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Thread: in usa most doctors are against obamacare

  1. #1 in usa most doctors are against obamacare 
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    so why did the government enact it? i think its bad


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    From a foreign perspective it is being reported as america's way of trying to offer some help and protection to the millions of americans without health insurance. If this is correct it seems like a very good thing that could help many, many people.


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    In the USA, we pay twice as much for medical care as in any other country, and that for some really mediocre health care.
    It is a travesty than many doctors got into the profession planning to get rich off of other peoples misery. And that greed began a feeding frenzy joined by the AHA, Insurance companies and pharmacitical companies.
    And, the costs of medical care were increasing at several times the rate of inflation while real wages were stagnant or falling.
    Something had to be done, and "Obama-care" was/is a bad compromise, but was enacted to try and control the malignantly inhumane costs.
    I think Kucinich had a better plan, and told my senator so.
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    Would americans like a national health system like we have in the UK where everybody gets any medical care they need for as long as they need without any insurance or having to pay for it. That way everyone would get the care they needed regardless of ability to pay.
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    Quote Originally Posted by Holmes View Post
    so why did the government enact it? i think its bad
    This would have been a much stronger thread if you'd pointed to a specific poll which shows that result an in particular the issue by issue Q&A survey results.

    For example, in a 2009 poll, most didn't think it went far enough and seemed to want a combined approach with private and public option.
    Poll Finds Most Doctors Support Public Option : NPR
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    Quote Originally Posted by sculptor View Post
    It is a travesty than many doctors got into the profession planning to get rich off of other peoples misery. And that greed began a feeding frenzy joined by the AHA, Insurance companies and pharmacitical companies.
    Doctors invest a lot of time, money and hard work. They deserve to make as much money as they are worth in a free market. Do you feel you have some claim on their services? Why?
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    claim? no, not really
    I hold them in the same regard and respect as i would any other fat piggy hogging the trough.
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    Quote Originally Posted by sculptor View Post
    claim? no, not really
    I hold them in the same regard and respect as i would any other fat piggy hogging the trough.
    Hey, this is a vaild point. Doctors are trained professionals and as such should be rewarded appropriately, but they do seem to get rewarded 'disproportionally' for there services when compared with earnings of paramedics, nurses, firemen or soldiers. All of whom you could make a good argument for saying that there work is just as vital in saving lives.
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    Quote Originally Posted by Chrisgorlitz View Post
    Quote Originally Posted by sculptor View Post
    claim? no, not really
    I hold them in the same regard and respect as i would any other fat piggy hogging the trough.
    Hey, this is a vaild point. Doctors are trained professionals and as such should be rewarded appropriately, but they do seem to get rewarded 'disproportionally' for there services when compared with earnings of paramedics, nurses, firemen or soldiers. All of whom you could make a good argument for saying that there work is just as vital in saving lives.
    In a free society, the rewards are determined by people freely deciding what they are willing to pay, and other people freely deciding what they will work for. It seems that a lot of people don't believe in such freedoms, a fact which I find appalling.
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    Agree-valid point:
    Did you see Michael Moor's movie "sicko"? In which it was claimed that re-attaching a handyman's 2 fingers would cost $72000.
    That represents well over a year's pay for a handyman-----for less than a day's work by the doctor and staff. Assuming the staff gets 1/2, then is a doctor worth 180 times more than the handyman, 120 times more, 90 times more? If both were starving, is the doctor entitled to 180 times the food afforded the handyman? If both were cast adrift on the ocean, is the doctor entitled to 180 times the life boat space as the handyman?

    Worth more? ok, i'll buy that. But just how much inequality is too much?
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    Quote Originally Posted by Harold14370 View Post
    Quote Originally Posted by Chrisgorlitz View Post
    Quote Originally Posted by sculptor View Post
    claim? no, not really
    I hold them in the same regard and respect as i would any other fat piggy hogging the trough.
    Hey, this is a vaild point. Doctors are trained professionals and as such should be rewarded appropriately, but they do seem to get rewarded 'disproportionally' for there services when compared with earnings of paramedics, nurses, firemen or soldiers. All of whom you could make a good argument for saying that there work is just as vital in saving lives.
    In a free society, the rewards are determined by people freely deciding what they are willing to pay, and other people freely deciding what they will work for. It seems that a lot of people don't believe in such freedoms, a fact which I find appalling.
    How many ordinary people are able to decide what they are willing to pay?

    If a man earns $40,000 dollars a year has no insurance what does he do if he requires $200,000 operation and can't afford it, at what point does he decide what he is willing to pay?

    Most people just don't have any choice is that really fair?
    If we were talking luxury items I'd agree with you, but medical treatment should a basic human right.
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    Harold
    This ain't no free society. And it ain't a free market. AMA lobbyist have been adjusting the laws and codes in their favor for quite some time.
    Would you see all regulation favoring doctors and insurance companies abrogated and learn what a free society and free market economy would really do?
    Or are these just words?
    (uninsured americans seeking health care in Cuba should be a real hint)

    Freedoms are always desired, but oft voiced pseudo freedoms are used by conmen to make trap for fools.
    Last edited by sculptor; July 3rd, 2012 at 09:23 PM.
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    Which specific laws and codes do you have a problem with?
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    Quote Originally Posted by Harold14370 View Post
    Which specific laws and codes do you have a problem with?
    Problem?
    I got no problem.

    I've adjusted to the current system where i cannot get a reasonably priced radiograph, nor buy an antibiotic, without a doctor seeing the injury first, ---gatekeeper fees suck. A free consumer should have the ultimate right to spend his/her money as (s)he sees fit, and not be forced to pay unnecessary fees(backsheesh).

