Because employers don't pay for healthcare, employees do. It's just another form of compensation.
Why is there not huge amounts of lobbying from corporations from every single industry that provides employer-based insurance, besides the insurance industry, in favor of a public option?
One cynical theory is that employers may prefer the tether of employment-based health care to a system that allows labor to move about without regard to their HMO.
Yes, but they match your contribution or somesuch. Plus, wouldn't they be able to just pocket your contribution with a little sleight-of-hand and fob you off on the public option?
it's also subsidized compensation b/c the benefit isn't taxed. Thus, employers can offer more compensation in real terms for each dollar spent.
The employer can pay you in jellybeans or cash or healthcare. It doesn't matter to the employer.
But offering a subsidized, tax-free compensation can't possibly be net cheaper than not having to pay for any, and not having to use any HR worker-hours whatsoever to manage insurance. Why would you want your business to stay super-complicated? Is it just one of these industry-norm effects, where any one business can't really not comply?
I think that the public option is still being funded in part by employers in the various plans. Either employers offer coverage or they pay into the public system.
The cost wouldn't rise as it has, so the idea goes.
I was listening to the Diane Rehm show last night as I was falling asleep, and it was pissing me off, how poorly informed they were. (I think that that sentence is odd. It probably comes from reading too much Greek.)
Also, I hate when they opine about the American people and how conservative and skeptical they are. I don't think that there's a massive uprising in favor of single payer or that we're now a liberal country, but what's the basis of saying that we're all terribly skeptical of government. I mean, we could have been voting for more government, i.e. a public option. I mean, how do they know?
Why would you want your business to stay super-complicated?
It gives bigger businesses a competitive advantage in attracting talent over small businesses? Small businesses don't really seem to be against it. There was testimony from small business owners in favor of reform, including a public option, since there was only one insurer in a particular state. I think that the woman was an African-American from Iowa. her brother wanted to move back to help with the family business, but couldn't because they didn't offer health insurance.
10 was I. I'm incredibly interested in health care, but I always grumble a bit when the topic comes up in the media, because the discussion sucks so much.
Somewhere some years ago, I heard a piece on the auto companies with factories in Detroit and Windsor. Right across the river from each other and very similar in many ways, but very different on this benefit. It sounded like they were somewhat more comfortable with the Canadian scheme, but it was close given some of the pluses and minuses mentioned above, so they were not inclined to spend much of their resources on it. Not that their judgment is to be trusted.
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Starting my day auspiciously with a viewing of Danton
Robbsie(Bob?):Danton must be arrested!
Freedom fighter #3:But Danton(Obama?) has the support of the bankers! It will be his triumph and the end of the Revolution.
The United States last year exported three times as much arms overseas as the rest of the world combined.
I'll be back.
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Lobbying means spending real dollars to make things happen, Heebie. I think plenty of non-insurance businesses would be perfectly happy to get healthcare out of their HR departments, but not enough to go spend millions of their own dollars to lobby for that result. (Because workers ultimately pay for it, as bjk said in 1.)
Also, and probably equally importantly: there's nothing in any currently proposed "public option" that would actually get any healthcare out of any HR departments. There are instead, in fact, things called "employer mandates" in most (all, I think?) the bills under discussion. Now they're just giving you heathcare because they love you, but if reform passes, they'll be legally required to do so. (With certain small business exceptions, etc.)
If the bills under discussion actually did anything to get employers out of the healthcare business, you might see more non-insurance business support.
What about the argument that it would benefit corporations if general health care premiums were driven down, and a public option would help?
I mean, when it comes to anything evil, you have corporations fighting tooth and nail over hundredths of a percent of a single carbon atom that they are dying to emit, or how lead testing should be done every two thousand products and not a single item more frequently. It seems like there's got to be some angle that would make a public option incrementally cheaper that they should be interested in exploiting.
15: The corporate execs need the health insurance execs to round out their foursomes.
What about the argument that it would benefit corporations if general health care premiums were driven down, and a public option would help?
I'm very skeptical that this is true, at least for the currently discussed incarnations of the public option (which are very limited). I understand the argument that the public option might be incrementally expanded over time and eventually produce real cost savings, but that's probably too tenuous a hypothetical to justify spending many real dollars today lobbying congress.
But I'm just spouting shit, really. Someone more informed should speak up: are the currently proposed health reforms in any way on net good for business (whether because of the public option or otherwise)? My impression is that they're not, really. Heebie's right that moving toward a single payer system (or otherwise getting rid of the employer-based system) would be a big benefit for many (non-insurance, non-healthcare) businesses, but that's not currently on the table.
"reverse campaign finance reform" is a bit misleading. They'd strike down legislation from 1907.
I do think that we are in the middle of an inevitable transition in the US from "lock-in" benefits to more free-floating ones (see recent history around pensions etc.). Companies seem to be bit mixed on how fast to go and how to secure their angle. The cynical take would be that they are trying to figure out how keep the lock-in (at their discretion) without paying for shit. Healthcare is complex, but it also provides an HR lever they can use in various ways. I truly think many of them don't really know their own mind on this one.
Another cynical take implied in several comments above is that given the eagerness of the corpwhores in Congress (and statehouses) to deal, it is better to save your lobbying dollars for getting working on specific "reverse Bills of Attainder" that benefit them more directly*.
*An example: A relative is probably about to retire early (not so willingly) because their corporation had guaranteed state Y that they would employ x number of physical workers in that state in return for favorable tax treatment. What with the downturn and layoffs their employment has fallen below that threshold, so they are wholesale picking up departments from state Z and moving them to Y (a more southern state). No telecommuting allowed, of course, you need to get the bum on a seat in Y for it to count.
My cynical theory is that the CEO class prefers solidarity with each other over helping their own businesses. If you're the head of a Fortune 500 company and have your lobbyists pushing for publicly funded health care, you get cold stares at the country club. If you stay out of it or side with the Chamber of Commerce, then you get to stay in the club and your competitors are still paying for their own health costs.
The Chamber of Commerce has spent a ton lobbying against health-care reform, both this time round and under Clinton.
Also, don't forget that the CEO class would probably see tax increases under publicly provided health care, and that health care providers like doctors and hospitals think they'd make less money with publicly funded health care.
19:Yeah. It's real comforting to see the corporatist/originalist assholes on the court grappling with how to deal with the almost entirely post-Constitutional institution of corporate influence on politics. What manner of logically-tortured fuckwittery will emerge from this?
If heebie should say "Corpgress", how should she pronounce it?
re: 21
Yes, I think that's basically right.
12: The auto companies had all those legacy benefits which complicated things.
What I don't get is the fact that they always say that you can keep your current benefits if you like them, but I've seen no evidence that you can switch if you don't.
but I've seen no evidence that you can switch if you don't.
My understanding is that you explicitly can't switch -- that health care exchanges are only for people who are qualified by not having employer-based health insurance. If you don't like your employer based health insurance, tough.
Sure you can switch--you just have to quit your job.
21 is right. Yes, due to tax breaks employer-provided insurance provides more compensation per dollar spent than paying the employees the equivalent amount directly, and yes, big businesses get better deals on health insurance than small businesses so that's (yet another) competitive advantage and the big businesses are the ones with lobbyists, and yes businesses like employees to not feel so free to leave.
The main reason, though, is probably cultural and/or class-based. Business-owners, for the most part, are free-marketeers, supply-siders, not fully Randroids because they couldn't function but pretty close. They're old enough to think of Soviet Russia when they hear "socialism", not France. They've drunk the Kool-Aid.
Just guessing, at least. Beyond those in the public eye we all know about, I only know three business owners well enough to know if they fit that description. It definitely does fit two. It doesn't fit the third, but he's a the publisher of a newspaper (in a Vermont college town, no less), so he's really the exception that tests the rule.
Question: McArdle's been pushing this idea that singlepayer health care works fine and keeps down costs everywhere else in the world only because the US market with its out-of-control costs subsidizes R&D worldwide, and if we went singlepayer, health care research and innovation would grind to a halt and I'd never be able to get that brain transplant I've been pining for.
Is anyone respectable grounding their opposition to health care reform on this theory, or is this McArdle being idiosyncratically wrongheaded.
That should end with "?", of course.
I'm fully prepared to believe that CEOs often prefer solidarity with each other over helping their own businesses, but before I'm willing to grant that any explanatory power in this case, someone needs to answer 18 and explain to me how anything in any of the current reform proposals would actually help ordinary businesses. Because I'm not aware of anything.
18:Someone more informed should speak up: are the currently proposed health reforms in any way on net good for business (whether because of the public option or otherwise)
Marcy Wheeler explains how "Almartway" can make big money from the Baucus Plan
Yeah, it's intricate. What else would you expect?
Yeah, the Baucus Plan will not become law. My guess we will have about 15 minutes to decipher the final bill before passage, that there will be one hundred other complicated provisions, and the the media and birthers will focus on some unrelated essential aspect that will need vigorous defense.
32: Buck runs a small business, and it'd help him -- he could drop the incredibly expensive health insurance he buys for his employees without feeling bad because they'd be able to get reasonable health insurance on the exchanges.
Is anyone respectable grounding their opposition to health care reform on this theory, or is this McArdle being idiosyncratically wrongheaded.
A false dichotomy! No one respectable is grounding their opposition on this theory, but lots of nonrespectable people are, so Megan's not being idiosyncratically wrongheaded at all.
27: Yeah, that's how it works in Massachusetts, and it's one fo the reasons that I haven't gotten behind the push. I write letters to Congress critters with my views on this, but I'm not going to jump in line behind the President's plan.
One of the really serious issues for me is that large-employer plans (ERISA--don't know how state and local government plans are regulated) can get out of mental health parity rules by not covering mental health at all.
I've recently joined two subcommittees of the children's behavioral health initiative (a committee tasked with reforming MA State services for children with serious emotional disturbances. The aim is to coordinate services. The process was set in place because of a class action law suit on behalf of children who were institutionalized, because there was a lack of adequate care in the community.)
I'm going to be serving on the insurance regulation subcomittee, and one of the things I'll suggest is that in order to prove creditable coverage, individuals should be required to prove that they have minimum mental health benefits, possibly by requiring supplemental mental health insurance (we need some kind of pool). It may be unworkablle, but I'm sure that there are a lot of people on these committees who don't understand the preemption issues at all.
34: Plus he could focus on the business he actually does and presumably enjoys and/or is good at instead of also having to worry about how to administer health insurance plans.
30: It's wrong, but not at all idiosyncratic.
re: 30
Her argument is an ancient trope that crops up whenever 'socialised' medicine gets discussed. It seems essentially to be an article of faith among certain people, i.e. "we pay more than everyone else, therefore either i) we are thick and are being ripped off, or ii) everyone else is free-riding off our backs, i) is too uncomfortable to contemplate therefore, ii)".
It's been discussed here more than once.
34: okay, granted, although that sounds like it's outside of the realm of what we were discussing in a variety of ways. (He's doing more than he's legally (or competitively?) required to do now; he's probably supportive of reform rather than oppposed to it; his business is presumably too small to engage in meaningful lobbying anyway; etc.)
Thanks for the link, Bob. It's a good one.
It's been great fun watching Mcardle embarrass herself in the health care debate.
Mark Ames warms my heart with this piece.
http://exiledonline.com/megan-mcardles-hypocrisy-exposed-portrait-of-a-libertarian-as-a-taxpayer-subsidized-brat/
From birth, Megan McArdle has been the beneficiary of public funds: taxes paid for her upbringing, paid her father to venture into a corruption-ridden business world based on using public money for private gain, and paid her wages in her first breakthrough job. Her response is to revile government intervention as an employee of the most notoriously corrupt magazine on the market.
30: Here's a good response, in case you hadn't seen it.
Oh, McArdle's argument is nonsense -- it's based on a set of factual assumptions that there's no support for at all: that any change in the profitability of pharma companies in the US market will cripple private R&D; that single-payer health care will make pharma companies less profitable (god knows that single-payer defense has done terrible things to Lockheed's profit margins); and that public spending on R&D can't possibly substitute for private spending.
What puzzles me about the argument is that if it were true, most of the developed-country population of the world would be looking at a situation where the engine of the R&D train they're free-riding on is at risk of shutting down. Wouldn't you expect Europeans generally to be reacting fearfully to the prospect of US health care reform? And doesn't the absence of such a reaction indicate that maybe they're pretty sure they can get along fine without our market 'driving' drug development?
Brandeis referred to the lock-in style discretionary pension as something like "our new peonage". Statements like that would probably keep you off the court today.
I'm also unclear on why McMegan is so keen on the US subsidizing all those socialist poltroons out there in the world. Doesn't that give them the wrong incentives and encourage their sloth?
god knows that single-payer defense has done terrible things to Lockheed's profit margins
This is funny and a good point. We're talking about more customers for pharmaceutical companies. Sure, the drug companies might see a dip on the cost-per-prescription. But anyone arguing that health care reform is the death knell of Big Pharma is being either flatly mendacious or incredibly obtuse.
Quite a few small businesses are actively in favor of reform. I've seen some around here with signs in their windows that say "This business supports healthcare reform." Now, this isn't the most representative place out there, but it's a data point.
What puzzles me about the argument is that if it were true, most of the developed-country population of the world would be looking at a situation where the engine of the R&D train they're free-riding on is at risk of shutting down. Wouldn't you expect Europeans generally to be reacting fearfully to the prospect of US health care reform? And doesn't the absence of such a reaction indicate that maybe they're pretty sure they can get along fine without our market 'driving' drug development?
Yeah, but from McArdle's perspective it wouldn't be surprising that the socialist weenies in Europe would fail to grasp the crucial importance of market-driven innovation in the United States in keeping their systems going.
Huh. If you start assuming that entire populations can be too blinded by ideology to act in their own rational self interest, doesn't that imply a fundamental problem with relying on markets to run everything?
