Monday Open Thread

I've got my cable and internet, but no phones yet. I've unpacked more than 100 boxes, and have 40 left to unpack. GotJunk has already removed 2 truckfuls of stuff and my 10 × 10 storage locker is full. This has been my most expensive move yet -- $3,500. for the movers (here and to storage) and $800 and still rising for GotJunk. And this is after having donated or thrown away at least one third of my stuff the last few days at the old house. Since I've also lost a week of work, it will be a few days before I'm back to blogging.

On the up side, I really like the new place and downsizing is really liberating.

Here's an open thread, all topics welcome.

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    Welcome back Jeralyn... (5.00 / 1) (#1)
    by fishcamp on Mon Oct 21, 2013 at 01:37:03 PM EST
    and I think if everybody sent TL some $$$ you could get back into some serious blogging and thereby get rid of me and my dopey comments.  BTW it's a hundo for you kdog.

    Got 99 bucks I can borrow? ;) (5.00 / 1) (#7)
    by kdog on Mon Oct 21, 2013 at 02:54:59 PM EST
    I hear ya bro...by all rights I probably owe J 5 figures for a decade of nuisance-making.

    Profound statement by Erza Klein (5.00 / 1) (#2)
    by MO Blue on Mon Oct 21, 2013 at 02:18:57 PM EST
    regarding Obama's speech on Obamacare. <cough-cough>

    In the end, though, Obama's speech doesn't matter. Either the Web site will be fixed in a reasonable time frame, and the law will work, or it won't be fixed and the law will begin to fail. The Affordable Care Act is no longer a political abstraction. It's the law, and it will be judged not on how well politicians message it, but how much it does to improve people's lives. link

    As much as I hate Obamacare (none / 0) (#3)
    by Slado on Mon Oct 21, 2013 at 02:31:37 PM EST
    It's the only current alternative to our broken system.

    Also this is a long game and we're not even into the 1st inning.

    The democrats can loose the 2014 election over it and maybe even the 2016 election but that will only be over how we fix it.   Not if it stays.

    Even though 53% or more of the country doesn't like it they will learn to accept it and it will become another entitlement we can't afford.

    The only thing I can be hopeful for is eventually it leads to a two tier private/public system.   We have that now but we don't call it that.

    Best to get a state level single payer system subsidized by the feds (see Medicare) and let the private industry fill int he cracks.

    This only shows that the idea that you can have a single payer system for 300 million run by a central organization (the feds) is impossible.


    I strongly disagree (5.00 / 7) (#4)
    by MO Blue on Mon Oct 21, 2013 at 02:46:07 PM EST
    A single payer system would be much less complicated and the basis for it already exists and would only need to be built upon.

    This is one of my many objections to the insurance based system that was adopted. If this overly complicated, hodge podge private insurance system fails, the lesson (a false one IMO) that you are deriving from this is the one that will be circulated. That a single payer system is impossible and we will just get to the point where only the affluent will be able to have health care.


    Single payer (none / 0) (#57)
    by Abdul Abulbul Amir on Tue Oct 22, 2013 at 06:49:36 AM EST
    When the private system ... (5.00 / 5) (#58)
    by Yman on Tue Oct 22, 2013 at 08:06:58 AM EST
    ... decides not to pay, you are also screwed.

    That being said, Canada's healthcare system ranks far better than the U.S. system.

    New Health Rankings: Of 17 Nations, U.S. Is Dead Last.  Probably why thousands of Americans risk jail to go to Canada for healthcare for decades, now.

    Not to mention the fact - even ignoring the fact that those systems cost much less than the US system - that people in Canada and Great Britain are much more satisfied with their healthcare systems than people in the U.S.


    Not at all (none / 0) (#66)
    by Abdul Abulbul Amir on Tue Oct 22, 2013 at 08:56:52 AM EST

    You can always pay yourself in a private system.  In a single payer system, it is illegal to pay yourself for services that the single payer covers.  Even when the single payer refuses to pay.  

    Part of the reason Canada ranks as well is because Canadians can get treatment in the US when their single payer decides not to pay.

    BTW the report you link states in part:

    ...men, have had either the lowest or near the lowest likelihood of surviving to age 50. The most powerful reasons found for that were homicide, car accidents, other kinds of accidents...

    Ranking national health care systems in part on how frequently 20 somethings ride their murdercycles into bridge abutments at 100mps may be a good way to get the ranking you want, but would seem to lack any real value.

    A better metric may be the degree your country is a source or destination for medical tourism.



    Medical tourism as a metric hmmm (5.00 / 6) (#71)
    by MO Blue on Tue Oct 22, 2013 at 09:17:33 AM EST
    Steep U.S. Medical Costs Send Americans Overseas for Affordable Surgery

    With health care costs rising in the United States, Americans are increasingly going out of the country for surgeries.

    Michael Shopenn went to Belgium in 2007 for hip replacement surgery. If he elected to have the surgery in the U.S., the cost would have approached $100,000. But in Belgium he paid only $13,660, which included all medicine, doctors' fees and round-trip airfare.

    As More Americans Have Surgeries Overseas, US Companies Consider 'Medical Tourism' a Health Care Option

    ...some American companies are considering outsourcing medical care, dubbed "medical tourism," as a health care option.

    In the end, HSM said it saves money. Outsourcing medical care has saved it nearly $10 million in health care costs over the past five years, according to the company. Close to 250 of its employees have traveled abroad so far for medical care, and more are scheduled to go.

    In the United States, Harwell's knee replacement would have cost more than $50,000. In Costa Rica, it costs half that amount at $23,531. In North Carolina, Guion's gastric sleeve surgery would have cost about $30,000, but in Costa Rice, it comes to $17,386. Both were placed in pristine rooms in state-of-the-art hospitals.

    And when the bandages come off, both will get a bonus check for at least $2,500 from their company, a percentage of the corporate savings in insurance costs.

    Medical Tourism: Why More Boomers Are Going Abroad For Treatment


    That's funny. (5.00 / 4) (#74)
    by Yman on Tue Oct 22, 2013 at 09:47:45 AM EST
    You can always pay yourself in a private system.  In a single payer system, it is illegal to pay yourself for services that the single payer covers.  Even when the single payer refuses to pay.

    Sure you can pay - if you have lots of money - which is the only people you wingers worry about.  "Illegal"?  That's strange, considering it's not even illegal in Canada, let alone all single-payer countries.  In fact, 30 percent of health spending in Canada comes from private sources (i.e. supplemental insurance and direct, out-of-pocket payment).

    Private healthcare is not illegal in Canada.

    See also, Snopes.

    Also, "Debunking the Myths of the Canada Health Act"

    Ranking national health care systems in part on how frequently 20 somethings ride their murdercycles into bridge abutments at 100mps may be a good way to get the ranking you want, but would seem to lack any real value.

    Good thing the report didn't do that, then.  Moreover, there are numerous studies and reports ranking the US system far underneath Canada and Great Britain's single-payer systems.  Would you like a few more?

    A better metric may be the degree your country is a source or destination for medical tourism.

    Ahhhh, you sure about that?  I understand why you'd prefer such a silly, simple metric, but I'm not sure you'd like those results.  Even so, you would need to look at net medical tourism numbers and compare the number of people traveling into a country versus the number of people traveling out of a country.  So, for example:

    A McKinsey and Co. report from 2008 found that between 60,000 to 85,000 medical tourists were traveling to the United States for the purpose of receiving in-patient medical care. The same McKinsey study estimated that 750,000 American medical tourists traveled from the United States to other countries in 2007 (up from 500,000 in 2006).

    So, in reality, you have 10 times the number of people traveling out of the US to get medical care compared to the number coming into the US for medical care.



    Great Britain's single-payer system (none / 0) (#161)
    by Abdul Abulbul Amir on Wed Oct 23, 2013 at 07:30:34 AM EST
    You must not have read closely (5.00 / 1) (#166)
    by CoralGables on Wed Oct 23, 2013 at 08:33:09 AM EST
    We refer to that here as hospice and/or palliative care. It's assisting people on making end of life decisions. We also have living wills. You'd have to be a pretty awful headline writer to refer to people choosing these options as being on death lists.

    Not surprising though that you'd gravitate to a National Enquirer type headline.


    That first claim didn't work out ... (none / 0) (#167)
    by Yman on Wed Oct 23, 2013 at 08:36:30 AM EST
    ... so well, so you're trying to switch gears now, huh?

    Can't blame you for trying, although an article in a British tabloid isn't going to cut it.

    As far as your cherry-picking of a single illness to judge an entire healthcare system, that's equally funny.  Of course, the reason you chose cancer is because it's the one area in which the US is better - at least on paper.  One of the reasons is because cancer treatment in the US tends to be very aggressive compared to other countries.  Another is that the US database (SEER) excludes populations with some of the worst outcomes, such as the poor and AAs:

    While NHS cancer data covers the entire population of the country, many other countries only include specific geographic regions.  The US cancer survival rate, for example, is "artefactually increased by the systematic exclusion of poor people and African Americans from the Surveillance Epidemiology and End Register."

    Plain version - Exclude patients with some of the worst outcomes and your survival rates tend to be higher.

    As far as some of the other problems inherent in your "logic" of judging healthcare systems based on survival rates of a single illness against a single country (have we moved past your old metric of medical tourism/Canada now?), see Factcheck - Cancer Rates and Unjustified Conclusions.


    Abdul: "You can always pay yourself in a private system.  In a single payer system, it is illegal to pay yourself for services that the single payer covers.  Even when the single payer refuses to pay."

    ... for relentlessly asinine right-wing ideologues like you. You've quite obviously never had to face a major illness such as cancer, as I have three times -- Hodgkins' Disease twice and melanoma once. You've probably never had your health care coverage dropped just because you had the temerity to get seriously ill, which forced you to actually call upon your insurance company to, you know, cover the costs of your health care like they promised.

    You clearly either don't know or don't give a rat's a$$ what it's like to have emerged from a major illness such as leukemia facing bankruptcy at age 53 because you exceeded your lifetime cap on insurance coverage. My cousin owes various providers $1.2 million for her care, which was accrued before the Affordable Care Act's provision removing such caps took effect. She and her family may well lose their home because of it, and my mother, aunt and uncle are presently discussing how to pool financial resources in order to pay that debt off for them.

    (Incidentally, my cousin's husband used to be a mindlessly doctrinaire GOP wingbat, just like you. But unlike you, his blinders have since been rudely ripped off thanks to his wife's illness, and his eyes are now wide open to the harsh reality of conservative dogma-cum-policy because of that experience.)

    But I digress here. To cut to the chase about single-payer Canadian health care, the Canadian Health Act of 1984 defines the five major principles of primary health care delivery as follows:

    • Comprehensiveness, by which the provinces must provide medically necessary hospital and physician services;
    • Universality, by which every provincial resident is entitled to receive health care per the provisions of the Act;
    • Accessibility, which mandates reasonable access to and charges for services, and as a means to control costs, precludes private or opted-out practitioners from billing beyond the provincially-approved fee schedules;
    • Portability, which allows Canadian residents to access necessary health care should they be travelling outside of their home province; and
    • Public administration of health care delivery, which requires each province to administer and operate its public health plan on a non-profit basis.

    By almost every measurable standard, from cost controls to successful outcomes per capita, the Canadian health care system has generally been superior to that found south of the border.

    Per capita expenditures in the United States for health care are nearly twice that spent by our Canadian cousins. As a percentage of gross domestic product, Canada's health care expenditures are 9.2%, compared to 17.8% in the U.S., which is the highest in the world.

    By and large, Canadian cancer patients tend to fare better than their American counterparts. Studies by both the U.S. General Accounting Office and Canadian researchers have shown superior Canadian survival rates for most cancers. Further, Canadians get more bone marrow transplants per capita than in the U.S.

    For those issues in the Great White North involving lag time between scheduling doctor's appointments and actually seeing the doctor, one can point directly to the five-year plan implemented four years ago by Prime Minister Steven Harper's Conservative government to cut federal funding for health care, and further shift the financial burden to already cash-strapped provinces. This has had a particularly harsh impact on the economically anemic Maritime provinces along Canada's Atlantic seaboard.

    Then again, this isn't really all about money, because the portability provisions in the Canadian Health Care Act require the provinces to send patients across the border, all expenses paid, if otherwise necessary care isn't readily available at home within a reasonable period of time. Rather, it is also an dual issue of both a shortage of specific medical specialists, and a conspicuous lack of long-term planning regarding the anticipation of future health care needs on the part of public administrators.

    For example, in the face of increasing rates of cancer, it takes 10 years to train a radiation oncologist, and at least 2 years to train a radiation therapist. But when we made funding decisions at the Hawaii legislature for public health care, I noticed that our Department of Health tends to rely on forecasts of two-year or three-year periods with few long-term projections. It's probably no different in Canada, and as such, this is clearly too short a window, and projections need to be lengthened considerably.

    It's amazing to note the synergy and correlation between you and your conservative friends, whereas they deliberately starve a given government program of funding, while you subsequently claim that it's hopelessly broken because it's not working optimally. But all you're really doing is simply underscoring the truth behind the old quip about conservatives who constantly complain that government doesn't work, and then proceed to go about proving it once they take power.

    If the Affordable Care Act isn't working optimally, it's thanks in no small part to your conservative friends in Red States who have deliberately refused to cooperate in its implementation. But as for yourself, you don't get to play this game any more, whereby you get to decry its failure. That ended last week with your good buddy Ted Cruz leading GOP conservatives on Capitol Hill into a brick wall while traveling at 90 m.p.h.

