Noah Smith joins to discuss what Tulsi Gabbard could do to America, the other anti-qualified nominees, the Penny/Mangione cases, and what Syria should remind us of.
Highlights / Lowlights
Mona: Rupert Murdoch's Succession Fiasco, Clive Irving at Vanity Fair
Linda: Why Does Pete Hegseth Keep Talking About ‘Warfighters’? Elliot Ackerman at The Free Press.
Bill: His WSJ column: Save a Reagan Initiative From Musk and Ramaswamy
Damon: When Democracy’s Defenders Turn Into Its Gravediggers, Yascha Mounck
Noah makes his reasoned pitch as to why rabbits make excellent pets.
With regard to Noah’s observation that women on the left appear to suffer the most negative consequences from exposure to social media. I would just say that it strikes me that’s perhaps more an issue of of who is more likely to self-report on psychological and emotional health issues than an actual statistical reality and my guess is it’s widespread across many demographics
Daniel Penny’s “controversial” “actions” ARE murder. NO person, no matter how marginalized and offensive with their acting out should be dead now because of ignorant prejudice (mentally ill, homeless and black) and feeling free to snuff out that life. Disgusting.
No, Noah Smith's comments are not helpful. In fact, they are lies. The average rate of denials is not around 3% - it's 17%, nearly 1 out of 5 claims. Some companies (among them United Healthcare - and what a misnomer that is) deny nearly HALF of all claims. Is there any other product or service we buy where we would accept that one out of five times we don't get what we pay for, much less that half the time we don't get what we pay for?
And while it's true that the profit margins are very small in health insurance, the profits are immense in real dollars. United Healthcare netted $20 billion in 2022. Someone who has just been denied treatment for their illness is not going to accept that it's because the insurance company can't afford it. And it's not just the profits that are enraging people, but the salaries. The CEO of the company makes $10 million per year - far more money that the average American will make in a lifetime.
It was chilling to hear Smith suggesting that a solution to denial of coverage is for companies to pay more claims, but at a lower percentage of cost, leaving patients to pick up the difference. People are already paying thousands of dollars in premiums ($20,000+ for families) and then have to pay deductibles and co-insurance before their plan pays anything. How much money does he think the average person has? This is not insurance - it is a racket.
The United States spends more per capita on health care, with the worse health outcomes of any industrialized democracy in the world. And we're the only industrialized democracy in which people go bankrupt because they can't pay their medical bills.
The only solution for people to be able to get the health care they need at an affordable price is national health insurance that covers everybody and is paid for by a tax assessed on personal and business income. All the money that goes to shareholder profits and that is spent on excessive executive compensation and benefits, as well as marketing and lobbying, would go to actual health care. Administrative costs would be substantially less for hospitals and physician practices by having just one entity (the US government) to pay, rather than a multitude of insurers. Billing would be simplified and collection costs non-existent.
This is all about mental health. I am reminded of John Hinkley Jr's assassination attempt of Reagen. I think we will find out soon enough about Luigi's mental health. That American's rejoice in someone's murder is sick and mentally ill in itself. Thompson's kids do not deserve having their father murdered. Does anybody think his choice of career is noble? No. Did he deserve to die? No. The man Penny killed was mentally ill. What Peney did was manslaughter. It's that simple. As the mother of a young man with Schizophrenia and Aspergers the American populace inability to understand mental illness and respond with compassion and the ability to de-escalate a health episode is frightening. Would we treat a person having a physical seizure and flinging themselves around by landing them in a hold with an arm on their neck and killing them in the process? This is my greatest fear for my son. He is a great citizen most of the time. And as a person with a pre-existing condition, over which I have little control, perhaps the system as designed should not exist. I don't give a rat's ass about their thin profit margin. Don't be in the business of making money on someone's suffering. The system we have by default is sick and mentally ill. While I agree with Bill, this is a dangerous moment, I really am done with this podcast. I find little understanding by the panelists of root causes and too many flippant political responses with laughter about mental illness.
Brilliant discourse. Thank you. Read "On Freedom" by Timothy Snyder. Americans cannot fathom what living in a country controlled by a sadist, but we may find out in round two.
