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Why Americans don't like Obamacare

Why Americans don't like Obamacare

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Old Jan 12th 2011, 4:06 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by ironporer
Yes, oddly enough we don't seem to have major issues accepting 'socialized medicine' for the military, VA, and Medicare/Medicaid....which I have read (somewhere) account for over 25% of the total market in the US.

Of course, many might argue that these programs often provide sub-standard care, and in the case of Medicare- have contributed to the ridiculous billing practices of most medical providers.

We also dont seem to have major issues with 'socialized schools'...except for the fact that US schools consistantly rate at the bottom of the world barrel.

Socialized/Government Mail delivery is another case in point...it seems to work well- except that UPS/FED Exetc can get your package there quicker, cheaper and in one piece.

Maybe that's why we are all afraid of a Gov't take over of the Medical system....cuz they pretty much suck hind tit at everything else they do?
The major problem with schools is that they are under the control of individual states, States rights and all, as opposed to a consistent policy nationally, and therefore have different standards and budget issues. Rating education in America is a process of rating each individual state and compiling an overall result, and too many States suck at dealing with education. Financial inequities between States contributes to that issue. So if government is to blame it is State government, not federal.

I would also admit that I have used USPS to send numerous packages and/or registered letters and it was always less expensive than UPS etc. and always delivered on time and in good condition. What many do not realize is that in many cases, International delivery for example, the package ends up in the hands of one of the couriers before it is finally delivered. So I disagree on the USPS critique although they are certainly not perfect. Nor are the couriers.

On the Medicare-Medicaid issues, it stands to reason that where there is a dual system of insured coverage, public versus private, one paying more than the other, the lesser paid services will likely suffer to some degree. It actually is an argument for a consistent single payer system where there is no difference in payment policies and therefore all patients are equal because all payments for services are equal.
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Old Jan 12th 2011, 4:52 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by dakota44
The major problem with schools is that they are under the control of individual states, States rights and all, as opposed to a consistent policy nationally, and therefore have different standards and budget issues.
To a large extent they are under the control of individual school districts. Even within a state, there are - imo intolerable - differences in education provision between districts.
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Old Jan 12th 2011, 5:00 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by Giantaxe
To a large extent they are under the control of individual school districts. Even within a state, there are - imo intolerable - differences in education provision between districts.
Absolutely correct that in many States there is no consistency from district to district. It is like some hodge podge patchwork cluster ****. The manner in which cities fund the schools is equally at fault when areas with higher property taxes, more affluent, get the bulk of the money while low income and therefore lower assessment areas get shit. Very unfair system.

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Old Jan 12th 2011, 5:06 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by ironporer
Yes, oddly enough we don't seem to have major issues accepting 'socialized medicine' for the military, VA, and Medicare/Medicaid....which I have read (somewhere) account for over 25% of the total market in the US.

Of course, many might argue that these programs often provide sub-standard care, and in the case of Medicare- have contributed to the ridiculous billing practices of most medical providers.

We also dont seem to have major issues with 'socialized schools'...except for the fact that US schools consistantly rate at the bottom of the world barrel.

Socialized/Government Mail delivery is another case in point...it seems to work well- except that UPS/FED Exetc can get your package there quicker, cheaper and in one piece.

Maybe that's why we are all afraid of a Gov't take over of the Medical system....cuz they pretty much suck hind tit at everything else they do?
The schools and 'competitiveness'
"American schools are better than they're commonly portrayed. We now have a massive study of the reading abilities of 15-year-olds (roughly 10th-graders) in 65 systems worldwide showing that U.S. schools compare favorably with their foreign counterparts.

The most pessimistic view of the study is that, on average, American schools do as good a job as schools in other wealthy nations. "

It costs me $5 to send a letter 80 miles across the hills, if I use a courier. It costs me .44 if I send it USPS.

I don't have a handy example about the VA medical (and would never defend medical billing), but my dad loves it.

Just saying, maybe check your assumptions.


