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PostPosted: Thu Oct 24, 2013 10:46 am 
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TheRiov:

I'm going to call BS on all your friends and family in the medical profession thinking the ACA is a good idea. Beyond that, what licensing is about "ideally" and what licensing is about "practically" are two different things.

In fact, I have a pretty good litmus test for this situation.

Do you support Texas's new abortion law, you know, the one Planned Parenthood is currently suing Texas over?

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PostPosted: Thu Oct 24, 2013 11:13 am 
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You're welcome to that hallucination, but my mother, the Ob-Gyn I've alluded to in numerous other posts and I actually had a discussion about it last night while she was in town for my daughter's choir concert.

As for the Texas law: I'm assuming you're referring to the one requiring internal sonograms, multi-day waiting periods, the in depth description of the features of the embryo, and the required reading of a document written by politicians not medical professionals to the patient, with data that has been disputed by the medical community?

Nope. not a fan.


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PostPosted: Thu Oct 24, 2013 11:19 am 
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Hopwin wrote:
*snip*


Ha! That photo's awesome, Hop.


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PostPosted: Thu Oct 24, 2013 11:29 am 
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Good points:

Ezra Klein wrote:
The classic definition of chutzpah is the child who kills his parents and then asks for leniency because he's an orphan. But in recent weeks, we've begun to see the Washington definition: A party that does everything possible to sabotage a law and then professes fury when the law's launch is rocky.

On Tuesday, Rep. Paul Ryan became the latest Republicans to call for HHS Secretary Kathleen Sebelius to step down because of the Affordable Care Act's troubled launch. "I do believe people should be held accountable," he said.

Okay then.

How about House Republicans who refused to appropriate the money the Department of Health and Human Services said it needed to properly implement Obamacare? How about Senate Republicans who tried to intimidate Sebelius out of using existing HHS funds to implement Obamacare? "Would you describe the authority under which you believe you have the ability to conduct such transfers?" Sen. Orrin Hatch demanded at one hearing. It's difficult to imagine the size of the disaster if Sebelius hadn't moved those funds. How about congressional Republicans who refuse to permit the packages of technical fixes and tweaks that laws of this size routinely require?

How about Republican governors who told the Obama administration they absolutely had to be left to build their own health-care exchanges -- you'll remember that the House Democrats' health-care plan included a single, national exchange -- and then refused to build, leaving the construction of 34 insurance marketplaces up to HHS? How about the coordinated Republican effort to get the law declared unconstitutional -- an effort that ultimately failed, but that stalled implementation as government and industry waited for the uncertainty to resolve? How about the dozens of Republican governors who refused to take federal dollars to expand Medicaid, leaving about 5.5 million low-income people who'd be eligible for free, federally-funded government insurance to slip through the cracks?

The GOP's strategy hasn't just tried to win elections and repeal Obamacare. They've actively sought to sabotage the implementation of the law. They intimidated the people who were implementing the law. They made clear that problems would be exploited rather than fixed. A few weeks ago, they literally shut down the government because they refused to pass a funding bill that contiained money for Obamacare.

The Obama administration deserves all the criticism it's getting for the poor start of health law and more. Their job was to implement the law effectively -- even if Republicans were standing in their way. So far, it's clear that they weren't able to smoothly surmount both the complexities of the law and the political roadblocks thrown in their path. Who President Obama will ultimately hold accountable -- if anyone -- for the failed launch is an interesting question. But the GOP's complaints that their plan to undermine the law worked too well and someone has to pay border on the comic.

If Republicans believe Sebelius is truly to blame for the law's poor launch, they should be pinning a medal on her.


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PostPosted: Thu Oct 24, 2013 11:41 am 
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^ Bullshit.

Republicans demanded a delay for the individual mandate because it wasn't ready and the $650M given to CGI to build the damn thing would fly in the face of the denying funding argument.

And if the plan was to build a single national exchange why wouldn't they be able to do it for the 34? Also why are the states with their own exchanges primarily democrat?

Also... aw screw it. Who cares?

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PostPosted: Thu Oct 24, 2013 11:51 am 
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The ACA website is a shambles for a number of reasons, not the least of which is federal rules regarding the way contracts must be spread out. Unfortunately, that means that no one company was in charge of the project, and something like 30 total companies were involved, none of whom were the technical lead.

Yes, its a debacle. Yes its an example of government mismanagement. But lets not pretend that the faults of the ACA (whatever they may be) are really in any way related to the faults in the website and its management. They're different issues. Though obstructionism IS relevant in the failures in the implementation of both the law and the website.


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PostPosted: Thu Oct 24, 2013 12:43 pm 
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I also call BS on current doctors liking Obamacare. Even ones that support public healthcare have a lot to be afraid of. You see, in Europe, they have public healthcare and doctors get paid less, but doctor training is two years less than here AND the government picks up most of the tab for school. Doctors that are practicing if and when we switch over will have to deal with reduced compensation, but they don't get those two years and $300,000 back.