    I'd offer to take up a collection here at TL to buy you a very sorely needed clue, if I weren't concerned that you'd just waste it instead on a donation to Breitbart.com. But regardless of that, rest assured that whatever problems the ACA has will be fixed, and further, this is just the first step to badly overdue general overhaul of the entire U.S. health care system. We're not going to go backwards, Abdul. You best get used to that.



    More on the Canada myth (5.00 / 5) (#135)
    by Yman on Tue Oct 22, 2013 at 04:25:24 PM EST
    In reality, only a very tiny percentage of people from Canada come to the United States for healthcare - @ 0.5% for elective procedures, 0.11% for emergency procedures.

    Phantoms In The Snow: Canadians' Use Of Health Care Services In The United States


    It is an urban legend that Canadians do without (5.00 / 5) (#120)
    by Militarytracy on Tue Oct 22, 2013 at 02:53:11 PM EST
    While we in America enjoy healthcare prosperity.  In my son's case, being a Veptor kid, Canada began paying for their children to receive treatment years before any child in the United States could get any insurer to pay for the new technology.  You could say in fact that Canada's support of Veptor allowed it to become something that the children in the United States could also eventually have.

    I believe most often it is an urban legend that the profit model also allows new medical tech to come on the scene because I have experienced it suppress and block new tech being able to come online.  Dr. Campbell invented Veptor, he was a poor kid who always wanted to be a doctor so had to join the military in order to receive the education.  As for Veptor, controlling scoliosis that kills was a problem he puzzled over for years and years, drafting over and over again sometimes on napkins how you would mechanically/ medically try to tackle and solve the issues.  I know all this from direct discussions with him.  Money was never even on the blackboard for him, only saving children's lives.  And Canadian children got easy access first because Canada's focus is on saving children's lives too.  Unsurprisingly, nobody saving the children's lives is starving either.....but children in the US were freer to die from life taking scoliosis.


    It's just going to become ... (5.00 / 5) (#6)
    by Robot Porter on Mon Oct 21, 2013 at 02:53:19 PM EST
    a poverty tax.  People who can't afford coverage will pay for the cheapest bronze plan to avoid fines (which will become quite large in just a couple of years), and they will receive practically no coverage.  Illnesses will still bankrupt them.

    This won't change because poor people have no voice in this country.  And there is no road from this to single payer.

    This is about giving insurance companies more money.  And that is all it's about.  If it was about giving people healthcare there would be no bronze plans.


    "there would be no bronze plans. " (none / 0) (#56)
    by Mr Natural on Mon Oct 21, 2013 at 11:19:55 PM EST
    As Frank Zappa said, that's the crux of the biscuit.

    How can it be a poverty tax (none / 0) (#83)
    by CoralGables on Tue Oct 22, 2013 at 10:53:46 AM EST
    if no one under 135% of the poverty level is required to have insurance?

    Problem is... (5.00 / 1) (#100)
    by kdog on Tue Oct 22, 2013 at 12:34:23 PM EST
    our "poverty level" has no basis in reality.  Even at 135% it's still a joke.  It should be 200% to qualify for a subsidy or something like that...or better yet just change the poverty level to something based in reality.

    Then you'll be happy (none / 0) (#102)
    by CoralGables on Tue Oct 22, 2013 at 01:03:42 PM EST
    because there are subsidies available up to 400% of the poverty level. That's tax credits on a sliding scale for an income up to $45,960 for an individual or $94,200 for a family of four in the contiguous 48 (higher levels for Hawaii and Alaska)

    That's simple-minded (5.00 / 2) (#110)
    by TeresaInSnow2 on Tue Oct 22, 2013 at 01:34:35 PM EST
    thinking, thinking that premiums and copays are the whole story.  They are not.

    COVERAGE is the story.  And the coverage is awful.  50% of the doctors of traditional plans.


    Teresa, I don't think most people realize (5.00 / 3) (#118)
    by Anne on Tue Oct 22, 2013 at 02:40:36 PM EST
    what the insurance companies have been doing with all the time afforded them between passage of the ACA and full implementation, but in addition to ramping up premiums in general, increasing co-pays and deductibles, we are now seeing a proliferation of narrowed networks, no caps on out-of-network services, balance billing, ratings for geographics, increased cost-sharing, and large deductibles, all of which ought to be a clue - of the giant, blinking-neon variety - that there was never a chance that the law was going to accrue to the benefit of "consumers."

    Many who have individual coverage on their own have been getting letters from their insurers, informing them that their current policy is being discontinued, and the individual has the choice to go get insurance on the exchange, or apply for a new, ACA-compliant policy through the insurance company of their choosing.  

    I read an article on PNHP, where the author said the following:

    But for all of the emphasis on affordable care, the new law reinforces the notion that access depends on how much you can afford, not how much you need. In the health insurance exchanges, the price of premiums will depend on your age, health, income, and on whether you opt for a bronze, silver, gold or platinum coverage. In Canada, access to necessary health care services is not a competitive sport.

    Margaret Flowers:

    The ACA leaves tens of millions without coverage. There are currently 48 million uninsured people in the US. At its best, the Congressional Budget Office estimates that the ACA will leave 31 million people without health insurance when it is completely rolled out. And even that estimate may be too low. Experience at the state level showed that none of the similar plans hailed as comprehensive met their coverage goals before they failed due to costs. Without effective cost controls, care remains unaffordable.


    The ACA continues the problem of financial barriers to care. Considering that 76 percent of Americans are living paycheck to paycheck without significant savings, the money simply isn't there to pay the out-of-pocket costs for visits to the doctor, tests or prescriptions. A health survey by the Commonwealth Fund last year found that 80 million people reported not getting care due to cost, 75 million were having difficulty paying medical bills and 4 million (over 2 years) went into bankruptcy as a result.

    * The ACA will circumvent the requirement to cover people with pre-existing conditions. One way that insurance companies are doing this is by restricting their networks to avoid places where sick people go such as large medical centers and public hospitals and by limiting the number of providers. This will push people to use out-of-network providers and bear more or all of the cost. Another method will be to raise premiums or stop selling insurance plans in areas where they do not make a profit. Insurers can't charge more for policies because of pre-existing conditions, but they can charge more based on age and location.

    So, we have a new platform that will leave 31 million people without insurance, many who get insurance won't be able to afford actual care, once they have paid premiums, co-pays and deductibles, will find that they are limited in their choice of providers and face the real possibility of falling into an out-of-network trap that will cripple them financially.

    How is this "reform?"  How is this not seen as one more corporate money transfer?

    There just seems to be no good reason why every single person in this country is not guaranteed a basic level of care without having to present proof of insurance: pre- and post-natal care, well-woman screenings, birth control, well-baby/child exams and immunizations, annual physicals, blood pressure screening and treatment, diabetes care, colonoscopy and prostate screenings, vision, hearing and dental exams.  

    I guess there's nothing left to do but see what happens when people begin to use these new policies.  I think for healthy people, it will be fine - for the chronically ill, those with serious health problems, who need specialized care, I think it's not going to be so great.

    And when that reality hits home for people who have been desperately waiting for help, the anger is going to be enormous.


    Stand corrected... (5.00 / 2) (#111)
    by kdog on Tue Oct 22, 2013 at 01:35:18 PM EST
    Appy Polly Logies.

    Better than I thought, but still a joke though...I make just north above that 400% figure, if my boss kills our plan I sure as hell can't affford can't afford these rates I'm seeing....even if I quit my herbal medicine, and that might lead to a heart attack;)

    When you're making 400% of the poverty level and still basically living check to check, there's something seriously wrong with the poverty level.  


    how many people who make far north of 400% of the poverty level still live paycheck to paycheck.

    And before you think that maybe such people are simply dipsh!ts, think about the people who are making 1/2 of what you make and who would think maybe you're a dipsh!t for living paycheck to paycheck.


    Touche... (5.00 / 1) (#176)
    by kdog on Wed Oct 23, 2013 at 10:13:55 AM EST
    I don't know how people who make half of what I make even make it from paycheck to paycheck...it's a true wonder.  Man can't live on bread alone but they gotta be.  

    I would think we're all in agreement that Uncle Sam is smoking crack if he thinks a single person making 12 grand a year is not living in poverty...what year do they think this is, 1972?


    I used to think the PL (none / 0) (#202)
    by sarcastic unnamed one on Wed Oct 23, 2013 at 12:27:46 PM EST
    was literal; that those on the wrong side of it lived in squalor, were destitute, paupers, etc.

    I think 12K/year in LA if you were young and had roommates, etc., would be doable on a non-permanent basis. Definitely wouldn't want to stay in that zone permanently though.


    I think you can get a subsidy (none / 0) (#103)
    by nycstray on Tue Oct 22, 2013 at 01:04:14 PM EST
    up to 400% of the PL.

    Yes. I saw that it covers (none / 0) (#146)
    by Towanda on Tue Oct 22, 2013 at 06:47:06 PM EST
    a family of four with an income of almost $100,000, for example.

    kdog, you may benefit from reading up on the benefit.


    Being 136% of the poverty level (none / 0) (#85)
    by sj on Tue Oct 22, 2013 at 11:08:50 AM EST
    isn't much of a difference, is it? And suddenly, one is dropped right back into poverty level.

    No (5.00 / 1) (#88)
    by CoralGables on Tue Oct 22, 2013 at 11:17:15 AM EST
    because at 136%, with the tax credits available, you will likely have a silver plan for free when you used to have no coverage at all.

    Yep (5.00 / 1) (#109)
    by TeresaInSnow2 on Tue Oct 22, 2013 at 01:33:19 PM EST
    And the costs just grow and grow and grow from there.  And the coverage sucks.  HMO, quality, quasi-Medicaid insurance policies that people have to pay for.

    We rejected the HMO's in the 90's. We'll reject these mandated HMO's again.  But not before people suffer for it.  


    That would be good (none / 0) (#90)
    by sj on Tue Oct 22, 2013 at 11:23:51 AM EST
    As soon as "likely" becomes "certainly" I will breathe much better.

    Without access to information from all states (none / 0) (#94)
    by CoralGables on Tue Oct 22, 2013 at 11:54:06 AM EST
    I put likely rather than certainly. The tax credits are based on the second lowest silver plan available in an area. Thus the lowest priced silver plan should be free, after ACA credits, when you first cross above the 135% threshold.

    When I played with numbers at Kaiser using the 135% threshold, with the local plans available under the ACA, the lowest price silver plan was free. The second lowest silver plan was $16 per month.


    Hmmm (none / 0) (#122)
    by MO Blue on Tue Oct 22, 2013 at 03:12:22 PM EST
    This chart shows a monthly premium of $41 per month for someone 136% of FPL ($40 for 135%), I ran a scenario for someone 45 at 136% FPL who is a non smoker on the Kaiser calculator. For indivdual coverage in my state and area and it came up with the same $41 dollar amount.

    Yes (none / 0) (#125)
    by CoralGables on Tue Oct 22, 2013 at 03:33:30 PM EST
    Love playing with the figures at Kaiser.

    The credits for each area are determined by the 2nd lowest silver plan which is what you see for an area. The lowest silver will be less cost with the same credit.

    It all depends on age, area, etc. I'd prefer a rule where insurance companies have to be involved in the entire state rather than cherry pick areas. That's nothing new though. They also do the same thing with homeowner's insurance


    I don't believe this is entirely accurate (none / 0) (#137)
    by MO Blue on Tue Oct 22, 2013 at 04:42:12 PM EST
    The lowest silver will be less cost with the same credit.

    People earning up to 250% FPL will be eligible for additional subsidies to help pay their out-of-pocket expenses (co-pays, deductibles, and co-insurance). These subsidies will be available for the second lowest-cost silver plan. Consumers may choose a different plan, but they will not receive cost-sharing subsidies for that plan.


    I believe (none / 0) (#139)
    by CoralGables on Tue Oct 22, 2013 at 04:56:07 PM EST
    those additional subsidies you apeak of are available for any silver level plan. It's been noted that with the additional subsidies that you mention that lower the out of pocket expenses, those eligible will be achieving gold level type out of pocket costs for the price of a silver plan.

    Everything I've read states (none / 0) (#140)
    by MO Blue on Tue Oct 22, 2013 at 05:19:30 PM EST
    that you must purchase the 2nd lowest silver plan to be eligible for the subsidies for out of pocket costs. From a CA website explaining subsidies:

    Co-pays, co-insurance, and deductibles will depend on the plan consumers select to best fit their needs. For example, bronze and silver plans will have lower premiums with higher out-of-pocket costs while gold and platinum plans will have higher premiums and lower out-of-pocket costs. The out-of-pocket costs for these same plans will be even lower for consumers who are eligible for cost-sharing subsidies (income up to 250% FPL) and who select the second lowest-cost silver plan.

    This wording regarding eligibility requirements of purchasing the second lowest-cost silver plan has been consistent in other articles that I have read. There doesn't seem to be any ambiguity in the actual wording. We do agree that the subsidy will upgrade the level of your plan. But that only occurs after paying the premium (after subsidies) for the 2nd. lowest silver plan.


    I believe what it says (none / 0) (#144)
    by CoralGables on Tue Oct 22, 2013 at 06:05:54 PM EST
    but would find it hard to believe to be true. That would swing all kinds of business to just one insurance company thus nullifying the effect of the marketplace.

    Somewhere I read the additional out of pocket subsidies were for any silver level plan. I'll have to search for it sometime and see where I read it. Still, either way it's a great deal for anyone that's eligible.


