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(Politico)   Now that Obamacare is the law of the land, Democrats are having a go at deciding that portions of it are stupid. Grab the popcorn   (politico.com) divider line 128
    More: Amusing, obamacare, Democrats, law of the land, Maria Cantwell, Centers for Medicare & Medicaid Services  
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1893 clicks; posted to Politics » on 12 Mar 2013 at 7:26 AM (2 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-03-12 10:51:18 AM  

Philip Francis Queeg: So let's eliminate any restraint on their ability to fark around with the money. Problem solved!


Again, they already fark around with the money. They're nothing if not ingenious when it comes to finding workarounds. They've been at it for 50 years with Medicare. Care to have another go at yet another rule that'll only be bent back on itself?

There's no perfect solution here, except to call these bastards' bluff. Shine a light on the roaches. Give them the flexibility AND the accountability, making it known that any fark-ups from here on in are strictly the state's problem.

mrexcess: It's pretty interesting - studies repeatedly confirm that the poorer someone is, the less healthy their diet is... a fact that has been observed for more than a century. Blaming the assistance programs for the poor themselves, then, is perhaps to blame a symptom rather than the cause?


They started out poor. With the federal government's help they're now poor AND fat AND disease-prone, and if they get sick enough they might even become more poor.

But the government can fix that.
 
2013-03-12 10:56:40 AM  

Gulper Eel: Philip Francis Queeg: So let's eliminate any restraint on their ability to fark around with the money. Problem solved!

Again, they already fark around with the money. They're nothing if not ingenious when it comes to finding workarounds. They've been at it for 50 years with Medicare. Care to have another go at yet another rule that'll only be bent back on itself?

There's no perfect solution here, except to call these bastards' bluff. Shine a light on the roaches. Give them the flexibility AND the accountability, making it known that any fark-ups from here on in are strictly the state's problem.


So then maybe giving them complete control of  the money isn't the best solution?

The fark ups won't be the State's problem. They will be the problem of the poor who need that assistance. People who seem to to not figure into your thinking in the slightest.
 
2013-03-12 11:06:31 AM  

Philip Francis Queeg: The fark ups won't be the State's problem. They will be the problem of the poor who need that assistance. People who seem to to not figure into your thinking in the slightest.


More importantly than my plans, the poor don't figure into the legislators' plans either, except for maybe one day every two years and only if they're in a competitive district.
 
2013-03-12 11:10:41 AM  

Gulper Eel: Philip Francis Queeg: The fark ups won't be the State's problem. They will be the problem of the poor who need that assistance. People who seem to to not figure into your thinking in the slightest.

More importantly than my plans, the poor don't figure into the legislators' plans either, except for maybe one day every two years and only if they're in a competitive district.


So fark the little bastards, right?
 
2013-03-12 11:28:16 AM  
Gulper Eel:

Examples: Diabetes II, obesity, the circulatory diseases that accompany obesity, arthritis and joint diseases, etc. Here you go.

(and some more drivel follows this statement)


And this is when I dedicated myself to completely ignoring anything you may say.  Ever.  On any subject.
 
2013-03-12 11:30:43 AM  

Snowflake Tubbybottom: neongoats: Democrats find plenty of it stupid, because it was assraped and mangled by republican obstructionism, so what we got was a watered down piece of shiat, instead of any kind of actual reform at all.

farking insurance industry, no farking better than pay day loan scam stores. Parasites that are worthy only of death.

It got zero republican votes, zero republican amendments, and yet passed and lauded as a great democrat achievement, and still you blame republicans? The only obstruction that took place was the two dem senate holdouts who took a Medicare bribe for their respective states that were later tossed after cloture. This is 100% democrat language, now own it.

Bless your heart.


Because the Republicans didn't filibuster the fark out of it to keep it from even coming to a vote for months.
 
2013-03-12 11:34:45 AM  

Klivian: Yea, that's what happens when you water something down to get it to pass Congress rather than just go single payer


over and done in one ...
 
2013-03-12 12:20:02 PM  

Lord_Baull: Snowflake Tubbybottom: Lord_Baull: Gulper Eel: Astounding. Congress fiddles with the health care system to make it more politically-driven and there are still problems?


This just in: providing healthcare for millions of Americans that could otherwise not afford it = political grandstanding.

/i guess for republicans it is. For the rest of us, it's common sense for the greatest country in the world to provide for its citizens.

Telling me that I have to purchase I couldn't afford or face a financial penalty isn't really the same as providing me anything or fixing the rising cost problems with actual healthcare and related rising insurance costs.


I wonder if a single-payer system would solve that problem.


Fix some, cause others but between total government run (let's just admit what single payer is) and this fiasco hybrid I'd choose the government most likely.
 