I asked Google: "What is gross margin of United Healthcare?" The response: "UnitedHealth Group average gross margin for 2022 was 24.17%, a 2.38% increase from 2021. UnitedHealth Group average gross margin for 2021 was 24.76%, a 3.73% decline from 2020." The source here is a website called "Macrotrends." For 2023, UHC had earnings before interest and taxes of 32.358 billion dollars on revenues of $290,827 billion, a rate of profit of a little over 11%. So I don't know where Noah Smith is getting his numbers, but it's not from the annual report of UHC, and his summary of the business sounded very suspect to me. They did post a net loss in one recent fiscal year.
Hard disagree with Noah on the healthcare providers getting to give everything and insurance being the bad guy…. Who tells the patients they don’t have coverage for treatment or their insurance has denied claims, the doctors and medical professionals, we see the agony, we say no bc our hospitals won’t allow treatment without payment, and we take the anger and despair. Also no mention that they are not qualified to know what a patient needs, very irresponsible to not understand the real system and report this. Also, no mention of the extremely high salaries and billions in profits listed while doctors who have schooling for 10 plus years make much
Much less. I believe that this panel needs to speak to hospital systems or healthcare professionals before stating as fact how the process works.
When talking about insurance costs, we really need to be looking at administrative expenses and compensation at the top. Those who are not providing direct care and service are making way too much more than those on the front lives healing and saving lives.
I want to address a point raised in passing by Noah because I think it perfectly captures a problem with discussing healthcare.
What he said is that insurance is a tough business and that margins are 1-3% compared to an average 12% for the S&P 500. That fact ignores the outsized profit margins of the IT-heavy Magnificent Seven which artificially inflate the overall average.
That’s simple math. No advanced training in econometrics is required nor will it explain it away. As the mathematicians say, it’s an identity.
Plenty of industries operate at 1-3% margins. Notoriously, grocery stores do. No one argues that’s why there’s food insecurity.
Meanwhile, while lamenting the challenges facing Mr Thompson and his peers, we ignore the fact that medicine and healthcare are, in the US, a business.
I’m sorry to report that there are only a few ways for businesses to make more money. And businesses use all of them including degrading their products and raising prices. Productivity gains are nice to talk about but much harder to pull off consistently than the more blunt force methods.
So of course premiums rise and coverage shrinks. It is about rationing, as Mona says. But rationing that favors shareholders at the expense of the insured.
Aside from the irreversible risk to national security with Gabbard, (which is something no one wants talk about but since he nominated her) Trump may also be in line with which is why he picked her — she’s his direct line to Moscow?!
With Hegseth it’s what he will do to
Moral and also whether he is capable of handling any unexpected military crises. If he’s just there to be Trump’s “yes” man and carry out Trump’s desires. But then there is him potentially hollowing out the military with his discrimination and bigotry towards minorities and women serving at a time when recruitment in poor. He said he was okay with women as pilots just not in combat. And he doesn’t want LGBT in the military. Maybe the generals can stop him and it won’t trickle down and hurt moral, but it could hurt our readiness.
As to Kennedy, yes, maybe Americans learn the hard way in states that decide to follow his advice. Many parents are not do foolish as to not want their kids to get vaccines and I’m assuming there won’t be a country wide ban on them. But stop vaccination in babies in some states that adhere to his advice in this political science experiment seems to me to be cruel as the ones who survive could come out with life-long debilitating health problems. Do we want to see kids crippled by polio or rickets, getting measles or the mumps, etc.
But we all could suffer if there is another Covid-like contagious outbreak (which is being predicted) and Kennedy sits back and does nothing or tries to prevent vaccines from becoming available. Not to mention how this will impact the ability to travel outside the country or even outside certain states if blue states go it alone and provide vaccines but want to block people in highly contagious red states from coming in. This alone scares me personally the most.
I beg to differ. Noah Smith and panelists can spend some time with hospital and clinics and ask some questions about the denial process, the staff required to handle insurance requirements including denials, pre authorization and claims management while also facing declining reimbursement from all quarters. Call the American Hospital Associayion and the National Rural Health Association and ask about the razor thin margins, in comparison to the “thin” margins of insurance companies. Try again.
