Comments by "Xyz Same" (@xyzsame4081) on "The Hill"
channel.
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
Larry Wilkerson Chief of Staff to Colin Powell: Obama might have risked being assassinated if he had chosen an anti-war, anti deep state stance. source - scroll down
*
Wilkerson: ...If I call President Obama for anything, it was his
timidity, and his lack of courage. His lack of courage with respect to
politics, and his lack of courage with respect to particularly his last
three years in office. Where I know from talking with him personally,
talking with him in the Roosevelt Room, that he understood. He said [to
me] there was a bias in this town towards war, with his Secretary of
State sitting beside him. He said quote : "There's a bias in this town
towards war" unquote. Well, he went on for another 20 minutes to
elaborate on that.
Well, Mr. President if you knew that - why didn't you start doing
something about it ? I mean, he could have done a lot more, if he'd had
the political courage to do it ..... I think it's because, first you get
trapped in that environment, and you want to make lots of money, and
you wanna be very happy, and you wanna be very satisfied when you leave
that office, especially if you're as young as he is.
And you realize that if you start these fights, if you start these
battles, not only might you be assassinated, you're probably going to
leave without anything like the dignity, and the honor, and the
emoluments, and the fortune that he left with.
And I don't say that lightly, that's a very difficult decision to make,
when you stand up for principle, when you stand up for the country, when
you are a true patriot, you usually are punished, not rewarded.
* It is at 5 : 10 of the interview - I posted that part of the interview as full transcript (I shortened it here) in the youtube comment section under the video. The Real News always embed the youtube video on their site and they often offer a transcript on their site as well but not in this case.
I am always very interested what Wilkerson has to say on foreign policy. I found that statement remarkable. (So it is not just me with the tinfoil hat on ?....)
https://www.youtube.com/watch?v=eMO4o5nRGQs
Wilkerson: Practically Everyone Opposes Trump's Reversal of Obama's Cuba Opening, the video is from June 2017
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
@davidcase1286 If all that migration, differences in age, levels of wages **, lifestyle (diet, alcohol, cigarettes) produce some difference in SPENDING, but in a relatively narrow range - and on the other hand the U.S. as much younger nation has DOUBLE the spending - what does that tell you ?
** Japan, Denmark, Sweden, .. have high cost of living. That translates to higher wages for qualified staff like nurses, doctors. And wages are an important factor for healthcare spending.
The explanations to spend a little more or less and for legitimate differences, are DWARFED by the dysfunction and waste if the private insurance companies (and also for-profit hospitals) are allowed to play a role in the system.
The less private insurance there is in a country the better, even too much supplemental is a sure sign there the public insurance agency is underfunded to pay sufficient rates for comprhensive and good care or to pay for ALL treaments. Or there would be no need for supplemental insurance in the first place.
Even then it leads to higher costs and unfairness (not as bad as in the U.S. though). A mild version of 2 class medical system develops.
2
-
2
-
2
-
2
-
2
-
2
-
2
-
@Bluebelle51 the Freedom Caucus (Tea partiers) dragged the Republican party during the Obama years (one would wish the Squad would show 50 % of that fierceness with their party leadership). They cost Boehner (a normie Republican) the last nerve. Showing fierce boldness and not giving a damn is easier to pull off when you do not care about the wellbeing of the voters. (and being selfish is part of your ideology and you find it easy to be an a$$hole).
They had no qualms to force a government shutdown, to lie about ACA (it is bad, but not that bad) etc.
To be fair: they got some negative press, but it is NOTHING like the shitstorm that progessives would get if THEY ever would cause that. After all is said and done the Tea partiers are also financed by the big donors (the same that make sure also to bribe Democrats and normie Republicans). Corporate media is not going to have an ongoing crusade against them.
But they will have a looooong crusade against Progressives on much lesser charges. Let alone being ostructionist to extort concessions from a very unwilling "leadership". then they would go after them for real because then they would become a danger.
Obama put Social Security on the table as bargaining chip *, to get an infrastructure bill with 60 votes after he had won the reelection. The Tea partiers forced their party to forego the golden opportunity.
Republicans (with the notable exception of Eisenhower) had opposed the concept of Social Security since the 1930s. So here they had the opportunity to undermine it (abolishing it would not fly politcally) - and their rabid wing was so hellbent on not letting the Obama admin have successes that they could not take the neoliberarls on the offer.
Many Democrats had objections anyway (Sanders started organizing against it), it is not clear the D party could have kept the offer alive, but the Republican party could not even seriously consider it - because of the rabid resistance of the Tea Party wing.