    But, I've adjusted. Do I think that a more egalitarian system would be for the greater good? "Gosh'n'gollies you betcha" (from 1000 clowns).
    Do I think that there are too damned many fat piggies at the trough using their wealth and power to manipulate the laws and codes of the polity into giving them even more money and power? Gosh'n'gollies you betcha! Do I think that gross inequalities are a danger to the society and polity? Again, Gosh'n'gollies you betcha. But, some folks don't really care for the drowning man as long as they have a safe place on the life-boat.
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    I've adjusted to the current system where i cannot get a reasonably priced radiograph, nor buy an antibiotic, without a doctor seeing the injury first
    Considering the problems we've already got with antibiotic resistance, I'd like to see doctors take an even stronger gatekeeping role in limiting their distribution. If we're not careful, we'll finish up where we were a century ago with no effective treatments for bacterial infections like TB or those you get from open wounds.

    As for America's health system, something has to be done. It might be worth what it costs you if your results were equivalently better than the results that the rest of the world gets. But to spend so much more than anyone else and finish up with 47 countries in the world having better infant mortality rates than you do seems silly. (Especially when you notice that desperately poor Cuba is one of those better-health-than-USA countries.)

    https://www.cia.gov/library/publicat.../2091rank.html
    https://www.cia.gov/library/publications/the-world-factbook/rankorder/2225rank.html?countryName=Australia&countryCode=as &regionCode=aus&rank=45#as
    (Note when you look at this CIA stuff, they often stick an average European Union statistic in these tables - but all those countries are already included - so always check your numbers.)

    48 countries in the world have longer life expectancy than the USA. Europe, Canada, Australia have equal or better health outcomes than the USA and spend a great deal less. And our doctors are pretty well paid too. You guys are not getting value for your money.

    From outside the USA, Obamacare looks a bit feeble. But it's a huge advance on what you're currently working with.
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    Adelady, doctors have been poor gatekeepers for antibiotics, prescribing them for everything from the common cold to acne. And farm animals are routinely fed massive amounts of antibiotics here.
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    Antibiotics, at least the right ones, are the ideal treatment for acne.

    The 'farm' animals only need antibiotics in those quantities because they're overcrowded, fed on grain instead of grass and stressed. (I don't regard a feedlot as a 'farm' for animals.)

    Those prescriptions handed out like lollies for the common cold are, I think, a consequence of the 'please the customer' approach rather than the 'participate in a proper health system' approach to medicine. In some ways, the old pre-antibiotic style of the doctor having a selection of foul-smelling, vile-tasting concoctions for treatment of coughs and colds was a much better solution. The doc handed over the disgusting liquid. People felt brave and 'in control' when they subjected themselves to taking the stuff with nose firmly held closed. The cold went away as it always does.
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    Um, doctors spend years upon years studying really abstruse topics while amassing tens of thousands of dollars in debt in the form of student loans. Afterwards, they are generally overworked by the institutions that employ them. If you want your nation to have doctors, you at least have to make the decision to begin this career financially feasible. If anything, doctors are being underpaid.
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    Also, doctors' attitude toward Obamacare is currently 50/50. The title of the thread is, at best, contentious and, at worse, false.
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    Just a quick question, in the US if a child needs an operation and the parents can't afford to pay does the state step in and sort it out?
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    Sorry for the lame pic post, but I could not resist:

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    Quote Originally Posted by Chrisgorlitz View Post
    Just a quick question, in the US if a child needs an operation and the parents can't afford to pay does the state step in and sort it out?
    That depends.
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    I really don't understand the American hostility to such basic provision. NHS doctors get a very decent pay and you can work privately if you really want to. But that is just messy details. The USA doesn't have to copy the NHS in every detail, it could take the best aspects of the UK, French, Dutch etc systems and forge something different that is ideal for their particular concerns. An American system that works. It seems like it's the actual concept of "free" healthcare which they oppose, which I just can not understand.
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    1) Reduce defence budget by half.
    2) Subsidise healthcare.
    Disclaimer: I do not declare myself to be an expert on ANY subject. If I state something as fact that is obviously wrong, please don't hesitate to correct me. I welcome such corrections in an attempt to be as truthful and accurate as possible.

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    It comes down to:
    -Unabashed capitalist, which time and time again proven to eek out the most efficiency and effectiveness.
    -No one else should pay for folks who can afford insurance--that's a large % of those uninsured.
    -Many of those who are sick have atrocious life styles--no one else should pay for their self imposed illness either.
    -No one should have to wait to be treated.
    -Government should stay out of private affairs--nothing is more private than sickness.


    --
    Now although I'm a life long republican, I don't agree with many of the arguments against a national health care system--but I do somewhat understand them and share much of the deep loathing for intrusive and inefficient government programs. That loathing of government is at the heart of American resistant to national health care--not the idea of free health care.
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    Why not focus on making government programs that aren't intrusive and inefficient instead of trying to stop progress every step of the way? Don't you observe government-intensive programs in other nations and see how they work and think, "Wow, those people actually seem happy"?
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    I don't understand the intrusive argument. Are countries like Australia, UK and Canada then wrong for having the healthcare systems they do? They are providing a service that really should be the best in the world for the world's largest economy. Why isn't it then?

    A healthcare system is more than just the care, it is also education on good health practises, regulation of drugs and care providers and the food industry. America is one of the most obese countries. If you want to motivate people towards more healthy living then, apart from education, provide incentives in the form of both negative and positive reinforcement. A good health campaign could then ultimately save a lot of money in the long run.
    Disclaimer: I do not declare myself to be an expert on ANY subject. If I state something as fact that is obviously wrong, please don't hesitate to correct me. I welcome such corrections in an attempt to be as truthful and accurate as possible.