My exact thoughts, you stated this much more eloquently
I want Rupert’s trust to stay in place!
I bumped on the idea that healthcare companies are on the razor's edge of profitability. The claim was 1-3% of profitability, with an insinuation that it barely makes sense to run a business at that level. UnitedHealth Group had $371.6B in revenues and made $22B in profit. My math might be rusty, that's just a hair under 6%.
And then comparing it to the S&P500 average profitability? That's apples to steel. Apple has almost a 24% profit margin. Should UHG strive for that level and consider itself a failure if it doesn't get there? If you are concerned about the profit margin for a company you're invested in, sell your shares and buy in a different company.
Did not even one of you read what all the signs said in the closing weeks of the Harris campaign? Did you not listen to any of her speeches? FREEDOM. FREEDOM. FREEDOM. Sadly, the idea of losing or gaining freedom did not resonate with the majority of American voters.
Tulsi Gabbard is a Lieutenant Colonel in the US Army Reserve and already has top-secret clearance.
https://en.wikipedia.org/wiki/Tulsi_Gabbard
see the last paragraph in the entry of her military service and the last sentenence of that paragraph.
In 2020, after serving with them for 17 years, Gabbard left the Hawaii Army National Guard for a new assignment with a California-based Army Reserve unit.[83] On July 4, 2021, Gabbard was promoted to the rank of lieutenant colonel, while she was deployed to the Horn of Africa working as a civil affairs officer in support of a special operations mission.[17][18][2] Subsequently, Gabbard was given the command of the 1st Battalion, 354th Regiment, based in Tulsa, Oklahoma.[84][85] As a lieutenant colonel, Gabbard has top-secret security clearance.[34]
Her five-year periodic reinvestigation will be coming up soon.
Well like a commenter above stated, “she’s a tool for our enemies.”
“Politics abhors a vacuum” -and our incoming administration is isolationist.
Hegseth, Gabbard, RFK Jr, and Patel are all threats! It’s not productive to try to figure out which one is worse than the others. We must try to stop them all. I don’t know how you can say that the potential damage from RFK Jr. can be undone. Tell that to the families of the children in Samoa who died after he blamed vaccines for their illnesses.
As an incurable optimist, I hold out hope that the senators may be planning to use the FBI vetting as a shield. “Oh, we wish we could confirm so-and-so, but you know, this FBI report . . . Of course we can’t tell you what’s in it; that would be unfair to the appointee.” Or they may be hoping that the appointees will take their names out of consideration once they realize what’s in the FBI report. (Like I say, incurable optimist. But my cat did come home two months after Hurricane Katrina, so miracles sometimes happen.)
Glad to hear about your cat!
Make America Get Polio Again?...that wasn't in the brochure
Don't always agree with Bill, but I thank him for being the only Bulwark person ive heard to take seriously Kennedy's threat to immunisation. Too often, I've heard glib comments, from JVL for example, saying a few kids may get polio, but oh well, that's just collateral damage. Anyone whose seen a person live their entire life immobilised in an iron lung wouldn't be so flippant.
Insurance companies make single digit profit margins while the actual care providers are raking in 2,3 in some cases 4x that. But the jnsurance company is the public facing scapegoat. No one seems to question why procedures, med tech, labs , pharma and hospital costs should get multi-digit profit margins, which plainly drives up the cost of premiums and copays. No one rails against provider and pharma CEOs in the wake of the CEO murder; it’s all about insurance with their by comparison low profit margins. Pretty sweet deal to have the middle man take all the blowback for your unreasonably high costs and giant margins.
Hands on Care “providers” certainly do not make millions and they have actual training to treat patients after years of schooling, unlike someone on a phone following an algorithm who does not have any education in medicine. We are the “face” of healthcare and take the brunt of the denials, seeing the despair and informing the patient of their lack of coverage. I would like to know what “service” this middleman provides?
I'm talking about provider industries like HCA and Pfizer, not individual workers. These corps are making the bulk of healthcare profits, and they're a big reason why a coverage industry exists in the US in the first place.
