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Season 12 Chit Chat Thread

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10 minutes ago, joyceraye said:

Is the ballot not secret ?

I think we are talking about elected republican members of Congress. Their votes are public, and I believe there are registers that can be referenced to confirm how the Congress folk vote on issues. It’s an accountability measure. 

Somone might fact check me. I’m still learning.

 

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2 hours ago, son-goku5 said:

I wouldn't throw them in jail for the vote but for the consequences. There are these things in US law called "voluntary manslaughter" and "involuntary manslaughter". While involuntary manslaugthter is "the homicide of a human being without intent, either expressed or implied", voluntary manslaughter deals with what we'd call heat of the moment homicide. You didn't plan in advance to kill someone but you decided in the moment, you didn't think and killed someone.

When republicans began saying they wanted to repeal the ACA, even in 2010, they never had a replacement. And they kept saying it and, in congress, they kept voting to repeal it, because then they could go to their constituents and say "Hey, we tried but the Senate wouldn't play ball" or "We tried but Obama vetoed it." Then, in 2016, they unexpectedly got an internet troll elected president (with the help of your "friendly" russian neighbor) who was a lifelong Democrat but used the R to get into office. Now they suddenly had all the power and needed to keep their promise to repeal the ACA. So they panicked and tried to write a new healthcare bill on the fly but as expected, nothing worked, yet they still tried to get it through.

Here comes the part where my wish for jail comes in.

These republicans were told, by numerous experts and expert groups consisting of Doctors and other health professionals, that repealing the ACA without a real replacement would kill people. It's impossible to know how many but the  New England Journal of Medicine publiushed an extensive study on the extension of Medicare coverage that calculated that for every 455 people getting coverage, one life was saved per year. Applying that figure to even a conservative estimate of 20 million people losing coverage in the event of an ACA repeal without a real replacement would yield an estimate of 43,956 deaths annually.

So these people in congress were told, "Hey, if you do this, thousand of people will die." This isn't just hyperbole, people would actually die because they can't afford treatment for their diseases.

So these republicans deliberately took an action that they knew would result in the death of thousands of people. If that's not deliberate voluntary manslaughter, I don't know what is.

It does sound pretty awful when you put it that way. 

But tax cuts.

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3 hours ago, son-goku5 said:

These republicans were told, by numerous experts and expert groups consisting of Doctors and other health professionals, that repealing the ACA without a real replacement would kill people. It's impossible to know how many but the  New England Journal of Medicine publiushed an extensive study on the extension of Medicare coverage that calculated that for every 455 people getting coverage, one life was saved per year. Applying that figure to even a conservative estimate of 20 million people losing coverage in the event of an ACA repeal without a real replacement would yield an estimate of 43,956 deaths annually.

So these people in congress were told, "Hey, if you do this, thousand of people will die." This isn't just hyperbole, people would actually die because they can't afford treatment for their diseases.

I don't think it works like that. I mean that you may be right about the deaths but there is no cause and effect that could be proven beyond a reasonable doubt in any individual case. Wait times in Canada are too long for many procedures but we don't see MPs accused of murder. If that could happen who would go into politics? 

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9 minutes ago, djsurrey said:

I don't think it works like that. I mean that you may be right about the deaths but there is no cause and effect that could be proven beyond a reasonable doubt in any individual case. Wait times in Canada are too long for many procedures but we don't see MPs accused of murder. If that could happen who would go into politics? 

Agreed. It’s a representational democracy. I think the argument is that the majority, having elected their representatives, is authorising them to enact policies the majority voted on. 

If the representatives fail to do what they said, then the solution is to vote them out, surely. 

And “but tax cuts” isn’t relevant. But that’s what was delivered instead.

Edited by Nogravitasatall
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9 minutes ago, Nogravitasatall said:

Agreed. It’s a representational democracy. I think the argument is that the majority, having elected their representatives, is authorising them to enact policies the majority voted on. 

If the representatives fail to do what they said, then the solution is to vote them out, surely. 

And “but tax cuts” isn’t relevant. But that’s what was delivered instead.

Tax increases don't necessarily get spent in an ideal way, so more revenue isn't always the answer. When income tax is cut, the treasury finds another,less obtrusive way of getting money in. Cuts to spending - if/when they really happen - are made to the easiest to deal with, not to inessentials.