The word being: rabid. That fierceness is harder to pull off if you care about constituents.
* I guess they would have weakened SS for the future which is not tangible for voters and young voters do not vote in sufficient numbers anyway. But the infrastructure bill would have had immediate and positive results. So also good for those up for election in the 2014 midterms.
After Republicans signalled no support for the infrastructure bill, Democrats tried to pass a rule change that would have allowed them to get a bill passed with a simple majority (they had the majority for that, at least in theory). In fall 2013. Joe Manchin (in Senate since 2010) and two other Senators posing as Democrats refused to go along.
Obama let Lieberman and a few other Senators with a D to their name kill the Public Option in 2009 (that was sold with help of media as: "We did not have the votes"- glossing over WHICH votes they missed, so the low information base could suffer from the impression, Republican votes would have been needed).
I think those defectors were gladly tolerated if not welcomed, Obama likely was glad they did not have to keep the campaign promise (big donors really did not want the public option) and Lieberman and a few like him took one for the D team. Likewise Biden was probably (secretly) happy to see the resistance of "conservative" Democrats against the 15 USD minimum wage till 2025.
But I am sure the Obama admin wanted the infrastructure bill. Likely a lot of favors for donors and kickbacks would have been possible. Usually Republicans are not opposed to that either.
Anyway: Obama and Biden, and Schumer are so feckless that they did not even drag Manchin and the 2 others for blocking something that they really wanted.
If Progressives had pulled such a stunt maybe to extract concessions or to force more green investment (likely it hurt the Democrats in the 2014, even 2016 election) - Corporate media and the party leadership would not have graciously glossed over it.
2
-
I saw an interview with Naomi Klein (Democracy Now Feb. 2021, they talked about the lies about the Texas blackouts, too). She said that Milton Friedman said: in a crisis it matters whose ideas are floating around. Klein: it is important that progessive ideas are floating around, so they cannot overwhelm the population when the next crisis hits. (paraphrased). The likes of AOC and Sanders have changed the discussion, even if they are too weak to drag the party, they still render an important service.
Usually the oligarchs act on: Never let a good crisis go to waste.
They learned in the 1930s, they had to bide their time but they pushed the idea of neoliberal economics, and worked on changing and framing the debate about economics. With thought stopping clichés.
That term is used for cults, but it applies also to terms used in economics. Free market, choice, competition, capitalism, freedom, these are words that are thrown around. People do not think it through (it does not hold up).
Economics as social "science" is soft science at best. But with economics we have a situation like in the movie groundhog day. No matter how many times they rise the minimum wage, invariably they will paint doom and gloom scenarios and invariably they will not come true.
Reality does not count and the claims are not impacted by facts or past experiences, and slogans are used to "settle the debate" in cults and in neoliberal economics.
Economics has been a tool of domination for a long time. In dictatorial monarchies (or republics) they could force certain economics on people. Brute force costs a lot of resources, so they prefered mind control even then, and people resigning themselves to the sitution. Organized religion helped with that: God had made the world like this, the monarch had his authority from god, and the peasants thad to obey.
That line of reasoning does not work anymore. Now it is the invisible hand of the market. Anonymous "market forces" have replaced the "will of god". As tool of propaganda.
Now the peasants have the vote. they could demand the minimum wage if they would be sure it does not cost jobs, ruin small businesses, or increase inflation substantially.
Sanders has changed the discussion on M4A - depite the resistance of mainstream media and the establishement of both parties. That is a huge ! accomplishment.
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
In Germany there was a wealth tax even on NORMAL homeowners, it did not have to be a mansion, nor were these RICH people. Loans were offered for that - because people did not have money (which was devalued anyway) or other assets they could have used to pay the extra solidarity tax. (solidarity with those who had lost their home to bombs, or they were refugees, who had to leave a region and lost all property there (Czechia, Poland, also Romania which had a German speaking minority that was exposed to hostility).
After some years a part of these loans was forgiven, the economy had recovered enough to make that TAX unnecessary. That was the reason for offering the loan, you cannot bite off a house, if you live in it, you might not even be able to rent it out.
I remember Dirk Mueller saying that his grandmother sewed till late into the night, so she could pay the installments and could hold the house for the family. Now, they may have made concessions for families with smaller children, who lived in the home.
If they had space they were ordered to take in refugees, until the government created provisory and then permanent housing for them.
They did not invonvenience the STILL rich people too much (and still rich meant they had routinely, glady or enthusiastically cooperated with the Nazis), the Conservative government then leaned HEAVILY on the middle class, those had already their fortunes in gold, jewels had it transfered to another place already.