A very interesting and useful discussion about the current moment and whether it is a populist one. A challenge to Noah Smith's claim that we aren't in a populist phase. He seems to make this claim primarily on the basis that there is very little populist action appearing in public spaces, aka, the physical world. However, there is a whole universe of common social activities that are also decreasingly occurring in public. Is it possible that we just don't understand what populism looks like in a society that largely avoids group activity and increasingly engages through digital media? Robert Putnam wrote his seminal book decades ago, and trends of individual isolation have persisted -- despite anomalous moments like the George Floyd protests -- while we have also watched the rise of social media as a primary means of human interaction. It is these two phenomena working in tandem that could confound a superficial analysis. It may be that 100 years from now we can compile a better sense of how populism develops in the 21st century information environment. We might find that we need to modify or reject ways of detecting or defining populism that rely on the model of the French Revolution or 20th century examples of fascism or socialism.
Yes, indeed, it would have been nice if the Democrats had even thought of running on Democracy (like Joe did) or freedom (like Kamala did). How have such supposedly well-informed people managed to miss the Beyonce anthem "Freedom" at every Harris rally? That one word was the best Democratic communication of the entire campaign, but it must be hard for Republicans to hear.
Percy, although the voting is still being analyzed, it already is known that "freedom" was not in the Top 5 or so reasons many Trump voters made their choice. The price of eggs, you know.
I do realize that. But I thought some on this panel implied that it would have been nice if the Dems had thought about big concepts like democracy and freedom. Tongue in cheek I am suggesting that they may not have followed the reality of the campaigns, only their perceptions of them.
Wow. This was a really terrible episode. Everything in their take on the insurance industry was just wrong.
Rabbits are excellent pets though. Litter trained for pee and the poops are dry and easy to vacuum.
Mona is so outraged at the killing of an innocent man while I am old enough to remember her calling people who were outraged at the innocent killing of babies and children in Gaza antisemetic. 🤷♀️
The Gaza protesters refused to blame the actual culprits - Hamas, which was using civilians as human shields.
Pleasantly surprised to see Noah on the pod. We've crossed paths at the local rabbit rescue, enjoying the company of bunnies while volunteering there. Mona - kitty so cute! And as always, love this pod and the different voices. Love the links to articles discussed on the pod. Thank you!
Please have Noah Smith back soon.
I completely agree with everyone that Tulsi Gabbard is the worst of Trump's nominees. I listened to Tim's podcast this morning with Adam Kinsinger and Kinsinger's discussion of Tulsi. Not only is she completely unqualified for the position, but she's just a tool of our enemies. Anyone that votes to confirm her for DNI is probably a traitor to the US as well.
Every other Western country has some form of socialized medicine and yet the US continues with our not working solution. There was a report out this week that says that we are the most medically suffering nation on Earth.
Not that I am a fan of an approach like the UK's NHS where you are prioritized by criticality, but there has to be some solution to this issue. My own doctors think that the approach used in The Netherlands is the way to go. The government there pays for basic health care and wellness (vaccines, testing, etc.) as well as common ailments (broken bones, sore throats, etc.) and diseases (diabetes, high blood pressure, etc.). People then individually buy insurance to cover major medical hospitalization, cancer, long term illness, etc.
It was great to hear that Penny was found not guilty. I know that is difficult for the family of the victim, but when you show up on a train and declare that you are going to kill people, that is a "him or me" situation, and I am sorry, but I intend to come off that train alive and if that person threatening me and others does not survive, too damn bad!
Suggest you look at Australia's universal health scheme. All illnesses, major and minor, are covered without need for additional insurance. You can buy insurance to access private hospitals. Those providing this insurance cannot refuse insurance because of prior conditions, and cannot cancel insurance because of illness.
Great for citizens until the government runs out of money.
Sounds like a financial disaster waiting to happen which is what the UK is now facing with the NHS. I just do not see how any government can absorb the costs of major medical for all citizens. That is why The Netherlands did what they did. Get people to take on the costs for major medical conditions that they will likely encounter at some time in their lives but also allow for pre-existing conditions.