I have had a voting life of approaching fifty years, during which HM's Governments have continued to claim that they're not only spending more money, it's on the right things. At the same time, The Oppositions have insisted the money has been been cut and important things like education housing, health and roads with it. If they had really cut that much, they'd be handing us money by now instead of taking it.  

 In the UK when we hear about increased spending on health we imagine it's on nurses and midwives, doctors, medicines, bandages, equipment, admin support for record-keeping, hygiene for operations, that kind of thing. Anybody who works there,however, knows it goes on crap like more and more pettifogging HR  matters, with staff inventing 'issues' to  prove they have a job, or phony training schemes for staff who already know what they're doing.

All countries need health care one way or another, however it's financed, and so I bet the NHS's issues are replicated elsewhere in one form or another, A few thousand extra dollars or pounds into the hospital coffers may just buy a machine or a drug that will save somebody's life. OTOH it might go on a change of colourway of somebody's office decor.

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2 hours ago, djsurrey said:

I don't think it works like that. I mean that you may be right about the deaths but there is no cause and effect that could be proven beyond a reasonable doubt in any individual case.

Actually, it could be: Person is sick and needs constant care/medicine, has healthcare via Obamacare -> republicans repeal Obamacare just because Obama made it and don't replace it with anything -> sick person loses coverage, can't afford care/medicine anymore -> dies

Cause and effect

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2 hours ago, joyceraye said:

 

All countries need health care one way or another, however it's financed, and so I bet the NHS's issues are replicated elsewhere in one form or another,

The biggest complaint I hear about "socialized medicine" as the Trumpsters like to call it, is that it will lead to long wait times for service, but we have Blue Cross Blue Shield which is rated pretty well and my husband needs a stress test according to his primary care physician. He has to see a cardiologist before he can go and he asked for an appointment last week and the first thing they had was the middle of September. We were very frustrated by that.

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43 minutes ago, Die Zimtzicke said:

The biggest complaint I hear about "socialized medicine" as the Trumpsters like to call it, is that it will lead to long wait times for service, but we have Blue Cross Blue Shield which is rated pretty well and my husband needs a stress test according to his primary care physician. He has to see a cardiologist before he can go and he asked for an appointment last week and the first thing they had was the middle of September. We were very frustrated by that.

It's been called 'socialised medicine' by Americans for decades, long before Trump reared his head. There are times, it's true, when the NHS gets overwhelmed and demand for services outstrips supply.  The only answer then is a waiting list. Waiting is not as bad as it was years ago, thanks in part to advanced technology and changing attitudes. 

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3 hours ago, Die Zimtzicke said:

The biggest complaint I hear about "socialized medicine" as the Trumpsters like to call it, is that it will lead to long wait times for service, but we have Blue Cross Blue Shield which is rated pretty well and my husband needs a stress test according to his primary care physician. He has to see a cardiologist before he can go and he asked for an appointment last week and the first thing they had was the middle of September. We were very frustrated by that.

When I needed an ultrasound, I had to wait six weeks. But my ultrasound wasn't because of something lifethreatening, so I wasn't that fazed by it. The reason for the wait time is simply supply. We have one doctor doing ultrasounds apart from the hospital itself and other things like MRIs take just as long. But if one made an appointment in a larger city, like Berlin or Dresden, the waiting times are usually a lot shorter because there are way more doctors/clinics providing these servicea

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10 hours ago, son-goku5 said:

Actually, it could be: Person is sick and needs constant care/medicine, has healthcare via Obamacare -> republicans repeal Obamacare just because Obama made it and don't replace it with anything -> sick person loses coverage, can't afford care/medicine anymore -> dies

Cause and effect

Not beyond a reasonable doubt. They may have died regardless, might have raised funds in another way...   ... it would never be clear cut for a conviction in an individual case and the people are ultimately responsible for who they elect.

Edited by djsurrey

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15 hours ago, joyceraye said:

Tax increases don't necessarily get spent in an ideal way, so more revenue isn't always the answer. When income tax is cut, the treasury finds another,less obtrusive way of getting money in. Cuts to spending - if/when they really happen - are made to the easiest to deal with, not to inessentials.