Those who had a shop, manufacturing shop or plant or inherited it (or a farm), were not bothered.
Now, they could not have paid any tax and were important elswhere.
As you can imagine having a farm then was a good thing, they always had enough food, they could make some money under the table (although that too profited more those who had larger farms.
If the loyalists to the Nazi regime had stocks of things (I do not means shares) or manufacturing equipment which was not seized - it often was in the Soviet occupied zone - they were ready to go in the new REAL economy. And were set up to be the winners againt. That much for "inequality".
Having a lot of money in form of German Mark was not important then (they had a reform and the money lost its value, AGAIN. The rich Nazi collaborators no doubt had ways to get money in form of another currency into countries like Switzerland.
One "entrepreneur" controlled the supply of garments, there were quotas, who much the population could buy. Then he hid the supplies towards the end of war in a cave, so he seized what was public property (they got these textiles with the help of the Nazi government and he was supposed to distribute them in a fair manner to the other citizens) - and then started over once the war had ended.
The Allied Forces usually did not lay a finger on those crooks, even if they had used forced labor from other countries (people kidnapped for instance from Poland, or worse from concentration camps).
Well the Soviets were known to shot Nazi collaborators, but not in the other areas, the capitalists from the sider of the winners, propped up the other capitalists).
2
-
2
-
2
-
2
-
2
-
2
-
2
-
2
-
No opting out ! from the payroll tax - that would be the public option. It means that some choose * to have full coverage by private insurance and others have full Medicare coverage (or the single payer agency that they are assigned to).
* In reality the insurance companies make that choice in the way they make the offers, the patients they do not want get a prohibitively high offer.
btw no nation does that on a large scale - neighbour country Germany has the "public option with the opt-out of the privilged". The allowe the "choice" for affluent citizens (and certain professions that can be expecete to have a good, safe and rising income) to have full coverage by private insurers.
That results in cherrypicking of course. And some (minor) distortions and inefficiencies. That is more a historic relic (when the system was founded in 1884 a two-class society was taken for granted, after WW2 right governments doing favors for private insurance companies, doctors and affluent citizens. Private insurers playing more of a role in the system does not make the system better, more cost-efficient or fairer.
In Germany only 10 % of the population have full private coverage - so they enjoy the benchmark and the protection of the 90 % (what must be covered, inflation rate in medical services). When the population takes good healthcare for granted the private insurers cannot play games with the privately insured when it comes to coverage (never mind many lawyers are among the inusred).
Public option with the possibility to opt out allows the private insurance companies to cherrypick.
A point that is often overlooked: public option / opting out undermines solidarity among the population. That means less political leverage for sufficient funding. and less corrective forces if the agency does not put the budgets to good use.
Nothing like having the affluent citizens use the same system as the low(er) income people to make sure the system is cost-efficient AND good quality.
With the Sanders plan a person can go to a doctor that does not have a contract with Medicare and pay out of pocket (but no insurance coverage, duplicative coverage is outlawed).
If almost all providers (doctors, hospitals) accept the public contract and services are good (and that is a question of reasonable funding) patients will almost always use the services free at the point of delivery.
The mandate (another very important pillar of the reform) makes them pay in form of payroll taxes, the very wealthy additionally contribute with general (wealth or higher income) taxes - they can as well use what they pay for.
The rich will have their out of pocket private doctors of course - but in well run single payer systems the affluent and regular citizens meet in the ER or use the same hospitals where they get the exact same treatment (provided they have the same medical scenario).
The public non-profit insurance agency can keep it simple (no marketing, sales staff, profits - which even ethically acting for-profit insurers have).
The agency hase task to collect the contributions, negotiate rates and pay the bills, plus thinking about preventive care, software solutions - all public non-profit agencies on the planet have figured that out - the private insurers simply cannot compete.
If for-profit insurers have a role it is because governments were doing them favors (always with higher costs) or it is a developing countriy with minimal basic coverage and the affluent buy the upgrades. (Thailand has a universal system, but I assume there are differences and not all patients are "created equal").
If a service / treatment / drug is covered by Medicare For All the private insurers are not allowed to offer coverage for it (under the Sanders proposal). Private insurance is not outlawed - it is made obsolete. With a package of coverage that is good and comprehensive..
No duplicative coverage.
So only out of pocket paymments for doctors that do not have a contract with the agency (which is a deterrent for patients and also for doctors - they have to chase payments or always ask for upfront payment).
