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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Wed May 27, 2015 10:28 am 
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Well, we are splitting hairs now. Yes, some people who are not covered by the medicaid expansion but are still low income will not pay a penalty but Obamacare is still compulsory for those that matter! Young healthy well off people who Boyracer claims are dropping insurance coverage. The whole point of compulsory coverage was to avoid an "insurance death spiral". Also you must have missed the US Supreme court decision that ruled the fee/penalty as a tax and therefore constitutional to the great dismay of opponents of Obamacare.
On the second point, the Medicaid expansion was a large part of expanding insurance, Medicaid reimbursements rate vary greatly from state to state. Rates are particularly low in the South. Hospitals seem to do OK. In fact more and more hospital based physicians are now employed directly by hospitals. So the hospital in effect subsidises their income. Less so for primary care physicians. Poor people have traditionally accessed healthcare in the US via the ER because they didnt have or couldn't afford t go to a primary care specialist. In certain states, I fear that may not change that much.
Here's an article that explains it.
http://www.washingtonpost.com/blogs/won ... e-pay-cut/


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Wed May 27, 2015 1:12 pm 
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Joined: Feb 19, 2014
Posts: 1380
double down wrote:
Well, we are splitting hairs now. Yes, some people who are not covered by the medicaid expansion but are still low income will not pay a penalty but Obamacare is still compulsory for those that matter! Young healthy well off people who Boyracer claims are dropping insurance coverage. The whole point of compulsory coverage was to avoid an "insurance death spiral". Also you must have missed the US Supreme court decision that ruled the fee/penalty as a tax and therefore constitutional to the great dismay of opponents of Obamacare.
On the second point, the Medicaid expansion was a large part of expanding insurance, Medicaid reimbursements rate vary greatly from state to state. Rates are particularly low in the South. Hospitals seem to do OK. In fact more and more hospital based physicians are now employed directly by hospitals. So the hospital in effect subsidises their income. Less so for primary care physicians. Poor people have traditionally accessed healthcare in the US via the ER because they didnt have or couldn't afford t go to a primary care specialist. In certain states, I fear that may not change that much.
Here's an article that explains it.
http://www.washingtonpost.com/blogs/won ... e-pay-cut/

Obamacare reduced the number of uninsured from 48 to 30 million. That's less than a 50% reduction, and I wouldn't call 30 million people "splitting hairs".....exactly.

I'm not certain, but I believe the issue of the ACA payment "bump" was addressed in the much bigger permanent "doc fix" bill signed last month. The House passed it, and I believe it made it to the final bill. It's referenced in the WaPo piece you cited.

Obama signs $200 billion 'doc fix' bill

http://thehill.com/homenews/administrat ... c-fix-bill

House Passes Bill To Fix Medicare's Doctor Payments ...


http://commonhealth.wbur.org/2015/03/me ... ayment-fix


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Thu May 28, 2015 6:00 pm 
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Posts: 1380
Elizabeth is not having a good week. She didn't have a good tech conference.

Senator Elizabeth Warren puts tech crowd to sleep with talk of infrastructure

VentureBeat
Above: Massachusetts Senator Elizabeth Warren, onstage at the Code ... Specifically, Warren says, America needs to resume investing in things like ...

http://venturebeat.com/2015/05/26/senat ... structure/

Elizabeth Warren dodges question on Uber... - The Hill
http://thehill.com/policy/technology/24 ... -employees

Does Elizabeth Warren have a Silicon Valley problem?

Fortune
Elizabeth Warren, the Democratic senator from Massachusetts, had a lot to say to the technorati gathered at this week's Code Conference in Rancho
http://fortune.com/2015/05/27/elizabeth-warren-tech/

And when National Journal starts asking questions, you know something is up, they don't do soundbites. Maybe she's too busy representing Elizabeth Warren to have time to represent the people of Massachusetts?

Is Elizabeth Warren an Effective Senator?
National Journal
May 26, 2015 "I don't want to go to Washington to be a cosponsor of some bland, little bill nobody cares about," Elizabeth Warren said in 2011. "I don't ...
http://www.nationaljournal.com/congress ... r-20150526

Politico unleashes baffling and nonsensical hypocrisy charges against Elizabeth Warren
Vox
Elizabeth Warren does not approve of the Trans-Pacific Partnership in part because she does not approve of its Investor-State Dispute Settlement .
http://www.vox.com/2015/5/21/8641709/wa ... rt-witness


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Thu May 28, 2015 9:12 pm 
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I'm not certain, but I believe the issue of the ACA payment "bump" was addressed in the much bigger permanent "doc fix" bill signed last month. The House passed it, and I believe it made it to the final bill. It's referenced in the WaPo piece you cited.