That's not how government works. It's not funded from a finite pool of money. We don't say the same about schools, public transport , defence forces etc. We fund them sustainably. It's not "a financial disaster waiting to happen". Do some research on it rather than.making snap judgements.
Really???? Then why is NHS for example rationing health care? Because there is a VERY finite pool of money available, Yes, that is a sustainable approach, but most people would tell you it is inhumane. No different than what the insurance companies are doing to people today.
Apologies about the comment re not learning from anyone else. You spoke favourably about the Dutch system so you are clearly not in that category.
Cheers and have a good Christmas.
No problem. I too get a bit wound up when replying to things, Have a great holiday as well.
Jeff, the NHS is not in Australia. Our system is different. A recent review of the NHS found Australia’s system (Medicare) is one of the best in the world and one from which the NHS could learn. Americans seem to lump everything under “socialised medicine”, whatever that means. Universal health schemes vary from country to country. They are not the same but World Bank data shows they deliver better outcomes than does the US.
Ours is sustainable because it is funded by a levy (a small % of income) of all taxpayers topped up from general revenue in just the same way as schools, etc are funded.
I sometimes think Americans have the view they are best at everything (the exceptional country) and therefore they have nothing to learn from anyone else. Don’t know you well enough to know if you are in that category or not. But I do know that no-one in Australia would swap our health care system (with all its faults) for that of the US.
America’s health care system is possibly one of the best in the world.
However, accessing it sucks because without insurance, the cost is astronomical and unaffordable for anyone but a billionaire. And even with insurance, accessing it can be daunting.
Then there are the outcomes which, based on the latest reporting, Americans are horrible as far as our health goes. We apparently live with a lot of pain due to (again) access to the system.
The for profit insurers in the US are taking heat for being the bad guys, which in some cases they are because they deny claims at a phenomenal rate at times all in the name of making a profit. Non-profit insurers seem to be a bit better in claims, but they too do not have an endless supply of funds.
The Australian system must be one of the better kept secrets in the Western world because until you explained it, I had not heard about it. I had assumed like most things in Australia, it would be patterned after the UK. So it is good to know that it is better than what the UK has in the NHS.
Because for 14 years, the Conservatives continually cut the appropriation for the NHS. They also began privatizing some aspects of the service. Privatization ALWAYS adds to the cost of a government service, despite the dishonest claims of privatization advocates. And it's basic arithmetic - you're adding shareholder profits and usually higher executive compensation to the cost of the service. What inevitably follows is a reduction of either the number of people served or the quality of the services rendered. And sometimes it's both.
Regarding Penny verdict, the only one who was actually assaulted was the victim. I guess preemptive war is also justified if enough people are "scared"
Actually, preemptive war is the right kind. And no the guy threatening everyone had assaulted and injured people in the past. The fault is In a system that does not monitor people for medication compliance once someone has been injured.
Jordan Neely's past history is totally irrelevant in determining whether Penny was justified in his action, as Neely's history was not known to Penny when he choked the life out of him.
Invading Iraq was wise & justified? Interesting view. Lots of disturbed individuals rant & rave saying threatening things on the subway or bus, should people choke them out every time it happens? Penny had no idea about Neely's criminal record so how would he know that force was necessary? If Neely had attacked someone that day then fine, but that's not what happened. Impulsive negligence.
Iraq was a dumb war that I spoke out against in advance. It was based on Bush II being upset there was no retribution for Sadam threatening his dad. Fear can be justified based on actual evidence.
As for Penny. He did not get up that morning saying he would kill someone on the subway. He got on and there was a man threatening people. And your excuse that the people did not know he REALLY WAS dangerous is lame. It was an accidental homicide. Tragic, but not Penny or Neely’s fault, really. Penny should have been under lock-up or monitored medication after the previous assault.
As for, seeing crazy people all the time and they USUALLY are not a REAL threat get real. People respond to fear. It is normal and a protective response.
I stand corrected. People who seem threatening in public should all be choked to death.
Twist my statements to your hearts content. The fact is that people interpreted his behavior as threatening and lo and behold we learn that he had seriously injured someone in a similar situation. Evidently, in this case, the instincts of people were right. He should not have been charged and now in the sickness of society he is a hero. It is all tragic.
