Progressives (Liberals)

georgeob1 wrote:

Happily the unwashed multitude of voters are a good deal more observant and discerning than are the elites of the media who seek to lead and instruct them.

Apparently you're claiming that people who are uneducated are smarter than people who write articles in the media. That's a rather sweeping generalization. Which is why I made the point that good judgment and common sense are qualities which can be found from the highly educated all the way to the functionally illiterate. If journalists are as out of touch as you seem to think they are is it just a matter of chance that the subjects they write about are familiar to us all? How does that work, georgeob? It seems you just object to their political perspective, using the pejorative term "elites" just like the president does.

To repeat, were the multitudes of common people were as discerning as you give them credit for we wouldn't be suffering with the widespread problem of prescription opioid abuse. Among other things.

However, as was amply demonstrated in the Failure of the Obamacare universal mandate, the masses are usually better able to see their self interests than are the "educated elites" (Like Prof Jonathan Gruber) who are so often sure they know better what's good for everyone.

About 6.5 million Americans paid an average penalty of $470 for not having health insurance in 2015 — 20 percent fewer than the year before, according to data released Tuesday by the IRS.

I believe the patronizing condescension of the Elizabeth Warren/ Jonathan Gruber types is often far less effective than these self styled elites assume, precisely for this reason.

And that’s where the irony kicks in. Republicans are running around screaming, “Obamacare’s architects think Americans are stupid!” but it’s the law’s opponents that have spent the last several years misleading the public, creating baseless fears, and exploiting public confusion in order to help sabotage the American system for craven, partisan reasons.

Gruber said something dumb that got picked up by a hot mic — he wasn't addressing voters.

That kind of thinking is the problem.

Their reaction [to the Gruber story] shows that for all the talk of ‘governing,’ the incoming GOP Congress is going to treat the next two years like one long episode of the Rush Limbaugh show. The most urgent question will be not whether they can make some kind of positive change, or even whether they can make progress on their particular policy goals. The question is whether they can score points, win the morning, get the administration on the defensive. For that, you don’t have to get anything done; every day is a new opportunity to express your outrage, which is an end in itself.

Well by your own statistics the fraction of Americans who paid a $470 penalty (pseudo "tax " per the USSC) to avoid the insurance mandate was about 30% of total number participating.

What kind of thinking?

Paul Waldman

You should really compare it to the total amount of people who were in the health insurance market, not just the people in the ACA. The mandate wasn't that you carry ACA coverage; it was that you had to have an effective policy. An estimated 177.5 million Americans had employment-based coverage in 2015 so with the ACA people (and not even counting the individual market) that's close to 195 million and the scofflaws were more like 3% of the total.

The use of electronic health records increased significantly with the 2009 passage of the Health Information Technology for Economic and Clinical Health Act, which offered financial incentives for hospitals to adopt them. Such records promised efficiency and better teamwork, but as they increasingly serve the needs of America’s corporate, profit-motivated health care, those promises remain mostly unfulfilled.

Insurance companies and hospitals demand ever more data to make decisions about payments and billing, so clinicians have to provide much more information about each patient at each interaction. Mounting regulatory requirements that get built into these records are described as insuring patient safety, but are ultimately tied to compensation, which means money. And in a system rife with legal risks, there is a strong incentive to overdocument everything.

This is why nurses and physicians must come together. We must acknowledge the harm done by these ever-increasing documentation requirements, without losing the core benefits of electronic record keeping.

One inspiration comes from a surprising place. Electronic health records are almost universally disliked, with one telling exception, those used by clinicians at the Department of Veterans Affairs. The reason: Billing concerns don’t shape the records at government-run V.A. hospitals. They document only what’s necessary to deliver better care.

Why can’t the rest of the health care system do the same? For example, some hospitals already have a periodic review of their electronic health records, paring items that do not relate directly to patients; more hospitals could do the same, and all could do it more aggressively. Another: A group of coders at Intermountain Healthcare in Utah is working on a more radical solution, called “activity-based design,” which updates records by voice, and offers helpful care algorithms to clinicians as they interact with patients.

The rationing of care, particularly to the elderly and those with serious diseases is a prominent feature of government managed health care systems.

Consider the wait times required to see a medical specialist in the government-managed systems in the UK and Canada. Hospitals across the northern U.S. serve large numbers of Canadians seeking quick referrals to various heart & cancer specialists to avoid the months long delays in the public services at home.

Have you considered what dining out would likely become if Government ran all the restaurants?