[POLITICS] If Trump is Innocent, he should prove it

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tstorm823:

I don't appreciate that you believe complete nonsense. You show me where Donald Trump thought white nationalists killing Muslims was ok. Show it to me.

I didn't say he said it was okay, I said that he opined it wasn't a problem. More strictly, he said there was no growing threat from white nationalists just after one busted into a mosque and shot over 50 people: "I don't really. I think it's a small group of people that have very, very serious problems. I guess if you look at what happened in New Zealand, perhaps that's the case. I don't know enough about it yet." For a start, he's dead wrong: it's been on the rise (and not just in the USA). Contrast that with whenever a likely terrorist attack conducted by Muslims occurs, where he's straight out there with the Islamic terrorist rage.

And this sort of minimising and brushing off of the far right by politicians is exactly what I mean.

Your view of Republicans is wrong. Dead wrong. It is based on decades of propaganda being supported by incredibly rare and isolated incidents, and often those incidents are themselves either grossly mischaracterized or have no connection to Republicans.

I have most definitely not stated that Republicans are white nationalists.

I think a chunk of Republicans are racist; some are more racist than most and getting somewhat sympathetic with white nationalist, and a subset of those tend towards and into white nationalism itself. It says something that a lot of these guys fucking loved Trump. They loved him because he said so much that warmed the cockles of their bigotted hearts. He's retweeted their comments. He's enabled them like no president in decades.

tstorm823:

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

Hey look, a bill that lets people out of prison by applying sentencing reform retroactively, seeks to improve prison conditions, and hypothetically would establish rehabilitation programs for inmates.

Also, if you'd like a solid example of biased information delivery, ask yourself why that wikipedia article feels the need to name exclusively Republicans as opponents of a non-controversial bill, when they could have picked at least a couple of the 57 Democrats in the House who voted against it.

Learn the rules and procedures WP operates under, and go there and argue it's an NPOV issue - that despite more Republicans than Democrats supporting the bill and despite far more Democrats than Republicans voting against it that 3/5 listed congressional supporters are Democrats and 0/6 listed opposers are. You could probably argue that that is a subtle attempt to present the topic as more partisan than it is.

Though it's worth noting that they also limited that to Senators, presumably specifically to use as an excuse against NPOV (all the *Senators* who opposed were Republican, after all), so you'll likely have your work cut out for you. Just do not get heated or aggressive, and if and when they try to apply different standards there than in other similar places call them out on it, with examples.

I once argued about a name going on a list article for a long while, and it took pointing out that the standard they were trying to impose for this one specific name would basically destroy the list if it were imposed across the whole thing. It was the list of political self immolations, and the guy literally mailed a manifesto about the issues he was protesting to a local paper then set himself on fire on the courthouse steps. In New England.

Leg End:

tstorm823:
*snip*

I was going to just leave this thread and delete what I typed up, but this bit in particular made me want to stick around to just post this. Thanks.

You made me dig up context and now I'm mad a second time. Journalists really are awful sometimes.

Donald Trump: "I?m not talking about the neo-Nazis and the white nationalists -- because they should be condemned totally. But you had many people in that group other than neo-Nazis and white nationalists. Okay? And the press has treated them absolutely unfairly."

Reporter: "Sir, I just didn?t understand what you were saying. You were saying the press has treated white nationalists unfairly?"

Like, what the hell is that crap? Trump says a lot of dumb things with even dumber implications, but how does a person hear "white supremacists should be condemned totally, but the other people are being treated unfairly" as "white supremacists are being treated unfairly." Jesus Christ.

It's called mental gymnastics and the ongoing effort for the media to try and fling whatever they can at Donald, regardless if the shit they're flinging even exists. If it doesn't, they'll fabricate it.

Fucking cowardly craven lying bullshit.

REPORTER: I just didn?t understand what you were saying. You were saying the press has treated white nationalists unfairly?

TRUMP: No, no. There were people in that rally, and I looked the night before. If you look, they were people protesting very quietly, the taking down the statue of Robert E. Lee. I?m sure in that group there were some bad ones. The following day, it looked like they had some rough, bad people, neo-Nazis, white nationalists, whatever you want to call ?em. But you had a lot of people in that group that were there to innocently protest and very legally protest, because you know, I don't know if you know, but they had a permit. The other group didn't have a permit. So I only tell you this: there are two sides to a story. I thought what took place was a horrible moment for our country, a horrible moment. But there are two sides to the country. Does anybody have a final ? does anybody have a final question? You have an infrastructure question.
...

?The night before? is referring to the Friday night torchlit rally of August 11, where more than 200 attendees held tiki torches on the campus of the University of Virginia and chanted ?Jews will not replace us? and ?Blood and soil.? Whatever this event may have been, it was certainly not ?people protesting very quietly.?
In short, Unite the Right was organized not by individuals who, in Trump?s words, ?felt very strongly about the monument to Robert E. Lee,? but by ardent white supremacists and white nationalists.

On multiple occasions before Unite the Right, attendees stated that the Confederate memorial that was supposedly their purpose was actually the least of their concerns. We have their statements, their videos, their posters, and their words.

We also have the transcript and video of how Trump responded. He did, indeed, refer to the people who attended Unite the Right, people who were likely well aware of and supportive of its messaging, as ?very fine people,? and he downplayed the tiki torch parade as ?people protesting very quietly.?
https://www.vox.com/2019/4/26/18517980/trump-unite-the-right-racism-defense-charlottesville

Have the basic decency to face reality.

tstorm823:

Avnger:

You do realize that Republican Representative Steve King's very existence alone (though he's far from the only one) exposes this for the nonsense it is, right?

edit: And before you say "But he was stripped of all his committee assignments!", that was only 5 months ago. The man has been in Congress for over 15 years...

And he is one person. Much like how the Dixiecrats were Democrats, and the vast majority of them stayed Democrats, but like 3 switched to Republicans so now all racists are Republicans, right?

Joe Biden has said far more racially tinged things than all but the worst Republicans. He helped create racial disparity in America multiple times. Hell, he eulogized one of those Dixiecrats, calling him a friend. But unlike Steve King, he's largely gotten a pass on his comments because there isn't an organized network of media outlets dedicated to amplifying his worst qualities. He wasn't stripped of his positions, he's a presidential front runner! Does that mean the Democrats are collectively racists dog-whistling white supremacists?

twistedmic:

First off all, the new tax reform bill was staggeringly biased towards the rich and super rich, with lower and middle class people get a mere fraction of the benefits.

People have been saying that, but they are incorrect. First, they lump tax cuts to corporations with tax cuts to the wealthy, and that's not how things work. Corporations saving on taxes don't just give that surplus as a lump sum to wealthy owners, but even supposing they did, the owners would then pay tax on that a second time. The tax cut benefited the middle class directly as far as paying less taxes, and the lower class indirectly from the much higher economic growth rate and much lower unemployment that otherwise forecasted (because business are reinvesting their profit , not just cutting wealthy owners fat checks).

'Tax Incentives' typically mean that the business owners and shareholders get more money for themselves. Those businesses might build in low income communities but that sure as hell doesn't mean that they'd be paying above minimum wage (currently $7.25/$7.50 an hour) which is not a livable wage.

