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OOTB's Political Thread . ..

Something Americans need to be honest about, but are afraid to say out loud is that free college is a mistake because too many people already go to college. We don't need to make it easier for people to go to college. I could reluctantly agree to giving some type of tax credit for associate or trade degrees, but free college at the university level shouldn't happen.
 
Polling says otherwise.
I smell a bet with @UNC71-00 coming.
No kidding. Polling as of today, with multiple candidates in the race, isn't exactly helpful. When push comes to shove, a Sanders vs. Trump contest is going to force moderate independents like me to choose between two candidates who are worse than the ones in the last election. It would be a bloodbath.
 
Something Americans need to be honest about, but are afraid to say out loud is that free college is a mistake because too many people already go to college. We don't need to make it easier for people to go to college. I could reluctantly agree to giving some type of tax credit for associate or trade degrees, but free college at the university level shouldn't happen.

Yep.

I'm all for making university level "more" affordable ($60K per year is ridiculous for an undergrad degree) but free? No way. Trade schools and 2 year degrees should absolutely be the focus of making post-HS education very affordable.
 
Trump could take a dump on the Statue of Liberty's face and I'd vote for him before Bernie/AOC.
My coworkers just asked what was so funny (I did not explain).

Yeah same - I really like my healthcare and doctors currently so that's why any change kinda freaks me out. Couple that with the change moving toward government run and I'm like hell MF no.

My main thought on healthcare is we need to do what makes doctors happy. We need to ensure that the smartest and most responsible people are going into the healthcare industry. The easiest way to do that is to cater to them with both money and by removing any obstacles that would upset them or make it harder to do their job. That's why the idea of the government being in control of doctors is a huge no for me.
Just one man's opinion, but I favor both Medicaid expansion and a public option. It would allow people who like their managed care insurance to keep it and create competition in the health insurance market. Also, it would make healthcare available to those who might not otherwise have access. Increased access would be good for patients, providers, and insurers alike.
 
Also, there are rumors floating around that Trump will replace Pence with Haley for 2020. This would be a very smart move by Trump which is why I doubt it will happen.

This would be an awesome move. I don't really like Pence at all, and do like Haley a lot. If Pence bungles this Coronavirus thing, that'd give Trump a great excuse to make the switch.

If a youngish, female, minority is on the same ticket as the old, misogynistic, racist, bigoted, mean white guy - that'll flip the Dem's gameplan on its head and leave them standing there like:

ConfusedCompetentChipmunk-small.gif
 
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Lots of people like to say that, until they are faced with the decision to actually have to do it. There is a reason that candidates always go out of their way to make sure the middle class won't pay more taxes. And it won't be slightly more if Bernie gets what he wants. Free health care, school, etc are going to raise taxes by a noticeable amount. He can claim it will be offset by not having to pay for insurance all he wants, but most people aren't dumb enough to believe that. Also, don't forget that our taxes are higher than that millionaire Bernie too (although smart people know that those guys are actually in a higher bracket and don't really pay less than us in income taxes).

It will be slightly more for the middle class and a lot more for the billionaire class and corporations. Plus there would be funding cut from other areas.

And Bernie is one of the poorest people in the senate. If people were familiar with his platform they’d know he isn’t going after personal wealth on that scale. He’s targeting the uber wealthy who exploit workers and throw their money into the political system to buy favors/policy.
 
Why shouldn't they?

You wanna turn healthcare into the DMV? You want doctors to get paid and have the skill level of DMV workers?

Private, for profit organizations have run better and more efficient than anything government run since the beginning of time. If part of privatizing that is that businesses have relationships with insurance companies to provide coverage then I'm all good.

That's why.

The rest of the developed world doesn’t seem to have a problem with it. The idea that doctors will suddenly become less competent because the government is cutting the checks is just silly.
 
It will be slightly more for the middle class and a lot more for the billionaire class and corporations. Plus there would be funding cut from other areas.

1. Slightly? Dude he can't find $25 more trillion that he needs even when he submitted a budget that does more than "slightly" raise taxes.

