black321 wrote:

But - the amount of short sightedness in the Dem party (“I’ll never vote Dem again after this”) will be a real problem. They need to stop arguing about pronouns and get to the real issue: loss of voting rights.

 Steely_D wrote:

That's how I look at it...and i believe only temp agreement, funding through Jan...so still a lot of negotiating left. Let's get thing working again while we figure a full year plan...

Think about this, tho. If the Democrat party is playing chess (hopefully)
1) The “defector” scapegoats don’t face election recall, so they were chosen by Dem leadership to cast these votes as they were most protected from being voted out in November.
2) “Holiday travel and plane flights and paychecks returned for the winter? You’re welcome. We couldn’t bear to see you suffer, but Republicans wanted you to.”
3) At midterms we’ll hear “we ended the GOP tantrum; they were showing that they’re willing to literally starve you.”
4) Later: “Your healthcare premiums went up, well, it was obviously the GOP intention that we warned you about.”
5) “You don’t like this? Vote Dem next time.”

 steeler wrote:
I guess you could argue that ACA in its current form is better than nothing, but...It really speaks to the point democrats can/should control the narrative.
eg, ok, lets get rid of ACA, which you, the GOP gutted and made ineffective, with a better plan...or are you, the GOP, only interested in making further cuts to medicaid/healthcare? 

 rgio wrote:
The Republicans are back where they were during Trump’s first term — repeal ACA (Obamacare) and replace it with nothing. Talk about the need for “reform”of the system, but do nothing more than getting rid of the ACA and making cuts to Medicaid.

DACO.

 black321 wrote:
Trump's got a plan like nobody has ever seen before, available in two weeks.  Just you wait.  It'll be amazing.

Republican plan... let's take away healthcare and stop feeding people because the rich have been paying too much in taxes.   

 Red_Dragon wrote:

neither side has a particularly compelling argument:
Let's make healthcare that much more expensive for people, or
Let's further increase how much we pay insurance cos for managing our healthcare. 

 Red_Dragon wrote:

Notice how all 8 cavers aren't up for reelection. 

TERFs gonna TERF
Democrats Can’t Blame Trans People for Their Own Failures
Despite the attempts by so many in the party’s establishment to paint trans rights as a toxic issue, transphobia was soundly rejected across the country this week.

 R_P wrote:

 Steely_D wrote:

+1

 kurtster wrote:

<Polyanna>Of course, that advocate is their primary physician.</Polyanna>

I developed a smile as I said, to more than one person who came in with their Good Housekeeping list of tests they wanted, "Would you like fries with that?"

After they recoiled and understood what I meant, I gently said, "What you really want is high quality medical care, and that's what I'm here for. Tell me what's up and we'll work on it together." And - usually but not always - they got it. The ones that didn't were ingrained with the "they're all liars and cheats and you have to fight for what you want!" mentality.

IMHO, I wanted no part of that sort of relationship. Good Housekeeping medical advice was replaced with the internet and Oprah and Dr Oz and now AI. Glad to be out.

Back to the topic of politics: Every day without universal health care coverage, not predicated on being employed, is a failure of our nation's leaders. Shameful at best, tortuous and murderous in reality.

BTW, screw the AMA, which allows ads for drugs on TV, Dr Oz in a position of leadership, and fails at advocacy for our nation's healthcare. They're worse than worthless, because they wear a cloak of importance, while failing at their job.

 kurtster wrote:
I'll try to keep this short... but we're aligned on this.

Trusting someone is critical, but so is the ability to responsively act. Referrals, networks, and other connections beyond the advocate need to be made with immediacy and without all of the useless noise that insurance creates.

That human (the advocate), and others "downstream" in treatments, need to be able to direct care through the system quickly and completely. If they say "do it", there shouldn't be someone remotely deciding it's not necessary. All treatment should cost something, as services are rendered. I think co-pays are a good thing. Financial ability for copays should be driven from your tax return, not which of the 15 plan levels you decide. The complexity drives costs, and profits, with zero benefit to the patients or healthcare providers.

Part of the reason that many avoid the doctor is because of the complexity and the deductible/co-pay system.  US healthcare now has the reputation of being expensive, and understanding what you pay is incredibly difficult.  The current system rewards not seeing a doctor.  If you want to encourage participation, create a surcharge for those who don't see someone each year.  The longer the avoidance, the higher the surcharge.   

So what I first responded to, and what I took as Islander's point, is that there are technological ways to streamline all of this and remove the vast majority of the complexity... IF... you're willing to accept that the for-profit insurance industry no longer delivers value in the US.  There is no balancing of efficient, affordable healthcare and shareholder returns.  They can not, and do not, support one another.  They are polar opposites.

We've also reached a point in our capitalist evolution that the connection to healthcare via employment is an impediment to both employment and healthcare.  It's time for a divorce.

I'm pretty sure we're all mostly aligned on this stuff... and to the realization that no politician yet has found the energy to take on the system.  At some point it will be a necessity, not something that can be argued for decades.  Technology makes the changes easier than ever...if someone will take on the healthcare industry.

Last thought... the stress that healthcare administration puts on everyone needs to be alleviated. It's insane to think that someone like Luigi Mangioni can garner any support for murder, but the frustration is real, and nothing ever seems to get easier or less expensive.  

A system as a whole can only be as good as it's worst member.

To my knowledge drawn mainly from personal experience, a health-care system with free access for all doesn't automatically work in the best way. Instead, it may have many issues. Here's one.

Two subsequent generations of fully insured patients (women) have been subject to histerectomies by more than 80%, just because some nutface in power said these surgeries were fully covered by public insurance, because of "studies". Same goes for knee and hip joint-replacements, etc. - Such waves of cashing-in always are being followed by further costs to the system as a whole.

Any "market" is easily exploited, as long as any actor's heart isn't guided by the will to serve all members of the system.
Health-Care should be covered for all, as all pay taxes. 

The path to an incorrupt system of health-care seems eons away from materialising, just as most any & all public endeavours. No Endsieg in sight, neither in reasonable economics, nor in political ideas applied in practise, not in health-care either.

UTOPIA - yet another goal to thrive for, for all of us.

Then perhaps the end result will be:
WE are all of us. Who are you?

 steeler wrote: 
I'm going to foolishly jump in on the advocate thing.

A critical part of any major treatment is having an advocate.  Even a knowledgeable patient needs someone trustworthy a step back watching and taking notes.  

I say this as someone who has been in a doctors office roughly once a week for the past 15 years.  Every other Wednesday at minimum.  And not in a lower tier outdated facility.

I am willing to say that I cannot see any medical system that deals in treatments of pathological situations and surgeries that can be designed to be foolproof and not require any human oversight on the patient's behalf.  Kinda like someone who acts as their own attorney ...

And then access does not guarantee care or outcome, at any level.

The best illustration I have for this is the unfortunate death of local Congresswoman Stephanie Tubbs Jones that happened right at the beginning of my medical odyssey and the whole health care debate in 2008.  She had access to the best health care in the US.  You got to use it properly or it doesn't matter how good it is. Point is that with regular visits a condition like hers would most likely have been detected and treated at some level. 

*You got to show up in order to get the proper care that you may not know that you need

Then there is the rest of the mess.  Address these issues first and then redesign a system around those results.  What ever is needed will have to be integrated into the existing system.  Can't start from scratch on this.

Of course this is in the perspective of  "a perfect world", which there ain't no such thing.

.
*  This is an afterthought on the showing up part.  Way back when discussing this in the days of the ACA discussion, the Japanese model was brought up where the individual or patient had to see a doctor on a regular basis whether they needed one or not in order to keep their health insurance coverage in effect.