    MO this was in Forbes (none / 0) (#145)
    by CoralGables on Tue Oct 22, 2013 at 06:08:22 PM EST
    If your income falls between 100 and 250% of the federal poverty level ($11,490 to $28,725 for an individual), you may be eligible for a Cost-Sharing Reduction subsidy, which can help lower your deductibles, copayments and coinsurance. In order to receive Cost-Sharing Reductions, you must purchase a Silver plan on the Marketplace. You will still have a variety of plans from which to choose, but it must be Silver to be able to take advantage of the Cost-Sharing Reduction subsidy.

    What drivel (5.00 / 2) (#8)
    by sj on Mon Oct 21, 2013 at 03:11:40 PM EST
    This only shows that the idea that you can have a single payer system for 300 million run by a central organization (the feds) is impossible.
    Firstly ACA is not single payer.

    And secondly we already do have the infrastructure for a single payer system ... run by a central organization (the feds). It's called Medicare. Granted it doesn't support 300 million but I'm betting it could.


    Who said it's single payer? (none / 0) (#14)
    by Slado on Mon Oct 21, 2013 at 04:04:56 PM EST
    Not me.    I'd prefer that to what we got.

    If we want subsidized medicine then lets have it.

    Not government subsidized unaffordable insurance otherwise known as ACA.

    My original post was more pointing out that as bad as ACA appears now we're stuck with it.


    Then how (none / 0) (#21)
    by sj on Mon Oct 21, 2013 at 04:26:29 PM EST
    pray tell, did you ever come up with this BS conclusion? It sounds even more stupid when you acknowledge that the ACA isn't single payer.
    This only shows that the idea that you can have a single payer system for 300 million run by a central organization (the feds) is impossible.

    In my opinion (none / 0) (#23)
    by Slado on Mon Oct 21, 2013 at 04:32:05 PM EST
    Running healthcare for 300 million people through one entity (the feds) is too big a task for our government.

    Better to have the states do it with federal regulations....IE expanded Medicaid.

    Medicare is already on it's way to being broke and is unsustainable.

    Roll it into a single payer system run through the states and let the private sector fill in the cracks.

    That's the Slado Healthcare plan.  


    Your opinion is one thing (none / 0) (#25)
    by sj on Mon Oct 21, 2013 at 04:39:25 PM EST
    Proof it most certainly is not. You can be as stupid as you want with opinions. Treat it as a fact and it's a different story.

    You have just as much proof (none / 0) (#89)
    by Slado on Tue Oct 22, 2013 at 11:22:35 AM EST
    that it will work by the way.

    That said I talked to my Dad the doctor last night and he says that Medicare could work for 300milltion its just a matter of cost.

    He like me also agrees however that a public/private system with government providing care for everyone would probably be the best.

    The trick is how do you break apart our current system.

    I think we can agree that ACA is probably not the best way but maybe it's the first step.

    We shall see.


    If it's a step, it's going in the wrong direction. (5.00 / 2) (#95)
    by Anne on Tue Oct 22, 2013 at 11:56:03 AM EST
    From an article by Dr. Margaret Flowers, posted at PNHP:

    The ACA moves our health system towards greater privatization. The ACA lacks provisions to stop the consolidation of ownership of health facilities by large for-profit entities, something that large insurers are doing more. It also cuts funding to safety net hospitals and shifts those funds to subsidize private insurance. In Massachusetts where a similar health law was passed in 2006, the need for safety net programs has not fallen as people, even with insurance, face financial barriers to necessary care.

    · Under the ACA, public insurances are being privatized. More states are moving their Medicaid patients into managed care organizations (MCOs). MCOs are for-profit administrators that compete with each other to cover the healthiest patients and are incentivized to cut care. Currently 75 percent of Medicaid patients are in MCOs and that number is expected to increase further under the ACA. And one of the early goals of the ACA was to cut back on Medicare Advantage plans which are essentially private insurance plans paid for through Medicare. The Advantage plans primarily insure the healthiest seniors and cost more than traditional Medicare. Instead of cutting back, the Obama Administration boosted payment to the Advantage plans. And enrollment in the plans has increased by 30 percent since 2010.

    That may be right (none / 0) (#105)
    by Slado on Tue Oct 22, 2013 at 01:16:41 PM EST
    but it's unsustainable.

    The cynic in me thinks Obama and Pelosi might be trying to make it so bad that the public at large eventually clamors for single payer.

    11 dimensional chess.


    Guess what, dude? (none / 0) (#134)
    by Donald from Hawaii on Tue Oct 22, 2013 at 04:24:17 PM EST
    They're going to be clamoring for it anyway, and would have even if the ACA had not been enacted. That train pulled out of the station a long time ago.

    In 2012, Medicare had almost 50 million (5.00 / 6) (#9)
    by Anne on Mon Oct 21, 2013 at 03:23:37 PM EST
    beneficiaries, and it seems to be working just fine - on top of that, it works at much less cost than the private insurance plans.  With the platform and structure already in place, how hard would it have been to allow people to become eligible for Medicare at 55 instead of 65?  That's how you start moving to a single-payer system that includes everyone - not by creating a hodgepodge of private plans with narrow networks and which will still result in where one lives having a great deal to do with how much access one has to care and how expensive it is.  I don't know if anyone has asked the insurance companies what people in urban areas are supposed to do if the hospitals closest to them are not part of the network because the insurance companies don't want the sicker, poorer, more medically complex patients - but I have a feeling people will not like the answer.

    And please - the ACA is in no way, shape or form an "entitlement;" it's not something any of us get because we've been having money deducted from our paychecks.  The only thing the ACA entitles anyone to do is have to have insurance - and much like employers subsidize a portion of the premiums for its employees, the government in this case will subsidize a portion of the premiums for people below a defined income threshold.  

    For how long it will be able to keep doing that is anyone's guess; what I'm pretty sure about is that whatever flaws there are, however poorly it works, the finger will be pointed not at the insurance companies for gaming the system - again - but at the government.

    Once people have signed up for their plans, the government is finished with you, other than to keep tracking you for subsidy purposes; your claims and premiums and disputes are going to be between you and your insurance company - not you and the Feds.

    Why we spent this much time and this much money to rearrange the deck chairs on a sinking system has to do with where the money's going, not the health and welfare of the people.


    It is an entitlement (1.00 / 1) (#12)
    by Slado on Mon Oct 21, 2013 at 03:56:22 PM EST
    Sorry Anne, it just is.

    It's going to cost taxpayers money to provide a service through the federal government.   That's an entitlement.

    Not saying we don't need it, not saying we shouldn't have it, just saying it's hear to stay and we better fix it before it gets worse.


    Entitlements (5.00 / 4) (#63)
    by squeaky on Tue Oct 22, 2013 at 08:40:12 AM EST
    So are the myriad tax deductions that wealthy people take advantage of... like the home mortgage deduction..

    oh.. that is right rich people are entitled so it is a given..
    poor people are not entitled so it should be taken away.

    GOP 101..

    oh no fear there will be trickle down...



    lol; well something's trickling down... (none / 0) (#181)
    by Mr Natural on Wed Oct 23, 2013 at 11:14:30 AM EST
    ... but I'm not sure I like the smell of it.

    What??? (5.00 / 3) (#11)
    by Yman on Mon Oct 21, 2013 at 03:44:01 PM EST
    This only shows that the idea that you can have a single payer system for 300 million run by a central organization (the feds) is impossible.

    How does it "show" that?!?

    Countries that already have single payer healthcare:

    United Kingdom
    United Arab Emirates


    None as big as the US (1.00 / 1) (#16)
    by Slado on Mon Oct 21, 2013 at 04:08:07 PM EST
    China doesn't have it, either does India or Russia.

    Wonder why?  

    If Dems want single payer I'd argue the expansion of Medicaid through the states is the way to get it with stricter federal guidelines.

    I'd have preferred that to this mess we're getting.

    Also we'd need to allow the private industry to exist on the side as it does in some of those nations you list.

    My point is no country as big as us is currently running a healthcare system we'd want any part of.

    And none of those countries had to overall an archaic semi private monstrosity that we have.   They all evolved to their currect status while we went down our crooked road.

    To late to go back now.   But expanded Medicaid cold work.  It just can't be the only solution because we can't afford it.


    So what? (5.00 / 2) (#29)
    by Yman on Mon Oct 21, 2013 at 05:11:57 PM EST
    None as big as the US

    Japan does it with 127 million people.  So somewhere between 127 million (Japan) and 316 million (US) it becomes impossible?  Where is that magic line?

    Also, why would Medicaid for all work, but Medicare for all wouldn't?


    France's health care (5.00 / 2) (#61)
    by MKS on Tue Oct 22, 2013 at 08:32:58 AM EST
    is considered top notch.  They have a combination of private insurance and a public option.  

    A Democratic Congress could modify the ACA by including a public option.


    Could'a Would'a Should'a. (5.00 / 2) (#86)
    by Mr Natural on Tue Oct 22, 2013 at 11:15:11 AM EST
    That ship has sailed, MKS.  Too bad Obama didn't spend more time engaging and steering Congress, in other words, leading.  Instead, we got a bunch of now boilerplate speeches about how historic Obama was.

    Here Here (none / 0) (#91)
    by Slado on Tue Oct 22, 2013 at 11:29:53 AM EST
    I think ultimately we will end up a private/public system.

    When I lived in Tennessee we had TennCare and like Obamacare it tried to provide insurance to the underprivileged in the hopes that a managed gruop of insured would lower costs etc... etc...

    It collapsed in on itself.

    Ultimately I think the ACA will as well and then what?

    Hopefully we get the system we should have gotten all along.


    Wonder no more. China, India and Russia, ... (none / 0) (#52)
    by gbrbsb on Mon Oct 21, 2013 at 10:11:58 PM EST
    even if catching up fast, are all still "developing" countries, (i.e. under developed, i.e. not advanced), from the World Bank's yearly analysis while the US is, as we know, already fully developed !

    Conservatives (5.00 / 1) (#31)
    by Ga6thDem on Mon Oct 21, 2013 at 05:29:14 PM EST
    really should embrace Obamacare because it's the last gasp of the current insurance model. If it does not work single payer is the only option.

    No (none / 0) (#5)
    by TeresaInSnow2 on Mon Oct 21, 2013 at 02:47:38 PM EST
    This only shows that the idea that you can have a single payer system for 300 million run by a central organization (the feds) is impossible.

    What it showed is the incompetence of the administration at reaching that goal. It can be done.


    I have my doubts (none / 0) (#13)
    by Slado on Mon Oct 21, 2013 at 04:03:10 PM EST
    No one else is doing it at the 300million person level.

    No state and no country.   Medicare is 6 times smaller then what we need and it doesn't break even.  It is a true entitlement.  

    I guess we could say China is doing it but I don't think we want their system.

    Just one man's opinion.

    We could have just made Medicaid universal through the states and it would have worked much better.

    I agree with one post that this administration has fumbled this badly.   But I point out it's only been three weeks.   Things will change.   One way or the other.


    Oh, for crying out loud (5.00 / 3) (#20)
    by sj on Mon Oct 21, 2013 at 04:22:56 PM EST
    Medicare is 6 times smaller then what we need and it doesn't break even.  It is a true entitlement.
    I would gladly redirect every penny going into for-profit health insurance. I suspect most people would if they looked at it logically.

    I could (and do!) spend hundreds of dollars a month which goes into a pool so that my insurer can make a profit. With single payer I could take those same dollars and invest it into a tax that goes into a pool that actually provides health care. And those who have no money to be taxed for health care could still get it. I'd take that trade off all day. Repeat: TAX instead of INSURANCE EXPENSE makes no difference in the size of my check.

    And by the way, who the f*ck set the rules that Medicare must "break even". Must the NSA ""break even"? Does the military have "break even"? Does the state department have to "break even"?

    No, the Post Office (the one agency specified in the Constitution) must "break even". SS must "break even". Medicare must "break even". Oddly enough, only services for real, you know, people.

    As far as I am concerned the freaking federal government should be spending money hand over fist to benefit the, you know, people.


    We could not make it Medicaid (none / 0) (#19)
    by MO Blue on Mon Oct 21, 2013 at 04:20:08 PM EST
    through the states. We can not even expand Medicaid in over half the states (26). Not to mention the fact that many of the states whose population who need health care the most have the most draconian requirements to qualify and they are also the ones for the most part who will not expand coverage when the feds are paying for it. Their attitude seems to be if people can't afford it, fck them. They can always go to the ER.

    As I read Ross Douthat ( know, why do that), (none / 0) (#10)
    by KeysDan on Mon Oct 21, 2013 at 03:39:20 PM EST
    in the NYT ("Failing Ahead of Schedule," October 20, 2013), he claims, with his customary right-wing rigor, that while the technocratic failure may bring schadenfreude to conservatives, a wreck of exchanges may actually be worse for conservative policy objectives (he does not elaborate on what these are) than a successful roll-out.

    The Medicaid expansion, and hence, the socialism component of ACA is likely to go forward, but Douthat fears that we will have a dysfunctional market component, the center-right vision for health insurance.  And, his big concern is that that situation will just energize Democrats to expand Medicare to ages 55-65 (at least at first).  So, from a liberal perspective, the glitches may work out well.  Perhaps, this is 11-dimensional chess, once again.


    He's right in a weird way. (1.00 / 2) (#18)
    by Slado on Mon Oct 21, 2013 at 04:14:54 PM EST
    I heard this put very well on Rush today by someone who wasn't Rush, fill in host.