I think I remember a friend of mine who works as a management consultant making McMegan-style arguments against health-care reform when we argued about it last year. In general, I've heard the the "oh noes, if we change anything we won't have wonderful new drugs and treatments" line batted about by the young and healthy who don't have to stop and think about how the current system pays for innovation on the backs of the old and sick, the people who are actually paying the exhorbitant drug costs.
Mostly, I was wondering if anyone else influential is making that argument in detail now -- I was thinking about posting about it, but I was hoping for someone to argue with other than McArdle. After the flurry of posts Holbo dropped on her, more seem uncalled for.
If you start assuming that entire populations can be too blinded by ideology to act in their own rational self interest, doesn't that imply a fundamental problem with relying on markets to run everything?
If you're too blinded by ideology to notice all the other fundamental problems with relying on markets to run everything, this one's probably not going to jump out at you.
54: Exactly correct!
Megan believes in markets (or maybe she's just pretending, I don't know), the way a good fundamentalist believes in Jesus.
I think Europeans are too worried about no longer being able to free-ride off our unbelievably generous defense umbrella to worry about no longer being able to free-ride off our unbelievably generous pharmaceutical development system. And they still have the temerity to complain!
After the flurry of posts Holbo dropped on her, more seem uncalled for.
WRONG.
I think the Europeans are mostly sniggering at the quality of the health-care 'debate'.
53: well, this guy seems to agree. As do the Pharmaceutical Research and Manufacturers of America generally, as one might expect.
That information about McCardle pere was interesting. It would have been just as funny though, if he weren't corrupt, but a quiet civil servant, and her libertarianism had been a straight act of rebellion.
60: The link was actually blocked for me as "Adult Content" -- what was the interesting bit?
63: He filmed porn while on the government payroll. Quite shocking.
While I suppose that's possible, I'm going to assume you're kidding.
You may already be familiar with it, but here's a quick summary. Her Dad has lots of work in government which he then parlayed into helping private firms get government contracts. (One of Megan's early jobs was as construction-y inspector which she got through her Dad.) There were some mob connections and corruption issues involved with her Dad's construction firm. He recently lobbied to be stimulus czar for the State of NY.
The argument is that her privileged upbringing was hugely subsidized by taxpayers and the government.
My cynical theory is that the CEO class prefers solidarity with each other over helping their own businesses. If you're the head of a Fortune 500 company and have your lobbyists pushing for publicly funded health care, you get cold stares at the country club. If you stay out of it or side with the Chamber of Commerce, then you get to stay in the club and your competitors are still paying for their own health costs.
This is exactly what I secretly believe.
Except now it's no longer a secret....
You mean... a certain class of people might have... class solidarity?
God, Unfogged is just a hotbed of ridiculous Marxist conspiracy theories these days. Next you'll be telling me that people who own media outlets have an influence on editorial content.
51:If you start assuming that entire populations can be too blinded by ideology to act in their own rational self interest, doesn't that imply a fundamental problem
Yes.
A very recent post by John Holbo was quite flatterng to IOZ, who offered to make out.
The dispute/reapprochement was over a presumed slight by Matt Taibibi to Chomsky's Manufacturing Consent and Holbo's post/comment section surfs the hegemonic theories.
Holbo often swims and deepdives the Neo-Gramscian seas.
The more I learn about Max Baucus the more I dislike him.
Holbo often swims and deepdives the Neo-Gramscian seas.
Be careful, John! Many have drowned!
73: The Onion can see through time.
http://www.theonion.com/content/node/33420
72: A very recent post by John Holbo was quite flatterng to IOZ, who offered to make out.
Hmm, IOZ recently offered to make out with Bérubé. Either your mixing up the two or IOZ is a slut.
72: In fact your whole comment looks like it is in reference to one MB did.
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Debtors Revolt Begins Now ...Yves Smith
But this sort of revolt does fit, that of a debtors' strike. It doesn't require violence or even public assembly.The first test of public mood will be whether this video (hat tip Karl Denninger via reader Scott) goes viral.
Doin' my lil' bit.
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76:Damn. It was Berube. I am embarrassed and ashamed.
I told one of them I kept mixing them up. I am not sure why.
I'll go get the link, small penance.
CEOs also make a lot of money and they want to keep their income taxes as low as possible.
God, Unfogged is just a hotbed of ridiculous Marxist conspiracy theories these days.
No, that's just Adam Smith:
People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices. It is impossible indeed to prevent such meetings, by any law which either could be executed, or would be consistent with liberty and justice. But though the law cannot hinder people of the same trade from sometimes assembling together, it ought to do nothing to facilitate such assemblies; much less to render them necessary.
I think the simple answer to the question of why corps aren't jumping on the reform bandwagon is that the Dem plan (as I understand it) will tax employers in order to help pay for expanded healthcare. I think that this is a wonderful idea, but the management at the corps probably do not. Also, Corpgress brings to mind two houses of zombie lawmakers...very apt.
82: Clearly some kind of crazy moonbat.
Oh, McArdle's argument is nonsense -- it's based on a set of factual assumptions that there's no support for at all: that any change in the profitability of pharma companies in the US market will cripple private R&D; that single-payer health care will make pharma companies less profitable (god knows that single-payer defense has done terrible things to Lockheed's profit margins); and that public spending on R&D can't possibly substitute for private spending.
Business R&D spending has held steady at 4% of GDP for at least 30 years. (If reduced taxes were supposed to cause in increase in free market productivity per Arthur Laffer, it sure didn't show up anywhere.) Meanwhile fed-funded direct R&D spending has fallen from 4% of GDP to around 1%, most of which is... wait for it... military R&D. That's not big pharma R&D spending but I don't see much in the way of big breakhrough drugs in the last 10-20 years. Mostly they seem to be tweaking the old drugs. (Which is fine, but not sufficient.)
The decline in R&D spending probably has something to do with why wages have tanked.
Interesting enough, insurance company gross intake (which does not include the costs of doctors, hospitals and drugs and the like!) has now risen to 5% of GDP.
max
['The market's up since March though!']
Is that tricksy Obama delivering his speech on 9/9/9 just to throw everyone off?
86:I turned those numbers upside down in my mind and became a Republican for a second. It was horrible.
Someone seriously needs to turn "single-payer defense" into a series of hilarious spoofs on YouTube that go viral and sweep aside any opposition to a good public option.
McManley, didn't you know that te only thing the government has ever done well is the military? Rush Limbaugh told me so.
34
Buck runs a small business, and it'd help him -- he could drop the incredibly expensive health insurance he buys for his employees without feeling bad because they'd be able to get reasonable health insurance on the exchanges.
What makes you believe this? My COBRA coverage runs out in a year so I have been vaguely interested in individual coverage. In Westchester an individual Blue Cross plan appears to cost $16752.72/year which doesn't seem very reasonable to me. What is it going to cost on the exchanges? I don't see any reason for it to be significantly less.
90: there's not much to bring costs down (because the public options actually on the table have been neutered), but there are subsidies up to 300-400% of the poverty line, which helps. And also, with the exchanges there'd be less ability for a single insurer to dominate a market--and hopefully the increased competition could drive down costs somewhat. (I'm not very enthusiastic about that, but it's a theory.)
"Meanwhile fed-funded direct R&D spending has fallen from 4% of GDP to around 1%, most of which is... wait for it... military R&D. That's not big pharma R&D spending but I don't see much in the way of big breakhrough drugs in the last 10-20 years"
The NIH alone spends $30bn a year on research projects, which is only a bit less than the whole global pharma industry spends, from the estimates I've seen. If you add in all the non-profit sources of research money and foreign governments, there's no doubt that the majority of research - especially the basic stuff rather than trials that bring drugs to market - isn't driven by profit.
91
there's not much to bring costs down (because the public options actually on the table have been neutered), but there are subsidies up to 300-400% of the poverty line, which helps. And also, with the exchanges there'd be less ability for a single insurer to dominate a market--and hopefully the increased competition could drive down costs somewhat. (I'm not very enthusiastic about that, but it's a theory.)
There are seven insurers offering plans in Westchester. The problem is medical care costs too much in the United States and the Democrat's plans do nothing to address this, just the opposite in fact.
Just doing the blogs
Why the Holy Fuck should I engage in these endless arguments? What response could possibly be an appropriate but outrage and its physical expression?
What I wonder is why we hear nothing of the fact that insurance companies have an antitrust exemption and thus openly collude on pricing. This would be a response to the "let the market work" canard.
93: The problem is medical care costs too much in the United States and the Democrat's plans do nothing to address this, just the opposite in fact.
It is true that the ratfucking by the crypto-nihilists has succeeded and is reflected in almost all current alternatives.
The problem is medical care costs too much in the United States and the Democrat's plans do nothing to address this, just the opposite in fact.
Right, all the bills seriously under discussion are aimed primarily at expanding coverage, not lowering costs. Measures designed to bring more significant cost reductions were all judged to be too politically risky (and given the howling Republicans have done about the very moderate cost-saving proposals in the current bills, that judgment was probably correct).
One thing that might help about the exchanges is that (and this is me spitballing, rather than an argument I've heard from someone credible, so it's perfectly possible I've missed something that means this makes no sense) is that there's a newly price-sensitive component of the market out there --people who would have gone uninsured by choice before. The fact that there are now people seriously looking for the cheapest insurance they can get, but who are comparing it to the price of other insurance (or the cost of the fine for being uninsured) rather than to zero, might encourage insurance companies to go after the broke/cheap-but-healthy segment of the market in a way they hadn't before.
98
One thing that might help about the exchanges is that (and this is me spitballing, rather than an argument I've heard from someone credible, so it's perfectly possible I've missed something that means this makes no sense) is that there's a newly price-sensitive component of the market out there --people who would have gone uninsured by choice before. The fact that there are now people seriously looking for the cheapest insurance they can get, but who are comparing it to the price of other insurance (or the cost of the fine for being uninsured) rather than to zero, might encourage insurance companies to go after the broke/cheap-but-healthy segment of the market in a way they hadn't before.
Actually insurers have tried to go after the healthy segment of the market. Hence medical rating and exclusion of pre-existing conditions. It is my understanding that this sort of thing is going to be banned.
Insurers have also tried to go after the cheap segment of the market with barebones high deductible plans and the like. It is my understanding that this is also going to be banned.
For example I would prefer to purchase insurance with no mental health coverage whatsoever. (Since I think mental health care is mostly psuedo-scientific witchdoctory why would I voluntarily buy such coverage?) But I am likely to be denied this option.
So as far as I can see the reform plans are just making my options worse.
I don't think that squarely addresses what I was talking about -- the fact that a healthy 23 year-old who would probably just go uninsured before this is now looking for the cheapest policy she can get, and there's some pressure on the insurance companies to attract her business. But I'm not sure at all that that will do much if any good to hold prices down.
99:So as far as I can see the reform plans are just making my options worse.
Very possibly - if not for you, then certainly for somebody else. But making health care better for everybody isn't the point - making health care available for everybody is.
98 describes a plausible mechanism, but offset against the reforms described in 99 (and the other reforms that have been proposed) I'm not sure it's realistic to expect significant cost reductions. It seems entirely possible that premiums will increase--surely at least some of the money insurers save by doing everything they can to avoid insuring sick people or paying claims is passed on to policyholders in the form of lower premiums.
But 99, "the healthy segment of the market" that LB was describing in 98 consists of people who currently choose not to purchase health insurance at all (because it's expensive and they're young and healthy), who'll be brought into the system through individual mandates. That's not a market segment insurers can reach today, because even a cheap health insurance plan is a hell of a lot more expensive than nothing.
For example I would prefer to purchase insurance with no mental health coverage whatsoever. (Since I think mental health care is mostly psuedo-scientific witchdoctory why would I voluntarily buy such coverage?) But I am likely to be denied this option.
But do you think it's wise for some individuals to be provided mental health coverage? I am very sure I don't need coverage for sickle-cell anemia, but I don't think I should be able to opt out of it.
surely at least some of the money insurers save by doing everything they can to avoid insuring sick people or paying claims is passed on to policyholders in the form of lower premiums.
This is possible, but I don't think it quite rates a 'surely'.
103: Those sickle cells ought to pick themselves up by their wee little sickle bootstraps.
The problem here is giving the insurance companies any seat at the table whatsoever. If we want to fix health care in the US, the best strategy would be to compile all the insurance industry's suggestions and then do exactly the opposite, all the way down the list. If they aren't screaming bloody murder, then rest assured the plan is worthless.
Am I crazy to think that the proposed caps on individual out-of-pocket costs per year is a really big deal? Overnight, all the worries about being bankrupted become not so worrisome.
You can joke about sickle cells, but what do sickles come with? Hammers. I think you know what I'm getting at.
I'm collaborating. I'm listening.
107: You're not crazy, but I think the numbers I've seen for caps are still very high in terms of the amount of money that could cause misery to a middle-class family. Around 15-20K is what they're talking, right? We're pretty comfortable, and 15K once would smart, two or three years running would really suck. For a family getting by on $60K or so, it'd be awful.
Hawaiian Punch is too illegit to quit.
Around 15-20K is what they're talking, right?
Oh fucking christ, that's exorbitant. How worthless.
Still exorbitant, but not as high as you quoted.
A much better link for the point in 116.
116: Really? That's much better than I'd thought. I can't remember what exactly I was looking at for the other number.
(Can I just say how annoying trying to figure out the merits of a finicky fixing-things-around-the-edges plan like this is when the details aren't set?)
116 117
But this $5000 cap is on top of the $17000/year I would be paying for the insurance. So you are just confirming that I won't be able to buy a high deductible or high copay plan.
116, 118: And the Senate HELP bill has caps at $5,800 individual, $11,600 family. The unofficial Finance Committee stuff circulated recently has a complicated system for limited cost-sharing that isn't as good, although I don't totally understand it.
See, that's hwat I'm talking about. An annual cap on out-of-pocket expenses that is actually lower than a lot of people's annual cost for insurance is a really low, good cap.
Now, as a healthy person ideally I would be able to pay $1/year for insurance, if I am not worried about any serious health problems other than the things that under the current system would cost an infinite amount of money, thus bankrupting me, and under the new system, thanks to the cap, would not. But what's the chance of this happening?