Something like 1% of employed people make minimum wage or below, and most of those below are working tipped jobs that actually make significantly more than minimum. They are paying above minimum wage, I guarantee it.

Where is the money coming from to help these black colleges? Is it coming from military spending cutbacks? Or are the Republicans planning to pull funding from public schools, federal parks, various social services etc? Are any of these obscenely rich Politicians donating their own money to help>

It's not always money. Sure, the HBCU got Pell Grants restored and are being spared any proposed cuts to education funding, but the projects they've worked on are largely networking. Getting these colleges into arrangements with other universities and professional industries to share resources and points of contact so that the students can connect to their desired profession. Historically black colleges aren't going exceptionally bankrupt and need mountains of money. But they do have the unique challenge of a lot of first generation college students who don't have a head start on making professional contacts.

Give me links to the info that Trump and his brood are trying to reform the prison system to help the incarcerated, instead of trying to privatize the prison system.

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

Hey look, a bill that lets people out of prison by applying sentencing reform retroactively, seeks to improve prison conditions, and hypothetically would establish rehabilitation programs for inmates.

Also, if you'd like a solid example of biased information delivery, ask yourself why that wikipedia article feels the need to name exclusively Republicans as opponents of a non-controversial bill, when they could have picked at least a couple of the 57 Democrats in the House who voted against it.

Are the Republicans helping minorities and the poor by constantly trying to strip them of health care, medicaid, medicare and WIC? What about their unending quest to strip women of their reproductive rights? Is that helping them?

Short answer, yes. Our miserable attempts at providing people "free" healthcare are a huge part of how healthcare in the US became an insurmountable mess. The "reproductive rights" you're talking about are killing human beings. Republicans hold the controversial opinion that people are better off when they have accessible, affordable healthcare and aren't killing their offspring.

You excuse Republicans in a way you would never excuse Democrats.

And anyone who claims the Southern Strategy doesn't exist doesn't have the best intentions.

Agema:

I didn't say he said it was okay, I said that he opined it wasn't a problem. More strictly, he said there was no growing threat from white nationalists just after one busted into a mosque and shot over 50 people: "I don?t really. I think it?s a small group of people that have very, very serious problems. I guess if you look at what happened in New Zealand, perhaps that?s the case. I don?t know enough about it yet." For a start, he's dead wrong: it's been on the rise (and not just in the USA). Contrast that with whenever a likely terrorist attack conducted by Muslims occurs, where he's straight out there with the Islamic terrorist rage.

And this sort of minimising and brushing off of the far right by politicians is exactly what I mean.

But that's not minimizing the severity of an individual event, that's about how widespread the issue is. That is very much not Donald Trump saying "white nationalism isn't a big deal, they don't hurt anyone", that's "white nationalism isn't something many people support." If a Democrat said that white supremacy was an extreme minority viewpoint held by people with very serious problems, would you describe that as calling it "minimizing the far right"?

And it's not unreasonable to treat Islamic terrorism and white-supremacist terrorism differently in this regard. Globally, there are nearly 100 people killed in Islamic terrorist attacks for each killed in white supremacist terror attacks. The Sri Lanka Easter Sunday bombings were as deadly as like the last decade of white nationalists combined.

Kwak:

Have the basic decency to face reality.

I am facing reality. The president is not an evil mastermind sending coded signals to white supremacists. He's just an idiot. You know he's dumb, I know he's dumb, don't pretend he isn't dumb.

Now ask yourself this: what is more likely? Evil mastermind Donald Trump said that white supremacy should be condemned entirely, but then he winked at all the neo-nazis and said "the Jews will not replace us" is quiet protest. OR. Bubbling buffoon Donald Trump didn't know what really happened and was speaking entirely based on pictures of what vaguely looks like a candle-lit vigil compared to pictures of people in black masks attacking people with baseball bats. Which of those seems more likely?

Donald Trump has explicitly condemned neo-nazis and white supremacists in no uncertain terms on multiple occasions. He has also said things that if you try to you can interpret as faint praise for those things. Listen to the things he said explicitly. The things you think he implied, I promise you, are accidental. Because the man is dumb.

Saelune:

You excuse Republicans in a way you would never excuse Democrats.

And anyone who claims the Southern Strategy doesn't exist doesn't have the best intentions.

Well typically, I'm condemning specific Democrats for specific actions and defending Republicans in general because other people are condemning Republicans in general rather than specific people for specific actions. You don't see me defending Steve King, just defending others from being burdened with Steve King's reputation. Conversely, you don't see me accusing all Democrats of making laws that deliberately hurt the African American community just because Joe Biden did it.

And the Southern Strategy doesn't exist. Richard Nixon never really won the South.

tstorm823:

People have been saying that, but they are incorrect. First, they lump tax cuts to corporations with tax cuts to the wealthy, and that's not how things work. Corporations saving on taxes don't just give that surplus as a lump sum to wealthy owners, but even supposing they did, the owners would then pay tax on that a second time. The tax cut benefited the middle class directly as far as paying less taxes, and the lower class indirectly from the much higher economic growth rate and much lower unemployment that otherwise forecasted (because business are reinvesting their profit , not just cutting wealthy owners fat checks).

Can you show me the numbers that backup your claim, rather than have me just take your word on it?
I never thought that the companies would be giving lump sums to the wealthy, I knew they were going to reinvest in the stock market, an action that would solely benefit the shareholders and not the actual employees.
Yet the middle class and lower class pay more taxes proportionately than the wealthy. More money is being taken from those who can afford it the least while giving more money to those who can easily afford a higher tax rate.
The lower class bit sounds like trickle down economics, which has never worked in the slightest. It was a failed concept from the very start.

Something like 1% of employed people make minimum wage or below, and most of those below are working tipped jobs that actually make significantly more than minimum. They are paying above minimum wage, I guarantee it.

What percentage of the American population us making a LIVABLE WAGE? That's the thing LIVABLE WAGE. Federal Minimum Wage is BELOW a livable wage. It doesn't matter how many people are making minimum wage if they are not making a living wage.

Short answer, yes. Our miserable attempts at providing people "free" healthcare are a huge part of how healthcare in the US became an insurmountable mess.

The ACA was actively hampered by Republicans. They tried to sabotage it from the very start. It seems that every hurdle in front of affordable healthcare for every citizen has been placed by Republicans.[/quote]

The "reproductive rights" you're talking about are killing human beings.

And your 'gun rights' are also killing human beings. Sky high drug prices are killing human beings. Stripping millions of their healthcare is killing human beings.

Republicans hold the controversial opinion that people are better off when they have accessible, affordable healthcare and aren't killing their offspring.

Where's the affordable healthcare? We had it, or were on the road to it, with the ACA until the Republicans sabotaged it. If the Republicans are so gungho for saving human lives why have they not implemented any form of gun control? Why is their solution always "more guns!". Why are women not allowed to chose what happens with their own bodies? I personally don't agree with abortion but, seeing as I am not a woman and therefore can not get pregnant, it is not my place to tell other that they can not get abortions.

twistedmic:
If the Republicans are so gungho for saving human lives why have they not implemented any form of gun control?

Because they don't believe the two to be related, or believe that restricting access to firearms will cost lives. Agree with it or not, that appears to be the stance.