2. I'm sick of this "billionaire class" thing like people think there are tons of billionaires living in America. There are 585 billionaires in America. Sweden, Iceland, and Norway all have more billionaires per capita than us. Thinking you can have 585 people pay for the other 326,999,415's healthcare and education is freaking lunacy.


We have 327 million people in America. Comparing Denmark, Sweden, etc. to the USA is like comparing feeding a kitten to feeding a jaguar. Sure, they're both cats but they are not even close to the same thing.
 
It will be slightly more for the middle class and a lot more for the billionaire class and corporations. Plus there would be funding cut from other areas.
Almost every expert, including left leaning ones, disagrees with you. Either Bernie is going to have to raise taxes on the middle class or borrow 25-30 trillion. Neither one is going to work in a general election. He's going to have a choice. Either be honest and say that there is going to be a tax hike on the middle class or lie and have everyone, including dems, call him out on it. It's a loss either way.

And Bernie is one of the poorest people in the senate.
I wish I could be as poor as Bernie.
 
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Doctors won't all of a sudden become less competent, but the brightest minds may very well choose something other than being a doctor if the lifetime value doesn't make sense. They take out $300K+ in debt to get their degrees. If under the new payment system they make 75% of what they make now, their payback period lengthens and it may not make sense.

For the top 5% of high schools and early college students, right now say they can make X as a doctor, and 0.8X as a lawyer. They'll be going to Med School. If that equation then changes to be making .75X as a doctor, and 0.8x as a lawyer - a large portion of the best of the best will be going to Law School, not Med School.
 
1. Slightly? Dude he can't find $25 more trillion that he needs even when he submitted a budget that does more than "slightly" raise taxes.

2. I'm sick of this "billionaire class" thing like people think there are tons of billionaires living in America. There are 585 billionaires in America. Sweden, Iceland, and Norway all have more billionaires per capita than us. Thinking you can have 585 people pay for the other 326,999,415's healthcare and education is freaking lunacy.


We have 327 million people in America. Comparing Denmark, Sweden, etc. to the USA is like comparing feeding a kitten to feeding a jaguar. Sure, they're both cats but they are not even close to the same thing.

Where is this 25 trillion number coming from? Mayor Pete made that claim about a ten year spending deficit, but I haven’t seen the sources that actually back that up.

You can be tired of it all you want but you might as well get used to hearing it because it isn’t going away. The problem isn’t the number of billionaires it’s the distribution of income and wealth. Our current distribution is not sustainable. Nobody said 585 people would pay for everyone else. But taxing them and the corprations they own would raise a lot of money. There’s no good reason for amazon to be effectively paying zero dollars in federal taxes.

Yes America has more people which also means a larger tax base. These issues should be analyzed on a per capita basis. Arguing that America has more people to provide for without acknowledging that we also have more people to tax for revenue is disingenuous.
 
Almost every expert, including left leaning ones, disagrees with you. Either Bernie is going to have to raise taxes on the middle class or borrow 25-30 trillion. Neither one is going to work in a general election. He's going to have a choice. Either be honest and say that there is going to be a tax hike on the middle class or lie and have everyone, including dems, call him out on it. It's a loss either way.


I wish I could be as poor as Bernie.

That’s not exactly accurate. Left leaning think tanks and economist have repeatedly claimed that M4A would save some money. The right leaning ones say the opposite and the center says their wouldn’t be that much of a difference.

This is all a moot point though. Medicare for all isn’t getting passed. But start the negotiation there and we may be able to expand Medicare and get a public option.

Free college isn’t getting passed either but we might be able to compromise and get free trade schools and two year tech schools. That would cut the burden in half for people smart enough to transfer after two years. Then you regulate student loans and look at some pricing controls for public universities and things look a lot better.

The republicans keep pushing the discussion to the right. When Democrats respond from the middle the discussion continues to drift right.

I dont support Bernie because I think we need to pass every policy in his platform. I like Bernie because he pushes the conversation in a different direction and gives us room to compromise.
 
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Doctors won't all of a sudden become less competent, but the brightest minds may very well choose something other than being a doctor if the lifetime value doesn't make sense. They take out $300K+ in debt to get their degrees. If under the new payment system they make 75% of what they make now, their payback period lengthens and it may not make sense.