James, you seem unhappy with the current situation and unhappy with the proposed reforms. What would you like to see instead?
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James, you seem unhappy with the current situation and unhappy with the proposed reforms. What would you like to see instead?
Well from a selfish point of view the proposed COBRA extensions which were eliminated from the stimulus bill would have been a good deal for me. The more generous have would allowed me to stay in my former employer's plan until (or nearly until) I qualified for medicare.
More generally you need reforms that actually cut costs. This is politically difficult as the real cost villians are more popular than the insurance companies liberals like to demonize. See this Erza Klein column.
Failing that I would like the freedom to buy the coverage I want not the coverage the liberals think I should have.
In Westchester an individual Blue Cross plan appears to cost $16752.72/year which doesn't seem very reasonable to me. What is it going to cost on the exchanges? I don't see any reason for it to be significantly less.
The individual mandate should lower individual premiums significantly by bringing the health people into the pool, although it will not lower total national health care costs. The major reason individual market costs are so high is that only expensive people buy.
More generally you need reforms that actually cut costs. This is politically difficult as the real cost villians are more popular than the insurance companies liberals like to demonize. See this Erza Klein column.
So you say the real problem isn't the insurance companies that liberals like to demonize, and for evidence you cite Ezra Klein, a liberal. I just don't get how you think.
I agree with you, a single-payer system would be much better than the status quo or anything likely to be passed in the current Congressional term. I blame conservatives for the fact that a single-payer system isn't on the table. Given that it isn't on the table, nor anything like it, what next?
Admittedly, blaming conservatives is roundabout at best when they're supposedly out of power. But (a) Democrats like Max Baucus are conservative, and (b) liberals in government would be doing more if not for fear of right-wing reactions, from criticism to assassination (it's happened). That may be wishful thinking on my part, but if not, surely it's fair to give conservatives at least some of the blame.
A modest proposal: why don't we formally recognize the lock big business has on our federal legislature, dissolve the existing Senate, and create a new one which represents corporations instead of states? Delegates shall be apportioned in accordance with the corporation's net value as determined by the number and values of its shares on the New York Stock Exchange.
I'm not even sure that I'm joking. At least it would be more honest than our current system.
Well from a selfish point of view the proposed COBRA extensions which were eliminated from the stimulus bill would have been a good deal for me. The more generous have would allowed me to stay in my former employer's plan until (or nearly until) I qualified for medicare.
So you wanted government programs to guarantee you access to health insurance until (or nearly until) you were eligible for government health care? Got it.
More generally you need reforms that actually cut costs. This is politically difficult as the real cost villians are more popular than the insurance companies liberals like to demonize. See this Erza Klein column.
I fully agree. What do you think we should be doing to cut costs?
Failing that I would like the freedom to buy the coverage I want not the coverage the liberals think I should have.
I have no idea what this means. You think there should be no, or fewer, insurance regulations? (What about the COBRA coverage you have right now? Is that a good idea?) I thought you were complaining upthread that currently the "freedom to buy the coverage you want" isn't worth shit since the coverage that's on offer from private insurers is unreasonably expensive (and probably full of plenty of loopholes and exclusions to boot)?
102: It seems entirely possible that premiums will increase--surely at least some of the money insurers save by doing everything they can to avoid insuring sick people or paying claims is passed on to policyholders in the form of lower premiums.
No. when insurance companies are doing well in the markets (recall: insurance comapnies are finance companies that raise money by offering money later in specified circumstances for a regular income stream now) they only raise prices a little. When the market tanks they all start complaining about how lawsuits are bankrupting them and then they raise rates. Since they tend to behave in a cartel-like fashion, basically, the only way to force rates lower is people to run uninsured.
The example I used in Yggle's comment section whenever that was, was automotive liability insurance. Back in the middle/late 80's sometime, the TX D's had majorities in both houses (but these would be Blue Dog type D's mind) and the insurance companies were unhappy. The deal was, was that about 20% of all drivers were uninsured and no one was buying liability insurance. (I did!) So when an insured driver and an uninsured driver collided, the insurance companies had no one to get money from. So they wouldn't pay. Then people would have to sue the other driver, who often didn't have any money to pay for medical care. Not so good.
So the D's proposed mandating liability insurance. Just before the Lege session opened the proposal was to tax all drivers a set amount and then make a pool and pay off the injured with that. Well, that was denounced as ungodly, unamerican, and probably homosexual. Also, it would force insurance companies to reduce rates on full coverage. (Or rather, the state insurance board would force that.) That was deemed ungod, so eventually the plan they settled on mandated that all drivers purchase liability insurance. Also, the uninsurable would be folded into a state insurance pool and the poor would get a subsidy. The law was written to make it difficult to get into the pool or get a subsidy. Then they made it a misdemeanor to drive while uninsured.
The numbered of uninsured drivers plummeted. Then, over the next coupla years, the mandated liability insurance rates headed upwards at a steep angle. The full coverage rates went flat (except for increases for inflation), whereas both rates had been rising in parallel to each other. (I know this because the DMN published a graph with insurance costs over a ten-year period.) It was clear as day that the insurance companies were jacking their rates up because they could - and the promised reduction in collision rates came by failing to increase them. Until the recession of the early 90's when collision rates started rising again, ostensibly due to excessive torts. (The stock market was flat and real estate prices had collapsed.)
Mind, Texas has always had a highly competitive auto insurance market - there are a shitload of companies (or fronts, at any rate). Nonetheless, rates never go down, they always go up, almost always faster than inflation. In fact, I think one year an insurance company (illegally) raised its rates higher than the insurance board allowed increased, and the company had to rebate some money. During the time period, it should be noted, accident rates per cap fell. Nonetheless, excessive torts breed like flies, apparently.
So when people talk about increased competition (amoungst a four-company monopoly) resulting in reduced premium costs, well, I admit I don't know what to say. I'd have the same reaction if someone here blogged about a pig flying out of their ass: .... what? Pardon?
max
['Is that a language that sounds just like English, or did you actually say a literal pig literally flew out of your literal ass?']
I'd have the same reaction if someone here blogged about a pig flying out of their ass
Well, I tried to get heebie to let me guest post on that very topic, but apparently she does have some standards.
131: wait, you quoted me, and then said "no", and then went on at length to agree with a lot of what I've said in this thread (with the helpful parallel example from the auto insurance world).
I wasn't actually claiming that health insurance premiums ever actually go down, mind you, just that if we passed all the no-rescission- annual-cap-etc.-etc. insurance reforms all on their own it's plausible to think that premiums might go up (rather than just seeing profits go down).
116-119:No, the cap on out-of-pocket is in addition to the price of basic insurance and may not cover everything (dental? eyecare?)
The best House plan puts a total at around $15-20k a year for a family of four making $66k. The $5k gap depends on tax deductions available, since Medcare comes off gross.
All the plans suck.
Comparison of House to Senate (Baucus) Ian Welsh working off Marcy Wheeler with help from Dave Johnson
The difference is that the House plan limits premiums to 10% of gross income at 300% (pg 137, pdf), and out of pocket expenses to $10,000 per family.
Dave Johnson helps with the tax adjustment.
So, 13-17k? 3-5k for an individual? Buy our standards maybe bearable, by world standards 2-3 times as much pain
(But as healthcare costs rise, and they sure as shit will, and maybe skyrocket, what happens?)
125
The individual mandate should lower individual premiums significantly by bringing the health people into the pool, although it will not lower total national health care costs. The major reason individual market costs are so high is that only expensive people buy.
I don't the believe the plan will actually suceed in screwing over enough healthy people by forcing them into the plan to lower premiums. Or that this is even possible.
126
So you say the real problem isn't the insurance companies that liberals like to demonize, and for evidence you cite Ezra Klein, a liberal. I just don't get how you think.
It's called an declaration against interest and is usually considered to have added credibility.
dday at Hullaballoo found a cute little clause buried deep that will nullify all state regulation and make it nearly impossible to sue health insurance companies. Will it sneak thru? Well, worked for credit cards. I love lawyers.
I will not trust anyone until and unless it is an all-out screaming war, with insurance stocks tanking to zero and doctors leaving en masse. (PS:Just like finance, health insurance was much better as mutuals than publics)
I am supposed to believe that my guys are sneakier and stealthier than their guys. We are gradually foolin' them into decent single payer. This is exactly how the economy has gone for the last decades, right?
129
I have no idea what this means. You think there should be no, or fewer, insurance regulations? (What about the COBRA coverage you have right now? Is that a good idea?) I thought you were complaining upthread that currently the "freedom to buy the coverage you want" isn't worth shit since the coverage that's on offer from private insurers is unreasonably expensive (and probably full of plenty of loopholes and exclusions to boot)?
It's unreasonably expensive because New York has already required the community rated, no exclusions, gold-plated plans that you all think are so great you want to mandate them nationally.
138:Shearer, most of their commenters no longer trust Ezra Klein or Matt Yglesias, which is why my links come from Digby, Firedoglake, Open Left.
Maybe that means you should check out EK and MY now.
It's called an
I thought that this particular phrase was outdated-- "It's called profit" to explain the high price of the fancy new CDs that just came out.
133: I wasn't actually claiming that health insurance premiums ever actually go down, mind you, just that if we passed all the no-rescission- annual-cap-etc.-etc. insurance reforms all on their own it's plausible to think that premiums might go up (rather than just seeing profits go down).
Sorry Brock - I was taking aim at the idea, rather than at you.
127: But (a) Democrats like Max Baucus are conservative, and (b) liberals in government would be doing more if not for fear of right-wing reactions, from criticism to assassination (it's happened). That may be wishful thinking on my part, but if not, surely it's fair to give conservatives at least some of the blame.
Well:
On July 20, I wrote that it looked like the White House to get something passed was by running a "co-op crunch," whereby the Senate passes a bill with co-ops and the Blue Dogs refuse to vote for anything else in the House. Far from opposing the White House on health care, the Blue Dogs have been the vehicle for jamming any House bill with the deals that the White House and Baucus cut with lobbyists representing PhRMA and the hospitals. Which is why Rahm Emanuel has been so emphatic about protecting them on health care.
But by July 30, as Scarecrow noted, Conrad "has so far declined to provide more than a vague definition of his co-ops and has yet to explain how such entities could function." So how did Mike Ross apparently know what the Conrad plan would be on July 31?
Of course it's possible Conrad just cribbed his plan from Mike Ross. If that's the case, it means that the Blue Dogs are the authors of the co-op plan in the long-awaited Finance Committe bill. Or, as Walker notes, that there was another source that distributed language to both.
On May 11, the White House received written proposals from PhRMA, the AMA, the device manufacturers, the hospitals and the insurance industry for "voluntary" cost cutting. Those proposals apparently became the basis for deals that the White House cut with these stakeholders, the details of which are still not know, but which appear to have been memorialized in Max Baucus's bill.You see where he's going with this? Point to bob: I said previously that I didn't see any evidence that Baucus was
It may be that the reason the WH did not put out a bill, is because they did put out a bill - they gave it to the Blue Dogs and Baucus to bring into public view. The Blue Dogs gets what they want, and the WH doesn't have to take the blame for lack of the public option, etc.
My my my.
max
['They were expecting more R support though, I'd expect.']
community rated, no exclusions, gold-plated plans that you all think are so great you want to mandate them nationally
Who's "you" there? I'm not sure that part of these bills is any more popular around here than the other parts.
I'm personally blaming the democrats much more than the republicans on this one. The R's are just doing that crazy thing that they do. The Dems, on the other hand, gave up their biggest bargaining chip (single-payor) before the party even started as a sell-out to corporate interests, leading to a virtual nullification of half of Obama's campaign promises.
144: The R's are just doing that crazy thing that they do.
Agree. This debate is only tangentially about health care for them. It is almost entirely part of 1) attempting to delegitimize Obama and the Dem majorities in Congress and government itself and 2) denying a Social Security-type victory to the Dems. Getting to specifically cater to the moneyed parts of the healthcare world is just gravy. And by retreating from any strong notion of universal healthcare as a key element of the general public welfare, or as an essential underpinning of the security of the country, the Dems have handed them the stage.
Prove me wrong tonight, Obama, let your seekrit socialist flag fly!
I am supposed to believe that my guys are sneakier and stealthier than their guys.
I guess you're supposed to believe it, but lord knows I've never seen any evidence of it.
This is from a comment from "Barbara" over at MY's
As I said in a previous post, providers are simply never going to consider making a trade off on their own reimbursement when they perceive that it will simply go to the benefit of an insurer.>
Look, doctors, drug companies, and medequip manufacturers are not as bad as FIRE. Drug companies prolonged my mom's life for years with free samples with huge nominal losses (although that might have been a tax break for them.) Providers took huge losses on her.
Providers, for the most part, hell almost entirely, want to help people.
Providers are not leaving Europe en masse, are willing to accept a more reasonable income. Why the fuck do they go thru their hells? But fucking not if their sacrifice go to Hospital shareholders and Insurers and Goldman Sachs instead of patients.
Obama understands this, and refused to listen to his family doctor (22 years) and personal friend who advocated for single-payer.
It's unreasonably expensive because New York has already required the community rated, no exclusions, gold-plated plans that you all think are so great you want to mandate them nationally.
Do you not get it, or are you just deliberately obtuse when it comes to liberal ideas? Community rating is expensive only when there's no mandate for healthy people to purchase.
On single payer, it makes by far the most policy sense if you go in a government direction. I think front-line providers would end up happier under such a system too -- their incomes might drop somewhat, but their working conditions would improve.
150
Do you not get it, or are you just deliberately obtuse when it comes to liberal ideas? Community rating is expensive only when there's no mandate for healthy people to purchase.
I understand the liberal theory but I don't believe it will work in practice. As I said above I don't believe you will succeed in forcing enough healthy people into the pools. And I don't believe it adds up arithmetically even if the mandate is effective. Most healthy people are in employer pools which will remain separate. What rate are you expecting to achieve?
