gbear

Our top IT person says the hack of OPM files is the biggest terrorism strike in the U.S. about which nobody talks because we are mostly ignorant of its potential uses and timeframe for its impact. This one seems potentially worse except we seem to at least be some what cognizant of this one because we can imagine how this data may be used.

https://forecast.weather.gov/wwamap/wwatxtget.php?cwa=sju&wwa=hurricane local statement SITUATION OVERVIEW ------------------ Hurricane force winds will likely continue across USVI, Vieques and Culebra through the afternoon hours; and across Puerto Rico through tonight. These winds will bring catastrophic damage. Severe injury is possible in less than a strong structure. Maria is expected to produce storm total accumulations of 12 to 18 inches with isolated amounts of 25 inches or more. Flash flooding is imminent or occurring.Now is the time to remain safely sheltered from the storm. Good luck KB. I hope you and your escape with as little loss as possible. Two in a row for USVI makes this a terrible month for the U.S. territory. With the hit now to PR, the whole region will need major help. I hope the U.S. realizes the people on these islands are fellow U.S. citizens in need of help.

Good luck. Please let us know you weathered the storm.

Thanks Peter, Quick question, aren't the exchanges bound to single states? I understand how CA exchange might fail with single payer because everybody would already have minimal coverage and the exchange would be solely for secondary coverage. Thus the exchange for primary health insurance would fail without buyers. How does this impact other states? I thought insurance companies were already looking at viability of each of the states individually. Isn't that why they have already pulled out of many states without enough patients for a good risk pool and/or too few providers to get any competition on price?How does CA change WA? Is it because patients might cross state lines?

I worry Democrats will make the same mistake Republicans made thinking that simply saying "single payer" is descriptive enough. Single payer for what? Everything? Does this mean if the government won't pay for it, nobody but the patient will, if it is even available? Are we talking communist medicine or socialized medicine, and yes there would be a difference. Does this mean the government will pay X for procedure y and if you want to go to somebody who charges X + $1,000 then the patient must pay the $1,000? Part of me looks at these types of questions and thinks Medicare for all is the simplest solution because we and the market understand it, and it allows for people to buy and use secondary insurance. The other part of me still longs for Hillary/Tsongas care where the government says we can afford to treat A through M. These are the treatments with the best quality of life improvements for the dollar. Our goal is based on strict Utilitarian values of "provide the greatest good for the greatest number." If we get more money, we will try to cover N through S, but really if you want coverage for anything beyond M, you had best purchase supplemental insurance. However, I am well aware this approach of using mathematics in an effort to quantify social good will be seen as heartless by many. I am just a math geek, so solving large problems with an eye toward maximization of some good seems natural to me, sometimes to the point I feel guilty thinking about the healthcare resources my family uses.

I agree on the collusion, but what is a reasonable outcome now? We elected the guy, warts and all. Collusion and levels of it are where I question out political willingness as a country to reassert our independence from outside influences in our elections. We are closely enough balanced R to D that a small influence can have huge impacts. How small an infraction are we willing to address as a nation? What should our answer be to Russian facebook posting organizational ads for the purpose of organizing groups who would destabilize us? How would you feel if you participated in such an event because of your beliefs? Racist beliefs are not illegal, just the acts they spawn. How should we deal with outside provocateurs? I dislike the results of our presidential election, but how do we stop the bleeding? How do we make the winners realize the potential internal hemorrhaging we are experiencing? I don't think we have it in us to go full out McCarthy, and having a family who lived through FBI investigations in that time, I include myself in that " having reservations about possible steps to prevent future destabilizing attempts." What would it take to prevent this from happening again?