Why are women not allowed to chose what happens with their own bodies?

Some of it is a religious angle, some of it a general moral angle, and for many it's a mix in-between. To several I've spoken with, it is the belief that life begins at conception which would mean an abortion is Murder. If you were aligned with that line of thought, wouldn't you put your foot in the door? Not saying it's true or that I believe it, but I can see where someone is coming from with that. From that perspective, it is not a matter of their own body, but another within that person.

There's a allot of countries I dislike(not the UK of course), but I would not want to wish any of them to have our health insurance system where people are dying silently in their homes due to suicides from being in debt, not getting the preventive care they need, dying from metal hip replacements, and I could go on, and on.

Our health insurance system is the bane of most American lives, most bankruptcies are due to this.

Hopefully, anyone but Boris Johnson gets elected in the UK, and if there is a trade deal that does away with the NHS I hope your parliament votes it down hard.

Big pharma and most if not all private health insurance companies in the US are the scum of the Earth.

twistedmic:

Can you show me the numbers that backup your claim, rather than have me just take your word on it?
I never thought that the companies would be giving lump sums to the wealthy, I knew they were going to reinvest in the stock market, an action that would solely benefit the shareholders and not the actual employees.
Yet the middle class and lower class pay more taxes proportionately than the wealthy. More money is being taken from those who can afford it the least while giving more money to those who can easily afford a higher tax rate.
The lower class bit sounds like trickle down economics, which has never worked in the slightest. It was a failed concept from the very start.

Here's a reasonable summary of the changes. Most tax brackets got a 3% cut. Much like a flat increase in taxes across the board is actually regressive because the same percent of your income means more when you have less income, a flat percentage cut off your taxes is more important to the people in the lower and middle class than it does to the wealthy. Then they eliminated a bunch of itemized deductions (sometimes referred to as loopholes, largely used by rich people who make enough to deduct more than the standard deduction) and doubled the standard deduction, which is good for us plebeians that can't reduce our income taxes by owning 7 homes. And it limited tax deductions for state and local taxes to $10,000, which is effectively a tax increase for people making some hundreds of thousands of dollars a year. All these income tax changes are good for average people.

The talking heads, of course, ignore all of this and focus straight in on the cut in corporate taxes from 35% to 21%, treating that tax cut as a gift to the wealthy. But they're all idiots. Corporations make decisions based on profit, if the taxes are high, they won't behave the same as if taxes were lower. Corporations pass most if not all of the monetary burden of taxes to consumers in higher prices and employees in lower wages. Less corporate tax will inevitably benefit employees and consumers through the natural readjustment of where optimal pricing is. A decrease in taxes decreases the cost of doing business, decreased cost of doing business makes it more profitable to decrease the price of goods in order to reach more consumers, selling more product at the new price requires more labor which increases the demand for labor, and an increased demand for labor requires paying more to attract the necessary amount of laborers. It's not some wonky theory, this is the basic economics they teach with supply and demand curves. It's not trickle-down economics. Trickle down economics is the idea that if you let rich people have more money, they'll spend it buying things from poorer people, and that will somehow make everyone richer. Cutting corporate taxes isn't trickle down economics because the tax burden of corporations is carried not just by the wealthy, but also by the employees and costumers of that corporation. I offer two concrete points of evidence: first, the cut in corporate tax wasn't some wild free market nightmare cut, it was cutting from one of the highest corporate tax rates in the world down to match the nations with the greatest income equality. You can compare these two lists at your leisure. Second, in the time since the tax code change, the great economic growth has not been found in the stock markets (there's a strong argument that Trump is just bad for the stock market), but rather it's been found in increasing employment and increasing wages that just won't stop going up. That's good for the regular person, not the ultra-rich.

The ACA was actively hampered by Republicans. They tried to sabotage it from the very start. It seems that every hurdle in front of affordable healthcare for every citizen has been placed by Republicans.

The ACA was never going to make healthcare more affordable no matter what Republicans did. It was, I would argue, the worst piece of legislation imagined in modern times, and I'm still not entirely unconvinced that it wasn't a deliberate train wreck designed to make actual universal healthcare more palatable. It's not Republican meddling that added the provision that insurers have to spend 80% of premium costs on medical care, leaving 20% at most for profit. That sounds like a perfectly reasonable concept until you think about it for more than 2 minutes. If you want to make more money, but your profits cannot grow faster than the medical expenses, the incentive becomes to deliberately overspend on healthcare. The ACA was never ever going to make healthcare more affordable.

tstorm823:

generals3:

Politics is a lot more subtle than that. Talk is cheap and condemnation of a particular act is even cheaper. What matters is the general attitude and communication on a more local level. You say that republicans will not let an act of bigotry pass by without a thousand condemnations. Yet they elected someone as president who made plenty of bigotted statements. The most well known and obvious being the one about mexican immigrants crossing the border who are apparently almost all criminals and rapists with "maybe some" being good people. How would you feel if someone said republicans are racists, sexists and nutjobs and maybe some are good people?

"Maybe some good people" would be a considerable upgrade to what people often say.

Just like you have plenty of republicans being equally harsh towards democrats "traitors", "pussies", "snowflakes", etc. But that doesn't necessarily represent the mainstream acceptable opinion.
But what if the next Democrat president started his campaign while saying that about republicans? How would you feel?

tstorm823:

The talking heads, of course, ignore all of this and focus straight in on the cut in corporate taxes from 35% to 21%, treating that tax cut as a gift to the wealthy. But they're all idiots. Corporations make decisions based on profit, if the taxes are high, they won't behave the same as if taxes were lower. Corporations pass most if not all of the monetary burden of taxes to consumers in higher prices and employees in lower wages. Less corporate tax will inevitably benefit employees and consumers through the natural readjustment of where optimal pricing is. A decrease in taxes decreases the cost of doing business, decreased cost of doing business makes it more profitable to decrease the price of goods in order to reach more consumers, selling more product at the new price requires more labor which increases the demand for labor, and an increased demand for labor requires paying more to attract the necessary amount of laborers. It's not some wonky theory, this is the basic economics they teach with supply and demand curves. It's not trickle-down economics. Trickle down economics is the idea that if you let rich people have more money, they'll spend it buying things from poorer people, and that will somehow make everyone richer. Cutting corporate taxes isn't trickle down economics because the tax burden of corporations is carried not just by the wealthy, but also by the employees and costumers of that corporation. I offer two concrete points of evidence: first, the cut in corporate tax wasn't some wild free market nightmare cut, it was cutting from one of the highest corporate tax rates in the world down to match the nations with the greatest income equality. You can compare these two lists at your leisure. Second, in the time since the tax code change, the great economic growth has not been found in the stock markets (there's a strong argument that Trump is just bad for the stock market), but rather it's been found in increasing employment and increasing wages that just won't stop going up. That's good for the regular person, not the ultra-rich.

Firstly, looking at the statutory corporate tax is useless. What you need to look at is the effective tax rate. And that one wasn't much higher in the US, and it has been decreasing for a long time.