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    Quote Originally Posted by Philovitist View Post
    Um, doctors spend years upon years studying really abstruse topics while amassing tens of thousands of dollars in debt in the form of student loans. Afterwards, they are generally overworked by the institutions that employ them. If you want your nation to have doctors, you at least have to make the decision to begin this career financially feasible. If anything, doctors are being underpaid.
    As is true of teachers, biologists, anthropologists, and pretty much anyone else who has pursued higer education.
    Our government has actually paid to shut down a medical school to help keep the supply of doctors low. and we import doctors from india and china.
    The whole system has some serious greed and rot problems, and will not readilly be fixed by simplistic solutions.
    And those who are profiting from the current system will fight any change kicking and screaming and hiring lobbyist all the way.

    A good start might be to open government run medical schools, with a free medical degree in exchange for 10 years service at equivalent military pay grades. Within a generation, we'd have a robust public sector and an in-place private sector. Perhaps offering "free medical care" in exchange for community service?

    Just as there is no rational answer to the fact that we pay trice as much for really mediocre care, there is no one solution to the problem which continues to worsen, like a cancer growing on the society. The "intrusive argument" is just one more smoke screen arguement designed to mislead the public, we already have intrusive insurance companies, so swapping them for the government is no big deal.

    And, I know no-one who is opposed to a single payer system: Though the bureau of propaganda, and their media stoolies would have you believe otherwise.
    Last edited by sculptor; July 4th, 2012 at 03:02 PM.
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    They are providing a service that really should be the best in the world for the world's largest economy
    I think you'd find that the American system works very well for the middle class and above. Many heartless conservatives (not I) would see this as just another motivator to invest in our economy, work hard and get at the "American dream."

    Quote Originally Posted by KALSTER View Post
    I don't understand the intrusive argument. Are countries like Australia, UK and Canada then wrong for having the healthcare systems they do? They are providing a service that really should be the best in the world for the world's largest economy. Why isn't it then?

    A healthcare system is more than just the care, it is also education on good health practises, regulation of drugs and care providers and the food industry. America is one of the most obese countries. If you want to motivate people towards more healthy living then, apart from education, provide incentives in the form of both negative and positive reinforcement. A good health campaign could then ultimately save a lot of money in the long run.
    I'm a big believer in education as well. The problem is in many places, there's a pattern of government officials making choices by making things illegal. Perhaps New York offers a useful example. They recently made it illegal for many places to sell larger than a 16 ounce refreshments--the intent to stop people from buying the very popular 32 ounce surgery drinks. That's a extraordinary example of government intrusion and overreach IMO.

    Now, personally I'm against the soft drink restrictions and would rather nudge people through education, or if there must be a law do it in a way that it still allows personal choices.

    A few years ago, there was a similar fight over trans fats used to deep fry foods. Now this is a case where a consumer wouldn't know the difference other than perhaps paying a few cents more for a box of fries -- but regular consumption was strongly linked to heart disease. They made it against the law in some places, but what really made the difference is a unified call by the medical community and other groups which eventually motivated many fast food chains to stop using the oils. The US government doesn't do nearly enough to educate in useful ways. They have an overly complex food balance chart now you can't put in paper, the last surgeon general most Americans could name is Everett Keep from 20+ years ago. The large and powerful anti-science branch of the republican party isn't helping either.
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    Quote Originally Posted by sculptor View Post
    Quote Originally Posted by Philovitist View Post
    Um, doctors spend years upon years studying really abstruse topics while amassing tens of thousands of dollars in debt in the form of student loans. Afterwards, they are generally overworked by the institutions that employ them. If you want your nation to have doctors, you at least have to make the decision to begin this career financially feasible. If anything, doctors are being underpaid.
    As is true of teachers, biologists, anthropologists, and pretty much anyone else who has pursued higer education.Our government has actually paid to shut down a medical school to help keep the supply of doctors low. and we import doctors from india and china.The whole system has some serious greed and rot problems, and will not readilly be fixed by simplistic solutions.And those who are profiting from the current system will fight any change kicking and screaming and hiring lobbyist all the way.A good start might be to open government run medical schools, with a free medical degree in exchange for 10 years service at equivalent military pay grades. Within a generation, we'd have a robust public sector and an in-place private sector. Perhaps offering "free medical care" in exchange for community service?Just as there is no rational answer to the fact that we pay trice as much for really mediocre care, there is no one solution to the problem which continues to worsen, like a cancer growing on the society. The "intrusive argument" is just one more smoke screen arguement designed to mislead the public, we already have intrusive insurance companies, so swapping them for the government is no big deal. And, I know no-one who is opposed to a single payer system: Though the bureau of propaganda, and their media stoolies would have you believe otherwise.
    It's supply and demand. Doctors are low in supply and high in demand. Whatever you say, the education of a teacher is easier and less expensive than the education of a doctor. And anthropologists simply aren't as important to our society as doctors are (no offense to anthropologists whose discipline I truly appreciate). The government already pays for medical school for military service through HPSP.
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    lover-of-life:
    It obviously ain't simple supply and demand.
    Graduates of foreign medical schools represent about 23 percent of actively practicing physicians in the United States.
    Being the "leaders of the free world" we should be exporting doctors, not importing them from poor countries and depriving their people of trained medical professionals.
    Since the early 1980s, the number of graduates of U.S. medical schools has remained stable, at about 17,000 a year.
    The AMA and american medical schools keep the number of graduates artificially low. Much like the "arab oil embargo" of the 70s, supply is being manipulated to keep demand, and $ artificially high.
    And, much like $100/bbl oil, the costs of that is simply too damned high for the greater health of the country and it's people.

    philovitist, I don't get it. How can you defend such an inequitable and inhumane system?
    Last edited by sculptor; July 4th, 2012 at 06:39 PM.
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    You're just giving more detail to what I'm saying.
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    we already have intrusive insurance companies, so swapping them for the government is no big deal.
    From outside the USA, this stuff is absolutely astonishing (especially to those of us who watch any television). The idea that an insurance clerk or a hospital bureaucrat can dictate what medical or surgical or oncology treatment is or isn't provided to individual patients is unbelievably offensive, mindless, heartless, intrusive, callous, inhumane ............ to those of us whose health systems offer sensible approaches.

