Comments by "Xyz Same" (@xyzsame4081) on "NowThis Impact"
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The lobbyists have been working overtime, their contingency plan is now Public Option. NO wealthy COUNTRY has the public option - and with good reason (maybe in some emerging or developing countries).
relevant candidates that jumped onto the medicare bandwagon have now switched to a public option (but they disingenuously still call it Medicare for xx). Incl. Warren, she is just sneaky about it. First public option with an epic battle and then after 3 years another epic battle to get Single payer passed ?
In these 3 years the insurers will have kicked out all costly and highe risk insured / patients. And single payer may never come. Of course the "reform" squanders the chance to simplify administration, there are still a lot of insurance plans out, billing stays insanely complex, etc.
I currently live in Austria, if voters were so foolish to allow a public option (with the possibility to "opt out" = in the U.S. that means: "You can keep your private plan or your union plan") - it would slowly erode the well established cost-efficient FAIR system.
In the U.S. public option has the potential to undo the reform while the system is in the VULNERABLE transition phase (when there are costs of transition, the cost savings of preventive care and streamlined admin do not yet fully manifest, there may be hiccups, there is a backlog - underserved patients, harm done by badly managed diabetes - 20 - 25 % of patients, opiode crisis etc.)
The insurance companies would like to go back to the times before ACA but that won't fly. They know the voters (who unfortunately - for them - still can use their vote) are getting restless. P.O. is the best chance of the profiteers to keep the most lucrative segment (the young and healthy), to stay relevant and then to work tirelessly to hit back and sabotage the reform.
Democratic politicians on their behalf killed the public option early on in 2009 - so now a decade later they would accept it as the lesser evil. But certainly not even that w/o a major fight.
If Warren has any political instinct at all or insight into how other countries are doing it (in detail and what keeps their system straight) - she wouldn't even make such a proposal (allegedly a person wrote the plan how to finance and implement her version of "Medicare" that was involved in ACA.
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One of the major rules of single payer: do not have large powerful profiteers in the system. Not hospitals (countries can manage to have a mix, but it is not ideal). And definitely not the "insurance" part, they are glorified middle men. Healthcare is a service where the "free market" and "competition" does not work at all, and the profit incentive does not get you a better product. On the contrary with healthcare for profit creates toxic incentives and at the minimum the need for regulations. That means more red tape and of course with the inherent complexitiy of medicine there are possibilities to work around that. Which creates MORE red tape.
The insurance companies can spend 2, 5, 10, ... dollars to make 1 dollar MORE in profits. They can pass on the costs, what are the insured gonna do about it ?
With a consumers product consumers could use their super power if they do not like price, quality or they cannot afford it: to NOT BUY AT ALL.
Wasting money for red tape to circumvent regulations or just to increase profits in other ways would not fly with other services and products.
On the other hand there are correcting factors * that guarantee quality and cost-efficiency of non-profit public insurance agencies and hospitals.
See all the other wealthy nations.
All the population is covered, low-income to wealthy, it is much harder even for right wing parties to attack the agency or cut budgets (if the agency has enough budgets they can pay reasonable rates so the hospitals and doctor practices have enough revenue).
the service is very tangible for the voters. all age and income groups use it, when they need it big time, they are emotionally involved. They remember if they had a good or bad experience.
Plus it costs a lot (even when the system is cost-efficient). And it costs more, the population is ageing and modern medicine has become more capable but also more expensive. So there is pressure on the non-profit players to stay within the budgets and they find the lard if there is one.
Medicine and the admin around it (and that includes "insurance coverage") must be very standardized - there are blueprints how to set up things (like running a hospital, making the surgery theater ready for use, how to set up a doctor practice).
Marketings skills, retailer networks, creativity, or consumer preferences do not play a role. Solid (boring) quality is enough. (the overwhelming majority of medical interventions are no spectacular medicine. people managing their diabetes well, getting the population to use cancer screening beats high tech medicine. you want the organ transplants (diabetes can damage kidneys) and the latest version of chemotherapy.
But preventive care beats that when it comes to the healthcare outcomes for the nation at reasonable costs.
