Now that the Republicans have a majority in the Senate, it is time to push for ObamaCare's replacement with "420Care" - reimbursing providers of charity care with revenue raised from a national sales tax on legalized marijuana (and the certainty of such reimbursements would result in community health centers, a central component of HillaryCare, springing up like mushrooms after a rainy summer night all over the country) - before we end up with nothing at all, not even EMTALA, which the teabaggers want repealed every bit as badly as they want the ACA repealed.

And I'm sure that the Rand Paul wing of the GOP would enthusiastically support 420Care - along with just about anyone who has seen their premiums go up under the ACA, which at last count was like 85 million.

If the Supreme Court guts Obamacare and effectively defeats it (I'd give that a greater-than-50/50 chance of happening), Obama's going to lose a key part of his legacy.

Regarding his overall historical legacy, he's been compared to a lot of presidents but I'm starting to see him being most similar to a seldom-mentioned one: Ulysses S. Grant.

Like Obama, Grant was already a historical figure upon his first inauguration.
Like Obama, Grant was elected twice with convincing electoral and popular vote margins.
Like Obama, Grant's party suffered significant losses in his sixth year in office.
Like Obama, Grant was widely criticized for minor scandals within his administration that were magnified at the time.
Like Obama, Grant was also criticized for his general hands-off approach.
Like Obama, Grant's signature reform (a Civil Rights act) was chipped away by the opposing party and the Supreme Court.
Like Obama, Grant came to office promising a softer policy toward the "enemy" of the time (Indians), only to leave office having authorized a new Sioux War.

Thoughts?

Originally Posted by '58 Flat

Now that the Republicans have a majority in the Senate, it is time to push for ObamaCare's replacement with "420Care" - reimbursing providers of charity care with revenue raised from a national sales tax on legalized marijuana (and the certainty of such reimbursements would result in community health centers, a central component of HillaryCare, springing up like mushrooms after a rainy summer night all over the country) - before we end up with nothing at all, not even EMTALA, which the teabaggers want repealed every bit as badly as they want the ACA repealed.

And I'm sure that the Rand Paul wing of the GOP would enthusiastically support 420Care - along with just about anyone who has seen their premiums go up under the ACA, which at last count was like 85 million.

Obamacare has been controversial. I have wondered if the Democrats overreached.

My brother Mark mentioned that New Mexico has a Federally backed risk pool (essentially insuring people who would otherwise be without). I have to wonder if an arrangement along these lines-in effect, extending the safety net-would have been more feasible in terms of practical politics. The result could have been described as a two-tiered health care system. unlike the nationalized systems in other countries.

Originally Posted by TimWalker

Obamacare has been controversial. I have wondered if the Democrats overreached.

My brother Mark mentioned that New Mexico has a Federally backed risk pool (essentially insuring people who would otherwise be without). I have to wonder if an arrangement along these lines-in effect, extending the safety net-would have been more feasible in terms of practical politics. The result could have been described as a two-tiered health care system. unlike the nationalized systems in other countries.

I don't care for the Obamacare 'system'. Since the old US healthcare 'System' is badly flawed and we should do better, why don't we look at a few of the best national systems in the world and design one based on the best. I would start with France. Probably better to include 3 or 4 others.

Originally Posted by radind

I don't care for the Obamacare 'system'. Since the old US healthcare 'System' is badly flawed and we should do better, why don't we look at a few of the best national systems in the world and design one based on the best. I would start with France. Probably better to include 3 or 4 others.

I have my own nitpicks with the ACA compared to other systems, but it's better than the status quo ante, and more importantly, given the composition and attitude of Congress in 2009 you probably weren't going to get much better.

Originally Posted by Superstring

Like Obama, Grant was widely criticized for minor scandals within his administration that were magnified at the time.

I'd like to see some expounding on this one. Other than this and perhaps your last one, unfortunately I can see the comparisons you're making.

Originally Posted by Superstring

If the Supreme Court guts Obamacare and effectively defeats it (I'd give that a greater-than-50/50 chance of happening), Obama's going to lose a key part of his legacy.

Regarding his overall historical legacy, he's been compared to a lot of presidents but I'm starting to see him being most similar to a seldom-mentioned one: Ulysses S. Grant.