Does this thread crash/lag more than any other thread on the board or is it just me? I was thinking about this thread last night. Let's assume some of what we think we know. Trump's business has had some previous dealings in Russia, and they had hopes of doing many more. Trump's business has likely sold many properties to Russian elites which were used to legitimize money from sources they would never claim. None of this would seem to be illegal even if shady. Now my question is what would should Trump have done during the election about these contacts, and what would need to be shown to get a Republican congress to act? If it is shown Russia offered help and Trump and his campaign did not turn them away and tell them to stay out of our politics is that enough to show collusion? I think in my grandparents generation that would have been enough, but the waters are muddier now and our political tribalism is a stronger motivator than nationalism. With the age of our congressmen and congresswomen, I have a harder time predicting. John Mcain for all his maverick perception was predictable on such matters, but how much of that is age and time of service related? So go a step further. If Trump asked Russia to release emails at strategic times to damage Clinton, is that enough? I could certainly see a defense of "I accept all the help I can get. I mean who wouldn't take free help." If this is the case would people and or Congress blame him? I honestly don't know. I would, but I have that tribal influence goading me. What if Russia decided to goad nativist movements in the U.S. for the general purpose of destabilizing us? Trump benefited and continues to benefit from them, but where does one assign blame on our home front for this? What would be an appropriate and legal outcome for any of these scenarios, and do we have a reasonable hope for that outcome?

So this is our Friday nugget of trump is a bad president news. I give it about a 5 for him. I will grant I am grading on a trump curve. I mean this is evidence he spent a while pondering an action which could be viewed as obstruction of justice. What's the song I am looking for from back when Russia was seen as an adversary by both political parties? I think it might appeal to the anti intellectionism vibe...just "another brick in the wall" Trump tried to build between him and anything that would embarrass him. Someday perhaps, that wall will be tall enough for all to see it for what it is. Then we can begin to repair as we take it down.

Are there videos or pictures of the violent alt left charging the right? He makes that point over and over as an equivalent. Were there injuries or arrests? Personally I would want people with atleast clubs if I was being threatened as the KKK has a history.

Bluefood, do you think trump knows who those people are?

I actually hope this helps Trump, in the sense that I want him to get some bounce when he does the right thing so he might make a habit of it. Pavlov? Of course if I were a politician, I would actually expect a bump in opinions from David Duke trying to call me out. I almost think that should be a goal of any good politician. http://www.msn.com/en-us/news/us/ex-kkk-leader-david-duke-has-meltdown-after-trump-condemns-white-supremacists-in-charlottesville/ar-AAq5wjt?ocid=spartandhp

I think we are all assuming the Republicans don't just wait for McCain to die, get a replacement and try again. Brain cancer is likely significantly lower his life expectancy and his ability to serve at all. The republicans needing death to pass their healthcare law would seem a bit of fitting imagery, and naturally nobody will come out and say this.

This was the best I have seen Bradley look in awhile, and our d was generally solid. Howard saved us twice with great saves. I know Dempsey will get justifiable press, and his footwork creates so much. I just think the other two would get my first and second stars for the game.

Don Quixote lives! I like the spirit of worrying about the poor displaced, and yet we live with much more free time, more disposable income, and higher quality of life than any time in history. This is due to the march of history and increases in technology. The march of tech allowed us to prove Malthus wrong. We need technology to continue to advance. I celebrate it while still worrying for the displaced.

My money for next new innovation to be developed is cheaper desalination. I think potable water will be as valuable as oil in the next 50-100 years unless we can find away to use the vast amounts of sea water for our water needs from drinking to irrigation.

https://www.washingtonpost.com/outlook/trump-jrs-russia-meeting-sure-sounds-like-a-russian-intelligence-operation/2017/07/14/5f7f3dfe-6762-11e7-9928-22d00a47778f_story.html?hpid=hp_no-name_opinion-card-e%3Ahomepage%2Fstory&utm_term=.b22a83dce8be This is an Interesting article written by somebody with a resume that should merit attention. Rolf Mowatt-Larssen is the director of the Intelligence and Defense Project at Harvard’s Belfer Center. He served for three years as director of intelligence and counterintelligence at the Department of Energy and for 23 years as a CIA intelligence officer in domestic and international posts. I note the opinion matches what I have heard from others who work for No Such Agency (NSA). Taking the meeting was the crime because of what it signaled. I read this and think about the article from the other week about the death of expertise.

