Healthcare - big bill VS smaller bill(s)

[Aunt Sponge]

[I'm cutting and pasting this from another thread - I know everyone, here, has talked about this - but I've been gone for a while and I haven't had cable - so I've been lost - and I'm finally catching up on what i've missed, in the news, by taking a few days break for my heavy studies.]

This is my view of it (The healthcare reform) - we wouldn't be in this healthcare reform pickle if they approached it in pieces ... the first thing they should have considered is redefining and reforming medicaid and medicare to include a broader spectrum of people .... That would have been much less of an issue wiht so many people. No one could have disagreed with that in itself.

They, though, coupled such a common sense thing in with a bunch of wordy hooey about different health-care issues.

I think they should have approached it in 3 or 4 stages - thus adverting such enormous public-outcry against it. First - public health option and modifying current gov-based support. Second - Healthinsurance reform (this is the most debated issue). Third - The business-end (The Practice of medicine and pharamaceuticles, and malpractice...)

First stage - public health option and reform/refining current assistance (caid, care, kids first, etc etc) given by the government. Maybe, also, reforming the current health-issurance problems. However, since that's what so many people are having issues with it would be best to deal with that separately so people who NEED assistance aren't left in the cold.
- passed that as one bill, perhaps including a clause or two that would make it easier to address the next issues ... aka - planning ahead)

The second stage, after giving the first stage some time to be formulated and put into action, the second stage would be to address the health inssurance issues (if it wasn't done in the 1st stage). This would mean opening insurance companies to being more competative by being allowed to function nationwide. Instilling strict regulations on allowing pre-existing conditions and defining max-costs, fines, regulations and taxes instilled on businesses only if necessary and if public-health option changes aren't effective and benificial ot making existing private insurance more affordable.

Third Stage, The Practice details - allowing panels to advise and cross-examine patients without the patient having to have a completely different exam by a different doctor. The effects of high-pricing on med supplies (including prescriptions and pharm-companies), malpractice caps and regulations in this area...etc etc etc.

Fourth stage - revision and adjustment to already in place changes to adjust to their effectiveness.


I think that would work ideally - curb public outcry and allow the most important thing which, because of public outcry, isn't even being considered, now - the public health option.

I htink it's bull**** that people who are in desperate needs for medications, treatment and relief and such aren't going to be getting it because joeblow is freaking out over how much he's going ot be paying if he refuses to pay for his employees health insurance. If they didn't cram everything into ONE big freaking bill then the most important thing wouldn't be put off because of other issues. Whie those issues are legitimate, it's not worth the fuss, in my opinion.

I don't understand why they're rushing ot try to do everything at once - it's only making it MORE complicated. If they were JUST proposin, now, Stage One that I've defined it would have passed with flying colors and bipartisan support.
Perhaps i'm really wrong - but I odn't see anything being done right now and people are really suffering.

I'm not concerned about people who can afford their own insurance but would rather not - I'm more concerned about people who are seriously ill and in pain and NEED relief and help and don't have any - or what they have isn't enough. That's why I'm shocked that they bunked out of public-health option when that is the only thing that's truely vital.
I think that's rather scumy, honestly.

[LoveKiss]

It could work, or it could just prolong the agony and *****ing. Then every one complains that you are constantly putzing with things and changing the rules of the game. No one can get used to things, the approach appears to be uncoordinated and disjointed, and so they ***** and moan. I write health care regulations. We've done complete overhauls of regulations and we've made piece meal changes. Either way, everyone whines, moans, groans, and *****es us out. People seem to instinctively abhor change. We can't please people either way, so now we take things on a case-by-case basis and decide our approach. If something is so utterly dysfunctional, a complete overhaul is in order. This allows us to modify/eliminate/add to the entire picture and all of its inter-related elements. If it's just a few distinct things, we tweak them one at a time.

[Aunt Sponge]

I don't think so, though - I think it would be smoother and more bipartisan if they approached it in parts. This is why:

Look at the Constitution, for example. At the time it was written there were 13 colonies and the majority of the colonists supported slavery or owned slaves. There was a minority of the "Framers" of the Constitution that were against slavery and wanted to do away with it.

