The U.S. Health Care Debate

[tibilicus]

http://news.bbc.co.uk/1/hi/world/8200844.stm

This made me laugh.The "Brits on the news" they're referring to is some obscure Tory MEP, even then only Fox news would give him the time of day, no surprise there..

BTW for any Americans, is Fox news really your most watched news channel? If so it explains a lot. I mean, after watching it for about 10 minutes I was literally in hysterics, half the stuff being broadcast didn't even have any truth to it! Although unsurprisingly that follows the same trend as many Murdoch owned news outlets..

[ICantSpellDawg]

You yanks are obsessed with abortion. I really don't understand it.


Obviously neither do the Democratic planners.

[ICantSpellDawg]

Since you pay for the non-contributing citizens already your arguement falls apart.
If other countries can pay for full universal healthcare and get far better medical care results for less than half the money the US pays for its jumbled part universal healthcare, then why woud America not be able to get the same results in full universal healthcare for the same level of funding as other countries do?


That sounds like rationing , I thought that was what the protesters were complaining about.


When you shop for insurance or a car (for example), are they rationing that policy or product because there is a price tag and legitimate reason to shop around? No. I don't fully understand your insinuation.

[ICantSpellDawg]

http://news.bbc.co.uk/1/hi/world/8200844.stm

This made me laugh.The "Brits on the news" they're referring to is some obscure Tory MEP, even then only Fox news would give him the time of day, no surprise there..

BTW for any Americans, is Fox news really your most watched news channel? If so it explains a lot. I mean, after watching it for about 10 minutes I was literally in hysterics, half the stuff being broadcast didn't even have any truth to it! Although unsurprisingly that follows the same trend as many Murdoch owned news outlets..


Again, I listen to WNYC/NPR lately as my primary news source because of my absurd commute AND read BBC. For fire fuel I read drudge. I don't like agreeing with people, so why would I watch Rupert Murdochs retirement plan?

The fact is that my girlfriend liks Fox and I don't mind it for a laugh at Democrats expense now and then. It is a channel for entertainment and indignation. I'm glad that it exists, becuase what would the alternative be? CNN and MSNBC, neither of which are the most objective or fair.

[Philippus Flavius Homovallumus]

When you shop for insurance or a car (for example), are they rationing that policy or product because there is a price tag and legitimate reason to shop around? No. I don't fully understand your insinuation.

In every other Westernised country in the world there is a principle that healthcare should be available to 100% of the citizenry, if not the population. Most do this be providing a tax-funded Health Service which is free, or near-free, at the point of source. Or, they supplement the system with legally mandated "National Insurance", essentially more tax.

As a result, the State controls costs by refusing to finance things which are inflated in price. It is the multiplicity of choice, and the poor state of coverage that have driven up costs in the US. If all funding came through the State then it would not matter what a procedure cost, because you have already paid for the right to have access to healthcare. You don't then have to pay again when you go to the hospital.

Americans pay twice for a third-rate system; if they can afford it. That's just crazy

In Britain we pay once, and if we lose our jobs we still get our broken legs fixed, our jabs, our new Kidneys, or our brain-surgery.

Hell, we even have prescription charges on the way out in the not too distant future.

Sure it might not be perfect, but I'd rather be ill here than America, and so would a lot of the Americans here.

[Seamus Fermanagh]

http://news.bbc.co.uk/1/hi/world/8200844.stm

This made me laugh.The "Brits on the news" they're referring to is some obscure Tory MEP, even then only Fox news would give him the time of day, no surprise there..

BTW for any Americans, is Fox news really your most watched news channel? If so it explains a lot. I mean, after watching it for about 10 minutes I was literally in hysterics, half the stuff being broadcast didn't even have any truth to it! Although unsurprisingly that follows the same trend as many Murdoch owned news outlets..

Sadly, almost all of America's broadcast news is slanted and distorted. FOX is slanted to our political right just as badly as CBS, NBC, and CNN (USA) are slanted left. It gains it's "most watched" status among cable news because the other networks divide up the pie of "lefty" news consumers.

We really have no news source that simply chronicles events. This amplifies the inevitable distortions already present because of the "man bites dog" factor that is inimical to news in the first place.

[ICantSpellDawg]

In every other Westernised country in the world there is a principle that healthcare should be available to 100% of the citizenry, if not the population. Most do this be providing a tax-funded Health Service which is free, or near-free, at the point of source. Or, they supplement the system with legally mandated "National Insurance", essentially more tax.

As a result, the State controls costs by refusing to finance things which are inflated in price. It is the multiplicity of choice, and the poor state of coverage that have driven up costs in the US. If all funding came through the State then it would not matter what a procedure cost, because you have already paid for the right to have access to healthcare. You don't then have to pay again when you go to the hospital.

Americans pay twice for a third-rate system; if they can afford it. That's just crazy

In Britain we pay once, and if we lose our jobs we still get our broken legs fixed, our jabs, our new Kidneys, or our brain-surgery.

Hell, we even have prescription charges on the way out in the not too distant future.

Sure it might not be perfect, but I'd rather be ill here than America, and so would a lot of the Americans here.


Cost of Healthcare and "Free Access" to the uninsured are two seperate issues. The United States has a vibrant society, but we do not believe that people who work hard "owe" those who do not. Health care should be affordable and sensibly priced, that will increase ease of access. The government should create the pool and regulate insurance practices to increase transparency. This should not result in a tax increase or univerasal coverage to those who refuse to pay for it, those people must rely on charity or learn to work for what they need.

New entitlements will not reduce cost, nor will they contribute to the kind of society that we are trying to build - one with citizens who are self-sufficient and attain for themselves their needs and desires without a parasitic relationship.

The majority of US citizens have health care. Our governemnt should help us keep it and make it more affordable, not write in new promises of money that they have no right to.

[Tribesman]

The United States has a vibrant society, but we do not believe that people who work hard "owe" those who do not.
Which is why you pay so much in taxes for so little result. You pay a fortune for Medicare and again for Medicaid.
You pay federal taxes and state taxes for programs that are in serious need of reform and object to reform because you claim they are going to make you pay tax....which you already pay to a system badly in need of reform.
Its why your arguement makes no sense whatsoever .
Who in their right mind would object to reforms of a system where you pay much more tax money than anywhere else and get inferior results by claiming that it would mean they are going to end paying more and getting less.

[Philippus Flavius Homovallumus]

Cost of Healthcare and "Free Access" to the uninsured are two seperate issues.

No, they aren't; and it's "Free at-point of access", that's different. You have a State healthcare system, tax-funded, which you also pay for. Most people try to manage the cost through insurance, many don't bother. Universal insurance would require (nearly) all Americans to pay, so there would be fewer uninsured.

Almost all people have "uninsured" dependants, parrents, children, nephews, nieces.


The United States has a vibrant society, but we do not believe that people who work hard "owe" those who do not.

1. UnChristian. The original objection to biological Darwinism was the natural leap to social Darwinism. Shame the one got dropped and the other picked up.

2. I hope neither you nor your friends lose their job when their company goes bust, or God forbid, their insurance company go bust.


Health care should be affordable and sensibly priced, that will increase ease of access.

Hasn't worked yet, and that's never going to include the poor, who probably still pay taxes.


The government should create the pool and regulate insurance practices to increase transparency. This should not result in a tax increase or univerasal coverage to those who refuse to pay for it, those people must rely on charity or learn to work for what they need.

Not everyone can get a job. University graduates in a recession, for example.

I'm not just talking about tax increases, I'm talking about not needing private insurance.

Try to grasp that concept.


The majority of US citizens have health care. Our governemnt should help us keep it and make it more affordable, not write in new promises of money that they have no right to.

18% of the population under 65 don't. That doesn't include the pensioners.

[Husar]

Well, who cares about those 18% as long as they belong to the other 82%. :juggle2:
That's ignoring the point that had been made that even those with insurance cannot be sure their treatment will actually be covered.
When I had some minor "problem" with my nose the doctor said he could fix it but my insurance wouldn't cover it and that it would cost 90EUR per side, that was preferable over him doing it first, then telling me I'd owe him 180EUR because the insurance refused to pay. :dizzy2:

[Philippus Flavius Homovallumus]

Well, who cares about those 18% as long as they belong to the other 82%. :juggle2:
That's ignoring the point that had been made that even those with insurance cannot be sure their treatment will actually be covered.
When I had some minor "problem" with my nose the doctor said he could fix it but my insurance wouldn't cover it and that it would cost 90EUR per side, that was preferable over him doing it first, then telling me I'd owe him 180EUR because the insurance refused to pay. :dizzy2:

Right, so you can probably theoretically double that.

Can we ask what the "problem" was? You don't have to say, but it's a bit hard to judge your anecdote without the context.

[Lemur]

Here's a must-read (http://www.theatlantic.com/doc/print/200909/health-care) article about how we arrived at the current system.

But health insurance is different from every other type of insurance. Health insurance is the primary payment mechanism not just for expenses that are unexpected and large, but for nearly all health-care expenses. We’ve become so used to health insurance that we don’t realize how absurd that is. We can’t imagine paying for gas with our auto-insurance policy, or for our electric bills with our homeowners insurance, but we all assume that our regular checkups and dental cleanings will be covered at least partially by insurance. Most pregnancies are planned, and deliveries are predictable many months in advance, yet they’re financed the same way we finance fixing a car after a wreck—through an insurance claim.

Comprehensive health insurance is such an ingrained element of our thinking, we forget that its rise to dominance is relatively recent. Modern group health insurance was introduced in 1929, and employer-based insurance began to blossom during World War II, when wage freezes prompted employers to expand other benefits as a way of attracting workers. Still, as late as 1954, only a minority of Americans had health insurance. That’s when Congress passed a law making employer contributions to employee health plans tax-deductible without making the resulting benefits taxable to employees. This seemingly minor tax benefit not only encouraged the spread of catastrophic insurance, but had the accidental effect of making employer-funded health insurance the most affordable option (after taxes) for financing pretty much any type of health care. There was nothing natural or inevitable about the way our system developed: employer-based, comprehensive insurance crowded out alternative methods of paying for health-care expenses only because of a poorly considered tax benefit passed half a century ago.

In designing Medicare and Medicaid in 1965, the government essentially adopted this comprehensive-insurance model for its own spending, and by the next year had enrolled nearly 12 percent of the population. And it is no coinci#dence that the great inflation in health-care costs began soon after. We all believe we need comprehensive health insurance because the cost of care—even routine care—appears too high to bear on our own. But the use of insurance to fund virtually all care is itself a major cause of health care’s high expense.

Insurance is probably the most complex, costly, and distortional method of financing any activity; that’s why it is otherwise used to fund only rare, unexpected, and large costs. Imagine sending your weekly grocery bill to an insurance clerk for review, and having the grocer reimbursed by the insurer to whom you’ve paid your share. An expensive and wasteful absurdity, no?

Is this really a big problem for our health-care system? Well, for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves.

[Louis VI the Fat]

Xiahou, CR - I must admit to not having read the original proposed bills. Nor do I think I ever will - there is a limit to my interest in this subject. I shall not pursue the subject any further.


Sadly, almost all of America's broadcast news is slanted and distorted. FOX is slanted to our political right just as badly as CBS, NBC, and CNN (USA) are slanted left. It gains it's "most watched" status among cable news because the other networks divide up the pie of "lefty" news consumers.Nah. CBS, NBC, CNN are moderate centrist.
Fox is populist hardright, but claims centrist right.

Pravda claimed to represent the left. And insited that other media were the bourgeois, capitalist, right.

Such is the nature of the extremist media.

[ICantSpellDawg]

Here's a must-read (http://www.theatlantic.com/doc/print/200909/health-care) article about how we arrived at the current system.

But health insurance is different from every other type of insurance. Health insurance is the primary payment mechanism not just for expenses that are unexpected and large, but for nearly all health-care expenses. We’ve become so used to health insurance that we don’t realize how absurd that is. We can’t imagine paying for gas with our auto-insurance policy, or for our electric bills with our homeowners insurance, but we all assume that our regular checkups and dental cleanings will be covered at least partially by insurance. Most pregnancies are planned, and deliveries are predictable many months in advance, yet they’re financed the same way we finance fixing a car after a wreck—through an insurance claim.

Comprehensive health insurance is such an ingrained element of our thinking, we forget that its rise to dominance is relatively recent. Modern group health insurance was introduced in 1929, and employer-based insurance began to blossom during World War II, when wage freezes prompted employers to expand other benefits as a way of attracting workers. Still, as late as 1954, only a minority of Americans had health insurance. That’s when Congress passed a law making employer contributions to employee health plans tax-deductible without making the resulting benefits taxable to employees. This seemingly minor tax benefit not only encouraged the spread of catastrophic insurance, but had the accidental effect of making employer-funded health insurance the most affordable option (after taxes) for financing pretty much any type of health care. There was nothing natural or inevitable about the way our system developed: employer-based, comprehensive insurance crowded out alternative methods of paying for health-care expenses only because of a poorly considered tax benefit passed half a century ago.

In designing Medicare and Medicaid in 1965, the government essentially adopted this comprehensive-insurance model for its own spending, and by the next year had enrolled nearly 12 percent of the population. And it is no coinci#dence that the great inflation in health-care costs began soon after. We all believe we need comprehensive health insurance because the cost of care—even routine care—appears too high to bear on our own. But the use of insurance to fund virtually all care is itself a major cause of health care’s high expense.

Insurance is probably the most complex, costly, and distortional method of financing any activity; that’s why it is otherwise used to fund only rare, unexpected, and large costs. Imagine sending your weekly grocery bill to an insurance clerk for review, and having the grocer reimbursed by the insurer to whom you’ve paid your share. An expensive and wasteful absurdity, no?

Is this really a big problem for our health-care system? Well, for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves.

I agree with that premise wholeheartedly. We should be paying out of pocket for 30 min doctors visits and annual physicals. We should reserve insurance for massive losses. The government should help us tear the insurance companies away from minor services because they are the ones elevating a minor 20 min check-up to 500 dollars for someone to touch you a few times and make small talk. Add to that a wait on average of 40 mins and 30 bucks out of pocket. Absurd. The system needs to be changed, Everyone on this site admits that.


In designing Medicare and Medicaid in 1965, the government essentially adopted this comprehensive-insurance model for its own spending, and by the next year had enrolled nearly 12 percent of the population. And it is no coinci#dence that the great inflation in health-care costs began soon after.

This is an important part to remember. When a massive organization with no feeling for cost came into the mix, the system changed and warped pricing. The government spigot was turned on an the premium to get a suckle at the teet skyrocketed. After all, "there are customers with an erratic money hemmoraging insurance company (US GOVT) to assist instead of you, unless you pay more."

Thus the problem was compounded by government intervention and prices were further skewed (to the insurance companies chagrin)

[Husar]

Right, so you can probably theoretically double that.

Can we ask what the "problem" was? You don't have to say, but it's a bit hard to judge your anecdote without the context.

Oh, something up there is a bit thick and he said he could thin it out, whether that will cure anything he could not say 100%(I went there for several small problems, my nose isn't straight, it's often full etc.). Nothing serious, but yeah, I go to doctors for nothing serious sometimes. :clown:

[Philippus Flavius Homovallumus]

Oh, something up there is a bit thick and he said he could thin it out, whether that will cure anything he could not say 100%(I went there for several small problems, my nose isn't straight, it's often full etc.). Nothing serious, but yeah, I go to doctors for nothing serious sometimes. :clown:

Interesting, because my mother recently had her nose straightened, inside, it was on the NHS, so no up-front cost. It took a couple of months from refferal to go in and have it done, but from there everything went fine, follow up was prompt etc.

[ICantSpellDawg]

Interesting, because my mother recently had her nose straightened, inside, it was on the NHS, so no up-front cost. It took a couple of months from refferal to go in and have it done, but from there everything went fine, follow up was prompt etc.


Medicare and medicaid are scheduled to bankrupt the nation and their answer is to inflate the plans further and make us more reliant on them. You don't live here, Philip. Nobody trusts these morons to fix the system.

You might like democrats because they are pro-abortion and love gays, but the reality is that their plans are moronic. They arn't old labour, they are in charge of the most powerful country on earth. The game is a bit bigger and so is the population.

Europeans who have the luxury of governing themselves don't know what it is like to live in a never ending beurocracy of 300 million people with totally different cultural outlooks. I know that you are trying to solidify the EU's octosquid control, but until then you are just large and small states compared to our system. California has an economy larger than Italy.

Please get off of your high horses, explaining how your tiny and homogeneous populations control themselves. Our immigrant and entitled population dwarf yours and we have to find a different way to provide health care for everyone. We want to break that cycle and get everyone working for what should be theirs. We simply can't keep writing rich peoples checks, we will go bust. There is another way and our ancestors crossed the atlantic to chart it out.

[Philippus Flavius Homovallumus]

Medicare and medicaid are scheduled to bankrupt the nation and their answer is to inflate the plans further and make us more reliant on them. You don't live here, Philip. Nobody trusts these morons to fix the system.

"Obamacare" doesn't go far enough, because it should scrap Medicare and Medicaid and replace them with a free-at-point-of-source system. The absurdity of State-run Hospitals billing the State is brought about ecause you and others have an absurd reaction to genuine State-run medicine.

Oddly enough, the same arguements were trotted out sixty years ago here. The Government simply forced the change, and the doctors just had to put up with it. There's a famous cartoon of doctors in front of the Health Secretary, as Gladiators, with the caption, "We who are about to die salute You."


You might like democrats because they are pro-abortion and love gays, but the reality is that their plans are moronic. They arn't old labour, they are in charge of the most powerful country on earth. The game is a bit bigger and so is the population.

I don't like Democrats, I'm not pro-abortion and I'm indifferent to homosexuals. The first two are well known on these boards, I think.

Yes, the plan is bad, halfarsed rather than moronic though. The "game" however, is exactly the same. The "game" is saving lives, and that is measured in individuals. I consider universal healthcare a matter of concience.


Europeans who have the luxury of governing themselves don't know what it is like to live in a never ending beurocracy of 300 million people with totally different cultural outlooks. I know that you are trying to solidify the EU's octosquid control, but until then you are just large and small states compared to our system. California has an economy larger than Italy.

Neither am I pro EU integration, also well known.

You're right though, my country is only 60 million people, one of the most populous in Europe and it only contains three distinct native populations, two of which intermittently hate the other.


Please get off of your high horses, explaining how your tiny and homogeneous populations control themselves. Our immigrant and entitled population dwarf yours and we have to find a different way to provide health care for everyone. We want to break that cycle and get everyone working for what should be theirs. We simply can't keep writing rich peoples checks, we will go bust. There is another way and our ancestors crossed the atlantic to chart it out.

Your current system costs 18% of GDP, ours costs 9.2, public and private.

As to "tiny", the UK population is still 1/5 of the US population, and I fail to see how greater numbers make a National Health Service so impossible.

So, get off your own High Horse and face up to the fact that our system is cheaper, better and provides universal coverage.

[Xiahou]

Well, it sounds like I'm in the majority (http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/august_2009/54_say_passing_no_healthcare_reform_better_than_passing_congressional_plan).

Thirty-five percent (35%) of American voters say passage of the bill currently working its way through Congress would be better than not passing any health care reform legislation this year. However, a new Rasmussen Reports national telephone survey finds that most voters (54%) say no health care reform passed by Congress this year would be the better option.
The study goes on to say:
This does not mean that most voters are opposed to health care reform. But it does highlight the level of concern about the specific proposals that Congressional Democrats have approved in a series of Committees.Again, I agree. Before I'd consider any government-run plan I'd like to see them come up with a way to fix Medicare and Medicaid so they won't bankrupt the country, like they're going to now. If they can't manage those two plans without blowing up the national debt, I don't trust them to manage a public plan that would be available to everyone. Additionally, any government-run plan should be adopted by members of congress as their own. If they wouldn't accept it, how can they foist it on us?

Naturally, the better idea would be for no government-run option at all. Government has made a complete mess of Social Security, Medicare, Medicaid, the mortgage industry, and so on. There's really got to be a better way.

[Tribesman]

Well, it sounds like I'm in the majority.

Which is irrelevant unless Ramunsen also asked the respondants if they knew what the bill was that they are opposed to .
As most people seem to have not read any of the proposed legislation and are basing their outrage on misinformation and outright lies their opinions on the possible passage of actual proposed legislation are completely meaningless.

[Centurion1]

As most people seem to have not read any of the proposed legislation and are basing their outrage on misinformation and outright lies their opinions on the possible passage of actual proposed legislation are completely meaningless.
:laugh4::laugh4::laugh4::laugh4::laugh4::laugh4:

Unfortunately most of the congressmen have not read it

[ICantSpellDawg]

Democrats are saying "misinformation" and "lies" - but of course they would. I don't trust them. I've seen blatant lies in their policies WAY too often. They seem to be incapable of following their mandate or telling people like it is.

Like this - Arlen Specter said that "Abortion coverage is in most policies now - if we were to take it away from people in a government plan, that would be wrong - so it's staying" (paraphrase)

BUT HE WAS LYING as I've already mentioned. He was doling out misinformation as a counter to the "misinformation" that conservatives have been spreading that the government is including elective abortions in a national health plan. But he was lying, so why would I trust his side of the story over the side of the legitimately concerned.

Obama is a proponent of Singler-payor. He has always has been. The Democratic angle of GoodCop BadCop isn't going to work. On the one side you have democrats who are in favor of a single payor system. On the other side you have a pro single-payor President who is pretending to be moderate to garner the support of moderates who oppose the single payor system.

HE WAS CAMPAIGNING FOR SENATE 4 YEARS AGO ON A SINGLE-PAYOR SYSTEM FOR CHRISTS SAKE. How gullible are you people? But conservative misinformation is the problem.