Unfortunately, the authorities who should monitor or lock up crazy people have too many incentives to ignore them and hope for the best. Since mental illness is a disability, they worry about falling afoul of the ADA if they overreact, but there is no penalty for underreacting. Another problem is that police just are not trained in how to deal with mentally ill people.
Several years ago, my apartment building burned down because the schizophrenic guy in the apartment above me went off his meds. His wife and sister complained to local authorities to no avail. Earlier that morning, he reportedly was starting fires outside, but the police refused to arrest him. He was clearly in a manic phase and was delusional, but the cops didn't want to deal with him.
We suffered through over a million dead due to Covid, and still a sizable portion of the American populace decided to reward Trump's incompetence with another Presidential term. So this concept that people will finally come around if there is more suffering is inherently flawed. Rather than trying to win back these "Nothing sensible get through" voters. we may have to focus our efforts on motivating sensible intelligent non voters, if they even exist at this point.
It’s mind boggling, as is the low Covid booster shot rates have been the past few years despite all the new Covid variants coming in, the debilitating effects of catching long Covid. Yet so many people aren’t getting them. I’ve had them and east side effect was a slightly sore - really just achy - upper arm where I got the shot which began 6-8 hours later, but was gone by day 2 or 3. And maybe I was a little tired, but I had been tired to begin with so I’m not sure the vax had anything to do with that.
The Covid boosters are all upgraded to protect against the latest variants and the newest Covid shots aren’t even called “booster” shots but now regular annual vaccinations like the flu vaccine which you can get at tte same time. Most people aren’t bothering to get them even though they’re free and readily available. But at least they’re available and I want to see them continue to be available.
Those intelligent ones are the minority unfortunately. Most find their little information bubble and bury their head in the sand
Unfortunately this is the risk…and it is a real risk.
The question is if trump doe everything he said he would do is it worse if (1) they like it or (2) don’t like it but change nothing. I got to say number 2 seems worse
As to health "insurance," in the US, not only is it immoral to prioritize shareholders over the health of the citizenry, it's also often incredibly stupid. Why is it that the insurers don't know their own rules and ask billers to explain their own rules? (Sometimes it's because they buy each other and there are no actual rules.) But as a person with a lifelong illness that should not have been my life's work (and wouldn't have been anywhere else on earth,) please explain to me how it is effective for *anyone,* shareholders included, to deny care something that costs less than $500 but which prevents a month in the hospital? Obviously, admitting someone to a US hospital costs more than $500, let alone keeping that person (who now can't work or do anything else) there for 30 days? Or my younger sister who for no apparent reason, in the middle of a course of chemo, was denied her treatment a couple of times -- and because the cost is not the actual cost in the US -- it's impossible for a regular person to say "OK, I will pay for it this time." It also has to do with doctors in the US, many of whom seem to exist only to write referrals to specialists and tests, some of which might be avoided if the doctors knew how/had the time to examine patients and listen/ question about certain complaints. No patient wants a counter full of meds or a life dedicated to dealing with insurance companies and running interference between doctors and those companies, but in the wisdom of the wealthiest nation on earth, it's too expensive for many to see a dentist or doctor, and guess what -- it costs all of us more in the end. Surely nobody believes this is a great system for healthcare?
PS, I agree on cats and rabbits though. Best unexpected combo of my life.
Has anyone mentioned the valorization of Kyle Rittenhouse by the MAGA followers? Was he not a featured speaker at TPUSA? Hanging with elected Republicans? This, along with the “approval” of the J6 violent insurrectionists is the issue.
Vigilante justice is never good and Mangione should be held accountable for his actions.
One should note however, that the right is (not so) tacitly encouraging vigilantes. Legislatures are enacting laws that reward people for turning in their neighbors who are traveling out of state or otherwise attempting to get abortions, or those who may be undocumented. It’s a slippery slope and we are well down that hill.
Far be it from me to argue with an economist, but looking at UNH's Year end 20231231 10K, I see an operating margin of 8.7%, and Net earnings margin of 6.0%. That ain't 12, but it's also not a razor's edge. Their earnings after taxes were $23 billion. They're paying an $8.40/share dividend.
