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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 83 to 107 of 107. Go back in thread:
Posted by Dinah on June 29, 2012, at 15:24:23
In reply to Re: Agreed » Dinah, posted by europerep on June 29, 2012, at 14:08:13
> There are two possibilities: I either fundamentally misunderstand your position on this issue, or you will see that it is you yourself who's to blame if someone were to call you egoistic and selfish.
Perhaps we should end on a statement to which we both can agree.
> Lastly, while I should have used more diplomatic terms, I completely stand by my assessment that both this and previous contributions by Philippa on political issues are unqualified and show her lack of knowledge and understanding on this issue. Just because everyone has an opinion on politics doesn't make all those opinions intellectually legitimate. This is as true for politics as it is for all other subjects: if you want to participate in a debate about medical treatments, you can't just come up with some voodoo nonsense and then complain that you'll be called out for that. If Philippa is upset about my comments, then that is the price to pay for entering into a discussion without even the most basic grasp of the actual matter. Misinformation is dangerous, and I won't refrain from pointing out the spreading of misinformation just on the basis of some absurd interpretation of politeness.
>Well, I'll refrain from calling you any names. But we fundamentally differ on our beliefs concerning civility.
Posted by Dinah on June 29, 2012, at 15:25:50
In reply to And what's The Difference, Anyway?, posted by ron1953 on June 29, 2012, at 13:33:57
Quite true.
And these last two posts were not the posts of an *ssh*l*. I apologize for calling you that. I may have jumped to a conclusion or two myself.
Posted by zazenducke on June 29, 2012, at 15:34:03
In reply to Re: Welcome USA To Socialism Healthcare Bill Passed » europerep, posted by sigismund on June 29, 2012, at 0:48:09
and I don't. I demand that you share.
Thank you Thank you Thank you in advance.
> >This whole debate is nothing but a joke, at the expense of poor and ill American citizens.
>
> Thank you thank you thank you
Posted by zazenducke on June 29, 2012, at 15:43:13
In reply to Re: Today After See A Trend? » Phillipa, posted by sigismund on June 29, 2012, at 0:51:09
Watch a lot of Fox do you? He is a moderate. Where do you come up with all your ideas about the US?
> PJ, Obama is a conservative, but not of the Fox news sort.
Posted by europerep on June 29, 2012, at 15:43:58
In reply to Re: Agreed, posted by Dinah on June 29, 2012, at 15:24:23
> Perhaps we should end on a statement to which we both can agree.
Well, actually we shouldn't, but if you're not willing to take this debate to an end, I have to accept that.
> Well, I'll refrain from calling you any names. But we fundamentally differ on our beliefs concerning civility.I don't think that our beliefs differ on the nature of civility, but maybe about whether civility should be allowed to override, if necessary, other aspects of a discussion. I won't sacrifice adequately characterizing someone's argument for the mere purpose of making sure that that person won't get his or her feelings hurt. Trying to link the Affordable Care Act to a political doctrine that has caused great harm to many people (ie, socialism) is not only ridiculously absurd, but it is either stupid or malicious. Either way, I strongly object to it.
Posted by zazenducke on June 29, 2012, at 15:45:29
In reply to Re: Agreed » Dinah, posted by europerep on June 29, 2012, at 15:43:58
Posted by europerep on June 29, 2012, at 16:06:41
In reply to It's not fair that you have a 500,000 property » sigismund, posted by zazenducke on June 29, 2012, at 15:34:03
> It's not fair that you have a 500,000 property and I don't. I demand that you share.
Ah, grossly mischaracterizing your opponent's arguments. A classic.
Posted by zazenducke on June 29, 2012, at 16:11:46
In reply to Re: It's not fair that you have a 500,000 property » zazenducke, posted by europerep on June 29, 2012, at 16:06:41
My opponent?!? Sigi?? Jumping to conclusions are you?
> > It's not fair that you have a 500,000 property and I don't. I demand that you share.
>
> Ah, grossly mischaracterizing your opponent's arguments. A classic.
>
Posted by zazenducke on June 29, 2012, at 16:31:03
In reply to Re: It's not fair that you have a 500,000 property, posted by zazenducke on June 29, 2012, at 16:11:46
Obamacare forces insurers to charge their eldest beneficiaries no more than 3 times what they charge their youngest ones: a policy known as community rating. This, despite the fact that these older beneficiaries typically have six times the health expenditures that younger people face. The net effect of this community rating provision is the redistribution of insurance costs from the old to the young.