I have had a voting life of approaching fifty years, during which HM's Governments have continued to claim that they're not only spending more money, it's on the right things. At the same time, The Oppositions have insisted the money has been been cut and important things like education housing, health and roads with it. If they had really cut that much, they'd be handing us money by now instead of taking it.  

 In the UK when we hear about increased spending on health we imagine it's on nurses and midwives, doctors, medicines, bandages, equipment, admin support for record-keeping, hygiene for operations, that kind of thing. Anybody who works there,however, knows it goes on crap like more and more pettifogging HR  matters, with staff inventing 'issues' to  prove they have a job, or phony training schemes for staff who already know what they're doing.

All countries need health care one way or another, however it's financed, and so I bet the NHS's issues are replicated elsewhere in one form or another, A few thousand extra dollars or pounds into the hospital coffers may just buy a machine or a drug that will save somebody's life. OTOH it might go on a change of colourway of somebody's office decor.

I’m only a casual reader on health policy. As Trump said ... healthcare is complicated. He had a quick go and then threw his hands in the air and instead delivered an unfunded (ie debt funded) tax cut that skewed to the already well capitalised.  Bright shiny things. But...

I believe Bernie Sanders has a universal health care proposal at hand that was costed out as directly increasing government outlays to 32 trillion on health. Which is a lot. The rub is that the USA collectively already is on track to spend that much anyway - for worse results, because of the inefficiencies built into the medical services deliveries system in the USA. They spend more money for less results than any other first world country. I think a lot of it is duplication and and maybe a fair bit of it is that health is not a normal market. In the States I believe there is a medical category of bankruptcy - where to save your life you become yourself totally totally impoverished. It’s a brutal way to ration health resources, to my mind. It was the foundation idea of “Breaking Bad”. The guy was going to die because he couldn’t afford the treatment. Unbelievable, right?

Anyway, in total, it’s likely that switching to the Sanders plan would save the whole US economy $2trillion.

https://www.vox.com/policy-and-politics/2018/7/30/17631240/medicare-for-all-bernie-sanders-32-trillion-cost-voxcare

I don’t know anything about NHS stories, and I’m sure there are many, but the concerns you express about NHS misallocations might figure at the scale of rounding errors in the NHS budget, in comparison to significant health services costs.

One of my kids was prem at 890g (say approx 2lb)  birthweight and required one-on-one nursing 24/7 at an estimated cost of $20k per day - back in the early 90s. She was in neonatal intensive care for months. A lot more expensive than an office repaint and any professional training days, I’d suggest.

Not to say those admin overheads can’t be well or better managed and sometimes aren’t, but the medical services are things that cost the big bucks. The NHS has the the government’s buying power behind the consumer. 

I think in the States the consumer is not so well backed.

Edit: back to say I don’t really know what the Trump plan is, but I read that it was reversionary. The administration apparently is working to inhibit the ACA and approve what used to be called junk or catastrophic plans, where you have plans at all. And there is still rugged individualism as a fallback.

I’d be happy to be more fully informed.

Anyway, not a healthcare expert.  Moving on.

Edited by Nogravitasatall
Rounding errors
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6 hours ago, djsurrey said:

Not beyond a reasonable doubt. They may have died regardless, might have raised funds in another way...   ... it would never be clear cut for a conviction in an individual case and the people are ultimately responsible for who they elect.

If you have a disease that you can keep in check with a daily pill and suddenly, you lose your healthcare coverage thanks to congress and can't afford that pill anymore and then you die from your disease, that's pretty clear. Your family could sue congress for damages.

And you shouldn't have to "raise funds" in other ways just so you can afford the things you need to survive because politicians took it away from you.

6 hours ago, Nogravitasatall said:

I’m only a casual reader on health policy. As Trump said ... healthcare is complicated. He had a quick go and then threw his hands in the air and instead delivered an unfunded (ie debt funded) tax cut that skewed to the already well capitalised.  Bright shiny things.

At the beginning, he claimed healthcare is easy (like peace in the middle east). It only became complicated when the repeal didn't go through because people actually like to have healthcare coverage.

