Current Events > For Democrats, Pragmatists Are Still Trumping Progressives Where It Counte

(+) Yeah! (+)

https://www.npr.org/2018/07/05/625822590/for-democrats-pragmatists-are-still-trumping-progressives-where-it-counts

Interesting.

We should instead have the Bernie Sanders in control of the Party to purify it.

No more of these Hillary Clintons, Nancy Pelosis, or Chuck Schumers. Old out of touch hacks who never did any good for anybody.

We need to have proud open far left socialist candidates so that we can win by landslides. Turn those red states blue.
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Makes total sense tbh

Run progressives in deep blue districts they'll win, run Blue Dogs or moderates in districts they'll win.
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Run Coffeebeanz w/ VP candidate Doom_Art and America wins
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Ooooo what'd our cabinet be like?

Error for Attorney General
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We need someone hardline for DoJ head

Whoever the opposite of Dawkins is

Tough on violent crime, soft on drug stuff
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It's not a secret that the left is very emotional.
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Good.
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Ron Paul / Bernie Sanders 2020

For a Confused America
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democrats are hardly pragmatic
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I have many thoughts but not all of them are ones I can easily articulate. So I'll say two things now and maybe more later if I think of how to word them:

1) I think they are discounting some races there that they shouldn't. Joe Manchin had a serious challenger from the left, and they did not go any where.

2) This is the real key imo: But in most House primaries, pragmatism has ruled the day including in the northern suburbs of Los Angeles, where a young moderate named Katie Hill beat progressive Bryan Caforio. Hill is the former head of California's largest anti-homelessness organization and the daughter of a local nurse and a local police officer. She is a lifelong gun owner who backs some gun control measures and has a plan to protect the Affordable Care Act as a transition to a single-payer health care system.

They're saying that the pragmatists are more progressive than they used to be.
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I don't know how you can back the ACA as a transition to single-payer, since it was literally designed with private insurance companies as the major economic beneficiaries.
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Coffeebeanz posted...

I don't know how you can back the ACA as a transition to single-payer, since it was literally designed with private insurance companies as the major economic beneficiaries.

Probably a transition for the requirements of whatever the paying is (no denying pre-existing conditions, no cap on benefits)

And a slight (needs to be harder) on how hospitals are paid (paid for quality of service, not how many tests were done)

Coffeebeanz posted...

I don't know how you can back the ACA as a transition to single-payer, since it was literally designed with private insurance companies as the major economic beneficiaries.

Eh. With the required payouts, it was a decent solution.
ACA then ACA with public option then single payer. It's pretty clear how the transition would work.
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Quality of Service is far too subjective.

In fact, recent studies have shown that patient-centered QoS metrics are INVERSELY proportional to patient outcomes.

It doesn't help that Medicare is about 20 years behind modern evidence-based practice when it comes to reimbursement. It won't pay for efficient care, but it will pay for tests and procedures that have been proven to be ineffective.
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Coffeebeanz posted...

Quality of Service is far too subjective.

In fact, recent studies have shown that patient-centered QoS metrics are INVERSELY proportional to patient outcomes.

I would be interested to read those studies...nothing will be perfect, but you cant reward a hospital for fucking up then charging extra for their fuck up

And agreed they need to modernize it. Medicare being like lol well just pay 35% of what you bill is so weird, same with private insurance being like 70% please and this whole gaming of who actually pays what

CruelBuffalo posted...

Coffeebeanz posted...

Quality of Service is far too subjective.

In fact, recent studies have shown that patient-centered QoS metrics are INVERSELY proportional to patient outcomes.

I would be interested to read those studies...nothing will be perfect, but you cant reward a hospital for fucking up then charging extra for their fuck up

That's not what I'm referring to.

The whole Press-Ganey "patient-centered medical practice" initiative has created a reimbursement system based on the totally arbitrary whims of patients which are rarely in line with actual quality medical care.

Patients either care about superfluous stuff (quality of the food, for example) or their expectations are clinically inappropriate (they always want the most expensive test, even if it isn't actually the most useful or appropriate)

A better reimbursement system would reward sticking closely to evidence-based guidelines.
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Just as a personal example, I cannot tell you how many times I've had issues with patients expecting MRIs for things in which an MRI would never be appropriate (appendicitis, for example). "A CT isn't good enough!". As if they even know what a CT is. Good, cost-efficient guidelines dictate that a patient with all the physical signs of appendicitis does not need imaging at all.
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Would an MRI tear my retainer out? It's metal and tucked behind my front teeth
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Coffeebeanz posted...

