See, I just don't like mean spiritedness

"Chariotoflove" (chariotoflove) 07/07/2017 at 16:09 • Filed to: just a little rant and then I'll be okay

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People come from all persuasions and philosophies. I get that. And people are very passionate about things that are important to them. I think that’s good. And it’s important to have conversations about important things like public policy, religion, civil liberties, all those kinds of things. I just don’t like when people substitute intelligent conversation with hot takes and gotchas.

What started this rant? Well, some work friends just came into my office, and the conversation turned to public health funding policy. Then they brought out the phrase, “not my president”. What a stupid phrase, really. If you are a citizen of this country, and you live by its laws, then the president is your president. You expressed your choice last November, and you live with the result. The only people who can say “not my president” are those who leave, and that’s a valid choice that some make.

If Clinton, or Stein, or Limberbutt McCubbins won the election, that person would be my president as much as this one is, and I’d live with it and move on just like I have to live with this one. I just don’t want to have to hear insults and incivility thrown around in lieu of legitimate discussion. It’s tiresome and gets in the way of actual discourse.

/rant

Here’s a convertible for your time. Have a great weekend. I sure will. I’m leaving early to make dinner for some visiting friends, and then I’m gonna watch my daughter kick some booty at her swim meet.

fintail > Chariotoflove 07/07/2017 at 16:13

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I kind of wish Limberbutt had won.

Somehow, the “not my president” craptakes received less condemnation before big orange (not aiming at you in particular).

Steve is equipped with Electronic Fool Injection > Chariotoflove 07/07/2017 at 16:15

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!!! UNKNOWN CONTENT TYPE !!!

That’s my attitude. I’m doing what I can to make the world a better place.

Jcarr > Chariotoflove 07/07/2017 at 16:25

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Limberbutt McCubbins/Turd Ferguson 2020

Textured Soy Protein > Chariotoflove 07/07/2017 at 16:28

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Rather than “not my president,” I prefer, “I voted against that motherfucker.”

Incivility is a genuine problem but it’s difficult as hell to be civil when:

In the history of presidents, Tump is such a uniquely bad one, both in temperament and his utter lack of understanding of policy in so many different areas, which was plainly obvious would be the case as soon as he threw his name into the race.

The modern GOP has little apparent interest in real legislative solutions, and would rather take moral stands about how the government shouldn’t do things, or spend money on things.

GOP legislators straight up lie to the public about things like a “healthcare bill” that shreds the existing individual plan marketplaces where 10 million people have purchased health insurance, and cuts $700 billion in Medicaid funding to give $700 billion worth of tax cuts to the wealthy, but will somehow improve health coverage for the rest of us, because rich people paying less taxes will magically make medicines and MRI machines more affordable, or something.

ttyymmnn > Chariotoflove 07/07/2017 at 16:32

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Limberbutt McCubbins 2020

Chariotoflove > Steve is equipped with Electronic Fool Injection 07/07/2017 at 16:38

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I like that attitude much better.

Chariotoflove > fintail 07/07/2017 at 16:39

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Different things come in fashion and go. I remember the fashion in Reagan’s time was to assert that he was senile, as if Alzheimer’s is in anyway a joking matter.

themanwithsauce - has as many vehicles as job titles > Chariotoflove 07/07/2017 at 16:39

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I can agree with the spirit of the post but it’s hard to be civil when the shit I put up with for 8 years because “YOUR BOY IS RUINING THIS COUNTRY!!!!” has now turned to “WHY ISNT THERE BIPARTISANSHIP?!?!?! ARENT WE ALL AMERICANS!!!!!” please note that they interject this while being racist and homophobic.

It’s not easy taking the high road. It usually involves heavy drinking.

Chariotoflove > Textured Soy Protein 07/07/2017 at 16:42

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I don’t disagree with much of those statements. I tend to vote Republican, but I’m increasingly frustrated with the party’s behaviors. I just think that as the world around us gets less and less civil, the best that we can do is to be more and more civil, and not in a snide, superior way, but in a respectful way that shows real goodwill.