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PostPosted: Thu Oct 24, 2013 12:55 pm 
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You're right. I just made it all up. :roll: its totally inconceivable that anyone, particularly the individual who raised one of the most liberal members of the board, who housed Obama campaign staff in her own home during the last election could possibly support the law.

Its absurd to think that any of the friends of those people who might share similar political ideologies could agree with the law.

Yes, indeed. I'm clearly just making crap up.

Hell, I have major problems with the ACA. That doesn't mean I don't support the primary goal; universal access to health coverage.


You guys have been hanging around the Glade too long. its warped your perspective about what 'normal' people think.

http://www.deloitte.com/assets/Dcom-Uni ... 031813.pdf

According to the survey 44% of US Physicians think the ACA is "a step in the right direction" and 38% think its "A step in the wrong direction" with 18% undecided.


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PostPosted: Thu Oct 24, 2013 3:20 pm 
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I fail to see how "obstructionism" (which apprently is what we call it when Republicans try to overturn a law passed by Democrat majorities in both houses and a Democrat President, once Republicans regain control of one of the Houses) in any way explains the technical incompetence involved in the website's launch.

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PostPosted: Thu Oct 24, 2013 3:27 pm 
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The theory being that the longer you have to produce a product the more time you have to sort out the bugs. (see RangerDave's post above)


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PostPosted: Thu Oct 24, 2013 3:33 pm 
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TheRiov wrote:
The theory being that the longer you have to produce a product the more time you have to sort out the bugs. (see RangerDave's post above)


Aside from the irrelevant references to medicare and the hilariousness of complaining that challenging a law one believes to be unConstitutional in court is "sabotaging" it, there's the fact that there has actually not been anything to stop the technical work on it. The "refusing to appropriate the money" is particularly amusing. So where did the money come for what was actually built, then?

They just did a shitty job. It's not like there's not models out there for public-access websites. If they truly didn't have the time, then they should ahve gone along with the Republicans on the one-year delay. This is just more of the "everything is the Republican's fault, because they didn't give the Democrats everything they wanted" reasoning.

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PostPosted: Thu Oct 24, 2013 3:43 pm 
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Actually I don't blame either Republicans or Democrats for the website issues. I think federal rules about awarding contracts are far more to blame than anything. (And though I don't know it, the spread-the-contracts-around stinks more of Democratic legislation than Republican, but I have no actual evidence of that)

That said, the Republicans clearly know they don't have the votes to remove the ACA legitimately, and have tried what? 40+ bills doomed from the outset to fail, in hopes of stirring up enough bad press that they can claim victory. They've pulled out every legislative dirty trick in the book and you don't think that's obstructionist?


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PostPosted: Thu Oct 24, 2013 4:09 pm 
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TheRiov:

I'm still calling bullshit on your friends and family in the medical profession calling the ACA a good idea. The ACA is a disaster. Reform, of some sort, is definitely a good idea. Some of the changes in the ACA, perhaps, are good ideas. The bill itself, however, in its totality, is a disaster and the medical profession knows that best. And, to be honest, I don't care how idealistic the medical practitioner is, none of them want more asymmetric shifts in their overhead and operating costs, which is what the ACA does.

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PostPosted: Thu Oct 24, 2013 5:46 pm 
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It is interesting, though, I find it fascinating that our national healthcare website barely functions and yet every single porn site in the world works like a charm. - Jimmy Kimmel

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PostPosted: Thu Oct 24, 2013 7:14 pm 
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RangerDave wrote:
I appreciate the line-by-line, DFK, but if I may simplify, it seems like whereever I pointed out an opening for them to play games with the numbers, you've simply assumed they didn't. When all is said and done, our disagreement basically boils down to you treating Heritage like a disinterested party performing a good-faith analysis and me saying that's a silly thing to do given their agenda and track record. We are at an impasse.


If that's your standard for throwing out evidence, you show throw out all statistical studies ever completed. Bias, ignorance, whathaveyou, it's ridiculous as a logical standard.

TheRiov wrote:
Licensing is about maintaining standards of care, not ensuring doctors salaries or that medical school tuition remains high.


Horseshit. Why aren't there more dermatology residencies?

TheRiov wrote:
http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/us_chs_2013SurveyofUSPhysicians_031813.pdf

According to the survey 44% of US Physicians think the ACA is "a step in the right direction" and 38% think its "A step in the wrong direction" with 18% undecided.