    We do complain about the long waiting lists for public hospitals for 'elective' surgeries, most of which meet only a legalistic definition of 'elective'. However, for those conditions we can get treatment almost on demand if we have private insurance. When it comes to a diagnosis of cancer requiring surgery the next day, we get surgery the next day. Regardless of our financial or insurance status. (It might affect whether you can have certain surgeons who only take privately insured patients - but that's the doctors not the government.) Private, public and any mixture of the two. Have complicated surgery at the only large public hospital that can manage it and move to a private hospital when you're out of recovery. Have apparently routine surgery at a private hospital and later move to a public hospital when complications require it or prolonged treatment means you're unable to meet the gap payments.

    But no-one ever, ever kicks you out of life-saving treatment just because you run out of money or insurance to pay for it. The only reason to stop treatment is medical judgement, not bureaucratic interference.
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    Quote Originally Posted by Holmes View Post
    so why did the government enact it? i think its bad
    Doctors are against it because it involves effectively capping their salaries by mandating prices on services. Medicare already does this for elderly people, but if it were extended to everyone then they'd have no way to make up their losses on medicare by overcharging elsewhere.

    Salaries would surely go down.

    Quote Originally Posted by Philovitist View Post
    Quote Originally Posted by sculptor View Post
    Quote Originally Posted by Philovitist View Post
    Um, doctors spend years upon years studying really abstruse topics while amassing tens of thousands of dollars in debt in the form of student loans. Afterwards, they are generally overworked by the institutions that employ them. If you want your nation to have doctors, you at least have to make the decision to begin this career financially feasible. If anything, doctors are being underpaid.
    As is true of teachers, biologists, anthropologists, and pretty much anyone else who has pursued higer education.Our government has actually paid to shut down a medical school to help keep the supply of doctors low. and we import doctors from india and china.The whole system has some serious greed and rot problems, and will not readilly be fixed by simplistic solutions.And those who are profiting from the current system will fight any change kicking and screaming and hiring lobbyist all the way.A good start might be to open government run medical schools, with a free medical degree in exchange for 10 years service at equivalent military pay grades. Within a generation, we'd have a robust public sector and an in-place private sector. Perhaps offering "free medical care" in exchange for community service?Just as there is no rational answer to the fact that we pay trice as much for really mediocre care, there is no one solution to the problem which continues to worsen, like a cancer growing on the society. The "intrusive argument" is just one more smoke screen arguement designed to mislead the public, we already have intrusive insurance companies, so swapping them for the government is no big deal. And, I know no-one who is opposed to a single payer system: Though the bureau of propaganda, and their media stoolies would have you believe otherwise.
    It's supply and demand. Doctors are low in supply and high in demand. Whatever you say, the education of a teacher is easier and less expensive than the education of a doctor. And anthropologists simply aren't as important to our society as doctors are (no offense to anthropologists whose discipline I truly appreciate). The government already pays for medical school for military service through HPSP.
    They are artificially kept scarce, by medical schools limiting enrollment. We could have a lot more doctors than we do if we were more lax on the entry requirements and made funding more readily available to help them through. (I'm quite certain we'd make back every dime we spent on this further down the line.) But the doctor guilds don't want that. They'll raise the licensing requirements however high they have to to maintain current market scarcity.

    It's a manipulated market. You can't go all "deregulation!! deregulation!! deregulation!!" in situation where the market is already being deliberately controlled.


    Quote Originally Posted by Harold14370 View Post
    Quote Originally Posted by sculptor View Post
    It is a travesty than many doctors got into the profession planning to get rich off of other peoples misery. And that greed began a feeding frenzy joined by the AHA, Insurance companies and pharmacitical companies.
    Doctors invest a lot of time, money and hard work. They deserve to make as much money as they are worth in a free market. Do you feel you have some claim on their services? Why?
    They do, and they should make an above average salary for that, but not an infinity salary. Not an unlimited salary that will continue to climb regardless of legitimate market pressures that ought to have been leveling it off.

    Quote Originally Posted by sculptor View Post
    In the USA, we pay twice as much for medical care as in any other country, and that for some really mediocre health care.
    It is a travesty than many doctors got into the profession planning to get rich off of other peoples misery. And that greed began a feeding frenzy joined by the AHA, Insurance companies and pharmacitical companies.
    And, the costs of medical care were increasing at several times the rate of inflation while real wages were stagnant or falling.
    Something had to be done, and "Obama-care" was/is a bad compromise, but was enacted to try and control the malignantly inhumane costs.
    I think Kucinich had a better plan, and told my senator so.
    Yeah. This is the problem. We're dealing with a situation where the pre-conditions for free market capitalism to work aren't present. Insurance companies have little or no control over which hospital their customers go to. So the buying decision is being made by one person, and payed for by another. Clearly that means they can't and won't act like proper consumers.

    Proper consumers shop around for a lower price before making a purchase. Health care consumers go to whatever hospital is closest. They'll shop for cheaper insurance, but the insurance company isn't able to pass that pressure on to the hospitals very effectively. The only way proper market behavior would be possible would be if the insurance company owned the hospital. Otherwise you've basically got 3 groups, one of which doesn't take input from the other two (the hospital doesn't receive any feedback on its prices.)