And you want the insured to err on the side of caution when they have symptoms. Sure it could be "nothing". The fear of overuse of the system (when it is free it has no value) is not based in reality when you look at the large picture: for one hypochonder there a 2 manly men that are dragged to the doctor by their wives to check the symptoms, and 3 other persons who should have gone much earlier to catch something right in the beginning (early diagnosis = lower costs for treatment and /or better outcomes).
As for "generic"
An uneventful hip replacement, a routine stent surgery is a good thing. But no one wants a "boring" car. Or generic garments.
So public agencies can do a good job with the admin around healthcare ("insurance"). As the data ! shows worldwide they perform well - but we wouldn't want them to design cars, or clothes.
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Operation Crosscheck (purging of ethnic / minority names by the millions in Republican run states in 2016). Greg got the data base and he contacted the Democratic party (I think even the Sanders campaign). No reaction, no coverage of Corporate media.
So there is also a fear and hesistance to even touch the issue, to speak out the unthinkable:
That one of the large parties meddles with the elections on such a scale.
The big donors that finance BOTH parties want quiet in their empire, they do not want the unwashed masses to start questioning if this is even a democracy. Once The People start organizing in masses the rulers cannot withstand them, and information that could outrage voters is the first step to get such a mass reaction.
I assume Sanders choses not to have that battle, media and establishment of both parties would come down like a ton of bricks on him, if he dared to imply that the integrity of elections is not guaranteed. He would be labelled as conspiracy theorist.
The Republicans might have been hindered to fully pull off Crosscheck, independent media reported a lot, it could have blown up on them, not sure how many of the names they had preselected for purging were actually removed.
They CHOSE to not even do the easy plausibility checks: like comparing birth dates or middle names when they filtered out the names - so they had no intention to do a legitimate purge.
If a Robert Brown had voted at several locations / states in former elections the name and registration in for the several * states got INTO the selection destined to be purged.
(* only in Republican states ! that participated in secret Operation Crosscheck)
The claim was that a person had voted more than once. No comparsion of birth date, or plausibility check. Like the limits of time and space: unless it was "Scotty beam me up" it was impossible that all the Robert Brown votes came from ONE person.
The Republican run states did not include the Democratic run states in the scheme. Voting more than once is a crime that carries up to 5 years in prison. They kept the whole project secret (until someone leaked the database to Greg Palast).
The Republicans also did not prosecute or reprimand the alleged "criminals" - or inform the public about the widespread outrageous violation of voting laws. They just threw them off the voter rolls. In the parRepublican states.
I would be very surprised if they don't try that or something like that in this election cycle.
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Russia interfered allegedly in 2016 ? They have nothing on the Corporate media AND on the DNC / Clinton machine. What does interfere even mean ? Trollfarms ? The CIA likely has more and has the better budgets. The U.S. media and letter agencies do not really think facebook ads for USD 50,000 before and 50,000 after the election (spent by "Russians" not necessarily political or government actors) and gooogle ads for less than 5,000 USD changed the outcome.
In a race where much more than 1 billion USD was spent. the media gave Trump free airtime worth hundreds of millions of USD in 2016. he liberal outlets fawned over Hillary Clinton.
The DNC was captured by the Clinton campaign and very cozy with the big "liberal" networks, to the point where they coordinate. We have proof for that, Podesta emails.
Ed Schultz wanted to report live on the announcement of Sanders in spring 2015 to run. The campaing planned with 30 million in small donations, no one incl. Sanders and Jeff Weaver thought they had a chance. after Warren had declined to enter the primary, Sanders drafted himself, he wanted to push HRC to the left and to discuss some important issues (like healthcare or regulation of big finance).
But Clinton had an "Early State trauma". Especially Iowa where Obama had pulled off a stunning win and with record turnout. She never really revocered from that blow by the outsider. And the guessed the outsider Sanders could do fairly well in Iowa and New Hampshire (oh yes).
So Ed got a call 5 minutes before start and was ordered by Phil Griffin the boss to stand down (for no good reason, he was ordered to cover 2 other issues, one that was trivial, and the other had gotten plenty of coverage the day before).
