release.

Ken Thomas, editor-in-chief of the Constitution Annotated, told the Post that the digital format allows for more frequent updates. “Before, we updated it every two years, and now we can do it more as cases are decided,” he said.

[bearishgurl]

[quote=paramount][quote=UCGal]But to clarify – It’s not just sending federal workers home.
* It’s WIC (formula and milk for low income children)
* It’s IRS call centers (which are pretty busy right now because if you filed for extension – that deadline is 10/15.)
* It’s VA call centers. And applications for VA disability are on hold.
* The NIH has halted research.
* It looks like if you’re a green card applicant – your visa app is on hold, even though the clock is still ticking on your application. (I work with several VERY concerned folks.)
* New applications for small business loans aren’t being accepted.
* Locally – Miramar air base is shutting down the commissary, the day care, the youth sports programs, etc. This impacts a lot of families in San Diego. I would imagine it’s similar at North Island.[/quote]

And it can be argued that many of those federal govt functions are unconstitutional anyway…

BTW, most are able to walk through the woods perfectly fine without govt help.[/quote]

Hi folks, I’m back in town trying to get groceries this evening but the commissary on 32nd St is now shut down, lol. I managed to go online today and activate all my Vons Just4U preference discounts and then brought in just four mfr coupons to the store with a list and my bill was $43.42 with a total savings of $42.38 (Just4U savings of $19.66 + Card Savings of $15.23 + paper (mfr) coupons of $7.49).

It can be done but it takes preparation before you enter the store. I’m going to miss my commissary privileges but sadly, they end when my youngest reaches age 18 … next summer … That is, IF this deadlock is resolved and they reopen before then, lol. I’ve had commissary privileges for more than 35 years and have shopped in three different commissaries (all improvements of the former) all at NAVSTA 32nd St.

Since none of them double coupons anymore, the prices at our local Vons, Ralphs and Albertsons are VERY cost-prohibitive (primarily for packaged groceries, personal and household items and sundries) unless you, as a consumer, play all the games they require to take advantage of the ultimate discounts they offer by having their card (for club savings) and repeat-buying of the same items to get further savings by first making a list online.

I currently seem to be able to “walk in the woods” okay “without govt help” in our local grocery chains but if one can’t make time in their day to organize themselves first before shopping, they will likely be ripped off in there, IMO.

For example, in the personal and household categories, most items (w/o “club savings”) are 2-4 times the price of the military commissary in the local grocery chain stores. It’s ridiculous and I don’t know how low-income people without military commissary privileges are actually surviving in SD.

[ucodegen]

[quote=no_such_reality]The underlying systemic issue is what is causing our prior model to break. We’re not a heartless nation saying just let people die, so we EMTALA. EMTALA results in 80% of ER visits being uninsured. The ER is one of the LEAST cost effective points for treating people.

….

IMO, the biggest savings of ACA will be driven by taking a large subset of the 40+ million uninsured and moving them from expensive, too little too late treatment in the ER, to less expensive, more preventative treatment up stream.[/quote]The problem is that many of the people who use the ER in this manner are illegal aliens. Mexico does have medical insurance, but it is tiered based upon how much you pay. If a US citizen goes to the ER for treatment, the bill collectors will hound them. They can’t hound an illegal. No SSN, no TIN. nada, nothing. Because of their status, they are harder to track and make pay into the system, or pay for costs they incur. Because of their status, most of them have advanced health problems. Because they are often the lower strata of Mexican society, they also have health problems from poor nutrition.

Take a look at the following:
Illegal immigration by state:
http://www.slate.com/articles/news_and_politics/map_of_the_week/2013/02/map_illegal_immigrant_population_by_state.html

Hospital costs by state:
http://www.governing.com/gov-data/health/average-medical-hospital-costs-by-state-map.html

Putting the graphs side by side is revealing. It correlates quite well, allowing for small statistical variations.

http://www.boston.com/news/health/articles/2008/04/20/organ_transplants_for_immigrants_stir_debate_in_calif/

It is also more likely that illegal aliens have Hepatitis, due to lower quality food and water supplys.

Obamacare does not help with this issue.

NOTE: On a final note, I suspect that hospitals also overplay the ‘uninsured’ count to try to give themselves more money.

[ucodegen]

[quote=SK in CV]It does mandate cost controls. Many policy holders have already got their second refund due to the MLR limits. In exchange for that MLR floor, the insurance companies got mandatory coverage. They’ll end up ahead in the deal.[/quote]
I didn’t see anything in terms of cost controls.. and I am reading through the text to make sure ..bleh.. where is it? MLR only controls the loss ratio on the insurance companies. It does not control actual medical costs.

[SK in CV]

[quote=ucodegen]
I didn’t see anything in terms of cost controls.. and I am reading through the text to make sure ..bleh.. where is it? MLR only controls the loss ratio on the insurance companies. It does not control actual medical costs.[/quote]

See §3025 regarding hospital readmission penalties.

The MLR floors cap the insurance premiums, thereby reducing overall cost of medical insurance. Medical insurance is an element of total medical costs.

[scaredyclassic]

“Dealing with terrorists has taught us some things,” said Washington Rep. Jim McDermott after voting no on one of Thursday’s GOP bills. “You can’t deal with ’em. This mess was created by the Republicans for one purpose, and they lost. People in my district are calling in for Obamacare—affordable health care—in large numbers. These guys have lost, and they can’t figure out how to admit it.” Why would House Democrats give away what the Supreme Court and the 2012 electorate didn’t? “You can’t say, OK, you get half of Obamacare—this isn’t a Solomonic decision,” McDermott said. “So we sit here until they figure out they fuckin’ lost.”

so, ummm…that could be a long time….

[FlyerInHi]

Republicans could say “we won’t fund the government or raise the debt limit until Obama resigns. In the mean time we have bills to fund only parts of the government we like.”

Is there that much of a difference?

[SK in CV]

[quote=FlyerInHi]Republicans could say “we won’t fund the government or raise the debt limit until Obama resigns. In the mean time we have bills to fund only parts of the government we like.”

Is there that much of a difference?[/quote]

Best tweet of the week:

Can I burn down your house?

No

Just the 2nd floor?

No

Garage?

No

Let’s talk about what I can burn down.

No

YOU AREN’T COMPROMISING!

Can I burn down your house?

No

Just the 2nd floor?

No

Garage?

No

Let's talk about what I can burn down.

No

YOU AREN'T COMPROMISING!

— Judd Legum (@JuddLegum) October 2, 2013

[scaredyclassic]

i wonder if they’ve tried humor.

calling the other side “terrorists” isnt really nice.

ii think they need to take a break and play a game together. maybe hang out and lift some weights. complain about their wives (but not like ina all women are bad kind of way. the women can complain abot their husbands too, all int he same weightlifting group.)

maybe a therapist to help facilitate healthy discussion.

[scaredyclassic]

would be really really weird if this were how the USA ends.

[Author]

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