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Ted King wrote:
[quote=rjmacs]
I'm afraid that the Democratic Party's approach to Medicare isn't a whole lot more rational than this.
Could you elaborate?
Preemptive request: please don't reply to my comments below with "the Republicans did that too," or, "the Republican position was worse" - that is not a logical defense, it's a political defense. My comments below are about the Democratic Party, per Ted's request.
So far, the party has been similarly unwilling to insist on either fiscal responsibility or outcomes-oriented reimbursement re: Medicare. Overwhelming support for Medicare Part D (the drug benefit) with no funding source or insistence on price negotiation as a condition of passage was just ridiculous. Year after year of accounting that is completely dependent on cutting reimbursement to providers, accompanied by year after year of deferring those cuts out of political cowardice. During the healthcare reform debate, there was a total failure of Democratic leadership to insist on outcomes-oriented reforms or comprehensive, team-based care.
The issue of Medicare's future is saturated on all sides of the debate by political cowardice. The reality is that the system needs to change, eliminate its fee-for-service structure, and become much more involved in managing patient care if it is to survive as a public program. The alternative is to privatize. These are deeply unpopular and politically difficult ideas, discursively at odds with popular American notions of individualism, entitlement, and rights (which themselves are full of irony and contradiction, but that's not the present point).
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mrbigstuff wrote:
[quote=Ted King]
[quote=rjmacs]
I'm afraid that the Democratic Party's approach to Medicare isn't a whole lot more rational than this.
Could you elaborate?
He's correct. Remember when the idea during the HCR debate was to allow 55+ to enroll in Medicare? Nooo, the Dems caved on that one right away and from what I read of it at the time, it would have provided a much needed boost to the entire system and solved one of the problems of people w/o insurance who fall between that gap in age. C'est la vie in DC.
Excuse me but Medicare's shortfall is 50% now. How do you expect to add millions of illness-prone subscribers to it?
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rjmacs wrote:
[quote=Ted King]
[quote=rjmacs]
I'm afraid that the Democratic Party's approach to Medicare isn't a whole lot more rational than this.
Could you elaborate?
Preemptive request: please don't reply to my comments below with "the Republicans did that too," or, "the Republican position was worse" - that is not a logical defense, it's a political defense. My comments below are about the Democratic Party, per Ted's request.
So far, the party has been similarly unwilling to insist on either fiscal responsibility or outcomes-oriented reimbursement re: Medicare. Overwhelming support for Medicare Part D (the drug benefit) with no funding source or insistence on price negotiation as a condition of passage was just ridiculous. Year after year of accounting that is completely dependent on cutting reimbursement to providers, accompanied by year after year of deferring those cuts out of political cowardice. During the healthcare reform debate, there was a total failure of Democratic leadership to insist on outcomes-oriented reforms or comprehensive, team-based care.
The issue of Medicare's future is saturated on all sides of the debate by political cowardice. The reality is that the system needs to change, eliminate its fee-for-service structure, and become much more involved in managing patient care if it is to survive as a public program. The alternative is to privatize. These are deeply unpopular and politically difficult ideas, discursively at odds with popular American notions of individualism, entitlement, and rights (which themselves are full of irony and contradiction, but that's not the present point).
I don't disagree with the facts you are presenting, but I don't agree with the characterization of that being "not a whole lot more rational" than the positions put forth by the Republican candidates in the debate. I say that because it seems to me that what you have described that has happened with Democrats and health care is that they are stymied by the politics of the situation. Is it a logical contradiction to take what they can get toward more health care for those who wouldn't otherwise have it even if the political process keeps them from adequately addressing things that you mentioned? I think that is different from advocating ideas that are diametrically opposed, as is what I think the Republicans are doing. Republicans bashed Democrats in the 2010 election cycle for voting for reductions in Medicare benefits which helped them take over the House and then what did they do - they passed Paul Ryan's bill that would very drastically reduce benefits. The Republican candidates for president just seem to advocate one side or the other of this contradiction - whichever is expedient at the moment - without acknowledging the contradiction. That's the reality distortion field.
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Ted King wrote:
I don't disagree with the facts you are presenting, but I don't agree with the characterization of that being "not a whole lot more rational" than the positions put forth by the Republican candidates in the debate. I say that because it seems to me that what you have described that has happened with Democrats and health care is that they are stymied by the politics of the situation. Is it a logical contradiction to take what they can get toward more health care for those who wouldn't otherwise have it even if the political process keeps them from adequately addressing things that you mentioned? I think that is different from advocating ideas that are diametrically opposed, as is what I think the Republicans are doing. Republicans bashed Democrats in the 2010 election cycle for voting for reductions in Medicare benefits which helped them take over the House and then what did they do - they passed Paul Ryan's bill that would very drastically reduce benefits. The Republican candidates for president just seem to advocate one side or the other of this contradiction - whichever is expedient at the moment - without acknowledging the contradiction. That's the reality distortion field.
I love your characterization that "the political process keeps them" from doing the right thing. And who, exactly, is running this "process?"
The issue with the Democrats is more pragmatic; they appear to believe that if they simply refuse to deal with the financial problems posed by Medicare, and continuously allow its costs to balloon, either 1) someone else will deal with it later, or 2) magic elves with bags of cash will appear and fix it. Cowardice is understandable, but not rational in this case. Sticking your head in the sand and not having a debate about what to do about Medicare is a reality distortion field all by itself.
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Correct me if I am wrong but neither Social Security nor Medicare were designed for what they are being used for today.