And this idea costumers and employees will benefit is just a part of the picture. In a country with a huge (and i mean HUGE) gap between what the poorest employees earn vs the top executives we can easily assume the wealth redistribution will follow that pattern. "one dollar for Joe, 1000 dollars for Big Donald".
And corporations also have a nasty habbit of transfering benefits after taxes towards shareholders. There are plenty of examples of companies cutting jobs and/or increasing prices just to increase the dividend rate. Why wouldn't a company use a lower tax rate to improve the dividend rate and increase shareholder return? And that's the point.
When the tax rate is higher the government can use that extra money for social programs which are specifically aimed at helping the poor. On the other hand a lower tax rate might somewhat help consumers and low wage employees but it will also help shareholders and executives a lot. So if your goal is to help the poor reducing taxes is a bad idea, especially in a country with an already extremely high wealth inequality and with poor welfare programs.

PS: as inflation has not reduced since Trump implemented his tax rate reduction we can say with certainty it didn't help consumers.
https://www.usinflationcalculator.com/inflation/current-inflation-rates/

tstorm823:
But that's not minimizing the severity of an individual event, that's about how widespread the issue is.

That's not the issue: it's the inherently different reaction depending on which terrorists are doing the killing. Play down the white nationalists, ramp up the Islamists. It's a constant way of talking about foreigners and darker skinned people that amplifies the perception of their criminality and threat.

tstorm823:
It's not Republican meddling that added the provision that insurers have to spend 80% of premium costs on medical care, leaving 20% at most for profit. That sounds like a perfectly reasonable concept until you think about it for more than 2 minutes. If you want to make more money, but your profits cannot grow faster than the medical expenses, the incentive becomes to deliberately overspend on healthcare.

And your favoured solution is just... to let them charge and spend whatever they want, allowing them to merely enrich themselves without investing in the system or improving service? Relying on their goodwill to do anything that isn't solely for their own benefit?

The problem right there is the profit motive. That's the direct root of the problem. Crazy idea, but maybe the solution doesn't rest in finding a way to let companies make as much money as they want from vital healthcare provision.

Silvanus:

tstorm823:
It's not Republican meddling that added the provision that insurers have to spend 80% of premium costs on medical care, leaving 20% at most for profit. That sounds like a perfectly reasonable concept until you think about it for more than 2 minutes. If you want to make more money, but your profits cannot grow faster than the medical expenses, the incentive becomes to deliberately overspend on healthcare.

And your favoured solution is just... to let them charge and spend whatever they want, allowing them to merely enrich themselves without investing in the system or improving service? Relying on their goodwill to do anything that isn't solely for their own benefit?

The problem right there is the profit motive. That's the direct root of the problem. Crazy idea, but maybe the solution doesn't rest in finding a way to let companies make as much money as they want from vital healthcare provision.

It's even crazier when you realize a spending of 20% of the premiums on profit is huge for an insurance companies. I know of (big) insurance companies that make much less on premiums because claims (+expenses) are close to premiums (with a big part of profits stemming from their investment portfolios).

Leg End:

twistedmic:
If the Republicans are so gungho for saving human lives why have they not implemented any form of gun control?

Because they don't believe the two to be related, or believe that restricting access to firearms will cost lives. Agree with it or not, that appears to be the stance.

Why are women not allowed to chose what happens with their own bodies?

Some of it is a religious angle, some of it a general moral angle, and for many it's a mix in-between. To several I've spoken with, it is the belief that life begins at conception which would mean an abortion is Murder. If you were aligned with that line of thought, wouldn't you put your foot in the door? Not saying it's true or that I believe it, but I can see where someone is coming from with that. From that perspective, it is not a matter of their own body, but another within that person.

Just for sake of argument, let's leave the moralistic preaching outside for a second and be more pragmatic. Women who would abort without bans will still search for abortion even if it's banned, but in unsafer environments. One important thing the ban doesn't stop is unwanted pregnancies from happening. It requires two to tango, and the ban punishes one; that's a pretty bad deterrent, specially in cases of non-consensual tango.

Another thing that the ban doesn't provide is better support for newborns and their mothers. The ban doesn't give any good incentives to give birth; only fear of law.

PS (aka, bringing back the preaching): Empathy doesn't mean letting them have their way. If they care so much for the unborn lives that they are willing to rob the future mother of her rights over her own body, then they should also carry the responsibility of having the baby to have proper care. Next time you talk to them, tell them that they can't claim they are saving lives by ruining them and letting them fade into misery.

tstorm823:
The ACA was never going to make healthcare more affordable no matter what Republicans did. It was, I would argue, the worst piece of legislation imagined in modern times, and I'm still not entirely unconvinced that it wasn't a deliberate train wreck designed to make actual universal healthcare more palatable.

Lest we forget, FartBongoCare was an adaptation of Romney's statewide plan, itself in turn a product of ideas plucked from the Heritage Foundation's '93 counter-proposal to the Clinton health care plan, and John Chafee's proposed HEART bill. It was a GOP plan through-and-through, and Congressional Republicans still did their damnedest to kill it (just as they did, successfully, in '93). Likewise, lest we forget single-payer was on the table initially, but that was quickly walked back by Democrats (including Obama) during the push to build party support.

generals3:

Just like you have plenty of republicans being equally harsh towards democrats "traitors", "pussies", "snowflakes", etc. But that doesn't necessarily represent the mainstream acceptable opinion.
But what if the next Democrat president started his campaign while saying that about republicans? How would you feel?

"You know, to just be grossly generalistic, you could put half of Trump's supporters into what I call the basket of deplorables. (Laughter/applause) Right? (Laughter/applause) They're racist, sexist, homophobic, xenophobic - Islamophobic - you name it."

"You cannot be civil with a political party that wants to destroy what you stand for, what you care about."

Hillary Clinton, 2016 Democratic candidate.

generals3:

And corporations also have a nasty habit of transferring benefits after taxes towards shareholders. There are plenty of examples of companies cutting jobs and/or increasing prices just to increase the dividend rate. Why wouldn't a company use a lower tax rate to improve the dividend rate and increase shareholder return? And that's the point.

Because it's actively bad for the company. There are plenty of examples of companies cutting jobs and increasing profits (to which dividends are owed a certain percent) because sometimes the market for what you're doing shrinks. If you can downsize and make more money, it means you were equipped to overproduce, which is a market inefficiency. If your business is operating efficiently to maximize profitability, you can't just cut jobs and pocket the savings. You will lose more profit from decreased output than you gained in savings from payroll. Similarly, if you can raise prices and make more money, it means you were underselling your goods to begin with. If you're selling goods at the optimal price, you can't just raise prices and pocket the difference, because you will lose more money from lost sales than you would gain from increased margin. This is the supply and demand curve. The supply line shows how many widgets producers would be willing to feed into the market at a given price, the demand curve shows how many people would be willing to pay for a widget at that price, the optimal price is where they intersect. If you cut production from there, you miss out on demand and lose money. If you raise the price, you scare away customers and lose sales.

Businesses adjust pricing or production to maximize profit in changing market conditions. A change in the tax code is a change in market conditions that businesses will adjust to in order to maximize profit. It's not a matter of charity that they do this, it's that they will make more money adjusting. When taxes are lowered, it allows you to make acceptable profit margins at lower prices where you can reach more customers. The supply curve shifts to the right, and the optimal price point for maximized profits (the intersection of supply and demand) moves toward selling more at a lower price. That means cheaper goods and services provided to more people by hiring more people to make them will let the ownership make more profit. It's not "well our margins just magically got bigger, what should we do with this windfall", it's "the basic equations of our business plan have shifted, how do we maximize our profits within this new framework".