And the New York plans aren't just expensive because of community rating. They are also gold-plated requiring all sorts of benefits that I might prefer not to buy.
They are also gold-plated requiring all sorts of benefits that I might prefer not to buy.
I don't think it's viable to only sell people the benefits they want to buy. Or, rather, the only way to make money selling a limited selection of benefits is by charging as much as you were charging for the full set.
150
I don't think it's viable to only sell people the benefits they want to buy. Or, rather, the only way to make money selling a limited selection of benefits is by charging as much as you were charging for the full set.
This doesn't make sense to me. A limited set of benefits costs the insurer less so they can charge less for it.
My cable TV provider sells a basic plan as well as premium plan. I don't see any requirement that they be losing money on the basic plan. As I understand it NY insurers aren't allowed to offer the equivalent of a basic plan.
Most developed countries where private insurance is a segment of universal coverage have community rating (Australia, the Netherlands).
The people in these pools will include the self-employed and employees of small companies, which seem to me just as good a risk pool as those with employer-provided insurance. They will also admittedly contain high-risk people who can't get care; in the long term, it's better to spread that burden out over the entire population.
The single-payer smear was gratuitous. Single-payer advocates in the U.S. don't support Canadian-style "severe restrictions" on private insurance.
Why would we want to watch Obama?
Evil grin and thumbs-up from McCain.
Unequivocal yes to mandates. Yay for the insurance industry!
162: They wouldn't stand up when the guy called death panel rhetoric a lie? Sweet Christ, what loathsome people.
Yeah, that was what prompted 162. Also, whatever that crazy screaming and booing was when Obama mentioned illegal immigrants.
What was that document those guys were holding up?
And now they sit and glower at the idea that Americans should have an affordable choice for healthcare.
163: Well of course Bave, it's not like the free market is strong and self-sufficient; it needs all the support we can give it. Where's your empathy?
For example I would prefer to purchase insurance with no mental health coverage whatsoever. (Since I think mental health care is mostly psuedo-scientific witchdoctory why would I voluntarily buy such coverage?) But I am likely to be denied this option.
Seriously, Shearer? I'm not really going to argue with you about this, but if you had a child or relative who was hearing voices and seeing things, you wouldn't want them to be able to see a psychiatrist to be prescribed an antipsychotic, because that's what plans which provide no mental health coverage, e.g., Whole Foods do. "No payment shall me made to any psychiatrist" is the way they put in the summary of the plan.
Good speech, good for him. Maybe you disagree with him, but he's speaking straight and elevating the discussion (not that that's hard). One of things I like about him is he doesn't talk down to the public and tries to be honest. About time he called out the Reps (and Baucus).
And now they sit and glower when he says he will protect Medicare. Psst, guys, you're blowing your cover!
Yeah, I am watching and listening.
The glowering was hilarious, accompanied as it was by whispered asides. "Protect Medicare? Can you believe this guy?"
They Republicans are fucking children ... and they're acting like immature assholes at this speech as well.
They Republicans are fucking children
Thank god they're not showing that on TV!
They Republicans are fucking children
I read that adjective there as a verb at first.
I'm feeling as though it was a good decision to skip watching the speech.
146: Yeah. Although maybe if LBJ were still around....
I would prefer to purchase insurance with no mental health coverage whatsoever.
Shearer, I am torn between thinking you are a useful reminder of the slice of the American population that sees the health of one's brain and emotions as basically akin to visual and dental insurance (!), and being mildly appalled that you (apparently) think so. Or are you just trolling again?
Just before the Lege session opened the proposal was to tax all drivers a set amount and then make a pool and pay off the injured with that. Well, that was denounced as ungodly, unamerican, and probably homosexual.
Molly? Is that you? You're missed, I hope you know.
That McCain grin was something else. Lugar looked pissed when they said that everyone should get coverage.
My sleep doctor hates paperwork and totally wants single payer.
At least, he called the death panels a lie.
My sleep doctor hates paperwork and totally wants single payer.
As would I in his place! (As do I in reality, too.)
I've spent a lot of time being pissed off at Obama lately, but it's hard to imagine how anyone could watch this and not see him as a basically reasonable, conscientious guy trying to herd a crowd of puerile adolescents.
slice of the American population that sees the health of one's brain and emotions as basically akin to visual and dental insurance (!),
But those are important too, Witt. Every kid ought to automatically have dental coverage, since sealant and cleanings might help prevent cavities, and dental health is tied to other disease like heart disease.
183: yup, exactly. I do respect the guy. If he really represented the American center then we'd be in pretty good shape.
183: It really is rich that the Repubs are always treated as the "adults being in charge" when they come to power.
182: It's a she. She only pays attention to Medicare regs.
CBS News just said that Obama said "No public option."
Have to go pack.
CBS News just said that Obama said "No public option."
fucking press. All a game.
182: It's a she. She only pays attention to Medicare regs.
Shame on me. Especially given that my doctors at the moment are all women, as is every friend of mine in med school or residency.
183:
I feel the same. I've been pissed that he's been so absent from the national stage and not providing more direction to the shambletastic way that congress has been proceeding. If this works though, maybe he played this right.
It wasn't a speech for me, but that's probably for the best. I'm still not convinced that we're going to get what we need out of this, but it seemed a smart move and it was good straight talk.
And Stephanopoulos (I'm paraphrasing slightly): "I've never heard anyone shout out the word "lie!" in a president's speech. That shows a kind of fearlessness in the opposition. On the other hand, I've never heard a president in a speech before a joint Congress use the word "lie" to describe his opponent's claims."
I'm still not convinced that we're going to get what we need out of this
You and me both. Bleah.
Ugh. I can't listen to any talking heads or Republican counterpoints.
I've never heard anyone shout out the word "lie!" in a president's speech.
Imagine if someone had done it all those times when the president's speeches were actually full of lies!
those are important too
Yes, for sure. However:
1. Very few Americans are going blind from preventable diseases.
2. Very few Americans are dying from dental health problems.
3. Even many people lucky enough to have insurance in the US right now still have plans that bracket out vision and dental as "options."
So while good eye care and mouth care are extremely important, most of the time you aren't going to die or suffer loss of a major life function from not having access to coverage. Even if you decide to pay out of pocket, it's unlikely to bankrupt you.
In contrast, not having mental health coverage as a 20-year-old who develops paranoid schizophrenia out of nowhwere, or a new mom who finds herself living with severe postpartum depression, can literally kill you. Or ruin your own and your family's lives both financially and otherwise.
So yes, going to the eye doctor is important, and I regularly send off my old glasses to New Eyes for the Needy. And yes, good dental care is important, and I always make sure the people I know without coverage are aware of the low-cost services through dental schools. But I honestly don't think vision and dental are even in the same realm as mental health parity.
"Waste & abuse"
"no addition to the deficit"
"paid for from existing funds, new efficiencies in Medicare"
I think Robert Reich tells the story about LBJ. That LBJ's economic team told the President that Medicare would be much more expensive than predicted and unaffordble in the current budget and LBJ kicked them out of room...and lied about the costs.
I think Robert Reich tells the story about LBJ. That LBJ's economic team told the President that Medicare would be much more expensive than predicted and unaffordble in the current budget and LBJ kicked them out of room...and lied about the costs.
So do you think Obama is doing the same thing, or does he actually believe that effective cost savings can happen that quickly?
But I honestly don't think vision and dental are even in the same realm as mental health parity.
I think they are. Dental especially can truly fuck up your life if you don't have it. And unlike mental health care, cures are clear, proven, and 100 percent effective.
197:I think in the speech, which should be available somewhere now, Obama expressly said that if costs exceed projections, he will find spending cuts to make up the difference.
This doesn't make sense to me. A limited set of benefits costs the insurer less so they can charge less for it.
Does it, though? You don't want mental health coverage beacuse you think a lot of mental health coverage is useful, so the insurance company is not likely to have to pay a huge mental health claim on your behalf even if they offered you the benefit.
My cable TV provider sells a basic plan as well as premium plan. I don't see any requirement that they be losing money on the basic plan. As I understand it NY insurers aren't allowed to offer the equivalent of a basic plan.
I was actually going to put in something about how this is why a la carte cable subscriptions don't work like people would hope. Cable companies bundle ESPN and HGTV; insurance companies could offer "buy maternity coverage, get prostate cancer coverage free!"
Adverse selection really matters in health insurance.
But I honestly don't think vision and dental are even in the same realm as mental health parity.
Disagree, as someone who literally can't see more than a few inches in front of my face without vision correction and needs expensive, specially fitted, gas-permeable lenses that I can't afford on my own. Nor can I afford to get a new pair of glasses, as if I don't pay for the extremely expensive, light-weight lenses I get tension headaches from the weight of them. (I get these even with the light-weight ones, just not as often, and they can be crippling). As such, my glasses are a good 8 years old. And I have straight-forward vision problems, no disease.
(Sorry, just have to speak up for the nearly blind among us.)
198: Well, maybe I'm looking an an unrepresentative sample, then.
Or maybe it's just that I know four places in this metro area to send a person who needs low-cost dental care, whereas every time I've had to deal with a mental health crisis it's been an exhausting and horrific series of phone calls to find out that no, really, there isn't any option. Sorry. No. Wait four months. No. Call 911. No. Come back when you have money. No.
I'm willing to believe that is unrepresentative too -- I really don't have anything resembling a full picture.
(Although: Happy coda to my complaints from the other day! The most recent call to a school of public health elicited a magic website link for immediate free electronic access to all student theses published 2008 or later. So maybe in the future I'll be better informed on health questions.)
Though not to say that mental health care isn't a huge priority of mine as well; one of my recent projects has been trying to figure out what mental health care options would be available for the uninsured and very poor, as I would like to recommend something to a friend's sister that I think could use some extra help.
202: Well, I did write 195 as a card-carrying member of the borderline-blind Americans, and I've spent a whole lot of money on eye care over the past 25 years. Based on my own (again, biased and possibly unrepresentative) sample, I'm still not convinced that lack of vision insurance is as serious a threat to health and welfare as MH.
But we can agree to disagree, because under the mess that is health care reform, odds are good that neither will be covered! /sarcasm
I don't think we really disagree, I just want everything covered and a pony too. Sorry to be so contentious.
You want farm animal insurance? Sorry, that is just too far.
Someone's gotta take care of ol' Bessie.
What do I think of Obama after almost two years of watching him? I think he just admires the hell out of Ronald Reagan.
I think he really really does not want to raise taxes.
I think he does not really want to increase the size of gov't, and trusts the free market.
I think he wants a strong military posture overseas and a strong defense. Maybe less Wilsonian than most of the last Presidents.
I think he really believes tweaks and reforms, finding efficiencies and better management techniques can solve most of our problems.
I think he really wants to create a lasting governing majority, by the above, by imprinting a governing philosophy on the young and making them feel like a vanguard generation. As Kennedys and Reagan did.
I think in the speech, which should be available somewhere now, Obama expressly said that if costs exceed projections, he will find spending cuts to make up the difference.
I've been thinking about this (and I was also underwhelmed by how much of the speech consisted of fencing off things that wouldn't be included in health care reform). I think what legitimately worried Republicans is that there aren't a lot of ways to insure that the Democrats are arguing in good faith on something like spending cuts.
I mean, think about the debate around the Bush tax cuts and how many republicans were saying, "oh, of course we will try to scale these back if the economy suffers too badly." Everybody knew they were lying because they were.
Didn't EK have a post recently about how "triggers" get talked about a lot before big bills but very rarely make it into legislation?
169
Seriously, Shearer? I'm not really going to argue with you about this, but if you had a child or relative who was hearing voices and seeing things, you wouldn't want them to be able to see a psychiatrist to be prescribed an antipsychotic, because that's what plans which provide no mental health coverage, e.g., Whole Foods do. "No payment shall me made to any psychiatrist" is the way they put in the summary of the plan.
Do they cover the drugs? Can other doctors prescribe the drugs?
Basically I don't want anything covered that hasn't passed the same tests for efficacy that are required for new drugs. It is understanding that the classic talking to a psychiatrist about your troubles treatment has never been shown to be effective.
I think what legitimately worried Republicans
I'd be more comfortable with the word 'legitimately' in there if they hadn't been systematically making cost-control measures politically impossible.
195
In contrast, not having mental health coverage as a 20-year-old who develops paranoid schizophrenia out of nowhwere, or a new mom who finds herself living with severe postpartum depression, can literally kill you. Or ruin your own and your family's lives both financially and otherwise.
It is my understanding that there is no effective treatment for paranoid schizophrenia.
There's no cure, but there are drugs that help people maintain.
I predict that just as "stupid"was spun against O in the Gates case, so too will "lies" be spun against him. People who tell lies are liars. Who is he calling liars? How dare he! (Never mind the truth of it.)
I'd be more comfortable with the word 'legitimately' in there if they hadn't been systematically making cost-control measures politically impossible.
Oh, I don't think their behavior has been at all responsible or justified.
But I do find myself thinking that it's always likely, if you're in the minority party and the other party is proposing something on the scale of health care reform (invading Iraq, for example), that you would worry that you were being sold a bill of goods.
That isn't to defend the behavior of Republicans, simply to say that the mere fact that they are worried that the presented goals won't match the ultimate outcome is not what makes them crazy.
Thinks about that a little more, the real question is who will end being in charge of implementation. Part of what made the debates about the Iraq war so frustrating after the invasion was that there were so few opportunities for oversight. In an ideal world the opposition party would be saying, "okay, we don't think this will accomplish what you say it will, and we want some negotiated way to have a say in how the legislation actually gets implemented." I'm not sure what that would look like, but it wouldn't be an unreasonable thought.
There may have been something else. I was saving up on triggers for when they looked probable.
I don't know why I listened to this speech. I don't play poker with guys with a state in their name, and I shouldn't let Obama try to sell me something.
200
Does it, though? You don't want mental health coverage beacuse you think a lot of mental health coverage is useful, so the insurance company is not likely to have to pay a huge mental health claim on your behalf even if they offered you the benefit.
