New President Donald J Trump

[laxwyo]

I don't believe it. He can go to any hospital and they have to treat him. He'll go on Medicaid and be taken care of. He's not going to die. He might not be in not as good of a financial position, but he won't die. This isn't Somalia.

You can't go to a hospital for the long-term medication that'll keep you alive. When you can't pay for it, they don't give it to you. You don't get a payment plan for it. That's where the 20,000 people dead/year figure comes from.

You will get treated at the emergency room in the future regardless of insurance status, but it's the long-time stuff that gets treated with medication or routine visits like old miners with black lung disease get that will no longer happen the same way.

What about Medicaid? Can't they just go on Medicaid?

Medicaid reimbursements are paying less and less.. healthcare isn't in great shape right now.

Also, Medicaid pays more and helps more for individuals with disabilities, not necessarily those with long-term diseases. Someone with cerebral palsy would fall under Medicaid, but someone with COPD may very well not be accepted under Medicaid.

AND good luck getting in to see a doctor when you are on Medicaid. Medication might be easier to procure, but doctors visits are few and far between with Medicaid. One of the Orthopedic physicians I work with will typically do 1 surgery a week for Medicaid users. The reason he can't do more? The reimbursement from Medicaid won't even pay enough to cover the costs of the equipment he uses/installs, let alone the cost of the OR, anesthesiologist, other personnel or his time, etc.

I call bullshit on the doctors. They always act they're going poor from malpractice insurance. Have you ever met a poor doctor?


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Congrats on not reading my post. I said it is difficult to find a doctor to take Medicaid regularly because they don't make money. The one in my example only takes ~1 Medicaid patient a week because he loses money on them. You are exactly right, doctors aren't poor and make good money...that's BECAUSE they don't do a bunch of Medicaid cases, if they did they would be poor.

They'd probably just shift the costs on to others anyway. Also, as a percentage of their income, their student loan isn't that great.


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[MrTitleist]

They'd probably just shift the costs on to others anyway. Also, as a percentage of their income, their student loan isn't that great.


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I had a doc tell me a few years ago (he was fairly established in his career) tell me, "I feel I get compensated fairly for what I do, but my student loan payment is as much as my mortgage payment." He was a spine/pain doctor.. not everyone makes surgeon money, sometimes just regular ol' family practice docs don't live much better than the rest of us.

 

[laxwyo]

They'd probably just shift the costs on to others anyway. Also, as a percentage of their income, their student loan isn't that great.


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I had a doc tell me a few years ago (he was fairly established in his career) tell me, "I feel I get compensated fairly for what I do, but my student loan payment is as much as my mortgage payment." He was a spine/pain doctor.. not everyone makes surgeon money, sometimes just regular ol' family practice docs don't live much better than the rest of us.

Maybe he should buy a bigger house! [emoji23]


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[johnywyo]

They'd probably just shift the costs on to others anyway. Also, as a percentage of their income, their student loan isn't that great.


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I had a doc tell me a few years ago (he was fairly established in his career) tell me, "I feel I get compensated fairly for what I do, but my student loan payment is as much as my mortgage payment." He was a spine/pain doctor.. not everyone makes surgeon money, sometimes just regular ol' family practice docs don't live much better than the rest of us.

Maybe he should buy a bigger house! [emoji23]


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Ultimately this attempt to demonize Trump boils down to the problems associated with repealing the ACA. I do sense the pain in this arena. My father has Supra Nuclear Palsy. He's in an institutional setting. Its ridiculously expensive. There is no cure. My folks have nothing left in the bank, many things change when these things happen. So, my problem with healthcare is that we need a fair and equitable program to do this. We need personal relationships with Dr's, not insurance companies bargaining fee schedules and dictating costs and deductibles. Obama tried to take this on and the risk pool he attracted, the 20 million or so were the uninsured, sickly, and very expensive demographic that desperately wanted free healthcare. I have a heart, as most do in this country. The ACA skewed pricing and passed increases on to those whom had coverage and up until 2011 reasonably affordable premiums and affordable deductibles. We, got the shaft. So, lets try and take what was effective in ACA and re/design a plan that can work for us all. Life is not fair, and thats the dimension neither democrat, republican or Trump will never be able to change.