    He said we already have a private/public system because of Medicare, Medcaid and federal rules and regulations.   There are arguments both ways for why one or the other is better but the only thing we can agree on is the two systems together don't work.

    In my opinion we'd be better off separating the systems and seeing what happens.    


    Very (5.00 / 2) (#15)
    by lentinel on Mon Oct 21, 2013 at 04:07:22 PM EST
    reassuring article in today's NYTimes.

    It seems that exposure to radiation isn't all that bad after all.

    I'm all aglow.

    You and me both (none / 0) (#17)
    by Slado on Mon Oct 21, 2013 at 04:10:34 PM EST
    As someone who's probably had 50 or so xrays, PET Scans and CT's I used to worry about this.

    My oncologist when asked the other day said we can't find cancer unless we do them and I've never seen a case where the only factor could be xrays, CT's and PETSCANs.

    Scan away doc.


    I was (5.00 / 1) (#22)
    by lentinel on Mon Oct 21, 2013 at 04:30:57 PM EST
    being snarky.

    I just saw my dentist run out of the room after he placed an x-ray plate among my teeth so that he could get the hell out of there before the zap.

    My take is that since the nuclear industry has a death grip on the people in government, articles like this are being floated to make us feel better about imminent accidents.

    One of the suggestions from the author to the people in Japan near Fukushima is that they all go outside and play because the levels are "safe".

    Not mentioned is that the levels are "safe" because after the disaster, the government significantly lowered the standards for radiation poisoning. That is, they raised the level of radiation that we are supposed to be able to tolerate before our noses fall off.

    I can only assume that our government will do the same.


    I'm not for unnecessary Xrays (none / 0) (#24)
    by Slado on Mon Oct 21, 2013 at 04:34:34 PM EST
    but as in most cautionary tales we go from one extreme to the other.

    Dentists overdue x-rays but I'm not sure gum cancer is evolving at an alarming rate because of it.

    I'd compare it to the fear that too much cellphone use can cause cancer.

    For someone like me the risk of xrays and radiation from CT's is outweighed by the positive results.   Like not being dead.


    I am not at all worried (5.00 / 1) (#37)
    by Zorba on Mon Oct 21, 2013 at 07:38:25 PM EST
    about gum cancer due to dental x-rays.  But I am somewhat worried about thyroid cancer, since I have a close relative who suffered (and died) from it.  I always ask for a thyroid (neck) shield when getting dental x-rays.  Maybe I'm being overly cautious, and my dentist is not one who takes x-rays all the time, thankfully.  But it isn't a big deal to ask for a thyroid shield.

    You (5.00 / 1) (#39)
    by lentinel on Mon Oct 21, 2013 at 07:48:21 PM EST
    are wise to do so, imo.

    As a thyroid (5.00 / 1) (#40)
    by Ga6thDem on Mon Oct 21, 2013 at 07:53:07 PM EST
    cancer survivor myself you are very wise. The thing is not too many people know this and you really should ask for it during mammograms too. But darn if I forgot this last time to ask for one and they knew my history and did not even remind me. People do not realize that the real risk from radiation is thyroid cancer not gum cancer. It seems it's always something that gets affected that's completely unrelated to what the x-rays are done for.

    Yes. (none / 0) (#41)
    by Zorba on Mon Oct 21, 2013 at 08:01:12 PM EST
    I do this, too.  Interestingly enough, the dental technician doesn't even blink when I ask for a thyroid shield, but I have had some strange looks from mammogram techs when I do so.
    I don't care, I still insist on them.  I'm kind of surprised that thyroid shields are not just standard practice for mammograms and dental x-rays.  We shouldn't even have to ask for them.

    I (none / 0) (#38)
    by lentinel on Mon Oct 21, 2013 at 07:47:49 PM EST
    really was referring to the foisting upon us of radiation from accidents or incompetence or acts of God. Not therapy. Choice is involved in therapy. It is controlled.

    With events like Fukushima, people have been exposed to dangerous levels of radiation. The sea has been contaminated, and continues to be contaminated. Milk is contaminated. Food is contaminated.

    And the article to which I referred in the Times seeks to manipulate us into believing that the people impacted by the horrors of Fukushima should lighten up and send their kids outside to play.

    I consider that to be manipulative propaganda. Propaganda that seeks to numb us to the effects of a nuclear accident. An accident that seems inevitable.

    And this is to protect the nuclear industry at the expense of the health and lives of the American people.


    My apologies (none / 0) (#108)
    by Slado on Tue Oct 22, 2013 at 01:28:10 PM EST
    That is a totally different issue.

    If I lived within 100 miles of that site I'd soon be 1,000 miles away if I could.

    We will never ever know the long term effects of that disaster.  

    As for cancer being caused by Xrays I found this bit of info on sharecare.com...

    A 2009 scientific advisory on the topic from the American Heart Association (AHA) offers some perspective. Your risk of developing some type of cancer during your lifetime is 41%, and the risk of dying as a result is 21%. The relative risk of dying of cancer from radiation due to a heart computed tomography (CT) scan is very small in comparison -- an estimated increase of about 0.05% above the 21% background risk. In addition, radiation-induced cancers don't occur until decades after exposure, making the cancer risk even less concerning for older people, who are likely to die from other causes (including heart disease) before developing cancer.

    That being said unnecessary xrays and CT's are not advised but if they're useful, scan away.


    Slado (5.00 / 1) (#132)
    by ScottW714 on Tue Oct 22, 2013 at 04:08:10 PM EST
    My oncologist when asked the other day said we can't find cancer unless we do them and I've never seen a case where the only factor could be xrays, CT's and PETSCANs.

    Did he/she happen to mention how many cases of cancer they were able to trace to a source ?

    That is not only a pretty ridiculous thing for a doctor to say, it's very misleading in that they surely know it's rare that cancer can be traced to a single source with any degree of certainly.

    Like the foot doctors back in the day say don't sweat the xray sizing machines, I've never seen a case where the only factor could be that machine.


    Radiating for sure ! (none / 0) (#49)
    by gbrbsb on Mon Oct 21, 2013 at 09:45:58 PM EST
    I still have (5.00 / 2) (#26)
    by Edger on Mon Oct 21, 2013 at 04:40:39 PM EST
    8 or 9 cardboard boxes full of stuff that haven't been opened even once since my last move almost 2 years ago.

    But I am certain that they must contain something absolutely crucial that will someday be needed, or I wouldn't still have them

    Would anyone like them? ;-)

    I never heard the apologies (5.00 / 1) (#27)
    by CoralGables on Mon Oct 21, 2013 at 04:44:11 PM EST
    but the firings happened.

    AP fired Bob Lewis and Dena Potter today for the false story saying Terry McAuliffe lied to federal investigators.

    Long-term planners. (5.00 / 2) (#28)
    by KeysDan on Mon Oct 21, 2013 at 04:50:30 PM EST
    Senator Dick Durbin (D.IL), in an apparent warm-up for budget talks, opened the door wider Sunday, on Fox News, to cuts in social security in exchange for increases in tax revenues.   Durbin said "Social security is gonna run out of money in 20-years."

    A statement akin to what Dorothy Parker would call analyzing the gamut from "Y to Z."  There is actually more to this alphabet: social security has a surplus of two trillion and, in 20 years, will run out of money to pay all benefits at the current level if nothing changes.  

    If a 20 to 25 percent budget cut were implemented in 20 years the program would be solvent for 75 years.  While the long-term planning is appreciated, it is also curious that concerns are registered for what will happen in 75 years, when there is jubilation at avoiding financial fiasco by raising the debt ceiling for about three months.  

    I was sitting (5.00 / 3) (#32)
    by Ga6thDem on Mon Oct 21, 2013 at 05:38:25 PM EST
    in the doctor's office this morning and saw the cover of Time magazine. I'm not sure if it's the most recent edition or what but the cover said "The United States of Texas". So i'm reading the article and thinking just shoot me now. If the entire nation becomes Texas we are going to be a third world country with 99% of our jobs minimum wage jobs and the elite in this country gaining more at the benefit of the middle class. I sincerely hope this is another one of those predictions that is wrong wrong wrong!!

    But (none / 0) (#48)
    by lentinel on Mon Oct 21, 2013 at 09:36:44 PM EST
    just think of all the executions we could have.

    AN AXE LENGTH AWAY, vol. 163 (5.00 / 1) (#34)
    by Dadler on Mon Oct 21, 2013 at 06:58:33 PM EST
    Evening linky to this morning's new one.

    Time to play housedaddy and come up with a dinner idea for tonight. Right now I got nothin'. It'll come to me. Always does. Peace out.

    Where's Zorba when you need her? (none / 0) (#35)
    by oculus on Mon Oct 21, 2013 at 07:32:23 PM EST
    LOL! (none / 0) (#45)
    by Zorba on Mon Oct 21, 2013 at 09:22:59 PM EST
    I made Greek baked chicken with potatoes earlier.  And since we still have the last of the garden tomatoes, plus lettuce from the garden, a nice big salad.

    Red snapper tacos with fresh guacamole (5.00 / 3) (#46)
    by Angel on Mon Oct 21, 2013 at 09:25:00 PM EST
    on freshly baked flour tortillas.  They were yummy!

    Grill some salmon (none / 0) (#43)
    by fishcamp on Mon Oct 21, 2013 at 08:39:34 PM EST
    and steam some spinach...you'll be good until mañana.  Don't forget the Kalamata olive oil.

    Or Kolymvari (5.00 / 1) (#44)
    by Zorba on Mon Oct 21, 2013 at 09:18:13 PM EST
    olive oil.  Either works.  ;-)
    BTW, fishcamp, have you tried baked kale?  Rinse and dry the kale, remove the stems and center ribs.  Toss with some olive oil, salt and pepper, spread in one layer on a cookie sheet or similar, and bake in a moderate oven until crisp.
    Really good.  And if you want, you can add seasonings such as paprika, cayenne pepper, etc.  Whatever works for you.

    Thanx Zorba... (5.00 / 1) (#47)
    by fishcamp on Mon Oct 21, 2013 at 09:31:51 PM EST
    so far I pretty much hate kale but I'll give it a try again.  I know how good for you it is but still.  You're right about the Kolymari oil being harder to find.  I'm ordering a 500 ml btll.

    I was never terribly fond (5.00 / 1) (#51)
    by Zorba on Mon Oct 21, 2013 at 10:04:23 PM EST
    of kale myself, until a friend of mine told me about these "kale chips."
    They are surprisingly good.
    I'm thinking that they would be even better if dipped into tzatziki sauce, and I may try that next time.
    Of course, there are a whole lot of good foods which would be even better with a bit of tzatziki sauce.   ;-)

    Or Bacon (5.00 / 3) (#53)
    by CoralGables on Mon Oct 21, 2013 at 10:40:47 PM EST
    Mmmmmmmmm (5.00 / 1) (#92)
    by Zorba on Tue Oct 22, 2013 at 11:32:44 AM EST

    Have you tried bacon with tzatziki sauce? (none / 0) (#93)
    by CoralGables on Tue Oct 22, 2013 at 11:35:20 AM EST
    or is that overkill of goodness?

    No, I think (none / 0) (#98)
    by Zorba on Tue Oct 22, 2013 at 12:30:52 PM EST
    that might be a bit of an overkill.
    Although, tzatziki is good with lamb, chicken, and pork.  So maybe...........        ;-)

    Kolymvari and tzatziki are (none / 0) (#67)
    by fishcamp on Tue Oct 22, 2013 at 09:06:23 AM EST
    tough words to wrangle.  You probably make your own yogurt too.  One recipe said to strain the yogurt.  That's another new one for me.  Maybe it meant strain the yogurt and garlic together.  You're changing my eating world Zorba.

    Straining the yogurt just takes out the whey (5.00 / 2) (#69)
    by vml68 on Tue Oct 22, 2013 at 09:14:02 AM EST
    so you get a much thicker, creamier product. You can just buy greek yogurt or "labneh" if you have access to a middle-eastern grocery store.

    vml68 is correct, fishcamp (5.00 / 1) (#82)
    by Zorba on Tue Oct 22, 2013 at 10:50:40 AM EST
    You just take the yogurt, dump it in a strainer lined with multiple layers of cheesecloth or, what I like to use, a clean dish towel (one I use just for straining yogurt).  Make sure this is not a terry cloth towel, but one of those finely woven ones.
    Put the strainer over a bowl, stick it in the refrigerator, and leave it alone for a couple of hours, until it's as thick as you want.  (Leave it long enough, and you get yogurt cheese.)
    Don't throw out the whey- use it in cooking or baking.

    Talking about food beats politics any day. (5.00 / 2) (#182)
    by Mr Natural on Wed Oct 23, 2013 at 11:18:00 AM EST
    That would be a 'flour sack' towel. (5.00 / 2) (#193)
    by nycstray on Wed Oct 23, 2013 at 12:05:04 PM EST
    More on the ACA rollout (5.00 / 1) (#60)
    by jbindc on Tue Oct 22, 2013 at 08:32:47 AM EST
    Health insurance exchange launched despite signs of serious problems

    There were ample warning signs that the system was not working properly, according to people familiar with the project.

    The Centers for Medicare and Medicaid Services (CMS), the federal agency in charge of running the health insurance exchange in 36 states, invited about 10 insurers to give advice and help test the Web site.

    About a month before the exchange opened, this testing group urged agency officials not to launch it nationwide because it was still riddled with problems, according to an insurance IT executive who was close to the rollout.