This reminds me of when we were trying to invade Iraq and told the American people what they needed to hear to get the green light, at the same time as we attacked Democrats with legitimate concerns as cowards and blind peaceniks. I still support the war as I assume the lying nationalized single payors will support their bloated system after we've fallen for that, too. I guess it comes around. If we keep knowingly lying to one another in such a big way it is going to get to a point where americans are going to start killing each other. It won't be one parties fault, though. Years ago it was small interest groups who tricked the rest of us, now entire halfs of the population are complicit in the big lies of their party.

EDIT****Thank You for moving on this, we will move with you (http://apnews.myway.com/article/20090816/D9A40N900.html)

[ICantSpellDawg]

So what do you all think of this most recent development? Someone is being baited and switched on. It is either liberals who believe in a single payor government system or Conservatives who stand against any sort of health reform.

As long as therer is no public option but there is cost control, I have no problem with both parties being dissapointed, because I disagree with both. A health system based on not-for profits, colored by cost realization would be a great thing for everyone.

[Seamus Fermanagh]

Here's a must-read (http://www.theatlantic.com/doc/print/200909/health-care) article about how we arrived at the current system.

Wow, a decently written piece that confirms what I've thought for some time, that the US system for healthcare is the worst of BOTH extremes combined.

[ICantSpellDawg]

Wow, a decently written piece that confirms what I've thought for some time, that the US system for healthcare is the worst of BOTH extremes combined.


Thats funny, This is what I've been reffering to for the past week to after hearing him speak on NPR/wnyc. I like his take very much.

[Marshal Murat]

Obama, you're no Machiavelli (http://www.salon.com/opinion/feature/2009/08/18/machiavelli/index.html)
Some sections selected from the article

"It must be considered that there is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order, this lukewarmness arising partly from fear of their adversaries, who have the laws in their favor; and partly from the incredulity of mankind, who do not truly believe in anything new until they have had actual experience of it. Thus it arises that on every opportunity for attacking the reformer, his opponents do so with the zeal of partisans, the others only defend him half-heartedly, so that between them he runs great danger."


In addition to exploiting one kind of "incredulity" -- disbelief that change will be better -- many conservatives shamelessly have exploited the incredulity and ignorance of poorly informed voters, who are being told that the Democratic plan will lead to euthanasia for the elderly and the disabled. It is no defense of these vile tactics to observe that the Democrats have made themselves vulnerable to wild conspiracy theories by not being completely candid about healthcare.

The president and the congressional Democrats have claimed that we can cover every American, allow people who want to keep their employer-provided insurance to do so, not raise taxes on the vast majority of Americans, not ration healthcare and cut costs. This cannot possibly be true. According to the CBO, the plan in its present form would cost more than a trillion dollars over a decade. An extra hundred billion a year for real healthcare reform could be a bargain, but let's not pretend that any significant reform can be revenue-neutral.

Progressive supporters of a public option are being less than candid when they claim that a public plan will not put private insurance out of business -- when in fact their not-so-secret hope is that over time the public plan will grow into universal single-payer by putting private insurance out of business. If not, why is the left so supportive of the public plan? A supporter of single-payer, I have no problem with the goal, but instead of trying to sneak the seed of single-payer in by stealth, proponents ought to make the case on its merits. Crude pseudo-Machiavellianism based on misdirection is likely to backfire. (In "The Prince," Machiavelli -- a small-r republican who preferred the many to the elites -- says that the best leaders are those whose reputations for virtue and honesty are actually justified.)

In short, by claiming all gain and no pain -- no rationing of any kind, no middle-class tax increases, no limits on doctor choice, no price controls, no seed of single-payer -- the Democrats have created an LBJ-like "credibility gap." Just as the discrepancy between the Johnson administration's pretext for escalation in Vietnam and its actual strategic motives created a gap that was quickly filled by conspiracy theories, so the gap between the promises of the Democrats and the reality of hard trade-offs has opened a door to false and revolting conspiracy theories, like Sarah Palin's claim that under the Democratic plan her Down syndrome child might have been euthanized.

[Ariovistus Maximus]

The Prince is a phenominal work. Like Sun Tzu's Art of War for politics. Although I wouldn't go so far as praising the methods of assassination etc, I really liked his method of comparing everything to history, to see how it will work in the future, as well as his understanding of human nature and it's role in politics.

For if, as Machiavelli says, politics is a science comparable to medicine, then history is it's pathology. :2thumbsup:

[Xiahou]

Wow, a decently written piece that confirms what I've thought for some time, that the US system for healthcare is the worst of BOTH extremes combined.
And the author also adds that the current reform proposals will do nothing to help. A notion I agree with.

Would our health-care system be so outrageously expensive if each American family directly spent even half of that $1.77 million that it will contribute to health insurance and Medicare over a lifetime, instead of entrusting care to massive government and private intermediaries? Like its predecessors, the Obama administration treats additional government funding as a solution to unaffordable health care, rather than its cause. The current reform will likely expand our government’s already massive role in health-care decision-making—all just to continue the illusion that someone else is paying for our care.

Personally, I think (as I've said) that real reform would divorce health insurance from employment and then it should find a way to incentivize patients to care more about the value of their treatment. Our current medical insurance system makes about as much sense as grocery insurance or gasoline insurance.

[Idaho]

Many of you seem more concerned about the costs of a centralised healthcare system, but utterly unconcerned with the devastating cost of not having one.

[rory_20_uk]

Many of you seem more concerned about the costs of a centralised healthcare system, but utterly unconcerned with the devastating cost of not having one.

Cost in which way? Economic or social?

Treating conditions acutely in hospital as opposed to the community means it costs a lot more. Even in the UK GPs working in A&E cost less than other doctors - as although their wage is higher they don't order a battery of tests on every patient. Hospitals then have to cross subsidise this, and charge more for other things, which then means the insurance companies charge more etc etc. It's just currently a bloody terrible system due to the waste that is built in.

Few countries give treatment based on assessment of use of the individual, but doing so would help everyone in the long term: more productive workers mean that the pot of money is greater for health, and hence there is more to spend on less useful areas.

For the good of humanity it's still best to sort out disease in 3rd world countries.

~:smoking:

[Idaho]

Cost in which way? Economic or social?

Treating conditions acutely in hospital as opposed to the community means it costs a lot more. Even in the UK GPs working in A&E cost less than other doctors - as although their wage is higher they don't order a battery of tests on every patient. Hospitals then have to cross subsidise this, and charge more for other things, which then means the insurance companies charge more etc etc. It's just currently a bloody terrible system due to the waste that is built in.

Few countries give treatment based on assessment of use of the individual, but doing so would help everyone in the long term: more productive workers mean that the pot of money is greater for health, and hence there is more to spend on less useful areas.

For the good of humanity it's still best to sort out disease in 3rd world countries.

~:smoking:

Social and economic costs end up being the same in the long run if our aim is to have stable, prosperous and healthy societies.

I agree about the developing world. It would be a good thing if malaria became endemic to Europe - we'd see a cure within 10 years.

[rory_20_uk]

Cures only allow money once, treatment is money forever.

Social and economic are not the same. There is no economic reason for an exponential increase in spending on the elderly and those with other severe developmental conditions. Whereas only a few years ago they'd die, we'd all have a cry and get on with it, now we can keep 'em sort of alive for in some cases decades costing in some cases over £1,000 a week when all their medication and services are taken into account.

I do not think we are more prosperous as a result and certainly the average health has declined as a result of this. Increasingly it is obvious we can't afford it, but no politician has the balls to do any more than tinker with the edges of the problem and feel grateful that their pension is index linked - so inflation proof.

~:smoking:

[Lemur]

As per usual, The Onion (http://www.theonion.com/content/news/congress_deadlocked_over_how_to) nails it:

Congress Deadlocked Over How To Not Provide Health Care

WASHINGTON—After months of committee meetings and hundreds of hours of heated debate, the United States Congress remained deadlocked this week over the best possible way to deny Americans health care.

"Both parties understand that the current system is broken," House Speaker Nancy Pelosi told reporters Monday. "But what we can't seem to agree upon is how to best keep it broken, while still ensuring that no elected official takes any political risk whatsoever. It’s a very complicated issue."

"Ultimately, though, it's our responsibility as lawmakers to put these differences aside and focus on refusing Americans the health care they deserve," Pelosi added.

The legislative stalemate largely stems from competing ideologies deeply rooted along party lines. Democrats want to create a government-run system for not providing health care, while Republicans say coverage is best denied by allowing private insurers to make it unaffordable for as many citizens as possible.

"We have over 40 million people without insurance in this country today, and that is unacceptable," Sen. Orrin Hatch (R-UT) said. "If we would just quit squabbling so much, we could get that number up to 50 or even 100 million. Why, there's no reason we can't work together to deny health care to everyone but the richest 1 percent of the population."

"That's what America is all about," he added.

House Minority Leader John Boehner (R-OH) said on Meet The Press that Republicans would never agree to a plan that doesn't allow citizens the choice to be denied medical care in the private sector.

"Americans don't need some government official telling them they don't have the proper coverage to receive treatment," Boehner said. "What they need is massive insurance companies to become even more rich and powerful by withholding from average citizens the care they so desperately require. We're talking about people's health and the obscene profits associated with that, after all."

Though there remain irreconcilable points, both parties have reached some common ground in recent weeks. Senate leaders Harry Reid (D-NV) and Mitch McConnell (R-KY) point to Congress' failure to pass legislation before a July 31 deadline as proof of just how serious lawmakers are about stringing along the American people and never actually reforming the health care industry in any meaningful way.

"People should know that every day we are working without their best interests in mind," Reid said. "But the goal here is not to push through some watered-down bill that only denies health care to a few Americans here and a few Americans there. The goal is to recognize that all Americans have a God-given right to proper medical attention and then make sure there's no chance in hell that ever happens."

"No matter what we come up with," Reid continued, "rest assured that millions of citizens will remain dangerously uninsured, and the inflated health care industry will continue to bankrupt the country for decades."

Other lawmakers stressed that, while there has been some progress, the window of cooperation was closing.

"When you get into the nuts and bolts of how best not to provide people with care essential to their survival, there are many things to take into consideration," Rep. Michele Bachmann (R-MN) said. "I believe we can create a plan for Americans that allows them to not be able to go to the hospital, not get the treatment they need, and ultimately whither away and die. But we've got to act fast."

For his part, President Barack Obama claimed to be optimistic, even saying he believes that a health care denial bill will pass in both houses of Congress by the end of the year.

"We have an opportunity to do something truly historic in 2009," Obama said to a mostly silent crowd during a town hall meeting in Virginia yesterday. "I promise I will only sign a clear and comprehensive health care bill that fully denies coverage to you, your sick mother, her husband, middle-class Americans, single-parent households, the unemployed, and most importantly, anyone in need of emergency medical attention."

"This administration is committed to not providing health care," Obama added. "Not just for this generation of Americans, but for many generations to come."

[Ariovistus Maximus]

Wow. :laugh4: That's awesome.

[ICantSpellDawg]

As per usual, The Onion (http://www.theonion.com/content/news/congress_deadlocked_over_how_to) nails it:

Congress Deadlocked Over How To Not Provide Health Care



That pretty much sums it up

[Ariovistus Maximus]

Oh, incidentally, I present for your enjoyment:

Two hotlinked pictures, now removed. BG

:beam:

[a completely inoffensive name]

Woman Yells Heil Hitler To Jewish Man talking about Israel's Nationalized Health Care at Las Vegas Town Hall
https://www.youtube.com/watch?v=GVS4Zgjm8HE

EDIT: It looks like the right has included foreign visitors in its list of acceptable people to link with Hitler.

[LittleGrizzly]

Hitler has been simultanouesly for and against ever major policy in the western world since the nazis were defeated...

Maybe this explains how he managed to get elected, who else can claim to be a free market left wing socailist conservative...

I think people should come to an agreement before this starts getting confusing... maybe one side gets to keep calling the opposition hitler and the other can adopt stalin as the person the opposition resembles...

[Ariovistus Maximus]

These town hall protesters have taken it too far. The whole lot has gone overboard, and they're really becoming self-defeating at this point. They're beginning to be downright abusive, and some of the senators and representatives have just about had it.

I loathe government interference too, and I would agree with the attitude of the town hall protesters at first, but they've degenerated so far, it's pretty disgusting.

The protesters as a whole would get their point across much better if they would temper everything with a much higher degree of civility. At this point they are starting to help out the government propaganda that they are a mob.

These senators/representatives are humans too, and they do deserve a degree of respect for their office. I'm not saying that they should be let off the hook for trying to pass trash in the legislature, however it doesn't warrant the degree of flak they are getting right now.

I'm really irritated by these idiots passing "Nazi" around. Get real; they're only using it for the shock value. And by doing this they just turn it into a sickening shouting match.


Woman Yells Heil Hitler To Jewish Man talking about Israel's Nationalized Health Care at Las Vegas Town Hall
https://www.youtube.com/watch?v=GVS4Zgjm8HE

EDIT: It looks like the right has included foreign visitors in its list of acceptable people to link with Hitler.

I'm ashamed that the same woman described herself as a Christian conservative on another news item. She was extremely childish and demonstrated the intellect of a pea.

And that guy was genuinely upset when she screamed "Heil Hitler" at him. Honestly... in Germany she would be under arrest.

However, I should think (hope) that she is not the average conservative. If this is where we're headed... ugggh.

[Lemur]

Another must-read, this time from Foreign Policy Magazine: The Most Outrageous U.S. Lies About Global Healthcare (http://www.foreignpolicy.com/articles/2009/08/18/the_most_outrageous_us_lies_about_global_healthcare?page=full).

[Tribesman]

Another must-read,
So if you couple that article about lies with the poll that half of all americans believe the lies its not surprising that the level of protest against reform is so loud.
Though apparently that proportion of gullible people increases to 3/4 if you just count people who say they watch fox news

[ICantSpellDawg]

So if you couple that article about lies with the poll that half of all americans believe the lies its not surprising that the level of protest against reform is so loud.
Though apparently that proportion of gullible people increases to 3/4 if you just count people who say they watch fox news


I'm not against reform, I just think that a reform that reform that has a different careless payor is not reform. I like the idea that they've split the bill, though.

I don't have a problem with the Massachussets system that bought basic private plans for those that couldn't afford them. I just want more cost of service transparency and for consumers to have a choice because they feel the heat of overpricing in some way. I don't really even have a problem with a voucher for a free top-to-bottom check-up ever two years paid for by the govt. What I have a problem with is people turning to government every time they have a problem instead of working on the system to make it better. Health insurance is a good thing, but the way in which we use it goes against the concepts that work best and are leading us to hemmorhage out our money on services that are wasteful.

Like it or not, the US has a different path from other nations and I would like to see the free-market aspect work better. If we have to make all private ins co's non-profit to make this happen, so be it. I'l read the article at work.

[Idaho]

There will never be a 'free market' in healthcare (not in pretty much anything really). Healthcare has too many inevitable distortions:


Lots of people who can't afford to pay for an expensive product that they need
A service that has a potentially open ended cost
A high capital cost to deliver
A market controlled by patents and intellectual property rights
An industry with a highly skilled and politically significant workforce

[rory_20_uk]

...I don't really even have a problem with a voucher for a free top-to-bottom check-up ever two years paid for by the govt...

Oh God what a waste!

Forever chasing the 10% with kidney cysts, those with liver cysts, anaemia? cause and a whole raft of other things that wasn't causing a problem and probably isn't a problem until they were told...

Almost instant transformation of the nation into hypochondriacs.

~:smoking:

[Lemur]

Apparently Tort reform (http://washingtonindependent.com/55535/tort-reform-unlikely-to-cut-health-care-costs) won't get us where we want to be (but we should still reform it anyway).


“It’s really just a distraction,” said Tom Baker, a professor at the University of Pennsylvania Law School and author of “The Medical Malpractice Myth.” “If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we’d be talking about 1.5 percent of health care costs. So we’re not talking about real money. It’s small relative to the out-of-control cost of health care.”

Insurance costs about $50-$60 billion a year, Baker estimates. As for what’s often called “defensive medicine,” “there’s really no good study that’s been able to put a number on that,” said Baker. [...]

Other health economists agree that “defensive medicine” is not the main driver of costs, and malpractice liability reform is not a panacea.

“If you were to list the top five or ten things that you could do to bring down health care costs that would not be on the list,” said Michele Mello, a professor of Law and Public Health at Harvard.

Still, that doesn’t mean the medical liability system we now have is a good one. Mello estimates the costs of so-called “defensive medicine” to be far less than Krauthammer does — around $20 billion a year. “So there’s some savings to be had and frankly the health reform package has not come up with a lot of ideas for major savings.”

[Philippus Flavius Homovallumus]

Like it or not, the US has a different path from other nations and I would like to see the free-market aspect work better. If we have to make all private ins co's non-profit to make this happen, so be it. I'l read the article at work.

What, seriously? That's just absurd, "We won't/can't do it because we're American".

Really? That's your answer?

I'm sorry Tuff, but that's just plain arrogant and hard-headed, and not true either.

[a completely inoffensive name]

I'm sorry Tuff, but that's just plain arrogant and hard-headed, and not true either.

I guess when the U.S. was founded by religious outcasts who were sick of the way thing were done in England, when we decided we wanted a fully Representative government controlled solely by the people with a balance of power between the branches instead of a monarchy with a unrepresentative Parliament, when we adopted attempted a policy of non intervention while Europe made alliances and began two world wars, when we tried several times and failed every time to accept and adopt the metric system and soccer don't count.

[Philippus Flavius Homovallumus]

I guess when the U.S. was founded by religious outcasts who were sick of the way thing were done in England, when we decided we wanted a fully Representative government controlled solely by the people with a balance of power between the branches instead of a monarchy with a unrepresentative Parliament, when we adopted attempted a policy of non intervention while Europe made alliances and began two world wars, when we tried several times and failed every time to accept and adopt the metric system and soccer don't count.

We haven't really adopted the metric system, either, I walk miles and buy my meat by the pound. All the things you mentioned are a matter of outlook, most are less important than you imply as well.

France has had a similar form of government to the US for quite some time, and they formalised the balance of powers concept. That's a strike there.

You aren't the only Republic, nor the first.

You aren't the only non-interventionist country.

So, I don't think you have a point either.

Tuff is arguing that America "has a different path", the suggestion that America is destined to be different from Europe, Australasia, and Canada implies some form of divinely ordained Manifest Destiny; that it absurd.

[Rhyfelwyr]

Well there is no doubt that the USA has a very unique history compared to the rest of Europe, and this has had both direct effects in terms of things such as economic development, and the values society holds, whether it's the work ethic, the role of the government etc.

And in that sense, the USA is special. But I think that over time it has been becoming much more similar to European nations. It started out as a nation welcoming all the poor huddled masses to a land of opportunity, now people talk about keeping the ordinary American's job from the foreigners. It started out as a nation which aimed to isolate itself from the power politics, state oppression, and imperialism seen in Europe, and yet eventually it would become notorious for policing the world. It was originally a diverse nation of many different people's, then people decided you had to be a WASP and nowadays the cheesy patriotism displayed by many Americans is becoming more similar to the nationalism seen in Europe with all the nasty connotations it has.

The US still has much of it's unique character, but it's only a matter of time before it disappears. :juggle2:

[a completely inoffensive name]

We haven't really adopted the metric system, either, I walk miles and buy my meat by the pound. All the things you mentioned are a matter of outlook, most are less important than you imply as well.

France has had a similar form of government to the US for quite some time, and they formalised the balance of powers concept. That's a strike there.

You aren't the only Republic, nor the first.

You aren't the only non-interventionist country.

So, I don't think you have a point either.

Tuff is arguing that America "has a different path", the suggestion that America is destined to be different from Europe, Australasia, and Canada implies some form of divinely ordained Manifest Destiny; that it absurd.

I am not saying we were the first or the only one in anything, I am just saying the US has a good record of going against what most of Europe practiced at the time.

As for an absolute direction different from Europe yes I agree that is silly; there are too many ties between the two entities for America to just go off by itself and do it's own 100% American thing for all topics. But there are multiple instances of America embarking on a path some of them in favor with Europe some of them without Europe's favor where America did have a sense of destiny and did things just because it was "America's destiny". I mean you have the "Manifest Destiny" into the west that you referenced, I don't think it is unreasonable for a person to think that when given this health care debate that Europe will handle it one way and for Americans to handle it in their own unique way. Obviously there are lessons to be learned from Europe, but America always had an affinity for free markets and Capitalism in general more so then Europe, so I highly doubt that to solve it's problem America will just copy a European model but will instead to implement change in "it's own way" so to speak by solving the cost and coverage issues while attempting to preserve the free market and reduce government involvement as much as possible.

[a completely inoffensive name]

Well there is no doubt that the USA has a very unique history compared to the rest of Europe, and this has had both direct effects in terms of things such as economic development, and the values society holds, whether it's the work ethic, the role of the government etc.

And in that sense, the USA is special. But I think that over time it has been becoming much more similar to European nations. It started out as a nation welcoming all the poor huddled masses to a land of opportunity, now people talk about keeping the ordinary American's job from the foreigners. It started out as a nation which aimed to isolate itself from the power politics, state oppression, and imperialism seen in Europe, and yet eventually it would become notorious for policing the world. It was originally a diverse nation of many different people's, then people decided you had to be a WASP and nowadays the cheesy patriotism displayed by many Americans is becoming more similar to the nationalism seen in Europe with all the nasty connotations it has.

The US still has much of it's unique character, but it's only a matter of time before it disappears. :juggle2:

People have been talking about keeping foreigners out since at least the 1840s. http://en.wikipedia.org/wiki/Know_nothing_party

Yes, the oppressed as now become the oppressors. I am very sad to have to acknowledge that. Before WW2 the US was implementing a non-intervention policy but now we have in many ways yet to turn off the Cold War mentality. But that will end eventually, probably within our lifetimes.