    If the government doesn't step in, the market isn't going to stop prices from climbing through the roof. Either that, or the system needs reworking on a more fundamental level (by creating more doctors, and putting their licensing in public hands so it doesn't get silly.) Also some tax breaks to companies that combine insurance and hospitals under one roof would be good.
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    Quote Originally Posted by Holmes View Post
    so why did the government enact it? i think its bad

    What do you think, the worst part of it is?
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    if we were more lax on the entry requirements.
    That's the last thing we should do. Perhaps if we stopped giving college grants for students to persue theater and other non-essential degrees we've have more qualified applicants to programs that are essential.

    And while this discussion seems to focus on doctor saleries, is there even real evidence that it has much to do with the problem?
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    Quote Originally Posted by Lynx_Fox View Post
    if we were more lax on the entry requirements.
    That's the last thing we should do. Perhaps if we stopped giving college grants for students to persue theater and other non-essential degrees we've have more qualified applicants to programs that are essential.
    It would be good to reform education so the student's major affects what they can collect. (And not when they declare it, but when they are actually accepted, so they don't all just claim the highest funded one and clear out their general credits before switching to something less valuable.)

    Having a nation full of liberal arts grads isn't a whole lot different from simply having a nation full of unskilled workers.


    And while this discussion seems to focus on doctor saleries, is there even real evidence that it has much to do with the problem?
    Scarcity of doctors is a problem. Lax entry requirements accompanied by lower salaries makes doctors more affordable in a lot of third world countries. You get what you paid for (certainly lower quality of care), but it's better than having to choose between the luxury class limousine service and nothing at all.

    However, I think the real central issue has been torts/lawsuits getting out of hand. Doctors have to pay higher and higher premiums for insurance to cover the generosity of juries (who are naturally very generous with the defendants' money, since it's not their own money.) They also end up having to do lots of unnecessary procedures such as MRI scans for very basic problems because, if on the off chance something were to go unseen and it gets blamed on them for not having checked thoroughly enough.

    If the government mandates lower prices for services, something's eventually going to give. Later on, after this has been going on for a while, they might then be able to pass legislation limiting the size tort payments, because it becomes apparent to the public that the doctors aren't going to be able to afford to pay multi-million dollar claims. It's emotional logic, but that's the reality in any kind of real world politics. As long as doctors and hospitals are perceived as being able to pay a high tort claim, the juries of the nation will want to award high claims. It's weird to think that when you break something like this into pieces, first making doctors unable to pay the high claims, and then telling juries not to award high claims, that they don't immediately put two and two together and realize they're being manipulated. But I am quite confident they won't. Peoples' minds are just geared too much toward taking things one issue at a time.
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    Quote Originally Posted by sculptor View Post
    Agree-valid point:
    Did you see Michael Moor's movie "sicko"? In which it was claimed that re-attaching a handyman's 2 fingers would cost $72000.
    That represents well over a year's pay for a handyman-----for less than a day's work by the doctor and staff. Assuming the staff gets 1/2, then is a doctor worth 180 times more than the handyman, 120 times more, 90 times more? If both were starving, is the doctor entitled to 180 times the food afforded the handyman? If both were cast adrift on the ocean, is the doctor entitled to 180 times the life boat space as the handyman?

    Worth more? ok, i'll buy that. But just how much inequality is too much?



    Dear Sculptor,

    I am very glad you, are a member of this forum. You are caring, rational, and sane. And I say the following out of respect for you, my considered respected friend.


    I think that you, (may) be being a bit too hard, on our doctors. Yes they are idiots who are over prescribing antibiotics, and (some) of them are very greedy. And some doctors are so crazy that they, should not even be allowed to practice medicine. And doctors are also (not) paying attention, to the huge % of their (corporate made) medicines, that are causing cancer, strokes, heart attacks ex.ex.ex



    But these doctors are locked into the same world as us, and they are only human. And they have problems, like having to spend lots of their income on malpractice insurance ex.ex.ex.

    And doctors are not CEO's, and they do not finance our government. Doctors do (not) get a 7%-17% tax rate like billionaires and corporate CEO's get. Doctors are forced to pay taxes up the ___. And at the same time pay for malpractice insurance.



    I personally think that our government, is responsible for most of these problems, not our doctors.

    example, our government should require all medical doctors, to take new classes to learn about, over prescribing antibiotics. (But our government, does not make them do it.)

    Our government should also pass laws, that would help certain doctors, pay for malpractice insurance. (But they do not.)



    I think I actually got a lot of these feelings from watching, a TV show called "Northern Exposure" a few days ago. There is a medical doctor in the show, and I really saw the way he (deep down) cared about his patients. And I believe many real life medical doctors, also have this same respect for their patients.

    Doctors do (not) write our laws, with corporate America. And they do not get the (special) billionaire and CEO tax rate, and they are not really part of that system. But I do feel your points, but I just think our government is responsible for most of these problems, not our medical doctors.


    Chad.
    Last edited by chad; July 5th, 2012 at 06:28 PM.
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    And while this discussion seems to focus on doctor saleries, is there even real evidence that it has much to do with the problem?
    I very much doubt it.

    General practitioners and specialists in Australia are perfectly free to charge 'gap' fees on top of the standardised Medicare fee. People who are poor often have to shop around for doctors who only charge the 'scheduled fee' or who charge a lesser additional fee than others in the same geographic area or medical/surgical specialty. But doctors are perfectly free to earn substantial incomes. afaik, Canadian, UK, NZ doctors aren't starving either.

    As I see it, one of the major issues with the USA system is the extraordinary costs of running so many insurance companies. There was some research done a while ago here, and the relative costs of private insurance administration and the costs of the government scheme reimbursement arrangements. The govt scheme costs were much, much lower than the private, certainly lower than mere economies of scale comparisons. I don't know the numbers but it's a reasonable guess that USA medical insurance would be much the same in terms of efficiency in cost containment.