Obama signs $200 billion 'doc fix' bill

http://thehill.com/homenews/administrat ... c-fix-bill

House Passes Bill To Fix Medicare's Doctor Payments ...


http://commonhealth.wbur.org/2015/03/me ... ayment-fix[/quote]

No. The Medicare "doc fix" has nothing to do with Medicaid. And if you don't know the difference between Medicaid and Medicare, further discussion is pointless.


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Fri May 29, 2015 3:57 am 
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Posts: 1380
double down wrote:
No. The Medicare "doc fix" has nothing to do with Medicaid. And if you don't know the difference between Medicaid and Medicare, further discussion is pointless.

Ha, a cheap shot like that will backfire on you. You likely just saw the WBUR headline referencing Medicare, didn't read the full pieces and assumed it was only about Medicare. I know the difference between Medicare and Medicaid. I never claimed that the "doc fix" had anything to do with Medicaid. Don't try to obscure the facts by attempting to put words in my mouth, you'll end up getting wet when I spit them out.

I simply pointed out that both WaPo and The Hill observed that Congress might take the opportunity to resolve the issue of the Medicaid "Bump" which you raised, when they were already scheduled to deal with the Medicare "doc fix" in April. And I believe that's what actually happened. The fact that Congress was scheduled to look at a Medicare issue, does not preclude them from looking at a Medicaid issue.

If you have evidence to the contrary,.......right about now would be a good time to spill it.


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Fri May 29, 2015 8:35 pm 
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Posts: 847
The Medicare "doc fix" is a good example of the importance of reimbursement rates on physician accessibility. The scheduled cuts were delayed every year because seniors were concerned that physicians might stop taking Medicare insurance and they would lose access to their physician. And because Senior have political clout every year Congress acted to delay the cuts until next year.
Now consider that Mecicaid rates are generally lower than Medicare(often much lower) and you see how accessibility could be a problem.
Primary care access has long been studied.
http://blog.academyhealth.org/how-hard- ... re-doctor/

http://www.modernhealthcare.com/article ... /307089964

The NEJM had a recent report on the effect of the "medicaid bump" on primary care access.

http://www.nejm.org/doi/full/10.1056/NEJMsa1413299

The NEJM is the most prestigious medical journal in the US. If it's editors consider that phsican accessibility is an issue worth reporting on then I think It's likely a real issue!
Here's a good discussion of the above paper.
The good news is that some states have decided to extend the Medicaid bump. But 23 states have decided not to. In these states Medicaid patients, particularly new patients will struggle, i think, to find primary care.


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Sat May 30, 2015 4:24 am 
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Joined: Feb 19, 2014
Posts: 1380
double down wrote:
The Medicare "doc fix" is a good example of the importance of reimbursement rates on physician accessibility. The scheduled cuts were delayed every year because seniors were concerned that physicians might stop taking Medicare insurance and they would lose access to their physician. And because Senior have political clout every year Congress acted to delay the cuts until next year.
Now consider that Mecicaid rates are generally lower than Medicare(often much lower) and you see how accessibility could be a problem.
Primary care access has long been studied.
http://blog.academyhealth.org/how-hard- ... re-doctor/

http://www.modernhealthcare.com/article ... /307089964

The NEJM had a recent report on the effect of the "medicaid bump" on primary care access.

http://www.nejm.org/doi/full/10.1056/NEJMsa1413299

The NEJM is the most prestigious medical journal in the US. If it's editors consider that phsican accessibility is an issue worth reporting on then I think It's likely a real issue!
Here's a good discussion of the above paper.
The good news is that some states have decided to extend the Medicaid bump. But 23 states have decided not to. In these states Medicaid patients, particularly new patients will struggle, i think, to find primary care.

That's all very well, I don't dispute anything there, but it's not in the slightest bit relevant to the point of contention, which is, whether or not the issue of the Medicaid "bump" got fixed last month. I'm not 100% sure, but I believe it did, and provided the WBUR link in support.

You, on the other hand, have provided a big fat zero in support of the alternative case, that it was not fixed, so I don't really understand what the hell you're complaining about, and I'm not sure you know either.

Your post is also totally totally irrelevant, totally, to your claim that I do not understand the distinction between Medicaid and Medicare. Put up, or shut up.

As to your assertion that because of my alleged ignorance, further discussion is pointless,......well you're not adhering to your own sentiment. Oops!