As for the cheesy nationalism, blame the 1980s with Reagan and the New Right coming to power.

EDIT: Oh as for that last sentence, I don't think it will disappear any more then France and Britain and Germany have lost their national identity. I mean is Europe more unified and homogeneous? Yes, but I can still tell with ease which country is which when I travel through them.

[Tribesman]

I guess when the U.S. was founded by religious outcasts who were sick of the way thing were done in England,
Good point , apart from the fact that the founding fathers of the US were not religious outcasts and came from just about every flavour of christianity, apart from those who considered themselves diests and those who were anti-religion

when we decided we wanted a fully Representative government controlled solely by the people
and they didn't want a fully representative government or represent all of the people.

Perhaps you mean the founding fathers of Jamestown who were from the established British church and went there to make money as a charter company....or perhaps you mean the religious zealots who ended up in Plymouth after they were having trouble keeping employed where they were welcome in Holland so decided to get together with another bunch of British merchants with a new charter to try and make money in a new colony...them ones really screwed up as they were among the minority and were seriously in debt to the other colonists

[Idaho]

I guess when the U.S. was founded by religious outcasts who were sick of the way thing were done in England, when we decided we wanted a fully Representative government controlled solely by the people with a balance of power between the branches instead of a monarchy with a unrepresentative Parliament, when we adopted attempted a policy of non intervention while Europe made alliances and began two world wars, when we tried several times and failed every time to accept and adopt the metric system and soccer don't count.


Well there is no doubt that the USA has a very unique history compared to the rest of Europe, and this has had both direct effects in terms of things such as economic development, and the values society holds, whether it's the work ethic, the role of the government etc.

I don't know what they teach you in your history classes - but this is a load of cobblers.

The US wasn't founded by religious outcasts. They didn't want a representative government. Non-intervention in the two world wars was a military and economic strategy, not a desire to be distant from the old world (although that was how it was sold to the public).

As for the US having a unique history - everywhere has a unique history. And the history of the US is inexorably bound up with Europe and Europeans. The work ethic is entirely 'Anglo-Saxon' and notions of the role of government are copied directly from the British.

[Crazed Rabbit]

Another must-read, this time from Foreign Policy Magazine: The Most Outrageous U.S. Lies About Global Healthcare (http://www.foreignpolicy.com/articles/2009/08/18/the_most_outrageous_us_lies_about_global_healthcare?page=full).

Article fail:

CANADIANS HEAD TO THE UNITED STATES FOR URGENT CARE

The lie: Canada's government-run health care is so bad that needy patients need to pay for care in the United States.

Some Canadians do come to the US and pay for treatments that they'd have to wait much longer for in Canada. I'm right on the border, and read of occasional cases in the local paper. They come because they can't get the care they want in a timely manner in Canada. Canada's supreme court has found that people die on waiting lists for treatments. Far from 'the most outrageous lies'.

In the way of evidence for freer-market plans, I give you this report. (http://www.marginalrevolution.com/marginalrevolution/2009/08/consumer-drive-health-care-plans.html) A review of ten years of "Consumer driven health care plans" in the USA.


CDH plans typically combine a high-deductible insurance policy with a health savings account or health reimbursement account.
...
The primary indications are that properly designed CDH plans can produce significant (even substantial) savings without adversely affecting member health status. To the knowledge of the work group, no data-based study has emerged that presents a contrary view.


Apparently Tort reform won't get us where we want to be (but we should still reform it anyway).

I've read that Texas has some success with that, and I am not persuaded otherwise by this article;

The experience of Texas in capping damage awards is a good example. Contrary to Perry’s claims, a recent analysis by Atul Gawande in the New Yorker found that while Texas tort reforms led to a cap on pain-and-suffering awards at two hundred and fifty thousand dollars, which led to a dramatic decline in lawsuits, McAllen, Texas is one of the most expensive health care markets in the country.

One anecdote about a single expensive town contradicts the huge drop in lawsuits and lowering of insurance rates? (http://www.bizjournals.com/austin/stories/2005/10/10/story8.html) (No, I did not read the whole 8 page article in the New Yorker)

CR

[Idaho]

Article fail:


Some Canadians do come to the US and pay for treatments that they'd have to wait much longer for in Canada. I'm right on the border, and read of occasional cases in the local paper. They come because they can't get the care they want in a timely manner in Canada. Canada's supreme court has found that people die on waiting lists for treatments. Far from 'the most outrageous lies'.

Of course people die on waiting lists. But people in the US die not on waiting lists nor with any hope of ever being on a waiting list.

[rvg]

Then what's the point? Death is death, dying while on a waiting list doesn't feel any better than dying without being on a waiting list.

[ICantSpellDawg]

What, seriously? That's just absurd, "We won't/can't do it because we're American".

Really? That's your answer?

I'm sorry Tuff, but that's just plain arrogant and hard-headed, and not true either.


Let me put it another way; Not everyone should be doing the exact same thing. Did you lobby Apple to adopt the exact same processor structure as average PC's? Do you believe that one way is always going to be better than another, or do you think that different laboratories should test using the exact same methods?

Why should the US adopt a system that we disagree with and that hasn't worked for us in the past just so that we can be like everyone else?

We go our own way because we should. We are going to find an acceptable alternative system to the one used in Canada and the UK and the world will be better for it. That isn't ego, it is just reality and agrees with our understandign of our past. The UK knows a thing or two about going their own way.


Varied testing ground is important

[Idaho]

Let me put it another way; Not everyone should be doing the exact same thing. Did you lobby Apple to adopt the exact same processor structure as average PC's? Do you believe that one way is always going to be better than another, or do you think that different laboratories should test using the exact same methods?

Why should the US adopt a system that we disagree with and that hasn't worked for us in the past just so that we can be like everyone else?

We go our own way because we should. We are going to find an acceptable alternative system to the one used in Canada and the UK and the world will be better for it. That isn't ego, it is just reality and agrees with our understandign of our past. The UK knows a thing or two about going their own way.


Varied testing ground is important

This sounds like the usual nonsense that american conservatives come up with. You think that American politics and philosophy reached perfection with Ronald Reagan and any change from that is a betrayal of the constitution.

[rory_20_uk]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

~:smoking:

[Idaho]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

~:smoking:

lulz :laugh4:

[Tribesman]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

Is that change we can believe in?

[ICantSpellDawg]

And Apple do use the same CPUs and GPUs as other PCs. They gave up on the old ones as they were inefficient...

~:smoking:


I know they do - that was the point. It was cooler to have two structure competitors. Do you beleive that every computer should use Windows? I love windows, but variance is important.

[Centurion1]

This sounds like the usual nonsense that american conservatives come up with. You think that American politics and philosophy reached perfection with Ronald Reagan and any change from that is a betrayal of the constitution.

Yeah well that sounds like the typical refutation by liberals who do not have an actual answer but decide they would just rather bash a large group of people indiscriminately. Yeah the only way YOU could be any more stereotypical is if you had blamed George W. Bush. :no:

[Crazed Rabbit]

Apparently in Michigan, (http://freep.com/article/20090820/BUSINESS06/908200420/1319/)

Hospitals in border cities, including Detroit, are forging lucrative arrangements with Canadian health agencies to provide care not widely available across the border.

Agreements between Detroit hospitals and the Ontario Ministry of Health and Long-Term Care for heart, imaging tests, bariatric and other services provide access to some services not immediately available in the province, said ministry spokesman David Jensen.

The agreements show how a country with a national care system -- a proposal not part of the health care changes under discussion in Congress -- copes with demand for care with U.S. partnerships, rather than building new facilities.

And then there's this story of a 15 year ordeal dealing with the NHS. (http://www.independent.co.uk/opinion/commentators/ian-birrell-why-i-dont-believe-that-the-nhs-is-sacrosanct-1775088.html)


It was a simple thing. Another blood test, some more investigations into whatever flawed gene or missing protein might be the cause of my daughter's troubled life, with her terrible seizures, her blindness, her inability to walk or talk or eat unaided. Over the past 15 years, there have been many such attempts to identify her condition.

One year later, we asked the doctor, a top geneticist at one of the world's most famous hospitals, what had happened to the results. His office told us a rambling story about financial restrictions and the need to send such tests to a laboratory in Germany. They said there was little he could do but promised to pursue our case.

It was a bare-faced lie. The precious vial of blood had been dumped in storage and forgotten. The following day it was despatched to a laboratory in Wales and 40 days later the specialists came up trumps. They identified her condition, an obscure genetic mutation called CDKL5.

The breakthrough was rather mind-blowing, giving us some peace of mind and the chance to talk to families of the hundred or so other children worldwide identified with the condition. It was also life-changing, since it means our other child and close relatives are in no danger of passing on the condition. Indeed, had we known sooner we might have even tried for more children.

But the most shocking thing was not the lying. Nor even the incompetence. It was our total lack of surprise at the turn of events, since after 15 years suffering from the failings of the National Health Service we are prepared for almost any ineptitude.

CR

[Tribesman]

And then there's this story of
Whatever happened to....


Enough of this, Lemur. You're just posting anecdotes,

But hey apparently in Detriot....

"I go to the hospital in Windsor and two hours later, I'm done having angioplasty in Detroit," he said. His $38,000 bill was covered by the Ontario health ministry.


Wow the Canadian healthcare is so bad they actually pay for their people to have treatment.
I like that though , the hospital got 400 foriegn visitors, so its only slightly behind that Thai hospital that took in 50,000 US patients who found they could get better treatment by crossing to another continent entirely.

[Centurion1]

He is fighting fire with fire. Or unexplained stories with unexplained stories. :sweatdrop:

[ICantSpellDawg]

The United States clearly has a unique path and variation in planning is healthy. It is hour our Federalized system is supposed to work - with each state as a seperate laboratory trying out ideas to see if they work.

The United states is exceptional in many ways. Other countries are as well, but the US is the destination of choice for more people immigrants than any other nation.

For example: After 2000, immigration to the United States numbered approximately 1,000,000 per year
http://en.wikipedia.org/wiki/Immigration#United_States_of_America

Our history and our future helps to make us different. To deny that the United States is particularly special in the modern age denies history and current fact. Additionally, to deny that the UK has a unique position is important in its own way as has had a disproportionate impact on history would be foolish.

We are special - deal with it.

[Beskar]

http://bluehampshire.com/diary/8028/a-childs-garden-of-teabaggery

This is the voice of those against universal health care.

[Husar]

The United States clearly has a unique path and variation in planning is healthy. It is hour our Federalized system is supposed to work - with each state as a seperate laboratory trying out ideas to see if they work.

So basically the US is built on the idea that people are guinea pigs? :inquisitive:

[Xiahou]

http://bluehampshire.com/diary/8028/a-childs-garden-of-teabaggery

This is the voice of those against universal health care.
Don't forget that they hate blacks too. Guilt by association ftw. :2thumbsup:

[Philippus Flavius Homovallumus]

Then what's the point? Death is death, dying while on a waiting list doesn't feel any better than dying without being on a waiting list.

Easy, you might die on a waiting list, you will die without treatement. Also, treatment is rationed based on need, not wealth.


Let me put it another way; Not everyone should be doing the exact same thing. Did you lobby Apple to adopt the exact same processor structure as average PC's? Do you believe that one way is always going to be better than another, or do you think that different laboratories should test using the exact same methods?

Why should the US adopt a system that we disagree with and that hasn't worked for us in the past just so that we can be like everyone else?

We go our own way because we should. We are going to find an acceptable alternative system to the one used in Canada and the UK and the world will be better for it. That isn't ego, it is just reality and agrees with our understandign of our past. The UK knows a thing or two about going their own way.


Varied testing ground is important

Rubbish. We have a socialised system, and while not perfect, only 12% of our population bother with private health cover. That private cover is efficient, because otherwise people will just go with the cheaper NHS.

America is not that different from other nations, unless you want to claim not to be art of Western Civilisation, it is certainly not that different from countries like Canada or Australia; unless it wants to be.

Given the abysmal state of the "American" system you might consider swallowing your nationalistic pride and copying either us or the Frech, or the Swiss.

[Centurion1]

Or maybe we should stay with a private payer system and reform medicare and the like so that it is not such a freaking waste of taxpayers dollars.

[Ariovistus Maximus]

Easy, you might die on a waiting list, you will die without treatement. Also, treatment is rationed based on need, not wealth.

Woah, wait a minute there.

What determines "need" anyways? Eh... wealth.

Except in obvious cases of course.

And that is one problem that we have, is that we don't like gov't determining our needs, or the significance of our needs.

For instance, there was a kid in MN who was FORCED to take conventional cancer treatments. The kid and his parents wanted to use other methods, herbal and organic etc. A court foced him to take chemotherapy.

Creeps me out a little bit. Not so much the specific situation, but that a court can force me into medical decisions. What if the court started sending people it deemed "maladjusted" to "reeducation centers?" I just don't want to go that route.

[a completely inoffensive name]

Good point , apart from the fact that the founding fathers of the US were not religious outcasts and came from just about every flavour of christianity, apart from those who considered themselves diests and those who were anti-religion
Umm, yes by the late 1770s, people from all different religions were in the colonies by that time.
I am talking about the people who originally settled what would become the different colonies. There were many different religious groups who were not looked upon kindly in England, so yes there were a variety but outcasts they were nevertheless.



and they didn't want a fully representative government or represent all of the people.

Perhaps you mean the founding fathers of Jamestown who were from the established British church and went there to make money as a charter company....or perhaps you mean the religious zealots who ended up in Plymouth after they were having trouble keeping employed where they were welcome in Holland so decided to get together with another bunch of British merchants with a new charter to try and make money in a new colony...them ones really screwed up as they were among the minority and were seriously in debt to the other colonists

Umm, if we didn't want a fully representative government, why did we rebel against England in the first place?

"Founding fathers of Jamestown" oh I see, you are a little confused over terminology. See "Founding Fathers" don't mean original settlers in America. They refer to the leadership during the war and the creators of the Constitution.

The Jamestown people went there not for money but to make a new life for themselves. To pay the company for their services they had to pay them back with the resources they gathered once settled, which didn't even work out so well considering most settlements including Jamestown had to keep all their supplies and resources harvested just to survive.

The Plymouth people left Holland because it was a different culture and lifestyle then they were used to. It wasn't for money, it was because they were used to a more agrarian lifestyle in the countryside of England while Holland was a much more compact, urban, commerce driven country.

[Philippus Flavius Homovallumus]

Or maybe we should stay with a private payer system and reform medicare and the like so that it is not such a freaking waste of taxpayers dollars.

You tried that, it didn't work. France has a government garenteed system, not "Single-Payer" as you call it, their healthcare is the best in the world. Your own private system doesn't work because there is no cheap government alternative.


Woah, wait a minute there.

What determines "need" anyways? Eh... wealth.

In Britain need is determined by the severity of disease, there is a cap on the amount the NHS will pay for a drug, but it's £22,000. Even then, the cap is only usually enforced with regard to drugs for terminal conditions that extend life only by a few months.

[a completely inoffensive name]

I don't know what they teach you in your history classes - but this is a load of cobblers.

The US wasn't founded by religious outcasts. They didn't want a representative government. Non-intervention in the two world wars was a military and economic strategy, not a desire to be distant from the old world (although that was how it was sold to the public).

As for the US having a unique history - everywhere has a unique history. And the history of the US is inexorably bound up with Europe and Europeans. The work ethic is entirely 'Anglo-Saxon' and notions of the role of government are copied directly from the British.

Ok, well let me say how wonderful it is that a British guy knows more about our own history then us Americans who obviously have no clue over our own culture.

Not founded by religious outcasts: False. From the top of my head, Maryland was first settled by Catholics who were looked down upon in England.

Didn't want a representative government: False. We fought the British because we just wanted our voices heard in Parliament.

Non-intervention was military and economic strategy not a desire to be distant: Well, I don;t see how those are incompatible. The US certainly did not want to get involved and dragged into wars in Europe which would have drained our money and military unnecessarily, so the people had a desire to be distant so such a thing would not happen.

So your argument is that, since everyone has a unique history we should all disregard our history and just become homogeneous according to what the rest do?

Yes, the US and Europe is greatly tied to each other, no denying that.

"Notions of the role of government are copied directly from the British": British philosophers such as Hume and Locke, greatly influenced our government (there are a few key differences so that you can't say it was "directly" copied) but not from the British government.

[a completely inoffensive name]

America is not that different from other nations, unless you want to claim not to be art of Western Civilisation, it is certainly not that different from countries like Canada or Australia; unless it wants to be.

Given the abysmal state of the "American" system you might consider swallowing your nationalistic pride and copying either us or the Frech, or the Swiss.

YOU ARE JUST LIKE US, YOU ARE NO DIFFERENT AND YOU MUST DO WHAT WE DO OTHERWISE YOU ARE ALL FOOLS.

[Philippus Flavius Homovallumus]

YOU ARE JUST LIKE US, YOU ARE NO DIFFERENT AND YOU MUST DO WHAT WE DO OTHERWISE YOU ARE ALL FOOLS.

Well, we use your 5.56 caliber round for our rifles, and the same rotating bolt action as the M-16, that's because they're good.

Your healthcare is rubbish, ours is better, by almost every measure.

[LittleGrizzly]

YOU ARE JUST LIKE US, YOU ARE NO DIFFERENT AND YOU MUST DO WHAT WE DO OTHERWISE YOU ARE ALL FOOLS.

The same way some Americans try and encourage democracy across nations without democracy (or argue for it) we Europeans (or some of us) try and encourage universal health care across nations without it (or argue for it)

Its not a pride thing, or a calling you stupid thing. We just genuinely believe if you looked past all the propaganda and hype you would see it is clearly a better system...

[Beskar]

You should judge a society on the basis of its poorest people, not its richest.

[Ariovistus Maximus]

YOU ARE JUST LIKE US, YOU ARE NO DIFFERENT AND YOU MUST DO WHAT WE DO OTHERWISE YOU ARE ALL FOOLS.
Of COURSE! :beam:

See, it's like this:

1. I am a well-informed, thoughtful, reasonable person; under no circumstances am I EVER biased.

2. All people have the same life experiences. Therefore, anyone who disagrees with me is wrong.

3. Thus, if someone disagrees with me, I KNOW that there is SOMETHING wrong with them. They are probably infirm.

4. I must deign to grace all such persons with my hightened level of intellect. It is my duty as God's gift to mankind.

5. All people who do not recognize these FACTS must have alterior motives. They are not to be trusted.

----

:laugh4:

OK, so the reality is that this could describe everybody. :yes:

[Ariovistus Maximus]

You should judge a society on the basis of its poorest people, not its richest.

How so?

I'd say that's a dangerous route to go on. The poor could very well be poor because they're lazy slobs. They could be poor because they haven't handled their possessions well. They could be poor because beer and cigarettes cost to much money, given the amount they drink/smoke.

So am I saying that no regard should be given to the poor? Certainly not.

What I AM saying is that to try and turn judging a society into a bumper sticker is a dangerous way to go.

[Beskar]

How so?

I'd say that's a dangerous route to go on. The poor could very well be poor because they're lazy slobs. They could be poor because they haven't handled their possessions well. They could be poor because beer and cigarettes cost to much money, given the amount they drink/smoke.

So am I saying that no regard should be given to the poor? Certainly not.

What I AM saying is that to try and turn judging a society into a bumper sticker is a dangerous way to go.


There is a difference, you contribute to society through working, there should always be opportunity for work, there is always a job to be done, even if it is to sweep the streets. Having people getting money for nothing is a failure in the system.

However, Essential Healthcare should be a fundamental human right. It should be provided for you.

The argument in America is a deathpanel or something like that, it is pretty much incorrect. In America, if you can't afford the treatment, they just let you die or people have chemotherapy then have to stay in tents. There are charities in the 3rd World will provide Healthcare service which is absent in the lives of Americans, in fact there are a few working in America.

Watch anything from Sicko, to the Panaroma review about the American Healthcare system. Anyone who suggests that is better than the NHS clearly does not know what they are talking about.

America praises itself as a land of opportunity, then it should allow people to have opportunities, rather then robbing them of them, because they come from a poor background.

Only people that lose out are the fatcats, and since they earn millions per year, it is not like they need it anyway.

[Husar]

How so?

I'd say that's a dangerous route to go on. The poor could very well be poor because they're lazy slobs.

Can you blame them if their laziness is genetic? Can you blame a sloth for being slow? :inquisitive:

[LittleGrizzly]

I have always thought society should be judged on how it treats its undesirables*... be they the poor, the lepers, the jews, the muslims, the racists or the peadophiles...

If they are humane and compassionate (thinking racist and paedophile here) rational and not forming lynch mobs you have a civilised society right there...

If they defend thier rights (jews and muslims) and stand up to those who try to slander and vilify them no matter what activities small sections of thier people do

If they provide the basics (poor) and try thier best to not only give them an enjoyable life but give them every chance of progressing themselves or at least ensuring theres a good chance thier children can move up...

So i suppose i kind of include the poor but its not just the poor, for a godwin example i think Nazi germany was ok to the poorest german men (although you could argue once thier stuff was taken the jews were poorer, so if we think back to before the jews stuff were taken) so under your definition the nazi goverment would be good... whereas under mine it would class as bad... a much more accurate conclusion...

Sorry if this is a bit off topic...

Edit

* undesirable as in people can often have problems with... rather than the fact those groups are undesirable... well the rapists and peadophiles are...

[Ariovistus Maximus]

I can see your point, Little Grizzly. However, it can EASILY be taken too far if you concentrate only on the one class and not the other.

