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Who should Politicians represent?

Herdfan

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@Chew Toy McCoy has a thread about Manchin and there have been some other references to him and Sinema holding up the $3.5T stimulus, so..........

It made me wonder who everyone thinks politicians should ultimately represent. Their constituents, their party or the nation as a whole?

It is their constituents who elected them, but at the same time there is a good chance that the party added money or other support to help get them elected. So should they be beholden to the party, or do what their constituent's want. In some cases, those are one in the same, but in the case of say a Rep or Senator from a purple District or State, it becomes a bit more complicated.

They may need the party support to get elected, but if they simply vote the party line, there is a chance they won't be reelected, especially in some of those districts that are essentially 50/50.

So should they represent what the voters want, or should they vote the way the party wants?

Or should they ignore both the voters and the party and vote the way they think is best for the country?
 

Chew Toy McCoy

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@Chew Toy McCoy has a thread about Manchin and there have been some other references to him and Sinema holding up the $3.5T stimulus, so..........

It made me wonder who everyone thinks politicians should ultimately represent. Their constituents, their party or the nation as a whole?

It is their constituents who elected them, but at the same time there is a good chance that the party added money or other support to help get them elected. So should they be beholden to the party, or do what their constituent's want. In some cases, those are one in the same, but in the case of say a Rep or Senator from a purple District or State, it becomes a bit more complicated.

They may need the party support to get elected, but if they simply vote the party line, there is a chance they won't be reelected, especially in some of those districts that are essentially 50/50.

So should they represent what the voters want, or should they vote the way the party wants?

Or should they ignore both the voters and the party and vote the way they think is best for the country?

They should vote based on what would help out the majority of their constituents but almost always vote on what will help the richest of their constituents.

On things like climate change in fossil fuel job heavy regions they should do whatever they can to promote and attract green jobs to replace those lost jobs.
 

TBL

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They should represent their wealthy donors and corporate benefactors. :D

I hate political parties, so I'm never going to say they should represent their party.

They should represent their constituents, but how does one balance that with doing the right thing? Republican politicians might not believe the election was stolen, but they have to go along with the lie to please their constituents which does more damage in the long run in undermining democracy. Are politicians really doing what they should be doing when all they care about is popularity to fuel their career?
 

Pumbaa

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They should represent their constituents, but how does one balance that with doing the right thing? Republican politicians might not believe the election was stolen, but they have to go along with the lie to please their constituents which does more damage in the long run in undermining democracy. Are politicians really doing what they should be doing when all they care about is popularity to fuel their career?
They should be representing the best interests of their constituents. Undermining democracy is arguably not compatible with that. Doing something that benefits the entire country or the world might be compatible with that.

Their constituents are also more than just the ones who voted for just them. If elected, one has a responsibility to all of their constituents.
 

Chew Toy McCoy

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Republican politicians might not believe the election was stolen, but they have to go along with the lie to please their constituents

Republicans promote the big lie because it doesn’t threaten the wealth of their donors. Ditto for illegals and voter fraud. National healthcare and taxing the wealthy polls favorably regardless of political leanings. They just toss out “socialism” and that is the entire side of the debate.

You’d think the big employers would favor national healthcare because then they wouldn’t have to provide insurance, but more importantly they see providing health insurance as leverage to keep people in shit jobs they would leave if that wasn’t part of the compensation. It’s also an excuse to not pay people more.
 

Alli

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Biden always says he’s here to represent all Americans, not just red or blue. (I’m getting tired of hearing that.) But that’s how all politicians should be. And if a majority of the constituents want something that is patently illegal, immoral, or undemocratic, then it is up to the elected leader to go against it.
 
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Herdfan

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You’d think the big employers would favor national healthcare because then they wouldn’t have to provide insurance, but more importantly they see providing health insurance as leverage to keep people in shit jobs they would leave if that wasn’t part of the compensation. It’s also an excuse to not pay people more.

Who is going to pay for it then?

I only see 2 options:

1) Higher taxes on businesses. So they end up paying for it anyway, or

2) Higher taxes on workers. So they are going to demand higher wages just to make themselves even.

If you say it will just be taxes on the rich, well they don't make enough to cover all of it even if you taxed them at 100%.
 

Pumbaa

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Who is going to pay for it then?

I only see 2 options:

1) Higher taxes on businesses. So they end up paying for it anyway, or

2) Higher taxes on workers. So they are going to demand higher wages just to make themselves even.