Those are the days when it's best to put the phone and computer away before hitting the bottle. This goes double if you are in the public eye. There is always a jerk saying things that show their character. Your character is shown in your response, and deciding to close out the world after a hard day says little bad about you.

No, big insurers dont sell in all states. Different states have different laws, and what's required to be covered isn't universal. Some insurers leave markets due to state regulations and other leave because service providers don't want to negotiate price. BCBS almost left CA when the hospital chain there insisted on raising prices by a huge amount. When BCBS insisted they would not pay the huge increases, the chain stopped accepting BCBS. How good is an insurance not accepted at any local hospital? There are all kinds of reasons even big insurance companies can stay out of certain markets.

SkinsPassion4Life, One might think a cap on increases would work. However, for most serious conditions, maintenance of coverage is no given. When I did my senior thesis in the 90's on HIV patients, one of the things that most surprised me is over half of them lost their insurance within 2 years. Why would they allow that to happen as they are incurring hundreds of thousands of dollars in medical bills (very expensive and profitable disease in the 90's)? I wondered whether that was still the case today, and according to the CBO in their scoring of both the house and senate plans, it is still a problem. In the 90's, insurance companies did things like not collect from the PO BOX the checks were sent until the day after the bills were due. Then they would cancel the coverage for late payment. Of course, that assume what was driving the need for expensive care didn't cause the patient to be laid off from work causing them to lose their insurance coverage. The simple truth is when we most need healthcare insurance tends to be when we are most likely to lose it.

Skinspassion4life, the answer to your first question on why insurance companies have to cover pre-existing conditions is in point 3 below. 1) Everyone needs to be insured. On this point I agree. Those who do not have insurance are still having their care covered in hospital ER, probably the most expensive way to get treatment. If they can not or do not pay, the hospitals have to make up the costs for their treatments. Want to guess who pays then? It's the people with insurance or the state. This was more often the case prior to the ACA. What people miss when they advocate for people to be able to avoid buying health insurance is the fact they are advocating everyone else pay for their expensive care. Without insurance there is almost no way they will be able to pay. 2) While we need as many choices as possible, the choices have to cover a minimum amount of goods and services that could be needed. If one state says the insurance need not cover costs above $X (life time caps) or a grouping of expensive treatments (like giving birth for example), then all of the insurance companies will declare that state as its headquarters. At least, they will until another state allows them to cover less. It quickly becomes a race to the bottom. 3) If you pool the elderly and those with pre-existing conditions and put their care on the state's budget, you are creating a huge financial outlay. Keep in mind, the way insurance works is the expensive cases can be covered because everyone pays in and comparatively few require massive coverage. Making the state pay for the expensive cases would be another huge corporate gift, especially with a mandate for everyone to pay into the system. Suddenly everyone has to pay in for insurance, but on the most expensive cases the insurance companies get to turn them over to the state? The whole point of the mandate in the ACA was create pools of people large enough that the costs for the expensive cases is spread thin enough to be bearable by all. It is very easy to forget that any of us could become that expensive case. Our minds are poorly trained to understand rare events until they happen to us or someone we know. We all think this won't happen to us, so why do I have to pay for something from which I will never benefit.

http://www.ideastream.org/news/healthcare-bill-should-preserve-coverage-american-medical-association-says Interesting to see the AMA, the AHA, and the AARP come out against the senate bill after already coming out against the House bill. So the doctors, the hospitals, and the elderly (largest group of healthcare users) are against it. Which stakeholders were consulted in setting this plan up? Also for an interesting read on the perspective of why we can't separate healthcare from dollars (healthcare is not a right), there is this article: https://www.bloomberg.com/view/articles/2016-08-23/health-care-is-a-business-not-a-right The hard part is reconciling the perspective of this article with a Christian culture purporting to value life. Yes, there is a bridge too far, and there always has been. I'm just not certain the issue he sees in the article isn't one of trying to identify the bridge "too far" with cold mathematical calculations. Still, I think the point stands. Nowhere in the world is every possible treatment covered regardless of costs.