Ed was a friend of Sanders (a loose connection, but he had him on on radio, they agreed on a lot of policy positions). He would have given him more friendly coverage over time. Free airtime in a non-hostile setting is a god send for a low budget outsider campaign. And since he was then the ONLY challenger for Hillary Clinton (Martin O'Malley entered the race later, it was the three of them in 2016 and O'Malley dropped out soon) it was certainly newsworthy to cover the announcment and to air a short prerecorded interview afterwards.
Well, not when Hillary Clinton and her team can prevent that.
Ed Schultz was fired 40 days later. At that time his fans thought it was because he was openly against TPP. Which is definitely a possibility. But also because the Hillary Clinton machine did not want Sanders to have access to any sympathetic, ongoing coverage (the kind she got on all the liberal networks, and a lot of it). They wanted to nip this in the bud.
Nothing screams "inevitable nominee / strong contender" like having to rig it right from the beginning and to deny an outsider even a small positive.
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@CasshernSinz1613 You are factually incorrect, masks (even DIY sewn masks) do prevent the particles, the mask producers have to do testing to prove the efficacy of masks that are sold as PPE (also against dust, chemicals or other germs). And they were so kind to even test materials for DIY masks. See the website of smartairfilters(dot) com
Not sure if links are allowed by this channel, so replace the dot with . in order to have a link.
They have an article on materials for DIY masks, from spring or early summer 2020. I was surprised how good the (theoretical) protection is.
Theoretical because gaps dramatically reduce effectiveness that is much more important than the material used. (now they wear 2 masks that can help to close gaps).
And the lawmakers and producers cannot control how the masks are worn: If you wear them in a sloppy manner to be defiant, or to avoid fogging of glasses, better fit around the nose would solve that, or to breathe more easily.
A president that leads by example and that explains it to the masses and a consistent message would have helped with that. So it is possible that the Asian countries get more out of mask wearing because the population is disciplined and they are told to wear WELL fitting masks. And they do not undermine that by defiantly wearing it in a sloppy manner when they have to (public buildings, work, ...)
Trump could have positioned himself as leader in difficult times and as someone to follow.
But he ran in 2016 as "outsider" and rebel. That is harder to pull off as sitting president, so he had to find another wedge issue to get people riled up (people that are very willing to be riled up anyway).
And his PERSONAL VANITY was also in the way of modeling mask wearing and mask information and messaging (Dr. Fauci could not overcome that. Dr. Brix said she and her aide were the only ones that wore masks IN the White House
I mean - Trump could have worn a better fitting bandana from April on (when the masks were recommended) and look badass.
One of the recommendations of smartairfilter (dot) com was to use 2 layers of cut up T-Shirt material (cotton or a blend with mainly cotton) - that was a good compromise between comfort (ease to breathe) and protection.
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@evanlaughlin6345 Now the only but major disadvantages of building with loam is if it is exposed to rain, longer times of humidity, or flooding. (and you are somewhat limited how high you can build, I can see 1 or maybe even 2 floors with some reinforcements but not more).
The cheap modern versions (corrugated iron) are not better, they get hot, and do not hold up either, they rust.
Now having a large roof that shields the walls from rain and having a foundation of stones, concrete or brick can solve that.
Loam does not need energy (heat) for its production, people just have to dig it up. The dense loan that is best suited for building is not suited for farming. It is like the layer under soil, but sometimes that kind of material is closer to the top.
a lot of energy is needed to burn the bricks and even more for cement - and loam can be rescourced from nearby.
Stones and sand (for concrete) need transport over distances and are also not easy to win.
Sand is globally becoming a more scarce resource.
I can see how a large pond could be dug out, the valuable top soil is put aside for farming, the material under it is used for construction, and the pond is used to create food, or as reservoire of water.
There was a project in Africa. "mud" buildings are traditional, but do not stand the intense rainy season well usually after a few years they get into trouble, need repair etc. and they are viewed as the housing of the poor.
Who used in the past what they had - like our ancestors. If they had trees they used them, and of course there are no termites in Europe.