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[Asmodeanreborn]

The ACA skewed pricing and passed increases on to those whom had coverage and up until 2011 reasonably affordable premiums and affordable deductibles.

That's not really true according to statistics, though. The year-by-year price increases have been pretty constant around 10% since 1999. The one big change was that the low deductible bad-coverage plans that were cheap went away because they were no longer legal. Sure, those let you see a doctor for free for checkups, but in case of something catastrophic happening, you were footing 40% of the bill and still had a lifetime maximum coverage of $150,000 or something.

I remember my first health insurance plan from 2006 (Blue Cross Blue Shield, I think?). When I asked about the details of that part of the plan, I was flabbergasted... but I came from a system where I was simply just covered, and cancer wouldn't have meant medical bankruptcy.

Sure I paid 5% more income tax just for that, but today I'd happily pay 10% more income tax for full health coverage with no deductible. $16k annually for my family is bloody insane.

 

[Cowduck]

If any of you were around during the Bush years on the rivals site you know where I stand politically (the board's resident left-winger) so take what I say with that on the table.

Forget about all the policy fights for a second. If I was just concerned about healthcare or taxes or immigration or whatever, I'd be super mad right now but I'd at least feel like there was a level playing field to fight back. But we are witnessing the breakdown of American democracy in real time. It hasn't even been a week and we've had promised crackdowns on voting rights by both state and federal governments in addition to ones already initiated, crackdowns pending in many state legislatures against peaceable protest (and you'll recall how fond Trump was of the Chinese government's response to the Tianamen uprising and his affinity for Putin's strong-arm rule in Russia - I shudder to think what he'll do to DAPL protesters this time around), the crackdown on the free press, the crackdown on the government's science apparatuses, the gag orders on government agencies, the deliberate and brazen disinformation from the White House - all this is straight out of the authoritarian playbook.

We are in real trouble. God help us if there's nobody in either party willing to really stand up to him.

 

[laxwyo]

I heard on NPR that the gag orders on the federal agencies always happens when a new president takes over until they can get a coherent philosophy together


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[Cowduck]

I heard on NPR that the gag orders on the federal agencies always happens when a new president takes over until they can get a coherent philosophy together


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The orders freezing new regulations before they are published are normal. The gag orders regarding sharing data produced by taxpayer-funded research are not (that's why USDA already had theirs rescinded in response to outcry - it's pretty hard to justify withholding data that may immediately affect public health). EPA is going to have all of their data subject to an explicitly political review process before it can be approved for release.

As an aside, it is also very ominous that Trump's transition team asked various departments for lists of employees who were working on certain projects. The natural conclusion there is that purges of career civil servants are coming.

 

[laxwyo]

I think the EPA sucks. The Bevill amendment sucks. Sounds like the EPA my company deals with are morons. How many monitoring wells and 3rd party verification does a company need to prove the pond liner doesn't leak?


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[Cowduck]

I think the EPA sucks. The Bevill amendment sucks. Sounds like the EPA my company deals with are morons. How many monitoring wells and 3rd party verification does a company need to prove the pond liner doesn't leak?


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I can concede they're a real pain for some people in a variety of industries, and perhaps unfairly so in some instances. That's a different issue altogether than whether it's good public policy for scientific data to be subject to political review before being released. Data should drive policy. Policy should NOT drive data.

 

[LanderPoke]

I think the EPA sucks. The Bevill amendment sucks. Sounds like the EPA my company deals with are morons. How many monitoring wells and 3rd party verification does a company need to prove the pond liner doesn't leak?


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Agree. Half of the North Fork of the Shoshone was destroyed by an irrigation district releasing sediment into the river in November. Where's the EPA when there's a real environmental disaster? nowhere. Haven't been heard from or seen, yet. The EPA is too preoccupied with their exceedingly liberal agenda (stopping fracking and giving entire cities over to indian reservations) to actually care about the environment.

 

[MrTitleist]

A pipeline burst in Iowa yesterday, letting a few hundred thousand gallons of diesel into the ground.

 

[Asmodeanreborn]

A pipeline burst in Iowa yesterday, letting a few hundred thousand gallons of diesel into the ground.