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Sat May 30, 2015 2:02 pm 
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Posts: 847
The decision whether to extend the Medicaid bump will be decided at a state level because, although it heavily subsidized by Washington, It is state run. 23 states have decided not to continue it.
http://www.advisory.com/daily-briefing/ ... d-pay-bump
In these 23 states I believe Medicaid patients, particularly new patients will have difficulty finding primary care physicians.You dismissed my original point that primary care physician access is a serious ongoing issue. I have shown that it has being widely studied and discussed and is a serious issue.
The other point was the compulsory nature of Obama care. This was it's most contentious and unpopular aspect. But it was essential in order to avoid the "death spiral" which BoyRacer alleges is happening. The Supreme Court ruled that the "mandate" was a tax and therefore constitutional. Now like all taxes it only applies above a certain income level. So if you household income level was below this level you were not liable. But this cohort were meant to be covered by the Medicaid expansion. Certain states decided not to do the Medicaid expansion {Texas and Florida being the biggest} so many people who should have gained insurance did not. For everybody else above the income level the choice is get insurance or pay the tax. if you think that's not compulsory fair enough but I do.
If you are familiar with Medicare/Medicaid, then you will know that, unlike the senior lobby, the poor do not have political clout in Washington. It would be hard to see any expansion of programmes to help the poor under a Republican controlled Congress which has traditional being hostile to there interest.


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Sun May 31, 2015 4:30 am 
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Joined: Feb 19, 2014
Posts: 1380
double down wrote:
The decision whether to extend the Medicaid bump will be decided at a state level because, although it heavily subsidized by Washington, It is state run. 23 states have decided not to continue it.
http://www.advisory.com/daily-briefing/ ... d-pay-bump
In these 23 states I believe Medicaid patients, particularly new patients will have difficulty finding primary care physicians.You dismissed my original point that primary care physician access is a serious ongoing issue. I have shown that it has being widely studied and discussed and is a serious issue.
The other point was the compulsory nature of Obama care. This was it's most contentious and unpopular aspect. But it was essential in order to avoid the "death spiral" which BoyRacer alleges is happening. The Supreme Court ruled that the "mandate" was a tax and therefore constitutional. Now like all taxes it only applies above a certain income level. So if you household income level was below this level you were not liable. But this cohort were meant to be covered by the Medicaid expansion. Certain states decided not to do the Medicaid expansion {Texas and Florida being the biggest} so many people who should have gained insurance did not. For everybody else above the income level the choice is get insurance or pay the tax. if you think that's not compulsory fair enough but I do.
If you are familiar with Medicare/Medicaid, then you will know that, unlike the senior lobby, the poor do not have political clout in Washington. It would be hard to see any expansion of programmes to help the poor under a Republican controlled Congress which has traditional being hostile to there interest.


I agree entirely that Medicaid is a state issue, generally speaking. But with the ACA states had the option of setting up their own "exchanges" or participating in the Federally operated exchange, Healthcare.gov. Here's an excerpt from an explainer.
Quote:
What are Health Insurance Marketplaces (Exchanges)?

ObamaCare (the Affordable Care Act) implements state-specific Health Insurance Exchanges (often called Marketplaces). These Health Insurance Marketplaces are online price comparison websites where consumers can purchase health insurance that counts as minimum essential coverage, receive federal subsidies, and be granted exemptions.

Signing Up For the Health Insurance Marketplace

State marketplaces offer 24/7 assistance to help you sign-up, enroll, or switch plans. Simply scroll down the page until you find your state’s marketplace to get started. Many states set up their own marketplaces, but 36 have not. If your state hasn’t set up their own marketplace, you’ll use HealthCare.Gov instead.

I haven't checked, but I'd be willing to bet that all the 23 states that have not re-upped the bump come from the 36 who opted to participate in the Federal system rather than set up their own. So for those 36, the Federal "bump" subsidy was critical, and the Feds have come good and re-upped. If 23 states choose not to avail of it, that's a local, not Federal Obamacare political decision. Different state governments on different days might make different decisions. Who knows?

I'd accept that new patients may have greater difficulty than existing patients, but how much more difficulty is at this point unknowable, and because it's unlikely to be uniform, is therefore not a reliable basis for critique of Obamacare.

Again, please don't try to put words in my mouth. I did not "dismiss" your original point that primary care physician access is an ongoing serious issue. Instead I contradicted the assertion implicit in your claim, i.e. that primary care was more difficult to access than specialist care. Here's what I actually said:
Quote:
The problem with the 2nd highlight is that implicit in that statement is a claim/belief that it is/will be easier to see a specialist than a primary care provider, which of course is not true, because in most cases, in most countries, in order to see a specialist, you have to see a primary care provider first. In this instance primary means both main/largest and first. Elective surgery may be an exception.

As to the rest of your post, I don't disagree with what you say, but it doesn't get you off the hook for wrongly claiming Obamacare is obligatory, when in fact the intention, but not the desire, was to leave thirty million uncovered.

This thread has drifted off-topic, Elizabeth Warren has not been a leader on Obamacare issues, and I'm getting tired of correcting the statements you've attempted to attribute to me, so this is the last I'll have to say on the issue here.
If you wish to continue criticizing Obamacare, I suggest you start a thread.