Ron, One problem with the membership model is portability of benefits. I will start with the rosiest of situations, living in the DC/Baltimore corridor where we have more doctors per thousand people than anywhere in the U.S. Let's assume I buy a membership to the large healthcare provider, John Hopkins. Great, they have doctors to treat just about everything. Does that mean I must stay in MD or risk some huge medical bill if something happens to me when I leave the area? Now to make matters worse, most of the U.S. doesn't have access to a healthcare network as extensive as Hopkins. Most have access to primary care doctors or internists, and many of those aren't close. So would they buy a member ship for those and just pray nothing happens the local membership doc can't treat? The access to care issue is exacerbated under these models unless the network is huge with agreements to treat anywhere, at which point the networks become a lot like standard insurance with in and out of network providers. The local network membership model only works where doctors and specialists are plentiful. That said, my wife had Hopkin's insurance when she was a nurse there, and it was better than my BCBS in terms of coverage and costs. However, it was a perk and not a system offered outside of employees and their families.

I am in an odd situation. I have supported and still do support a utilitarian approach of "do the greatest good for the greatest number." I support this even though if implemented I would probably not get the MS treatments I have already gotten (more than a million dollars worth and counting). I think I would still support this if it were only me. However, with the four kids my wife and I have taken into our home each having received roughly a million dollars worth of medical services and care, I am thankful society has valued our wellbeing so highly. Still at 5 mil and growing, there is a side of me very aware the opportunity costs we represent. I may be slightly inflating the costs, but I doubt by too much w each of them having spent months in the hospital... Mine is a family of miracles, some medical and some of our country's good will. So instead of saying the utilitarian is the only good approach, I give thanks and try to make the most of the opportunities we are given in a generous society. The last I tell people as a push back against the perception of our society's heartless ways of looking out only for ourselves (allowing some individual's have ability to be giving separate from society).

Funny thing is what you are suggesting is closer to what Tsongas and that Hillary lady were proposing in the 90's for which she is demonized to this day. He might have had a chance to be demonized as well, but he...well...he died. They basically took an approach of we have x dollars which means we can afford to cover a,b, and c. If you want D, we aren't saying it is no good. We are simply saying covering it will not grant as many quality life years as a, b, or c. So you can purchase insurance for D if you want. It just won't be the insurance we believe all Americans are entitled to have. The premise was basically greatest good for the greatest number possible using x dollars. That failure became a starting point for the death panel misnomers that plagued the affordable care act decades later when they tried to cover doctors having end of life care discussions with patients. Isn't it amazing how fear and slogans can slant a populations perspective for decades? Sorry, I am feeling a bit jaded on the impact of politics on our healthcare, and yet it seems politics is a battlefield on which our fight must be carried.

As we cut social service programs because they are too expensive, I wonder how long it will be until we relearn the lessons of "Million Dollar Murray." It doesn't matter if it is opioids (current epidemic), weed, crack or liquor. The question to my mind is how serious are we about solving the problems? One of my favorite quotes about what it takes for society to deal effectively with similar situations is "We can either be fair or effective, but we can't be both." How do you tell the hard working single mom that society will provide a home and counselor to this troubled man while she struggles to pay rent and provide food? Again, we can either be fair or effective. As I watch so many safety nets taken down because they are too expensive for the tax payers, I find myself expecting we will pay far more in dollars and wasted lives traveling down our chosen path in the name of "fair." There is a side of me left wondering if a problem that crosses racial and economic boundaries at will might finally bring the tragedies to enough light to re-inspire the side looking for solutions without preconceptions of morality beyond a desire to help those in dire need.