Huh, funny you should quote that. I'm actually WAY more familiar with that than you are, and your piecemeal quotations forgot to include some key findings:

Deloitte wrote:
[Within the Executive Summary]
Based on the results of the Deloitte 2013 Survey of U.S.
Physicians,* most U.S. physicians are concerned about the
future of the profession and consider many changes in the
market to be a threat. Most believe that...
•The performance of the U.S. health care system is
suboptimal, but the Affordable Care Act (ACA) is a
good start to addressing issues of access and cost.
•The future of the medical profession may be in jeopardy
as it loses clinical autonomy and compensation.
•Satisfaction with the profession is driven by patient
relationships.
•Medical liability (malpractice) reform is a major concern
to physicians.
•Health insurance exchanges (HIXs) are unlikely to be ready
for enrollment by the 2013 deadline.
•Physicians are likely to increasingly compete with mid-level
professionals in primary care
[...]

Also, the literal FIRST "key finding" states:

Deloitte wrote:
Physicians are pessimistic about the future of
medicine. The majority worry about the profession’s
erosion of clinical autonomy and income, and its
inability to achieve medical liability reform


Furthermore, the poll on ACA was trinary: "A good start," or "a step in the wrong direction," or "don't know" were the only three choices. Not "I like it" or "I view it favorably" or "it's the best solution." JUST whether it's a good start or the wrong way.

It should also be noted that this is a retrospective study to data polled in 2012, which means that (as of this conversation) we have 10 months of rollout/implementation of the law that those polled did not know about at the time of polling.



@RD: Ezra Klein, in that article anyway, is retarded. Congress has no obligation to fund anything. And Klein, Jon Stewart, and any other liberal who is screaming to just "fund it and get out of the way" is both an idiot and fails to understand the balance of power created through the checks and balances of our system.

Or, as Obama is a fan of saying, "elections have consequences."

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PostPosted: Thu Oct 24, 2013 8:36 pm 
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TheRiov wrote:
That said, the Republicans clearly know they don't have the votes to remove the ACA legitimately, and have tried what? 40+ bills doomed from the outset to fail, in hopes of stirring up enough bad press that they can claim victory. They've pulled out every legislative dirty trick in the book and you don't think that's obstructionist?


No, I don't, mainly because they aren't legislative "dirty tricks", any more than what the Democrats have done to keep it going. "Obstructionist" is a meaningless criticism. Duh. Of course they are. When you think something is a really bad idea, you try to obstruct it going forward.

It just so happens that the Republicans control a house of Congress, but Obama and the Democrats seem to still think they hold control of everything and the Republicans are just supposed to acquiesce. In fact, even when all the Republicans had was the filibuster, it wasn't obstructionist. Our system is never supposed to allow either side total control.

There's also a reason why laws like Obamacare are funded separately from the actual law creating the program....

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PostPosted: Thu Oct 24, 2013 9:19 pm 
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Khross wrote:
TheRiov:

I'm still calling bullshit on your friends and family in the medical profession calling the ACA a good idea. The ACA is a disaster. Reform, of some sort, is definitely a good idea. Some of the changes in the ACA, perhaps, are good ideas. The bill itself, however, in its totality, is a disaster and the medical profession knows that best. And, to be honest, I don't care how idealistic the medical practitioner is, none of them want more asymmetric shifts in their overhead and operating costs, which is what the ACA does.

Cliff notes -

People vote their paycheck. I'd call bullshit on any assertion to the contrary too. When the paycheck isn't an issue things get fuzzy, but otherwise it's where the smart man will put his chips.

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PostPosted: Thu Oct 24, 2013 10:03 pm 
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Nitefox wrote:
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It is interesting, though, I find it fascinating that our national healthcare website barely functions and yet every single porn site in the world works like a charm. - Jimmy Kimmel

Porn site builders only get paid when their **** works. They or their client go broke if their **** doesn't work, and you can't get blood from a stone.

Government doesn't work that way, though. If your **** doesn't work in government, you get paid MORE as politicians try to throw money at the problem.

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PostPosted: Fri Oct 25, 2013 7:39 am 
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Kaffis Mark V wrote:
Government doesn't work that way, though. If your **** doesn't work in government, you get paid MORE as politicians try to throw money at the problem.

I'd like to think it was just the government, but the private sector does this too, sometimes.

I once had a great year as an admin - 0 minutes of unscheduled outages for an entire year on the AIX systems I alone managed for a company. My 3 windows admin co-workers ... not so much. They let a virus definition update process on the company workstations stay broke for months, long enough so that the entire business got infected and had 3 business days where nothing worked 'cause the virus took over and clogged the tubes. Total shutdown.

They got kudos from the IT director at an all-hands for all their hard work of fixing that problem. My perfect score went unmentioned, even though the systems I managed did ALL the heavy lifting at the company.

I left the next year, and I'm still pissed. A perfect freaking score on their most important business systems and it didn't get acknowledged at all by management.

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PostPosted: Fri Oct 25, 2013 8:43 am 
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Taskiss wrote:
People vote their paycheck. I'd call bullshit on any assertion to the contrary too. When the paycheck isn't an issue things get fuzzy, but otherwise it's where the smart man will put his chips.