Like Obama, Grant was already a historical figure upon his first inauguration.
Like Obama, Grant was elected twice with convincing electoral and popular vote margins.
Like Obama, Grant's party suffered significant losses in his sixth year in office.
Like Obama, Grant was widely criticized for minor scandals within his administration that were magnified at the time.
Like Obama, Grant was also criticized for his general hands-off approach.
Like Obama, Grant's signature reform (a Civil Rights act) was chipped away by the opposing party and the Supreme Court.
Like Obama, Grant came to office promising a softer policy toward the "enemy" of the time (Indians), only to leave office having authorized a new Sioux War.

Thoughts?

You forgot similar age and following a President now largely reviled as a failure -- and a huge difference in military service.

Obama had never achieved anything out of the ordinary for a 47-year-old US Senator. He was successful at two levels of legislative activity. He was known for political acumen before becoming President.

Grant won twice in landslides.
Most Presidents' parties lose House and Senate seats in their sixth year of office.
The biggest scandal is marginal (Solyndra) and it has died down.
President Obama has been attacked for being both too much of an activist and for being too hands-off. As usual, much of the harsh derogation of his Presidency is contradictory.
Many interests want ACA dismantled (any surprise)... but we shall see whether the Supreme Court so guts it as to be meaningless.
Obama never promised to be 'soft' on al-Qaeda and other terrorists. He has been the worst possible President for dealing with terrorists -- that is, if one is a terrorist. He has shown himself sneaky and brutal.

Originally Posted by radind

I don't care for the Obamacare 'system'. Since the old US healthcare 'System' is badly flawed and we should do better, why don't we look at a few of the best national systems in the world and design one based on the best. I would start with France. Probably better to include 3 or 4 others.

If the GOP were interested in making a better system instead of deriding a two-term President from before he was elected, it would have offered something better or tried to improve what President Obama won. All the GOP is interested in is to establish the most profitable, yet otherwise failed, system best described as "Run Out of Money and Die", a parallel to much else that it stands for.

Originally Posted by Bronco80

I have my own nitpicks with the ACA compared to other systems, but it's better than the status quo ante, and more importantly, given the composition and attitude of Congress in 2009 you probably weren't going to get much better.

I was really thinking of the next change. On Obamacare I fault the Republicans for not supporting any change, and I fault the Democrats for not going for a better plan.

Originally Posted by pbrower2a

If the GOP were interested in making a better system instead of deriding a two-term President from before he was elected, it would have offered something better or tried to improve what President Obama won. All the GOP is interested in is to establish the most profitable, yet otherwise failed, system best described as "Run Out of Money and Die", a parallel to much else that it stands for.

But, there is likely to be another change. I don't think that the Republicans can rescind Obamacare and I would like to see better plans at least considered in the future.

Originally Posted by radind

But, there is likely to be another change. I don't think that the Republicans can rescind Obamacare and I would like to see better plans at least considered in the future.

Should the GOP win the Presidency, hold the House, and hold the Senate, then Obamacare is dead. So are Social Security, Medicare, the federal minimum wage, prohibitions on child labor, federal protection of the environment, public education, the right to organize unions and strike, and regulation of workplace safety -- not to mention in the permanent Single-Party system. Returning to the Gilded Age with brutal repression of any challenge to it is the current dream of the plutocrats behind the GOP. Debt-peonage (the norm in the South, but it would be extended to labor in the North) could quickly become the normal relationship between employer and employee.

In that case, the best thing for Americans would be for America to get mauled badly in some War for Profit (military procurement, expansion of a captive market, securing cheap resources and ultra-cheap labor) with either a leftist insurrection or utter defeat.

Originally Posted by radind

I was really thinking of the next change. On Obamacare I fault the Republicans for not supporting any change, and I fault the Democrats for not going for a better plan.

I think Bronco80 has it exactly right. The Dems had 60 votes in the Senate, and needed them all. Joe Lieberman and Max Baucus were unwilling to bend, so a plan using private insurance was a must. It might have been a lot wiser to blow-off healthcare reform at the time, and go for a big stimulus to get the economy moving. The backlash would have been avoided, and the post-2010 or post-2012 periods may have provided a bit more breathing room. Too late to worry about that now.

