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What's the most difficult situation you've ever had to deal with while working under President Obama?

I worked at the Call Center for the Affordable Care act on first and second enrollment.Honestly most of my job was fine, I signed up the better part of 18'000+ people in the two years. Only once did I get a call from a person that could not afford health care that actually got fined. (That was mostly because he seemed to have massively over extended his money)But it was very difficult getting calls from people in states that did not expand Medicaid. Because I had to tell them they would not get health care, and could not get help paying for health care. (Because they should have been covered under Medicaid) And many where convinced they would be fined for not having medical care. (They would not, you are exempt it the cheapest care will cost more then 8% of your income)My worst call. (I will cut out and collapse some of it, it was a 90+ min Call)Me: "Welcome to the health care market place, my Name is William Moore how can I help you today."Caller: "Ya that N*GG*R Said I had to get insurance and I got this number to call."-At this point I should make a note, I am a man with a not so light Kentucky Accent, this called was a man with a not so light Alabama Accent, and sounded to be a older man-Me: -Long pause- "Sir are you referring to the President?"Caller: "Ya! That N*GG*R."Me: -Long Pause- "Sir I would love to help you with your health care, but I'm going to have to ask you to please stop using that kind of language."Caller: -Stars crying openly over the phone- "I'm sorry, I just don't know what to do. I don't have any money, I live by my self. I can't afford Insurance and I can't pay a fine, I don't want to go to jail."Me: -I had to spend the next 15 minutes calming him down by telling him that I was going to help him, and I was not going to hang up or even go home before I helped him."Me: "Sir I'm very sorry but your state has not expanded medicaid so you won't be covered. But you don't make any money to your income is $0. Eight percent of Zero is Zero. So you are exempt, you don't have to pay a fine."Caller: "They're gonna throw me in jail!"Me: "NO Sir, no one is going to throw you in Jail."Caller: "But they said they were gong to!"Me: -Frustrated pause- "Who? Who Said that?"Caller: "The News."Me: -Flabbergasted sound- "WHAT news?" -Pause- "Don't Answer that sir, I don't need to know or care. Let me read you the law sir."Me: -I spent the next 15 minutes reading the exemption part of the law word for word for the man, and finally convinced him that he was fine. Then directed him to a local library, which I called and asked to help him fill out a exemption form... which he did not have to do, but I wanted him to have the piece of paper to make him feel better. I Then directed him to a local hospital program so he could have yearly checkups-Caller: -The whole call ended with him thanking me, and apologizing again, saying that he didn't hate the president and he didn't mean to call him those things, But he was just so frightened and mad.-There you go.

What would the US look like after 20 years of complete Democratic control?