Sounds like it's been fairly well contained, at least. That the ground was frozen probably helped a lot. Bet that farmer whose land it's on is happy it didn't happen in the summer, at least.

 

[MrTitleist]

A pipeline burst in Iowa yesterday, letting a few hundred thousand gallons of diesel into the ground.

Sounds like it's been fairly well contained, at least. That the ground was frozen probably helped a lot. Bet that farmer whose land it's on is happy it didn't happen in the summer, at least.

No kidding.. frozen ground saved this from being a huge mess.

 

[laxwyo]

A pipeline burst in Iowa yesterday, letting a few hundred thousand gallons of diesel into the ground.

Sounds like it's been fairly well contained, at least. That the ground was frozen probably helped a lot. Bet that farmer whose land it's on is happy it didn't happen in the summer, at least.

No kidding.. frozen ground saved this from being a huge mess.

There's literally millions of miles of pipeline. I'd imagine the accidents are on par with plane crashes. Sure it can happen but playing the odds, I'd say they have a good record.


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[Asmodeanreborn]

A pipeline burst in Iowa yesterday, letting a few hundred thousand gallons of diesel into the ground.

Sounds like it's been fairly well contained, at least. That the ground was frozen probably helped a lot. Bet that farmer whose land it's on is happy it didn't happen in the summer, at least.

No kidding.. frozen ground saved this from being a huge mess.

There's literally millions of miles of pipeline. I'd imagine the accidents are on par with plane crashes. Sure it can happen but playing the odds, I'd say they have a good record.


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Compared to tanker trucks, they definitely have a good record, but aging pipelines are becoming a bit of a problem too. Here's a fairly comprehensive list of recent spills and accidents:

https://en.wikipedia.org/wiki/List_of_pipeline_accidents_in_the_United_States_in_the_21st_century

As you can see, many of them did not leak a significant amount.

 

[laxwyo]

A pipeline burst in Iowa yesterday, letting a few hundred thousand gallons of diesel into the ground.

Sounds like it's been fairly well contained, at least. That the ground was frozen probably helped a lot. Bet that farmer whose land it's on is happy it didn't happen in the summer, at least.

No kidding.. frozen ground saved this from being a huge mess.

There's literally millions of miles of pipeline. I'd imagine the accidents are on par with plane crashes. Sure it can happen but playing the odds, I'd say they have a good record.


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Compared to tanker trucks, they definitely have a good record, but aging pipelines are becoming a bit of a problem too. Here's a fairly comprehensive list of recent spills and accidents:

https://en.wikipedia.org/wiki/List_of_pipeline_accidents_in_the_United_States_in_the_21st_century

As you can see, many of them did not leak a significant amount.

I'd rather have the pipeline than some of the old tanker rail cars too


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[CowboyNV]

A pipeline burst in Iowa yesterday, letting a few hundred thousand gallons of diesel into the ground.

Sounds like it's been fairly well contained, at least. That the ground was frozen probably helped a lot. Bet that farmer whose land it's on is happy it didn't happen in the summer, at least.

No kidding.. frozen ground saved this from being a huge mess.

There's literally millions of miles of pipeline. I'd imagine the accidents are on par with plane crashes. Sure it can happen but playing the odds, I'd say they have a good record.


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Compared to tanker trucks, they definitely have a good record, but aging pipelines are becoming a bit of a problem too. Here's a fairly comprehensive list of recent spills and accidents:

https://en.wikipedia.org/wiki/List_of_pipeline_accidents_in_the_United_States_in_the_21st_century

As you can see, many of them did not leak a significant amount.

I'd rather have the pipeline than some of the old tanker rail cars too


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Here is a link to studies that mapped pipeline incidents over the past 30 years. They are not quite as rare as one would think:

http://www.citylab.com/weather/2016/11/30-years-of-pipeline-accidents-mapped/509066/

 

[WestWYOPoke]

Technically, rail car has shown to be the safest method of transportation for oil (excluding barge/tankers). I have no clue what would be the cheapest (I'm assuming pipeline), but over the last 20 years, rail car is safer than both trucking or piping.

 

[laxwyo]

Them fuckers crying so much about a few rail car incidents in North Dakota, I would have sworn the rail tanker fleet was falling apart


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