But they will pay the benefit to others so my rates will be higher. Same as if you put smokers and non-smokers in the same pool.
I was actually going to put in something about how this is why a la carte cable subscriptions don't work like people would hope. Cable companies bundle ESPN and HGTV; insurance companies could offer "buy maternity coverage, get prostate cancer coverage free!"
I am not talking about a total a la carte plan, just different bundled levels of service like basic and premium cable. If I recall correctly the Yankees network tried to get a law passed that they had to be included in the basic cable bundle but failed. It is my understanding that New York medical service providers have been more successful at getting mandatory inclusion.
Adverse selection really matters in health insurance.
This is true which makes community rating problematic.
Ezra Klein on triggers.
The problem is that there's no real constituency for that compromise: Liberals want a public plan because they want a public plan. Conservatives don't want a public plan because they don't want a public plan. Moreover, conservatives don't just oppose the public plan, but most of them actually oppose passage of a bill. The number of additional votes you can get by making substantive concessions is thus much smaller than the number of additional votes you could get if substantive concessions were actually the sticking point.
It is understanding that the classic talking to a psychiatrist about your troubles treatment has never been shown to be effective.
Ummm, yes talk therapy has been shown to be effective, as effective as anti-depressants. You need to check out the actual research.
205
I don't think we really disagree, I just want everything covered and a pony too. ...
Which is why it is hard to believe the plans will reduce costs.
219
Ummm, yes talk therapy has been shown to be effective, as effective as anti-depressants. You need to check out the actual research.
Links? It is also my understanding that the evidence that anti-depressants work is fairly weak.
220: That was a joke! And I do think that if I had had dental insurance over the last 10 years, I would have had preventative care that was relatively cheap. But I didn't, and I know that the next time I finally get to the dentist's office I'm going to be paying, and paying, and paying.
202:
As I was going through a crisis of my own this spring (with pretty full coverage) and searching for the first time for a therapist, my friend, who has struggled with severe depression, made the point that the messed up thing about mental health coverage is that when you're in a crisis, which is when most people seek it out for the first time, you have wade through the bureaucracies and somehow locate someone to work with and probably be told that it'll be at least two weeks before you can get an appointment.
This friend round about that same time was trying to make an appointment with a psychiatrist on our soon to be defunct state health plan so that she could get her meds adjusted only to be told that clinic after clinic didn't take it. This seems like something that would need addressing with the public option too.
210last:That's just wrong and dumb.
221: dude, aren't you qualified to do your own googling? Anyway, here's one
http://health.dailynewscentral.com/content/view/000592/77/
I think in the speech, which should be available somewhere now, Obama expressly said that if costs exceed projections, he will find spending cuts to make up the difference.
This forces the CBO to score the spending cuts, making it more likely that it will pass and opening more room for Chuck Schumer to muscle it through via reconciliation if needed. Just saying, "We assume there will be cost reductions" doesn't make the CBO do anything, even though everyone thinks there will be cost reductions.
I think Robert Reich tells the story about LBJ. That LBJ's economic team told the President that Medicare would be much more expensive than predicted and unaffordble in the current budget and LBJ kicked them out of room...and lied about the costs.
On the other hand, Obama said "spending cuts" and not "nut-cutting", so sharpen the pitchforks!
225:On the other hand, Obama said "spending cuts" and not "nut-cutting", so sharpen the pitchforks!
Hey I watched Danton this morning. Nut-cutting is accomodation.
Just got off the phone with my Republican Baptist anti-choice mom, who reports that Obama's address clarified every issue she was worried about and she's fine with his plan now. I haven't listened to it or read the thread, but I am guessing this means we're sold out?
I've been occupied for the last couple of weeks and hadn't listened to the news at all; today I listened to (chiefly) NPR -- radio reporting -- and the extent to which discussion of the health care reform debate presented the scenario as a dubious proposition altogether was striking.
Whatever the public is hearing, even on NPR it sounds like a jumble of confusion and gobbledygook. I thought fleetingly of Emerson's diatribes over the state of the media.
On preview, I'm tickled pink by AWB's mom's conversion.
AWB: Obama's speech ended grandly, but midstream it assured the public that no way, no how, would any reform bill fund abortions or health care for illegal immigrants (or kill your grandma). It's unknown what your mom was worried about.
no way, no how, would any reform bill fund abortions
Oh, I didn't catch that bit. That's what I get for trying to read and write comments on Unfogged and watch the speech simultaneously.
Hi.
Yeah, on the abortion thing as well as many other things, there was, well, a lot of unclarity on specifics. I imagine conservatives can continue with many of their charges if they feel like it.
I recommend taking some time away from the computer screen!
231: I think the abortion part got buried by the nutjob yelling (in fucking Congress, for fuck's sake). I certainly missed the abortion line when listening. Here's the text of that part from HuffPo:
There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false - the reforms I'm proposing would not apply to those who are here illegally. And one more misunderstanding I want to clear up - under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
It's no surprise to me that Obama is to my right on policy, but I am heartened to find that my mom has not secretly joined some kind of creepy OBAMA=HITLER cult and is willing to hear the guy out. She repeated several of his talking points to me, not just about the abortion thing, but telling me how bringing down health care costs is important, and so forth. What I get from that is that, whatever he may have said, he said it in a way that was calm, clear, and rational enough that even someone with a pretty wild trigger can hear him out, understand his points, and repeat them with clarity and passion. And deep down, yeah, that's what I wanted him hired for.
Yeah, that "you lie" doofus. WTF? Apparently in his apology he said he's sorry but he's entitled to his opinion. This doesn't make sense to me. It's your *opinion* that the President is lying? It's your *opinion* that the bill says it will fund health care for illegal immigrants? These are not opinion-based things. They can be checked out.
It is, of course, possible that he said "you blave!" and was making a comical, if quizzical, Princess Bride reference. Those zany Republicans! Always with the quirky references!
The abortion stuff is directed at Catholics, a bloc that once voted reliably Democratic and no longer does. I can't find a good link, but I'm reasonably confident that a huge group of religious leaders, many of them Catholic, recently came out in support of health care reform. That line was for them. Newsflash: Obama wants to hold the center, including non-nutso religious people, more than please the left.
I find the outrage over someone shouting at the president much more off-putting than the shouting itself. The man is the elected leader of a republic. He's just a guy; he has no divine right to rule. The outrage is making me wish that people shouted more often in congress and at the president. Anyway, it's not like someone caned him.
By the way, my transformation to bob mcmanus is complete. The surgery actually hurt much less than you might guess.
I find the outrage over someone shouting at the president much more off-putting than the shouting itself. The man is the elected leader of a republic. He's just a guy; he has no divine right to rule.
Exactly.
Newsflash: Obama wants to hold the center, including non-nutso religious people, more than please the left.
Insisting that the federal government not spend any money on abortions is not nutso?
How is it possible that the government could actually end up funding zero abortions? Seems like either a humongous sellout or a lie to me. And if it's a sellout it will require some sort of new and highly effective anti-abortion bureaucracy. Is there something in the bill that re-instates the Global Gag Rule?
238 gets it right as welll.
Newsflash: Obama is a conciliator, or triangulator, or mediator ... or conservative, if you will. Or he just wants to pass a fucking bill that has any chance of passing. There was a largish section of the speech devoted to the proposition that starting over from scratch with a progressive single-payer plan or with a Republican plan to eradicate employer-provided insurance altogether were both unworkable (too much change, you see).
Insisting that the federal government not spend any money on abortions is not nutso?
It's the law. (It's an incredibly shitty law, but it's the law.)
Being the law and being nutso are not mutually exclusive.
239: Before your transformation to bob mcmanus is complete, my child, you must first review the 3 movies you saw on cable tonight.
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Important news. Hef has filed for divorce.
Rabbits rejoice.
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I was sort of heartened by the bit of the speech where he emphasized health care as a moral issue. I don't think the Democratic party does this often enough. Health care? It's a moral issue. Cutting greenhouse gas emissions? It's a moral issue. Reclaim that mantra from the Republicans. It's so discouraging to hear things primarily discussed in terms of what they cost, how practical they are, whether they're what the American people want, whatever. Fuck that. Sometimes something is just the right thing to do.
Ben Alpers' comments at EotAW are good.
Is there really outrage over Wilson's outburst? At any rate, listening respectfully doesn't suggest that the president has a divine right to rule; it's just decorum. And while it might be fun sometimes if our congresspeople yelled clever insults at each other the way they do in the British Parliament, the greater likelihood is that it would just devolve into the same idiotic, testosterone-fueled bellowing we've been hearing at the town hall meetings. Fuck that. That said, I wouldn't have minded if Pat Leahy had punched Cheney in the face when Cheney told him to fuck himself, but the initial breach of decorum was the VP's.
The thread's moved on, but I'm still catching up:
specially fitted, gas-permeable lenses
I miss those. My eyes basically rejected them after I had an eye infection that forced me to wear glasses for a few weeks. I'm on soft lenses now, which are easier to order and replace - and the optometry visit is the same - but the vision just isn't as sharp. It also took about 4-5 months of disconcerting blurriness to settle on the right kind, totaling over 10 visits from the end of hard lenses to the adoption of soft lenses. Almost all of that was, fortunately, covered under a student plan (except the co-pay).
Incidentally, vision care sometimes just means optometry. Medical conditions involving the eyes might be covered under the regular medical plan, as happened with my eye infection. If that hadn't been covered, it would be a serious problem. Not having glasses/contacts covered is still a problem, but not at the same level.
(essear wants to talk about the grand part.)
Rachel Maddow declared, in a voice of slight awe, that the concluding portions of the speech constituted what may have been the first ever public political ideological defense of liberalism, like ever. (pause, awe) Or words to that effect.
I was smiling at her, but okay, yeah, the wrap-up in the speech about the American suspicion of government going hand in hand with recognition of the need for it was well done. Does that guy write his own speeches?
252: MSM outrage. And bloggy outrage. Look, I agree that it's not a great moment, yet another symptom of the deep sickness rotting the GOP (and our public discourse) from the inside out. And I agree that if uncensured such episodes may portend bad things. But really, the outrage is a bit much. Obama, again, is just a guy: a brilliant guy, a guy who gives great speeches, but nevertheless just a guy. And the office of the presidency is just the highest office in an ostensibly republican form of government. People are supposed to fill that position, not demi-gods.
And the office of the presidency is just the highest office in an ostensibly republican form of government. People are supposed to fill that position, not demi-gods.
Why do you hate America, ari? Next you'll be telling us George Washington didn't really chop down the cherry tree, and Benjamin Franklin didn't invent the internet.
I don't know, ari. Yelling out was a wink to the same teabagging types that have showed up with bully tactics at town halls. "Keep it up, guys!" it seemed to say. He's free to yell out, but calling bullshit over it is also okay, since, you know, he's yammering bullshit.
Anyway, I don't see how calling out Wilson for his breach of decorum makes Obama a demi-god. Wilson acted like an asshole; censure him, cane him, whatever. But saying that the lesson to be learned is that the president is just a man? I knew that.
And while it might be fun sometimes if our congresspeople yelled clever insults at each other the way they do in the British Parliament
I must note here, too, that calling someone a liar is generally deemed unparliamentary language, even in nice raucous places like the House of Commons.
The outrage is making me wish that people shouted more often in congress and at the president.
DAMN RIGHT
Stanley, there's saying that it's more of the town hall bullshit and then there's the wringing of hands. It's the latter that doesn't sit well with me. For example, when Rahm Emanuel says that no president has ever been treated this way, I want to puke my guts out.
All of that said, I'm not especially outraged over the wingnuts* who show up at the town halls, either. The ones with guns creep me the hell out, sure. But your basic winger shouting a bit, well, that's part of the process as far as I'm concerned. And the more that Independents are confronted with the depraved clusterfuck that is movement conservatism, the better off we're all going to be over the long run.
* And yes, I know that a lot of what we've seen is astroturfed bullshit. It grosses me out. I disagree with it. But I'm not outraged by it. Frankly, I'm far more outraged that Obama waited this long to make a fucking speech before congress. If he really wanted the bill passed before the August recess, he should have gotten off his ass sooner.
259: I'll say it again: I'm not opposed to calling Wilson out. It's the aggrieved tone, the "how can anyone treat the president this way?" rhetoric that gets my back up.
For example, when Rahm Emanuel says that no president has ever been treated this way, I want to puke my guts out.
Hair-trigger gag reflex? I mean, it's a stupid exaggeration, but puke your guts out? That's the kind of boilerplate political rhetoric that gets to you?
Proper decorum is: "I call to the attention of the Speaker and Senate Majority Leader that the distinguished gentleman from the District of Columbia is lying."
If the guy yelling hadn't been a congressman, he would have been arrested for yelling that. If it had been at a Bush Jr. speech, he would have been arrested and then waterboarded.
260: Indeed, and the raucous stuff is for question time, not for a prepared speech given by the head of state.
263: The aggrieved tone, ari? Good God, man, it's the fucking Internet.
264: Partly it's that it's Emanuel, who's apparently the prime mover behind ditching the public option in the executive branch. So I'm ready to puke about almost anything that shande far di goyim has to say. But yeah, I also have issues with the idea that presidents should be treated like kings.
And the office of the presidency is just the highest office in an ostensibly republican form of government. People are supposed to fill that position, not demi-gods.
All true. And yet the likely effect, and the intended effect, of this and similar nonsense isn't to remind people that the president is just a guy, but to convince people that Obama is just a guy, and thus not a real president. And, let's be honest, that a black Democrat with a funny name can't possibly be a real president.
It's annoying.
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I can't imagine being fit enough to be able to do thirty of these in one minute.
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Good God, man, it's the fucking Internet.
No, it's not; it's the president's chief of staff, trying to score political points on the cheap by setting up his guy as beyond reproach. And it's also the New York Times. Did you click the link?
So I'm ready to puke about almost anything that shande far di goyim has to say.