Or think the earth homes in the prairie, have you read the books of Laura Ingalls-Wilder ? (I think some natives tribes had them too).
The Litte House at Plum Creek was in the earth (and according to the book derived from a Swedish tradition, at least the person that owned it was a Swede), and the roof was woven branches covered with sods.
Back to Africa (I forget the country)
Having a European style house is a sign of status, and of course it withstands the torrential rains in the season much better.
but with modern possibilties one could merge the benefits of European and African architecture. So they built the school with a solid foundation (stones transported over a distance) that could withstand humidity from the groud up, and a large roof - but the thick ! walls are loam.
And a large roof, that extends the walls. That is cheap, it is energy efficient, ecological, it creates local jobs.
Loam is also good for insulation (in the moderate climate zone), if the walls are thick they insulate well and even out the spikes in temperature. Cool in hot summer, and warm in winter.
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Rand Paul might still have immunity from his infection from spring 2020 (he showed also irresponsible behavior then *) but a) It could have worn off and b) even if he has full immunity, that does not mean that he cannot transmit it to others.
1) currently they know that most people will be immune for at least 6 months, Rand Paul got infected in April 2020. Only over time and in hindsight will it be possible to say how long the immunity will last.
We have the date on measles or polio or the tuberculosis vaccination. Years of experience. In the middle of a pandemic with a NOVEL strain, no one can guarantee that infection OR vaccination will mean an immune person cannot pass it on.
And that is only true for the old variant, at the moment it looks like the natural immunity from infections or that from the vaccines still work on the NEW variants that are even more infectious and / or cause more symptoms (some indication that the Astra Zeneca vaccination is LESS effective against the new variants. That is bad news for those who would prefer to take a traditional vaccine. And every dose that can be produced helps on a global scale).
We have to get a grip on it before the mutations get out of control (highly contagious with the same or worse symptoms).
2) there are infectiuous diseases where the SPREAD is cut off - vaccinated persons cannot transmit it
And there are others - like measles.
No one knows for sure with CoVid19. Globally there are so many cases, there will be plenty of mutations, that can change, too.
There are measles outbreaks but we do not have epidemics so the likelyhood of a mutation (that is worse than the existing virus) is very slim.
We know that measles can be transmitted by persons that do not get sick themselves. Measles is higly contagious, so it overcomes the effects of herd immunity (vaccinated persons should at least be less effective spreaders) more easily. One would expect that an immune person is not a good spreader.
But if the viurs is highly contagious (or improves in that regard while it is mutating because there are millions of cases), that (protective) effect is compensated for.
* Rand Paul knew he had tested positive and chose to use the gym of the Capitol anyway. Then - in spring 2020 - the highly effective treatments that VIPs can get (the president, Rudy Giuliani, maybe also Senators and members of Congress or the Supreme Court) were not even tested.
Sure Rand Paul is younger and healthy so HE had a reasonable expectation that he would be fine, they have good healthcare and could expect to get the best modern medicine has to offer in case that is needed.
He has many older collegues (the average age on the Capitol is certainly higher than among the average populiation). And there is the staff that cleans, does maintaince, runs the cafeteria and gym. These jobs are usually outsourced to contractors so it is not even certain that the persons taking care of the wellbeing of politicians would have health insurance (I read an article that the staff that runs the cafeteria can hardly make it in DC. Housing and rent is very high, and the contractor did not pay much).
Let that sink in.
And then there is the staff of the politicians. Many of them are UNPAID volunteers (then they are young and often come from affluent or politcaly well connected families. Their parents subsidize their unpaid gigs, in the hope that will lead to a career in D.C. later). Plus regular normal staff, they might do O.K. but they are by no means rich (unless they are in a position where lobbyists are doing them favors around 3 corners). The right hand of Nancy Pelosis is certainly courted, but no the usual desk work bees.
There are lots of people that will NOT get the VIP treatments and could not afford them. (Even if they can overcome the obstacle whether they are "important" enough to get the scarce resources).
But Rand Paul could not be bothered to quarantine for 14 days or at least 1 week.
To make things worse: he is a doctor of medicine.