But please do keep in mind that I really don't disagree with you, but I'd like to mention how an imbalance in the areas you mentioned can cause trouble. Thus, it is harmful to have tunnel vision here.

Exempli gratia:


If they are humane and compassionate (thinking racist and paedophile here) rational and not forming lynch mobs you have a civilised society right there...

However if they become so compassionate that they let murderers go free the first time, then you have a lawless, rather than a civilized, society.

And before you consider that to be too extreme of an example, listen to this quote from Constantine (IIRC), which sums up the concept.

"I would rather that the guilty go free, then that the innocent be punished." That's a dangerous route to take. When you think only of the "underdog" you become unbalanced. Quite frankly, the reason that underdogs get attention is because they are relatively rare.


If they defend thier rights (jews and muslims) and stand up to those who try to slander and vilify them no matter what activities small sections of thier people do.

However you must guard against protecting the rights of the minority above those of the majority.

I really am concerned that being a majority (white), I may actually be handicapped by society. Disagreeing with Obama has often been equated with racism.

I honestly believe that many African-Americans are racist. I know this is touchy, which really just proves my point. I think that they often segregate themselves, and look down on other groups almost as a reaction to the terrible treatment they have received in the past.


If they provide the basics (poor) and try thier best to not only give them an enjoyable life but give them every chance of progressing themselves or at least ensuring theres a good chance thier children can move up...

But at what point does personal responsibility come in? I'd agree with giving them the opportunity to succeed, but often it goes much farther than that. Wellfare is widely manipulated by the lazy and parasites of society, and it actually DISCOURAGES advancement in many cases.


So i suppose i kind of include the poor but its not just the poor, for a godwin example i think Nazi germany was ok to the poorest german men (although you could argue once thier stuff was taken the jews were poorer, so if we think back to before the jews stuff were taken) so under your definition the nazi goverment would be good... whereas under mine it would class as bad... a much more accurate conclusion...

Eh... why would I describe Nazi Germany as good? "words in mouth" . :clown:

Do I need to apply Godwin's law here? :laugh4:


Sorry if this is a bit off topic...

Personally, I think it's a great topic, and very insightful.

And keep in mind that on the whole I agree with what you're saying. However, go full-bore into any of those and you have a problem. As with anything, balance is essential. And I'm not even saying that my rightist oppinions are balanced, either.

I hope you see where I'm coming from.
[/QUOTE]

[Ariovistus Maximus]

Can you blame them if their laziness is genetic? Can you blame a sloth for being slow? :inquisitive:

I take it you're serious.

OK then.

No, I don't blame a sloth for being slow. However, you don't see me feeding the sloth every day so that he doesn't have to bother with getting up. :smash::smash::smash:

I love dismantling analogies. :beam: So much fun.

And actually the sloth isn't lazy. It's just slow.

I'm talking lazy here.

[LittleGrizzly]

However if they become so compassionate that they let murderers go free the first time, then you have a lawless, rather than a civilized, society.

And before you consider that to be too extreme of an example, listen to this quote from Constantine (IIRC), which sums up the concept.

"I would rather that the guilty go free, then that the innocent be punished." That's a dangerous route to take. When you think only of the "underdog" you become unbalanced. Quite frankly, the reason that underdogs get attention is because they are relatively rare.

I wasn't so much thinking in terms of the punishments we give them (or not) though i would say part of being a civilised society is that we lock our prisnors up not out of vengance* but as a punishment (though i think rehabilition rather than punishment I don't see basic imprisonment as too barbaric)

*along the same lines as its ok to smack your kid but you don't do it in anger...

My point was more geared towards individual peoples attitude towards these people, Jesus loved the prostitute, or the murderer... or some bible story backs my point but im vaguely remembering it... (help! christian required!)

It is more about people's attitude towards these people, (paedophiles and racists) when they go and form lynch mobs to get these people, when these people are mercilessly hounded. In a just and civilised society it should only be the justice system that hands down punishments, people should accept the wrong these people have done and if anything try to help them overcome themselves...

Im not saying have the paedophile babysit or take you black friend to visit the racist guy (although the second one could work if he isn't too far gone) just don't hound and ostracise these people and well if anything help them... (or that is what would/should occur in a civilised society)

However you must guard against protecting the rights of the minority above those of the majority.

I really am concerned that being a majority (white), I may actually be handicapped by society. Disagreeing with Obama has often been equated with racism.

I honestly believe that many African-Americans are racist. I know this is touchy, which really just proves my point. I think that they often segregate themselves, and look down on other groups almost as a reaction to the terrible treatment they have received in the past.


I think that is important too, not so much because the majority requires too much protection, but mainly because once the majority starts to feel disenfranchised thats when the racist partys start picking up votes...

I do think thier anger is somewhat understandable... I remeber a recent visit to Israel by the last german chancellor, A group of Israeli's who all looked fairly young (20's my guess) were burning a german flag and shouting stuff (probably not racist stuff but not pro-german either i doubt) these are people whose parents or even grandparents suffered and told them about it, somewhat similar to young black americans today...

Although I do think on a level some reverse racism policys are nessecary... as the minority will have a slight bad effect from not being part of the majority... so some slight policy which favours minority is more of a leveller...

Im not a fan of Affirmative Action though for example, If they really want to help the worst of blacks it should be a sliding scale of how many points you get for nothing depending on your background, Obamas kids get no points and crack baby 4 in the ghetto gets the maximum (then i would also make it for all races)

But at what point does personal responsibility come in? I'd agree with giving them the opportunity to succeed, but often it goes much farther than that. Wellfare is widely manipulated by the lazy and parasites of society, and it actually DISCOURAGES advancement in many cases.

Well I was more thinking of your minumum wage worker than unemployed scrounger....

If were talking someone who is already an adult I refer to things such as, helping them gain some qualifications (like a forklift lisence or simple things like that) if they need childcare or they cannot afford the time off work to better themselves then the goverment should help. They should have a health service that keeps them in good working order (healthy citizens are productive citizens!) and there should be unemployment benefit for those who fall on hard times...

That was more geared towards the minumum wage worker than the unemployed scrounger, unfortunately it is hard to help the worker and at the same time avoid funding the scrounger... the one thing i will say is i dont think scrounging is too big a problem... like paedophilia* for example it is widely reported as its something that angers people alot.

*As in we hear about it alot in relation to the amount it happens... compared to deaths by donkeys for example...

Eh... why would I describe Nazi Germany as good? "words in mouth" . :clown:

Do I need to apply Godwin's law here? :laugh4:

Sorry my post was mainly aimed at Beskar's comment of society should be judged on how it treats its poor...

So I was saying that technically, under the mantra of judging a society by how it treats its poorest, that technically (before the jews become the poorest) Nazi Germany was a good state as it made every effort to help get the unemployed back into work and such (across a very small timeframe this reference could be made...)

I was almost backing your point up of its probably a bad way to judge a society...

Personally, I think it's a great topic, and very insightful.


:2thumbsup: Thanks, I did find it intresting which is how i managed to ramble on for so long...

Your points are well made and i see where you are coming from...

[Banquo's Ghost]

Gentlemen,

The topic of this thread is the US Health Care debate.

That should be quite enough to divert us. Please get back to that topic.

Thank you kindly.

:bow:

[a completely inoffensive name]

Gentlemen,

The topic of this thread is the US Health Care debate.

That should be quite enough to divert us. Please get back to that topic.

Thank you kindly.

:bow:

Ok, so health care, now I don't want to rock the boat here but.....I think we might we need some. But how? I'll let others build on this so I don't hog what little conversation in this thread.

[Lemur]

I hate to interrupt this debate about who settled Jamestown first, but I'm going to derail this thread into healthcare reform.

After doing a goodly bit of reading, I'm increasingly of the opinion that tort reform is a distraction. From the CBO (http://www.cbo.gov/doc.cfm?index=4968&type=0):


Some observers argue that high malpractice premiums are causing physicians to restrict their practices or retire, leading to a crisis in the availability of certain health care services in a growing number of areas. GAO investigated the situations in five states with reported access problems and found mixed evidence. On the one hand, GAO confirmed instances of reduced access to emergency surgery and newborn delivery, albeit "in scattered, often rural, areas where providers identified other long-standing factors that affect the availability of services." On the other hand, it found that many reported reductions in supply by health care providers could not be substantiated [...]

In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency. Thus, choices about specific proposals may hinge more on their implications for equity--in particular, on their effects on health care providers, patients injured through malpractice, and users of the health care system in general.

And a quote from actuary J. Robert Hunter (http://insurance-reform.org/TrueRiskF.pdf), Director of Insurance for the Consumer Federation of America (CFA), former Commissioner of Insurance for the State of Texas:


Thirty years of inflation-adjusted data show that medical malpractice premiums are the lowest they have been in this entire period. This is in no small part due to the fact that claims have fallen like a rock, down 45 percent since 2000. The periodic premium spikes we see in the data are not related to claims but to the economic cycle of insurers and to drops in investment income. Since prices have not declined as much as claims have, medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been remarkably profitable over the last five years.

Our study also shows that states that have passed severe medical malpractice tort restrictions on victims of medical error have rate changes similar to those states that haven't adopted these harsh measures. Finally, our research makes clear that medical malpractice claims and premiums have almost no impact on the cost of health care. Medical malpractice premiums are less than one-half of one percent of overall health care costs, and medical malpractice claims are a mere one-fifth of one percent of health care costs. If Congress completely eliminated every single medical malpractice lawsuit, including all legitimate cases, as part of health care reform, overall health care costs would hardly change, but the costs of medical error and hospital-induced injury would remain and someone else would have to pay.

[rory_20_uk]

Here is a rather good article. (http://www.timesonline.co.uk/tol/comment/columnists/daniel_finkelstein/article6801061.ece)

It shows the massive value placed on what we have compared to the value we assign to something that is offered. Those that are anti-reform appear to want to continue with the current unsustainable system.

~:smoking:

[a completely inoffensive name]

Well I mean on the topic of health care, all joking aside here is what I think with all seriousness.

I think that among all this bickering, the big picture is somewhat being missed. I mean this is not a black and white world and when we talk about health care there is no right answer. Is our health care system right now totally ****** up? Absolutely, but to argue that it must be this way or that way, that we must do our own thing or that we need to just swallow our nationalistic pride and copy from Europe is not very constructive in my opinion.

You can have a totally socialized government owned health care system, hospitals, doctors etc and it would work, you can have single payer system with a basic gov coverage or a public option and private for those with money and a want for extra coverage and it would work, you can break up the collusion among the insurance companies and break them apart into smaller competing companies with anti trust laws and inject much needed consumer protection to prevent coverage being denied once a person becomes too expensive along with some other smart regulation such as tort reform etc and that would work as well.

If we are going to debate this it really shouldn't be about what is the right way to do it (because again, there is no "right" way), but rather if it is being implemented correctly. I have read a lot of the bill that is getting a lot of criticism (HR 3200) and it is a huge bill which obviously just from my skimming of it has a lot of loopholes, benefits and special interest influence that don't help the people but are going over looked because the only people pointing things out for the most part are those manipulating the interpretations of the good parts spewing half truths and lies in order to satisfy their own political agenda. Now I wouldn't want this bill to be passed not because I am against the big ole scary government but because I want this bill to work flawlessly with the first time around so people still are not suffering due to the pens of corrupt lobbyists and politicians.

Right now I am looking at another bill that I hear has some promise as well, HR 676 that does not seem to be as full of such problems. I mean the bottom line is to get those 47 million covered and to save those already covered some money as well as receive better coverage, to deny a bill that can do that just because you don't like government running your life or because you hate those fat capitalist pigs making money off of peoples fear of sickness is missing the point. That's about all I have to say. I can't for the first replies telling me how wrong I am because their view of pro-gov or anti-gov is the one with all the facts behind it.

[Seamus Fermanagh]

I don't know what they teach you in your history classes - but this is a load of cobblers.

The US wasn't founded by religious outcasts. They didn't want a representative government. Non-intervention in the two world wars was a military and economic strategy, not a desire to be distant from the old world (although that was how it was sold to the public).

As for the US having a unique history - everywhere has a unique history. And the history of the US is inexorably bound up with Europe and Europeans. The work ethic is entirely 'Anglo-Saxon' and notions of the role of government are copied directly from the British.


Depends on where in the USA. Massachusetts Bay and Maryland could be considered as founded by religious outcasts. Can't make the same claim for any of the former French or Spanish areas. Pennsylvania took its "freedom of religion" approach fairly seriously, and did become something of a haven for Mennonites and Quakers. Most of the rest were not religious in focus and some (Virginia) were set up as profit centers pure and simple.

The founders did want a representative government, but by no means was the whole thing supposed to be direct representation. The House of Representatives were supposed to represent the people in their district, whereas the Senators were there to represent their state/state government. This WAS supposed to function as a check on too much popular sentiment -- the founders did NOT want government by referendum.

Isolationism was both policy and sentiment. Like any such policy, both "driving forces" tend to become intertwined. Certainly we took a much more active role in the Americas, emphasizing isolation from the Old World, but even there our dust-up with the Barbary pirates indicates there were economic issues that would over-ride the basic "steer clear of Europe" theme. GW really did crystalize our early isolationism with his "keep free of the entanglements of Europe" approach to foreign policy. Part of the reason he did so, however, was simple self-preservation. He didn't want some European power to gain leverage over the USA when we were just barely a going concern.

US culture draws heavily on European sources and our Legal system is, in all but one state, largely framed around English Common Law. While we have had asiatic and latin cultural influences as well, these have really only recently begun to have a lasting effect on the larger culture.

[woad&fangs]

Good post, ACIN.

I'm going to try to read H. R. 2520 tomorrow. It's only 250 pages, so I'll try to read the whole thing. HR 2520 is Paul Ryan's (R) proposal. It will set up state based health insurance exchanges. I'm very curious about this bill.

[Banquo's Ghost]

Since my earlier request was pointedly ignored, I have deleted the off-topic bickering. The topic of the thread is interesting to many members, and therefore it will be kept open.

There is certainly some benefit in discussing the topic within cultural context, but I feel sure there is a great deal more to be illuminated on the healthcare debate itself.

Further discussions on the history of the United States may be taken to a new thread, where respect for each other's knowledge and point of view will no doubt, be a key standard.

Any resurrection of earlier disagreements will be dealt with in the usual manner applied to the shambling dead: head-shots and deletion.

Thank you kindly.

:beadyeyes:

[Ariovistus Maximus]

So sorry Banquo! :embarassed:

My most humble apologies.

Henceforth, I shall not let myself get carried away.
:bow::bow::bow:

So, the main issues that HC detractors seem to have:

1. Tort reform would accomplish the same thing without gov't interference. I believe that someone has already posted an article dealing with the other side of this issue.

2. Costs too much. Supporters argue that the short-term cost is not that much higher than the current system, and the long-term benefits are worth it.

3. Government care will be inefficient. Supporters would show where private businesses are inefficient.

4. We just generally fear big government. Well, this gets into that little cultural argument... so let's not got there.

OK, so other issues do we have?

[Xiahou]

1. Tort reform would accomplish the same thing without gov't interference. I believe that someone has already posted an article dealing with the other side of this issue.Has anyone here argued that? Tort reform would be a positive step, but I don't think anyone could reasonably claim that it would "fix" healthcare.

2. Costs too much. Supporters argue that the short-term cost is not that much higher than the current system, and the long-term benefits are worth it.This one seems like a clear win for opponents. The OMB has come out and said that the proposed reforms would "bend the curve up" when it came to the growing costs of health care. It would accelerate the skyrocketing costs- not decrease them.

Despite it's lofty goals, our proposed health care reforms would accelerate costs and still not provide universal coverage. No thanks. Maybe they should start smaller- find a way to control the spiraling costs of Medicare first. Prove you can do that and then come back and talk to us about providing government health insurance available to all Americans. So far, the only cost saving measure we've seen the administration is further slashing reimbursement to health care providers for Medicare treatments. That's something like the proverbial finger in the dam compared to the huge wave of red ink from Medicare. It's great that they're trying to save money, but it's not a meaningful step compared to the massive overall burden of Medicare costs.

[Ariovistus Maximus]

Sorry, mate. Just trying to be objective. :D

Ah, yes. That's another thing I forgot. The above points would be problems with the ideal health care system.

It would be quite a stretch to suppose that, in light of the success of recent measures, our glorious legislature will come up with anything close to the ideal.

Cash for clunkers was supposed to last... how long? And it got, what, 30% of the way to the deadline before they ran out of money? :laugh4:

[Tribesman]

Cash for clunkers was supposed to last... how long? And it got, what, 30% of the way to the deadline before they ran out of money?
errrr....There was no deadline until they announced a deadline last week:dizzy2:

[Ariovistus Maximus]

errrr....There was no deadline until they announced a deadline last week:dizzy2:

Umm, yes. And unless they dump more money into the system, it will run out before said deadline at the current rate.

But if I'm a retard for engaging in simple mathematics, I concede the issue to you. Congratulations on your most noble victory. :bow:

Anyways, don't let my previous off-topic discussion distract you all. Debate! Discuss! Contribute!

[Don Corleone]

Damn you... damn you all... have you no regard for proper form?

The official name of the program, which according to Rham Emmanuel must be used in its entirety is:

THE WILDLY POPULAR Cash for Clunkers Program.

Get it right, people.

[Seamus Fermanagh]

Damn you... damn you all... have you no regard for proper form?

The official name of the program, which according to Rham Emmanuel must be used in its entirety is:

THE WILDLY POPULAR Cash for Clunkers Program.

Get it right, people.


Why do you hate hope?

[Tribesman]

THE WILDLY POPULAR Cash for Clunkers Program.

Get it right, people.

Not as wildly popular as Irelands version.
At least America put restrictions on what you could trade in, just imagine what the uptake would have been if you had been allowed to just dump a rusted pile of scrap metal on the forecourt and call it a car.

[Ariovistus Maximus]

Why do you hate hope?

Perhaps he hates it when it collides violently with reality. :beam: Because excessively unrealstic hope is actually counter-productive. You will pass up what you CAN accomplish in hopes that you can accomplish the impossible.

Or such is the possibility.


Not as wildly popular as Irelands version.
At least America put restrictions on what you could trade in, just imagine what the uptake would have been if you had been allowed to just dump a rusted pile of scrap metal on the forecourt and call it a car.

Wow! How's that been working for them?

I can see how that would be popular though. :beam:

[Lemur]

GOP releases "Seniors' Bill of Rights (http://online.wsj.com/article/SB125112553661853921.html)."


The Republican Party issued a new salvo in the health debate Monday with a "seniors' health care bill of rights" that opposed any moves to trim Medicare spending or limit end-of-life care to seniors.

Intended as a political shot at President Barack Obama, the Republican National Committee manifesto marks a remarkable turnaround for a party that had once fought to trim the health program for the elderly and disabled, which last year cost taxpayers over $330 billion. [...]

The country's largest lobbying group for seniors, AARP, said it welcomed the RNC's commitment to protect Medicare. But the group, which supports efforts to overhaul the health-care system, also dismissed the RNC statement as misleading and alarmist.

"Change by itself is anxiety producing, but as we have analyzed the various bills [before Congress], the proposed Medicare savings do not limit benefits, they do not impose rationing and they do not put the government between patients and their doctors," said John Rother, AARP's executive vice president.

Mr. Rother said that AARP was frustrated by the lack of concrete proposals being put forward on the Republican side of the debate. "The debate as I see it doesn't even focus on health care," Mr. Rother said. "It is all about the role of government and the importance of the federal deficit."

The Republican statement highlights an irony in the health debate, as illustrated during some of the emotional town-hall meetings this month: Many Americans say they fear a government takeover of health care, even as they resist any cuts to Medicare, the federal government's largest health program.

[Xiahou]

I just read a column (http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082103033.html?nav=rss_opinion/columns) on the Washington Post that raises a Constitutional issue I hadn't considered in regards to individual insurance mandates. That being- does the federal government have the authority to mandate individuals to purchase health insurance? After skimming through their argument, I would agree that, no, it does not. It'd certainly make for an interesting Supreme Court Case.

Edit:For Lemur: Steele Today: "Don't Cut Medicare!" Steele in 2006: "Cut Medicare!" (http://tpmdc.talkingpointsmemo.com/2009/08/steele-today-dont-cut-medicare-steele-in-2006-cut-medicare.php)So RNC chairman Michael Steele took to the pages of the Washington Post to warn seniors, "we need to protect Medicare and not cut it in the name of 'health-insurance reform.'" A convenient refrain for the current political climate, but, in bad news for Michael Steele, a complete departure from GOP business as usual. Here, for instance, is an October, 2006 exchange on cutting Medicare between Tim Russert and--wait for it--Michael Steele.

MR. RUSSERT: What programs would you cut?

LT. GOV. STEELE: Well, what I would like to do is something that we did in Maryland. We -- Governor Ehrlich and I came into office, we had a $2.2 billion deficit staring us in the face and a bloated government to contend with. And so we stepped back and evaluated exactly what the priorities of our government should be. Seventy-eight percent of our spending is in two areas: education and health care.

MR. RUSSERT: It's the same in the federal government.

LT. GOV. STEELE: It's the same. And my point...

MR. RUSSERT: Seventy percent is Social Security, Medicare and Defense.

LT. GOV. STEELE: Absolutely. Absolutely.

MR. RUSSERT: Would you touch those?

LT. GOV. STEELE: Abso -- Tim, everything has...

MR. RUSSERT: Everything's on the table.

LT. GOV. STEELE: Everything has to be on the table, my friend. We are living in a time -- we have to -- government has to act like the rest of, the rest of the world and sit back and look at your budget. If you don't have enough money in any given month, what do you do? You've got to reprioritize. You've got to take care of the business at hand.