According to my sources, this was a favor that Democrats did for the AARP, which was advocating for its older members. Democrats were happy to help out their ally, whose members are active at the voting booth, compared to younger Americans, who vote less often. The AARP actually wanted Obamacare to have a community rating ratio of 2:1that is, insurers could charge their eldest beneficiaries only twice what they charged their youngest. But they had to settle for 3:1.
It also mentions how estimates of how much insurance premiums will go up are increasing (surprise surprise) and that will also effect young people who are just starting out more than more established people.
Posted by zazenducke on June 29, 2012, at 16:46:43
In reply to P.S., posted by emmanuel98 on June 28, 2012, at 20:37:00
> I get really, really angry about turning this forum into a political debate.
You're really really angry at yourself?
Keep your politics to yourself.You first :)
This is not what this forum is for.Sez who?
Posted by Dinah on June 29, 2012, at 16:51:09
In reply to Re: Healthcare Bill Deemed Constitutional » Dinah, posted by 10derheart on June 29, 2012, at 13:20:09
Same here. :(
Posted by zazenducke on June 29, 2012, at 17:32:40
In reply to Re: Healthcare Bill Deemed Constitutional » Dinah, posted by 10derheart on June 29, 2012, at 13:20:09
> I presently consider Babble 100% unmoderated.
>
> I suppose that brings pleasure to some, but not me.I was glad Dinah wasn't blocked for name calling.
Is that pleasure?
Posted by PartlyCloudy on June 29, 2012, at 17:36:54
In reply to Re: Healthcare Bill Deemed Constitutional » 10derheart, posted by zazenducke on June 29, 2012, at 17:32:40
>
>
>
>
>
>
>
> > I presently consider Babble 100% unmoderated.
> >
> > I suppose that brings pleasure to some, but not me.
>
> I was glad Dinah wasn't blocked for name calling.
> Is that pleasure?
>
Who's peeing in the pool now?
I'm telling.
Posted by zazenducke on June 29, 2012, at 17:41:13
In reply to Re: Healthcare Bill Deemed Constitutional » zazenducke, posted by PartlyCloudy on June 29, 2012, at 17:36:54
> >
> >
> >
> >
> >
> >
> >
> > > I presently consider Babble 100% unmoderated.
> > >
> > > I suppose that brings pleasure to some, but not me.
> >
> > I was glad Dinah wasn't blocked for name calling.
> > Is that pleasure?
> >
>
>
> Who's peeing in the pool now?
> I'm telling.
>
>Nooooo Nooooo not the naughty button!!!!!!!!
Posted by emmanuel98 on June 29, 2012, at 17:58:36
In reply to Re: Healthcare Bill Deemed Constitutional » emmanuel98, posted by Dinah on June 29, 2012, at 12:10:03
> > I get angry at how little most people know, yet how much they think they know.
>
> For example, had you said that you thought Carter was too harshly judged for the bad economy in his time, and explained why, that would be one thing.
>
> Instead you said the above.
>
> I hate unregulated boards.
I did explain why. The federal government has NO CONTROL over the Federal Reserve. They are entirely different institutions. Federal Reserve employees are not civil servants. Their budget does not come from the Treasury. Their main committees represent bankers who, in fact, own the 12 regional Feds. The president appoints the governors and chair who serve 14 year terms, so that a sitting president has virtually no control over the Fed in a single term. The Fed caused the economy to fail, not Carter. The Fed in 1979 engineered the worst recession, at that time, since the 1930s. The short-term interest rate (which the Fed sets and controls) rose to 21%. This had nothing to do with Carter. This is what I mean when I say people don't understand enough about how the economy works.
>
Posted by 10derheart on June 29, 2012, at 18:01:44
In reply to Re: Healthcare Bill Deemed Constitutional » 10derheart, posted by zazenducke on June 29, 2012, at 17:32:40
Sure. Why not? Though it's not up to me to say what pleasure is for you. :-)
Liking moderation doesn't mean seeing or giving warnings or blocks actually pleases me. I just favor a civil environment. Blocking has rarely pleased me (though I'll admit to being relieved and satisfied in cases of cruelty/bullying) in and of itself. But I really have sensed those who have posted over the years they hated what they saw as overly strict civility rules did find pleasure in a free-for-all type environment instead. Which is not for me at all.