6 hours ago, Nogravitasatall said:

I’m only a casual reader on health policy. As Trump said ... healthcare is complicated. He had a quick go and then threw his hands in the air and instead delivered an unfunded (ie debt funded) tax cut that skewed to the already well capitalised.  Bright shiny things. But...

I believe Bernie Sanders has a universal health care proposal at hand that was costed out as directly increasing government outlays to 32 trillion on health. Which is a lot. The rub is that the USA collectively already is on track to spend that much anyway - for worse results, because of the inefficiencies built into the medical services deliveries system in the USA. They spend more money for less results than any other first world country. I think a lot of it is duplication and and maybe a fair bit of it is that health is not a normal market. In the States I believe there is a medical category of bankruptcy - where to save your life you become yourself totally totally impoverished. It’s a brutal way to ration health resources, to my mind. It was the foundation idea of “Breaking Bad”. The guy was going to die because he couldn’t afford the treatment. Unbelievable, right?

Not to say those admin overheads can’t be well or better managed and sometimes aren’t, but the medical services are things that cost the big bucks. The NHS has the the government’s buying power behind the consumer.

The  thing with the US healthcare system is, until you get to Medicare/Medicaid, all of healthcare is private (except the VA, but republicans want to privatise that too). That's why the costs are so high. Every link in the healthcare chain rips off the customer. Administrative costs (paperwork etc) are 25% of what a customer pays in his premium, whereas with Medicare, it's around 2%. So if you pay a $1000 premium a month to your private insurer, $250 are used to pay the people working there, pay the bloated salaries of the CEOs and the boards and the paperwork.

Add to that, republicans want to bring back the lifetime caps. So, if you have a heart condition from birth, you can hit that lifetime cap of what the insurance company has to pay out for you before you reach adulthood. After that, you'll never be able to find insurance again.

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1 hour ago, son-goku5 said:

If you have a disease that you can keep in check with a daily pill and suddenly, you lose your healthcare coverage thanks to congress and can't afford that pill anymore and then you die from your disease, that's pretty clear. Your family could sue congress for damages.

And you shouldn't have to "raise funds" in other ways just so you can afford the things you need to survive because politicians took it away from you.

At the beginning, he claimed healthcare is easy (like peace in the middle east). It only became complicated when the repeal didn't go through because people actually like to have healthcare coverage.

The  thing with the US healthcare system is, until you get to Medicare/Medicaid, all of healthcare is private (except the VA, but republicans want to privatise that too). That's why the costs are so high. Every link in the healthcare chain rips off the customer. Administrative costs (paperwork etc) are 25% of what a customer pays in his premium, whereas with Medicare, it's around 2%. So if you pay a $1000 premium a month to your private insurer, $250 are used to pay the people working there, pay the bloated salaries of the CEOs and the boards and the paperwork.

Add to that, republicans want to bring back the lifetime caps. So, if you have a heart condition from birth, you can hit that lifetime cap of what the insurance company has to pay out for you before you reach adulthood. After that, you'll never be able to find insurance again.

I think it’s pretty obvious their situation is pretty poor. But now the Republicans are sucking up to Putin, formerly a communist, maybe they can step back a degree and socialise their healthcare - it’s only logical. Heheh.

Edited by Nogravitasatall

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1 hour ago, Nogravitasatall said:

I think it’s pretty obvious their situation is pretty poor. But now the Republicans are sucking up to Putin, formerly a communist, maybe they can step back a degree and socialise their healthcare - it’s only logical. Heheh.

Socialising health care that's hitherto been run for profit would be/will be amazingly difficult. The British NHS system, which was at its heart a nationalisation of existing insurance companies, came within a whisker of being abandoned before it was implemented because the government of the day hadn't done enough research into finding out how many people weren't covered. Private health insurance was run on a provident basis, ie with no shareholders, and still is. If a government has not only to buy up insurance firms but also to compensate investors for lack of income before it even starts covering the uncovered in a population the size of the US, it's going to run out of money before it gets anywhere.

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39 minutes ago, joyceraye said:

Socialising health care that's hitherto been run for profit would be/will be amazingly difficult. The British NHS system, which was at its heart a nationalisation of existing insurance companies, came within a whisker of being abandoned before it was implemented because the government of the day hadn't done enough research into finding out how many people weren't covered. Private health insurance was run on a provident basis, ie with no shareholders, and still is.