When the tax rate is higher the government can use that extra money for social programs which are specifically aimed at helping the poor. On the other hand a lower tax rate might somewhat help consumers and low wage employees but it will also help shareholders and executives a lot. So if your goal is to help the poor reducing taxes is a bad idea, especially in a country with an already extremely high wealth inequality and with poor welfare programs.

I have no problem with the idea that we need to fund the government, ideally for the benefit of those most in need. But if YOUR goal is to maximize the benefit to the poor and in need, why would you increase a tax that kicks them in the shins before handing them the money? We have a progressive income taxes to draw from the wealthy without hurting the poor, we can have property taxes on only egregious real estate, we can put excise taxes on luxury goods that people don't need to live, there are 1000 ways to target the money of the wealthy in both direct and indirect ways that don't change what business practices are efficient in a way that hurts the general public. The way I see it, corporate taxes are a way to pass the financial burden of funding the government to the poor and middle class in a way that doesn't make the taxman into the boogeyman. It's a way to hide how much the poor pay into funding the government.

Second,

PS: as inflation has not reduced since Trump implemented his tax rate reduction we can say with certainty it didn't help consumers.
https://www.usinflationcalculator.com/inflation/current-inflation-rates/

Inflation calculations are messy and flawed in some way or another no matter how you do it. The biggest thing you have to realize is that inflation lately is driven upwards by things like rent, tuition, and health care. The first has a lot of non-corporate competition in private renters, and the second and third are industries with immense presence of not-for-profit institutions. Knocking down corporate tax rate isn't going to effect these industries much.

tstorm823:

"You know, to just be grossly generalistic, you could put half of Trump's supporters into what I call the basket of deplorables. (Laughter/applause) Right? (Laughter/applause) They're racist, sexist, homophobic, xenophobic ? Islamophobic ? you name it."

"You cannot be civil with a political party that wants to destroy what you stand for, what you care about."

I knew that one was coming, however, at least she said "half" and didn't say "Republicans". Trump won the primaries but he sure didn't with all republicans voting for him. So her comment is more like "A significant minority of republicans...". AND, most importantly, she didn't become president because many democrats didn't feel enthousiastic about her. Unlike how Republicans now feel extatic about Trump.

Because it's actively bad for the company. There are plenty of examples of companies cutting jobs and increasing profits (to which dividends are owed a certain percent) because sometimes the market for what you're doing shrinks. If you can downsize and make more money, it means you were equipped to overproduce, which is a market inefficiency. If your business is operating efficiently to maximize profitability, you can't just cut jobs and pocket the savings. You will lose more profit from decreased output than you gained in savings from payroll. Similarly, if you can raise prices and make more money, it means you were underselling your goods to begin with. If you're selling goods at the optimal price, you can't just raise prices and pocket the difference, because you will lose more money from lost sales than you would gain from increased margin. This is the supply and demand curve. The supply line shows how many widgets producers would be willing to feed into the market at a given price, the demand curve shows how many people would be willing to pay for a widget at that price, the optimal price is where they intersect. If you cut production from there, you miss out on demand and lose money. If you raise the price, you scare away customers and lose sales.

Why is it bad for a company? A company's goal is to reward its shareholders. And this is not about things that are "optimal", you can always find ways to trim the fat, you may argue that which was cut was inefficient but considering this is all about helping the populace that really doesn't matter now does it? If you fire 25% of your staff because many weren't working efficiently you still caused 25% to lose their job and wages. And for what? Often times to reward shareholders and top executives. The same goes with prices, certain goods or services can be sold at absurd prices due to them being necessities and/or imperfect competition (which is usually how markets are, not perfectly competitive), but that doesn't make it right, the consumer is fucked. And who wins? Again, shareholders and executives. The american healthcare market is a prime example of that phenomenon.

Lastly all these fancy economic theorems are all based on the assumption of the nonexistant "Homo Economicus". Consumers don't have excel sheets in which they calculate their Utility curves and create their consumer's basket based on prices (from all suppliers) which they update every day.
So you can very well increase or decrease prices with less than expected reactions on the demand curve, even with perfect competition.

Businesses adjust pricing or production to maximize profit in changing market conditions. A change in the tax code is a change in market conditions that businesses will adjust to in order to maximize profit. It's not a matter of charity that they do this, it's that they will make more money adjusting. When taxes are lowered, it allows you to make acceptable profit margins at lower prices where you can reach more customers. The supply curve shifts to the right, and the optimal price point for maximized profits (the intersection of supply and demand) moves toward selling more at a lower price. That means cheaper goods and services provided to more people by hiring more people to make them will let the ownership make more profit. It's not "well our margins just magically got bigger, what should we do with this windfall", it's "the basic equations of our business plan have shifted, how do we maximize our profits within this new framework".

Ironically corporate tax increases or reductions should in no way affect optimal production according to classic economic theory. Whether or not an additional unit of production is profitable is based on its margin: income - expense. And it is that margin that is taxed. But if your margin is positive it will remain positive after tax regardless of the tax rate (unless you go above 100%).

I have no problem with the idea that we need to fund the government, ideally for the benefit of those most in need. But if YOUR goal is to maximize the benefit to the poor and in need, why would you increase a tax that kicks them in the shins before handing them the money? We have a progressive income taxes to draw from the wealthy without hurting the poor, we can have property taxes on only egregious real estate, we can put excise taxes on luxury goods that people don't need to live, there are 1000 ways to target the money of the wealthy in both direct and indirect ways that don't change what business practices are efficient in a way that hurts the general public. The way I see it, corporate taxes are a way to pass the financial burden of funding the government to the poor and middle class in a way that doesn't make the taxman into the boogeyman. It's a way to hide how much the poor pay into funding the government.

All this would be true if executives wouldn't have their salaries heavily tied to net profits (as they also often hold shares) as well as investors. The net benefit is used to fund them. So yes you also tax employees that way, because theoretically a company could reduce its desired gross benefits due to a tax reduction. But it isn't often the case and usually those who are hit the most are the wealthy. You could see it as a second type of progressive taxation. And while it may not be the best way to specifically target the wealthy, it sure is better than nothing. Because that's the thing, Donald Trump didn't combine that with taxes aimed at the rich to compensate. Here we often talk about "Tax Shifts" but Republicans always talk about "Tax reductions" and that's a problem. Because for every dolar a poor person earns more on their paycheck they'll lose two in lost government aid or government aid that could have been added at the same cost as the tax cut.

Inflation calculations are messy and flawed in some way or another no matter how you do it. The biggest thing you have to realize is that inflation lately is driven upwards by things like rent, tuition, and health care. The first has a lot of non-corporate competition in private renters, and the second and third are industries with immense presence of not-for-profit institutions. Knocking down corporate tax rate isn't going to effect these industries much.

Just like it could be said that wages are increasing due to an increasingly lower unemployment rate (which merely followed a trend that already started prior to the tax cut).