BTW, I've been enjoying your posts on this thread.
Posted by emmanuel98 on June 29, 2012, at 18:13:35
In reply to Obamacare unfair to young people?, posted by zazenducke on June 29, 2012, at 16:31:03
> Obamacare forces insurers to charge their eldest beneficiaries no more than 3 times what they charge their youngest ones: a policy known as community rating. This, despite the fact that these older beneficiaries typically have six times the health expenditures that younger people face. The net effect of this community rating provision is the redistribution of insurance costs from the old to the young.
>
> According to my sources, this was a favor that Democrats did for the AARP, which was advocating for its older members. Democrats were happy to help out their ally, whose members are active at the voting booth, compared to younger Americans, who vote less often. The AARP actually wanted Obamacare to have a community rating ratio of 2:1that is, insurers could charge their eldest beneficiaries only twice what they charged their youngest. But they had to settle for 3:1.
>
Maybe it's just because I work in MA, which tends to be liberal, but my 20-something students are well aware that they, too, will grow old, as will their parents who will need help and support. They do not feel put upon by this and do not respond to efforts to fuel some kind of inter-generational conflict over either health care or social security.
Posted by Dinah on June 29, 2012, at 18:55:01
In reply to Re: Healthcare Bill Deemed Constitutional » zazenducke, posted by 10derheart on June 29, 2012, at 18:01:44
Naturally I turned myself in. Such behavior shouldn't be tolerated.
Posted by jrbecker76 on June 29, 2012, at 20:39:25
In reply to Re: Healthcare Bill Deemed Constitutional » zazenducke, posted by PartlyCloudy on June 29, 2012, at 17:36:54
Supreme Court Decision Benefits People With Mental Illness
http://www.huffingtonpost.com/michael-friedman-lmsw/aca-mental-health_b_1636839.html
It is good news for people with mental illness and their families that the Supreme Court has ruled that the Affordable Care Act is constitutional. The benefits would have been greater if the court had not made expansion of Medicaid eligibility optional for the states. But even if some states choose not to provide Medicaid for more people who cannot afford health care or health insurance, millions of people without coverage or with inadequate coverage -- including people with mental illness -- will now be able to get the health and mental health care they need.
The ACA benefits people with mental illness in six major ways:
(1) It provides improved coverage of physical health care, which is extremely important to people with mental and/or substance use disorders because (a) they are at higher risk than the general population of having co-occurring chronic physical disorders and (b) they have dramatically lower life expectancy than people without mental illness, in significant part because of poor health and poor access to good health care.
General health coverage improvements that will benefit people with mental and/or substance use disorders include:
Insurance reforms, such as coverage of pre-existing conditions and maintenance of coverage during long illnesses.
Access to more affordable health coverage for individuals and small businesses through state health insurance exchanges.
Expanded eligibility for Medicaid in states that do not opt out of the "requirements" built into the Affordable Care Act.(2) The ACA also provides improved coverage of mental health and substance abuse conditions. This is a major advance. Just three years ago, new federal laws required "parity" in the coverage of mental and physical health conditions in employer-based health benefit plans and Medicare, but the provisions were limited. The ACA carries these requirements forward and expands them considerably.
(3) The ACA also provides enhanced Medicare coverage of medication, including of psychiatric medications. This will result in:
Reduced out-of-pocket spending on pharmaceuticals by shrinking the "donut hole," i.e. the phase of personal spending on medications not covered by Medicare.
Enhanced access to psychiatric medications prescribed by a physician that were not covered in the original version of Medicare prescription drug coverage.(4) The ACA emphasizes the importance of integrating and coordinating the delivery of physical and mental health services and provides incentives to providers to integrate care, including:
Rate increases for medical practices recognized as "medical homes" that provide coordinated care and preventive services, among other features.
Increased federal funding for Medicaid payments to "health homes," which are organizations that coordinate care for people with chronic physical and/or behavioral health conditions.
Contracts with "accountable care organizations" -- a new type of structure designed to improve care quality and contain costs.(5) The ACA also emphasizes preventive interventions. For example, it provides Medicare payments for preventive health care and health promotion for the first time. This, of course, benefits people without mental illness as well as those with mental illness, but it is particularly important for people at high risk of obesity and the diseases it drives such as hypertension, diabetes, and heart disease. These are conditions that are particularly common among people with serious mental illness.