2013-03-12 12:26:14 PM  

HeartBurnKid: Snowflake Tubbybottom: neongoats: Democrats find plenty of it stupid, because it was assraped and mangled by republican obstructionism, so what we got was a watered down piece of shiat, instead of any kind of actual reform at all.

farking insurance industry, no farking better than pay day loan scam stores. Parasites that are worthy only of death.

It got zero republican votes, zero republican amendments, and yet passed and lauded as a great democrat achievement, and still you blame republicans? The only obstruction that took place was the two dem senate holdouts who took a Medicare bribe for their respective states that were later tossed after cloture. This is 100% democrat language, now own it.

Bless your heart.

Because the Republicans didn't filibuster the fark out of it to keep it from even coming to a vote for months.


Which in no way changed the content of the law.
 
2013-03-12 12:28:33 PM  
Gulper Eel
They started out poor. With the federal government's help they're now poor AND fat AND disease-prone, and if they get sick enough they might even become more poor.

As opposed to dead from starvation or diseases acquired from digging through garbage cans for meals...? You're missing the point in any case - being poor tends to result in having a poor diet. Maybe we should look at the causes of this, rather than a symptom?

Also, re-quoting the more important parts of my post that you forgot to respond to:

First, the referenced article is behind a paywall, so I can't read it. Can you summarize the facts and figures? Second, that's only dealing with Medicare... do you have any overall numbers?

Third, that's an example of what you consider to be a lifestyle disease, not a clear definition of what lifestyle diseases are. Arguably every disease is either congenital or acquired as a result of someone's actions - a technical definition is important to understand where you're actually drawing the line when calculating this figure.

Fourth, Americans are not the only people to acquire diabetes type II, or to suffer obesity-related health problems like hypertension. Can you explain why our health costs are more than double that of, for example, Australia, despite the rate of obesity not being that dissimilar in the societies (25% vs. 35%)?
 
2013-03-12 12:29:57 PM  

Snowflake Tubbybottom: HeartBurnKid: Snowflake Tubbybottom: neongoats: Democrats find plenty of it stupid, because it was assraped and mangled by republican obstructionism, so what we got was a watered down piece of shiat, instead of any kind of actual reform at all.

farking insurance industry, no farking better than pay day loan scam stores. Parasites that are worthy only of death.

It got zero republican votes, zero republican amendments, and yet passed and lauded as a great democrat achievement, and still you blame republicans? The only obstruction that took place was the two dem senate holdouts who took a Medicare bribe for their respective states that were later tossed after cloture. This is 100% democrat language, now own it.

Bless your heart.

Because the Republicans didn't filibuster the fark out of it to keep it from even coming to a vote for months.

Which in no way changed the content of the law.


Yes, in fact it did.  For example, they took out funding for end-of-life planning because the Republicans deliberately misread it and started insisting it has "death panels".
 
2013-03-12 12:50:02 PM  

Dr Dreidel: // can there be found at least 10 righteous people there?


Not likely. Just give me more of a heads up before the fire and brimstone start so i don't end up drunk and screwing my daughters.
 
2013-03-12 12:51:38 PM  
Gulper Eel:I'm not carrying any water for the Krafts and McDonald's of the world. That should be clear, but you seemed to have missed my point so let me make it clearer: they AND Congress have a shared interest in the increasing size, cost and complexity of the federal government.

As for the poor, I would indeed gut the food-stamp program - to replace it with a state-by-state food program funded by block grants.


Yet you argue that there should be less bureaucracy.  So if you sent this block grant money to the states, you'd rely on their promises that it would actually be used for that reason, not shunted off to some pet project, tax rebate for the wealthy, or way to fix a budget hole?  I can tell you, that if left to their own devices without any way of there being oversight into what the state uses that money for, those poor people will be left to starve.
 
2013-03-12 01:32:10 PM  
As a very liberal nurse who also is a nurse in a large doctors office, I feel ok in saying that there are parts of this bill that suck large donkey balls and gives me a sad on the daily.
 
2013-03-12 01:37:38 PM  

mrexcess: Gulper Eel
Yes - because a massive amount of the healthcare required is for lifestyle diseases

Citations for that claim, please? What percentage of our healthcare spending is "for lifestyle diseases"? What is the technical definition of a "lifestyle disease"?


What I can add to this is that doctors are going to be penalized if Joe Schmoe, who is a non complaint diabetic with terrible average glucose readings does nothing to get them down. His doctor can do gold standard treatment, but if the patient goes home and continues to shovel down the twinkles, it's the doctors who get dinged for Joes lack of responsibility. It sucks. There is no provision for babysitting diabetics written into the law, unfortunately.
 