    The other issue is the costs associated with so-called competition in health provision. I remember 20+ years ago reading about the maniacal arrangement of facilities, in either NY or Chicago, of a city intersection with 3 or 4 hospitals on its corners. Some hideously expensive technology was newly available. So what did they do?

    Every single hospital bought its own full set of outlandishly expensive gizmos and used them as marketing to attract 'customers' away from their competitors. A sensible health system would have come up with a profitable facility sharing arrangement where all of them could have made some money - while compensating the higher capital outlays of the 'first adopter' - and building up expertise in all 3/4 hospitals at once. They managed to find the most expensive, least efficient possible option for introducing new procedures.
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    Quote Originally Posted by Lynx_Fox View Post
    It comes down to:
    -Unabashed capitalist, which time and time again proven to eek out the most efficiency and effectiveness.
    I agree with that in principle, but it seems fairly clear that the (US) healthcare industry is the exception to that rule. It costs more and has worse outcomes (overall, generally speaking) than state run systems.

    Quote Originally Posted by Lynx_Fox View Post
    -No one else should pay for folks who can afford insurance--that's a large % of those uninsured.
    If I can not afford "fire insurance" why should you subsidise me?

    Quote Originally Posted by Lynx_Fox View Post
    -Many of those who are sick have atrocious life styles--no one else should pay for their self imposed illness either.
    Even if it resulted in a lower cost to you? You pay more for your healthcare than pretty much any other country in the world.

    Quote Originally Posted by Lynx_Fox View Post
    -No one should have to wait to be treated.
    I agree, but that is not a problem unique to state run systems

    Quote Originally Posted by Lynx_Fox View Post
    -Government should stay out of private affairs--nothing is more private than sickness.
    Yet many who oppose government run healthcare would be in favour of intervention in other private aspects of your life (abortion, gay marriage etc).


    Quote Originally Posted by Lynx_Fox View Post
    --
    Now although I'm a life long republican, I don't agree with many of the arguments against a national health care system--but I do somewhat understand them and share much of the deep loathing for intrusive and inefficient government programs. That loathing of government is at the heart of American resistant to national health care--not the idea of free health care.
    Your second and third points do suggest that the resistance is (in part at least) down to the idea of free health care

    I appreciate that you yourself may not necessarily believe in the points you raised, so feel free to ignore my counters to them
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    If I can not afford "fire insurance" why should you subsidise me?
    That's the wrong question. The question is if you decide to prioritize living in large house and drive a newish car instead of health/fire insurance. Also American's don't subsidize fire insurance--if you don't pay for insurance you're on your own. In some communities that extends all the way to paying a fee for the fire department--pay or the fire department will watch your house burn down (not that I agree with that failure of government--but it exist in many rural communities).

    Your second and third points do suggest that the resistance is (in part at least) down to the idea of free health care
    The entire term "free health care" is a farce. What you don't pay for directly comes out of peoples taxes--and if there's one thing nearly a majority of American's agree on, its a resistance to more taxes.
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    Quote Originally Posted by Lynx_Fox View Post
    ... The entire term "free health care" is a farce. What you don't pay for directly comes out of peoples taxes--and if there's one thing nearly a majority of American's agree on, its a resistance to more taxes.
    The really silly thing is, that we are already paying for health care, and paying far too much. You paid with your military service. Most pay with money to insurance companies, and some pay directly for services.
    The people who tried to sell universal health care really dropped the ball by not focusing on the costs to the average american.
    (coupl'a examples)
    (1)once when i had a saw injury cleaned and glued together with crazy glue, they screwed up typing in my numbers, and accidentally sent me a bill for $600.00 for 30 minutes of a nurse and physicians assistant's time--and listed the crazy glue as "suture material" and charged $69.00 for 2 dollars worth of crazy glue.
    (2) a self employed carpenter I know was paying $1200. per month for health insurance, when it was raised to $1600., he dropped it and now only pays for major medical insurance.

    Shifting that (virtual tax) burden from insurance companies to our government takes money and power from the pigs who currently run the system, and coincidentally would deny our congressmen and women $billions in lobbyists contributions. So, why would our millionaire congress want to change the system? Why would they even want to present the case in a manner acceptable to the electorate?
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    We are homo sapiens, but today some of you, seem to have developed, the morals of insects.
    And you all no longer act like humans.


    What about your family members and friends, that don't have health insurance? (You all will gladly let them die, and this is NOT the natural behavior, of a human being.)


    One of the things that makes us human, is our love for each other.
    Ancient fossil records show, that early humans took care of their sick and handicapped family members.


    Since our species, has always taken care of their sick and handicapped family members.
    Why do you all think, that some of you, no longer take care of your sick and unhealthy family members? (and you all do NOT want them, to have health insurance, and you all will GLADLY let them die.)





    A few scientific questions,

    Why is it that humans who lived 150,000 years ago, took care of their sick and handicapped family members.
    But today you people do (not) take care, of your sick and handicapped family members?
    Last edited by chad; July 5th, 2012 at 07:53 PM.
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    Quote Originally Posted by Lynx_Fox View Post
    If I can not afford "fire insurance" why should you subsidise me?
    That's the wrong question. The question is if you decide to prioritize living in large house and drive a newish car instead of health/fire insurance. Also American's don't subsidize fire insurance--if you don't pay for insurance you're on your own. In some communities that extends all the way to paying a fee for the fire department--pay or the fire department will watch your house burn down (not that I agree with that failure of government--but it exist in many rural communities).
    True enough, but unless you own your home outright, whoever is extending you your mortgage will probably require you to carry it until you're done paying it off.