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rjmacs wrote:
[quote=Ted King]
I don't disagree with the facts you are presenting, but I don't agree with the characterization of that being "not a whole lot more rational" than the positions put forth by the Republican candidates in the debate. I say that because it seems to me that what you have described that has happened with Democrats and health care is that they are stymied by the politics of the situation. Is it a logical contradiction to take what they can get toward more health care for those who wouldn't otherwise have it even if the political process keeps them from adequately addressing things that you mentioned? I think that is different from advocating ideas that are diametrically opposed, as is what I think the Republicans are doing. Republicans bashed Democrats in the 2010 election cycle for voting for reductions in Medicare benefits which helped them take over the House and then what did they do - they passed Paul Ryan's bill that would very drastically reduce benefits. The Republican candidates for president just seem to advocate one side or the other of this contradiction - whichever is expedient at the moment - without acknowledging the contradiction. That's the reality distortion field.
I love your characterization that "the political process keeps them" from doing the right thing. And who, exactly, is running this "process?"
The issue with the Democrats is more pragmatic; they appear to believe that if they simply refuse to deal with the financial problems posed by Medicare, and continuously allow its costs to balloon, either 1) someone else will deal with it later, or 2) magic elves with bags of cash will appear and fix it. Cowardice is understandable, but not rational in this case. Sticking your head in the sand and not having a debate about what to do about Medicare is a reality distortion field all by itself.
Well, there is this thing called a Senate filibuster as an example of "the political process keeps them". But I sense that more of our disagreement is semantic - what is rational? I get the sense that I tend to tilt much more heavily toward the "logical" orientation of its potential meanings and you more to the "reasoning" orientation. Language is a dynamic thing, so I'm not going to say your use is wrong, but my inclination is to think that the way you want to use the word "rational" is a little too loosy-goosy for me. :-)
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Ted King wrote:
Well, there is this thing called a Senate filibuster as an example of "the political process keeps them". But I sense that more of our disagreement is semantic - what is rational? I get the sense that I tend to tilt much more heavily toward the "logical" orientation of its potential meanings and you more to the "reasoning" orientation. Language is a dynamic thing, so I'm not going to say your use is wrong, but my inclination is to think that the way you want to use the word "rational" is a little too loosy-goosy for me. :-)
Okay. My notion of what is rational is less strictly tied to formal logic and more broadly extends from notions of reasonableness. That is, the capacity to make sense of something when viewed in its totality, rather than merely when evaluated in discrete parts.
No matter the case, reality is distorted from both the Democratic and Republican positions as regards Medicare. So, we can quibble about my choice of the word 'rational' in my initial post, but that obscures the lack of reasonable coherence to be found in the positions and actions of either side, which was really the core of my point.
What you said best applies to both sides in practice: "Don't try to make sense of it. It will just make your head hurt." I don't CARE whether the Democrats make a more cogent argument on paper, if they then never follow through on it. To me, that's just as unreasonable as never making sense in the first place. It might even be more irrational. It's certainly just as useless.
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Reporter: "Are you a member of an organized political party?"
Will Rogers: "No. I'm a Democrat".
The more things change ...
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rjmacs wrote:
Okay. My notion of what is rational is less strictly tied to formal logic and more broadly extends from notions of reasonableness. That is, the capacity to make sense of something when viewed in its totality, rather than merely when evaluated in discrete parts.
No matter the case, reality is distorted from both the Democratic and Republican positions as regards Medicare. So, we can quibble about my choice of the word 'rational' in my initial post, but that obscures the lack of reasonable coherence to be found in the positions and actions of either side, which was really the core of my point.
What you said best applies to both sides in practice: "Don't try to make sense of it. It will just make your head hurt." I don't CARE whether the Democrats make a more cogent argument on paper, if they then never follow through on it. To me, that's just as unreasonable as never making sense in the first place. It might even be more irrational. It's certainly just as useless.
Sometimes the philosophy major in me probably gets overly niggley about certain things - like what is rational. When you move beyond logic (which really is just bunch of rules about assessing when thinking is valid and sound) then values enter into the picture and then what becomes rational or irrational depends on what value judgments you make. IOW, what is considered rational becomes much more relative to your value system and less about objectively following rules of logic.
If the Democrats cannot overcome issues like the Senate filibuster to raise taxes enough to get sufficient funding for Medicare, then what is the reasonable thing for Democrats to do?
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Ted King wrote:
Sometimes the philosophy major in me probably gets overly niggley about certain things - like what is rational. When you move beyond logic (which really is just bunch of rules about assessing when thinking is valid and sound) then values enter into the picture and then what becomes rational or irrational depends on what value judgments you make. IOW, what is considered rational becomes much more relative to your value system and less about objectively following rules of logic.
If the Democrats cannot overcome issues like the Senate filibuster to raise taxes enough to get sufficient funding for Medicare, then what is the reasonable thing for Democrats to do?
I really don't want to dive to deeply into this philosophical debate, but there's a compelling argument to be made that once you enter the realm of human activity (and leave that of abstracted mathematics), logic is thoroughly embedded in values, and its use without attachment to moral valuation is nonsensical. See the Frankfurt School (Marcuse, Horkheimer, etc.) and other critical theorists for details.
Well, one reasonable thing would be to stop demonizing the opposition and positioning Republicans as essentially and permanently antithetical to truth, justice, and the American way. To remain committed, in the face of Realpolitik threats, to painful and risky compromises that carry political costs. To acknowledge that personal reelection and individual political careers are sometimes the cost of good political action.
But those rest on a 'rationality' that puts the good of the people above the good of the politician, or the party. So is it really rational at all?
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