    "We discussed . . . is there a way to do a pilot -- by state, by geographic region?" the executive said.

    It was clear at the time, the executive said, that the CMS was still dealing with the way the exchange handled enrollment, federal subsidies and the security of consumers' personal information, such as income.

    One key problem, according to a person close to the project, was that the agency assumed the role of managing the 55 contractors involved and had not ensured that all the pieces were working together.

    Some key testing of the system did not take place until the week before launch, according to this person. As late as Sept. 26, there had been no tests to determine whether a consumer could complete the process from beginning to end: create an account, determine eligibility for federal subsidies and sign up for a health insurance plan, according to two sources familiar with the project.

    People working on the project knew that Oct. 1 was set in stone as a launch date. "We named it the tyranny of the October 1 date," said a person close to the project.

    Call me curious, but (none / 0) (#107)
    by christinep on Tue Oct 22, 2013 at 01:18:03 PM EST
    what would you propose, jbindc, that would allow people access/improved access to health care in the US? Also: What about the insurance reform aspect of ACA--the various individual reforms regarded as alleviating/doing away with what has been regarded as the more oppressive aspects of pre-ACA healthcare coverage?

     Perspective on where a critic starts from is always helpful in these kinds of discussions.  In short: Were you ok or accepting of pre-ACA healthcare situation ... if you wanted to see changes, what specifically ... do you regard the ACA approach as too much or too little government involvement ... and, for comparison and template purposes, does any country offer a model that you would like to see us eventually emulate?

    Since your comments are often well-sourced and since you evidenced concern about "access" above, I became curious about your position about this most important matter.  Thanks.


    I wanted public option (5.00 / 1) (#141)
    by jbindc on Tue Oct 22, 2013 at 05:22:45 PM EST
    And instead all I got was this lousy website.

    As I'm sure you know (2.00 / 2) (#153)
    by christinep on Tue Oct 22, 2013 at 08:17:02 PM EST
    the ACA is much more than a website.  But then, your point may be the talking point that you just put forth.  Nice. (BTW, also nice pass on any questions related to your broader position as to insurance reforms or other country's model.)

    Tell me christine (5.00 / 2) (#158)
    by jbindc on Wed Oct 23, 2013 at 06:29:13 AM EST
    Do you actually HAVE to use the website?  Do you actually HAVE to try and buy an insurance policy on the open market?  Because if you don't, you are in a really nice position to talk in platitudes, but have no concept of the real world experiences and frustrations that many of us face.  So while there are some good things to this bill, it angers many of us that this launch was so FUBAR'd from the beginning, at the cost of millions of dollars, and more to come to fix the problems (that could have gone to provide, you know, ACTUAL CARE to people), that this is not just something that can be whisked away by hopeful thinking and fairy dust.

    To add more information to this conversation - take a look at this - another piece of the pie that is cracking.  With this many cracks in the system, how do you propose this law, as intended, will hold? (Emphasis mine)

    When the new health-care law was being cobbled together, Congress decided to establish a network of nonprofit insurance companies aimed at bringing competition to the marketplace, long dominated by major insurers.

    But these co-ops, started as a great hope for lowering insurance costs, are already in danger.

    While the debut of the Affordable Care Act this month has been marred by widespread computer problems, the difficulties the co-ops face have been less obvious to consumers. One co-op, however, has closed, another is struggling, and at least nine more have been projected to have financial problems, according to internal government reviews and a federal audit.

    Their failure would leave taxpayers potentially on the hook for nearly $1 billion in defaulted loans and rob the marketplace of the kind of competition they were supposed to create. And if they become insolvent, policyholders in at least half the states where the co-ops operate could be stuck with medical bills.

    Although the co-op plan originated in the Senate, resistance to the initial proposal quickly materialized on Capitol Hill, in part because of pressure from insurance industry lobbyists.

    So Congress saddled its new creations with onerous restrictions that, experts say, doomed many co-ops to failure. Federal grants for the co-ops were converted to loans with tight repayment schedules; they were barred from using federal money for crucial marketing; and they were severely limited from selling insurance to large employers, which represent the most lucrative market.

    And even as the Obama administration was setting up the program, White House officials, who had no pride of authorship and feared it would be risky, repeatedly suggested that funding for the co-ops be reduced, according to more than half a dozen people familiar with budget negotiations and the legislative debate. The funding was cut to a small fraction of what experts told Congress would be needed for the ventures to be viable.

    In part, you are correct, jbindc (2.00 / 1) (#173)
    by christinep on Wed Oct 23, 2013 at 09:26:44 AM EST
    I have been very fortunate for years to have Kaiser coverage ... selected from the federal exchange mechanism available for federal employees for many years.

    I understand your concerns in view of my whole family background, and the economic realities and medical needs confronting my family as I grew up.  As noted a number of times in other threads, that is the reason I came to support strongly government advancement in the healthcare/insurance reform arena. It is a life passion for me, simply stated.

    I also recognize the early website start-up problems (and believe that the developers and supervisors accountable should be held accountable after we get through this early bump.) It is of particular concern, as you suggest, for the people who need this sign-up process now ... for the certainty, the surety that the positive changes will cover them ASAP in January.

    To be honest, your apparent background alignment with a number of the Repub talking-points and positions has impeded me in reacting to you at this time on this subject.  For example, it is meaningful and important to ask -- as I did -- about what changes you support and what further changes you would like to see.  (Because the public option was long ago taken off the table, isn't that really a dodge at this point?  Yeh, I wanted the public option too ... but, I'm dealing with the facts of the ACA now and have for some time.)  If this is an exercise, tactically, in being the critic in the catbird's seat for this week, I understand that as well.


    No, it's really not (5.00 / 3) (#188)
    by sj on Wed Oct 23, 2013 at 11:42:14 AM EST
    For example, it is meaningful and important to ask -- as I did -- about what changes you support and what further changes you would like to see.
    Having that conversation at this point in time is just mental masturbat!on. The time to have that conversation is when policy is being written, or (since I know you like to wait and see which way the chips have already fallen before voicing any sort of caution) when enough of the policy has been implemented to get to the "lessons learned" phase.

    And you know what? I have employer based health insurance so I haven't personally been struggling as jb and Teresa have, but I'm offended on their behalf by this:

    To be honest, your apparent background alignment with a number of the Repub talking-points and positions has impeded me in reacting to you at this time on this subject.
    Being GOP doesn't automatically mean "wrong". I know our minds turn to the batsh!t crazy GOP -- which neither jb nor Teresa are, so the sneaky, sly insult was ... even more insulting. But just because the "Repub" talking points are taking a certain tack doesn't mean there isn't some there to substantively criticize. And automatically assigning criticism of the ACA implementation to alignment with "Repub" perspectives is really low.

    What got to me, sj, was christine being so (4.00 / 4) (#203)
    by Anne on Wed Oct 23, 2013 at 12:29:20 PM EST
    passively/aggressively dismissive of jb's clear statement that she wanted a public option - and the reason: because the ACA doesn't contain one.

    So, what, I wondered, was the point of asking if christine was going to insist that everyone ought to just be dealing with what is, like she's doing.  And I'm sure, doing so well, don't you know.

    Neither jb nor Teresa - nor most of us, for that matter - have criticisms of or objections to the reality of the ACA because OBAMA; our problem is with the fact that this warmed-over, Heritage Foundation/Bob Dole plan isn't "reforming" the system, it's entrenching the insurance companies and indenturing millions of people to them - even as there will still be tens of millions of people who won't have the opportunity to get health insurance.

    And that isn't - someone tell Christine - the reason the GOP objects to "Obamacare." They DO object because, well, OBAMA.  They have nothing else to offer other than "sell insurance across state lines" and "tort reform."

    Liberals/progressives and people who actually ARE passionate about this issue have suggested any number of things that would make it better, and christine damn well knows what those things are because they've been listed and discussed in detail here and in many other places for over 4 years.

    Sorry for the rant - my anger isn't with you - but there's only so much mealy-mouthed, meaningless, passive-aggressive, self-congratulatory garbage I can take in one day.


    Nothing makes one automatically wrong (none / 0) (#194)
    by christinep on Wed Oct 23, 2013 at 12:08:42 PM EST
    But, in this climate of politics, the unfortunate reality is that when one often seems to repeat the talking points of those adamantly and always opposed to the ACA (in this case, the Repubs) there just as often is a correlation between the two.  Looks like a duck, quacks like a duck, etc.
    (Additionally, when earlier general campaign statements tracked Romney's arguments for the most part, the image is walking the walk as well.)
    While it may not mean that to you, what it means to me is that the argument in the given instance probably is agenda-driven in terms of political persuasion. (By asking what one would like to see happen in the facts of today, that matter could be clarified.)

    An interesting point:  As a young child, the argument against what-was-then-called "socialized medicine" (used to describe government involvement in insurance and/or healthcare) loudly cautioned that "you won't be able to choose your own doctor" or "the government will determine your treatment" or "you'll won't have the choices you have now" and more along that line.  That has always been the rightwing condemnation about having government involved in healthcare and/or insurance.  That point--as a point of complaint--has definitely shown up in this thread as well.


    Well, maybe some people (4.00 / 3) (#198)
    by sj on Wed Oct 23, 2013 at 12:14:57 PM EST
    don't really know a duck when they see one. Who knew?
    Looks like a duck, quacks like a duck, etc. ... While it may not mean that to you, what it means to me is that the argument in the given instance probably is agenda-driven in terms of political persuasion.
    I suppose it makes it easier for you to ignore criticism by deciding it is "agenda-driven" rather than policy driven.

    Tom Englehardt notes this morning (5.00 / 2) (#78)
    by Edger on Tue Oct 22, 2013 at 10:27:52 AM EST
    that there's a phrase - "war crimes" - headlined in the British Guardian report on a new Amnesty International investigation of U.S. drone strikes that you are guaranteed not to see in headlines about the subject in the U.S. mainstream media. Heaven forbid! "War crimes" are the sorts of things that bad African leaders or evil rogue powers commit, not you-know-who. Here's the relevant passage. -- Tom

    "But Amnesty mounted a major effort to investigate nine of the many attacks to have struck the region over the last 18 months, including one that killed 18 labourers in North Waziristan [Pakistan] as they waited to eat dinner in an area of heavy Taliban influence in July 2012. All those interviewed by Amnesty strongly denied any of the men had been involved in militancy. Even if they were members of a banned group, that would not be enough to justify killing them, the report said.

    "`Amnesty International has serious concerns that this attack violated the prohibition of the arbitrary deprivation of life and may constitute war crimes or extrajudicial executions,' the report said. It called for those responsible to stand trial."

    US drone strikes could be classed as war crimes, says Amnesty International

    Not to worry though (none / 0) (#80)
    by Edger on Tue Oct 22, 2013 at 10:43:24 AM EST
    Whoever's president after 2016 will most likely take care of things.

    BART strike over (5.00 / 1) (#87)
    by Dadler on Tue Oct 22, 2013 at 11:15:21 AM EST
    Asshat management, which last week refused the unions' offer of binding arbitration to settle remaining issues (gee, maybe because they knew they wouldn't do well), and after a couple of senseless deaths of track inspectors struck by a train being moved (and not, obviously, operated by a regular driver, well, management decided they'd phucked up enough and did the right thing. Idiots.

    Trainee operators, according to Googlr (none / 0) (#96)
    by oculus on Tue Oct 22, 2013 at 11:56:57 AM EST
    news item.

    whomever vit was... (none / 0) (#124)
    by Dadler on Tue Oct 22, 2013 at 03:22:34 PM EST
    ...obviously it was a situation where they KNOW they are going to pay heavily to the families of those killed. Damage control. And sort of insidiously so, IMO. How is San Diego today, btw?

    BART damages may be limited to (none / 0) (#131)
    by oculus on Tue Oct 22, 2013 at 04:00:59 PM EST
    Workers' Comp.

    72, mostly sunny. Beautiful.


    We'll see about worker's comp (none / 0) (#185)
    by Dadler on Wed Oct 23, 2013 at 11:34:31 AM EST
    ...since the actual BART policies on this matter seem to be, to put it mildly, idiotic at minimum, criminally liable more likely. But we shall see. Our laws are HEAVILY skewed against average people, which means you may prove prescient.

    AN AXE LENGTH AWAY, vol. 164 (5.00 / 1) (#128)
    by Dadler on Tue Oct 22, 2013 at 03:46:02 PM EST
    AN AXE LENGTH AWAY, vol. 165 (5.00 / 1) (#168)
    by Dadler on Wed Oct 23, 2013 at 08:38:04 AM EST
    He owns an edger now, but he's edgier than it'll ever be. (link)

    Volume 164

    Volume 163

    Good Wednesday to you, my friends. I just heard the trash truck coming, and my son forgot to put out the cans last night. Time to sprint...

    Momentum (5.00 / 2) (#177)
    by ScottW714 on Wed Oct 23, 2013 at 10:17:05 AM EST

    For the first time ever in a Gallup poll, a clear majority of the country - 58 percent - say that pot should be legalized. That figure represents an increase of 10 percentage points since last year, according to Gallup.

    "Americans are increasingly recognizing that marijuana is less harmful than they've been led to believe," said Mason Tvert, a spokesperson for Marijuana Policy Project.

    You don't say...

    Let the booze and pill propaganda begin! (none / 0) (#187)
    by Dadler on Wed Oct 23, 2013 at 11:36:39 AM EST
    I can't wait until Reefer Madness 2013 hits theatres soon. More likely, however, Smirnoff and Phillip Morris will mangage to transition into overcharging for sh*tty weed. They got the bucks to bribe with and corner they market if they want to. Hope not.