    Anyway, you know the "priority" thing is bullocks. Most of the people who are worried about it could no more afford to include health insurance in their budget than to buy a unicorn for their kids. The "large house" they're prioritizing is a 2 bedroom apartment, and the "newish car" is a 1992 Toyota the burns oil. Between insurance on the car, gas to get to work, and food for the month, they'd be lucky if they could fit in a few trips to the movie theater, let alone a $300.00+ premium to cover themselves and their kids.

    Sure, they probably should have gotten a college degree, so they could at least make mid range 5 figures. So what happens to those who miss that particular achievement in life? Do we just throw them by the side of the road and let them die (and their kids too)? A lot of those people work very hard now. They can't go back and rewrite their past, and they're not going to adopt out their kids to strangers so they can attend night school while they juggle 2+ part time jobs.




    Your second and third points do suggest that the resistance is (in part at least) down to the idea of free health care
    The entire term "free health care" is a farce. What you don't pay for directly comes out of peoples taxes--and if there's one thing nearly a majority of American's agree on, its a resistance to more taxes.
    Yet we already extend "free health care" to the majority of retirees. We're already covering the biggest insurance risks through the most medically troublesome stage of their life (the one that ultimately ends with a visit to the hospital from which they don't recover.)

    And people are crying about what would happen if we added the nation's children? You ever consider what we'll collectively save down the road if all of those children get preventative care? Even if they were going to grow up and be successful enough to afford the life long health problems they may incur by going unchecked as children..... that's money they could have saved and spent elsewhere, like buying services from another business.

    Quote Originally Posted by Lynx_Fox View Post
    --
    Now although I'm a life long republican, I don't agree with many of the arguments against a national health care system--but I do somewhat understand them and share much of the deep loathing for intrusive and inefficient government programs. That loathing of government is at the heart of American resistant to national health care--not the idea of free health care.
    I think this is more likely to be the heart of the matter. Conservatives are using a practical matter as a soap box to preach ideology.

    Real, tangible, people who physically exist and are physically suffering (in the worst possible way), are being used as hostages to force the public to accept their rhetoric. They'd rather physically maim a child rather than give up a chance to be heard in the "government is too big" debate.
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    Why is it that humans who lived 150,000 years ago, took care of their sick and handicapped family members.
    Don't be so sure about that.

    I remember a friend of my husband's family who worked in the wild mountains of New Guinea during the 1950s. He said it was quite common to see children and adults who were intellectually disabled (cretins mostly - some areas had soils that were severely lacking in iodine so thyroid problems were serious). But babies were often enough born with physical disabilities - a foot twisted backwards or some such - and they were never seen again.

    Life on the very edge of survivability exacts a very high price sometimes.
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    Quote Originally Posted by adelady View Post
    Every single hospital bought its own full set of outlandishly expensive gizmos and used them as marketing to attract 'customers' away from their competitors. A sensible health system would have come up with a profitable facility sharing arrangement where all of them could have made some money - while compensating the higher capital outlays of the 'first adopter' - and building up expertise in all 3/4 hospitals at once. They managed to find the most expensive, least efficient possible option for introducing new procedures.
    That's because of the insurance vs. hospital disconnect I was mentioning. Hospitals compete for quality, but they also *only* compete for quality. Price is a non-issue as long as their rates are within range that insurance companies will (have to) cover them.

    Think about it. They're a for-profit business which has been told price will not be a serious factor in determining their sales volume. What right minded business person *wouldn't* find every possible way to jack up their price tag? It's like a car salesman trying to get you to buy a nicer sound system with your car to increase the size of their own commission on the sale. Hospital administrators can expect their salary will go up with their budget.
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    Quote Originally Posted by adelady View Post
    Why is it that humans who lived 150,000 years ago, took care of their sick and handicapped family members.
    Don't be so sure about that.

    I remember a friend of my husband's family who worked in the wild mountains of New Guinea during the 1950s. He said it was quite common to see children and adults who were intellectually disabled (cretins mostly - some areas had soils that were severely lacking in iodine so thyroid problems were serious). But babies were often enough born with physical disabilities - a foot twisted backwards or some such - and they were never seen again.

    Life on the very edge of survivability exacts a very high price sometimes.



    Scientists have found 75,000+ year old human bones, that had huge defects, and these humans could (not) have survived, without the help of other humans.

    Our 1.5+ million year old evolutionary line, has always had the behavior of hunter/gathers, this is our natural animal group structure. But you are correct about human behavior, and humans will even eat each other, when the going gets tough.

    Your correct in everything you said, and its damn cruel. Buts its the truth, and what we are, and what we can be.



    But its 2012, and we both live in industrialized countries. And we do (not) need to kill, our family members and friends, by withholding health insurance from them.
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    not the 1950's
    Life for the locals in the 1950s in the wild fastnesses of the New Guinea mountains wasn't much different from how it would have been hundreds of years or tens of thousands of years earlier.

    Many of them were still cannibals - in one area at least that resulted in fatal neurological problems because of kuru. Kuru (disease) - Wikipedia, the free encyclopedia
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    Quote Originally Posted by adelady View Post
    not the 1950's
    Life for the locals in the 1950s in the wild fastnesses of the New Guinea mountains wasn't much different from how it would have been hundreds of years or tens of thousands of years earlier.

    Many of them were still cannibals - in one area at least that resulted in fatal neurological problems because of kuru. Kuru (disease) - Wikipedia, the free encyclopedia

    Point taken. I edited out (not the 1950's) in my above post.

    I think I am going to read about, these New Guinea 1950's people. I have heard of them before, but I dont know, anything about them.