The biggest problem is that this program was not explained better; they should have been out in front of the criticism and showed some of the objections to be the idiocy that they were (are).
Death panels/Earl Blumenauer.. give me a break. Creating a billing code for a 15 minute time permission with your doctor to talk about hospice and other options when you're old.
What is a very sensible idea turned into a pitchfork-wielding mob.
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Old Jan 12th 2011, 5:25 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by meauxna
The schools and 'competitiveness'
"American schools are better than they're commonly portrayed. We now have a massive study of the reading abilities of 15-year-olds (roughly 10th-graders) in 65 systems worldwide showing that U.S. schools compare favorably with their foreign counterparts.

The most pessimistic view of the study is that, on average, American schools do as good a job as schools in other wealthy nations. "

Sadly, not true in my definition of favorably.

The PISA exam is one of a handful of tests that compare educational levels across nations, and is considered to be the most comprehensive. The test focuses on how well students are able to apply their knowledge in math, reading and science to real-life situations. Some 470,000 students took the test in 2009 in 65 countries and educational systems, from poor, underdeveloped nations to the most wealthy.

Scores from the 2009 Programme for International Student Assessment to be released Tuesday show 15-year-old students in the U.S. performing about average in reading and science, and below average in math. Out of 34 countries, the U.S. ranked 14th in reading, 17th in science and 25th in math.

Those scores are all higher than those from 2003 and 2006, but far behind the highest scoring countries, including South Korea, Finland and Singapore, Hong Kong and Shanghai in China and Canada.

Of 34 OECD countries, only 8 have a lower high school graduation rate.

The United States spends more per student, on average, than other countries. In the 2009 PISA study, only Luxembourg spent more per student. The report notes that countries like Estonia and Poland perform at about the same level as the United States, while spending less than half the amount per student.


http://www.usatoday.com/news/educati...-ranking_N.htm
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Old Jan 12th 2011, 5:44 pm
  #81  
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Default Re: Why Americans don't like Obamacare

Originally Posted by meauxna
Death panels/Earl Blumenauer.. give me a break. Creating a billing code for a 15 minute time permission with your doctor to talk about hospice and other options when you're old.
What is a very sensible idea turned into a pitchfork-wielding mob.
Actually, that was one of the things that I agreed 100% with- even though as I understand it, it was originally included under a Bush order (heard it on NPR, can't remember the source and can't be arsed to look it up now). I also read that 25% of Medicare $ goes to people in the last year of their lives, and 50% of that money goes to people in the last week of their lives. It's about time Grandma and Grandpa (and kids if need be) be informed about end of life care....and whether they want to go home with onlt paliative care and die with dignity, or have your life be artificially streached out for a few more months on respirators and all kinds of other expensive (and often painful) care. Me? Just give me a big syringe of morphine and I'll exit quietly and in dignity TYVM.

As to the USPS, perhaps that was a bad example- generally I am quite happy with both the service of the Post Office, and their price and delivery. Perhaps a better example might have been the service/price that Immigration delivers! That is what I fear.
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Old Jan 12th 2011, 6:09 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by dakota44
Sadly, not true in my definition of favorably.
Did you read the whole piece I linked? It makes me wonder if we are counting 'all students' equally across the globe.

Originally Posted by ironporer
Me? Just give me a big syringe of morphine and I'll exit quietly and in dignity TYVM.

As to the USPS, perhaps that was a bad example- generally I am quite happy with both the service of the Post Office, and their price and delivery. Perhaps a better example might have been the service/price that Immigration delivers! That is what I fear.
If you lived in Oregon, we can do that dignity thing for ya.

The immigration deal isn't half bad now; I'd have to call it a 90% improvement since you & I played that game.
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Old Jan 12th 2011, 6:19 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by ironporer
Actually, that was one of the things that I agreed 100% with- even though as I understand it, it was originally included under a Bush order (heard it on NPR, can't remember the source and can't be arsed to look it up now). I also read that 25% of Medicare $ goes to people in the last year of their lives, and 50% of that money goes to people in the last week of their lives. It's about time Grandma and Grandpa (and kids if need be) be informed about end of life care....and whether they want to go home with onlt paliative care and die with dignity, or have your life be artificially streached out for a few more months on respirators and all kinds of other expensive (and often painful) care. Me? Just give me a big syringe of morphine and I'll exit quietly and in dignity TYVM.
.......
The New Yorker had a very good article about end-of-life dilemmas a few months ago. It is one in the series of articles by Atul Gawande; well worth reading
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Old Jan 12th 2011, 6:26 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by meauxna
Did you read the whole piece I linked? It makes me wonder if we are counting 'all students' equally across the globe.