2013-03-12 02:23:30 PM  

nmrsnr: Dr Dreidel: // can there be found at least 10 righteous people there?

Not likely. Just give me more of a heads up before the fire and brimstone start so i don't end up drunk and screwing my daughters.


A +1 for getting the reference, you salty dog, you.
 
2013-03-12 02:34:37 PM  

Satan's Bunny Slippers: Gulper Eel:

Examples: Diabetes II, obesity, the circulatory diseases that accompany obesity, arthritis and joint diseases, etc. Here you go.

(and some more drivel follows this statement)

And this is when I dedicated myself to completely ignoring anything you may say. Ever. On any subject.



Hell's bells, do I have to provide a citation for EVERYTHING, even if it's intuitively obvious to the (non-Fark) casual observer that being a fatass is going to put above-average strain on the joints?

Mayo Clinic. "Rheumatoid arthritis is an autoimmune disorder that causes inflammation of the joints and also affects other organs in the body. Having excess fat can also contribute to chronic inflammation - a condition that is known to increase the risk for diseases like heart disease and diabetes, and potentially also arthritis. Extra weight around the joints may further accelerate arthritis progression."

AurizenDarkstar: Yet you argue that there should be less bureaucracy. So if you sent this block grant money to the states, you'd rely on their promises that it would actually be used for that reason, not shunted off to some pet project, tax rebate for the wealthy, or way to fix a budget hole? I can tell you, that if left to their own devices without any way of there being oversight into what the state uses that money for, those poor people will be left to starve.


And here's another one who's arrived at the station at 10:45 and is in outraged shock that the 9:45 train has left the station.

States are already shunting off the money to pet projects. This corrupt scenario you describe has already been happening.

New York, as I noted, got away with $15 billion worth of this just on alleged care for the developmentally disabled. New York was spending $4500 per patient, per day, and that was four times what the next-most-expensive state was spending...although most of the money wasn't getting anywhere near the developmentally disabled. And the federal government was perfectly okay with letting that happen for years, under both Republican and Democratic presidencies, Congresses and state governments. The process went:

1) Washington makes a rule for how their Medicaid matching funds can be spent
2) NY finds a way around the rule, or engineers a loophole
3) NY politicians profit
4) return to 2)

Note that there's no "2a) poor patients do better" in that process, nor has there ever been. Anywhere. Seeing as there's no will from any party to stop the above process from happening...why again is it supposed to continue, other than it's free money for politicians to throw around to playact at compassion?

It's a process that is irreparably broken. Block grants are a way of saying game-over to state governments, and if they fark up there's no Washington rule to kick the blame to any more.
 
2013-03-12 02:49:19 PM  

JenFromTheWood: What I can add to this is that doctors are going to be penalized if Joe Schmoe, who is a non complaint diabetic with terrible average glucose readings does nothing to get them down. His doctor can do gold standard treatment, but if the patient goes home and continues to shovel down the twinkles, it's the doctors who get dinged for Joes lack of responsibility. It sucks. There is no provision for babysitting diabetics written into the law, unfortunately.


While I'm libertarian on a lot of issues, I have no problem with taxing the fark out of bad choices, starting with all sugars and any starches that the body easily converts to sugars. You want to be a dumbshiat with what you put into your body? Pay up. You want to maybe switch from Twinkies to cauliflower? I think we can arrange a rebate.

First thing to do, though, is ditch the agriculture subsidies. That should hit fatso in his wallet what with the price of high fructose corn syrup then jumping.
 
2013-03-12 02:55:41 PM  

Gulper Eel: Hell's bells, do I have to provide a citation for EVERYTHING, even if it's intuitively obvious to the (non-Fark) casual observer that being a fatass is going to put above-average strain on the joints?

Mayo Clinic. "Rheumatoid arthritis is an autoimmune disorder


That's as far as I needed to get into your citation to know that you're full of shiat, again. Do you know what an autoimmune disorder is? I'll give you a clue: they are not usually caused by obesity. Your citation states that inflammation can be made worse by excess fat, not that the fat does not cause the disease. If you're going to communicate in text, you should learn how to read.

Plenty of people with low body fat, including a relative of mine, have RA. It is not a lifestyle disease. At all. End of story. You are ridiculously farking wrong.
 
2013-03-12 02:57:06 PM  

thurstonxhowell: not that the fat does not cause the disease.


That should say "not that the fat causes the disease".
 
2013-03-12 03:04:42 PM  
So Gulper, you are the one who suggests dismantling the food stamp program to replace it with block grants, even though you know that it won't be used for that purpose (with the accompanying name calling, which I've come to accept from someone like you...you can't just answer a simple farking question without doing so).