Originally Posted by pbrower2a

Should the GOP win the Presidency, hold the House, and hold the Senate, then Obamacare is dead. So are Social Security, Medicare, the federal minimum wage, prohibitions on child labor, federal protection of the environment, public education, the right to organize unions and strike, and regulation of workplace safety -- not to mention in the permanent Single-Party system. Returning to the Gilded Age with brutal repression of any challenge to it is the current dream of the plutocrats behind the GOP. Debt-peonage (the norm in the South, but it would be extended to labor in the North) could quickly become the normal relationship between employer and employee.

In that case, the best thing for Americans would be for America to get mauled badly in some War for Profit (military procurement, expansion of a captive market, securing cheap resources and ultra-cheap labor) with either a leftist insurrection or utter defeat.

I don't agree with your assessment.
-If the GOP sweeps it all in 2016( no sure thing), then we can check in 2017 to see if your dire predictions take place.

Originally Posted by radind

I don't agree with your assessment.
-If the GOP sweeps it all in 2016( no sure thing), then we can check in 2017 to see if your dire predictions take place.

Until I see indications to the contrary, pessimism is the sole method of self-defense. Optimism about the American political system is now wishful thinking. God help us if I must choose between Russia and America in 2017. At least I am good with languages.

Originally Posted by pbrower2a

Until I see indications to the contrary, pessimism is the sole method of self-defense. Optimism about the American political system is now wishful thinking. God help us if I must choose between Russia and America in 2017. At least I am good with languages.

While is school ,I studied Spanish and German. Unfortunately, I am not good with other languages.

Originally Posted by Bronco80

I'd like to see some expounding on this one. Other than this and perhaps your last one, unfortunately I can see the comparisons you're making.

Grant's administration was tarred with several scandals, none of which were traced directly to him personally, but they dragged his popularity down. Obama hasn't had any serious ones but the right has hyped up several in the media, none of which have been traced to him. So in that sense, there are some similarities.

Originally Posted by pbrower2a

You forgot similar age and following a President now largely reviled as a failure -- and a huge difference in military service.

Obama had never achieved anything out of the ordinary for a 47-year-old US Senator. He was successful at two levels of legislative activity. He was known for political acumen before becoming President.

Grant won twice in landslides.
Most Presidents' parties lose House and Senate seats in their sixth year of office.
The biggest scandal is marginal (Solyndra) and it has died down.
President Obama has been attacked for being both too much of an activist and for being too hands-off. As usual, much of the harsh derogation of his Presidency is contradictory.
Many interests want ACA dismantled (any surprise)... but we shall see whether the Supreme Court so guts it as to be meaningless.
Obama never promised to be 'soft' on al-Qaeda and other terrorists. He has been the worst possible President for dealing with terrorists -- that is, if one is a terrorist. He has shown himself sneaky and brutal.

No arguments for his handling of terrorists. But Grant came to office promising a more peaceful policy toward Indians. He was the first president to acknowledge they were the true native Americans. Likewise, Obama came promising a new beginning in the Middle East and a withdrawl from the wars. In spite of his efforts, Grant was eventually pulled into fighting the Sioux War in his last 2 years. Obama similarly, and contrary to his wishes, has been pulled into fighting the ISIS war.

Originally Posted by pbrower2a

Should the GOP win the Presidency, hold the House, and hold the Senate, then Obamacare is dead. So are Social Security, Medicare, the federal minimum wage, prohibitions on child labor, federal protection of the environment, public education, the right to organize unions and strike, and regulation of workplace safety -- not to mention in the permanent Single-Party system. Returning to the Gilded Age with brutal repression of any challenge to it is the current dream of the plutocrats behind the GOP. Debt-peonage (the norm in the South, but it would be extended to labor in the North) could quickly become the normal relationship between employer and employee.

And this possibility is a big reason why the analogy to Grant could fit so well. Grant tried in vain to reconstruct the nation with full equality under the law for all citizens. In the end, the racist Democrats killed his reforms, the GOP adopted its focus on big business interests, and so was born the first Gilded Age.

Originally Posted by radind

I don't care for the Obamacare 'system'. Since the old US healthcare 'System' is badly flawed and we should do better, why don't we look at a few of the best national systems in the world and design one based on the best. I would start with France. Probably better to include 3 or 4 others.

Without a doubt, you would need a Democratic president, and a congress even more Democratic than 2009's, for this to be even considered. That is at least 6 years away; maybe more.