Agema:

That's not the issue: it's the inherently different reaction depending on which terrorists are doing the killing. Play down the white nationalists, ramp up the Islamists. It's a constant way of talking about foreigners and darker skinned people that amplifies the perception of their criminality and threat.

Well, when a terrorist attack is claimed by ISIS, you don't have to question the motives. I know there was a bit of time where it was genuinely unclear if ISIS was actually causing terrorist attacks in the west or if they just took credit for every attack they could, but I don't know if you noticed, since ISIS started crumbling, Islamic terrorism has come to a dead halt in America. When the white supremacists are ideologically rogues, and the Muslim terrorists are connected to a specific organization we're effectively at war with and can defeat, different treatment is totally justified.

Silvanus:

And your favoured solution is just... to let them charge and spend whatever they want, allowing them to merely enrich themselves without investing in the system or improving service? Relying on their goodwill to do anything that isn't solely for their own benefit?

My favored solution is breaking out the ol' anti-trust laws and dissolving the cabal of middlemen that artificially maintain outrageously inflated prices. The current health care landscape has all the downsides of government healthcare (bureaucracy, inefficiency, unaccountability, and corruption) without any of the benefits, and I'd prefer to tear down the system of insurers and benefit managers who've been allowed to make decisions on your behalf but for the benefit of others. These people are supposed to have a fiduciary responsiblity to their clients, but are truly acting on behalf of their own monetary interest.

generals3:

It's even crazier when you realize a spending of 20% of the premiums on profit is huge for an insurance companies. I know of (big) insurance companies that make much less on premiums because claims (+expenses) are close to premiums (with a big part of profits stemming from their investment portfolios).

The 20% remaining isn't all profit, they have to pay all their non healthcare expenses as well. The issue isn't the proportion, it's that the proportionality exists in the first place. It takes away the incentive to provide inexpensive treatments like generic drugs and incentivizes paying for things like brand name drugs deliberately so that they can legally increase premiums the next year.

tstorm823:
Well, when a terrorist attack is claimed by ISIS, you don't have to question the motives.

When a white supremacist shoots up a mosque or synagogue, you don't have to question his motives, either.

The 20% remaining isn't all profit, they have to pay all their non healthcare expenses as well. The issue isn't the proportion, it's that the proportionality exists in the first place. It takes away the incentive to provide inexpensive treatments like generic drugs and incentivizes paying for things like brand name drugs deliberately so that they can legally increase premiums the next year.

1) Broadly, insurance companies do not decide what treatments people get; healthcare professionals like doctors do.

2) Rules of competition still exist: an insurance company that inflates its healthcare expenditure to increase its profits needs to charge customers more, therefore is likely to lose customers to competitors.

The drive to cover brand name drugs over generics is really about complex interactions and dealings between pharmaceutical firms, third party pharmacy supply/distributor middlemen, and insurers/providers. For instance, the insurers may be getting brand name drugs at lower cost than they could get generics because the pharmaceutical firm is selling them via the pharmacy middlemen at a massively discounted cost (the benefit for the pharmaceutical company is that it helps shut out generics and maintains market share). There are of course stings in the tail: the long-term effect of suppressing competition ends up as higher prices, for instance, and plenty more. The pharmacy middlemen are thought to be doing all sorts of dodgy shit.

Anyway, from the insurers' point of view, many are superficially seeing savings from cheaper drugs, which allows them to reduce costs: get a $50 brand name at $20 when the generics cost $25? Do it. Maybe without the crazy institutionalised process in the background they might get a generic for $16 - but that's a whole other order of calculation and required action.

3) The funny thing is, there's plenty of evidence the ACA has reduced healthcare costs in the USA compared to if it had not been enacted - it was full of provisions to cut waste in healthcare spending.

tstorm823:

Saelune:

You excuse Republicans in a way you would never excuse Democrats.

And anyone who claims the Southern Strategy doesn't exist doesn't have the best intentions.

Well typically, I'm condemning specific Democrats for specific actions and defending Republicans in general because other people are condemning Republicans in general rather than specific people for specific actions. You don't see me defending Steve King, just defending others from being burdened with Steve King's reputation. Conversely, you don't see me accusing all Democrats of making laws that deliberately hurt the African American community just because Joe Biden did it.

And the Southern Strategy doesn't exist. Richard Nixon never really won the South.

The whole party is guilty of defending and supporting Trump.

And yes, it exists, and yes Nixon won the South, and no, it was not limited to just him either anyways.

Again, anyone who denies the Southern Strategy existing doesn't have the best intentions.

Agema:

When a white supremacist shoots up a mosque or synagogue, you don't have to question his motives, either.

I think you do. I think if there were comparatively a rise in terrorist actions from unaffiliated Muslims who had not been in contact with organizations that actively seek to use them as a suicide attack it would be perfectly reasonable to step back and go "we don't know what this person was thinking, we're not going to blame this on anyone but the perpetrator without more evidence."

To my knowledge, there isn't a white-supremacist organization that is pushing people into terror attacks. While it's certainly correct to condemn the ideology, blaming white supremacy for a school shooter that drew swastikas on the gun in not the same as blaming militant Islamists who directed the terrorist to act and then took credit. These groups are not boogeymen, there are 4 specific organizations that are responsible for the majority of terrorism globally. So far as I know, white supremacy lacks anything comparable, the closest you get are some prison gangs, and I'm not aware of any major terrorist attacks conducted by them.

Ultimately, my point is that terrorism is terrorism because it's done with a purpose. Someone acting at the behest of ISIS is doing so to destroy the west and advance the goal of a single Islamic world government. Even in a case as clear cut as neo-nazi attacks a
synagogue, you can identify the ideology that led to the problem, but you don't know what the person was trying to accomplish.

1) Broadly, insurance companies do not decide what treatments people get; healthcare professionals like doctors do.

2) Rules of competition still exist: an insurance company that inflates its healthcare expenditure to increase its profits needs to charge customers more, therefore is likely to lose customers to competitors.

The drive to cover brand name drugs over generics is really about complex interactions and dealings between pharmaceutical firms, third party pharmacy supply/distributor middlemen, and insurers/providers. For instance, the insurers may be getting brand name drugs at lower cost than they could get generics because the pharmaceutical firm is selling them via the pharmacy middlemen at a massively discounted cost (the benefit for the pharmaceutical company is that it helps shut out generics and maintains market share). There are of course stings in the tail: the long-term effect of suppressing competition ends up as higher prices, for instance, and plenty more. The pharmacy middlemen are thought to be doing all sorts of dodgy shit.

Anyway, from the insurers' point of view, many are superficially seeing savings from cheaper drugs, which allows them to reduce costs: get a $50 brand name at $20 when the generics cost $25? Do it. Maybe without the crazy institutionalised process in the background they might get a generic for $16 - but that's a whole other order of calculation and required action.

3) The funny thing is, there's plenty of evidence the ACA has reduced healthcare costs in the USA compared to if it had not been enacted - it was full of provisions to cut waste in healthcare spending.