If you lived in Oregon, we can do that dignity thing for ya.

The immigration deal isn't half bad now; I'd have to call it a 90% improvement since you & I played that game.

I read it and from my point of view it was little more than a whitewash of the problem. If one is going to discount the results because our country has a more diverse racial population when compared to others, that is a tragic disavowing of the fact that our educational system is obviously unfair in terms of racial bias. White areas have better schools and better results. Because we fail a significant portion of our population does not permit us to then say we want to only compare the middle class white students with the rest of the world. It is disingenuous and ignores the problems with inner city and many rural schools.

Even resorting to that racial profiling tactic, we still lag behind, no matter what he says. The system as a whole needs to be revamped. For every student. Everyone deserves a proper education, and far too many are not receiving one.

Just my opinion.
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Old Jan 12th 2011, 7:48 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by dakota44
...

I would also admit that I have used USPS to send numerous packages and/or registered letters and it was always less expensive than UPS etc. and always delivered on time and in good condition. ... So I disagree on the USPS critique although they are certainly not perfect. Nor are the couriers.

....
And remember - the Post Office is legally required to deliver to every address in the US, regardless of any 'cost-benefit' analysis, while FedEx is not.

Originally Posted by ironporer
Actually, that was one of the things that I agreed 100% with- even though as I understand it, it was originally included under a Bush order (heard it on NPR, can't remember the source and can't be arsed to look it up now). I also read that 25% of Medicare $ goes to people in the last year of their lives, and 50% of that money goes to people in the last week of their lives. It's about time Grandma and Grandpa (and kids if need be) be informed about end of life care....and whether they want to go home with onlt paliative care and die with dignity, or have your life be artificially streached out for a few more months on respirators and all kinds of other expensive (and often painful) care. Me? Just give me a big syringe of morphine and I'll exit quietly and in dignity TYVM.
...
The great irony here is that the Insurance Companies are falling over themselves to address the issue you raise above because they too see the massive costs associated with 'end of life'. So while everyone is panning the Govt. for setting up 'death panels', the private sector is pursuing the exact same approach for the exact same reasons. However, it's being done quietly and under the guise of business efficiency.

Actually, on this particular subject, it is the DOCTORS who are resistant, and not only because they want to generate more revenue. Their entire training and career is devoted to 'fixing' something, and now they are being told to stop trying to fix, but to allow to break. That's a challenge for many doctors. A hospice nurse told me a 'dark humor' joke - "why do they have nails on coffins? to keep the doctor away from the patient".