So much for that, I guess.
I, for one, am relieved that we don't have a bunch of incompetent opportunists in the opposition... :sweatdrop:

[Xiahou]

doh

[Beskar]

I saw this and it made me think of this thread:

https://img132.imageshack.us/img132/4967/outrageous.jpg

[Ariovistus Maximus]

Inmates Receive Stimulus Checks

http://finance.yahoo.com/news/Stimulus-checks-not-boosting-apf-2542694170.html?x=0&.v=2

Sorry hyperlink's not working for me. Will fix soon.

[Don Corleone]

I heard an interesting perspective on the health-care debate and the particular question of rationing.

The argument from the Right is that a single-payer system, by necesity, leads to scarcity and rationing issues, where issues of care are decided by bureaucrats on a government panel, not by the patient and doctor.

FOUL! cries the Left. The above is a disingenuous argument, because while it may be true, every system of health care has scarcity issues, and in the current system, decisions of coverage are also made by bureaucrats, only these ones work for the insurance company and at least the ones in a single-payer system would be appointed, and therefore accountable at some level through the political process.

While I agree with the Left that the Right is certainly glossing over a big gaping hole in their logic, I actually believe I have a rebuttal that puts their argument equally out of sorts:

-In order for the panel to be devoid of croneyism and nepotism, the panel will have to act indepdent of the will of elected politicians, thus voiding the "accountability & fairness" argument they're making.

-Actually, there is accountability in the current system. Yes, Aetna, BCBS, Harvard-Pilgrim & other large providers can (and do) spend large sums of money determining how best to avoid paying claims they'd rather not pay, there is a limit... should a provider pull this lever too often, their clients will leave. It's not a direct feedback system, because the provider is typically contracted by the employer, while the services are provided to the employees. But don't kid yourself into thinking there's no cause and effect here. According to HR, lack of satisfaction with the insurance provider ranks up in the pernnial top 3 complaints they receive.

What's more, I know I certainly researched the insurance options for any potential employer as part of my compensation package on the way in. If others can't be bothered to do this, I have little sympathy for them, nor do I believe that there is any system that could adequately serve such a woefully willfully ignorant consumer.

And before I get the hail of "You have coverage...." arguments, remember, I am NOT opposed to universal coverage. I am adamantly and irrevresibly opposed to single-payer systems.

[Banquo's Ghost]

At the moment, I am not really seeing much coverage of constructive alternatives in the press to which I have access. The proposals seem like a muddle and mess because real reform is being shied away from in favour of the minimum possible politically - and, it must be said, some startling level of cowardice being shown by Democrats if real reform is what they believe in. However, all I see of the other side is yah-boo scaremongering.

If I may, could I ask Don Corleone and Seamus to explain the kind of system that they would like to see in the United States? As far as I understand the numbers, something of the order of 46 million fellow citizens of the US are uninsured, many more part insured or vulnerable to redundancy, and there are 18,000 unnecessary deaths due to lack of medical insurance each year - and many more bankruptcies. (These are figures widely quoted in the papers here, so I am open to them being challenged with other evidence).

You two gentlemen are deeply Christian, wise and caring individuals who also believe in a conservative solution to most social issues. I may not always agree, but your opinions are always thought-provoking. Your thoughts on the best, even ideal, reform (given that the existing system, if the above figures are even remotely accurate, is deeply immoral and close to barbarism for a wealthy country) would be very valuable for me to understand the direction of the ongoing debate.

:bow:

[Beskar]

The argument from the Right is that a single-payer system, by necesity, leads to scarcity and rationing issues, where issues of care are decided by bureaucrats on a government panel, not by the patient and doctor.

If you think about this, would all those people having access to medical care really ration it out? If so, build more hospitals. Anyway, it isn't rationed by some evil government panel which stops doctors and patients, it is rationed based on need and availability. What stops people now, is money, as doctors can't treat patients, or even worse, the doctors fleece the patients of their money.

Fact is, any real universal healthcare package would "ration supplies" as there is far more demand to supply. To solve the issue, you have more supplying.

[Don Corleone]

At the moment, I am not really seeing much coverage of constructive alternatives in the press to which I have access. The proposals seem like a muddle and mess because real reform is being shied away from in favour of the minimum possible politically - and, it must be said, some startling level of cowardice being shown by Democrats if real reform is what they believe in. However, all I see of the other side is yah-boo scaremongering.

If I may, could I ask Don Corleone and Seamus to explain the kind of system that they would like to see in the United States? As far as I understand the numbers, something of the order of 46 million fellow citizens of the US are uninsured, many more part insured or vulnerable to redundancy, and there are 18,000 unnecessary deaths due to lack of medical insurance each year - and many more bankruptcies. (These are figures widely quoted in the papers here, so I am open to them being challenged with other evidence).

You two gentlemen are deeply Christian, wise and caring individuals who also believe in a conservative solution to most social issues. I may not always agree, but your opinions are always thought-provoking. Your thoughts on the best, even ideal, reform (given that the existing system, if the above figures are even remotely accurate, is deeply immoral and close to barbarism for a wealthy country) would be very valuable for me to understand the direction of the ongoing debate.

:bow:

:bow: Thank you much for the high compliments, sir, and for your confidence in me to propose a free market solution. I'm not certain I can, but I would argue that our current situation is not a free market system either. Some practices/guidelines I would adopt for cost savings:


I believe we have numerous problems which overlay to form the quagmire that is our current medical system.

1) We do not incentivize doctors to make people healthy, we incentivize them to "do something". I would recommend altering the way doctors are compensated to more of a fixed payment schedule, where they get paid the same whether they recommend you for additional procedures or not.

2) Costs are best controlled when the decision maker is well informed of the costs of their decision. This is why I am so strongly in favor of high-deductible plans (level of deductible based on your income, to make it a sliding scale... such as 0.5% of your gross income or some such). I myself just went on a a high-deductible plan, and I'll tell you, you learn to ask questions like 'And how much will this procedure cost?'

3) We have to nullify all the protectionist laws enacted on behalf of the pharmaceutical companies. They are anti-competitive and are a big part of how we got to where we are. End Medicare Part D (at the very least, the no bid requirement) and allow for competitive sourcing of drugs from other markets.

4) We need torte reform. I don't believe in limiting the ability to sue, or the damages rewarded. But I do believe that if the judge finds your case to lack any bearing, he can refer you to a judicial oversight committee. If they find your case to be utterly without merit, you (or your attorney) have to pick up the legal costs for the defense. That should end those "WhoCanISue.com" and late-night Robert Vaughn ads that run "IF you win, I get 1/3, if you lose, you don't pay a dime" shticks.

For the coverage issue:

I like the way Germany, Japan and the State of Massauchusetts are set up. Require insurance from a government approved medical insurance provider. However, as part of this:
-Remove tax incentives for corporations to provide coverage, put everyone into the open market.
-Allow the formation of buying groups or co-ops (which are currently illegal in the US....well, they are and they aren't... large corporations buying for their employees are allowed, but I'm not allowed to form one).
-On an evaluation of an individual's ability to pay, the government will subsidize medical premiums. Families that make less than 40K a year will receive 100% of the money they spend in insurance premiums back at the end of the year. 50% up to 80K and so forth. Once your family hits 6 figures, you pay the whole nut. But, if you violate the law and do not get insurance, you don't get one red cent.

And one more thing I would do, to incentivize the insurance companies to cover everyone...

Set their income tax based on a new figure I would call their coverage index.

A 24 year old male with no family history gets assigned a +20. A 79 year old woman with Crohn's disease, diabetes and early stages of cancer gets assigned a -20.

The index is the sum of all individual ratings of everyone you covered for the entire year, pre-existing condition cases not included (if you don't cover them, you don't get their index points). At the end of the year, when your accountants calculate your taxes, they add or subtract your index from your corporate income tax. If you go out and cover a bunch of end-of-lifers, you'll be rewarded handsomely by the taxman. :2thumbsup: If you insist on dropping coverage on all risks, you'll be taxed heavily for that policy. :smash:

Edit: Edited to add cost reduction measure number 4.

[Strike For The South]

You know where I see the death of America? In the sheer lack of manners I see at these town hall meetings. My momma would tan my hide if I ever spoke to another person (Esp. a stranger, an elder stranger, an elder congressman stranger. She may have killed me) like that. All these people are hootin and cussin, whatever happend to common decency?

I know your life savings are being bled or you're scared you're in a socialst paradise or you're having to deal with more brown people and quite frankly you don't like that

But my God, talk about uncivil discourse. Do people really think the louder they yell and the more times they invoke Hitler and the constitution they'll win? This is what happens when you let Yankees run the country.

Is the lack of manners not unsettling to anyone else? Or am I just being to gentlemanly?

[Louis VI the Fat]

Is the lack of manners not unsettling to anyone else? Or am I just being to gentlemanly?You are just being too Dixie. Southerners like you and I have complained about the encroaching Yank and his unrefined manners for well over a century now. We've been right all along. :shame:


Thank you for your lengthy reply, DC. I would still vote you for President.

[Lemur]

That's actually a pretty good system the Don recommends. Corleone for President! Don't turn us into France, turn us into Germany!

[Lemur]

Fantastic, must-read essay (http://www.firstthings.com/onthesquare/2009/08/confessions-of-a-health-care-rationer) on health care and rationing. The entire thing is worth your time:


All modern societies ration health care. A wise society considers the options and chooses a method of doing so which best conforms to its values and capabilities. Thus we come to the terrible question we would so very much like to avoid: How shall we ration health care? How shall we explicitly ration it? So noxious a question is this, so offensive in its tacit assumptions and implications, that most politicians and wishful thinkers will deny that we need to address it at all. They will argue that the fundamental problem is one of distribution, not one of unmeetable demand. They will argue, with more enthusiasm than evidence, that an emphasis on preventive care would substantially reduce aggregate demand. Some will say we must reduce the role of government; others will argue that we should augment it. If only we will adopt their plan—they’ll say—waste, fraud, and abuse will be abolished. There will be chicken—or at least chicken soup—in every pot, and a vaccine in every arm. People love honesty, but they hate the truth. To frankly acknowledge and address the ineluctable reality of healthcare rationing is not merely to touch the proverbial third rail of American politics; it is to lie across the tracks in front of the onrushing train.

Come, let us speak of unpleasant things. How is health care to be rationed? Who gets the short end of the stick?

Note: The author works for a healthcare insurance company, so his conclusions are (naturally) pro-insurance company. That's not interesting or surprising: what I found amazing was the admission and (rosy-colored, but still explicit) explanation of how rationing works under the current system.

[Xiahou]

I think these people should look up what rationing (http://www.merriam-webster.com/dictionary/rationing) actually means.

The article's author points out:
Most economists would exclude this sort of market allocation as a form of rationing by definition.It's not just economists- it's anyone who uses the literal definition of the word. Just because someone can't afford as much as a good or service that they would want to have doesn't mean it's rationed.

Rationing suggests that something is doled out more or less equally based on its supply. If I go down to the grocery store and buy all the Wheaties so no one else can get any, it's not the same as the grocery store rationing them. :no:

[Centurion1]

I am against this health care plan. I am not against reform however. I do not understand the excessive need of the democrats to force this bill through right now, any later and the world will end. It makes me suspect they are hiding things.

I think we should start with actually reforming things. My main problem with obamas plan is in addition to medicare and the like we have this new system. Medicare, Medicaid, Social security need to be drastically reformed or scrapped and completely remade. No single payer system (current) should have as high of a cost per year as we do.

[Ariovistus Maximus]

It makes me suspect they are hiding things.


Quite so. You know, I think some of this debate must be culture-clash.

Perhaps Europeans tend not to have a deep-seated distrust of government like we often do?

That would explain some of the disagreements here.

[Xiahou]

It makes me suspect they are hiding things. Where would you get that idea (http://www.detnews.com/article/20090825/OPINION01/908250316/1008/Editorial--Taxpayers-shouldn-t-pay-for-UAW-s-rich-health-care-benefits)?

One reason the public so distrusts the health care plan being considered by Congress is that so many troublesome details keep bubbling out of the massive legislation.

The latest example is the $10 billion taxpayers will be asked to shell out to prop up the United Auto Workers' retiree health insurance program.

That provision is tucked deep into the bill passed by the House.

In effect, it would ask every taxpayer, regardless of whether they'll have health insurance coverage themselves after they retire -- and most won't -- to chip in to maintain the UAW's coverage, which even after the union's givebacks is still better than what the average American worker receives. A $10bn payout to unions? Gee, I wonder why they're in favor of the bill? :idea2:

Howard Dean recently stated (https://www.youtube.com/watch?v=IdpVY-cONnM) that tort reform isn't in the bill because Democrats were afraid of making enemies of the trial lawyers. I guess a hefty payoff was what it took to get the unions on board. Bear in mind that people are still finding things like this in the bill almost daily. If Obama had gotten his way this bill would have been signed into law already. So yeah, I could see how you might think they're trying to rush it through before we see what's really in it. :yes:

[Tribesman]

The latest example is the $10 billion taxpayers will be asked to shell out to prop up the United Auto Workers' retiree health insurance program.

The government sholdn't put tax payers money into this insurance , they should let the ex workers use tax payer funded programs for people without insurance instead

[Ironside]

Quite so. You know, I think some of this debate must be culture-clash.

Perhaps Europeans tend not to have a deep-seated distrust of government like we often do?

That would explain some of the disagreements here.

Depends a lot from witch region of Europe you talk about, but comparing with Sweden, I would say that we're more trusting of the goverment. But I sometimes get the feeling of how the existing distrust is shown differently.
In the US, when the flaws are shown, people are more accepting of it when it's their side doing it (the news shows for example) or are using it as proof that the state are always corrupt and tries (and usually fail) to reduce the state instead of try to fix it. Then again, you do have more grass root movements as well (not sure what that means on the whole though).

I do suspect that the US governing problems are linked to how the congress work. Personally, I say that the best reform you would ever get, would to put about a dozen very talented people in the field, unconnected (or low connected) to interest groups, to work out the ideas for a year or 2 and then slam the suggestions through congress before they knew what hit them.

I mean, the longer a proposal goes through congress it gets more and more perked, porked and watered down. Some review is good, but the congress is overdoing it.

[Hosakawa Tito]

Like most issues the main problem is that monied interests, coporate or organized labor, throw so much 'free speech' at politicians whose real main concern is getting re-elected. Term limits for all would go a long way in fixing this legalized bribery.

[Banquo's Ghost]

Thank you Don, for taking the time to add such an interesting and constructive proposal. :bow:




1) We do not incentivize doctors to make people healthy, we incentivize them to "do something". I would recommend altering the way doctors are compensated to more of a fixed payment schedule, where they get paid the same whether they recommend you for additional procedures or not.

My grandfather used to tell me that the Chinese paid their doctors only when they were well - stopping payment the moment the doctor "failed" and they became ill. Like much of my grandfather's wisdom, this is probably entirely mythical, but it does raise an interesting perspective for state-run healthcare and preventative healthcare - maybe we should stop a doctor's salary when a patient gets ill? (Before rory has a coronary, I'm joking - but all health systems should have a substantial incentive towards preventative care - and how is this done in a "free market" rather than a public health system? The incentive for the free market is surely to have as many ill people as possible?)


2) Costs are best controlled when the decision maker is well informed of the costs of their decision. This is why I am so strongly in favor of high-deductible plans (level of deductible based on your income, to make it a sliding scale... such as 0.5% of your gross income or some such). I myself just went on a a high-deductible plan, and I'll tell you, you learn to ask questions like 'And how much will this procedure cost?'

I'm not sure what a high-deductible plan might be. I assume from the context that this might be similar to what we would term an "excess" - an amount of the total cost payable by the insured. The higher this amount agreed, the lower the insurance premium as the insurer is less exposed to the total costs. Again, young and healthy people will tend to take large excesses, knowing they are unlikely to need to claim at all - but when tragedy strikes, they then face enormous bills. Whilst I don't disagree that in most cases costs are controlled by information, the problem is one's health doesn't allow it. If you need a course of chemo for your cancer, the provider is in the box seat.


3) We have to nullify all the protectionist laws enacted on behalf of the pharmaceutical companies. They are anti-competitive and are a big part of how we got to where we are. End Medicare Part D (at the very least, the no bid requirement) and allow for competitive sourcing of drugs from other markets.

At the very least. Pharmaceutical companies are the ruin of all modern health systems. The patenting of drugs (most of which are researched by state-funded universities and then finalised into a marketable product by the pharmaceutical companies) plus aggressive marketing where patients and doctors are bullied and frightened into using the very latest and most expensive treatments should be the main aim for any reforms.


4) We need torte reform. I don't believe in limiting the ability to sue, or the damages rewarded. But I do believe that if the judge finds your case to lack any bearing, he can refer you to a judicial oversight committee. If they find your case to be utterly without merit, you (or your attorney) have to pick up the legal costs for the defense. That should end those "WhoCanISue.com" and late-night Robert Vaughn ads that run "IF you win, I get 1/3, if you lose, you don't pay a dime" shticks.

You have my vote. :thumbsup:


For the coverage issue:

I like the way Germany, Japan and the State of Massauchusetts are set up. Require insurance from a government approved medical insurance provider. However, as part of this:
-Remove tax incentives for corporations to provide coverage, put everyone into the open market.
-Allow the formation of buying groups or co-ops (which are currently illegal in the US....well, they are and they aren't... large corporations buying for their employees are allowed, but I'm not allowed to form one).
-On an evaluation of an individual's ability to pay, the government will subsidize medical premiums. Families that make less than 40K a year will receive 100% of the money they spend in insurance premiums back at the end of the year. 50% up to 80K and so forth. Once your family hits 6 figures, you pay the whole nut. But, if you violate the law and do not get insurance, you don't get one red cent.

I like the idea. It would be interesting to do the sums and see if the cut-off point you propose actually does provide adequate cover. I'm totally amazed that you make co-operative illegal in the US - corporations really have the legislature wrapped around their fingers, don't they?


And one more thing I would do, to incentivize the insurance companies to cover everyone...

Set their income tax based on a new figure I would call their coverage index.

A 24 year old male with no family history gets assigned a +20. A 79 year old woman with Crohn's disease, diabetes and early stages of cancer gets assigned a -20.

The index is the sum of all individual ratings of everyone you covered for the entire year, pre-existing condition cases not included (if you don't cover them, you don't get their index points). At the end of the year, when your accountants calculate your taxes, they add or subtract your index from your corporate income tax. If you go out and cover a bunch of end-of-lifers, you'll be rewarded handsomely by the taxman. :2thumbsup: If you insist on dropping coverage on all risks, you'll be taxed heavily for that policy. :smash:

Fascinating proposal. I'm going to have to think hard about the implications of how that might be applied, since I would expect the big insurance corporations are unlikely to pay their full contribution to taxes anyway (they'd be mist unusual if they did). I suspect that like car insurance, there would still be a group of people who remained uninsurable because the balance of risk versus tax liability would mean most insurers would still cherry-pick with a token amount of "end-of-lifers" to reduce liability on the $15 they didn't salt away in the Caymans.


I am adamantly and irrevresibly opposed to single-payer systems.

This is an odd phrase doing the rounds, which I understand to mean a system where only the government buys healthcare. Even in the UK, patients have the opportunity to source their healthcare from a range of trusts, and even to pay for private treatment. These health trusts, while given taxpayers' money, have to apply a budget and they buy the services they need. Some trusts therefore develop an expertise in a particular field, which means patients will often try to access them for treatment in that field. The constraint of "trade" is the same for any system - distance from one's home.

The biggest damage to these budgets is the drugs bill - and as you noted, the lack of competition means the pharmaceutical companies can make up whatever charge they fancy. With the introduction of NICE (the body that decides whether a drug is worth the expense) there's been a number of times when the Pharma lobby has successfully railed in the press to get a rejected drug put on the list. If this pressure fails, they invariably drop their price quickly.

So I don't think the problem is so much the "single-payer" as the lack of a market from which to buy.

[Centurion1]

My grandfather used to tell me that the Chinese paid their doctors only when they were well - stopping payment the moment the doctor "failed" and they became ill. Like much of my grandfather's wisdom, this is probably entirely mythical, but it does raise an interesting perspective for state-run healthcare and preventative healthcare - maybe we should stop a doctor's salary when a patient gets ill? (Before rory has a coronary, I'm joking - but all health systems should have a substantial incentive towards preventative care - and how is this done in a "free market" rather than a public health system? The incentive for the free market is surely to have as many ill people as possible?)

Hmm, perhaps bonuses for finding diseases before they become dangerous.

[Don Corleone]

Thank you Don, for taking the time to add such an interesting and constructive proposal. :bow:

Thank you for the high praise, and for the constructive feedback.



I like the idea. It would be interesting to do the sums and see if the cut-off point you propose actually does provide adequate cover. I'm totally amazed that you make co-operative illegal in the US - corporations really have the legislature wrapped around their fingers, don't they? I proposed one set of numbers and brackets, but by my very own admission, I have no earthly idea what the actual numbers should be. I meant them as variable placeholders. I think people who live below the poverty level should get their healthcare completely free, and I think the top 25% should be off the reimbursement. How it gets gradiated in between is open for discussion.


Fascinating proposal. I'm going to have to think hard about the implications of how that might be applied, since I would expect the big insurance corporations are unlikely to pay their full contribution to taxes anyway (they'd be mist unusual if they did). I suspect that like car insurance, there would still be a group of people who remained uninsurable because the balance of risk versus tax liability would mean most insurers would still cherry-pick with a token amount of "end-of-lifers" to reduce liability on the $15 they didn't salt away in the Caymans.
Thank you. :beam: Well, you're flirting with another one of my other big reforms... tax reform. I don't believe in taxing corporations more heavily. In fact, I believe in lowering corporate tax rates. But, I would end the loophole of paying taxes based on where you created a good or service, or where you record the income. Whereever the transaction takes place, for online transactiions this means wherever the buyer is at the time of the transaction, that is the prevailing tax rates & authority.