However, the people who wanted to do away with it knew that if they said "accept the constitution, and we're doing away with slavery, too" those who supported slavery would have just given them the finger and walked away.
The Constitution would never have been ratified by the colonies and slavery would have continued indefinitely and We'd probably be the "Confederated States of the North American Union" or some crap like that or even Warred into Mexico or back to the British.

However, instead of introducing their desire to abolish it into the Constitution they knew that their priority was to get the Constitution ratified, first, get hte new government going, and then slowly approach it, again, so they could gain eveyrone's support - instead of everyone's opposition.

You have to slowly guide people to accept things that they, at first, are very against. Even if it takes longer, in the end, but you have to stick to it.

And I'm not suggesting that they make it take the process of overall healthcare reform last a few years - but within a year passing all the aspects, sure, I would have no issue with that.

(Why am I comparing this healthcare reform to abolishing slavery? Because abolishing slavery was a massive-change to the American view and if it wasn't for our Constitution being written and ratified then it wouldn't be possible for us, today, to argue about other issues relating to "inalienable rights" - Thus, slavery was abolished based on them finally saying "yes, you are all people just like us" ... and so is healthcare reform - specifically the public-option - it is based on these same inalienable rights of "life, liberty and the persuit of happiness"

[LoveKiss]

I can see the parallels in your analogy, but there are quite a few key differences that make this situation a helluva lot more dastardly.
1. Numbers. 13 vs 50
2. Consensus. Everyone has a common enemy that must be thwarted (those damn Brits who'd like to control us again) vs no agreed-upon definition of the problem (lots of people with health insurance like the system just fine)
3. Communication. In person speeches with a common touch were used to persuade. Newspapers were loimited to major cities and not widely read. vs TV, newspapers, viral e-mails/youtube videos/blogs/etc., cable, radio, etc. There is a complete inability to control the message.
4. The process. Lock a bunch of dudes in a room for one effing long time to get it written without worries of anything other than getting that 1 task complete, then let them sell it. vs. Congress, town hall shout fests, gun toting protests, millions of dollars in campaign funds at stake, approaching mid-term elections, and the Clinton administration's failure/Republican take-over of '94 looming in the back of everyone's mind.

Yes, sometimes the slow, steady, chipping away process does work. I just don't think it would here. The circumstances are not right, the social and political willpower isn't there for such a concerted long-term effort (1 year is unreasonable), the moaning is too loud, the time between election cycles is too short, etc. etc. etc. There will be a chipping away process once the larger bill is passed. Congress will give us legislation, but it it up to the agencies in the executive branch to take that legislation and put it into action. There will be regulations, which have their own process and cycle to go through, during which even more time and consideration will be given to congressional and public input to fashion the functional workings of the overhaul. It's not a one shot deal even with a huge piece of legislation.

[Aunt Sponge]

True, times have changed - yet the measures (aka - differences I'm refering to) that were put in place can be worked in favor of reform, not against it.

The states have increased and, thus, proportionately the population and members in the House have increased from 55 to 535 - 435 members are in the Congress and 100 members are in the Senate.

The Declaration of Independence was signed in 1776 - This is what everyone rallied in favor for (in opposition to the British government) and this is what declared us separate from them.
the Constitution was written and ratified in 1787 as a separate document with a separate purpose than the Declaration of Independence. The Constitution was written to solidify and form a new national government.

The Constitution actually completley replaced the Aritcles of the Confederation which was put in place after the Revolutionary war. The lack-of-governing under the Ar-Con is what people protested in that day - Shays's Rebellion, among other actions, actually made them realize that the Ar-Con wasn't the right outline for government (in fact, it left us without much of a national government to the point that the first president under the Articles of the Confederation, John Hansen, didn't even take his president-possition serious enough to show up)

I agree with the consensus point you made - it's true, our Constitution has sealed our right to know and learn, technology has made it possible to know and learn without being part of a select "group" of politicians and scholars and owning property isn't a basis for valuing your opinion, anymore.