A national healthcare system is essentially what the goverment tells the insurance companies what to cover and what to demand as premium. Here in Germany, you pay your monthly premium as a percentage from your paycheck, with you paying half and your boss paying the other half. The percentage is 14,6% so a workers premium is 7,3% of your paycheck.

We also have private insurance. There you can choose more things you want to have covered and your premium is calculated on what you have chosen.

49 minutes ago, joyceraye said:

Socialising health care that's hitherto been run for profit would be/will be amazingly difficult.

I don't see why. In the US, there's already socialized health care, it's called Medicare. The difficulty is the lobbyists. If any administration would seriously consider doing a Medicare for all idea or even the public option, the private insurance industry would send out their hordes of lobbyists to bribe their way around congress to make it fail. The Koch Brothers and others would use their influence groups to convince the stupid people that getting cheap healthcare run by the government is a very bad thing because it's a mandate.

Or, as you could say it: "You may go broke when you get sick but, by god, that's your choice."

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23 minutes ago, son-goku5 said:

A national healthcare system is essentially what the goverment tells the insurance companies what to cover and what to demand as premium. Here in Germany, you pay your monthly premium as a percentage from your paycheck, with you paying half and your boss paying the other half. The percentage is 14,6% so a workers premium is 7,3% of your paycheck.

We also have private insurance. There you can choose more things you want to have covered and your premium is calculated on what you have chosen.

I don't see why. In the US, there's already socialized health care, it's called Medicare. The difficulty is the lobbyists. If any administration would seriously consider doing a Medicare for all idea or even the public option, the private insurance industry would send out their hordes of lobbyists to bribe their way around congress to make it fail. The Koch Brothers and others would use their influence groups to convince the stupid people that getting cheap healthcare run by the government is a very bad thing because it's a mandate.

Or, as you could say it: "You may go broke when you get sick but, by god, that's your choice."

I spent some time in West Germany in 1975 when my friend was expecting a baby. I was very impressed by the healthcare system there. The impression I got was that everybody was a private patient. All but the richest people in the country were obliged to have health insurance. Patients could go to any doctor they liked. My friend had a sort of chequebook  issued by the insurer from which she wrote out  payments when she saw the Frauenartz . I thought it was a splendid idea : a doctor associating his income with his patients like a vet. Many doctors in England were arrogant swine in those days, especially the men, so different from the attitude I got when the dog was sick. Forgive me if I've muddled any details, BTW.

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6 hours ago, son-goku5 said:

So, if you have a heart condition from birth, you can hit that lifetime cap of what the insurance company has to pay out for you before you reach adulthood. After that, you'll never be able to find insurance again.

I have a friend who was born with a heart condition and had cancer as a teenager. He is basically un-insurable. He's on his wife's insurance right now.

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10 hours ago, Die Zimtzicke said:

I have a friend who was born with a heart condition and had cancer as a teenager. He is basically un-insurable. He's on his wife's insurance right now.

That’s terrible. As I understand it, the ACA tried to fix that. It tried - it wasn’t perfect - but it tried. It could have been made better. But it seems to me the ideologues on the right, who have coverage themselves, and so think of this as an ideological abstraction rather than life or death, want to kill it, the venal want to continue holding the health insurance money-extorting-vacuum to the wallets of the afflicted,  and Trump just wants to kill whatever Obama did.

Trump said, "Obamacare. We're going to repeal it, we're going to replace it, get something great. Repeal it, replace it, get something great!" Just on that I’d be sceptical.

It’s peculiar how far he has got - all the way to the top - on culture wars alone. About the only time I believe he is honest is when he is saying something inflammatory. 

Golly, it’s depressing. And I don’t live there, I just read about it. I wonder if there is anything to be done and will it be done? About improving healthcare. Is that even on the agenda now? Trump’s noise seems to be keeping that question out of the news.

Edited by Nogravitasatall
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9 hours ago, Nogravitasatall said:

Golly, it’s depressing. And I don’t live there, I just read about it. I wonder if there is anything to be done and will it be done? About improving healthcare. Is that even on the agenda now? Trump’s noise seems to be keeping that question out of the news.