This is an odd phrase doing the rounds, which I understand to mean a system where only the government buys healthcare. Even in the UK, patients have the opportunity to source their healthcare from a range of trusts, and even to pay for private treatment. These health trusts, while given taxpayers' money, have to apply a budget and they buy the services they need. Some trusts therefore develop an expertise in a particular field, which means patients will often try to access them for treatment in that field. The constraint of "trade" is the same for any system - distance from one's home.
This could very well be the extremism of American politics raising its ugly head again, but it is my belief that one of the reasons for pushing for health-care reform is that the American left wants to collective health care. Not only engaging in cost-fixing measures (debatable) and universal coverage (laudable), but outlawing fee-for-preferred treatment or private insurance. I'm pretty sure that's how the system in Australia works, and that's how the American Left wants it to work here.

When you hear "single-payer-system" in America... rejected widely by the right, called for by the Left, initially called for by Obama, though now he claims he's willing to drop it FOR NOW, this is what we're all talking about... the ability to control your own medical care. It was over this very sticking point that Ted Kennedy and the Democrats in 1972 rejected Nixon's offer for Universal Coverage. And when you read most Left policy wonks today, like Paul Krugman, they allow that is the final goal, but one which Americans resist too much to be enacted now and therefore universal coverage must be a first step.

[Crazed Rabbit]

Some perspective on American life expectancies: (http://www.reason.com/news/show/135458.html)

It's true that the United States spends more on health care than anyone else, and it's true that we rank below a lot of other advanced countries in life expectancy. The juxtaposition of the two facts, however, doesn't prove we are wasting our money or doing the wrong things.

It only proves that lots of things affect mortality besides medical treatment. Heath Ledger didn't die at age 28 because the American health care system failed him.

One big reason our life expectancy lags is that Americans have an unusual tendency to perish in homicides or accidents. We are 12 times more likely than the Japanese to be murdered and nearly twice as likely to be killed in auto wrecks.

In their 2006 book, The Business of Health, economists Robert L. Ohsfeldt and John E. Schneider set out to determine where the U.S. would rank in life span among developed nations if homicides and accidents are factored out. Their answer? First place.

That discovery indicates our health care system is doing a poor job of preventing shootouts and drunk driving but a good job of healing the sick.

CR

[Evil_Maniac From Mars]

Isn't the American life expectancy at birth also effected by a higher than average infant mortality rate?

[Beskar]

There are a couple of quotes from a TV comedy show about this, which I found amusing. Anyway:

"Only time a British person has the same Life-expectancy rate as an American, are when they do joint military manoeuvres."

"I read in an American newspaper that if Stephen Hawking was British and got treated by the NHS, he wouldn't be here with us today... which is a very good and emotional argument... however... Stephen Hawkings IS British, and he is commented saying he OWES his Life to the NHS, for saving him."

[Ironside]

Some perspective on American life expectancies: (http://www.reason.com/news/show/135458.html)


CR

Any idea if they factored in what social group those who died a premature death belonged to? :inquisitive: I suspect most ghetto residents doesn't exactly have the best healthcare the US can offer. But it looks like you might actually get something out of that 50% more spending than anyone else that you do.

[Beskar]

The biggest "drain" on the NHS is old people, with 6/8th of the patients being over the age of 65. In America, where there is a lot of gun-crime, etc, many people don't even reach that age and on-top of that, many old aged people might not get the help in America, due to lack of funds and the ones that do, could be argued coming from richer families where they might have a far healthier lifestyle such riches could bring. That is the problem about being selective with figures.

[Evil_Maniac From Mars]

The biggest "drain" on the NHS is old people, with 6/8th of the patients being over the age of 65. In America, where there is a lot of gun-crime, etc, many people don't even reach that age

:inquisitive:

You have all the things in the world available that cause death, and you pick gun crime as your top one?

I will never understand the left...

[Beskar]

Is it usual for the right to not read things properly since Ironside and CR was talking about gun-crime, homocide and accidents being the reason for low life-expectancy ?

I was talking about being selective with figures, not gun-crime.

[Evil_Maniac From Mars]

Is it usual for the right to not read things properly since Ironside and CR was talking about gun-crime being the reason for low life-expectancy ?

I don't see where they mentioned gun crime specifically, I do see where they mentioned homicides.

[Beskar]

Please return to the subject manner, if you want my opinion about guns, then go to the relevant thread. It has no meaning or bearing in here. I never said gun-crime was the top one, it was the one of many mentioned. It's nice though you felt the need to come in with a snippy comment though.

[Lord Winter]

Blaming our low stats on deaths is blowing crime and accidental deaths out of proportion. Also if that article was true wouldn't cost cutting still be needed to fight our deficit and to fight these epidemic non medical causes?

[jabarto]

Whenever I join a thread on healthcare, this is one of the first things I like to post. It's a post from Something Awful Forums user Gul Banana that pretty much perfectly outlines why we *need* universal healthcare.


There have been a lot of debates and discussions recently, both on this forum and in other venues, about the state of healthcare. Looking at the rising costs of health insurance, and at the growing numbers of the uninsured, many are calling for government intervention, and the institution of a system where care is guaranteed to all - usually described as "universal" healthcare. It's a fascinating topic - the issues involved include humanitarian, financial and ideological ones. Unfortunately, debate on the subject is characterised by a startling phenomenon: one side is right, and the other is completely wrong.

Given the importance of medicine, I feel that it would be useful to clarify this issue. I will explain clearly, and with evidence, why it is that universal healthcare of any sort would be better than the current system in every significant way. If you find yourself disagreeing with this assertion, I ask that you read on before replying, as all conceivable objections will be addressed and resolved.

Why The Current Situation Is Bad

At the moment, healthcare in America is provided mostly by private entities, who charge high fees. These fees can be attributed largely due to the difficulty and expense of the medical profession, and although they are significantly higher than those of similar nations this difference is only a small portion of healthcare costs. There then exists the health insurance industry, a loose network of corporations that charge individuals or organisations premiums and will pay for their health costs if any are incurred.

Unfortunately, this system has enormous problems. As of 2006, 44.8 million people in America do not have health insurance. Many are unable to afford it, many are denied coverage by insurers who believe that as customers they will not be economical, and others choose not to purchase it. Without health insurance, the up-front costs of health care are impossible for most people to afford. In fact, 50.35% of all bankruptcies were caused, at least in part, by medical fees. In 2001, this was 2,038,549 bankruptcies.

Furthermore, health insurance does not fully cover medical expenses. Different insurers and different plans have many exemptions, co-pays, threshholds and other expense-minimising devices. As a result, 62% of those two million bankruptcies occurred despite the debtors having health insurance coverage for the duration of their illness.

As well as failing to provide care, and driving individuals into bankruptcy, the existing system is also exorbitantly expensive. Health care spending is now 15% of U.S. GDP - the highest in the world. The costs to businesses, who commonly pay premiums for their employees in lieu of salary, rose by 13.9% in 2003. The annual cost increase has been above inflation since at least 1981. Paying more doesn't result in more value, either - obesity, diabetes, and similar disorders are more common in the United States than anywhere else in the developed world, the U.S. is ranked 72nd in overall health, and life expectancy is below that of 41 other countries.

What Is Universal Health Care?

Universal Health Care, or UHC, refers to a wide range of different systems, the common characteristic of which is that a nation's government guarantees all its citizens access to healthcare. Every developed nation (OECD member) in the world, apart from the United States, has a UHC system. There are three main types:

In a fully public system, there is no or little private healthcare, and the health insurance industry is not a significant one. Medical service providers are government employees, and the education of doctors is also subsidised. The most well known example of a fully public system is the original English NHS, although a private sector is now developing in the U.K. as well.

In an optional public, the government provides the same services, but a private health services industry also exists (generally regulated), and . Sometimes health insurers exist, used by people who prefer private services. This is the most common, and examples include Australia and Sweden.

In a subsidised private system, the government pays for health care, but it is provided by private entities. Either the government acts as a health insurer for the populace, or it pays the fees for private health insurers to do so. This is done in Canada.

For the purposes of discussion, I will be assuming the characteristics of an optional public system, like those used in most of Europe. However, the benefits of UHC apply to all of the above types of organisation.

How UHC Will Improve Things

The single largest problem with healthcare in America is that many people don't have it. It's obvious how UHC solves this: by providing it to all citizens directly (or paying for it to be done). By definition, this is no longer a problem under UHC. All developed nations other than the United States make this guarantee to their citizens, and have so far been able to uphold it. The two reasons which make a person uninsurable - insurer decisions and lack of money - will no longer exist.

The second major problem with the current system is its high cost. This can be divided into two parts: individual cost, and government cost - which to the individual shows up as taxation. UHC is inherently cheaper - far cheaper - due to economies of scale, the bargaining position of monopolies with regard to drugs and salaries, reduced administrative costs, and the lack of a profit motive. When it comes to individual health care costs:

According to the World Health Organisation, average American individual spending on healthcare is $3371 per year. Since this includes the uninsured and those covered by their employers, actual costs are higher. For comparison:

Australia: $1017
Canada: $916
Sweden: $532
United Kingdom: $397

The first of those is the second-highest in the world - meaning that Americans pay, not including taxes, more than three times as much as citizens of any other nation. This would be somewhat justifiable if they received better healthcare, but again - 28% have no care at all, life expectancy is below all other developed nations, and general health rating is below all other developed nations.

It is commonly assumed that this difference in cost is because under UHC systems, higher taxes are required to fund the system. Not so. As mentioned, UHC is a great deal cheaper than private healthcare, and as a result America's health-related taxation is also the highest in the world. According to the OECD, in 2006, American government spending on healthcare was $2887 per person. For comparison:

Australia: $2106
Canada: $2338
Sweden: $2468
United Kingdom: $2372

American healthcare taxes are in fact the highest in the OECD, with France second at $2714. In conclusion, every single UHC system in the world costs less money for individuals, requires lower taxes, and provides better care to more people than the American health care system. By implementing UHC in the U.S., things can only get better.

Frequently Raised Objections

There are many incorrect arguments against the implementation of UHC in the United States. In order to better facilitate discussion, I will explain the errors found in the most common.

"America isn't Europe!", or It Won't Work Here
The argument from American exceptionalism states that what works in Europe will not work in the U.S. It's said that this is because European nations have more people in less space, resulting in less logistical difficulties, and because European government is more competent.

Firstly, not all developed nations are European. The most obvious example that counteracts the logistical argument is Australia, where there are 20 million people in only slightly less space than America's 300 million. This does indeed affect prices, as can be seen by comparing Australia to Sweden or the U.K. - but it doesn't bring them anywhere near the levels currently experienced in America.

The argument that American government is uniquely incompetent, and cannot do things that every other nation in the world can do, is simply nonsense. Not only has America, and American government, achieved many things that other countries have not, America has so many resources and the improvement in care and cost from moving to UHC is so large that even with incredible inefficiencies it would still be a good idea.

"It is immoral to force me to pay for others' healthcare."
You are already paying for others' healthcare. Furthermore, you are paying far more than you would be under UHC. The U.S. government incurs massive costs from paying hospital fees when ER visitors have no money, and from the limited coverage that it provides, which cannot take advantage of economies of scale and which has to subsidise corporate profit.

As demonstrated above, U.S. taxes devoted to healthcare are the highest in the world. Even if you choose not to have health insurance, under the current system, you are still paying more for others' healthcare than you would be paying for theirs plus your own under UHC.

"This is socialism."
It is not socialist to recognise that there is a service the free market is inefficient at providing, and to decide it should better be provided by the government. Even the most staunch libertarian admits that there are some services in this category, such as national defence.

Secondly, it is irrelevant whether this is a "socialist" policy; it's effective. It costs less and provides better care to more people, and as a result is used literally everywhere else in the entire world. Those who want to ensure that society remains ideologically committed to market capitalism need to look for other issues, as if they cling to this one they will only end up providing evidence against their position.

"I don't want more government bureaucracy."
UHC will involve much less bureaucracy than is commonly assumed, as it can replace the existing partial systems like Medicare and also the plethora of state-specific programs. Regardless, the lives and money saved are more important than any potential expansion of the state.

"Why don't we try making the system even more private instead? That might help."
It might. However, there's no evidence to suggest it, and many reasons to presume it wouldn't. By its nature, the less publicly-supported a system, the more people will be unable to purchase health services.

The only potential gain would be reduced costs due to some sort of market mechanism, and in practice this has never occurred; every private healthcare system that has ever existed in world history has proved inefficient and been replaced by public systems, and given the demonstrable gains that have resulted the U.S. must follow.

"Doctors will be paid less."
They probably will. In nations with UHC, doctors often earn less - for example, U.S. doctors earn 30% more than Canadian doctors - but this isn't an inherent problem. It is still one of the highest-paying professions in the world, and there are many other ways of attracting skilled people to medicine - such as subsidising their education.

It is sometimes claimed that doctors paid less in a country with UHC will instead go elsewhere where they can be paid more, but once the U.S. has UHC there will not be an elsewhere to go.

"Medical research is funded by the payments of the rich in the current system, and will be reduced."
It is not true that most medical research is done in the United States. In 2000, U.S. research spending was $46 billion, but European spending was also $43 billion. And although U.S. research spending doubled in the last decade, the funding's efficacy has actually decreased.

Secondarily, if the option for private healthcare still exists - and there is no reason why it should not - there will still be people choosing to pay more for a higher quality of care, faster service, et cetera. Their profits will still be reinvested in the development of new drugs, equipment and understanding of the human body, as they still are in nations with UHC today. Even in the United States, private spending accounts for only 57% of research spending.

"With the option of private healthcare, the rich will 'opt out' and costs will go up."
This isn't necessarily true at all; although private healthcare is usually allowed in UHC nations (for good reasons), it doesn't have to decrease the taxes paid by all to support the public system!

"Other countries fix drug prices, so the US has to pay more for drugs."
This is another common misconception. U.S. healthcare does not include higher pharmaceutical spending than other countries; it's around the average or even slightly lower. From the OECD:

Canada: 17.7%
Germany: 15.2%
Iceland: 13.3%
Australia: 13.3%
US: 12.4%
Sweden: 12%
Ireland: 11.6%

In Conclusion

Thank you for reading. To those who were not previously supporters of UHC, I apologise if anything seemed condescending, but there's no shame in being wrong due to not having all the facts or having been misled. If anyone has questions feel free to ask, and hopefully we can now discuss what sort of UHC system ought to be implemented or how the political will for it can be gathered, rather than being bogged down by misconceptions about its desirability.

[Lemur]

jabarto, you gotta get hip to the tag when you post long texts. Example:

[ex]VERY LONG ARTICLE
Does wonders for your readers.

Meanwhile, hat tip to Slashdot for turning me on to a systems designer's perspective on HR 3200 (http://brucefwebster.com/2009/09/07/hr-3200-from-a-systems-design-perspective-part-i/). Very eager to read the upcoming part 3.

-edit-


It is not socialist to recognise that there is a service the free market is inefficient at providing, and to decide it should better be provided by the government. Even the most staunch libertarian admits that there are some services in this category, such as national defence.
I should introduce the author to a couple of people I know. One guy, in particular, believes that the U.S. Military is a socialist boondoggle best replaced by well-trained mercenaries. He even argues that roads should be privatized. Admittedly, he's a kook, but he calls himself a libertarian.

[jabarto]

jabarto, you gotta get hip to the tag when you post long texts. Example:

[ex]VERY LONG ARTICLE
Does wonders for your readers.

Meanwhile, hat tip to Slashdot for turning me on to a systems designer's perspective on HR 3200 (http://brucefwebster.com/2009/09/07/hr-3200-from-a-systems-design-perspective-part-i/). Very eager to read the upcoming part 3.

-edit-


I should introduce the author to a couple of people I know. One guy, in particular, believes that the U.S. Military is a socialist boondoggle best replaced by well-trained mercenaries. He even argues that roads should be privatized. Admittedly, he's a kook, but he calls himself a libertarian.

Oops, I forgot all about the spoiler tags. :sweatdrop: I'll edit my post accordingly.

It's really funny what you posted, though, because one of the chief arguments against libertarianism is "How would you feel if roads/police/firefighting services/whatever were privatised?" That someone would honestly agree to that, though...wow.

[Lemur]

He's a hoot. I told him that his vision for the U.S.A. sounded like an extra-cruel version of 1700s London, with the East India Company replaced by Blackwater. His response: "Is that bad?"

[Xiahou]

Blaming our low stats on deaths is blowing crime and accidental deaths out of proportion.Maybe not.https://img89.imageshack.us/img89/2115/trafficu.jpg
When they standardized life expectancy by taking fatal injuries into account, the US had the longest life expectancy of any nation.

[Strike For The South]

Does anyone think by simply allowing you to buy health insurance across state lines we could mitiagate allot of this craziness.

[Lemur]

Does anyone think by simply allowing you to buy health insurance across state lines we could mitiagate allot of this craziness.
I'd certainly be interested to see a study on what sorts of savings we could expect.

But frankly, at this point I'm in a state of advanced despair over either the Dems or Repubs getting serious about cost containment. The Dem plan, from what I can understand of it, does little to cap costs. And the Repubs have made a vow to never cut Medicare, which is insane.

I read a math geek this morning saying that Medicare D was actually five times more expensive than HR 3200. Maybe we could all agree to scrap Medicare D? Could that be a start?

[Strike For The South]

I'd certainly be interested to see a study on what sorts of savings we could expect.

But frankly, at this point I'm in a state of advanced despair over either the Dems or Repubs getting serious about cost containment. The Dem plan, from what I can understand of it, does little to cap costs. And the Repubs have made a vow to never cut Medicare, which is insane.

I read a math geek this morning saying that Medicare D was actually five times more expensive than HR 3200. Maybe we could all agree to scrap Medicare D? Could that be a start?

Well if we end up with a public option doesn't medicare becomre redudant?

Right now a few companies are holding states hostage, if it was eaiser to start an isurance company or move into another state they would simply get undercut.

Also for people who don't have insurance, they should actually have to pay. Give them the care they need but hunt them down and make them pay or at least take collatrol. Right now we have this limbo and the gov't usually foots the bill. I don't want to mandate insurance becuase I think you should have that choice. I also think you should live with your decisons.

[Lemur]

Well if we end up with a public option doesn't medicare becomre redudant?
Nope. Under Medicare, if you're over a certain age you get taxpayer-funded medical treatment. The public option would be an entirely different animal.


Also for people who don't have insurance, they should actually have to pay. Give them the care they need but hunt them down and make them pay or at least take collatrol.
Um, that's what we do now. Unless they file for bankruptcy, we expect people who have had medical treatment to pay. And the amusing thing is that they pay much higher costs than people with insurance. For example, let's say a hospital asks for $800 for an operation. An insurer will probably pay somewhere between $200–$500 for it, while an uninsured Joe off the street will be billed for the full $800.

Or if you have my insurance, they bill $800, then the insurer decides what they think the operation ought to cost in their private fantasyland, pays that (or doesn't), and then you get stuck with the remainder. Worst of both worlds.

[Strike For The South]

Nope. Under Medicare, if you're over a certain age you get taxpayer-funded medical treatment. The public option would be an entirely different animal.

So we have an NHS for old people? And I wasn't informed? Why do old people get all these sweet deals!




Um, that's what we do now. Unless they file for bankruptcy, we expect people who have had medical treatment to pay. And the amusing thing is that they pay much higher costs than people with insurance. For example, let's say a hospital asks for $800 for an operation. An insurer will probably pay somewhere between $200–$500 for it, while an uninsured Joe off the street will be billed for the full $800.

Or if you have my insurance, they bill $800, then the insurer decides what they think the operation ought to cost in their private fantasyland, pays that (or doesn't), and then you get stuck with the remainder. Worst of both worlds.


That's good to know

The bolded part is the problem. Dare I say we need more regulation? If the insurance company can screw you when it's convienet for them or when you need exspensive treatment then is the really any point to do buisness with them in the first place?

This is what I don't understand. In any other buisness if you pulled these kind of tricks you'd be run out of town but why can isurance companies get away with it?

[Lemur]

So we have an NHS for old people?
Yep, and they love it. Not sure they understand what they're getting, though; more than one protester at the town halls was shouting about "Keep government away from my Medicare." Um ...


Why do old people get all these sweet deals!
Because they vote in large numbers, and they like their entitlements. That's why we (as a nation) allow large numbers of children to go without health coverage, even though the slightest common sense would tell you that healthcare for kids is far more economically important than healthcare for 90-year-olds.

[Banquo's Ghost]

I'm getting confused now.

If you have an "NHS" for old people, and this is sacrosanct to the Republican Party - and the world has not so far come to an end, God is in His Heaven and Liberty Reigns from Sea to Shining Sea...

...why does the Soviet Union win if this principle is extended to all age groups?

[Lemur]

I'm getting confused now.
Oh, it gets even more confusing. The biggest legislative accomplishment under Bush 43 and the all-Republican congress was Medicare Part D, in which the government promised to buy full-retail-price pharmaceuticals (no discounts! no generics!) for everyone on Medicare.

As I said, the cost of this boondoggle is estimated to be five times greater than any of the bills being evaluated now for healthcare reform.

Apparently neither party has the guts to talk seriously about cost control, 'cause that would mean rationing. Heaven forefend we discuss that.

Oh, and because of the politics of hysteria, now we won't even advocate end-of-life counseling to those pampered seniors, 'cause that would be a death panel. So even if a senior citizen wants to die peacefully, without multiple medical interventions, we aren't helping them get it done. 'Cause we don't want death panels.