Bringing me to my next point. Linda rightly identified the customers of UNH as the companies (employers) that pay them, rather than the patients (employees). Stipulated that people reveling in the man's murder is horrific, but it wasn't the HR and benefits associates sending those tweets.
Who among us have not felt, when they are receiving health care and travelling the maze of service, coverage, and payment that their presence was incidental to the whole operation and limited to having the thing done to us and then waiting to see how much of whatever it was we need to pay for.
Finally, I'd say that the experience is designed to become an adversarial one where care sometimes takes a back seat to figuring out who will pay for what and how much.
I think you misunderstood Linda's point. Since medical bills are paid by payers (insurance companies, Medicare, and Medicaid) rather than by patients, from the PoV of medical providers, their customers are the payers, not the patients. That limits the ability of patients to advocate for themselves or negotiate directly with providers.
What a heartless clueless spiel by Noah. How about insurance companies don't profit off of Healthcare. Medicare for all. Public option. Get all these corporations out of it. This issue crosses parties. It's a class struggle
Do you really think people will be happier to have their claims denied by a federal bureaucracy rather than by a private-sector bureaucracy? Only the anti-capitalist far left will even care.
What makes you think claims would be denied by the government? Although Medicare does initially deny some claims, it does not require pre-approval. So people are not left without care as Medicare and the health providers work out whatever the problem is.
The idea would be more transparent standards. Medicare accreditations, Critical pathways much less care and benefits left to whims of the middle men and what they can get away with. Its not anti capitalist, its pro human.
Medicare denies much less than private insurance, seniors in this country have longer lifespans due to Medicare- no large salaries and bonuses for executives
Thank you for your thoughts. You manage to say, ‘get corporations out of it,’ without damning corporations. Exactly, public option, plus a corporate health care option. Your choice. We, voters have to demand choices in our care. I can’t bring myself to demonize corporations since I’ve benefited greatly from them in every facet of my life. But everyone deserves standard care, no question.
No people are not satisfied with the Penny verdict. The passengers were yelling for him to stop. It was pure racism,public lynching.
Gabbard (ODNI) simply is *not* the most dangerous position-holder in this cabinet. That would go to either Patel (DOJ), Hagseth (DOD), or Noem (DHS) depending on which agency you view as potentially most dangerous when weaponized by an authoritarian admin.
Let's be very clear about American intelligence here: other "five eye" countries benefit from *our* intelligence much more than we benefit from theirs. Losing access to UK/AU/etc. intel is not a huge deal. Now compare that to what DHS and DOJ can do domestically both in terms of illegal shit and destruction to our political system and it is orders of magnitude worse. The same for Hegseth if he decides to get the military involved with certain insurrection act invocations. DHS has more armed agents than DOJ does and was using unmarked agents/vehicles to round up protestors in Portland in 2020. That's the kind of shit that is truly dangerous--not missing out on the UK's intel that at best mimics ours. MI6 is straight up not on par with the intel fusion we get between CIA/NSA/NGA/DIA--not even close.
I don’t understand how people don’t recognize that 5 eyes literally is a receiver of our information, not the other way around.
I listened to a British pod who had the last head of mi-6. He said that they provide the most of all 5 eyes and it was 1/10th of what the USA provides.
It's because most people don't work in the intel world, and even if they do they may not have TS/SCI access. Once you've worked in *that* world you see where we are in comparison to the rest of our partners and adversaries, but until then you don't really. Not even at the secret level do you get that kind of exposure.
Yeah the mi-6 head was there during the last Trump term. He said the only other country which provided super useful information that was better than Americans was Israel…for Iran. Other than that though it’s basically all USA. He even said Australia’s intel was worth almost nothing
I take your point, which is focused more on domestic than foreign threats, and is based on the long term damage to the Republic these people seem to intend to do. I won't argue. I will say it's an interesting parlor game arguing which of his nominees is the worst.
That said, as I was listening one danger from Gabbard not mentioned was that, given her attraction to BS conspiracy theories, her role in selecting the intelligence that gets to Trump may lead to some interesting bleats from him in the next four years. So more fun!