Almost all other candidates that are still in the debates have a fake Medicare for xx proposal that is a variety of public option. That is no coincidence: it is plan B of the insurers now. They know some change will come, and that is their best bet to keep a significant share of the "market". The public option (that allows some to opt out) offers them the best chances to undermine any meaningful reform. (and it is easy to deceive the public, giving more "choice" seems innocent, a little tweak of Medicare for all).
90 % of spending in healthcare is caused by 10 % of the insured. The insurance companies in other countries have healthcare more as a fringe issue (supplemental for the most part, especially if for some historic reason things like basic dental are not covered. Typically the private insurance covers the services of specialists, they are not interested in the expensive stuff like surgery in hospitals).
These insurance companies do not have the hordes of beancounters. It would not warrant the costs. Also: if they are fringe players the chance to maintain ! regulation is much better.
Not so in the U.S.: the for-profit insurance companies are predators, they have the Art Of The Purge perfectioned. And the lobbyists and professional gaslighers are already at work ! (Warren was the last to backtrack from genuine single payer)
With a public option the young and healthy would get offers that seem to be reasonably priced (but are anything but - considering the cherrypicked pool).
All the patients with higher risks or costs will land with Medicare. Which is stuck with much higher spending.
Currently the Medicare agency already has the most costly group over 65 years, so the private insurers in the U.S. already have a cherrypicked pool. Likewise Medicare is not allowed to negotiate drug prices - but private insurers could (they have no interest though).. They had the opportunity to shine with the advantage that was handed to them - and look hat they made of it.
2
-
Less efficient use of the funding by for profit insurers is systemic (even if they are honest). They always need higher budgets and on top there are incentives to game the system and they bring higher complexity into the admin.
As for wrong incentives because of profit: The range is from some tolerable distortions (Germany, ….) to considerably higher costs but at least good services (Switzerland) to predatory and ruthless behavior in the U.S.
If the opt out is possible the for-profit INSURERS WILL CHERRYPICK and the public agency has to deal with the most costly partients. It will be easy to badmouth it and to defund it (even though Medicare puts the budgets to much better use, less than 3 % overhead versus 20 %, much simpler admin and better negotiated rates).
ALL healthcare insurers (non-profit agenies or for-profit companies) are middlemen and with that service (healthcare) the public non-profits without exception beat the heck out of the private for-profit actors - everywhere on the globe.
The single payer agency has almost an monopoly and allows for a very streamlined admin and clarity (as opposed to countless insurance packages, no clarity who has what coverage and with or without co-payments). It covers ALL that is necessary from a medical point of view, so no deductibles, ideally basic dental is covered as well, etc.
Monopolies screw consumers if they are for profit, but as a non-profit they act for the benefit of the insured (which are the much weaker market participants in healthcare). That may seem "unfair" to doctors who more or less have to accept the contract even if they would prefer to work with private insurers which pay them higher rates.
- but the patients also do not have a choice - so there goes the "fairness" argument
With consumer products the citizens have the most important of all choices: to not buy at all - they do not have that power with healthcare.
U.S. doctors (at least a part of them especially specialists) have a higher income than doctors in most other wealthy. Sure first they have to pay back the high costs of medical school. - which is free in most other nations. But even so - over lifetime they make much more money. (Of course U.S. doctors with their own practice have to finance the staff for the insane red tape and billing, and spend 3 weeks per year on the phone with insurance companies).
On the other hand the doctors in other weatlhy countries are still doing fine (much less red tape and they hardly ever have to contact the agency to get clearance for a procedure. That is very rare).
It will be a political / societal decision if U.S. doctors (at least some of them, typically specialists with their own practice) continue to get those higher incomes (financed with the revenue from Medicare).
In that case Medicare will need higher budgets so they can pay the higher rates. And the spending per person will not get to the level of other wealthy nations - but at least it will not be as ridiculously overpriced as now
The American Medical Association has of course made sure that only a restricted number of doctors graduate and there are many hurdles to accept the certification of doctors from other countries. So they kept the "prices" high and competition down. (AMA was also fiercly opposed to Medicare in the 1960s, they almost prevented it)
The almost monopoly of a non-profit public healthcare insurance ageny means:
very streamlined admin, simple billing because there is only ONE insurer and one kind of coverage ("Single Payer"). The always achieve lower rates for doctors and hospitals compared to the many private insurers. But the doctors and hospitals save on administrative staff as well. Which is one of the downsides of public option as one of the many insurers (even if they are not predators like in the U.S.) it squanders the cost savings of a very streamlined admin.