    It doesn't matter... (none / 0) (#189)
    by kdog on Wed Oct 23, 2013 at 11:47:23 AM EST
    how cheap big corporations can sell sh*tty dirt weed...dirt weed is dead and it ain't ever coming back.  In my "black market only" neck of the woods I don't even know anybody who sells it anymore...nobody wants it.

    After how we've been spolied by the glorious work of growers the last 15-20 years, how could we ever go back?  It would be like switching from Sam Adams to Coors Light, or Grey Goose to Popov.  

    You've got the model out by you with the dispensaries...none of them sell dirt weed, do they?



    Jaysus, let me put my ass back on, LOL (none / 0) (#190)
    by Dadler on Wed Oct 23, 2013 at 11:56:38 AM EST
    I think I meant weed that is as cheap for them to grow as possible, shitty being relative. As for here, well, some places sell low end stuff that wouldn't be considered ditch weed by old school standards. But stuff goes around that is really only sold for cooking with, making butter out of, not smoking. That's as close to the ditch as we get. But, no, the bags of seeds and stems and elephant cage smelling sh*t are long gone. Thank the God I don't believe in. Peace out, my man.

    P.S.) USF will be playing out at St. Johns this winter, December 18th. I didn't re-up my season tix, but I'll go to a few games.


    I gotcha... (none / 0) (#200)
    by kdog on Wed Oct 23, 2013 at 12:18:24 PM EST
    good chance they would reduce the THC levels as much as the market would bear, so as to increase consumption. Less money in "one hit and quit". ;)

    PS) At Carnesecca Arena on campus 12/18...nice.  Go Johnnies!


    Still Sell it Here in Texas... (none / 0) (#199)
    by ScottW714 on Wed Oct 23, 2013 at 12:17:49 PM EST
    ...and it's what people use to roll J's.

    Weed dealers don't carry it, it's the pill and blow guys that always seems to have just the right amount to round the transaction to a nice even ATM amount.

    But now we have all kinds of crazy stuff, liquid that looks like thin hash oil but is actually liquid THC.  It's way stronger and smells like hydro rather than hash.  It comes is capsules that can be put in an e-cigarette like devise.

    I don' partake anymore, but damn I still hang around folks that do and they are always showing me some sort of insane new weed or new method of ingestion.  On our trip one friend brought capsules of THC that looked and smelled like grass, as in the stuff in your lawn.

    It's all coming from Colorado, which is a thin strip of Oklahoma away from Texas.

    These current day bums, one friend thought I was pulling his leg when I spoke of seeds in weed, now they just whip out an ecig and get more THC than an old school J, and they do it right out in the open with little fear.  They got it so easy...


    Back east... (none / 0) (#204)
    by kdog on Wed Oct 23, 2013 at 12:33:10 PM EST
    they call it wax...that stuff is no joke.

    I haven't converted yet because I really like to smoke...but I know some people who are strictly wax now.  It's certainly healthier, and like you said so cool to vape pen with it anywhere with no non-heads the wiser.  It's revolutionary.


    Still Sell it Here in Texas... (none / 0) (#201)
    by ScottW714 on Wed Oct 23, 2013 at 12:18:25 PM EST
    ...and it's what people use to roll J's.

    Weed dealers don't carry it, it's the pill and blow guys that always seems to have just the right amount to round the transaction to a nice even ATM amount.

    But now we have all kinds of crazy stuff, liquid that looks like thin hash oil but is actually liquid THC.  It's way stronger and smells like hydro rather than hash.  It comes is capsules that can be put in an e-cigarette like devise.

    I don' partake anymore, but damn I still hang around folks that do and they are always showing me some sort of insane new weed or new method of ingestion.  On our trip one friend brought capsules of THC that looked and smelled like grass, as in the stuff in your lawn.

    It's all coming from Colorado, which is a thin strip of Oklahoma away from Texas.

    These current day bums, one friend thought I was pulling his leg when I spoke of seeds in weed, now they just whip out an ecig and get more THC than an old school J, and they do it right out in the open with little fear.  They got it so easy...


    I have... (none / 0) (#192)
    by sj on Wed Oct 23, 2013 at 12:02:53 PM EST
    ... so much admiration for Mason Tvert. This would have never happened without his efforts. He was absolutely indefatigable, and took networking to levels I've never seen before.

    Question for those of you who have health (none / 0) (#30)
    by vml68 on Mon Oct 21, 2013 at 05:19:00 PM EST
    insurance through your employers. Have your premiums gone up significantly in the past year?
    For the past few years our(husband+me) premiums went up about $200/year. For this year it went up $1000 and just found out that for next year it will be going up $2000. Same plan we have always had!

    Yes (5.00 / 1) (#33)
    by sj on Mon Oct 21, 2013 at 05:53:29 PM EST
    and Yikes!

    The closer you get (none / 0) (#36)
    by fishcamp on Mon Oct 21, 2013 at 07:33:56 PM EST
    to Medicare age the higher your rates become.  The last year when you are 64 it really skyrockets.  Greed.

    I don't doubt it. But it does not apply to us... (none / 0) (#42)
    by vml68 on Mon Oct 21, 2013 at 08:22:35 PM EST
    because it is going to be quite a while before my husband and I are Medicare age.

    No. It actually went down (negligibly) (none / 0) (#50)
    by magster on Mon Oct 21, 2013 at 09:53:34 PM EST
    like $5 bucks per month.

    Colorado and Kaiser Permanente if you're curious.


    I was about to say the same (none / 0) (#81)
    by ruffian on Tue Oct 22, 2013 at 10:45:33 AM EST
    Single person, 55, non-smoker, group health through Aetna. Went down about $15 per month.

    Hmm... we have Aetna too. Wonder why our (none / 0) (#84)
    by vml68 on Tue Oct 22, 2013 at 11:00:21 AM EST
    premiums are going up so much. If I am not being too nosy, do you have high deductibles, copays, etc.
    While we have the option of choosing different plans, we have always gone with the no deductible, $20 copay PPO/EPO plans. I wish I had kept track of the premiums for the other plans to see if those premiums are changing as much as our plan.

    Don't mind at all....It is a PPO (none / 0) (#113)
    by ruffian on Tue Oct 22, 2013 at 01:43:48 PM EST
    $1000 per person in network deductible,  $2250 out of network deductible. $20 co-pay...prescription coverage.

    Plus I work for a pretty huge company.....I'm sure they get a good deal.


    Are you sure this government is capable of single (none / 0) (#54)
    by redwolf on Mon Oct 21, 2013 at 10:45:19 PM EST
    of a national healthcare system?  The incompetence of the Obamacare roll out seems to indicate that our ability to big things well is behind us as a people.  

    Medicare's worked well for nearly 50 years. (4.67 / 3) (#136)
    by Donald from Hawaii on Tue Oct 22, 2013 at 04:30:32 PM EST
    It's actually much more efficient than private insurance, and enjoys an overhead that's a fraction of that found in the private sector.

    All that's required to make Medicare universal is to remove the floor of 65 years of age for beneficiaries, and open it up to all ages. Whatever increased costs to be incurred personally in payroll taxes, will still be a lot cheaper than having to pay insurance premiums at the present amount, because Medicare will have the largest risk pool in the country.


    Well behind us as a people? (none / 0) (#147)
    by Jack203 on Tue Oct 22, 2013 at 07:09:26 PM EST
    When the rise and fall of the American Republic is  studied and debated, I don't think the Affordable Care website will be involved.

    Ohio approves Medicaid expansion today (none / 0) (#55)
    by CoralGables on Mon Oct 21, 2013 at 10:57:33 PM EST
    Republican Governor John Kasich sidestepped the Republican Legislature in Ohio and approved Medicaid expansion under the ACA. The number being thrown around is that about another 360,000 will have health care in the state.

    Correction (5.00 / 2) (#59)
    by jbindc on Tue Oct 22, 2013 at 08:21:10 AM EST
    About another 360,000 will have INSURANCE in the state.

    Whether or not they actually get access to CARE is another story.


    On the contrary (5.00 / 1) (#62)
    by CoralGables on Tue Oct 22, 2013 at 08:37:25 AM EST
    They won't have insurance. They will have single payer. So 360,000 more people in Ohio will now have access to free health care.

    On the contrary (5.00 / 1) (#65)
    by jbindc on Tue Oct 22, 2013 at 08:47:12 AM EST
    Just because you can get Medicaid does not guarantee that doctors have to take you. In fact, many doctors do not accept Medicaid patients because of the low rates that Medicaid pays out.

    So while this is a good thing that more people might have the opportunity to get some medical assistance, it does not, as your original statement said, mean that there are 360,000 more people with CARE.


    I'm enjoying your knee-jerk reaction (3.50 / 2) (#68)
    by CoralGables on Tue Oct 22, 2013 at 09:08:29 AM EST
    But they now have access when they used to have none.

    You're right that not all doctors accept new medicaid patients. Of course regular insurance isn't accepted by all doctors either.

    Are you offended that a GOP Governor is helping the less well off citizens in Ohio? Perhaps you prefer Governors like Rick Scott, Scott Walker, and Rick Perry?


    Access to none? (none / 0) (#76)
    by jbindc on Tue Oct 22, 2013 at 10:05:43 AM EST
    Someone without inusrance would ALWAYS be accepted at an ER, so your comment is a pure fallacy.

    Medicaid will now allow them to see a doctor in an office, as opposed to going to an ER.  But that's if they can find a doctor that will accept Medicaid.  Some will be able to get in - that's great.

    But I do love YOUR knee jerk reaction that this means your (overinflated) number will all get care.


    Is There One Documented Case... (none / 0) (#72)
    by ScottW714 on Tue Oct 22, 2013 at 09:32:21 AM EST
    ...of someone with Medicaid not being able to find care ?  Maybe, is it a problem, absolutely not.

    Just because some doctors don't take it doesn't mean they are without care, it means the ones that do take it will have more patients.

    And I suspect, states with residents with lower than average incomes probably have higher than average numbers of doctors who will take Medicaid, like Ohio.


    I think it might depend on where (5.00 / 1) (#73)
    by MO Blue on Tue Oct 22, 2013 at 09:45:46 AM EST
    you live within the state. People who live in large cities with well funded teaching hospitals or community health centers might find it easier to get good quality care when on Medicaid than people who live in areas where there is a shortage of doctors etc. Not necessarily impossible just much harder.

    But... (none / 0) (#99)
    by ScottW714 on Tue Oct 22, 2013 at 12:32:45 PM EST
    ...small communities don't have the expenses that say a clinic in Manhattan might have.  Their overhead is nothing compared to places like the Medical Center here in Houston.

    In places, like the deep south, no one has money, so the doctors and clinics are set-up for that, to handle the load of the communities they service.

    This comment is in regards to Medicaid.


    I know the comment was about (5.00 / 1) (#115)
    by MO Blue on Tue Oct 22, 2013 at 02:25:43 PM EST
    Medicaid. That is why I specifically mentioned it in my comment. IIRC all Medicaid payments are not equal. IOW the reimbursement rate is much higher in Manhattan than it is in a small town in a rural area.

    You may choose not to believe this information but it is recent and put out by what I consider reliable sources.

    McClatchy: Most Doctors Still Reject Medicaid As Program Expansion Nears
    Because of the program's history of low payments, fewer than half of U.S. doctors and other health care professionals accept Medicaid patients, according to a recent study. For those that do, getting an appointment sometimes can take months because of the high demand, particularly among specialists. The problem is worse in rural areas such as Bonifay, in the Florida Panhandle. While 20 percent of Americans live in less-populated parts of the country, only 10 percent of U.S. doctors practice there. That's why 77 percent of the nation's 2,000-plus rural counties are designated as health professional shortage areas, according to the National Conference of State Legislatures. Nationwide, the lack of doctors is a growing problem that will only worsen as some 27 million people get health coverage by 2016 as part of the Patient Protection and Affordable Care Act (Pugh, 5/15). link

    To set the record straight I am not against the Medicaid expansion. It is definitely better than what many people have now and people in states that do not accept the expansion will IMO be worse off than they are now since the payments to hospitals that accept people without insurance will decrease. That does not IMO negate the potential problems of having multiple insurance systems with varying payment rates.



    Here's one answer (none / 0) (#75)
    by jbindc on Tue Oct 22, 2013 at 10:03:03 AM EST
    Is There a Point in There ? (5.00 / 1) (#97)
    by ScottW714 on Tue Oct 22, 2013 at 12:25:54 PM EST
    Right now, the United States is short some 20,000 doctors, according to the Association of American Medical Colleges. The shortage could quintuple over the next decade, thanks to the aging of the American population -- and the aging and consequent retirement of many physicians. Nearly half of the 800,000-plus doctors in the United States are over the age of 50.

    We are already short and people are getting care, even those on Medicaid.

    You made a pretty broad assumption, back it up with more than generalities and opinion.  Find me some people with Medicaid that can't find care.

    That link is just plain sad, the horror of finally giving people care may lead to a greater shortage of doctors and that is somehow argument to be against ACA.  A real spiteful argument from one of the obvious 'haves' who apparently don't like the 'have nots' taking up their doctor time.  Pathetic.

    Seems like it really champions ACA in that it's giving people who didn't have care in the past, care now.  A shortage of doctors because more people are getting care in the normal world is a damn good thing.