Thing is, rules of competition don't exist in this market. In many places, major healthcare providers have been allowed to buy out entire counties worth of doctors offices. 3 or 4 national chains control most of the entire retail drug industry. 3 pharmacy benefit managers own almost the entire market. Companies like CVS have vertical monopolies that manage every step from the doctor to the drug manufacturer to your personal pill bottle. The dodgy things you describe might be happening behind a thousand closed doors, but it's a largely coordinated effort. The web is woven so tightly, there's not competition, there's collusion.

A single manufacturer shouldn't be able to declare epipens massively more expensive on a whim. Insurers trying to act in their clients interests should reasonably say "look dude, we'd rather ask our patients to learn a different less expensive epinephrine injector than siphon thousands of dollars from them to you." That attempt was not made. Insurances paid specifically for epipens at price gouging levels. That's coordinated, and assuredly responsible for some amount of premium increase.

Agema:
The funny thing is, there's plenty of evidence the ACA has reduced healthcare costs in the USA compared to if it had not been enacted - it was full of provisions to cut waste in healthcare spending.

It certainly reduced my employer's health care costs. As the ACA went into effect we had 15-25% rate increases every year. They had to let a couple of people go late last year, which put them below the magic number and let them discontinue our health insurance entirely. Which means I'm now on the marketplace, which raised my insurance premium by another $50/month, after applying the estimated tax credit in full. For worse coverage.

On the upside, my fianc? starts her new job next week, and we're getting married around when her training is over. It's a state job, and public employee insurance for a couple is much less than what I'm paying for just me on the marketplace.

tstorm823:

I think you do. I think if there were comparatively a rise in terrorist actions from unaffiliated Muslims who had not been in contact with organizations that actively seek to use them as a suicide attack it would be perfectly reasonable to step back and go "we don't know what this person was thinking, we're not going to blame this on anyone but the perpetrator without more evidence."

How do we know all of these Muslim Extremists were actually in contact with ISIS/ISIL/Taliban? Maybe these organizations merely take credit for the attack to make themselves appear more dangerous.

To my knowledge, there isn't a white-supremacist organization that is pushing people into terror attacks.

They view anyone that isn't straight and white as sub-human, little better (if at all) than animals. Many white supremacists want to kill all gays, Jews and non-whites. That alone is enough to encourage murderous terror attacks.

While it's certainly correct to condemn the ideology, blaming white supremacy for a school shooter that drew swastikas on the gun in not the same as blaming militant Islamists who directed the terrorist to act and then took credit.

Why not?

These groups are not boogeymen, there are 4 specific organizations that are responsible for the majority of terrorism globally. So far as I know, white supremacy lacks anything comparable, the closest you get are some prison gangs, and I'm not aware of any major terrorist attacks conducted by them.

And there are major, distinct white supremacist groups that are likely responsible for most of the white supremacist led attacks. The Aryan Brotherhood, The Aryan Nation and the Ku Klux Klan.

Ultimately, my point is that terrorism is terrorism because it's done with a purpose. Someone acting at the behest of ISIS is doing so to destroy the west and advance the goal of a single Islamic world government.

Even in a case as clear cut as neo-nazi attacks a synagogue, you can identify the ideology that led to the problem, but you don't know what the person was trying to accomplish.

They were trying to kill anyone who wasn't straight and white. That will always be the goal of white supremacists. They want anybody that is gay, Jewish or non-white dead.

tstorm823:

generals3:

It's even crazier when you realize a spending of 20% of the premiums on profit is huge for an insurance companies. I know of (big) insurance companies that make much less on premiums because claims (+expenses) are close to premiums (with a big part of profits stemming from their investment portfolios).

The 20% remaining isn't all profit, they have to pay all their non healthcare expenses as well. The issue isn't the proportion, it's that the proportionality exists in the first place. It takes away the incentive to provide inexpensive treatments like generic drugs and incentivizes paying for things like brand name drugs deliberately so that they can legally increase premiums the next year.

I still have to ask what has to be included in the "80%". Because as far as reporting and follow up goes the only ratio used for such a regulation i can think of is the combined ratio. And a combined ratio of 80% would be a wet dream for big US non life insurers.

Now I must admit I don't know how it works in the US but over here it is the doctor who decides which medication is prescribed. There have been plenty of government campaigns to push them to presribe generics over brand name drugs. I would consider it quite weird for the insurer to be the one who decides which drug you should take for your treatment.

And on the other hand without limitations on the combined ratio insurers could theoretically demand ever higher premiums. And while competition could reduce the effectiveness of such tactics I was under the impression the healthcare insurance business is not as competitive as it could be due to stupid regulations? (And let's not forget that even with competition the customer can be fucked due to price fixing as is done by the pharma industry in the US. They deny it but when several pharma companies continuously increase the prices of the same drugs quasi in synch something fishy is clearly going on)

EDIT: And how would you feel about the government taking over the role of health insurer? They wouldn't gain from increasing premiums to increase their profits because premiums would be taxed and profits would be used not to tax more. And they wouldn't benefit from forcing people to take brand name drugs over generics as that would require them to increase taxes to subsidize big pharma (which would make the government unpopular). It would effectively allign the patient's interests with the insurer's interests. And that's without getting into how the government would have a much greater bargaining power than all those small individual insurers.

generals3:
Now I must admit I don't know how it works in the US...

Assume the most prone to corruption method available - that's what there is.

tstorm823:

My favored solution is breaking out the ol' anti-trust laws and dissolving the cabal of middlemen that artificially maintain outrageously inflated prices. The current health care landscape has all the downsides of government healthcare (bureaucracy, inefficiency, unaccountability, and corruption) without any of the benefits, and I'd prefer to tear down the system of insurers and benefit managers who've been allowed to make decisions on your behalf but for the benefit of others. These people are supposed to have a fiduciary responsiblity to their clients, but are truly acting on behalf of their own monetary interest.

To clarify I understand your position: are you thinking of a system in which people do not require insurance, and in which the only direct relationship is between the individual and the (private, for-profit) healthcare provider?

tstorm823:
Ultimately, my point is that terrorism is terrorism because it's done with a purpose. Someone acting at the behest of ISIS is doing so to destroy the west and advance the goal of a single Islamic world government. Even in a case as clear cut as neo-nazi attacks a synagogue, you can identify the ideology that led to the problem, but you don't know what the person was trying to accomplish.

Yes, we do know what they were trying to accomplish: cleansing "white" countries of what they regard as foreign racial and cultural pollution. The individual may be relatively muddled, but the same themes (such as fighting or kicking off a culture/race war that will result in destruction or expulsion of foreign-ness) go all the way through.

Many aren't that different from many Islamic terrorists. Lots of the ones killing in the West seem to have backhistories of crime and drug use, and they haven't met an ISIS recruiters. They're fucked up individuals who went further off the rails and self-radicalised via the internet. Sure, ISIS claims the kill, because that's ISIS PR[1].

Thing is, rules of competition don't exist in this market. In many places, major healthcare providers have been allowed to buy out entire counties worth of doctors offices. 3 or 4 national chains control most of the entire retail drug industry. 3 pharmacy benefit managers own almost the entire market. Companies like CVS have vertical monopolies that manage every step from the doctor to the drug manufacturer to your personal pill bottle. The dodgy things you describe might be happening behind a thousand closed doors, but it's a largely coordinated effort. The web is woven so tightly, there's not competition, there's collusion.