If you say it will just be taxes on the rich, well they don't make enough to cover all of it even if you taxed them at 100%.
I wouldn’t be too sure about that.
Your current circus is wasting plenty of money, both private and public. And you’re spending tons of public money on healthcare anyway.

Paying for it is not a zero sum game.
 

SuperMatt

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Who is going to pay for it then?

I only see 2 options:

1) Higher taxes on businesses. So they end up paying for it anyway, or

2) Higher taxes on workers. So they are going to demand higher wages just to make themselves even.

If you say it will just be taxes on the rich, well they don't make enough to cover all of it even if you taxed them at 100%.
In many other countries, these taxes are less than what we pay for insurance in America. So the businesses would have more taxes, but it would be more than made up for by not having to pay for insurance.

Also, businesses already pay healthcare taxes (they pay 50% of the medicare tax for every employee), so this is not a new thing.

When you consider the fact that most healthcare spending is from the elderly, you realize that much of healthcare spending is already "socialized medicine" in America. It makes a lot of sense to extend it to everybody, not just the elderly.
 

Chew Toy McCoy

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Who is going to pay for it then?

I only see 2 options:

1) Higher taxes on businesses. So they end up paying for it anyway, or

2) Higher taxes on workers. So they are going to demand higher wages just to make themselves even.

If you say it will just be taxes on the rich, well they don't make enough to cover all of it even if you taxed them at 100%.

Higher taxes for sure, but my question also is how much of the ridiculously high cost of US healthcare is blamed on subsidizing people who aren't insured? What happens when everybody is covered and they no longer have that scapegoat?

Also AFAIK other countries who have more socialized healthcare also have price negotiating power (as it should be) where providers can't just charge whatever the fuck they feel like. That also brings the cost down.
 
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Herdfan

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In many other countries, these taxes are less than what we pay for insurance in America. So the businesses would have more taxes, but it would be more than made up for by not having to pay for insurance.

Also, businesses already pay healthcare taxes (they pay 50% of the medicare tax for every employee), so this is not a new thing.

When you consider the fact that most healthcare spending is from the elderly, you realize that much of healthcare spending is already "socialized medicine" in America. It makes a lot of sense to extend it to everybody, not just the elderly.

Good point about the elderly. Hadn't really thought about that.

However, Medicare reimbursement is not enough to keep most hospitals open, they need the higher payments from private HI. How is the difference made up?

What would be your thoughts on a consumption based tax to pay for it like a VAT or Sales Tax? Europe uses VAT taxes quite a bit even if they are a bit regressive.
 

Chew Toy McCoy

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What would be your thoughts on a consumption based tax to pay for it like a VAT or Sales Tax? Europe uses VAT taxes quite a bit even if they are a bit regressive.

I’d be open to a system that requires some form of accountability, like a required yearly physical and taking measures to improve any health issues between physicals. Not willing to do that, then you can go back to the diddly squat tier we praise as the best in the world. FREEDOM AND CHOICE!
 

Yoused

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Who is going to pay for it then?

That really is the wrong question, though.

Consider the problem of homelessness. It has been observed that it is straight up cheaper to just give the homeless a decent place to flop. It takes them off the street, so that the rest of us are not plagued by their schizophrenic rantings, shooting up or dirty, pathetic urchins in our faces as we stroll about the streets. Once we get to that point, dealing directly with the individuals' problems becomes less problematic, and people in general will have less anxiety about what would happen if their world comes crashing down and they have nowhere to go.

Healthcare is a similar sort of thing. Providing it for everyone, no questions asked, is hugely more efficient (less administrative red tape BS) than imposing this system of conditions and trying to deal with the overall costs of where the system fails. Marketplace dynamics may be an elegant solution to some things, but the profit motive often comes with steep costs that are socially problematic and impact all of us one way or another.

With UHC, part of the implied subtext is that once the government gets a look at the whole picture, they might start outlawing or heavily taxing/regulating the vices that lead to higher system costs, and that would be a bad thing. Or, perhaps it would not. What would happen to us if Americans were pushed toward more healthy lives?
 

SuperMatt

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That really is the wrong question, though.

Consider the problem of homelessness. It has been observed that it is straight up cheaper to just give the homeless a decent place to flop. It takes them off the street, so that the rest of us are not plagued by their schizophrenic rantings, shooting up or dirty, pathetic urchins in our faces as we stroll about the streets. Once we get to that point, dealing directly with the individuals' problems becomes less problematic, and people in general will have less anxiety about what would happen if their world comes crashing down and they have nowhere to go.