Strong words from the man who was willing to sell out for some of Brian Leiter's Christmas hams.
269: I'll say it one more time: I don't support what Wilson did. I just think the tone of the outraged response is way over the top and emblematic of a move to put the president on a pedestal. It would be healthy, I think, if the American electorate recognized that our elected officials, including the head of state, are just people. In fact, it would be healthy if our elected officials, and their chiefs of staff, made this point themselves.
272: I'm so bored by my own argument that I might cry. So do let's talk about Leiter's hams. I'll start: they're magnificent.
Ari, you're trying to make me crazy. You linked to a NYT piece and a TPM post. The Times piece did not express an aggrieved tone; it quoted Rahm Emanuel, who did, but he's Rahm fucking Emanuel commenting on essentially the same thing that got Kucinich censured a while back. What do you expect? And the other thing was the fucking Internet. Nobody's saying that presidents should be treated like kings, for God's sake.
That AWB's mom has not secretly joined some kind of creepy OBAMA=HITLER cult and is willing to hear the guy out is making me unreasonably optimistic. That said, 266 is not wrong; the contrast between the chain-linked off "free-speech zones" of yore and the fact that the ones with guns creep [Ari] the hell out is making me less.
275 seconded. It's a wonderful point that presidents ain't kings. But no one said otherwise, and Rahm Emanuel tries to score political points every time a hamster farts.
275: There's no comity here, I'm afraid. I think the reactions have been outraged. You disagree? Okay. Anyway, like I said above, I'm totally bored by what I'm saying. It's a small argument, really, hardly worthy of discussion in the wake of that speech. And I'm totally sick of propping up the sideshow tent.
273: Mixed feelings given that as noted above that we are smack in the middle of an orchestrated campaign attempting to delegitimize the president. So, yeah let's all move to the "he's just a guy" position right now. Maybe we can get a 9-0 decision from the Supreme Court that he should testify in various sundry lawsuits pushed by political enemies; what harm could possibly come from that?
Look, I agree it's some protocol-obsessed pricks quibbling with mega-pricks (who as JM pointed out were previously totally over the top on this in the other direction).
Have I piled on enough? Anything trite left unsaid?
277: You weren't outraged, Stanley? Did I misread the tone of your comments? If so, my mistake.
I'm outraged at ari's outrage at Rahm and the internet's outrage at Wilson's outrage at Obama.
Now I'm outraged. Who does that fucking ari think he is? Some kind of king, or god, or even bob mcmanus? The fucking nerve of that guy.
279.1 is a totally fair point. And my sense that it's incumbent upon Democrats to make the first move in this regard is probably completely stupid. So can we move on to Leiter's hams?
got Kucinich censured
But Kucinich just said that the state of the Union is a lie!
Jesus is right. The Times piece did not read like scandalized outrage. And Duvall is right too -- the message behind yelling over Obama isn't that it's legit to disrespect the President, it's that Obama isn't a legit President.
Etiquette is one of the things that makes institutions run. I'm guessing Ari wouldn't be too happy about people yelling "liar" over the department chair at the faculty meeting. If you want to fight the imperial Presidency (a worthy goal!) start with that horrible quasi-fascist habit of referring to the President as "our commander in chief".
Whoops, delayed too long before posting. Move on.
Really, National Institute of Standards and Technology?
You weren't outraged, Stanley?
I wasn't. Congressman Wilson was rude, but I'm not frothing at the gills about it.
Anyhow, yes: hams. I've eaten ham.
Ari wouldn't be too happy about people yelling "liar" over the department chair at the faculty meeting.
Ah, finally, a topic near and dear to my heart. And, as it happens, you're completely wrong. When the department chair lies, someone should call him on it. If they yell while doing so, that's unfortunate, and probably bad politics, but I'd find it laughable if people later defended the chair by pointing to the august nature of his office.
And again, I'm not defending Wilson. Is that really so hard to understand?
Here's where I misread you, Stanley:
I think the abortion part got buried by the nutjob yelling (in fucking Congress, for fuck's sake).
It was the "in fucking Congress, for fuck's sake" that led me astray, I think.
And again, I'm not defending Wilson. Is that really so hard to understand?
I don't see evidence that anyone's not understanding that.
291: Ah. I meant only that he was being rude and throwing a bone to the astroturfers. No outrage. Does this look like my outrage face? It is not my outrage face.
But really, my cows hams.
292.1: Are you going to make me cut and paste from PGD's comment. Don't make me do it, Stanley. Because I will, you know.
292.2: Like I said, my bad. Okay, I've exceeded my maximum weekly quota of unfogged comments by quite a bit. So now, I'm off to edit. Or swim. Seriously, it's pretty hot here right now, and a dip in the pool might be just the thing.
I would agree that ari isn't not unwrong, but I have to take issue with the extent to which he seems to endow hams with magnificance.
Damn. ari has become me.
I want that surgeon's number.
In other news, The Mist was a great horror movie, and Stuck is one of the few movies in years to make me laugh out loud.
I seriously hope you're kidding about The Mist.
Is that based on the Stephen King story of the same name? (Which, in retrospect, seems a bit like The Birds (film version).)
I believe so. Although I doubt the book version had the same horrifically poor twist ending.
I should have known better than to rely an academic having any respect for the lowly office of department chair, the job every good professor prays he will never have to take.
224
dude, aren't you qualified to do your own googling? Anyway, here's one
Generally I think it is the responsibility of the person making the assertion to provide evidence for it.
I did some googling and found this and this that suggest antidepressant drugs are largely witchdoctory in that most of their effect comes from the patient's belief that they work.
The Mist was indeed an excellent horror movie -- it just took the giant killler insects theme and just rode that fucker to the max. You know they scare you.
In other news, "The Class" is superb. Maybe the best movie about education ever made. But the French secondary educational system looks waaay better than ours.
It should be noted that you couldn't shout `liar' in Parliament; it would be unparliamentary language, and you would be asked by the Speaker to withdraw the remark and apologise.
But ari, what if we happen to elect an actual demigod to the office? What then?
I'll be the first to kneel before her throne, Walt. I promise.
235
Yeah, that "you lie" doofus. WTF? Apparently in his apology he said he's sorry but he's entitled to his opinion. This doesn't make sense to me. It's your *opinion* that the President is lying? It's your *opinion* that the bill says it will fund health care for illegal immigrants? These are not opinion-based things. They can be checked out.
I expect his opinion is many illegal immigrants will end up covered regardless of what the bill says. Like when Bush said the US doesn't torture. If you don't trust the President you don't have to take his word on things like this.
Yes, but we thought Bush was lying, and wouldn't have apologised for saying so.
242 244
How is it possible that the government could actually end up funding zero abortions? ...
Seems unlikely. Current law allows funding for some abortions. Be interesting to know how many in practice.
antidepressant drugs are largely witchdoctory in that most of their effect comes from the patient's belief that they work
You say antidepressants are witchdoctory, I say that the brain is incredibly complex. And at least the second article seemed to say that antidepressants don't work better than a placebo that you believe will work, but as far as I know antidepressants are unusual in that they have a good chance of working even if you don't believe in them.
309
Yes, but we thought Bush was lying, and wouldn't have apologised for saying so.
You aren't Democratic members of Congress. Durbin apology .
311
... but as far as I know antidepressants are unusual in that they have a good chance of working even if you don't believe in them.
So you think antidepressants would work just as well if the patient didn't know they were being administered (they were secretly added to food for example)? I doubt it. Experiments along these lines have been considered but apparently would violate human experimentation guidelines.
Durbin didn't directly say Bush was lying, so the comparison isn't particularly good.
The thing is that saying that Obama is a liar is a very strong charge, and if he doesn't really believe it, he shouldn't have said it, and if he does believe it, he shouldn't have apologised, so saying that he's sorry but he still believes is mad.
Whereas, it is possible that Durbin thinks Guantanamo is a horrible stain, but on reflection realises that not as bad as the gulags.
(But he still shouldn't have apologised.)
The rules of Parliamentary conduct developed in Britain during the eighteenth century when MPs typically had an emotional age of 12 and carried short swords as a sign of their class. They were intended to prevent honourable members disembowelling each other on the floor of the House.
The current climate in US politics leads me to believe that such rules retain their full importance there. Wilson remains a cosmic jerk, but the fact that he was made to back down probably helps to postpone the outbreak of the Second Civil War by a few months.
Adventures in self-referential headline writing*:
"'YOU LIE!' Rep. Joe Wilson apologizes after shouting at Obama as he talked about insuring illegals." [emphasis added]
From FOXNews so what can you expect, but still.
So you think antidepressants would work just as well if the patient didn't know they were being administered (they were secretly added to food for example)?
From what I understand, yes. Slightly less well because of the placebo effect, but yes.
My understanding is that Shearer is substantially right. Metanalyses of clinical trials of anti-depressants don't really back up the claims made for them. That's not to say they don't have any effect at all, but they don't have THAT much of an effect.
I'm prepared to believe that drug company studies exaggerate the benefit. And it's no secret that you havve to try a bunch to find the one that works foe you. But no where close to "ineffective".
321: I found that if you use it's extremities to hit the keys rather than the head it works better.
its its its its its its its its its its its
its its its its its its its its its its its
its its its its its its its its its its its
its its its its its its its its its its its
its its its its its its its its its its its
re: 320
How would you know? The whole reason we have double-blind clinical trials and meta-analyses of multiple trials is that individual anecdotal evidence -- however compelling to the indivual concerned -- is known to be totally unreliable.
Who said I was invoking anecdata?
"it's no secret that you havve to try a bunch to find the one that works foe you"
Sounded like anecdata to me. Sorry if you were basing it on something else.
If a drug works well on 20% of the pop., and there are ten drugs using ten diff. neurologivcal pathways, then most depressed people can get relief.
re: 327
But that isn't my understanding of how the large-scale trials and 'metatrials' actually pan out. I have a copy of a recent book on the topic at home, right now, but haven't read it all yet. I'll try to remember to dig out the relevant material.
I'm prepared to believe that drug company studies exaggerate the benefit.
It's really, really difficult to slip stuff past the FDA. They run their own statistical analyses on the data, and falsifying data can land you in the pokey but quick.
326. A fairly solid body of anecdata, though - it applies to everybody I know whose ever used ADs over an extended period with few enough exceptions that they would represent about the expected percentage of the sample if they hit the right one first time entirely by chance.
There's things like this:
http://content.nejm.org/cgi/content/full/358/3/252
The bigger problem with anti-depressant trials is that, like pain trials, outcomes are very subjective. It isn't like measuring blood pressure or tumor size or T cell counts. Same thing with pain medication studies. We know that pain medications work, for example, but the standard measurement for pain outcomes is having the subject put an X on a 100-mm line, where the leftmost point represents no pain and the rightmost the worst pain you can imagine. That's going to vary from person to person, obviously, and depression is even harder to quantify.
Yes, and also, with the cycling of anti-depressants, a lot of people are just going to get better anyway, so it's hard to tell whether they've hit the medication which _really_ does work for them. I'm not personally a full-blown sceptic, but there is a reasonable scientific literature that seems, over the past few years, to have been pushing back against some of the claims made for anti-depressants of various kinds.
Astonishing, I know, to say this, but isn't this a Shearer misdirection? What matters, from the point of view of his insurance, is not just how (in)effective psychiatric treatment is, but also how expensive it is. I don't think most psychiatric treatment *is* all that expensive compared to heroic anti-cancer medications, major surgery, etc. e.g. Quick google suggests cost of anti-depressants to the NHS in 2006 was just shy of £300 million, or roughly £6 per capita. Even if US health insurance providers were paying massively more for their anti-depressants, or using massively more expensive ones, hard to see it could be more than say ten times what the NHS is paying.
The only thing that would be really expensive in mental health care, I should think, would be dementia (because it involves very intensive care over potentially a very long period). I assume that even Shearer would like to be insured for that.
So non-dementia mental health insurance really shouldn't be a big part of Shearer's insurance per annum. It's like the cheap cable package costs 90% as much as the inclusive one.
Anybody with lard in their handle is okay by me.
On reflection, I retract my 126 and 127. I can't get into too much detail now just because I have a meeting in 10 minutes and I haven't even finished reading the thread, but the obstacle to whichever bill is on the table isn't conservatives, the Democrats are the converatives in this context, I don't feel a need to defend whichever bill is on the table except as being marginally better than the status quo, and Shearer is insane, at least through comment 200 or so.
Single-payer would be ideal, and on a seperate but slightly related note, we need a genuine liberal party. I'm not even sure which issues I would support them on, but if nothing else that damn Overton Window in this country, at least on economics, is well into the comfort zone of an 1890s robber baron and needs to be pushed left. I remember about two years ago occasionally expressing fear about how the anti-current-Republican coalition of everyone left of David Frum would split up and become acrimonious once Republicans would be out of power, and purely for sentimental reasons I was afraid of the divisions that would result between current alliances. Well, I'm ready.
On the 'liar' thing, while I hate the imperial presidency, I disagree with Ari. It's not about respect for the presidency, it's about symmetrical treatment of the parties. When Bush was in office, it was conventional for the media and politicians to treat anyone using the word 'lies' about the crap coming out of the administration as self-discredited -- anyone who would use such language was so blinded by their hatred that they couldn't possibly be right about anything.
I think that's a sucky standard, but it's workable if it's evenhanded -- if the word 'lie' is too horrible to use, you can circumlocute around it. On the other hand, if the standard is that criticism of right-wing politicians has to be gentle and measured to be treated with anything but offhanded condemnation, but criticism of anyone to the left of Attila the Hun gets treated as meaningful and serious regardless of its intemperance, that's really going to (continue to) distort the discourse.
We really have to do everything possible to enforce the same standard of discourse in both directions.
337: Unsurprisingly, I agree with Kucinich.
I don't know why I am perpetually newly annoyed, but why does NPR's story on the public's reactiion to the speech take place at a libertarian meeting in Denver? How on earth is that meaningful or representative?