For the top 5% of high schools and early college students, right now say they can make X as a doctor, and 0.8X as a lawyer. They'll be going to Med School. If that equation then changes to be making .75X as a doctor, and 0.8x as a lawyer - a large portion of the best of the best will be going to Law School, not Med School.

Well to be fair Bernie is also trying to address the student loan debt issue so ideally they wouldn’t have that much debt.

But I like the idea. We’d need a supply and demand curve to actually understand how many people wouldn’t pursue careers in medicine in your example. However it’s also worth noting that the demand for other high level jobs is finite. Not everyone can become a lawyer just because they’ll make a little bit less as a doctor. I’m not so sure doctors would see a decrease in their earnings though. You’d have lower prices but higher demand. Hospitals wouldn’t be able to charge people 25 bucks for a box of tissues and an aspirin though.
 
I try to avoid political discussions for the most part, but there is one thing my far left and far right friends agree with me on. A good chunk of student loan debt could be avoided if they'd just take advantage of the much less expensive community college system we have in NC. Knock the first two years out at a community college then transfer to a four year school. Your diploma will still say "UNC," "Appalachian State," etc...

Back to the trade school point someone made above. I'm in the construction business and almost every sub you talk to can't find good labor, even when they pay them a really good salary. Electricians, plumbers, HVAC, etc... None of the kids today want to go that route. Even if they could quickly find work and later parlay that into their own business.
 
Yes America has more people which also means a larger tax base. These issues should be analyzed on a per capita basis.
Agreed, but scalability needs to be taken into account as well. Something that works well in Denmark with ~5M people might have fairly different results in a country with 60x the population.

But I like the idea. We’d need a supply and demand curve to actually understand how many people wouldn’t pursue careers in medicine in your example. However it’s also worth noting that the demand for other high level jobs is finite. Not everyone can become a lawyer just because they’ll make a little bit less as a doctor. I’m not so sure doctors would see a decrease in their earnings though. You’d have lower prices but higher demand. Hospitals wouldn’t be able to charge people 25 bucks for a box of tissues and an aspirin though.

I do think building out that curve would help. There's obviously people that would pursue a career in medicine even if it paid minimum wage, just because of a particular passion they have.

Tax rates would need to factor in as well. Someone making 200K at an effective tax rate of 25% nets 150K. Someone making 80K at an effective tax rate of 15% nets 68K. If the tax rates get raised on the "rich" first job and not as much on the second job, then maybe the math starts to look like 200K at 40% effective = 120K net and 80K at 17% effective =67K net. Maybe right now 87K/year is worth it to the first guy to put in the extra schooling, longer days, etc. to get the job paying 200K. But with the raised taxes to pay for a lot of the programs, maybe the 53K/year difference isn't worth it - and the "more skilled" guy will just take the "lesser" job which is something we'd want to avoid as well.
 
I try to avoid political discussions for the most part, but there is one thing my far left and far right friends agree with me on. A good chunk of student loan debt could be avoided if they'd just take advantage of the much less expensive community college system we have in NC. Knock the first two years out at a community college then transfer to a four year school. Your diploma will still say "UNC," "Appalachian State," etc...

Back to the trade school point someone made above. I'm in the construction business and almost every sub you talk to can't find good labor, even when they pay them a really good salary. Electricians, plumbers, HVAC, etc... None of the kids today want to go that route. Even if they could quickly find work and later parlay that into their own business.

My uncle is trying to hire electricians right now and he says the same thing. They can basically name their price because there’s so few left.
 
Doctors won't all of a sudden become less competent, but the brightest minds may very well choose something other than being a doctor if the lifetime value doesn't make sense.
Never mind your hypothetical. Look at what's happening right now. There is a shortage of primary care doctors in the United States for one very simple reason, which is that specialists make multiples of what primary docs do. Now imagine removing the earning incentive for all doctors by doing something moronic like going to a single-payer system. Demand goes through the roof and supply bottoms out. It's simple economics **coughs**.
 