What would the US look like after 20 years of complete Democratic control?20 years isn't long enough to turn around the Titanic. The US is literally sinking, and drowning, under GOP rule. We are facing a healthcare crisis of epidemic proportions.The Democratic Party leadership is the only party capable of addressing healthcare, because it is the only party willing to face the problem head on.The GOP have swept it under the rug, and fought any decent healthcare for decades; while other countries have continuously addressed universal healthcare for their residents. They are now way ahead of the United States.The US is in imminent danger of being unable to compete on a global scale, because we refuse to provide affordable and accessible healthcare to everyone.Common sense tells us a prosperous nation needs affordable healthcare, affordable housing, healthy food, education and jobs.The Democratic Party has continuously fought for these critical needs for all Americans.If a head of a household does not have healthcare, access to healthcare, or simply can't afford healthcare, then they can't take care of themselves or their families. That's just an indisputable fact.This means that they may not be able to work, are way more likely to end up disabled, and living on the public dole. This is the antithesis of what anyone wants; especially for the GOP that wants nothing to do with healthcare.The argument against universal healthcare is that the US will not be economically free. Conservatives want a market based approach to healthcare. They see UHC as socialism.The weakness with this argument is that we have less economic freedom than other countries with universal healthcare.[1] In other words, top countries with universal healthcare, that are market based, blow us away.Edit: Mauritis now has UHC.Of the largest economies in the world, the US is the only one without UHC.Of the richest countries in the world, the US is the only one without UHC.Of the countries with the richest people in the world, the US is the only country without UHC.Healthcare: If a picture is worth a 1,000 words, then our world healthcare map is a masterpiece.“America is a health-care outlier in the developed world"[2]Notice the countries in red. The US and some countries in Africa are the only places without some form of universal healthcare. Of the 195 countries in the world, the US is the only country that joins the 40 left without UHC, all of which are war torn or impoverished. [3]Edit: Indonesia now has UHC.Let's get to whataboutism.Here is a list of the healthiest countries in the world. They all have UHC, and pay dramatically less than the US for their universal healthcare coverage. Notice that the US is not on this list.The US does make #1 on the list for the world's most expensive healthcare. Note this graph is from 2014, and the gap has become worse.With all of the money that the US spends on healthcare, one would expect that our healthcare outcomes would be better than those countries with UHC, who pay much less. Sadly, this is not the case.The US has the highest life expectancy right? No.Other comparable countries have a higher life expectancy. This applies to men and women, across races, and across projections to 2030.Let's look at infant mortality rates first.Infant mortality rates were highest in the U.S., with 5.8 fatalities out of every 1,000 live births. For other countries, the average infant mortality rate was 3.6 fatalities for every 1,000 live births.[4]Edit: 02/14/2020The latest CDC US Maternal mortality rates for 2018 are out [5]""new [maternal mortality] rate, while capturing just how poorly the U.S. ranks among other countries, is actually a significant underestimate of the problem."17.4 maternal deaths per 100,000 live births. The US ranks 55th in the world…behind Russia.The US has a very high Amenable Mortality Rate compared to other developed nations. [6] [7]These stats are from 2016, and they are getting worse because the US stats are getting worse.Even worse, the Amenable Mortality Rate within the US, compared state by state is a disaster. [8]The poor southern states rank substantially higher.[9] This map is interactive. If you go directly to the citation, the range in amenable mortality rates goes from the high 90s to over 143 for MS. Alabama is 112. Georgia is 103. South Carolina is 99.9. Tennessee is 114. Kentucky is 113. West Virginia is 108.9. Facts don't lie. These states all have the same thing in common. I also didn't get into the states, like TX at 95.The US Spends less than other countries right? No.In 2016, the US was spending 10K per capita. That is 2.5 times the average of similarly situated and wealthier countries.In 2016, the U.S. spent 17.8 percent of its gross domestic product (GDP) on healthcare. Other countries’ spending ranged from a low of 9.6 percent of GDP in Australia to a high of 12.4 percent of GDP in Switzerland[10]The U.S. has the best health care in the world right? Yes and No.We do a good job with cancer survival rates. We are right up there with Japan and Canada on 5 year colorectal and breast cancer rates.We also have excellent healthcare research, and 1,000s of drugs that are in trials.Remember, we pay dearly for those drugs…more than any other country in the world. American's literally have zero bargaining power against big pharma. That doesn't sound market based.Don't get fooled by the R & D argument either. Big Pharma spends twice as much on marketing than R & D. How about we see a few less tv ads and save the money on the cost of drugs.This self serving industry article disputes this and says it's because of the cost of free drugs. [11] Then stop the free drugs!! Just make them affordable! Don't give me BS excuses.The US has lead the way with hospital safety too.[12]Here is where we struggle:[13]We are facing a shortage of doctors.We are suffering in primary care.We have coordination of care issues. This leads to unnecessary delays of abnormal healthcare tests and treatment.We have hospital bed shortagesWe have serious obesity ratesThere are many more issues than what I listed in this short essay.The administrative costs added by insurance companies, billing entities inside hospitals, extremely expensive procedures and tests, drugs and comparable surgeries, are astounding compared to other countries with the same or better quality healthcare.So what's the point?The point is that we are nothing without our health.Anyone who has ever had a health scare, or faced a family member's health concerns, knows this.We are all literally one catastrophe away from being bankrupted by healthcare costs.[14]If you are young reading this and think that nothing will happen to you, I hope that you are right, but don't count on it.If you are older and reading this, either you know what I mean, or there is a good chance that you will learn soon enough.Your health isn't solely dependent on how well you eat, how much you exercise or how much you weigh.So many factors play into it, including genetics, and accidents, outside our control.That's the whole frickin’ point of insurance in the first place! It's a hedge against risk! You already are paying for everyone else's healthcare, and it's damned expensive! You can still end up in serious debt and bankruptcy anyway, and there is a good chance of it on our present trajectory.At least UHC actually gives us a hedge of protection; not a hedge that throws us off the cliff, which is what our current healthcare insurance system does anyway.My fellow Americans, we are facing a tsunami. We must move to higher ground, and I mean that literally and figuratively.Vote Blue 2020!P.S. A damning new study about US life expectancy was just released by JAMA. [15]P.S. [16] Another incredibly well written answer backs up everything that I am saying factually and historically. Reaganomics was the doom of America, and the continued denial of universal basic healthcare, will be its absolute downfall.His conclusion here:Footnotes[1] Conservative Think Tank: 10 Countries With Universal Health Care Have Freer Economies Than The U.S.[2] America is a health-care outlier in the developed world[3] List of countries with universal health care - Wikipedia[4] U.S. health spending twice other countries' with worse results[5] The New U.S. Maternal Mortality Rate Fails to Capture Many Deaths — ProPublica[6] America’s ranking on amenable mortality is an embarrassment - PNHP[7] Mortality amenable to healthcare - Peterson-Kaiser Health System Tracker[8] Mortality amenable to health care[9] Mortality amenable to health care[10] U.S. health spending twice other countries' with worse results[11] Do Biopharma Companies Really Spend More on Marketing Than R&D?[12] Health Costs: How the U.S. Compares With Other Countries[13] Health Costs: How the U.S. Compares With Other Countries[14] This Is the No. 1 Reason Americans File for Bankruptcy | The Motley Fool[15] Life Expectancy and Mortality Rates in the United States, 1959-2017[16] Frank Seward's share of George Tait Edwards's answer to What does the practice of the Washington Consensus of macroeconomics/austerity ultimately produce? in RealPolitics