The whole 'Death Panels' thing was the most disgusting of all the mis-information about the new health care reform.
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Old Jan 12th 2011, 8:07 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by Steerpike
.............
Actually, on this particular subject, it is the DOCTORS who are resistant, and not only because they want to generate more revenue. Their entire training and career is devoted to 'fixing' something, and now they are being told to stop trying to fix, but to allow to break. That's a challenge for many doctors. .............
This is the most interesting insight in the New Yorker article that I linked to a few posts earlier. (And it is written by a doctor.) He admits, from his own experience as well as that of others, that doctors are often inappropriately optimistic when they give advice to gravely ill patients, so often steer patients and their families in the direction of painful, hopeless and long-drawn out treatment options.
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Old Jan 12th 2011, 9:16 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by robin1234
This is the most interesting insight in the New Yorker article that I linked to a few posts earlier. (And it is written by a doctor.) He admits, from his own experience as well as that of others, that doctors are often inappropriately optimistic when they give advice to gravely ill patients, so often steer patients and their families in the direction of painful, hopeless and long-drawn out treatment options.
That was a fantastic - but at times very very painful - article you linked to. I would recommend anyone interested in end of life issues to give it a read. Like Steeerpike, I was totally disgusted by all the "death panel" nonsense that the likes of Palin raised. It's an important subject and all her comments do is make rational debate on it that much more difficult.
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Old Jan 12th 2011, 9:27 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by dakota44
The major problem with schools is that they are under the control of individual states, States rights and all, as opposed to a consistent policy nationally, and therefore have different standards and budget issues. Rating education in America is a process of rating each individual state and compiling an overall result, and too many States suck at dealing with education. Financial inequities between States contributes to that issue. So if government is to blame it is State government, not federal.
Originally Posted by Giantaxe
To a large extent they are under the control of individual school districts. Even within a state, there are - imo intolerable - differences in education provision between districts.
Originally Posted by dakota44
Absolutely correct that in many States there is no consistency from district to district. It is like some hodge podge patchwork cluster ****. The manner in which cities fund the schools is equally at fault when areas with higher property taxes, more affluent, get the bulk of the money while low income and therefore lower assessment areas get shit. Very unfair system.
If any of that were the reason, then the schools in DC would be a shining example of wonderfulness. But they're not.
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Old Jan 12th 2011, 10:33 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by chartreuse
If any of that were the reason, then the schools in DC would be a shining example of wonderfulness. But they're not.
D.C. runs it's own school system, not the Federal Government, with all the same independence. It is interesting to note that High school graduation rates were at 72 percent for D.C. schools in 2009, an increase of three percentage points from 2008. By 2010, D.C. Comprehensive Assessment System reading pass rates had increased by 14 percentage points, and math pass rates had increased by 17 percentage points. This was under the supervision of Michelle Rhee as Chancellor, appointed by the Mayor at the time, whose name I forget. He lost his recent reelection bid and Rhee resigned. The District may well go backwards now.
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Old Jan 12th 2011, 11:11 pm
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Default Re: Why Americans don't like Obamacare

Originally Posted by dakota44
I read it and from my point of view it was little more than a whitewash of the problem. If one is going to discount the results because our country has a more diverse racial population when compared to others, that is a tragic disavowing of the fact that our educational system is obviously unfair in terms of racial bias. White areas have better schools and better results. Because we fail a significant portion of our population does not permit us to then say we want to only compare the middle class white students with the rest of the world. It is disingenuous and ignores the problems with inner city and many rural schools.

Even resorting to that racial profiling tactic, we still lag behind, no matter what he says. The system as a whole needs to be revamped. For every student. Everyone deserves a proper education, and far too many are not receiving one.

Just my opinion.

The conclusion of the piece says:
"..these persistent achievement gaps demonstrate the limits of schools to compensate for problems outside the classroom -- broken homes, street violence, indifference to education -- that discourage learning and inhibit teaching. As child-psychologist Jerome Kagan points out, a strong predictor of children's school success is the educational attainment of their parents. The higher it is, the more parents read to them, inform and encourage them.

For half a century, successive waves of "school reform" have made only modest headway against these obstacles. It's an open question whether the present "reform" agenda, with its emphasis on teacher accountability, will do better. What we face is not an engineering problem; it's overcoming the legacy of history and culture. The outcome may affect our economic competitiveness less than our success at creating a just society. "

If it is racial, it is also economic and social. I've attended elementary schools in the US, Canada and Spain; there was definitely more social and economic diversity in my US classes. What Samuelson writes makes sense to me. I don't think he is saying 'oh, the white kids are measuring up so let's forget the whole thing', he's saying, you can't lay all of this at the feet of the teachers.
The opening of the paragraph I quoted above begins "Americans have an extravagant faith in the ability of education to solve all manner of social problems. In our mind's eye, schools are engines of progress that create opportunity and foster upward mobility."
Schools and curriculum may not be the best place to address the social problems that are holding some students far behind.
Just like law enforcement personnel are not mental health workers (or firemen medical technicians.. oh wait, they are now).

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