When Bush was in office, it was conventional for the media and politicians to treat anyone using the word 'lies' about the crap coming out of the administration as self-discredited
Who are you thinking of?
My recollections, admittedly hazy, are of my being incredibly frustrated that no one in any position of authority (media/politicians) would stand up and say "Lies!", not that people were doing so and were discredited for it.
But I could easily be forgetting.
337 -- A party that attracts the left-most 10% of the Dems puts Sarah Palin in the White House. A party that attracts the left-most 80% of the Democratic Party puts Sarah Palin in the White House. I wish we didn't live in a world where Joe Liebernman would be elected in Connecticut of all places, but we certainly did in 2006, and I don't see any reason to believe that we don't still in 2009.
343: I'd have to google for examples (maybe Cynthia McKinney?). Mostly, what I'm remembering is interactions of the form: Democrat says something having as its natural (and perfectly accurate) implication that the Bush administration had said something untrue, and the response was that the Democrat had been self-discreditingly unhinged by implying that there were lies being told.
335, 340: awww.
344: I just don't see how progressives can get anywhere in a system where the acceptable range of political discourse is between the conventional wisdom and the far right. Perhaps the answer is just that they can't get anywhere and should settle for keeping Sarah Palin out of office, surely a noble goal but perhaps an insufficient one.
It seems sort of related to this point to note that Heloise & I went to DC for a couple of weeks recently and saw, in various places, quite a lot of middle-aged men with very visible white supremacist tattoes. That's not something I've ever seen in DC before & the sight of a dozen or so such people wandering unremarked into the Hirshhorn Museum is both a bit freakish & a bit of a measure of how far right public acceptability goes.
I may not have expressed that very well.
The fact that antidepressants don't outperform placebos is a very recent finding. In the first round of studies, they _did_ outperform placebos -- they wouldn't have gotten FDA approval as treatments for depression otherwise. The fact that they no longer do so is a big mystery. I don't see how this is witchdoctoring.
tattoes
Ick. White supremacists in sandals?
re: 347
I wouldn't personally use 'witchdoctoring' to describe the pharmaceutical work. The questionable empirical/theoretical foundations of current psychiatric nosology and the near total absence of plausible acounts of the etiology and pathology of much of what appears in the DSM is more of an issue.*
* none of which is to deny the existence of mental illnesses.
NB - note in 346 this is a different Heloise to that in 340...
There are no plausible real-world scenarios that put Sarah Palin in the White House, short of the sudden death of 75% of the electorate. Swing voters would vote for Kucinich over Palin.
351: I think the point is that you'd split the democratic vote and Palin would have a plurality.
I'd like to believe 351, but I don't think I do.
Specifically with Kucinich, I don't buy it either. But the issue there isn't his politics so much as that she's attractive and charismatic and he isn't. With a more personally appealing candidate, you wouldn't have to get all that far from Kucinich politically to beat Palin.
338: First, you're not disagreeing with me. In response to JP, I've explicitly disavowed the idea of separate standards for the two parties. Second, you may not have noticed, but everyone's (except for true-believing loonbags like Eric Erickson) treating Wilson as "self-discredited". Third, despite that wonderful outcome, an outcome that, in most cases, didn't wait for anyone to bother checking if he was right*, there's certainly no parallelism in the treatment of the parties.
* Again, the initial reaction was about the offense against the office of the presidency, not an assault on the truth. Today, though, several people are pointing out, even if only as an afterthought, that Wilson was also wrong on the facts. That's progress, at least.
I don't disagree with 354, but that doesn't make 353 any less sad.
And 353 was also disagreeing with the first sentence of 351. I think 344 is probably right.
That Walt was exaggerating doesn't actually undercut his point: the idea that someone as absurd as Sarah Palin could become president is a fabrication of our media culture. At least I hope so. And now, I really do have to go walk the dog. For I am bob.
Sarah Palin is not more absurd than Ronald Reagan was, people.
It's absurd that Ronald Reagan will be elected to president again.
No, Ronald Reagan, even when he didn't know anything, covered pretty well. The moments when he looked completely lost and confused weren't common. He probably didn't know much, if anything, more substantive than she does, but he was a much less ridiculous public presence.
#348. Gladiator sandals, even. This season they're very in with the supremacist crowd.
#344. Last night I saw a car with a personalized "Nobama" license plate. I must say that I was more amused by the jackleg who would spend 60 dollars to make his point than I was angered by the sentiment expressed.
Jackleg? Interesting. Did you make that up? Could it be a variant on jake-leg? I like the dismissive sound of it.
331: Where there is money to be made, there is corruption. Those kinds of skewed results seem to e to indeicate that the researchers know which side their bread is buttered on and are willing to forgo a publication in order to ensure future revenue. The whole way pharmaceutical research is funded in the US is broken.
the idea that someone as absurd as Sarah Palin could become president is a fabrication of our media culture.
Then again, election outcomes are also a product of our media culture.
Hey, since we're on about right wing absurdity, does anyone have a link to a good refutation of the birther nonsense? I've got a family member that I need to forward it to. He's not actually insane, but he seems to think there's something potentially there, and he hasn't been able to find anything to counter it.
No, Ronald Reagan, even when he didn't know anything, covered pretty well.
Ronald Reagan could read a speech. So can Palin. Reagan's handlers kept him on script better than Palin's did, but she could have better handlers next time. Seriously, she's at least as smart as Reagan ever was (remember: trees cause air pollution), every bit as telegenic, and she's selling the exact same snake oil.
The Pauline Kael effect is strong with this one.
I've explicitly disavowed the idea of separate standards for the two parties.
Yeah, but it's a matter of tactics. Not getting outraged about accusations of lying, when the other side does, seems like unilateral disarmament to me. If we could get to a symmetrical standard under which calling anyone a liar wasn't outrageous, then I'd be happy, but I don't think unilaterally abandoning outrage gets us there.
But this is tactics, not principle. I could be wrong.
357: I for one welcome the new Bob-n-Ari oligarhy.
365: Salon's handy-dandy guide to refuting the Birthers
I found out yesterday that the birthers now think BHO was born in Canada.
"Government is not reason, it is not eloquence; it is force. Like fire it is a dangerous servant and a fearsome master"
370: Really? Neat. How does that work?
372: Pretty much like here, but it is paid for by the Canadian government.
345: Not exactly walking back an accusation of lying, but to me one of the classic (and most infuriating) examples of asymmetry was the firestorm and ultimate wlakback of Durbin's "some mad regime" comment. Of course it was cast as "not supporting the troops".
370:
"Think" isnt the correct word. Maybe "feel" or "perceive" or "believe," but, definitely, not "think."
I think the best possible third-party hypothetical is one in which the Republicans fragment into the Small-Government Party and the Jesus Party. For a while there, I thought Ron Paul was the answer.
355:I just don't see how progressives can get anywhere in a system where the acceptable range of political discourse is between the conventional wisdom and the far right.
Shite, such negativity. It's easy.
Like the "death panelers", like the full-on American Revolutionaries, like the Civil Rights Movement, like the Jacobins or Bolsheviks, like the Greens, like any marginal or minority political movement...
you organize and persist.
There. Not so hard.
376: For a while there, I thought Ron Paul was the answer.
Plenty of people thought that. I think they've moved to pushing for a return to the gold standard.
Recent Wired article about how placebos are getting stronger.
380: That's because medical research has given us better placebos.
372: His mother registered for classes at U Washington shortly after he was born. I am not sure of the actual "evidence" involved beyond that fact (and the Kenya stuff collapsing) but this is linked with giving birth in Vancouver since otherwise how did she get set up in Seattle so quickly after giving birth in Hawaii. Something like that.
you organize and persist
I agree with this.
Not so hard.
I do not agree with this.
Did you make that up?
"Jackleg" is a (mostly, I think) southern word. A jackleg is a shifty, worthless, dishonest person of no account. Often used to describe preachers and lawyers. "Jackleg(ed) fool" was one of grandmother's favorite dismissive epithets.
382: They do know Seattle is in the US, don't they?
369: "Handy-dandy" really ought to always be followed by "notebook."
384: I'm going to do my best to use that word at least once a day for the next few days, so I'm sure it will stick in my active vocabulary.
#384. I should say my grandmother, but I'm willing to share her.
382: Yes, apparently. It was a cover story for the Globe last month -- based on the "reporting" of WorldNutDaily.
385: The argument is that if he had simply been born in Seattle the Birth Certificate would be from there. You aren't thinking like a wingnut. (Although that little bit of thinking, *if* you buy into all of the premises on the bogosity of the Hawaii one, is actually semi-logical.)
Perhaps liberals need to just start making crap up, and ranting and raving.
We also need to start sending out more bat-shit insane emails.
"Newt left his wife when she was in the hospital!!!!!"
"Vitter likes to wear diapers!!!"
"Canter hasnt had a constructive idea ever!!!"
"Santorum took home a dead baby for his kids to hold!!!"
"Jindal performed an exorcism!!!"
"Mike Huckabee stole furniture from the state of Arkansas!!!
"
Reagan was intensely interested in politics. Palin has no interest in the subject whatsoever. I would have said you couldn't become the governor of a state with no interest in politics, which just provides further evidence that we admitted Alaska prematurely.
Why won't Glenn Beck clear up those old rumors?
I thought Vitter really did like to wear diapers. (Not that there's anything much wrong with that.)
370: yeah why are you friends with that guy? Especially after the public ouster of the (IMO and I am not defending him in any way shape or from) somewhat less trollish guy a few weeks ago?
396: All of those statements are true. (Well, 'hasn't had a constructive idea ever' is opinion, but certainly defensible.)
Reagan was intensely interested in politics. Palin has no interest in the subject whatsoever.
Palin is plenty interested in politics. What neither Reagan nor Palin had/have the slightest interest in is *policy*.
399 -- No, I think this is mistaken as to RWR. The puppeteers shit bricks at that summit in Iceland because, dammit, the old man started to think he liked policy. He "won" the Cold War by realizing, finally, that Nixon/Ford/Carter had been right about detente, and he'd been an idiot.
I suppose the fact that the politics of total obliteration are different when you're in office than when you're running in Republican primaries didn't hurt.
I think Reagan was always interested in political philosophy, in the earnest libertarian manner. In any case, he's a far more interesting character to Sara Palin, who is just a mediocrity.
391: but those are all true. Multiple exclamation points don't automatically equate to insanity!!!
Oh Lord -- a letter to The Corner approvingly quoted by KLo:
Most people were sick of seeing Obama's proud face and hearing his boring rhetoric during Primetime, especially as he just acts like he can call a State of the Union speech any old time he wants to, because he is Barack Obama.
403: Not to put too fine a point on it, but one imagines the writer wrestling with the right choice of synonym for "uppity".
The President can't call a State of the Union or other major speech any time he wants to? I mean, I guess Congress can say no, but come on.
Proud face, good lord.
Reagan was always interested in political philosophy, in the earnest libertarian manner
That's kinda like saying PZ Myers is interested in theology, in the earnest atheist manner. "Government is the problem, not the solution" is a pretty weak tea as political philosophy goes.
We simply disagree about Reagan, PGD. I think he gets freebie points because people like to think well of their leaders once they're dead, but I simply don't see any evidence that he was any smarter than Palin. Stack either one against Nixon, Bush Sr., Carter, Clinton, or Obama, and neither one is even competitive.
We simply disagree about Reagan, PGD. I think he gets freebie points because people like to think well of their leaders once they're dead, but I simply don't see any evidence that he was any smarter than Palin. Stack either one against Nixon, Bush Sr., Carter, Clinton, or Obama, and neither one is even competitive.
Maybe so, but the key difference is that Palin is widely acknowledged to be a moron, not just by liberals, but by people that barely follow politics. Reagan never had anything like the Couric interviews or Palin's resignation address, at least not before 1980.
Stack either one against Nixon, Bush Sr., Carter, Clinton, or Obama, and neither one is even competitive.
I'm not following this. Carter was stacked against Reagan, and lost. We don't elect people based on how "smart" they are, or how "interested" they are in "policy". And what about Bush Jr.? I don't think there's good reason to think he's significantly less absurd than Reagan or Palin--why give him a pass?
Palin is widely acknowledged to be a moron, not just by liberals
As was Bush Jr. in 2000....
Looking at old Reagan debate clips he doesn't look anything like as dumb as Palin. Glib, simplistic and folksy, yes, but not in the same league of stupidity as Palin.
I really don't think smarter or dumber is a useful way of speculating about Palin or Reagan. My guess is that they were/are both fairly bright (well, until Reagan's dementia kicked in), and also both ignorant and intellectually incurious, which makes it hard to tell how smart someone is.
In terms of substantive governing ability, I'd say they're tied for awful. In terms of public presence, including ability to improvise when he had no idea what he was talking about, Reagan was head and shoulders above Palin, unless my memories of him are all distorted by the passage of time.
All of those statements are true, yet liberals go around forwarding emails containing those truthful statements.
The crazy right wingers forward outright falsehoods.
darn it. I meant to include a "don't" in there.
We don't elect people based on how "smart" they are
Obviously, but you're not disagreeing with me. Britney Spears also sold more records than Maria Callas.
ability to improvise when he had no idea what he was talking about
She sputtered incoherently, he smoothly spouted loads of nonsense. That's a trainable skill.
Reagan was a better actor, and he was cast for a better part. Grandfatherly wears way better than defiant redneck.
Anyhow, I don't really want to rerun the "Reagan was a nitwit" argument. The point I'm trying to make is that if you think Sarah Palin couldn't possibly get elected president, you're seriously underestimating the gullibility of the American public.
418 -- . . . and the impact of self-demoralization in the leftward regions.
406
I simply don't see any evidence that he was any smarter than Palin.
Reagan attended one college and graduated in 4 years. Palin (according to wikipedia) attended 5 and took 6 years.
401
I think Reagan was always interested in political philosophy, in the earnest libertarian manner. ...
416: She sputtered incoherently, he smoothly spouted loads of nonsense. That's a trainable skill.