Agreed, but scalability needs to be taken into account as well. Something that works well in Denmark with ~5M people might have fairly different results in a country with 60x the population.



I do think building out that curve would help. There's obviously people that would pursue a career in medicine even if it paid minimum wage, just because of a particular passion they have.

Tax rates would need to factor in as well. Someone making 200K at an effective tax rate of 25% nets 150K. Someone making 80K at an effective tax rate of 15% nets 68K. If the tax rates get raised on the "rich" first job and not as much on the second job, then maybe the math starts to look like 200K at 40% effective = 120K net and 80K at 17% effective =67K net. Maybe right now 87K/year is worth it to the first guy to put in the extra schooling, longer days, etc. to get the job paying 200K. But with the raised taxes to pay for a lot of the programs, maybe the 53K/year difference isn't worth it - and the "more skilled" guy will just take the "lesser" job which is something we'd want to avoid as well.

You’re a finance guy right? So you know better than most how huge of a difference 53k a year, compounded (even at conservative annual rates) over thirty years is. Personally I can’t imagine that many highly qualified people forgoing millions of dollars in lifetime earnings because of a few extra years of school. But I could be wrong.
 
I’m not so sure doctors would see a decrease in their earnings though. You’d have lower prices but higher demand.
Doctors can only see so many patients a day. If you're seeing 20 patients a day, 5 days a week, would you rather see the ones whose insurance pays you $300 a visit or the ones whose insurance pays you $100 a visit?
 
Why the fuk worry about how to pay for anything? We’re like a trillion in debt. We haven’t paid for jack shit in decades. Just print more money or borrow more from China.
That's true, but these numbers we are talking about would literally double our debt. It's by far bigger than any increase in american history. I don't think we could ever sell that much debt. There is no way to do this other than raise taxes for everyone.
 
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Doctors can only see so many patients a day. If you're seeing 20 patients a day, 5 days a week, would you rather see the ones whose insurance pays you $300 a visit or the ones whose insurance pays you $100 a visit?

I would hope that education reform would help increase the number of doctors by reducing the student loan burden.

How do our primary care docs per capita numbers compare to other countries with various forms of universal healthcare?

To clarify, I don’t necesarrily think M4A is the solution. A public option is the main thing I’d like to see get passed.
 
Never mind your hypothetical. Look at what's happening right now. There is a shortage of primary care doctors in the United States for one very simple reason, which is that specialists make multiples of what primary docs do. Now imagine removing the earning incentive for all doctors by doing something moronic like going to a single-payer system. Demand goes through the roof and supply bottoms out. It's simple economics **coughs**.

Why does a single payer system remove the earning incentive for all doctors? Do doctors in Canada work for free?
 
I would hope that education reform would help increase the number of doctors by reducing the student loan burden.
I sincerely doubt that anyone who wants to practice medicine is dissuaded by the prospect of student loan debt. Can't believe I have to say this out loud but the lifetime earning potential for physicians is through the roof.

How do our primary care docs per capita numbers compare to other countries with various forms of universal healthcare?
What am I, Google?
 
I sincerely doubt that anyone who wants to practice medicine is dissuaded by the prospect of student loan debt. Can't believe I have to say this out loud but the lifetime earning potential for physicians is through the roof.

What am I, Google?

Yeah and their lifetime earning potential in Canada is still pretty damn high too. I’m not saying their model is perfect but claiming that single payer removes the earnings incentive for doctors is hyperbolic. They would still make really great money. The biggest hit would be to insurance companies and big pharma.

Quick google search says that in Canada physicians earn an average of 125k. In Britain they make about 160k. Not bad for two countries with universal healthcare programs. All of those numbers are lower in the US, but there’s still plenty of earning incentive. And those numbers came from an article about how much less doctors in Canada make, not some left wing puff piece.
 
Why does a single payer system remove the earning incentive for all doctors? Do doctors in Canada work for free?
Medicare does not negotiate payment rates with healthcare providers. Medicare dictates what they will pay, which is a fraction of what commercial managed care (Blue Cross, Cigna, Aetna, etc.) pays. Healthcare providers lose money on Medicare. If all health insurance were to start paying Medicare rates, virtually every healthcare provider in the country would be forced to close its doors.
 