    For the record, the link claims 69% of doctors take Medicaid, that means (somewhat) if you live within 10 doctors, odds are about 7 will take your Medicaid.  Not exactly bad odds.


    Find me some people with Medicaid that can't find (5.00 / 1) (#148)
    by Jack203 on Tue Oct 22, 2013 at 07:14:14 PM EST
    So what would really convince you is anecdotal evidence?

    Strange request in a serious debate.


    Actually, my point was very clear (none / 0) (#101)
    by jbindc on Tue Oct 22, 2013 at 12:48:16 PM EST
    Giving someone INSURANCE (such as Medicaid is), does not mean they are guaranteed CARE (which is what CG's statement said in the first place).

    His statement was factually incorrect.


    So by your reasoning (2.00 / 1) (#106)
    by CoralGables on Tue Oct 22, 2013 at 01:17:57 PM EST
    no one is guaranteed "care" because they actually have to go to a doctor. Even a top level insurance plan doesn't guarantee healthcare by your convoluted logic.

    You still haven't answered. Does it bother you that Ohio now offers healthcare to the less well off? Do you prefer the plan in Texas, Florida, and Wisconsin?


    Got it, Non-Sense (none / 0) (#114)
    by ScottW714 on Tue Oct 22, 2013 at 01:45:34 PM EST
    Yeah, just because everyone at work has insurance, there is no guarantees they can get actual care.  Which is actually far more accurate in that the number of doctors that take that insurance is a fraction of those who take Medicaid.

    In reality, people with insurance get care, ditto for Medicaid.  Not sure why you are pushing the "More people with insurance is a bad thing" angle with your comment and the link, but back here in reality, the more people with coverage is a really good thing.


    Scott, please stop being deliberately obtuse. (5.00 / 5) (#121)
    by Anne on Tue Oct 22, 2013 at 02:57:44 PM EST
    Of course we can all get care, but in reality, many who have insurance don't get it because after they pay the premiums, and the co-pays and deductibles, they don't have money left over for the actual care.

    Sure, they can get their annual screenings, but if they get a sore throat, or pneumonia, or break a wrist, if that back pain just won't go away, they know that it's going to cost them more money than they can afford.

    I went to the orthopedist not long ago - I had twisted my foot about a month before my daughter's wedding, and was kind of half-afraid they might stick me in a cast or a boot, so I waited.  

    The office visit was $305.00; the xray was $69.00.  I have Blue Cross/Blue Shield, which "adjusted" the charges by $213.47, leaving me a balance due of $160.53 - which I had to pay because I hadn't met my deductible for the year.  So, almost $600/month in premiums, and I am still out of pocket for the charges.

    I could pay it - but for someone else, that $160.00 could be half a car payment, or two weeks' groceries, or the electric bill.

    Come on, Scott - get your head out of your a$$ and stop acting like people are just making this sh!t up.


    Maybe this will help Scott and CG understand (5.00 / 4) (#142)
    by jbindc on Tue Oct 22, 2013 at 05:29:21 PM EST
    I'm not sure why they can't distinguish beetween "insurance" and "care", but then again, the people who get on TV and talk about the law (or the people who passed the law) don't either, so, go figure.


    When insurance marketplaces open on Oct. 1, most of those shopping for coverage will be low- and moderate-income people for whom price is paramount. To hold down costs, insurers say, they have created smaller networks of doctors and hospitals than are typically found in commercial insurance. And those health care providers will, in many cases, be paid less than what they have been receiving from commercial insurers.

    Some consumer advocates and health care providers are increasingly concerned. Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.

    But instead they'd rather paint me as someone who who would rather that people don't get enrolled in Medicaid, as opposed to understanding that just because they get enrolled doesn't mean squat unless they can get care.

    And then, there's this little gem, aside from Medicaid, that never gets talked about (since Scott and CG are so concerned about the poor):

    Some families may end up owing Uncle Sam a sizable refund if they accept government help on buying health insurance next year under President Obama's Affordable Care Act.

    A study published Monday in Health Affairs estimates that 38% of families that qualify for federal premium subsidies might have to repay some portion if changes in their household income aren't reported to the government.

    These subsidies are a crucial part of the federal healthcare law intended to help make insurance more affordable for lower- and middle-income people. Individuals earning less than $46,000 a year, and families below $94,000 annually may qualify for these premium tax credits.

    But a raise, bonus or other unexpected income during the year could alter a person's eligibility and subsidy amount, triggering a repayment when the person files income tax forms for 2014. Some policy experts worry that experience could sour people on the healthcare expansion.

    Anne (2.00 / 2) (#138)
    by ScottW714 on Tue Oct 22, 2013 at 04:43:38 PM EST
    My comment and discussion was related to this statement:
    Just because you can get Medicaid does not guarantee that doctors have to take you.

    Which has nothing to do with cost prohibition of the insured/Medicaid.  But thanks for explaining how insurance works and for the other non-related comments.

    You need to read the comment I was (5.00 / 3) (#151)
    by Anne on Tue Oct 22, 2013 at 07:47:05 PM EST
    responding to before you slather on the sarcasm, Scott.

    And the statement quoted in your comment, above, is correct: there is nothing that requires any doctor/provider to accept Medicaid.  Or any other insurance, for that matter.  Try bullying a doctor into taking care of you when he or she doesn't accept whatever insurance you have - and then we'll see how well your argument holds up.  

    While there ARE doctors who take Medicaid, it isn't always easy to find them - my daughter's friend had to travel almost 40 miles round trip to find an obstetrician who accepted Medicaid AND was taking new patients - and she had to deliver in a hospital that wasn't her first choice because the doctor didn't have privileges there.

    Having insurance is no guarantee of care, much less that it will be affordable care.  Given the abundance of information that supports that observation, I'd suggest you lose the belligerent attitude.

    The sad reality is that whether it's Medicaid or Aetna or United Health, if insurance stands in the way of your getting the care you need from the provider you want, that insurance is a barrier to care, not a pathway.


    Now It's... (3.00 / 2) (#171)
    by ScottW714 on Wed Oct 23, 2013 at 09:17:43 AM EST
    ..."provider you want with insurance".

    My original point had nothing to do with income, or rather lack of it.  But good to see you and JB right on point with each other.

    I am not going to spiral into an idiotic conversation that has nothing to do with any of my original post about Medicare recipients not being about to get care.


    Because (none / 0) (#172)
    by jbindc on Wed Oct 23, 2013 at 09:24:52 AM EST
    Your original post had nothing to do with CG's original comment which was that all these people in Ohio who will now apply for Medicaid will now get care.  

    Which is still incorrect.

    So you're correct about one thing - this conversation has turned idiotic because people have jumped in with topics that had nothing to do with the original comments.


    You should be happy (1.00 / 1) (#174)
    by CoralGables on Wed Oct 23, 2013 at 09:30:05 AM EST
    with the most recent news since you don't like Medicaid expansion. Some Ohio Republican State Reps have sued the Republican Governor to try and stop Medicaid expansion in Ohio. Right to life groups have also signed into the lawsuit.

    Please just stop with the (4.50 / 6) (#179)
    by Anne on Wed Oct 23, 2013 at 10:58:43 AM EST
    you-hate-Medicaid garbage. No one said anything about being opposed to Medicaid expansion.  No one.  In fact, I don't think you will find anyone who objects to anyone getting the health care they need.

    The issue is - and always has been - that insurance is not care.  It may allow you access to care, and it may improve your chances of getting care, but that access can and often is determined by what providers participate in your plan: if the doctor you want to see is not accepting the insurance you have, he or she can refuse to accept you as a patient.  

    Yes, you can still walk into an emergency room and get care, and you might be able to find a doctor who isn't in your plan who will take you if you pay cash upfront - lord knows they make you sign your life away as it is, agreeing to be responsible for anything insurance doesn't cover.

    Many of the comments I've read over the last two weeks were written by people like Teresa and jb, neither of whom are fortunate enough to have employer-sponsored insurance.  In jb's case, she's been advised that her existing policy, that she has on her own, is going away, so she's having to go out on the exchange and try to find a plan she can afford, with the coverage she needs, and a network that works for her.  

    Teresa has some health issues that make choosing a plan a much more problematic endeavor. And the research she's done in her area was what put her onto things like narrow networks, no out-of-network caps, balance billing, etc.  And the reports I'm seeing would seem to suggest that what Teresa is finding in her area is not limited to her area.

    People's health matters to them.  Being able to afford to get care after paying for insurance matters to people.  Stop acting as if those of us critical of the ACA are opposed to people getting care - we're not opposed to that.  What we are is opposed to ongoing barriers between individuals and health care that are not being solved by the ACA.  If you can afford the premiums of a bronze plan, but the high deductibles and co-pays mean you can't afford to get actual care, who has been helped by that?

    We're going to have to live with it, and I know that I and jb and Teresa and others who have been critical of the ACA sincerely hope that more people are helped than are not - because getting affordable care is what's important, not getting affordable insurance - so please stop acting as if we don't want poor people to get health care.


    Anne I congratulated Ohio on expanding medicaid (2.00 / 1) (#197)
    by CoralGables on Wed Oct 23, 2013 at 12:12:35 PM EST
    where over a quarter million needy people now get healthcare and you folks can't even view something positive in it. You should be embarrassed.

    Speaking of putting words in someone's mouth... (none / 0) (#178)
    by jbindc on Wed Oct 23, 2013 at 10:42:39 AM EST
    For most people (none / 0) (#127)
    by vicndabx on Tue Oct 22, 2013 at 03:45:27 PM EST
    the deductibles, copays and coinsurance are dealt with after the care.  Your statement is factually incorrect for most people.  Copays generally are not extravagant.  At worst, I see prescription out of pocket cost being the biggest factor for deductible & coinsurance.

    Also, your example of a twisting your foot is actually what makes determining costs so difficult.  Fortunately for you, your waiting to get your leg checked out didn't result in a more serious injury.

    So many that do have coverage or access to care wait - for numerous reasons beyond cost, and in the waiting, cause the amount of care and therefore time & costs associated with healing to be greater.

    Simple answers (just throw more money at the problem) to complex problems do not work.  


    "Factually incorrect?" (5.00 / 4) (#129)
    by Anne on Tue Oct 22, 2013 at 03:58:35 PM EST
    I don't think so.

    Co-pays usually are paid at the time of service, and many providers won't treat you until you have provided proof of insurance and paid the co-pay.

    And sure, the deductible gets sorted out in the billing process, but my point was not about process, it was about people not getting the care they need because the bottom-line cost is too great.

    How many times do you have to get sticker shock for a seeing the doctor for a sore throat before you stop and think, "this will go away on its own?"

    When you have no deductible, and a $20 co-pay - you are not in the same position as someone with a $2,000 deductible and a $50 co-pay - which they have because it keeps the premiums lower.

    I never suggested throwing more money at this problem - so I don't know where you are getting that.


    Not real sure where you are from (5.00 / 3) (#130)
    by MO Blue on Tue Oct 22, 2013 at 03:58:58 PM EST
    but in my neck of the woods co-pays are due at the time of service. IOW, you walk into the doctors office and pay the co-pay prior to seeing the doctor. That is why there are signs in every doctors office and cancer centers etc. that clearly state ALL CO-PAYS MUST BE PAID AT TIME OF SERVICE.

    On all health insurance policies that I have had that had a deductible they billed me for the deductible after the service had been provided but the insurance paid zero, zip, nada until after all deductibles were met. IOW if my deductible was $3,000, I was on the hook for all fees until I paid $3,000 out of pocket.


    "Free health care?" Not necessarily. (none / 0) (#77)
    by Anne on Tue Oct 22, 2013 at 10:07:47 AM EST
    From Medicaid.gov:

    States have the option to charge premiums and to establish out of pocket spending (cost sharing) requirements for Medicaid enrollees. Out of pocket costs may include copayments, coinsurance, deductibles, and other similar charges. Maximum out of pocket costs are limited, but states can impose higher charges for targeted groups of somewhat higher income people. Certain vulnerable groups, such as children and pregnant women, are exempt from most out of pocket costs and copayments and coinsurance cannot be charged for certain services.

    States can charge limited premiums and enrollment fees on the following groups of Medicaid enrollees:

        Pregnant women and infants with family income at or above 150% FPL ($22,065 for a family of 2 in 2011)
        Qualified disabled and working individuals with income above 150% FPL ($16, 334 for an individual in 2011)
        Disabled working individuals eligible under the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA)
        Disabled children eligible under the Family Opportunity Act (FOA)
        Medically needy individuals

    States have the option to impose higher, alternative premiums on other groups of enrollees, if their family incomes exceed 150% of the federal poverty level. Certain groups, such as institutionalized individuals and most children, are excluded from higher cost sharing.

    There's also a section on prescription drugs and non-emergency use of the emergency room.


    States establish and administer their own Medicaid programs and determine the type, amount, duration, and scope of services within broad federal guidelines. States are required to cover certain "mandatory benefits," and can choose to provide other "optional benefits" through the Medicaid program.

    Two things:

    1.  It's good that Kasich is allowing Medicaid to expand in Ohio; it will allow people who would otherwise fall through the cracks of the ACA to have access to coverage.

    2.  As long as states have the right to tweak the cost-sharing, we will continue to be a country where being able to afford care depends in large part on where you live.

    And maybe a third thing:

    Do you have any idea how hard it is to be approved for Medicaid coverage?  It's not like Medicare where, several months before you turn 65, you start getting information from Medicare (and every health insurance company that offers Medi-gap coverage), and the application process is a piece of cake.