Idjits.

-edit-

Here's the sales video for the Seniors' Bill of Rights (https://www.youtube.com/watch?v=mbjq6OfkMlg), in which the Repubs declare that no cuts can be made to Medicare. Madness.

[Xiahou]

Or if you have my insurance, they bill $800, then the insurer decides what they think the operation ought to cost in their private fantasyland, pays that (or doesn't), and then you get stuck with the remainder. Worst of both worlds.It could vary from state to state, but I only know of one way that could happen. If your plan is part of a network and you went outside the network to get your treatment.

My insurance would have pre-negotiated rates with all providers in their network. Therefore, when I saw a doctor, they would get reimbursed the preset amount by my insurance company. Now, if I went to a provider outside the network they could charge whatever they wanted, but my insurance would still only pay what their network rate is. It's a way of keeping premiums down.

I actually had the pleasure of telling an office's billing dept to go to hell when they tried to bill me for the difference between the network rate and what they would've liked to charge me. When I called their office, they tried to tell me that I was responsible for the difference. I told them they were in my network and were not allowed to charge me more- he persisted. I then asked for the guys name and contact information, called my insurance company and told them they were trying to bill me beyond the network coverage. Once I explained everything, they said they'd call him and take care of it. I never heard from them again- it was a pretty satisfying experience. :yes:

[Tribesman]

...why does the Soviet Union win if this principle is extended to all age groups?

You should understand that by now.

It is simple to understand

The whole reason is because its the democrats not the republicans:yes:

[Seamus Fermanagh]

You should understand that by now.

It is simple to understand

The whole reason is because its the democrats not the republicans:yes:

Well, there a some who do view things through exactly that lens, along with others from the other party who have the mirror position. I envy them their clarity, in a way. I've never been able to look at politics and truly think "My guy is perfect your gal is a twit" since I hit double digits in age.

Current US healthcare consumes more than 16% of the GDP. While it can be argued that the therapeutic treatments available are the best, or among the best, on the planet, it is also readily apparent that we've got the worst hybridized system in the world to pay for it.


I oppose a national health system (or the "public option" which will beget it) because I:

1. Don't want government managing health care as I think it's extraneous to the purpose of government in general and of our federal government in particular,

2. Don't want the federal government involved because the federal government is bloated and overly involved in the lives of all Americans and should be pared back, not enhanced,

3. Don't want the federal government involved because of their miserable track record in terms of efficiency, and

4. Believe that ANY such effort by the federal government exceeds their constitutional mandate and therefore believe they have no standing to make such laws (of course, I'm one of the 12 remaining people who also thinks the 10th ammendment is still part of the Constitution, so what do I know).


I believe we would be better served by a system of private insurance and fee-for-services, regulated by the government ONLY to the extent necessary to prevent fraud. Under such a system, not all will receive medical care (some by choice, others by circumstance).

Life cannot be "legislated" into fairness. Attempting to do so is well-intentioned utopianism.

[Lemur]

It could vary from state to state, but I only know of one way that could happen. If your plan is part of a network and you went outside the network to get your treatment.
You're assuming I'm on an HMO, which I am not; it's a PPO, and they change what is in and out of network on an arbitrary and daily basis.

Also, you clearly don't understand how they figure the deductible. I don't hit my limit until I have spent X dollars, but they figure X by what they think procedures ought to cost, not by what they actually do. So you could very easily need to be $10,000 out of pocket before you hit their $2,000 deductible limit. It's a total scam.


Life cannot be "legislated" into fairness. Attempting to do so is well-intentioned utopianism.
Given how many real-world examples there are of national health systems that work adequately, I don't think you need to be a starry-eyed idealist to say that those systems deserve serious consideration. Empiricism, to my way of thinking, is the opposite of utopianism.

[Xiahou]

You're assuming I'm on an HMO, which I am not; it's a PPO, and they change what is in and out of network on an arbitrary and daily basis.No, I've never been in an HMO and I didn't assume you were either. The situation you described sounds exactly like what could happen if you got a procedure outside of your provider network. Generally speaking, out of network HMO care is just flat out denied coverage. All non-emergency care must go through the HMO. When you're talking in-network and out of network coverage, you're talking about PPOs.


Also, you clearly don't understand how they figure the deductible. I don't hit my limit until I have spent X dollars, but they figure X by what they think procedures ought to cost, not by what they actually do. So you could very easily need to be $10,000 out of pocket before you hit their $2,000 deductible limit. It's a total scam.
Nope, I understand deductibles, but I think you're talking about the out of pocket maximum. Again, being in network or out of network makes all the difference. My max out of pocket for a family was $2500 in network and it jumped to $10,000 for out of network service. When you're part of a PPO type plan, it's just a bad, bad idea to go to a provider who isn't part of the network. Whenever I was thinking of moving, I would get on my insurers website and make sure there was an in-network hospital nearby (there always was). To be put in the position of going to a non-network hospital for treatment could end up costing thousands of dollars.

I'm not saying it's perfect, but I don't think it's accurate to say that they screwed you over with some sort of bait and switch. I'm sure had you called and told them that you were having procedure A done out of network, they would've told you how much they'd reimburse for it. Out of network coverage is always expensive, and in my opinion, best avoided.

For anyone interested, here's (http://www.agencyinfo.net/iv/medical/types/hmo-ppo-pos.htm) a description of HMOs, PPOs, and POSs. I've had experience with the last two, but never an HMO.

[Lemur]

A "hospital" that was in newtwork? ORLY? Are you quite sure?

A girl I used to work with did just as you described, made sure the clinic where she was getting the procedure was in-network. Turns out the radiologist was not. So the surgeon was fine, the nurses were fine, the pharmacy was fine, but the radiologist was not. And she got stuck with a really nice bill. Last I talked to her, she was still paying it off.

Normal people can't compete with that kind of bureaucratic opacity. Most of us have jobs and lives. The status quo is untenable.

[jabarto]

1. Don't want government managing health care as I think it's extraneous to the purpose of government in general and of our federal government in particular

See my response to bullet point #4 of this post.


3. Don't want the federal government involved because of their miserable track record in terms of efficiency, and

People trot this line out all the time. But really, how many things has the government messed up with? Last I checked, the Interstate Highway System and USPS were resounding successes. And it's worth mentioning that we already have nationalized medicine for our government, military personnel AND their families, and the elderly. It's pretty obvious that the government can handle UHC.


4. Believe that ANY such effort by the federal government exceeds their constitutional mandate and therefore believe they have no standing to make such laws (of course, I'm one of the 12 remaining people who also thinks the 10th ammendment is still part of the Constitution, so what do I know).

Doesn't the constitution explicitly state that the government is responsible for the welfare of its citizens?


I believe we would be better served by a system of private insurance and fee-for-services, regulated by the government ONLY to the extent necessary to prevent fraud.

Why would you want ANY private insurance? Do you really want the industry to be (mostly) regulated by the people who will profit from it? Besides which, the insurance companies have proven themselves unable to render the services for which they're being paid, over and over and over again. They're worthless and should have been out on their asses years ago.


Under such a system, not all will receive medical care (some by choice, others by circumstance).

And that's why such a system would merely be a band-aid over a gushing artery.


Life cannot be "legislated" into fairness. Attempting to do so is well-intentioned utopianism.

I know a little group of people called "every industrialized nation on the planet except for this one" who would like a word with you.

[drone]

Doesn't the constitution explicitly state that the government is responsible for the welfare of its citizens?

Do you realize how dangerous this connection would be? It's bad enough with the abuse of the interstate commerce clause. Making this a precedent would nanny-state us to death.

Now that I think of it, does that statement occur outside of the preamble? The preamble itself does not give the government any powers, it just puts the rest of the Constitution into context for judges.

Edit-> Seamus, will you marry me? :flowers:

[Louis VI the Fat]

I know a little group of people called "every industrialized nation on the planet except for this one" who would like a word with you.Nononon!!

We are quite happy the way it is. Big Pharma consists of many European corporations. They are perfectly happy to have the US as a playground. They love the American allergy to protecting the interests of civilians against corporations.

The US federal government is a perfect tool for our interests. The average US citizen is a perfect tool too. Erm..I mean, a perfect tool in the global struggle against healthcare communism!



Many European companies are a member of the largest and wealthiest lobby group in Washington, that of Big Pharma. See link below.
Please don't kill European profits by insisting Washington protects the rights of American citizens over our rights to suck you dry? Please?
http://www.statemaster.com/encyclopedia/Pharmaceutical-Research-and-Manufacturers-of-America

(Note that the PhRMA is a lobby group representing the pharmaceutical industry in, not of, the US )

[Azathoth]

Here are some of the notes I took if you prefer a quick summary to an hour-long speech:

Introduced members of the cabinet first

Black secret service guy looks tough

President came in 8:12; took 5 minutes to start

He looked pissed off at the applause (he said be seated twice hah)

Mentions situation of last winter (ie. recession)

Reminds recovery is still far away

Says he wants unemployed to have jobs

Claims his administration has helped economy recover greatly

Thanks Congress and American people

Wants to build future (ie. healthcare)

Wants to do something decisive on the issue

Attests to history of healthcare reform (since Theodore Roosevelt)

Puts listeners on defensive by talking about failure of insurance and lack of coverage for many, compares US to world

Describes cases of insurance failure where people died, says US is better than that

Talks about how current insurance problems lead to greater taxes and Medicare and Medicaid costs

Says health care is most important problem

Tries to take middle ground, describes both sides; wants to improve current system

Talks about massive support for health care reform that exists; mentions bipartisan support

Censures most ardent opponents for "scare tactics"

Three points: Slow growth of health care costs, insurance for those who don't have it, security for those who do

Places responsibility on all Americans

The plan will not require those with existing health insurance change their plan; illegal for denial of customers over preexisting conditions or drop coverage during illness; no arbitrary limit on amount of coverage and insurance companies must cover routine checkups and preventive measures

For those who don't have health insurance create marketplace for insurance companies for competitive prices, including non-profit government insurance; if not enough money, government tax credits based on need

Wants all Americans to have same opportunities as politicians in healthcare

Low cost coverage for those really in need or with terminal illnesses

Not having health insurance when it is affordable is irresponsible; basic health insurance a requirement, and business must cover healthcare or help employees with health insurance; small businesses exempt and very poor people exempt

Stresses benefit to economy and all Americans

Talks about the controversy; dismisses "death panels" as lie and says that the reforms don't (sorry, I meant don't) apply to illegal immigrants (lots booed at this) and federal money won't fund abortions

Defends state-sponsored insurance as more choice in competition, playing to Republican capitalists; talks about insurance monopolies

Wants to hold insurance companies accountable

Wants the government insurance company to be self-sufficient and not supported by taxpayer money

Mentions public and private school systems

Often says that he won't back down on basic issues

Says the plan will not add to deficit

Reminds viewers of the source of the deficit (Bush administration)

Pay for plan by finding saving in existing health care system (Medicare and Medicaid) by limiting waste and abuse; a commission of doctors and adminstrators will identify this

No money from Medicare trust fund used to pay for plan; Obama will protect Medicare

Some sort of medical malpractice reform that Republicans like

Plan will cost $900 billion over 10 years, which he claims is a relatively small amount; once again says that wasted money will mostly pay for it

Ends with letter from Ted Kennedy about his support for health reform and the moral issue at stake in the health reform controversy

Talks about American ideals and how great Ted Kennedy was

Tries to endear people to Ted Kennedy by talking about him as a caring father

Says ability to help others is also an American ideal and that government is sometimes necessary to do it

Talks about historical examples (Roosevelt, Social Security, Medicare) to rally support for the present initiative

Ends with a lot of "I still believes" and some nice-sounding rhetoric

Uses colloquial often

Tries to take middle ground constantly, “seek common ground”

Often dismisses most zealous adversaries as pranksters and opportunists

[Papewaio]

In Aus we have private & public healthcare.

If you earn a lot you either get private healthcare or pay more tax to cover your healthcosts.
If you don't get private healthcare by age 30, then for every year above that age (-1 year in total for lapses) your Private Healthcare rate goes up by 1%.

So if you are 61 years old and decide to join private health then the provider can charge you a 30% loading.

There is also a 30% rebate from the Government on all private health cover.

[ICantSpellDawg]

Since we already provide food stamps to some, why don't we just buy everybody food?

[Tribesman]

Since we already provide food stamps to some, why don't we just buy everybody food?
You already do.

[ICantSpellDawg]

You already do.

Oh, In that case, lets just pool all of our money together and see which one of us can spend it the fastest.

[Lemur]

Best comment (http://andrewsullivan.theatlantic.com/the_daily_dish/2009/09/taking-the-bait.html#more) of this morning:


Moreover, Obama's proposals are within the center of rational debate, and he is open to persuasion. As he said last night, he's happy to back tort reform, or McCain's catastrophic insurance idea. He has also bent to the Clinton position on mandates. His proposal, one should recall, is to massively increase the markets for private insurance companies and drug companies. If David Cameron, the British Tory leader, were to propose this, he'd be called a Thatcherite radical. But in the world of Fox News, this is tantamount to government "take-over". Piffle. Claptrap. Bollocks.

[Xiahou]

A "hospital" that was in newtwork? ORLY? Are you quite sure?

A girl I used to work with did just as you described, made sure the clinic where she was getting the procedure was in-network. Turns out the radiologist was not. So the surgeon was fine, the nurses were fine, the pharmacy was fine, but the radiologist was not. And she got stuck with a really nice bill. Last I talked to her, she was still paying it off.

Normal people can't compete with that kind of bureaucratic opacity. Most of us have jobs and lives. The status quo is untenable.Yeah, a hospital. Which isn't a clinic. In a clinic, individual doctor's can and often are treated as separate practices. You need to make sure the specialist that you're there to see is in network.

The flip side of that is if the provider is in-network, but the clinic itself is not. If the provider orders up tests and you get them performed at the clinic, which is out-of-network, you can quickly find yourself in billing hell. That's a definite sore spot for PPOs. Luckily, most of us will never encounter that- the examples I've seen of it involved people with rare diseases or conditions who need care at very specialized facilities. Unfortunately, people in those situations are going to have a difficult, expensive future ahead of them no matter what insurance they have..... :shame:

The question is, should the entire system be changed to accommodate these cases? If the government forces insurers to allow people specialized care at any facility of their choosing, what will happen to everyone else's costs? It's not hard to find stories of maltreatment for chronic disease sufferers in countries with government-run healthcare, so I don't think it's a panacea either.

From my perspective, I kind of like the way HMOs look. My wife and I are both fairly young and healthy so we don't need specialized care and an HMO would offer comparatively low premiums and offer near total coverage for any common medical services we'd be likely to have. Plus, pretty much all non-emergency care has to be referred thru your primary physician and pre-approved, taking the guess work out of what's going to be covered where. Unfortunately, there just aren't any available to me due to the tangle of rules and regulations that cover the insurance industry.

If the government must meddle in health coverage, I think the most helpful things it could do is separate medical coverage from employment, improve transparency, and break down barriers to insurance competition. Of course [I]something/I] is going to have to be done about medicare/medicaid too. Those are the 500lb gorillas that everyone is afraid to look at- Im afraid no one is going to have the courage to fix those until it's too late. :sweatdrop:

[ICantSpellDawg]

Best comment (http://andrewsullivan.theatlantic.com/the_daily_dish/2009/09/taking-the-bait.html#more) of this morning:

Moreover, Obama's proposals are within the center of rational debate, and he is open to persuasion. As he said last night, he's happy to back tort reform, or McCain's catastrophic insurance idea. He has also bent to the Clinton position on mandates. His proposal, one should recall, is to massively increase the markets for private insurance companies and drug companies. If David Cameron, the British Tory leader, were to propose this, he'd be called a Thatcherite radical. But in the world of Fox News, this is tantamount to government "take-over". Piffle. Claptrap. Bollocks.



All of that sounds very good. Remember, the more you lump us individually with Fox News, the more enemies you make. It has been demonstrated rather well that we have our own opinions on the subject. Those who would confound and hamper resolution are always present on both sides - when you don't have a message that can cut through the peanut gallery it is easy just to place the blame on the immortal unmoving jerks (who can sometimes be entertaining.)

Find a real middle ground instead of rhetoric and the rational and skeptical center will buy it. Fox news and limbaugh woun't be enough to obfuscate real moderation. The problem is that the only moderate approach thus far has been "the potemkin moderate approach". If you search, there are plenty of Republicans who want and will vote for reform. They don't all have ideologically puritan conservative suggestions either.

[Ariovistus Maximus]

Generally I think the anti-Obamareform side hasn't really brought up the core issue:

We dislike strong government! I mean, sure you can argue dollars and cents, but quite frankly I don't want to sell myself to the feds to make a buck, and I think it's a legitimate issue!

[Seamus Fermanagh]

People trot this line out all the time. But really, how many things has the government messed up with? Last I checked, the Interstate Highway System and USPS were resounding successes. And it's worth mentioning that we already have nationalized medicine for our government, military personnel AND their families, and the elderly. It's pretty obvious that the government can handle UHC.

Tricare works well, though it does help to minimize costs when well over half of your client base is under the age of 40 and a large minority of the recipients are required to pass physical fitness tests periodically or risk losing their jobs.

Medicare has a raft of problems and is NOT noted for its efficiency. It is noted for encouraging a number of the better physicians to forgoe working with medicare patients at all. Even adjusted for inflation, Medicare is so grossly over the costs predicted for the program at its outset as to be laughable.

My fear is not that the government can't handle UHC, but that it will do so according to its own glorious standards.


Doesn't the constitution explicitly state that the government is responsible for the welfare of its citizens?

No, the preamble to the Constitution states that WE THE PEOPLE are establishing this Constitution to "provide" for the common defense and "insure" domestic tranquility, but only to "promote" the general welfare. Government was meant to encourage that welfare, and to establish conditions that would allow everyone the chance to better themselves. It was never meant to underwrite the whole thing. Our founders would likely to have deemed such a notion preposterous.


Why would you want ANY private insurance? Do you really want the industry to be (mostly) regulated by the people who will profit from it? Besides which, the insurance companies have proven themselves unable to render the services for which they're being paid, over and over and over again. They're worthless and should have been out on their asses years ago.

I think you'd be surprised at the quality of coverage provided if the health insurers were allowed to craft their own policies and provide the insurance needed by the individual themselves. Instead, there are more mandates and "must includes" than you can comfortably list. All such must be paid for and it is impossible in many places for insurance companies to establish substandard ratings and underwrite risk fairly.

I do thank you for your clear expression of a sentiment that I believe DOES underly a segment of the support for UHC in the United States -- a loathing for corporate capitalism. Whether intended or not (and mostly I think it is) the 'public option' will eat private insurance alive. It is impossible to out-compete an entity that can lose money endlessly without ending up bankrupt.


I know a little group of people called "every industrialized nation on the planet except for this one" who would like a word with you.

A foolish opinion, held by thousands, is still foolish.

Still, since many of them can vote, we will very likely see UHC in my lifetime and I will have to learn to cope with life in a Socialist Democracy. Franklin's quip about liberty and safety falls on deaf ears.

I breathe, therefore you are required to feed me, clothe me, entertain me, and keep me healthy to the maximum extent possible. My existence trumps all! Is that not what government is for?

:dizzy2:

[Lemur]

Still, since many of them can vote, we will very likely see UHC in my lifetime and I will have to learn to cope with life in a Socialist Democracy. Franklin's quip about liberty and safety falls on deaf ears.

I breathe, therefore you are required to feed me, clothe me, entertain me, and keep me healthy to the maximum extent possible. My existence trumps all! Is that not what government is for?
By this logic, should we have publicly funded fire departments? Police departments? Roads? Libraries?

Some things are already judged to be better handled by the government than a business. Do any, some, or all of them make us a "Socialist Democracy"? Is healthcare a special, different thing from any other service? If so, how?

Is every other industrialized nation a "Socialist Democracy"? Does this apply to South Korea, Taiwan, Japan, Australia? If not, why not? If so, why?

Are you suggesting that every other industrialized nation in the world is socialist in some fundamental way that we are not?

[jabarto]

Tricare works well, though it does help to minimize costs when well over half of your client base is under the age of 40 and a large minority of the recipients are required to pass physical fitness tests periodically or risk losing their jobs.

Medicare has a raft of problems and is NOT noted for its efficiency. It is noted for encouraging a number of the better physicians to forgoe working with medicare patients at all. Even adjusted for inflation, Medicare is so grossly over the costs predicted for the program at its outset as to be laughable.

My fear is not that the government can't handle UHC, but that it will do so according to its own glorious standards.


this morning I was awoken by my alarm clock powered by electricity generated by the public power monopoly regulated by the US department of energy.
I then took a shower in the clean water provided by the municipal water utility.
After that, I turned on the TV to one of the FCC regulated channels to see what the national weather service of the national oceanographic and atmospheric administration determined the weather was going to be like using satellites designed, built, and launched by the national aeronautics and space administration. I watched this while eating my breakfast of US department of agriculture inspected food and taking the drugs which have been determined as safe by the food and drug administration.

At the appropriate time as regulated by the US congress and kept accurate by the national institute of standards and technology and the US naval observatory, I get into my national highway traffic safety administration approved automobile and set out to work on the roads build by the local, state, and federal departments of transportation, possibly stopping to purchase additional fuel of a quality level determined by the environmental protection agency, using legal tender issed by the federal reserve bank. On the way out the door I deposit any mail I have to be sent out via the US postal service and drop the kids off at the public school.

After spending another day not being maimed or killed at work thanks to the workplace regulations imposed by the department of labor and the occupational safety and health administration, enjoying another two meals which again do not kill me because of the USDA, I drive my NHTSA car back home on the DOT roads, to ny house which has not burned down in my absence because of the state and local building codes and fire marshal's inspection, and which has not been plundered of all it's valuables thanks to the local police department.