Medicare does not negotiate payment rates with healthcare providers. Medicare dictates what they will pay, which is a fraction of what commercial managed care (Blue Cross, Cigna, Aetna, etc.) pays. Healthcare providers lose money on Medicare. If all health insurance were to start paying Medicare rates, virtually every healthcare provider in the country would be forced to close its doors.

But a public option would negotiate prices correct?
 
Call me a commie socialist if you like but free health care and college education should come before going to mars or a space army or a border wall or a war in Afghanistan or aid to Israel or f-35 fighter jets (7yrs behind schedule) and m-1 abrams tanks (already 2000 sitting idle)

Jmo
 
Yeah and their lifetime earning potential in Canada is still pretty damn high too. I’m not saying their model is perfect but claiming that single payer removes the earnings incentive for doctors is hyperbolic. They would still make really great money. The biggest hit would be to insurance companies and big pharma.

Quick google search says that in Canada physicians earn an average of 125k. In Britain they make about 160k. Not bad for two countries with universal healthcare programs. All of those numbers are lower in the US, but there’s still plenty of earning incentive. And those numbers came from an article about how much less doctors in Canada make, not some left wing puff piece.
a) Only someone who doesn't know what they're talking about (that's you) would say I'm being hyperbolic.

b) I make more than Canadian physicians, which only proves my point about single-payer gutting the financial incentive for Americans to become doctors. I also spent considerably less time in school and work far less than the average doctor.
 
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This would be an awesome move. I don't really like Pence at all, and do like Haley a lot. If Pence bungles this Coronavirus thing, that'd give Trump a great excuse to make the switch.

If a youngish, female, minority is on the same ticket as the old, misogynistic, racist, bigoted, mean white guy - that'll flip the Dem's gameplan on its head and leave them standing there ...

I agree that she fits a bunch of identity politics (woman, minority, etc)….I wish that identity politics weren't such a big part of politics, but it is where we are as a country, for sure. (What identity boxes you check way outweigh your competence and experience). Example: all the Ds saying they need to put a black woman on their ticket as VP: why? shouldn't the VP's ability be more important than what demo boxes they can check?

I do very much like that Haley is young, vibrant, articulate, and seemingly has a clean past, and has had to work her way up from the bottom within a minority group. She tells (doesn't whine, just explains) of how her Indian parents have been discriminated against in their community at times.

It does bother me that all the candidates remaining are 75+ and show frequent signs of physical and/ or mental deterioration. Not confidence-inducing to be leader of free world and leader of US domestic and foreign policy.

Haley is anti-establishment and is / was a friend of the tea party movement. I think it would be a pretty steep uphill climb for her if the R establishment supported someone else. She might have some trouble raising money. And I sometimes wonder if she is tough enough and battle-tested enough to stand up to - and thrive in - the nasty, ruthless, poisonous garbage world that is big league national scale politics, and the related national media / social media.
 
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I try to avoid political discussions for the most part, but there is one thing my far left and far right friends agree with me on. A good chunk of student loan debt could be avoided if they'd just take advantage of the much less expensive community college system we have in NC. Knock the first two years out at a community college then transfer to a four year school. Your diploma will still say "UNC," "Appalachian State," etc...
^^^ This! When I decided to go back to (grad) school, I took as many pre-requisites as possible at a local community college. Not only did it save me thousands of dollars in tuition but my employer's tuition reimbursement program paid for most of it. I also wholeheartedly agree that we need to quit telling every child that they have to go to college to make a good life for themselves.
 
Medicare does not negotiate payment rates with healthcare providers. Medicare dictates what they will pay, which is a fraction of what commercial managed care (Blue Cross, Cigna, Aetna, etc.) pays. Healthcare providers lose money on Medicare. If all health insurance were to start paying Medicare rates, virtually every healthcare provider in the country would be forced to close its doors.
Can you tell in your job if the percentage of doctors accepting medicare is decreasing any? One of the talking points you hear is that a growing number of doctors aren't accepting medicare anymore because they lose money, but I wasn't sure if that was actually true or just some talking point.
 
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