The last thing republicans did was get rid of the individual mandate, which is the thing that actually pays for Obamacare, as part of the tax cuts for the rich

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12 hours ago, Nogravitasatall said:

Trump just wants to kill whatever Obama did.

If Obama has ordered Charmin toilet paper for the White House, Trump would have changed it to Scott by now. Obama makes him crazy. If it had not been pinned with the name Obamacare it would not have been at the top of his list. It's basically after all the same thing Romney did on a state level.

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3 hours ago, Die Zimtzicke said:

If Obama has ordered Charmin toilet paper for the White House, Trump would have changed it to Scott by now. Obama makes him crazy. If it had not been pinned with the name Obamacare it would not have been at the top of his list. It's basically after all the same thing Romney did on a state level.

It was coined Obamacare by the right and the rest took it over. It's called the Affordable Care Act.

During the 2012 campaigns, during one conference call, one Romney campaign aide called it "Obamneycare" because even they knew that it was build on Romneycare in Massachusetts. Romney running against his own healthcare plan would have been funny if it hadn't been so sad.

And Trump's grief with Obama is simple. A classy black man who did a great job. And Donald can't stand that. His racist core can't stand the fact that black people can be successful and more liked than he. Just look at his current attacks on Lebron James.

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If he had done a great job Hilary would be president. As to LeBron James he seems okay with Michael Jordan.  Also to add Trump offered to help Chicago with aid in controlling all the shootings, which the majority are black. Rahm turned him down and Obama has been silent on the matter.

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14 minutes ago, Chrismo said:

If he had done a great job Hilary would be president.

Without the Russians and James Comey, she would have been.

14 minutes ago, Chrismo said:

As to LeBron James he seems okay with Michael Jordan.

Because Michael Jordan is almost religiously anti-political. MJ does nothing that would be seen as political, which translates that MJ doesn't speak out against Donald. But LJ does, and Trump can't stand that. And before you start trying to explain that his rage at people criticizing him has nothing to do with race or misogyny, there are white men blasting Trump (just look at what Gregg Popovich, head coach of the San Antonio spurs, says about Donald) and Trump doesn't say anything about them. No tweet, no comment in one of his rallies

19 minutes ago, Chrismo said:

Also to add Trump offered to help Chicago with aid in controlling all the shootings, which the majority are black. Rahm turned him down and Obama has been silent on the matter.

You mean when Trump offered to send in the "feds" or the National Guard? Yeah, because tanks rolling through black neighborhoods is such a great idea. Otherwise, he has never offered anything of substance. To be more accurate, his answer to that question, how to fix things in Chicago was “By being very much tougher than they are right now.” So, a typical Trump answer.

Oh, by the way, for all the murders in Chicago, the city is only in 8th place in the ranking of highest homicides per capita. St. Louis is on #1

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7 hours ago, son-goku5 said:

The last thing republicans did was get rid of the individual mandate, which is the thing that actually pays for Obamacare, as part of the tax cuts for the rich

The individual mandate was intended to offset the costs incurred by compelling insurers to provide coverage to people that had been previously classified as un-insurable. Like most things designed by politicians and bureaucrats, it didn't work as intended. For many young people, (those the individual mandate was supposed to pull into the insurance pool), the benefit of avoiding the penalty for not purchasing insurance was not enough incentive to make them buy costly coverage that they felt did not conform to their situation and needs.  

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33 minutes ago, son-goku5 said:

 

You mean when Trump offered to send in the "feds" or the National Guard? Yeah, because tanks rolling through black neighborhoods is such a great idea. Otherwise, he has never offered anything of substance. To be more accurate, his answer to that question, how to fix things in Chicago was “By being very much tougher than they are right now.” So, a typical Trump answer.

Oh, by the way, for all the murders in Chicago, the city is only in 8th place in the ranking of highest homicides per capita. St. Louis is on #1

Per capita is a meaningless number. I'm sure that's would make family members at ease. 10% of 10 and 9 percent of 100 still means 8 people  more dead in the 100 number. All I know there has been more marches in Chicago lately and I live in a nearby suburb. What's more hysterical is the CNBC and CNN's of the world talked about Rudy having his dead numbers screwed up more than about the people who died.

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