Originally Posted by pbrower2a

Should the GOP win the Presidency, hold the House, and hold the Senate, then Obamacare is dead. So are Social Security, Medicare, the federal minimum wage, prohibitions on child labor, federal protection of the environment, public education, the right to organize unions and strike, and regulation of workplace safety -- not to mention in the permanent Single-Party system. Returning to the Gilded Age with brutal repression of any challenge to it is the current dream of the plutocrats behind the GOP. Debt-peonage (the norm in the South, but it would be extended to labor in the North) could quickly become the normal relationship between employer and employee.

They would need to win the Presidency, hold the House, and get 60 seats in the Senate for any of this to happen - and with only 10 Senate Democrats up for re-election in 2006 (compared with 24 Republicans) and eight of them are in deep blue states, the chances of the Republicans getting 60 seats in the Senate in 2016 (and also note that the Republicans face an uphill battle in Pennsylvania, where their incumbent governor was trounced last week, and in Ohio, where Rob Portman will likely lose in the primary thanks to his support for same-sex marriage) are slim and none - and slim has just converted to Judaism and emigrated to Israel under the Law of Return.

In that case, the best thing for Americans would be for America to get mauled badly in some War for Profit (military procurement, expansion of a captive market, securing cheap resources and ultra-cheap labor) with either a leftist insurrection or utter defeat.

Or merely the outbreak of such a war - whereupon minorities, the poor etc. heed Phil Ochs' song from back in the day and decide, yes, that "even treason might be worth a try" - in which case, if the "treason" is successful (as it was in Russia in 1917-18), the war effort could be abandoned before such "mauling" has the chance to occur, with the victorious insurrectionists brokering a Brest-Litovsk-style peace settlement that would make post-war America pretty much a carbon copy of Australia when it comes to how much global might it would assert.

Here's an excellent explainer if you're trying to understand why the plaintiffs' lawsuit against the ACA is so ludicrous:

http://thinkprogress.org/justice/201...ing-obamacare/

Originally Posted by Bronco80

Here's an excellent explainer if you're trying to understand why the plaintiffs' lawsuit against the ACA is so ludicrous:

http://thinkprogress.org/justice/201...ing-obamacare/

Here's hoping at least five justices see it that way.

Very interesting study on controlling health care costs.

http://www.scientificamerican.com/ar...medium=twitter

How House Calls Slash Health Care Costs


…”before Obamacare came on the scene, New Jersey physician Jeffrey Brenner was already working on innovative ways to slash health-care costs. He scoured health-care billing data at local hospitals and discovered that a small number of “super utilizers” clustered in certain geographic areas were responsible for the bulk of health-care costs in Camden, N.J. He brought together a team of social workers and medical professionals, who made regular house calls to those patients, accompanied them to doctor’s appointments and conducted long interviews with them to obtain health histories—all to help the city cut medical costs and provide better care to these neediest patients. That was some six years ago. His work, called health-care hot spotting, helped net him a MacArthur “genius” award in 2013.”…


…”Has the Affordable Care Act (Obamacare) impacted your work? The law sent a huge market signal out to the health-care industry that the game needs to change and become more efficient and accountable. Under the Affordable Care Act, there was also a $10 billion fund put together to support innovation over a decade. The Centers for Medicare and Medicaid Services have been putting grants out. We got a $2.7 million three-year innovation grant that is helping to pay for the research team in the field. It’s one of our 28 sources of funding.”…

The Presbyterian integrated healthcare system in New Mexico is beginning an initiative called "Home Paramedic." The medics will go out to frequent hospital and ER users and try to keep them stable at home by increasing the amount of shorter term assessment and modification of treatment options.

Six Sigma quality improvement algorithms, and other systematic continuous quality improvement systems have long known this concept. It's also known as the "80:20 rule." Most problematic systems work roughly this way.

One can only wonder why healthcare has lagged so far behind ...

Originally Posted by radind

Since the old US healthcare 'System' is badly flawed and we should do better, why don't we look at a few of the best national systems in the world and design one based on the best.

There are two ways to look at health care. One is it is an economic good, like a car or a house, available to those who can pay for it.

The other is it is an entitlement like food or K-12 education for children.

Conservatives fall into the first camp. They oppose any sort of public provision of healthcare as immoral.

Suppose an ingenious analyst found a less heinous-looking way to torture people? Would this mollify those who oppose torture as an immoral act?