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part 6 why public option is a bad idea ? - Because it has the potential to slowly erode a well set up system (I currently live in such a country Austria) - and in the U.S. it would likely undermine the reform within a few years.
There is a reason no other wealthy country (4 continents, many countries, 70 years, plus 1 billion people covered over time) has a Public Option.
Superficially it would seem to be a plausible arrangement: let the government ALSO offer an insurance plan, as one of the players on the "market" - well that is not how it works.
1) The chance to streamline adminstration is squandered (major costs). The many plans must still be handled, billing stays complex. Doctors and nurses will be still on the phone wasting their time fighting to get treatments approved. Many bills will not be paid, and especially hospitals have to chase the payments even if they get paid eventually.
2) the insurerance companies cherrypick and extract profits from the segment of the young and healthy. 10 % of the insured cause 90 % of the spending. They just have to do the purges (and U.S. insurers excell in that), the public coverage will be stuck with all the high cost and higher risk patients and insured.
That also means that cuts in funding will have disproportiate effects.
3) With purging the pool it is easy to make offers for the young and healthy that seem to be reasonably prices. Likewise it is easy to badmouth the public insurance agency (costs, qualitiy of services one can get with that coverage). It is easy to impose bureaucracy on them that makes it harder for them to do a good job.
(Example: Medicare cannot even negotiate drug prices. Only VA can, they brought them down by 40 %. The private insurers could negotiate, they completely fail in the task of cost control. They have no interest in that (for drugs or other services), they can just pass on the too high costs. What are the insured / patients gonna do ? Not have medical treatments when they need them ?
Defunding can make sure the public coverage will be the inferior offer.
With 5,400 USD per person (take or leave 400 USD) almost all wealthy nations pull it off. The U.S. spends 10,260 USD per person (2017 Kaiser Foundation, also see World Bank).
With the same budget and COMPARABLE pools (not cherrypicked) a public non-profit insurance agency will ALWAYS beat private insurance companies - there is not one example gloabally to the contrary. But of course it is politically possible to create unequal conditions that favor private insurers.
And the Corporate media in the U.S. would help with the disinformation campaign. Private insurance is good after all and public coverage ("government run" healthcare) is inferior and too costly.
At the same time there would be a lot of people remain privately insured and it would be a possibility for many providers (especially doctor practices) to refuse accepting the rates of the public agency.
4) it undermines solidarity among the insured. It undermines POLITICAL LEVERAGE of the insured. Affluent citizens can retreat to the equivalent of gated communities. Their plans will be way too expensive but at least they have good coverage (if they or the employer pays enough).
The mandated payroll tax for public coverage is modest so the affluent must help fund it (Medicare "for many"). At a certain point even the cost efficiency does not compensate for the higher taxes (general tax revenue). They (a small segment of the population) would be better off with lower taxes and private (if too expensive) insurance.
If that is possible right-wing or center right parties will make political hay by attacking the system. Especially in the U.S. Republicans AND Corporate Democrats.
It is easy to undermine the healthcare system of a nation. There are a few ways to get it right (or to correct if necessary) - and countless options to sabotage it.
It needs a sustiained good faith effort of all major parties to set it up, to monitor it (to weed out flaws). And even cost efficient healthcare is expensive, it is a substantial part of the government budget (that is added to the payroll taxes).
So there would be an incentive to cut the budgets of the public agency, then they cannot pay for all ** that is medically necessary.
It is also a major part of the economy and a service where the insured / patients can be exploited, so handing over a part of the pie to the profiteers (in exchange for favors for politicians and donations to the party) would be very, very tempting.
(** There is no "basic" versus "luxury" version in medicine, either it is necessary and has a reasonable chance to promote better outcomes - or not. Not even a rich person would "consume" a X-ray or chemotherapy they do not need. For ethical reasons most people agree that the low income people should also have access to the same good treatments like the affluent).
With underfunding next thing you know hospitals and doctors can't deliver good care with the revenue they get from the insurance agency. Or doctors and even hospitals do not accept the contracts of the public agency and patients with that coverage anymore. Then there is less choice, longer waiting times and lower quality - for those who cannot afford the upgrades or out of pocket expenses.