- Which is why it's important to break it down and approach it little by little. In such a capable, informed arena It's far more likely that you'll gain necessary support when you keep it simple (remember, KIS)

I prefer, I suppose, to have a large number of people be in support of such a measure - this would ensure that it continues, strong, even after being put into effect.

I'm not seeing it as just helping people - I'm seeing it as making a complete change to people's overall opinions and values.

[LoveKiss]

Originally Posted by Aunt Sponge True, times have changed - yet the measures (aka - differences I'm refering to) that were put in place can be worked in favor of reform, not against it. The states have increased and, thus, proportionately the population and members in the House have increased from 55 to 535 - 435 members are in the Congress and 100 members are in the Senate. The Declaration of Independence was signed in 1776 - This is what everyone rallied in favor for (in opposition to the British government) and this is what declared us separate from them. the Constitution was written and ratified in 1787 as a separate document with a separate purpose than the Declaration of Independence. The Constitution was written to solidify and form a new national government. The Constitution actually completley replaced the Aritcles of the Confederation which was put in place after the Revolutionary war. The lack-of-governing under the Ar-Con is what people protested in that day - Shays's Rebellion, among other actions, actually made them realize that the Ar-Con wasn't the right outline for government (in fact, it left us without much of a national government to the point that the first president under the Articles of the Confederation, John Hansen, didn't even take his president-possition serious enough to show up) I agree with the consensus point you made - it's true, our Constitution has sealed our right to know and learn, technology has made it possible to know and learn without being part of a select "group" of politicians and scholars and owning property isn't a basis for valuing your opinion, anymore. - Which is why it's important to break it down and approach it little by little. In such a capable, informed arena It's far more likely that you'll gain necessary support when you keep it simple (remember, KIS) I prefer, I suppose, to have a large number of people be in support of such a measure - this would ensure that it continues, strong, even after being put into effect. I'm not seeing it as just helping people - I'm seeing it as making a complete change to people's overall opinions and values.

But the people recognized that the inherent weakness of the articles of confederation did make us vulnerable. There was still the threat of a common outside enemy. And still, 21 years later, the vivid memory of that common enemy lingered, just as the vivid memory of recentish events lingers for us.

I think you are far more confident about the information level of the lay person than I am. Unfortunately, I have encountered more uninformed/misenformed/ignorant people than I have well/accurately informed individuals in the health care reform debate. People are hearing and speaking through a filter of fear. Even when you break it down kindergarten style, the reaction has been one of staunch refusal. It's fear of change. Big change, little change, any change. That fear is being stoked by the huge number of available communications avenues. Rather than helping, the plethora of options is overwhelming and hurting. The fear mongers are also hurting, but I'll leave that one for another discussion.

I agree that getting the masses on board would be ideal. It would certainly make my job of implementing health care reform far easier. But I think the country is too ideologically divided to achieve that goal. Look at the birthers. Look at the 85% of white southern democrats who defected from their own party during this past election cycle (vs. the 55% who defected last time) and ask yourself if they didn't defect because of his skin color. Kerry was just as liberal as Obama, so it sure wasn't a defection based on political views. Look at how many people still cringe at the mention of W's name, and he's not even in office any more. Look at the leaders of various parts of our society who advocate for hate. Look at the gun-toting guys attending health care rallys, intentionally (IMHO) intimidating with the implied threat of violence. There are so many signs of the deep divisions in this country. Unfortunately, health care reform is also a devisive issue. It's not a place where common ground and good policy are going to meet and be friends.

I'm now brainstorming for an idea of what OBAMA could tackle that would be a uniter and help bridge that chasm. I'll let you know if I come up with anything. I would love to see it happen. I would love to see some of the wounds in this country start to heal.

[Aunt Sponge]

too true - we both see eye ot eye on that - the downfall to anything is ignorance and a lack of educatoin in any situation, not just this healthcare reform.