    Thanks for the link,
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    It has been said that male grizzly bears fear very few things, and one of these things is a momma grizzly bear with cubs.
    that being said:
    prions scare the hell outa me
    so, i quit eating head cheese, though as a lad i really liked it.
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    They are providing a service that really should be the best in the world for the world's largest economy I think you'd find that the American system works very well for the middle class and above.
    Last I checked about a third of the Americans under age 65 had access to Canadian or French or Swiss or German or Norwegian standard health care. The other 2/3 make do with less. It's not just the uninsured, but the partly and restrictedly insured, who fall short of Western norms.

    As far as paying taxes, Americans are paying as much per capita in taxes for health care as anyone on the planet except maybe the Norwegians (who are taxing the oil riches, not middle class incomes, for the extra). Then on top of that they buy health insurance, pay out of pocket, go without drugs and treatment.

    Health care seems to be one of those things - like education - that Americans are willing to pay for and not get. The motive appears to be the problem that if they set things up so they got what they've been paying for, everybody would get it - including the undeserving, minority races, etc.

    The minority race thing is maybe something you foreigners don't quite appreciate - back in the 1950s when Eisenhower was building freeways and trying to set up a national health care system, the single biggest stumbling block was Jim Crow laws in the Confederate regions - black people joining white people in the hospital was just not going to fly, and separate but equal created all kinds of problems and expenses. We've had a legacy problem ever since.
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    Quote Originally Posted by iceaura View Post
    Health care seems to be one of those things - like education - that Americans are willing to pay for and not get. The motive appears to be the problem that if they set things up so they got what they've been paying for, everybody would get it - including the undeserving, minority races, etc.

    The minority race thing is maybe something you foreigners don't quite appreciate - back in the 1950s when Eisenhower was building freeways and trying to set up a national health care system, the single biggest stumbling block was Jim Crow laws in the Confederate regions - black people joining white people in the hospital was just not going to fly, and separate but equal created all kinds of problems and expenses. We've had a legacy problem ever since.
    Probably the problem is that, being proper capitalists, they want to be sure there is a variation in quality, so if you work extra hard (or have an extra large trust fund), you can spend more money to get better than average care.

    However, this is an impossible dream because of tort laws. If any poor person visits a hospital and receives care that falls short of what Bill Gates would have gotten in the same hospital, and as a result dies or suffers a health set back that could have been prevented if they did get Bill Gates' level of treatment, the hospital will get sued and have to pay not only the amount of money they didn't spend, but also thousands or even millions more in punitive damages.

    So, we're already getting a (more or less) flat quality of care. The only difference is if you're rich you get more preventative care because you probably have a lower deductible (or no deductible) and consequently visit your doctor more often .... which means only rich people are catching their maladies in the early stages, when treatment is inexpensive. Everyone else is waiting until the problem has progressed so far they need some kind of godzillion dollar surgery/treatment to fix it....... which of course costs more than prevention would have cost. So basically, the poorer people are costing us more under this system than they would under a socialized system AND getting worse care BOTH.
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  54. #53  
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    So, we're already getting a (more or less) flat quality of care.
    Hardly. There's an enormous gap in medical care that adds up to more than a decade life expectendy difference between the lower and upper half of income level. Wealthy in the US get earlier and better care. Trends in Mortality Differentials and Life Expectancy for Male Social Security–Covered Workers, by Average Relative Earnings
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  55. #54  
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    Quote Originally Posted by Lynx_Fox View Post
    So, we're already getting a (more or less) flat quality of care.
    Hardly. There's an enormous gap in medical care that adds up to more than a decade life expectendy difference between the lower and upper half of income level. Wealthy in the US get earlier and better care. Trends in Mortality Differentials and Life Expectancy for Male Social Security–Covered Workers, by Average Relative Earnings
    I mean when you do get it, the quality is flat. You're right that the lack of prevention (because poor people often do not get prevention) shifts the overall level of care upward for wealthy people. It also shifts the overall cost for them down, because their problems are caught early.

    Poor people actually cost us more when we don't cover them. By the time they actually go to a hospital, they're in dire straights and we have to patch them up the same as we would a rich person in dire straights.

    There are certain exceptions, of course, to the rule. It's only a rule of thumb. One exception is if there is a specialist who's services are in wide demand, like if they're truly the best in their field and are able to render a quality of service none of the other doctors can render - that guy will probably be assigned to rich patients. In general, specialists tend to be in short supply and some allowances are made for them to be distributed unevenly.
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    I mean when you do get it, the quality is flat.
    And I still disagree. The poor often hit strong limitations set by their insurance policies on diagnosis (you get the X-ray instead of the MRI that doc would prefer...which misses what wrong), drugs (a less effect substitute is proscribed) and other treatments allowed. It translates into better overall care for the well-to-do by a large margin in the US.
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  57. #56  
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by Holmes View Post
    so why did the government enact it? i think its bad
    This would have been a much stronger thread if you'd pointed to a specific poll which shows that result an in particular the issue by issue Q&A survey results.

    For example, in a 2009 poll, most didn't think it went far enough and seemed to want a combined approach with private and public option.
    Poll Finds Most Doctors Support Public Option : NPR
    we dont have a "public option"do we?

    Doctors Threaten to Quit over Health Care Law - Health & Science - CBN News - Christian News 24-7 - CBN.com
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    Obama has no record of any kind to run on. He has built no relationships in Congress and none with foreign leaders. He is detached and lazy. The Middle East is burning as Obama apologizes for insults to "the prophet." Our ambassador in Libya is murdered along with two Navy Seals and a fourth American. American flags are being torched as Obama chooses to downplay terrorist threats. Obama has been in over his head from day one and should never have been president. His incompetence projects only weakness overseas.
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  59. #58  
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    Jim Colyer,
    If you going to resurrect dead threads, than at least make it something about the topic.
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