MR2_FTW - Group J's resident Stig > Textured Soy Protein 07/07/2017 at 16:43

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The modern GOP has little apparent interest in real legislative solutions, and would rather take moral stands about how the government shouldn’t do things, or spend money on things.

They and their supporters keep saying that, but they vote in just as much frivolous spending as everybody else. And the party that says “less government” sure seems to like banning things they don’t like, just like the “more government” side does.

It’s almost like they are all the same.....

Chariotoflove > ttyymmnn 07/07/2017 at 16:43

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Let’s start building momentum now.

Chariotoflove > themanwithsauce - has as many vehicles as job titles 07/07/2017 at 16:46

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Then toss ‘em back if that’s what helps. There is always going to be combative behavior from party loyalists on both sides. The trick is to not let them direct the conversation.

fintail > Textured Soy Protein 07/07/2017 at 16:50

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And the best part is when the so-called right complains about disrespect and lack of civility, when they offered zero of it from 2008-16.

fintail > Chariotoflove 07/07/2017 at 16:52

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Definitely not something to laugh at, I have dealt with it in my family. Reagan was probably senile, though, wasn’t he?

user314 > Chariotoflove 07/07/2017 at 16:52

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Chariotoflove > fintail 07/07/2017 at 16:55

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While in office he was not from everything I know. Afterwards, Alzheimer’s did set in, as most know from his biography (he was quite old after all), and it was as sad a decline for his family as it is for any so afflicted.

Highlander-Datsuns are Forever > Chariotoflove 07/07/2017 at 16:58

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How can one be civil when the president is a one man tweeting disaster.

Highlander-Datsuns are Forever > themanwithsauce - has as many vehicles as job titles 07/07/2017 at 17:00

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Exactly. Civility is a two way street. Sorry republicans, you can’t have your cake and eat it too, unless you can actually manage to pass any real policy changes, which remains to be seen from the party of no.

Chariotoflove > user314 07/07/2017 at 17:05

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There’s a Simpsons clip for every situation. I hope they play the right ones at my funeral.

Chariotoflove > Highlander-Datsuns are Forever 07/07/2017 at 17:07

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When someone is behaving badly, it is even more important to behave properly in response. Don’t descend to the level of the person you detest.

Also, how has no one yet tackled that man and taken away his phone?

user314 > Chariotoflove 07/07/2017 at 17:10

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Go to the Finkiac and get them set up now!

There’s also the Morbotron for Futurama gifs and macros.

Textured Soy Protein > Chariotoflove 07/07/2017 at 17:11

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Speaking as a died-in-the-wool “let’s use government to solve problems of society” Democrat, I’d happily engage with folks on the opposite side who were interested in crafting real solutions.

This is true of people on both sides, but so much of politics has gotten away from crafting government to work for the people using the principles that people believe in. While the Democrats might not be perfect, they at least generally are trying to do things that will have a net positive impact on society.

Whereas the GOP all too often does stuff that is based on some rhetorical, hypothetical belief in the free market solving all our problems and getting government out of the way of the free market, when in reality that rarely produces a good outcome for the majority of everyone. Except of course when they want to spend loads of money on the military, or defense contractors, or use the government to enforce the conservative Christian version of morality on the rest of everyone else.

That kind of agenda is so undesirable to someone like me that it’s frustrating when people throw in with it and it’s tough to get them to talk in terms of real solutions that benefit people.

Healthcare is my pet issue because both my dad and sister work in healthcare public policy, and it’s often one of the largest expenses in a typical household. It affects everybody’s quality of life in a real and significant way. My dad actually wrote the report on Dubya and Kerry’s healthcare proposals that they spent a whole debate arguing about.

Yet for all the talk of supposedly improving healthcare in a conservative-leaning way, when the GOP got control of all 3 branches of government, their plan was instead a mass redistribution of wealth from the poor and elderly to the highest income brackets. Something like 40% of all of the tax cuts will go to the top 3% of earners. Then Paul Ryan goes on tv with a shit-eating grin and a powerpoint about how this is supposedly going to make healthcare better for people.

So when the Fox News and Breitbart demographic starts yet again spouting out some anti-reality talking points in service of an agenda that is so obviously not good for the majority of the country, you’re damn right that people like me will run around shouting like our hair’s on fire.