(6) Finally, the ACA emphasizes services in the home and community instead of in institutions. There are new demonstration grants as well as new opportunities for Medicaid waivers for state efforts to reduce the use of nursing homes and other institutions and instead provide care for people with disabilities in their homes and communities. In this way it carries forward the policy goal of helping people with psychiatric and other mental disabilities to live in the community rather than in institutions. It also will help states to fulfill the mandate of the Olmstead Decision of the Supreme Court, which interpreted the Americans with Disabilities Act as requiring states to provide supports to enable people with disabilities to live in the "most integrated" setting in the community rather than in institutions.
All in all the Affordable Care Act is a great step forward in America's efforts to meet the needs of people with mental health conditions and to do so in the community rather than in institutions whenever possible. As it is implemented, it should be a great boon to people with mental illnesses and their families, contributing to recovery and improved quality of life.
This will depend, of course, on how well the provisions of the ACA are implemented. Sadly, it is not likely in the current political atmosphere in the United States that ideological disputes will shift to the background so that federal, state, and local governments, providers, insurers, and advocates can focus on critical issues of implementation. We would be happy to be wrong about that.
Michael B. Friedman, LCSW, teaches at Columbia University. Kimberly A. Williams, LCSW, is the Director of the Center for Policy, Advocacy, and Education at the Mental Health Association of NYC.
Also see:
http://www.nytimes.com/2012/06/29/opinion/the-real-winners.html
Posted by jane d on June 29, 2012, at 22:11:24
In reply to Re: Healthcare Bill Deemed Constitutional » Dinah, posted by 10derheart on June 29, 2012, at 13:20:09
I think this legislation is more likely to make a difference to my long term health than any post about the latest and greatest new medication. And I believe this even though I'm not at all sure how well this plan will work.
I understand all the warnings bout what can happen to friendships when you discuss politics but, when it's really important, who else do you discuss it with? People you have no ties to other than your opposing beliefs? That's a guaranteed formula for polarizing the discussion. Here at least I think there is the potential for people to temper their initial reactions out of respect for their existing relationships and maybe actually (hopefully) discuss it. Or, if they don't believe this can happen, just skip the thread entirely. This conversation is going on today all over the web. Personally I'm skipping it in most of those places because I don't have anything invested in those people.
Posted by sleepygirl2 on June 29, 2012, at 22:30:40
In reply to I think this discussion DOES belong here, posted by jane d on June 29, 2012, at 22:11:24
Jane :-)
Hi
Do you happen to know of a good source of info on the web about this issue?
NPR mentioned a website, but I can't remember it.
Posted by jane d on June 29, 2012, at 23:16:12
In reply to Re: I think this discussion DOES belong here » jane d, posted by sleepygirl2 on June 29, 2012, at 22:30:40
> Jane :-)
> Hi
> Do you happen to know of a good source of info on the web about this issue?
> NPR mentioned a website, but I can't remember it.I don't. But the first thing I'd try is npr.org If they mentioned it there's a good chance they'll link to it. If you remember what show you heard it mentioned on you can check their page too. If you find the site and like it would you post it back here? I'd like to read more too.
Posted by jane d on June 30, 2012, at 21:25:11
In reply to Welcome USA To Socialism Healthcare Bill Passed, posted by Phillipa on June 28, 2012, at 12:37:06
Posted by ihatedrugs on July 2, 2012, at 23:18:41
In reply to Welcome USA To Socialism Healthcare Bill Passed, posted by Phillipa on June 28, 2012, at 12:37:06
Posted by zazenducke on July 3, 2012, at 12:51:09
In reply to Experiment (nm), posted by jane d on June 30, 2012, at 21:25:11
Here's a critique of the Mass experiment.
The one drawback it says is spiraling costs.
There are bills pending to cut spending.
And how will that spending be cut?
I don't know but how else to cut costs but some form of limiting services or rationing?
With half of the newly covered people being added to Medicaid cost cutting will probably make an often dreadful program even worse. Doctors claim now that medicaid payments are not enough to cover their costs. How are they going to find doctors that will even participate in the program?
I think people who are forced to use Medicaid for mental health care are often misdiagnosed and overdrugged. The 15 minute med check was invented for managed care and the low reimbursement rates for Medicaid makes it likely that the Medicaid clinics with high volume are the only ones that will be providing a lot of people with care and that care will be influenced by what is most profitable for the provider.
But I hope I'm wrong.
This is the end of the thread.
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