Does the U.S. need looser federalism, where progressives and conservatives can have states to their liking?

That’s certainly a possibility, though I don’t think it’s realistic.There’s a cliche in discussions of American politics and policy that describes the states as “laboratories of democracy.” So they can try things out, and if they work well, the federal government can identify them and take them national.But there are some problems with that perspective:States don’t have the resources or authority to try out many major policies. The federal income tax is much, much higher than most states’ income taxes, so states don’t have the resources to do things they might otherwise. (For example: Vermont was going to implement a single-payer health care system until they realized how much it’d cost the state in higher taxes). And states don’t have the authority to take a lot of actions: they can’t affect much of health care policy directly, negotiate trade agreements, manipulate the currency’s value, or raise an army. To be clear: it’s definitely a good thing that we have a central government for those functions! But that does mean states are limited in what they can do.“Patchwork” laws across the states are a royal pain in the ass. It’s fairly easy to drive across the country without running afoul of states or localities thanks to mostly standardized traffic laws (though those aren’t enforced by the federal government; we’ve just been lucky enough that most states have agreed to them). How much of a pain would it be if you had to stop and get your car inspected at every state border? Or pass another driver’s test? If states had greater authority to legislate, it’s entirely possible that they’d take actions that residents of other states would find wholly objectionable - from, say, banning guns entirely to denying all state funds for abortion services. And then we’d be back to the federal government trying to enforce its will.It’s not actually all that easy to pick up and move states. Never mind that people have roots and connections to their home states; moving states means securing a job, finding a place to live, and hundreds of other things. I do like the idea that people can move states when they dislike policies enough, but I don’t think the effect is substantial enough to be workable for most of the population. Yes, yes, there’s plenty of emigration from California to its bordering states over taxes. But again: the feds control the biggest, most significant policies.To be clear, I think people should have the freedom to vote with their feet if they don’t like a given state’s or locality’s policies. But telling an out-of-work welder in Pennsylvania, say, to pick up his family and move to Alabama if he wants things to be different is pretty callous.

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