Most of the doctors (if they are not capacities in their field or offer a speciality like accupuncture) must accept the contract of Medicare. Else they would not have enough patients. No duplicative coverage: if Medicare covers something then the private insurers are not allowed to offer insurance for it. That restricts the private insurers to the fringes where they belong (for healthcare !).
2
-
Healthcare is unusual - the mechanisms of "free market" do not apply. At. All ! (same with natural monopolies btw). - Single payer nations removed the profit motive from situations that are complex. (Complexity always helps the profiteers to sneak in profits, and to game the system - at least a little bit. And it even allows for predatory behavior: Regulators cannot help to contain that, they would have to monitor EVERY medical situation resp. decisicion, which would be very costly and intrusive).
Single payer nations removed the profit motive from situations that are complex. If the doctors have no pressure (to withhold treatments or to apply without necessity) and the system is set up with proper funding they will do the right thing to the best of their professional knowledge.
So doctors will tend the broken bone with the adequate care which might be simple if it is an uncomplicated break - and are free to ramp it up if there are complications. (And they never ask the public insurer for permission, the agency only sets the framework for the doctors to make the decisions and have the necessary tools).
One of the most important reasons why healthcare is a terrible fit for the free market:
In a free market all participants must have about the same power. - "Choice" is meaningless, the consumers cannot _choose to NOT have healthcare, _and the complexity is such that even doctors consult other experts if they need treatment. The consumers have a massive information disadvantage. Medicine is complex and billing and contracts can be MADE complex to put consumers at a disadvantage.
With healthcare all humans have the same needs, and healthcare (the admin incl. "insurance" and the delivery of medical services) is very standardized.
Product differentiation (be it in the insurance part which is ONLY admin ! or the delivery) does not make sense. So profit does nothing to make better healthcare available for the patients - and therefore it makes no sense to make for-profit insurers the gatekeepers. Rich people can always pay out of pocket, but for the overwhelming majority the insurer (non-profit, or for-profit) will be the gatekeeper to getting medical services.
Likewise non-profit hospitals will always beat for-profit hospitals. Certainly in 99,9 % of the cases regarding general care. There may be very ! rare exceptions, but I think many of the prestigious clinics (some of them in the U.S.) that are on the forefront of ground breaking surgery, cancer treatments, research are private non-profits anyway. When it is basic research there is a very good chance they get public funding.
For services that are a good fit for the free market (so not healthcare ! or natural monopolies) it makes sense to have very differentiated products. And profit is the reward for entrepreneurs to cater to those NICHES. There is the need for marketing and a sales staff etc. - but for THOSE products it is necessary so that the consumers "find" the product. These costs are necessary expenditures for the variety of offers.
.
Consumers have different needs, preferences and we accept that not all can afford the same.
What would be the basic version of a life saving surgery versus a gold-plated one ? What is the basic version of adequate care for a uncomplicated broken bone versus a luxury version ? Even a rich person would not want to have unnecessary X-rays and surgery (never mind what their insurer could be deceived to pay based on their platinum plan). On the other hand there could be cases where a seemingly harmless break needs more medical intervention than usual.
The incentive to sell more (typical for not necessary consumer products) would be toxic in healthcare. Marketing is not necessary. If people need surgery you do not have to convince them that they want it.
Profit does not help to make healthcare better, the less for-profit there is in a system the better. Theoretical condiserations and obersation confirm that - the U.K. has the lowest spending per person on healthcare for any wealthy ! nation. 42 % of the U.S. spending per person, versus 50 - 54 % for most (the range is 47 - 56 % and outlier Switzerland that relies on private insurers only with 78 %. The base is U.S. spending per person in 2017 of USD 10,260).
The U.S. does not have "single payer" they took it one step further. Germany was on the frontier in 1884 (but as often the case the early adopters have some quirks and live with them if they are not too bad). The U.K. did good in 1947, they learned from the experiences.
The NHS has been defunded for the last 10 years (and they had a lean but sufficient budget to begin with).
Plus post-war U.K. did not include basic dental, so needless to say that is expensive.
.
But if the NHS had sufficient funding (putting the UK still among the wealthy nations with the lowest spending per person) the NHS would run like a charm.
But then there would not be any pretext why there should be a (partial) privatization. The Tories have been hostile towards the NHS since its foundation in 1947. They just had to become more sneaky about it because all voters love it. Most wealthy nations spend 8 - 11 % of GDP on healthcare (19 % in the U.S.) the Tories always found it offensive that such a market should be off limits for the "investor and landlord class".
2
-
2
-
2
-
2