Maybe, but he was world-class, and she's nowhere. I'd be scared of her if she started exhibiting the capacity to babble smoothly about bullshit, but without that, she doesn't worry me.
420: And Bill Gates never finished college. That moron.
I'd be scared of her if she started exhibiting the capacity to babble smoothly about bullshit, but without that, she doesn't worry me.
And even then, her disastrous 2008 performances would still just be one YouTube away. She's done.
Which is not to say that someone just as dumb won't be elected president instead. Just not her.
423: Neither did Steve Jobs. I'm sensing a pattern here.
From 401:
REAGAN: Yes. And I used that argument in my fight to get tuition in the University of California. I have to tell you about that fight with the University of California-they were very much opposed! They wanted it kept totally free, as it had been. The tuition I was proposing was less than 10 percent of the actual cost of educating the student-which is more than $3,500 now, and at that time was roughly $3,000. I was proposing $300 tuition-and I used the exact same argument you're using. Finally, tuition was instituted.
I had no idea that any public schools were ever actually free in this country. Thanks, Ronnie!
I think I'm long-ways agreeing with apo and Brock here. Reagan said plenty of nutty dumb things and had gaffes galore, but he was also comforting and telegenic. Reagan won because in 1979 the world was crazy scary and the Democrats were deeply divided and rudderless. In 2009 we have the advantage of pretty fresh memories of the last guy who worked the dumb but folksy angle and a Dem president who's more reassuring in hard times than Carter could ever manage to be.
Of course that's now. In 2012, when the Mayan calendar ends and it plays hell with accounting software, it could be a whole nother story.
426: Late fifties, early sixties, when my parents both went to CUNY (neither graduated), there might have been some tuition, but it was really nominal.
419: . . . and the impact of self-demoralization in the leftward regions.
"Self-demoralization" is the kind of word that can possess me.
Danton ends, after the beheadings, with a young boy reciting the Declaration of Rights to a fevered and terrified Robespierre. The funny thing, is that as I remember, the Dantonists never felt much guilt or conscience-crisis. They had the benefit of absolute moral certainty. Obama may not know if he is right or wrong, but he knows he is good, as do his supporters.
The radical questioning of bourgeois liberalism is a glimpse into the abyss, internal and external. Settembrini was always the more comfortable companion.
The fact that antidepressants don't outperform placebos is a very recent finding. In the first round of studies, they _did_ outperform placebos -- they wouldn't have gotten FDA approval as treatments for depression otherwise. The fact that they no longer do so is a big mystery.
If the effectiveness of a placebo depends on how strongly the patient and the doctor believe it will work, the knowledge of effective antidepressants should increase the effectiveness of placebo antidepressants.
I'm not sure this counts as "intelligence" but Reagan struck me as emotionally more mature and a better judge of people than Palin. For better or worse, Reagan was able to pick good advisers and follow their advice.
Palin's operation is amateur hour, and I chalk that up to her immaturity. Her defensiveness, paranoia and impulsivity are clear in her actions as mayor, as governor, as a candidate, and now. Her family life and her educational "career" seem to be examples of this as well.
I don't recall anything similar being said about Reagan.
The issue is that the placebo effect is mysteriously getting stronger across many different disease indications. While the standard biostatistical models have changed some, they haven't changed that much, and not in ways that would exaggerate the placebo effect. Nobody is quite certain what's going on, but it's causing all manner of anxiety in the pharma industry (luckily, they have pills for that).
430 -- I, as usual, was thinking more simplistically. The lesson of 1994 is that if our side doesn't go to the polls, the other side will win. As sportscasters are wont to say, "They're going to have to score some points to have any hope of winning this game."
What's really annoying, of course, is that, in 1994, the Republicans won because the health care initiative was a failure, which our fine media (and the gleeful victors) turned into a mandate against health care reform.
Palin's operation is amateur hour
This is probably a reflection of the relative complexity of governing the most populous state (CA) versus a barely populated one (AK) as much as anything.
At the time, there was plenty of talk about Reagan's less-than-exemplary family life.
I don't see any way in which you can plausibly argue Palin and Reagan are similar. Reagan had a clear and consistent political philosophy, one that he carried out as governor of California, and President of the United States. It was a stupid philosophy, and one that fucked up California and the US, but he had thought about policy before he ever appeared on the national stage. Palin had clearly never given policy questions outside of Alaska a moment's thought. Reagan served as governor for 8 years. Palin served as governor for 3 1/2 before quitting out of boredom. I doubt she's seriously considering a run at the Presidency.
The issue is that the placebo effect is mysteriously getting stronger across many different disease indications. While the standard biostatistical models have changed some, they haven't changed that much, and not in ways that would exaggerate the placebo effect. Nobody is quite certain what's going on, but it's causing all manner of anxiety in the pharma industry (luckily, they have pills for that).
What are some of the indications I'd be likely to have heard of?
Stronger belief that a placebo will work due to either more effective drugs or more prevalent DTC advertising seems like a likely suspect.
Seems like something one should be able to get NIH money to look into...
434:Our Side
Obama disinvites House Progressives, Summons 16 Conservadems.
I know which of these groups are also correct on torture, detention, war, climate change, DADT, DOMA
The self-demoralization comes when I actually pick a side or stay home. I guess what's interesting is that some aren't de-moralized by choosing the lesser evil.
The big ones are psychiatric and pain meds. But also some more easily measured areas areas like intestinal disorders, Parkinsonian tremors, ulcers, erectile dysfunction, and performance-enhancing drugs.
Is it clear that the placebo effect is increasing, and not that the effectiveness of the drugs is decreasing?
The body's natural healing powers are improved by websurfing on the internet.
Is it clear that the placebo effect is increasing
Yes.
What's the best way to administer a placebo? Syringe? Bong? Soak your testicles in it?
The problem with 431 and 438 is that if drug confidence is increasing placebo efficacy, it should also increase real drug efficacy by a similar amount.
The radical questioning of bourgeois liberalism is a glimpse into the abyss, internal and external. Settembrini was always the more comfortable companion.
Settembrini was the representative of bourgeois liberalism. Do you mean to say that gazing in to abyss is comfortable?
443: Rectally, of course. Excellent absorption.
They have rectal vaporizers now? Do you need a friend to administer it?
I mean you specifically, oudemia. We're friends, right?
432: Reagan was able to pick good advisers
I dispute this. The neocons who fucked up so horribly under Dubya cut their teeth under Reagan. These are the same idiots who spent the 1980s exaggerating Soviet capabilities and insisting that the USSR was constantly on the verge of a first strike, as well as insisting that left wing movements globally all took their marching orders from the Kremlin. Policies crafted by the neocons nearly started a nuclear war. This is also the same crowd that gave us Iran-Contra.
344
A party that attracts the left-most 10% of the Dems puts Sarah Palin in the White House. ...
Probably not. Obama beat McCain 53-46. Democrats are about 40% of the electorate. Lose 10% of them and you still win 49-46. And Palin would run behind McCain.
450: I was going to dispute it as well, but decided I didn't want to get into it. Reagan had highly effective campaign teams; he had a bunch of goddamn lunatics for advisers.
351
There are no plausible real-world scenarios that put Sarah Palin in the White House, short of the sudden death of 75% of the electorate. Swing voters would vote for Kucinich over Palin.
Her most plausible path to the White House was getting elected as McCain's VP and then succeeding to the office. That now being out I agree, she has little chance.
450, 452: Right. I meant political advisers. Palin, by contrast, can't even handle accepting and declining invitations to speak.
416
She sputtered incoherently, he smoothly spouted loads of nonsense. That's a trainable skill.
So's shooting baskets but that doesn't mean anybody can be Michael Jordan.
431
If the effectiveness of a placebo depends on how strongly the patient and the doctor believe it will work, the knowledge of effective antidepressants should increase the effectiveness of placebo antidepressants.
So should a false belief in the existence of effective antidepressants.
455: Are you saying that Reagan was the Michael Jordan of spouting nonsense?
433
The issue is that the placebo effect is mysteriously getting stronger across many different disease indications. While the standard biostatistical models have changed some, they haven't changed that much, and not in ways that would exaggerate the placebo effect. Nobody is quite certain what's going on, but it's causing all manner of anxiety in the pharma industry (luckily, they have pills for that).
Or maybe the trials are being run more carefully with better blinding.
There are no plausible real-world scenarios that put Sarah Palin in the White House
Stated too strongly, I think. It's very unlikely that Sarah Palin will ever become President, but not at all implausible. Squeaking out a contested win against an unexciting, demoralized opponent and a third party spoiler, Bush '00-stylee, probably won't happen again, but it's certainly plausible.
459: Yes, and she could reinvent herself. I don't imagine many people around in 1962 thought there was a scenario in which Richard Nixon could become President .
Or maybe the trials are being run more carefully with better blinding.
No, Apo's response in 442 to 441 takes care of that.
But maybe more trials are choosing, as subjects, patients who are more likely to respond to any sort of therapy. People who are closer to the hopeful extreme than the hopeless extreme of their particular prognosis, so to speak.
Probably not. Obama beat McCain 53-46. Democrats are about 40% of the electorate. Lose 10% of them and you still win 49-46. And Palin would run behind McCain.
And Obama would run behind Obama, with Great Depression II still refusing to improve despite the best Hoover-esque remedies that our government can manage to compromise on.
334
The only thing that would be really expensive in mental health care, I should think, would be dementia (because it involves very intensive care over potentially a very long period). I assume that even Shearer would like to be insured for that.
I don't think nursing home type care is usually included in medical insurance in any case.
Reagan was very smart, very composed, an excellent politician. He had a very thoughtful and internally consistent narrative worked out that gave surface plausible explanations for most of the things he'd be asked about, and he communicated it very well. The narrative was way way off, but that's another story. Palin is pretty much just a random putz who got lucky.
Reagan also benefited by coming up before the conservative movement got totally dominant. He actually had to convince people from outside his ideological bubble.
The fact that antidepressants don't outperform placebos is a very recent finding. In the first round of studies, they _did_ outperform placebos -- they wouldn't have gotten FDA approval as treatments for depression otherwise.
I'm not sure about that -- I think metanalysis of the earlier studies is what showed the problems. There are lots of things you can do with a small study and by picking your populations. It's very clear that big, obvious side effects were totally missed in the early studies (e.g. sexual side effects of Prozac, withdrawal symptoms). The effects were never large in any case.
Reagan also benefited by coming up before the conservative movement got totally dominant.
True. He also helped create it, or at least Lee Atwater did on his behalf.
Reagan was very smart...He had a very thoughtful and internally consistent narrative...and he communicated it very well
This raises an important question: do you sit around saying to yourself, "What can I write on unfogged that will cause ari to start banging his head against the wall?"
I guess "important" is a bit of an exaggeration.
I don't think nursing home type care is usually included in medical insurance in any case.
Hmm. I wonder if this is true. I know (because I know people who benefit from it) that public aid does cover nursing home care. And if most people (with medical insurance) are insured through employer provided plans, it seems like chances of being uninsured (aside from Medicare/Medicaid) are likely to increase when you enter nursing home care.
But I have no real point here, just pondering.
If only you could see how I cackled with glee and rubbed my hands together writing that, Ari!
Anyway, it was in part driven with my annoyance with the way the term "smart" is used on the left. Reagan was an ideologue, it's a different kind of "smarts". But he clearly devoted a lot of thought to his ideology, polished it up well, and used it effectively to change the country. He did a lot of damage, but I'm not sure about the definition of intelligence under which he would be an unintelligent man. He was very simplistic, as was his ideology, but that made him more effective at accomplishing his goals. People who refuse to recognize complexity are often more effective at changing the world.
do you sit around saying to yourself, "What can I write on unfogged that will cause ari to start banging his head against the wall?"
That thing about Joe Wilson last night? That had nothing to do with showing reverence for the president.
Using Obama's vote in 2008 as a measure of anything at all in the hypothetical 3 way race is pretty questionable. Gore 2000 is probably a better measure of "normal" circumstances.
A third party challenge doesn't just draw off votes; it also draws off enthusiasm. (Otherwise no one would care what McManus thinks about either senatorial or presidential politics -- as a voter, he has no significance to the outcome. It's as a polemicist that he wields his influence.)
with the way the term "smart" is used on the left
The way I use smart has nothing to do with my politics. Nixon, Cheney, Atwater, Bush Sr., all very smart guys. Reagan, Bush Jr., Palin, not so much. Effectiveness≠smarts. Nader used to be effective; now he isn't. I don't believe he got less intelligent since the 70s.
Otherwise no one would care what McManus thinks about either senatorial or presidential politics -- as a voter, he has no significance to the outcome. It's as a polemicist that he wields his influence
Yes! His vast, vast influence!
Reagan confused events from films he acted in with reality; he said he served in WWII when he had not, in the mid-80s. It is possible that he understood a lot about people he saw face-to-face.
Can comity be achieved by saying that Reagan wasn't smart, but he did have mental whateverness?
475: Are you saying Ogged should date zombie Reagan?
433 - it's causing all manner of anxiety in the pharma industry (luckily, they have pills for that).
Or at least they think they do.
474
... he said he served in WWII when he had not, ...
He was never in combat or even overseas but he was in the military.
I don't think nursing home type care is usually included in medical insurance in any case.
Hmm. I wonder if this is true.
It is certainly true that you can purchase long-term care insurance, precisely because many types of nursing care are NOT included in traditional health insurance.
When a person becomes suddenly and severely disabled mid-life, I think they usually end up on SSDI and Medicaid/Medicare. There's been a some shift toward home and community-based care (rather than institutional care) over the last decade-plus, but I don't have good bird's-eye data of how much of that is rhetoric or consumer-desire as opposed to real policy changes and/or policymaker-desire.
I do know that the disability-rights folks have been agitating for the MiCassa legislation for what seems like forever. Apparently it's now named the Community Choice Act. And it's still sitting in Congress. Boo hiss.
473 -- An order of magnitude greater than mine, at the least. Yours, too?
406: I am paying for this snowmachine .