    From the Maryland Medicaid website:

    5. How can I get Medicaid?

     All people who receive money through Supplemental Security Income (SSI) or Temporary Cash Assistance (TCA) automatically receive Medicaid.

    If you do not get SSI or TCA, you must file an application to find out if you are eligible for Medicaid.  To do this, you must go to the Local Department of Social Services in the city or county where you live.

    If you are interested in applying for the Maryland's Children's Health Program (MCHP), you may obtain an application from your Local Health Department.  The completed application can be returned by mail or in person.

    6. What will I need to do when I apply?

    You will be interviewed by an eligibility worker who will ask for information about your income, assets, and private health insurance coverage.  You will be asked to prove what you say is true.

    If you are too sick to come to the Local Department of Social Services office to apply, you may send someone to the interview for you who is knowledgeable about your money situation and other circumstances.

    MCHP does not have an interview requirement.

    I guess my point is that Medicaid is a lot more complicated than you make it sound, and it isn't free to everyone who qualifies.

    But I'm glad Kasich is doing the right thing and opening it up to more people.


    ... in a given state can also be effectively capped by that state's government, simply by playing with the program's legislative allocation. I know, because that's what our legislature did out here in the late 1990s when we suffered a local economic downturn.

    As staff, I didn't like it and considered it a heartless and shortsighted policy, but then there was really nothing I could do about it, because I didn't have a vote on the House floor.


    Your figures (none / 0) (#79)
    by CoralGables on Tue Oct 22, 2013 at 10:37:47 AM EST
    are for certain categories for those above 150% of the poverty level. Since Medicaid under the ACA covers everyone in states that accept it up to 135% of the poverty level, the figures you quote are not a factor.

    I agree. They will have access (none / 0) (#104)
    by KeysDan on Tue Oct 22, 2013 at 01:05:24 PM EST
    to health care.  Often overlooked is that Medicaid provides tremendous help to poor seniors who are also on Medicare.  Medicaid can cover much more long-term care than Medicare, it will ;pay for services not covered by by Medicare, or if covered, serve as a secondary, can help with prescription drug costs, and pay Medicare premiums for Part B.  Of course, each state has different eligibility requirements, but Medicaid does provide care that otherwise may not be available.

    That number seems a little high (none / 0) (#64)
    by MO Blue on Tue Oct 22, 2013 at 08:45:56 AM EST
    Most of the news articles I've seen have been using Kasich's figure of 275,000.

    Some 275,000 adults could also benefit from the Ohio decision, according to the Kasich administration's calculations, which have been verified by Politifact. link

    Regardless of the number, the additional people will be better off than they would have been especially since the hospitals will have their funds cut for treating people without insurance whether they expand Medicaid or not.


    I've seen both numbers tossed around (none / 0) (#70)
    by CoralGables on Tue Oct 22, 2013 at 09:15:39 AM EST
    Not sure why the math difference. But yes, either number is a good number and good for Ohio.

    In Virginia in 2009 (none / 0) (#112)
    by CoralGables on Tue Oct 22, 2013 at 01:35:21 PM EST
    The Republican candidate won the election for Governor by 17.3 points.

    The newest Rasmussen poll for the 2013 Virginia Governor election in 2 weeks has the Dem candidate Terry McAuliffe leading his GOP counterpart by 17 points.

    Outlier? It should be noted that in the 2012 presidential election Rasmussen had a 3.7 point GOP bias. It could be a landslide for the Dems in a purple state.

    I would (none / 0) (#116)
    by Ga6thDem on Tue Oct 22, 2013 at 02:30:35 PM EST
    think it's an outlier UNLESS Hillary's appearance this past weekend was able to double Terry's margin because it had been around 9 points. If I were a conspiracy theorist I would say Rasmussen put out those numbers hoping that Dems sit home. I would wait for a more reliable poll to come out before saying it's going to be a landslide.

    Of course Cuchinelli also had Rick Santorum campaigning for him so maybe it's the Santorum Bounce!!!


    The poll was taken Sunday (5.00 / 1) (#119)
    by CoralGables on Tue Oct 22, 2013 at 02:52:37 PM EST
    the day after Hillary's visit which garnered lots of coverage. Perhaps it's a Hillary bounce.

    The week old NBC News/Marist poll which had McAuliffe with an 8 point had a 20 point lead for the Dem with just female voters 52 to 32. It looks like women will carry the day in Virginia.


    It's more about (none / 0) (#143)
    by jbindc on Tue Oct 22, 2013 at 05:34:57 PM EST
    The shutdown and how it hurt Cucinelli (remember -there are a LOT of contractors and government workers who live here and were harmed by the shutdown).  Hillary may have given McAuliffe a bit of a bounce for now, but neither candidate is highly admired or liked here. In fact, most people really can't stand either candidate.  Terry M may benefit from the fact that Cucinelli is rabid crazy Republican (and the population of Northern Virginia is not), his running mate is completely bat-$h!t crazy, and there is a Libertarian running with about 10% of the vote - splitting the conservative vote.

    Well (none / 0) (#149)
    by Ga6thDem on Tue Oct 22, 2013 at 07:43:17 PM EST
    actually Krazy Ken has been trailing in the polls for months now. Apparently even the VA GOP has given up the ghost on him. I understand the Lt. Gov candidate has a bigger lead than Terry Mac.

    Oh, (none / 0) (#150)
    by Ga6thDem on Tue Oct 22, 2013 at 07:44:28 PM EST
    and for some laughs the GOP boards are talking about how Ken is going to win or they are saying that he is going to lose because he's not far right enough. I wonder which faction will win that argument?

    Let that crazy train keep rolling (5.00 / 3) (#152)
    by CoralGables on Tue Oct 22, 2013 at 08:06:39 PM EST
    and soon enough you might have a Dem Senator in Georgia.

    Honestly (none / 0) (#154)
    by Ga6thDem on Tue Oct 22, 2013 at 08:44:38 PM EST
    if this keeps up with the GOP we are going to have Paul Broun as the GOP senate candidate.

    My man Parov Stelar remixes Marvin Gaye (none / 0) (#123)
    by Dadler on Tue Oct 22, 2013 at 03:13:55 PM EST
    I wish he'd been less persuasive... (none / 0) (#164)
    by unitron on Wed Oct 23, 2013 at 08:03:58 AM EST
    ...it's not nearly as big a desecration as whoever it was that screwed up "Go Now" a while back, but it certainly makes it obvious that the original was just fine like it was.

    Oh it was fine alright (none / 0) (#183)
    by Dadler on Wed Oct 23, 2013 at 11:21:01 AM EST
    But this is just a modern DJ version. Take it for what it's worth, IMO.

    Some songs are reborn and made better by a remix/retake/cover, just as Aerosmith would say about "Walk This Way" in the 80s that Run-DMC covered. That single-handedly revived Aerosmith's career by making them seem hip and new again.


    Jay Carney walked out of the press (none / 0) (#126)
    by Slado on Tue Oct 22, 2013 at 03:44:48 PM EST
    briefing today.

    Probably a good move considering he's "Not a computer programmer"

    Spam scam... (none / 0) (#159)
    by fishcamp on Wed Oct 23, 2013 at 07:16:57 AM EST

    spam lamb? (none / 0) (#160)
    by CoralGables on Wed Oct 23, 2013 at 07:19:38 AM EST
    Hawaiian McDonalds serve spam (none / 0) (#162)
    by fishcamp on Wed Oct 23, 2013 at 07:33:08 AM EST
    I think.  BTW Donald when you were cruising the US possessions in the South Pacific did you go to Samoa and American Samoa?  I Googled that but it was unclear what and where the difference is. I do recall it's the Samoans that trim the palm trees in yards in Honolulu.  They bring the entire family and set up camp with cooking etc. in your backyard.  Very strange.

    Donald can chime in (none / 0) (#165)
    by CoralGables on Wed Oct 23, 2013 at 08:23:23 AM EST
    What is with Hawaii and Spam? (none / 0) (#169)
    by Yman on Wed Oct 23, 2013 at 08:39:51 AM EST
    I've seen a couple of cooking shows with Hawaiin chefs who mention (affectionately) the use of Spam.  I'm assuming there's got to be some reason for it.



    I believe (none / 0) (#170)
    by jbindc on Wed Oct 23, 2013 at 09:13:23 AM EST
    SPAM was introduced into Hawaii during WWII (because it was easily shipped and could last forever and did not have to be refrigerated) and generations of Hawaiians grew up on it.  Also, while one of the largest cattle ranches in the country is on the Big Island, there really aren't that many farms with "big" livestock sitting out in the middle of the Pacific Ocean.  (Also why milk is very expensive out there - it has to be shippped in).

    When I was in the Northern Marianas... (5.00 / 1) (#184)
    by Dadler on Wed Oct 23, 2013 at 11:27:11 AM EST
    ...as a kid, traveling with my con-man second stepfather, a WWII vet who'd made connections during his time in the Pacific, I noticed, especially in Guam, how much Spam was eaten. Saipan too. Although I have to say, in Saipan the black teeth from chewing betel nut were the most evident thing, but Spam was a close second. This was 30-plus years ago, however, things may have changed -- regarding the betel nut, that is. Spam? Forget about it, that sh*t lasts forever.

    Kind of Related (5.00 / 1) (#191)
    by ScottW714 on Wed Oct 23, 2013 at 11:58:20 AM EST
    The Great American Menu: Foods Of The States, Ranked And Mapped

    The best:

    1. Chicago-style deep-dish pizza (Illinois)
    2. Shrimp and grits (South Carolina)
    3. Mission-style burrito (California)
    4. Crab cake (Maryland)
    5. Peach pie/cobbler (Georgia)

    funny, just last night I have a burrito from Mission Burritos, though those were more Tex-Mex than California.

    23. Hot Hawaiian breakfast (Hawaii)
        - This is Spam, eggs, and rice.

    Spam is apparently Hawaii's most famous dish, I would have though it would be Kalua Pork.

    The worse:

    1. Akutaq (Alaska)
    2. Boiled dinner (New Hampshire)
    3. Not having any authentic local culture to speak of (Nevada)
    4. A fu*king steamed fu*king cheeseburger (Connecticut)
    5. Being hit by a car
    6. Cincinnati chili (Ohio)


    Speaking of Saipan, that was the ship I spent 3 years as an indentured servant, LHA-2.  But more interesting it was the residence of DHL founder Larry Hillblom.

    If you haven't seen Shadow Billionaire I highly recommend it:

    DHL Founder and billionaire Larry Hillblom seemed to have vanished into thin air when he failed to return from a routine flight in his vintage Seabee over the Pacific. After his disappearance, a dark side of Larry emerged. Even before he was officially declared dead, bar girls throughout Southeast Asia came forward claiming to have had children by Larry and seeking a piece of his vast fortune. BILLIONAIRE unravels the secretive and scandalous life of this enigmatic and reclusive tycoon. The battle over his estate took on epic proportions, pitting impoverished, teenage prostitutes against Larry's former business associates and several of the largest law firms in the world. In the end it is a David and Goliath story, as a surprising hero emerges to untangle the web and discover the startling truth.

    I remember that story (none / 0) (#195)
    by Dadler on Wed Oct 23, 2013 at 12:11:42 PM EST

    Even more crazy was the money my stepfather managed to skim from bringing young kids from Saipan (and Pohnhei in the Carolines) to SoCal ostensibly for vocational training. Same with Vietnam refugees we sponsored and housed. No way he does that without being able to profit, that was his entire game, act like the saint while pocketing plenty. Mentioned this once before, but he was like the John Mahoney character from the Cameron Crowe 80s movie, SAY ANYTHING.

    And WTF is a "boiled dinner?" It makes me recall the line from a Woody Allen movie, I can't remember which one: "My mother was too busy putting the boiled chicken through the de-flavorizer."


    That's Pohnpei (none / 0) (#196)
    by Dadler on Wed Oct 23, 2013 at 12:12:21 PM EST
    Not Pohnhei.

    Technically... (none / 0) (#163)
    by unitron on Wed Oct 23, 2013 at 07:48:03 AM EST
    ...sig spam.

    GOP infighting continues (none / 0) (#175)
    by CoralGables on Wed Oct 23, 2013 at 09:49:26 AM EST
    According to Roll Call, here are the 7 Senators Republicans would like to replace next year and are expected to be primaried from the right.

    1 Michael Enzi, Wyoming
    2 Mitch McConnell, Kentucky
    3 Thad Cochran, Mississippi
    4 Lindsey Graham, South Carolina
    5 Pat Roberts, Kansas
    6 Lamar Alexander, Tennessee
    7 John Cornyn, Texas

    Seven damn liberals

    White House Fires Tweeting Critic (none / 0) (#180)
    by Mr Natural on Wed Oct 23, 2013 at 11:02:04 AM EST
    President Obama's staff has unmasked and fired a national security official who tweeted critical comments under a pseudonym.

    Jofi Joseph, tweeting under the handle @natsecwonk, once wrote: "I'm a fan of Obama, but his continuing reliance and dependence upon a vacuous cipher like Valerie Jarrett concerns me."

    Of course, Joseph also insulted Republicans on his mystery Twitter feed: "So when will someone do us the favor of getting rid of Sarah Palin and the rest of her white trash family? What utter useless garbage .... "

    Glad that the individual was fired (5.00 / 1) (#186)
    by christinep on Wed Oct 23, 2013 at 11:36:32 AM EST
    ... now that person can spew whatever he/she wants.  'Noticed that his referenced targets and smart%#s character remarks relate to women.