A single manufacturer shouldn't be able to declare epipens massively more expensive on a whim. Insurers trying to act in their clients interests should reasonably say "look dude, we'd rather ask our patients to learn a different less expensive epinephrine injector than siphon thousands of dollars from them to you." That attempt was not made. Insurances paid specifically for epipens at price gouging levels. That's coordinated, and assuredly responsible for some amount of premium increase.

It seems obvious to me that pharmacy benefit managers are likely to be dodgy as hell. I understand the utility of a dedicated large corporation that can manage drug procurement and distribution where a host of smaller suppliers buying directly have far weaker economic leverage, but I suspect there's a great deal of inefficiency mixed in there too as the pharmacy benefit managers look to maximise their profits. However, there's no guarantee that insurers actually have the power to break this system: that pharmacy benefit managers have expanded their operations so pervasively and successfully in the first place suggests that's where the leverage currently is. Collusion may occur, but I don't think there needs to be any collusion at all: just a pattern of where economic power lies, deals and profit motive is quite enough to create sub-optimal outcomes for the end user.

In the case of your epipens, what's possibly going on is that they sign a package deal gets certain drugs (I don't know modafinil, citalopram, whatever) at a massive discount, but at the cost of also accepting other products at higher price. Overall, the cost is potentially lower for the insurance company and customers as a whole, but that some individuals really get it in the neck if they're unlucky enough to be on non-discounted medication. As for manufacturers massively increasing the price at a whim, they totally have that right under free market principles. As we know, this causes a great deal of unhappiness (consider the recent daraprim affair), but if they can they may as well do.

The UK I suppose has a de facto pharmacy benefit manager, except that it's an arm of the entire national health service. One might argue it's a monopsony, but it's absolutely amazing at getting drug prices down. When the USA is discussing trade deals with the UK and opening up the NHS, a lot of what they mean is breaking this system so Britons pay more for drugs, to the benefit of... well, not the British people, that's for sure.

If you want to break these sorts of problem, as the free market seems incapable of doing so, it seems you would need government to step in. But then you need a party willing to seriously interfere in business, which is to say not the Republicans.

* * *

Schadrach:

It certainly reduced my employer's health care costs. As the ACA went into effect we had 15-25% rate increases every year. They had to let a couple of people go late last year, which put them below the magic number and let them discontinue our health insurance entirely. Which means I'm now on the marketplace, which raised my insurance premium by another $50/month, after applying the estimated tax credit in full. For worse coverage.

On the upside, my fianc? starts her new job next week, and we're getting married around when her training is over. It's a state job, and public employee insurance for a couple is much less than what I'm paying for just me on the marketplace.

Sorry to hear that - but unfortunately some people get the dirty end of the stick in the great big merry-go-round of life. Some people get a tax increase, for which others get a useful bus service.

I don't think anyone believes the ACA is perfect, but on a gross utlitarian measure it's better than its predecessor.

[1] There's a 30-year old comedy fantasy novel by Tom Holt - I think it's "Expecting Someone Taller" - where there's some kind of explosion at an airport and half a dozen terrorist groups claim it was them - it's what terrorist groups have done for decades.

generals3:

Now I must admit I don't know how it works in the US but over here it is the doctor who decides which medication is prescribed. There have been plenty of government campaigns to push them to presribe generics over brand name drugs. I would consider it quite weird for the insurer to be the one who decides which drug you should take for your treatment.

The doctor decides what is prescribed over here too, and some states (like mine) have additional laws that require pharmacists to fill with an identical but cheaper generic if one exists unless specifically ordered otherwise.

The thing is, the insurance decides what it's willing to pay for, which means a whole hell of a lot.

For example, my marketplace plan has a different formulary than my previous plan did. I'm currently on two drugs, and they're both "keep taking these or you'll die in a horrible fashion in a few short months" kind of drugs. There are several drugs in that general class, and for the two specifically I'm on one of them has two brands of the same drug (though with different delivery methods), and the other has a functionally very similar but chemically slightly different drug. I had to get my doctor to switch both of them to the other option this year, because my marketplace plan offers those two on $50 copays each for a month supply, but provides no coverage at all for the two I was on before.

So while my doctor could just continue to prescribe the same drugs I was on, the insurance would have offered no coverage for them at all. Which means that functionally, the insurance really has the deciding voice in what I'm taking.

EDIT: I HATE AUTOCORRECT!

Trump Honors D-Day Veterans:

Agema:

Sorry to hear that - but unfortunately some people get the dirty end of the stick in the great big merry-go-round of life. Some people get a tax increase, for which others get a useful bus service.

Thing is, my situation is far from unique. Large rate increases each year for employer health insurance programs as the ACA rolled out are not exactly rare. The largest employers can absorb much of that, but smaller ones generally can't - I was paying less than $90/mo pre-ACA and more than that per paycheck last year.

The same kind of thing is why I oppose the whole $15 federal minimum wage thing - cost of living varies *wildly* from place to place. It makes more sense to adjust the minimum range regionally, either statewide or even municipally to take that into account. While $15/h could barely get you a cardboard box in one of the shittier allies in San Fran, people making $15/h here can afford to buy a house, so long as they don't shoot for anything crazy (I bought a 1400 sq ft single story 3 bed/2 bath on a flat lot not in the floodplain and less than 10 min outside Charleston last year for ~90k).

Agema:
I don't think anyone believes the ACA is perfect, but on a gross utlitarian measure it's better than its predecessor.

It's exactly what you'd expect from a healthcare reform that wants to make sure the health *insurance* industry is well taken care of, in exchange for not letting them refuse paying customers just for needing the product being sold.

Schadrach:
The same kind of thing is why I oppose the whole $15 federal minimum wage thing - cost of living varies *wildly* from place to place.

I support the $15/hour federal minimum wage, but it must be backed up by targeted subsidies and tax breaks for small employers (actual small employers, not major employers claiming to be small businesses via accounting conjury), strict housing market regulation, and large-scale infrastructure spending for less-developed regions. And honestly, a national health care system, and transition to progressive payroll taxation, would be an excellent first step towards developing that economic landscape.

Saelune:
Trump Honors D-Day Veterans:

Jeez! It's like an Internet Troll giving a press conference. Where the heck are the mods!?

Schadrach:
It's exactly what you'd expect from a healthcare reform that wants to make sure the health *insurance* industry is well taken care of, in exchange for not letting them refuse paying customers just for needing the product being sold.

Yeah well. That's what happens in a country that believes in the rights of businesses to make profit anywhere and everywhere more than it does the right for people to have healthcare and a political system that promotes obstruction.

Don't worry though: the Republicans are well on their way to breaking the ACA (through the courts, of course, because it's already sufficiently appreciated that they don't dare take the political hit by legislating against it). They'll talk loud about a new healthcare system for 2020 when the idea's fresh in everyone's mind, which will of course be dropped or lost in the usual legislative hell by 2024, and it'll be another few decades of fruitless gridlock. Back in the pre-ACA world, you might well get a better employer scheme. Millions of Americans will go back to no healthcare coverage, but that's what they deserve for being poor.

Agema:
, but that's what they deserve for being poor.

Poor people should just get a small loan of a million dollars from their fathers to stop being poor

Duh

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