The fact that a significant number of people on this board fail be able to even comprehend that someone could have another motive is really quite sad.


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PostPosted: Fri Oct 25, 2013 9:34 am 
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The fact that your people accept a paycheck, own material goods and have not taken a vow of poverty would indicate their motivations are, at the least, partially materialistic.

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PostPosted: Fri Oct 25, 2013 9:47 am 
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TheRiov:

The fact that you oppose Texas's new abortion bill actually indicates your ideology does not line up with the reasoning you stated for supporting the ACA. Texas actually took measures to prevent Kermit Gosnell and other individuals from continuing to operate with little to no oversight for abortion procedures. Everything in that bill is about patient protection, information, and knowledge, and assuring the patient that adequate facilities exist in case of an emergency. In fact, Planned Parenthood is having trouble demonstrating its claim that no one west of Houston would have access to abortions in their suit.

Georgia passed a similar bill over a decade ago, as far as admitting privileges at the nearest hospital goes, because an OB/GYN left a woman and the fetus to bleed out in his office after a questionably legal procedure. Said physician fled the country and has, as of yet, not been apprehended.

People vote with their paycheck. And our resident physician has already voted with hers: she retired early (that's SquirrelGirl), because she couldn't afford the two new full-time employees the immediate ACA provisions would have required.

Like I said, your mother may support the general principle behind the ACA; she probably supports some of its provisions; unless she's a gloriously shielded member of an HMO or extremely large group practice, she doesn't support the bill in its entirety, because its her livelihood and paycheck that got put front and center.

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PostPosted: Fri Oct 25, 2013 10:24 am 
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I'm not suggesting that it isn't a concern.

But you don't know these people. My parents are far 'better' people than I am. They give generously to charity. They took their large cash windfall from the sale of my grandfather's company and split it between their church and buying a freaking water treatment plant for the village in Zambia they serve. Apart from this year, they spend a minimum of a month there as missionaries/medical staff. Only the fact that my mother is just wrapping up cancer treatment this year prevented their trip. They surround themselves with people of a similar bent.

But you don't see my parents driving sports cars, living in a huge mansion, buying extravagant luxuries. Yes, they have money, but they've always treated it like it wasn't theirs to own, but theirs to pass on to others, beyond what they need. They're the archetypal Sermon on the Mount Christians--I grew up in a freaking Norman Rockwell painting.

But don't start trying to make claims with ZERO knowledge of the individuals, about what they actually think. But unlike some people here, Im willing to actually provide some verification of the claims I make (as much as is possible in the internet).

http://www.caringbridge.org/visit/karif ... index/12/0

Read "Unfair" --read the rest of the blog.

That's my mother. Thats my family. Hell. I'm mentioned a couple of times in there.

So don't presume to tell me your interpretation of me and mine's opinions, our experiences, or our beliefs. You don't have the right. And you sure as hell don't have the knowledge.



Edit: http://www.drsforamerica.org/patients-o ... -is-coming
http://www.netrootsnation.org/profile/carolyn-senger/
Dr. Carolyn Senger is the sister of one of my best friends growing up, and also a advocate for the ACA. Look her up on facebook or the like. She doesn't exactly keep a low profile.


Last edited by TheRiov on Fri Oct 25, 2013 10:54 am, edited 1 time in total.

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PostPosted: Fri Oct 25, 2013 10:48 am 
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Khross wrote:
TheRiov:

The fact that you oppose Texas's new abortion bill actually indicates your ideology does not line up with the reasoning you stated for supporting the ACA. Texas actually took measures to prevent Kermit Gosnell and other individuals from continuing to operate with little to no oversight for abortion procedures. Everything in that bill is about patient protection, information, and knowledge, and assuring the patient that adequate facilities exist in case of an emergency. In fact, Planned Parenthood is having trouble demonstrating its claim that no one west of Houston would have access to abortions in their suit.

Georgia passed a similar bill over a decade ago, as far as admitting privileges at the nearest hospital goes, because an OB/GYN left a woman and the fetus to bleed out in his office after a questionably legal procedure. Said physician fled the country and has, as of yet, not been apprehended.

Please. THis argument is utterly beneath you-its totally intellectually dishonest.
A patient can be admitted to a hospital without the doctor who performed the initial procedure.
Just because I object to the law as written does NOT imply that I feel that regulation, access to more advanced medical facilities,etc should be required. Stop setting up this straw man and argue the real issue.


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PostPosted: Fri Oct 25, 2013 11:27 am 
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TheRiov wrote:
Stop setting up this straw man and argue the real issue.


I'll just put that out there right back to you, given that you're trying to use the anecdotal (and secondhand) experience of your mother while ignoring that your own citation undermines your assertion.

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