Here are the dangers I see posed by Gabbard:
1) She misdirects US intel collection efforts and misses something that leads to a terror attack on US soil
- Even when we have this kind of intel in hand, the president can often deprioritize that info and we get the terror attack anyway (see Dick Clarke warning Bush in late summer of '01 that UBL is *determined to attack US homeland* and we get 9/11 anyway)
2) She starts sharing intel with Russia so as to enhance "US-Russia anti-terrorism cooperation" and gives up sources and methods in doing so that make future collection against Russia difficult
- Trump has and can do this kind of thing anyway (one recalls when he gave Lavrov US intel in the WH), so this is a kind of moot point since Trump may order it anyway regardless of who is ODNI
3) She focuses the agencies so much on surveilling China that she misses things that apply to European partner nations and they get hit by things like Russia or terrorism
- This could come from any GOP nominee to ODNI, because they're all going to have a China focus anyway
4) She burns out the intel agency workforces via demoralization and a bunch of them leave service and we have a "brain drain" in the intel agencies that could hinder our best efforts at good intel collection for a half generation moving forward
- the DOGE group efforts may end up doing things like this anyway regardless of who is ODNI
*On intel sharing, it's important to remember that other countries benefit from our intel *way* more than we benefit from theirs. Five eyes is more about us giving intel to them than them giving intel to us. It's a partnership defined by who we trust enough to share our intel with, not the other way around.
I had TS/SCI clearances, and I think Tulsi is the worst because of the second danger you point out. People in Russia, Syria, and other places who spied for the US will die. After that happens, it will take a generation to rebuild American humint capabilities - and then we really will need to rely on our partners - assuming they are even willing to share intel with us anymore.
Tulsi will fit right in with Trump's effort to destroy our alliances and international multilateral institutions that comprise the democratic world order. As far as I am concerned, that's the most important battle that we must fight with Trump. We can afford to lose all the other battles, but not that one.
Yes but you face that same danger with Trump at the top of the classification chain anyway regardless of who is ODNI. Trump could just as easily make this deal with Putin, and if Tulsi wanted to make that deal with the SVR/GRU then it would have to go through Trump anyway. From where I sit, concern #2 is more likely to come about through Putin getting Trump onboard with it than through Tulsi wanting to do it on her own initiative (which would require Trump’s sign off anyway).
Even when our intel agencies “work” we still got “WMDs in Iraq” via Curveball (the primary HUMINT source that turned out to be complete BS) and the CIA still missed the USS Cole, 9/11, and Benghazi. HUMINT tends to be the least reliable intel source and is only trustworthy when it can be backed up by ELINT/COMINT/etc. or when the HUMINT source has a long enough track record of reliability.
And given our record of abandoning allies in Afghanistan and soon to be Ukraine/NATO, I’m not sure Trump needs to sink our street credit as reliable partners much more than what’s already been done for a great number of potential spies to not trust us anymore. That damage is already like 80% done. Would you trust us under a Trump admin if you were a disgruntled GRU officer even if it weren’t Tulsi as ODNI? There’s your proof.
Let's go with they are all equally problematic. Because they are.
They're all problematic, but definitely not equal. Labeling Tulsi as the most dangerous is a joke.
It depends on which worst case scenario may rear its ugly head. We should be filling positions with people who can meet those possible challenges. They are all lightweights.
See my worst case scenarios for Gabbard in response to Tupper's reply
We should be able to do better.
We should be a lot of things, but what we are is a deeply unserious and decadent country. We're the silken slippers going down the stairs (to use the Voltaire metaphor).
I beg to differ. Education is the fifth pillar of democracy. Water it down, tilt it, or destroy it, and you have an even more mentally malleable public. No one is talking about Linda McMahon because the others are the shiny objects of misdirection. Take a look at Florida SB 7044 (2022) the atomic bomb of higher education accreditation. That is the national parties future. And Linda McMahon has the ball..
I often think about education and the lack thereof throughout our nation 😔
What if they could radicalize a whole generation? If disinformation becomes information? History may be written by the victors, but controlling the narrative is victory!