Healthcare is a similar sort of thing. Providing it for everyone, no questions asked, is hugely more efficient (less administrative red tape BS) than imposing this system of conditions and trying to deal with the overall costs of where the system fails. Marketplace dynamics may be an elegant solution to some things, but the profit motive often comes with steep costs that are socially problematic and impact all of us one way or another.

With UHC, part of the implied subtext is that once the government gets a look at the whole picture, they might start outlawing or heavily taxing/regulating the vices that lead to higher system costs, and that would be a bad thing. Or, perhaps it would not. What would happen to us if Americans were pushed toward more healthy lives?
The loss of insurance companies‘ donations would be a serious problem for many politicians.
 
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Herdfan

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Healthcare is a similar sort of thing. Providing it for everyone, no questions asked, is hugely more efficient (less administrative red tape BS) than imposing this system of conditions and trying to deal with the overall costs of where the system fails. Marketplace dynamics may be an elegant solution to some things, but the profit motive often comes with steep costs that are socially problematic and impact all of us one way or another.

With UHC, part of the implied subtext is that once the government gets a look at the whole picture, they might start outlawing or heavily taxing/regulating the vices that lead to higher system costs, and that would be a bad thing. Or, perhaps it would not. What would happen to us if Americans were pushed toward more healthy lives?

I would probably give you that if it were 20 years ago. But technology has gone a long way to eliminating those costs. Used to be you gave your Dr. a copy of your insurance card and they initially went with what it said on the front. Then if it wasn't correct or something wasn't covered, then bills had to be sent out, insurance had to be billed etc. Last time at my annual, they took my new card, called up my policy in their system, told me exactly what insurance would pay and what I had to pay.

As for regulating vices, good luck with that. Too many politicians are alcoholics.
 

SuperMatt

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I would probably give you that if it were 20 years ago. But technology has gone a long way to eliminating those costs. Used to be you gave your Dr. a copy of your insurance card and they initially went with what it said on the front. Then if it wasn't correct or something wasn't covered, then bills had to be sent out, insurance had to be billed etc. Last time at my annual, they took my new card, called up my policy in their system, told me exactly what insurance would pay and what I had to pay.

As for regulating vices, good luck with that. Too many politicians are alcoholics.

Below are actual numbers on the costs of healthcare administration in America. More than 1/3rd of healthcare costs in America are administrative. In Canada, it's about 1/6th. So much for "government inefficiency."

U.S. insurers and providers spent $812 billion on administration, amounting to $2497 per capita (34.2% of national health expenditures) versus $551 per capita (17.0%) in Canada: $844 versus $146 on insurers' overhead; $933 versus $196 for hospital administration; $255 versus $123 for nursing home, home care, and hospice administration; and $465 versus $87 for physicians' insurance-related costs. Of the 3.2-percentage point increase in administration's share of U.S. health expenditures since 1999, 2.4 percentage points was due to growth in private insurers' overhead, mostly because of high overhead in their Medicare and Medicaid managed-care plans.

Source (2017):
 

Yoused

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Below are actual numbers on the costs of healthcare administration in America. More than 1/3rd of healthcare costs in America are administrative. In Canada, it's about 1/6th. So much for "government inefficiency."

Source (2017):
https://pubmed.ncbi.nlm.nih.gov/31905376/
According to this article, US Medicare has administrative costs significantly below 2%, which is less than a fifteenth of 1/6th. They do mention other analysis that says it is 6%, which is still barely over a third of 1/6th, but
This enormous disparity between two measures that used to be almost identical should long ago have triggered inquiries within Congress and the US health policy community as to whether the higher administrative costs associated with the growing privatization of Medicare are justified.
 

SuperMatt

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According to this article, US Medicare has administrative costs significantly below 2%, which is less than a fifteenth of 1/6th. They do mention other analysis that says it is 6%, which is still barely over a third of 1/6th, but
This enormous disparity between two measures that used to be almost identical should long ago have triggered inquiries within Congress and the US health policy community as to whether the higher administrative costs associated with the growing privatization of Medicare are justified.
There is no evidence that private insurance is cheaper than a system like Canada's. All the evidence is to the contrary, that it costs at least 2x as much, and that's only counting administrative costs. I can only think that insurance companies have many politicians in their pockets. America would save billions every year if we got rid of the current medical insurance system.
 
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