Frank Grimes > Chariotoflove 07/07/2017 at 17:23

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I totally agree. For some reason people think that if they have a good argument but are terrible unsufferable insulting asses that its ok.

fintail > Chariotoflove 07/07/2017 at 17:35

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I remember reading some pretty heady debate about his status in office. Not saying it to knock him, as I am old enough to remember those days, and thought he had a generally positive presence, even if his work wasn’t perfect.

I wouldn’t be surprised if there’s a little dementia with the current POTUS.

DipodomysDeserti > Chariotoflove 07/07/2017 at 17:40

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He’s a president, not a king. To say a citizen has to take ownership of leadership that they are diametrically opposed to or leave the country is absurd. That is not a legitimate discussion. It’s an intellectually dishonest one.

I thought we were done with the whole “with us or against us” bs.

Your boy, BJR > Chariotoflove 07/07/2017 at 18:10

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They said I should be the change. They told me to go high when others went low, to put into this world, the good I wanted to see come out. That animosity doesn’t kill animosity. That I should set the example, and combat hate with love.

Tried it.

Didn’t like it.

shop-teacher > Highlander-Datsuns are Forever 07/07/2017 at 19:59

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This is what I tell my students and my own kids: Don’t be part of the problem, be part of the solution.

I haaaaaate Trump, but I’m not stooping to his level.

shop-teacher > Chariotoflove 07/07/2017 at 19:59

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Exactly. Be part of the solution, not the problem.

shop-teacher > Chariotoflove 07/07/2017 at 20:01

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Yep. That’s all I have to say about that.

6691 zapS > themanwithsauce - has as many vehicles as job titles 07/08/2017 at 21:58

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But I thought they were going to all leave the country, Oh, wait now it’s the knee-jerkers from the other side who want to move......

Chariotoflove > fintail 07/09/2017 at 12:09

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Not dementia. Some other problem.

Chariotoflove > DipodomysDeserti 07/09/2017 at 12:45

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No one said you have to be with the president. I’m not on most of his policy so far. But to say “he’s not my president “ is silly. It implies illegitimacy somehow. The only way he is not the president of my country is if this is not my country. And to sling personal invective doesn’t help change things. That’s all I’m saying.

Chariotoflove > Textured Soy Protein 07/09/2017 at 12:48

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I get the frustration. All I’m saying is that reacting with bad behavior similar to the opponents hurts your argument. No one ever wins a snarking contest.

fintail > Chariotoflove 07/09/2017 at 13:22

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Narcissism or social disease?

DipodomysDeserti > Chariotoflove 07/09/2017 at 13:44

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It is perfectly ok for someone to deny responsibility over a person who rose to power through race baiting and nationalistic jingoism. Those are illegitimate views to hold as the leader a nation of immigrants.

I couldn’t care less what adults want to call other adults. Of all the things going on in the world right now, focusing on people being mean is pretty childish.

These guys are writing legislation based on their own personal feeling on things. If their personalities are completely devoid of intellect or substance, or if they use fairy tales to guide their way, then I think it is perfectly ok to refer to them as dolts. It might not change anything, but it might wake some people up.

Textured Soy Protein > Chariotoflove 07/09/2017 at 16:13

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Well as you can see, I devoted several paragraphs to thoughts and ideas, and the only thing that might resemble snark was referring to Paul Ryan’s shit-eating grin. But that’s something that really did happen.

It’s heartening to me that you’re realizing this path the GOP is on is not a good one.

Chariotoflove > fintail 07/10/2017 at 10:39

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Maybe he just wasn’t raised right? I dunno. Some people just don’t know how to behave properly or think before they speak.

fintail > Chariotoflove 07/10/2017 at 10:42

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Could be, daddy was apparently a piece of work.

Chariotoflove > Textured Soy Protein 07/10/2017 at 10:43

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I didn’t mean to suggest you were behaving badly. I was just referencing the reason for my thread. All those issues are really important. I just wasn’t in a position to discuss them while at my daughter’s swim meet.