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@e.g.4483 The deaths per 100,000 include the deaths from the first wave in spring 2020. That is relevant because densely populated Europe was hit earlier than the U.S. Sure the huge cities in California, New York City and also Seattle (lots of traffic in the economic powerhouses had problems early on - but the rest of the U.S. had much better conditions to delay and to get a grip on it).
Italy was the first nation in Europe that got into very serious trouble, but also France, Spain, Belgium, ....
UK allowed mass spread by wasting time initially with their first "herd immunity" attempt. They changed gears, but never did as well as the other nations. UK is also densely populated, they have defunded the NHS, let rent explode (so many multigeneratitonal households), and they have large cities like London with a LOT of international travel.
So they had more difficult conditions than Denmark, Netherlands or Germany, or even France (social and welfare politics) - and inept leadership on top of that. It shows UK has even more deaths per 100,000 than the U.S.
Mid March most EU countries went into lockdown (I would estimate 65 % of the population of the EU were affected - and all larger countries went into lockdown ! Independent nations cooperated better and fasted than the States of the Divided States of America).
Only on March 9th all of Italy went into lockdown (before they unsuccessfully tried to only lock down the most affected region), but then things changed quickly. In Italy the catastrophic situation for hospitals in the most affluent region of the country triggered them into action - and the other nations that had eyed Italy nervously for a few weeks finally ! sprang into action, the situation in Italy spooked them.
They did not want lockdown anymore than the Italian government, but then they realized there was not way to avoid that.
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you can be sure that the Secret Service came in earlier for security checks. On site and in the streets around. But it is not their place to question where the Trump campaign holds their events. And no "informal" hints either. Jared and Ivanka did not even allow their security details (form the SS for the protection of family) to use one of the 6 toilets in their home. - They had to go to shops nearby. The Kushner's or the SS first set up a port-a-potty, but the fancy neighbours did not appreciate the sight on their street.
Then the agents had to use a bathroom built into a garage in a (former) home of the Obama's, or they drove several miles to a property that belongs to Mike Pence where the SS had a post etc.
Plus: Trump endangered the SS when he did his little tour from the hospital instead of staying in quarantine.
Dr. Birx said only two people of the cabinet wore masks: She and an aide. That means Trump and his merry band also exposed the SS and the White House staff to infection risks * (and they unlike Trump or Giuliani do not get the scarce resources the highly effective treatments).
* That was the reason Dr. Birx gave in an interview why there were even mass break outs, with all the daily testing, and Trump being a self declared germophobe. Interviewer: If no one but you wore the masks isn't that a National Security Risk ? ..... Dr. Birx nodding ominously and expressively.
I once read about the relationship between White House staff and the Obama resp. Bush family. They treated them like friends resp. like family. (or the other way round). I guess they also treated the people that would put their life on the line with some decency.
Not the Trump family and his cabinet. The Secret Service were the first to notice the unusual location, and if the landscaping biz did not take it seriously so far - then they knew they were coming. And could jump into action. Clearing the space, the campaign provided the wall paper.
There is a chance that the SS was not motivated to let the campaign know about the unusual location.
That they had no incentive to spare the campaign the embarrassment.
At that time it would have been most likely too late anyway: preparing the hotel lobby, securing the hotel and the area around it, changing the address info given to media, I assume some journalists went to the wrong site, the hotel ;)
Also: traffick is likely not bad in that commercial area, so it is easier for the SS to control that. But it might be more of a big deal where the fancy hotel is situated, so they need more time for that.
No change in the 11th hourpossible.
Never mind that the managment of the real hotel (unlike Giuliani) was sure that Trump would not be inaugrated (this was several days after the election, Biden had improved steadily, the networks were cautios, but it was obvious Biden would pull it off. he even improved his numbers the vote of the expats and the military must have leaned heavily towards Biden.
So the Four Seasons Hotel would have thought about their bills being paid. They might have demanded payment in advance. They probably would suffer to being stiffed by the sitting president but not by the sore loser !
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