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 Post subject: Re: Elizabeth Warren - A One-Woman Ass-Kickin' Machine!
PostPosted: Wed Jun 03, 2015 3:54 pm 
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An example of the increasing amount of press critical of Warren. Not so long ago she walked on water, or is that her grasp extends beyond reach?

DID WARREN GO TOO FAR WITH MARY JO WHITE SLAM? - POLITICO's Patrick Temple-West and Ben White: "Wall Street and the White House had a swift and furious reaction to Elizabeth Warren's blazing attack on Securities and Exchange Commission Chair Mary Jo White: Senator, you've gone too far. ... Defenders of White's tenure at the regulatory agency said Warren's 13-page letter attacking the SEC chair raised highly questionable points and badly mischaracterized the actions of a widely respected former federal prosecutor.

"'I don't understand Sen. Warren's criticism of White for recusing herself where there is a conflict of interest,; said Wayne Abernathy, a top lobbyist for the American Bankers Association, referring to Warren's criticism that White isn't involved in SEC actions when her husband's law firm represents the companies involved. 'Is it that she would prefer that the chairman go forward and participate in enforcement cases despite the conflict of interest?'

"When he nominated White two years ago, President Barack Obama said, 'You don't mess with Mary Jo," citing the diminutive former prosecutor's record winning cases against terrorists and financial criminals during her 1993 to 2002 tenure as U.S. Attorney for the Southern District of New York, which many consider the most prominent prosecutorial position in the country. ...

"But Warren clearly 'messed with Mary Jo' on Tuesday, and the White House was not happy about it. 'The president continues to believe that the reasons that he chose her, based on her experience and her values, continue to be important today," press secretary Josh Earnest told reporters. "The president does continue to believe that she is the right person for the job.'"

WHITE DEFENDED -
"White defenders said the SEC was always clear that she would have to recuse herself on certain cases. And senators, including Warren, voted to confirm her anyway. 'It is rather extraordinary for a U.S. Senator to send this kind of letter to one of our more distinguished public servants,' said Robert Kelner of law firm Covington & Burling, an expert on political compliance. 'The allegation concerning recusal seems to me especially unfair because the Senate was very much on notice that under existing law Mary Jo White would have to recuse herself form a variety of matters.' Kelner added that 'the criticism of agency inaction on corporate political disclosure also seems misplaced because corporate political disclosure has utterly nothing to do with the SEC. It's a beef that should be taken up with the Federal Election Commission.' http://politi.co/1JoiK3e

WARREN DEFENDED - A former SEC official emails:
'I don't often agree with Senator Warren's views of the markets, but her view of the SEC's leadership under Chair White seems spot on. ... Despite an incredibly talented staff, the SEC has nothing to show for its last several years. Partisanship isn't to blame. It's leadership. The Chair's autocratic style and refusal to compromise means that every issue is a fight - with battles at the staff and Commission levels. ... Given that, and the Chair's lack of securities regulation experience, it's not surprising that she has made essentially no progress on finalizing rules that are now several years overdue. Forget about ever getting final derivatives rules, the Consolidated Audit Trail, or meaningful disclosure reforms.

"As for her enforcement record, that also speaks for itself. Large firms are still allowed to avoid the supposedly automatic consequences of their misconduct-even as the conduct has grown worse and more frequent. Criminal lying, cheating and stealing? No problem. Have your shareholders pay a lot of money and we'll be fine. The Chair's initially splashy revisions to the 'no admit or deny' policy have proven to be a joke. Oh, and smart folks facing SEC action may have now figured out that they can deadlock the Commission by hiring the Chair's husband." Full email: http://bit.ly/1dKshGp

ICBA's Cam Fine: "We agree with Sen Warren on this issue. The SEC has been more of a lap dog than Doberman when it comes to Wall Street regulation and enforcement. I mean how many times do the Wall Street mega banks have to plead criminally guilty to law breaking before the SEC does anything real or hold even a single individual accountable?? Does a Wall Street Exec have to be standing over a body before the SEC will take action?"

ONE MORE VIEW - From a senior Wall Street Dem: "On the one hand, not remarkable at all. Senators, members of Congress, and their staffs love to write these long detailed polemics accusing nominees of not living up to their expectations and commitments they made at the time of their nominations. Of course, Warren's letters receive disproportionate coverage (even relative to a note by HFSC Chair Hensarling) because they largely echo (reinforce?) views held by the (liberal) media.

"And while it's pretty outrageous to basically call the President's appointee to run the SEC an unprincipled liar, it's not exactly the first time between her highly personalized attacks on Michael Froman, Tim Geithner (he's on the side of the banks), Antonio Weiss (remember Paris?), and even Janet Yellen."


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