Chariotoflove > fintail 07/10/2017 at 11:34

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I’ve heard that. If you grow up with no one showing you consequences for your behavior, you don’t learn ways to regulate it, or even see that it is necessary. That’s the kind of impulsiveness I see in our president. Even if he were to be thoughtful and deliberate behind the scenes, he sabotages so much of what he might do with outward appearance.

Chariotoflove > fintail 07/10/2017 at 11:34

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I’ve heard that. If you grow up with no one showing you consequences for your behavior, you don’t learn ways to regulate it, or even see that it is necessary. That’s the kind of impulsiveness I see in our president. Even if he were to be thoughtful and deliberate behind the scenes, he sabotages so much of what he might do with outward appearance.  

Chariotoflove > Textured Soy Protein 07/10/2017 at 12:04

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Okay, I’ve a little time now, and I think your detailed thoughts deserve some kind of response. I too have been kind of inside the healthcare system over my life. My parents are both physicians in academia, and my wife and sister as well. I myself spent time working at the VA and in hospitals as a researcher. I am also one of those that has to spend a disproportionate amount of my income and time on healthcare. I am lucky enough to have good benefits.

Healthcare as a societal issue is probably the stickiest policy issue of all for two main reasons that I see. First, insurance companies suffer the paradox that their imperative as a private company (make profits for their owners/investors) is at direct odds with doing the very thing they are created to do (pay for clients’ healthcare needs). This means that straight market capitalism doesn’t work the way it is intended for most businesses. It also makes it worse that there is seldom adequate competition in most markets to allow the insured to negotiate for the best prices, as many in the GOP proclaim. Second, there is not even agreement between people of different ideologies about what the goals of the system should be. Many, for example, look to universal healthcare systems like in the UK, which provides basic coverage for everyone, but rations higher levels of care or big procedures. Everyone gets their ear infections and hypertension taken care of, but getting a heart or liver transplant or getting the latest and greatest treatments is only accessible to people with the money to pay for private coverage, and more people die waiting for organs or treatments. Many see that as an acceptable balance, while others, especially in the US, believe that anybody should have access to whatever care is needed regardless of price, period. They see rationed coverage that could end up leaving out someone in need as unacceptable.

So, it’s really hard to find a balance that everyone, or even most, can agree on as the goals we should aim for. When I was younger, I thought a government run, single payer system seemed like the obvious choice to eliminate insurance company avarice, but I’ve come to believe that governments are uniquely bad entities at running businesses. On the other hand, if we are going to go with private, for-profit insurance companies, they must be regulated. If not, they will screw their customers every chance they get to keep from paying. We also need to find a way to curb medical equipment and pharmaceutical companies who will overcharge as much as they can knowing that their customers often have no choice but to pay. But the main goal is to come to terms as a society with what kind of care we want to prioritize with the limited resources available.

Textured Soy Protein > Chariotoflove 07/10/2017 at 12:59

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Generally, I dislike the idea of for-profit insurance companies being the primary means of paying for healthcare, especially since now the vast majority of health insurance plans have several thousand dollar deductibles.

I believe the government should provide a baseline level of coverage, below what’s offered by Medicaid/Medicare, but more than just preventive care, to everyone. It would then be up to insurers to offer supplemental plans that provide real value, instead of charging 5-figure yearly premiums for plans with 4-figure yearly deductibles.

Until that happens though, some of the major problems with our current system include:

Bigass deductibles that are rarely fulfilled by routine care, only catastrophic/emergency situations.

Providers not disclosing to patients what care costs and why it is needed.

Manufacturers and providers gouging the hell out of top-line “rack rate” prices as a negotiating tactic with the insurers, but it gives insurers cover to tell patients that even before they’ve satisfied their deductible, they’re getting a benefit of paying only the insurer’s negotiated rate and not the rack rate.

Insurers dictating what care patients can receive from providers, in theory because the insurer is paying, but often the patient has not yet satisfied their deductible.

To address these problems, I would make the following changes:

Offer federal tax credits for employer contributions towards health insurance premiums and HSA contributions. (There’s a patchwork of state tax credits for employer contributions towards premiums but it’s far from comprehensive.)

Require providers and insurers to process estimates for treatments before they are performed, provide that information to patients, and explain whether these services are essential. There would be exemptions for emergency situations.