Just as a personal example, I cannot tell you how many times I've had issues with patients expecting MRIs for things in which an MRI would never be appropriate (appendicitis, for example). "A CT isn't good enough!". As if they even know what a CT is. Good, cost-efficient guidelines dictate that a patient with all the physical signs of appendicitis does not need imaging at all.

Is that how other countries do it?

Doom_Art posted...

Would an MRI tear my retainer out? It's metal and tucked behind my front teeth

The answer is - it kind of depends on whether the metal is ferromagnetic. MRIs can generate a magnetic field up to 4-5 Tesla, which is enough to rip non-magnetized iron out of your body. Titanium, however, I believe is OK in an MRI
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CruelBuffalo posted...

Coffeebeanz posted...

Just as a personal example, I cannot tell you how many times I've had issues with patients expecting MRIs for things in which an MRI would never be appropriate (appendicitis, for example). "A CT isn't good enough!". As if they even know what a CT is. Good, cost-efficient guidelines dictate that a patient with all the physical signs of appendicitis does not need imaging at all.

Is that how other countries do it?

There's a lot more emphasis on avoiding unnecessary tests and procedures in other countries. Yes, it's mostly from a cost saving perspective, but if you look at the data the outcomes are at least as good, if not better, than what we get in the US.

We have a system that heavily favors patient satisfaction. The problem is that patients don't really know what actually is "good" health care. It's like saying the guy fleeing a burning house knows as much about how to stop house fires as the Fire Department.
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It's funny, everyone seems to think that raising taxes and spending more money will help us have universal health care. When, in fact, it's actually quite the opposite.

We could have fantastic universal health care and spend a lot LESS money. I've said it before and I'll say it again, universal health care and single-payer are far more fiscally conservative than what we currently have. It's exceptionally ironic that Republicans are now against it.
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Coffeebeanz posted...

It's funny, everyone seems to think that raising taxes and spending more money will help us have universal health care. When, in fact, it's actually quite the opposite.

We could have fantastic universal health care and spend a lot LESS money. I've said it before and I'll say it again, universal health care and single-payer are far more fiscally conservative than what we currently have. It's exceptionally ironic that Republicans are now against it.

Making economic sense isnt republicans anymore. They want fight for yourself and lazy people get fucked

So if they have to pay way more for worse service so that someone doesnt have access to it because they didnt work as hard...then good.

CruelBuffalo posted...

Coffeebeanz posted...

It's funny, everyone seems to think that raising taxes and spending more money will help us have universal health care. When, in fact, it's actually quite the opposite.

We could have fantastic universal health care and spend a lot LESS money. I've said it before and I'll say it again, universal health care and single-payer are far more fiscally conservative than what we currently have. It's exceptionally ironic that Republicans are now against it.

Making economic sense isnt republicans anymore. They want fight for yourself and lazy people get fucked

So if they have to pay way more for worse service so that someone doesnt have access to it because they didnt work as hard...then good.

I don't mean to piss off both sides here, but neither side gives one hot shit about actually making good economic policy.

It's all about proposing things that sound good to their constituency, at least on a superficial newsreel-worthy level.
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Coffeebeanz posted...

CruelBuffalo posted...

Coffeebeanz posted...

It's funny, everyone seems to think that raising taxes and spending more money will help us have universal health care. When, in fact, it's actually quite the opposite.

We could have fantastic universal health care and spend a lot LESS money. I've said it before and I'll say it again, universal health care and single-payer are far more fiscally conservative than what we currently have. It's exceptionally ironic that Republicans are now against it.

Making economic sense isnt republicans anymore. They want fight for yourself and lazy people get fucked

So if they have to pay way more for worse service so that someone doesnt have access to it because they didnt work as hard...then good.

I don't mean to piss off both sides here, but neither side gives one hot shit about actually making good economic policy.

It's all about proposing things that sound good to their constituency, at least on a superficial newsreel-worthy level.

Not everyone, but large enough portions. Theyre still Republicans out there that want to do go, theyre drowned out by asses like Ted Cruz and spineless chumps like Marco Rubio