And how is that supposed to help anyone?  You know the block grant program will be used for other things, yet you would do it anyway.  And don't try and wrangle out of that, you were the one that suggested the dismantle food stamps/replace with block grants idea, not me.
 
2013-03-12 03:20:41 PM  

AurizenDarkstar: So Gulper, you are the one who suggests dismantling the food stamp program to replace it with block grants, even though you know that it won't be used for that purpose (with the accompanying name calling, which I've come to accept from someone like you...you can't just answer a simple farking question without doing so).

And how is that supposed to help anyone? You know the block grant program will be used for other things, yet you would do it anyway. And don't try and wrangle out of that, you were the one that suggested the dismantle food stamps/replace with block grants idea, not me.


The status quo: a food stamp program that's used to buy crap...because that's what's cheapest. I can't blame a poor mom for trying to make that card last by buying processed-out-the-arse white bread and so forth. Not her fault the federal government subsidizes crap and steers her kids toward it. You seem to be perfectly okay with this.

Far as the block grants go, it's hopelessly obtuse to be upset that they can be used for political reasons if the money delivered under the status quo is already being used for political reasons - food stamps amount to a subsidy for agribusiness and big-box stores. Proper nutrition is a tertiary concern.

Block grants don't come rule-free - tell me you don't really think that. There may be fewer rules than with heavily-regulated grants...but since that big mess of rules are being broken willy-nilly, there's no point I can see to continuing the charade except that it works wonderfully as a bureaucrat-employment measure.

My one main stipulation for the grants: that they go to buy a recommended daily allowance of minimally-processed vegetables, fruits and proteins. I have no problem if the block-grant winds up costing a bit more, seeing as it's more labor intensive to provide actual food than it is to provide an EBT card. But that's labor that will be in contact with people in their homes, as opposed to being behind a desk downtown.
 
2013-03-12 03:27:11 PM  
I think block grants need MORE regulation and oversight if only due to the fact that they are rarely used for what they are being given for.  As far as food stamps being used for crap food, maybe something should be done to make healthy food choices more affordable while accepting food stamps (as many farmer's markets are trying to do now).

Simply put, I think the food stamp program is a good thing, but that the things that people need to eat (more fresh meats (as fresh as possible) and vegetables) need to be the things that are affordable, not the crap.  Maybe we should be subsidizing the farmers that actually grow/raise things we can eat instead of the ones on the bandwagon growing acres of corn to be used for nothing other than feed corn and HFCS.
 
2013-03-12 03:41:29 PM  

AurizenDarkstar: I think block grants need MORE regulation and oversight


Then they're not block grants, are they?

The whole point of block grants is to tell the states "here - since you're so smart, and constantly biatching about hamhanded interference from Washington and unfunded mandates, here's some money and your chance to prove how smart you are".

A lot people here are laboring under the delusion that because Washington has put in place a whole mess of rules and specific targeting strategies for grants, that they then observe the rules and are immune to attempts to bend the rules.

Which is bullshiat. Take a look at that article. Look who worked wonders in bending the existing system, among others - Mitt Romney.

The last line of the article says it all: "Once New York really grasped the rules of the game, it set the agenda," Professor Castellani added. "The feds never caught up."

All the rest is drama from the state politicians. This isn't about helping the poor. It's about preserving a gravy train.
 
2013-03-12 05:37:02 PM  
It seems that passing a bill that provides government subsidies for non-profit health insurance companies and or non-profit healthcare startups would solve a lot of issues I have with the ACA. Especially if there were inflation-adjustable salary caps for employees of the NPCs taking the subsidy.
 
2013-03-12 06:08:19 PM  

Tomahawk513: Well, it ain't perfect and it could sure be improved, but like in TFA, it's still a huge milestone.


Milestone?  So was the Autobahn that Hitler created.  The word "tax" appears almost 100 times in this unconstitutional bill.  Here is a pic of your beloved pinko bill.  http://michellemalkin.com/2013/03/12/obamacare-regs/
 
2013-03-12 06:11:08 PM  

armoredbulldozer: Tomahawk513: Well, it ain't perfect and it could sure be improved, but like in TFA, it's still a huge milestone.

Milestone?  So was the Autobahn that Hitler created.  The word "tax" appears almost 100 times in this *unconstitutional bill.  Here is a pic of your beloved pinko bill.  http://michellemalkin.com/2013/03/12/obamacare-regs/


*Yes, this bill is unconstitutional.  The SCOTUS got it wrong.  President cocksucker appointed the Racist Sotomayor and the other biatch that HAS NEVER BEEN A JUDGE!!!!
 
2013-03-12 10:54:02 PM  
Curiously, the word "dickwad" doesn't appear at all. Neither does the word "colonoscopy."
 
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