Rack rates would be capped at some percentage above the national average Medicaid reimbursement rate. Not all providers offer services to Medicaid patients because of the low reimbursements. This would provide enough room above Medicaid rates while also removing the insurers’ argument that they are providing value through access to their negotiated rates.

Forbid insurers from denying coverage to any service that is covered by Medicaid.

There are a bunch of assorted fixes to address shoring up the stability of the Obamacare health insurance exchanges, but these are my ideas specifically covering consumer-friendliness.

fintail > Chariotoflove 07/10/2017 at 14:15

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I am sure there is an apples-and-trees relationship there. It might explain the lack of self-awareness of his own spawn, too. Impulsive, indeed.

Chariotoflove > Textured Soy Protein 07/10/2017 at 17:05

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In general I am not in favor of the government getting into the insurance business because I think they would likely mismanage it as a business and waste our tax money. I am in favor of regulation of insurer behavior. The companies would bitch and moan of course, but everyone would no doubt find when the dust cleared that there is still plenty of money to be made. My biggest thing is something you mentioned in your point 4. I detest companies telling patients what care they can get and what medications they can have. Insurers should be barred from questioning a doctors medical decisions.

I wonder who would decide what the caps should be for services to prevent gouging and how that calculation would be done.

Textured Soy Protein > Chariotoflove 07/10/2017 at 17:36

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Government isn’t in the health insurance business, and I don’t want them to be. Government is in the paying for healthcare business. Medicaid and Medicare are not insurance, per se. Insurance companies profit by paying out less in claims than they collect in premiums. Medicaid and Medicare collect tax dollars and disburse that money to pay for their members’ healthcare costs.

While there are plenty of examples of government not being the most efficiently run entity out there, Medicare and especially Medicaid are often more efficient than health insurance companies at converting money they receive into money paid out for their members’ benefit.

So let’s say everybody had their basic healthcare needs like primary care physicians, dental, prescriptions, maybe addiction treatment, etc. covered by the baseline government plan for everyone. Those costs are no longer part of the calculations for insurance companies. Then it’s up to the insurance industry to fill in the gaps. Employers can still offer those plans as employee benefits, or people can go buy them out on the individual market. But we’re no longer stuck relying on for-profit insurance companies for our basic medical needs.

But again, getting to that point is a much bigger change than shoring up the ACA. We can still do a lot of things that would take our existing health system and make a genuine improvement in many people’s quality of life.

Regarding caps, right now, every state runs its own Medicaid program and is reimbursed by the federal government. Every state sets its own Medicaid reimbursement rates. That $700+ million in Medicaid spending the GOP wants to cut is not direct payments for people’s care, it’s reimbursements to the states. The trick with setting a cap that’s directly tied to Medicaid is that states can and often do slash Medicaid reimbursement rates to save money without regard to provider profitability. You could have a federal law that says rack rates in each state are not allowed to exceed, say, 125% of each state’s Medicaid reimbursement rates, but you would need to put some cushions in there so that if a state’s Medicaid program slashes a reimbursement for something, it doesn’t immediately slash the reimbursements for everyone else.

Regarding preventing insurers from dictating care, it’s not as simple as saying insurers can’t tell providers what to do. Because often providers perform more work than is necessary, either because they want to cover their ass against potential malpractice suits, or because they figure insurance is paying for it, not consumers. But that mindset ignores the reality that more often than not consumers, not insurers, are paying for stuff now, because of everybody’s deductibles growing exponentially.

That’s why I was saying providers need to give an estimate and justification before performing services. Politicians, mostly GOP ones, and insurance company lobbyists, often talk about high deductible health insurance plans “give consumers more control over their healthcare,” but the reality is unless we know how much stuff costs and why it’s being done, we have no control at all. By requiring insurers to at minimum cover the same things as Medicaid/Medicare, it removes a lot of the back-n-forth over what the insurers will cover. Also if a doctor recommends something should happen, but both the insurer and the patient feel it’s unnecessary, the thing doesn’t get done and the patient doesn’t get charged. The goal is to give patients real control over their care and not just this BS “control” that the insurance lobby talks about now.