I then log on to the internet which was developed by the defense advanced research projects administration and post on freerepublic.com and fox news forums about how SOCIALISM in medicine is BAD because the government can't do anything right

Okay so you're probably not a freeper but you get my point.


No, the preamble to the Constitution states that WE THE PEOPLE are establishing this Constitution to "provide" for the common defense and "insure" domestic tranquility, but only to "promote" the general welfare. Government was meant to encourage that welfare, and to establish conditions that would allow everyone the chance to better themselves. It was never meant to underwrite the whole thing. Our founders would likely to have deemed such a notion preposterous.

Perhaps. I don't know.


I think you'd be surprised at the quality of coverage provided if the health insurers were allowed to craft their own policies and provide the insurance needed by the individual themselves. Instead, there are more mandates and "must includes" than you can comfortably list. All such must be paid for and it is impossible in many places for insurance companies to establish substandard ratings and underwrite risk fairly.

I do thank you for your clear expression of a sentiment that I believe DOES underly a segment of the support for UHC in the United States -- a loathing for corporate capitalism. Whether intended or not (and mostly I think it is) the 'public option' will eat private insurance alive. It is impossible to out-compete an entity that can lose money endlessly without ending up bankrupt.

Now wait a second. You just said that the government would do a poor job of running a UHC system. Why, if that's the case, would the insurance companies go under? If the government doesn't manage healthcare well, no one will drop their private coverage.

Oh, and I don't think most people want to eliminate the private option. The politicians sure don't.


A foolish opinion, held by thousands, is still foolish.

Still, since many of them can vote, we will very likely see UHC in my lifetime and I will have to learn to cope with life in a Socialist Democracy.

It's only been a generation since McCarthyism and Reagan's subsequent efforts to plunder this country ended. I would be very surprised if UHC happened in my lifetime (and I'm probably younger than you).

Then again, I do think UHC is an inevitability. There wil come a point when the populace has been screwed over badly enough for long enough that something will have to change.


Franklin's quip about liberty and safety falls on deaf ears.

What liberty is being given up in the name of security here?


I breathe, therefore you are required to feed me, clothe me, entertain me, and keep me healthy to the maximum extent possible. My existence trumps all! Is that not what government is for?

Hmmmmm yes why would the government want a happy, healthy workforce? I wonder... :juggle2:

[Tribesman]

Our founders would likely to have deemed such a notion preposterous.
Like they would have deemed bacteria, modern medicine, powered flight, nuclear energy and motorcars as proposterous notions , while finding the notion of slavery normal.

[ICantSpellDawg]

Like they would have deemed bacteria, modern medicine, powered flight, nuclear energy and motorcars as proposterous notions , while finding the notion of slavery normal.


You'll get youself into quite pickle with that line. Who says that we have a right to free speech if not the Bill of Rights? Or the freedom of Religion? Or freedom from unreasonable search and seizure? Or the right to elect those who govern us? Those ignorant fools had no idea what they were talking about.

Who decides which of those things are preposterous? The people and their elected representatives by a larger than average consensus. They then change the particular wording in the document to reflect their modern opinions by a large majority

Codified laws exist for a reason and are always outdated shortly after codification.

What is not an acceptable avenue is to ignore the document and intentionally act as though it means nothing. Due to laziness our current and recent governemnts have not taken the time to appropriately adjust anything, just to abandon all regards for the document unless it suits their immediate purposes. This is what primarily frustrates quite a few Americans with regards to assumed liberties abused by the federal governemnt, both on the right and left.

[Seamus Fermanagh]

Now wait a second. You just said that the government would do a poor job of running a UHC system. Why, if that's the case, would the insurance companies go under? If the government doesn't manage healthcare well, no one will drop their private coverage.

Oh, and I don't think most people want to eliminate the private option. The politicians sure don't.

It doesn't matter how poorly they do. They can't go bankrupt if they screw up. If an insurance company makes bad judgement in assigning risk, it loses money. It then has to raise rates to compensate. Raising rates makes it less attractive to potential customers. A "public option" would never need to raise rates no matter how much money it lost as the taxpayers would be forced to absorb the cost -- or do you see Congress voting to direct in increase in co-pays etc. after promising their constituents "free" healthcare? Moreover, as currently written, there is a lot of economic incentive for small businesses to STOP providing any healthcare benefit, thus dumping those workers into the "public option" by default. Admittedly, in the case of this last point, no "final language" bill has been promulgated.

[Seamus Fermanagh]

Like they would have deemed bacteria, modern medicine, powered flight, nuclear energy and motorcars as proposterous notions , while finding the notion of slavery normal.

Tribes, my comment related to a lasting point of political philosophy -- the proper role of government. Such a point is inherently more "lasting" because of its intangibility than are most of the items you list above. Our Constitution delineates a government that is specifically empowered to do those things and provide those services that could not and cannot be provided at some lower level of political collective. The "Bill of Rights" restricts the federal government, not the individual, and was written to prevent the government from acquiring further powers unless it was granted to them by a majority of the several states. Government at the lowest possible level was the goal.


Slavery WAS normal at the time. Slavery -- whether labeled serfdom or indentured servitude or whatever -- was a component of many human societies and had been for millenia. Virtually every society that moved past the "clan" stage practiced slavery in some form. Even so, a goodly proportion of the founders opposed it at the outset. Sadly, they lacked the political will to end slavery as they founded our nation. We have paid a steep price for this, and still continue to pay some of that price today.

[Lemur]

Quote for the day (http://www.ordinary-gentlemen.com/2009/09/does-no-one-remember-the-prescription-drug-benefit/):


Look, I think we all know why the prescription drug bill wasn’t fought against where health care reform is: the elderly are a protected political class, and those without health care are not. But few people are willing to admit to such naked horse race concerns behind their policy preferences. So what can people who are explicitly opposed to health care because of concerns of fiscal responsibility say in defense of the prescription drug benefit?

If you are blogging or writing politically now, and you weren’t then, you get a pass. If you have some separate reason for resistance to reform other than the expenditure, that’s ok too. But if you are specifically arguing that you don’t like health reform because it’s too expensive or fiscally irresponsible, and there’s no record of you arguing similarly against the wildly expensive prescription drug bill, it’s hard not to see that as hypocritical and partisan. Fair?

[ICantSpellDawg]

Quote for the day (http://www.ordinary-gentlemen.com/2009/09/does-no-one-remember-the-prescription-drug-benefit/):

Look, I think we all know why the prescription drug bill wasn’t fought against where health care reform is: the elderly are a protected political class, and those without health care are not. But few people are willing to admit to such naked horse race concerns behind their policy preferences. So what can people who are explicitly opposed to health care because of concerns of fiscal responsibility say in defense of the prescription drug benefit?

If you are blogging or writing politically now, and you weren’t then, you get a pass. If you have some separate reason for resistance to reform other than the expenditure, that’s ok too. But if you are specifically arguing that you don’t like health reform because it’s too expensive or fiscally irresponsible, and there’s no record of you arguing similarly against the wildly expensive prescription drug bill, it’s hard not to see that as hypocritical and partisan. Fair?



The elderly are a protected class because they are freaking useless. Have you ever spoken to old people? They are at a complete disadvantage against the rest of us and we will all be there at some point in our lives. They are protected because most of us are on equal footing in our old age - low income, mentally unstable, ignorant of important technological advancements and unable to take decent care of oursleves.

Children are a protected political class, too - and they don't even vote.

Most of the rest of us are keeping up with progress, competetive in the work force and in at least average control of our senses. We drive the economy and make our own decisions effectively (relatively). It is more practical to hold the hands of those groups that need it and let the groups that don't need it as much play ball with the big boys.

If anyone honestly thinks that the amount of money we spend on the disadvantaged vs what they give back isnt generous - I don't have any idea where you are coming from. What you are demanding has nothing to do with any sense of "fairness" or natural law, but with religion. That's all well and good until those religious convictions start controlling everyone elses pocket book. I thought that was a page we could turn to together.

I want health care to be affordable enough for everyone to be able to purchase it, unless they are totally dead weight, at which pont we will chip in to be civil.

[Lemur]

The elderly are a protected class because they are freaking useless. Have you ever spoken to old people? [...] Children are a protected political class, too - and they don't even vote.
I think you're drawing a false equivalence here. Old people are given extremely generous benefits; children often get the shaft. In 2007 an estimated 9 million (http://www.cbsnews.com/stories/2007/05/02/eveningnews/main2755159.shtml) American children had no insurance at all. Not what you would expect from a protected class. Likewise, in 2007 President 43 vetoed (http://www.washingtonpost.com/wp-dyn/content/article/2007/10/03/AR2007100300116.html) an expansion of SCHIP, a program explicitly aimed at expanding healthcare coverage for children, on the grounds that expanding state-subsidized healthcare for kids would hurt private insurers and grow soclialist tendencies.

Can you imagine the uproar if such an argument were made against seniors?

No, sorry, old people are a protected class, kids are not.

[rory_20_uk]

I think you're drawing a false equivalence here. Old people are given extremely generous benefits; children often get the shaft. In 2007 an estimated 9 million (http://www.cbsnews.com/stories/2007/05/02/eveningnews/main2755159.shtml) American children had no insurance at all. Not what you would expect from a protected class. Likewise, in 2007 President 43 vetoed (http://www.washingtonpost.com/wp-dyn/content/article/2007/10/03/AR2007100300116.html) an expansion of SCHIP, a program explicitly aimed at expanding healthcare coverage for children, on the grounds that expanding state-subsidized healthcare for kids would hurt private insurers and grow soclialist tendencies.

Can you imagine the uproar if such an argument were made against seniors?

No, sorry, old people are a protected class, kids are not.

Old people are are able to vote, and go so more than the young. They are aware that they need medical input that will only increase as they get older.

Children can't vote
Parents might not have illness as high on the agenda - certainly not for themselves, and probably less so for their children.

~:smoking:

[ICantSpellDawg]

I think you're drawing a false equivalence here. Old people are given extremely generous benefits; children often get the shaft. In 2007 an estimated 9 million (http://www.cbsnews.com/stories/2007/05/02/eveningnews/main2755159.shtml) American children had no insurance at all. Not what you would expect from a protected class. Likewise, in 2007 President 43 vetoed (http://www.washingtonpost.com/wp-dyn/content/article/2007/10/03/AR2007100300116.html) an expansion of SCHIP, a program explicitly aimed at expanding healthcare coverage for children, on the grounds that expanding state-subsidized healthcare for kids would hurt private insurers and grow soclialist tendencies.

Can you imagine the uproar if such an argument were made against seniors?

No, sorry, old people are a protected class, kids are not.


You would hear an uproar if you clipped elder care because the elderly get upset when you ask them if they know how to use a computer. Imagine if you told someone who couldn't work and earned only what the governemnt gave them that you were taking that away. Of course there would be an uproar.

I was using "children as a protected class" to oppose your arguement. In both cases the classes need added protection.

This nation pays for 9 hour day-care for children every day. We've been doign that for around 100 years. Additionally - no hospital would deny care to a child if it was necessary to save their life, with or without insurance. Health care for children is important as preventative care and the real question was "who is going to finance it".

The President vetoed the expansion of SCHIP because it was thinly veiled attempt at a public plan. Other Republicans have ushered in health plans for children on a state basis and the President was merely protecting the Federal system from additional entitlements that would have been (and were being) better served by State level work.

Oh, I'm sorry, I forgot that Bush was a child hating villain.

Either way, I think I'm missing the point of your arguement. Are you suggesting that Senoirs are a catered-to class who should not have the Federal health benefits OR are you suggesting that because Seniors have the benefit that all of us should, irrespective of whether we are capable earners in the prime of our lives who are competant to make our own decisions?

[Lemur]

Are you suggesting that Senoirs are a catered-to class who should not have the Federal health benefits OR are you suggesting that because Seniors have the benefit that all of us should, irrespective of whether we are capable earners in the prime of our lives who are competant to make our own decisions?
I'm suggesting that seniors' benefits should be on the table for discussion, while currently they are not. And I would very much like to bury Medicare Part D in a dark hole full of radiated scorpions.

We have one party committed to never raising taxes, and another party committed to never cutting benefits. Between the two of them it's hard to see how we're going to reach a sane result.

[ICantSpellDawg]

I'm suggesting that seniors' benefits should be on the table for discussion, while currently they are not. And I would very much like to bury Medicare Part D in a dark hole full of radiated scorpions.

We have one party committed to never raising taxes, and another party committed to never cutting benefits. Between the two of them it's hard to see how we're going to reach a sane result.

Ahhhh. I see. That's just posturing on their part. I'm in favor of slashing expenses wherever they need to be slashed. Even...gasp... the military. In my opinion, every single program should be radically overhauled every 10 - 20 years with cuts and re-evaluations of benefits.

Try to touch school issues on a federal basis - then you come to another "protected class" - Teachers. This is nonsense because teachers, as we have discussed, are in the prime of their lives and able to compete - why htey need government to hold their hand and level an already fair playing field, i have no idea.

When one party tries to change anything, the other party rallies to the defense of those with the rug being sensibly adjusted underneath them. Absurdly, this happens every time. Ironically it is necessary in some cases and probably a good physical dynamic to have in place in the long run, however frustrating it may be.

[jabarto]

http://news.bbc.co.uk/2/hi/in_depth/8200844.stm

Americans give their opinions on the NHS. Why is it always the NHS?

[tibilicus]

http://news.bbc.co.uk/2/hi/in_depth/8200844.stm

Americans give their opinions on the NHS. Why is it always the NHS?

Stopped watching about 5 seconds in.

"Your health Care in the UK sucks"

Funny that, seeming surveys have continuously showed about 90% of the general public is satisfied with the NHS and the service it provides. Sure, we wait longer than you do in the US, but it's greatly exaggerated. If you need medication, surgery or whatever it may be, you can get it near enough no problem.

Also saw the signs about socialism, those jokers wouldn't know what socialism was if it slapped them across the face. I myself am miles away from socialism politically, and do I feel the NHS is the beginning of the red army coup coming to the UK? No.

The fact remains that as far as I'm aware, the USA is the only rich westernised nation that doesn't offer universal health care, quite frankly you ought to be ashamed. Then again do I expect any better from a nation where a large proportion of it's citizens seem to linger on inequality like it's the "American thing to do"? America has been a nation driven with inequality and a massive rich poor divide since the day it was born, you think that the people might actually want to do something about it.

The simple fact remains that health care in the US is seen as something that only those who can pay deserve to get. Health care should be a basic human right, the argument that healthcare standards would drop if you had universal health care is also flawed. Statistically America is one of the most unhealthy rich nations. I mean c'mon, even your doctors want healthcare reform.

/End rant.

P.S American media, quit hating on our NHS, we like it, your just jealous. :2thumbsup:

[aimlesswanderer]

Yes tibilicus, the whole circus seems very strange. I love the "Communist", "Socialist", or even "Nazi" (huh? Hitler would not approve I dare say) signs, that just confirms to me that the lunatics are loose!

Yep, an insane amount of money is spent for crappy outcomes and vast numbers of people with no care at all. If, in any other developed country, the leader of a major political party said that they were going to change the health system to an "American" model, they would do extremely badly at the next election. Now, this either shows that the rest of the developed world is Communist/Socialist/Nazi, or just more sensible and fair minded.

[Lemur]

Just to dig in on a point: Medicare D is projected to cost us $8.1 trillion (http://www.babylontoday.com/prescription_drug_benefit.htm) dollars, according to the CBO. It was originally supposed to cost $1.2 trillion over ten years.

Somebody explain to me why nobody is protesting Medicare D?

[Strike For The South]

Just to dig in on a point: Medicare D is projected to cost us $8.1 trillion (http://www.babylontoday.com/prescription_drug_benefit.htm) dollars, according to the CBO. It was originally supposed to cost $1.2 trillion over ten years.

Somebody explain to me why nobody is protesting Medicare D?

Becuase old people vote and there's fixin to be allot more of them. We need to scrape medicare and medicaid, it's like the worst of every system put into 1.

I really am sick of old people and there crap. I'm not paying millions of pesos to go to school only to have nana take it away down the road simply becuase she's old and gives Wethers caramels.

[Xiahou]

Just to dig in on a point: Medicare D is projected to cost us $8.1 trillion (http://www.babylontoday.com/prescription_drug_benefit.htm) dollars, according to the CBO. It was originally supposed to cost $1.2 trillion over ten years.So, when healthcare reform is projected to cost $1 trillion.... should we believe them?

[Lemur]

I'd be thrilled if either party would talk coherently about cost containment. But it certainly seems as though Obama's plan is being held to higher scrutiny and investigation than Medicare D ever received.

The path to real savings probably lies with one of two politically unrealistic options: single-payer or Paul Ryan's roadmap (http://www.house.gov/ryan/roadmap/roadmap.htm). Single-payer has the advantage of being a tested system, since every other industrialize nation has had a run at it. Ryan's proposal is much more radical, but even greater savings might be realized. Bit of a leap of faith.

But neither outcome will happen, so why am I bothering talking?

[ICantSpellDawg]

I'd be thrilled if either party would talk coherently about cost containment. But it certainly seems as though Obama's plan is being held to higher scrutiny and investigation than Medicare D ever received.

The path to real savings probably lies with one of two politically unrealistic options: single-payer or Paul Ryan's roadmap (http://www.house.gov/ryan/roadmap/roadmap.htm). Single-payer has the advantage of being a tested system, since every other industrialize nation has had a run at it. Ryan's proposal is much more radical, but even greater savings might be realized. Bit of a leap of faith.

But neither outcome will happen, so why am I bothering talking?


Single-payer would get the job done, but at the expense of the US health industry. PLUS I think that it would obscure cost even further, unless the government essentially controlled the production of health materials, which would be totally insane.

I love the roadmap. It makes sense to me and puts visible money in between most doctor-patient transactions. I'll be damned if I'm going to keep going to a doctor who, after an hour wait in his disease filled office and a 20 minute **** talk, gives me a bill for $700. I'd spit in his face.

The roadmap is radical. That's why I love it. I love radical, minimally-socialist ideas. That's why I am sometimes uncomfortable with the title "conservative", because I favor a radical overthrow of conventrional norms too often, but almost never in favor of flower-child "single payer/command economy" nonsense.

I know that the current system is a failing one. Everyone can see how it has contributed to skyrocketing cost, but nobody wants to jettison a sinking ship. The US is all about new ideas, why can't we go Paul Ryans way?

[Centurion1]

Seniors are jerks. all they care about is getting that check in the mail and they vote for whoever promises to uphold it.

You askme before we make more reform we have to either scrap medicare and social security or drastically reform it, before *shudder* the baby boomers get into the game. They ruined every other public institution they touched (schools)..... they are like a cancer, they just eat away.

[Seamus Fermanagh]

Just to dig in on a point: Medicare D is projected to cost us $8.1 trillion (http://www.babylontoday.com/prescription_drug_benefit.htm) dollars, according to the CBO. It was originally supposed to cost $1.2 trillion over ten years.

Somebody explain to me why nobody is protesting Medicare D?

I objected when Bush pushed for it and have stated my opposition to in on many occasions in the BR. A boondoggle of the first rank.

[Papewaio]

A foolish opinion, held by thousands, is still foolish.

Still, since many of them can vote, we will very likely see UHC in my lifetime and I will have to learn to cope with life in a Socialist Democracy. Franklin's quip about liberty and safety falls on deaf ears.

I breathe, therefore you are required to feed me, clothe me, entertain me, and keep me healthy to the maximum extent possible. My existence trumps all! Is that not what government is for?

:dizzy2:

US of A is the superpower whose citizens enjoy the most personal freedoms. However that does not make the US of A automatically have the citizens with the most personal freedoms in the world. Beating Russia and China in personal freedoms does not put one at the top of the list.

I'm pretty sure there are countries that have UHC + Free Market Economy + Socialistic Democracy that have more personal freedoms for their citizens.

=][=

I see a balance of power. The more free market the economy the more socialist the government needs to be (there are other ways to get to the same end point). Essentially the more powerful the horsepower on the car, the better the suspension need to be to smooth out the trip.

Health Body = Healthy Mind. So to remain competitive on the world stage having a well educated and fit population would seem a smart option to follow. One only has to see the costs of a steadily aging population to understand that lack of working fitness is a major economic drain.

[Evil_Maniac From Mars]

I'm pretty sure there are countries that have UHC + Free Market Economy + Socialistic Democracy that have more personal freedoms for their citizens.


I can't name a single European country with those and more personal freedoms, and I think that is what you're getting at.

[Papewaio]

Yes, because the world stops at Europe.

Check out which free market economies have democracy and long human life span (life span being one of the rules of thumb in health both body and mind). Then check out personal freedoms (now that is a very subjective thing, and nominative as everyone has different things that they like to do)... but in the main no modern country has more or less.

The main point being that UHC =/= less freedoms.

[Evil_Maniac From Mars]

The main point being that UHC =/= less freedoms.

You're right there, but I think that you're going to have a very difficult time of finding a country more free than the United States.

[Lemur]

You're right there, but I think that you're going to have a very difficult time of finding a country more free than the United States.
I wouldn't mind having autobahns without speed limits. That's pretty darn cool. Not saying Germany is more free than us, just thinking wistfully about how cool it would be to do 120 mph on a freeway ... legally. Sigh.

[Papewaio]

Might be bad if you just spent a weekend in Amsterdam...

[Evil_Maniac From Mars]

I wouldn't mind having autobahns without speed limits. That's pretty darn cool. Not saying Germany is more free than us, just thinking wistfully about how cool it would be to do 120 mph on a freeway ... legally. Sigh.

It'd be awfully nice if we could have better access to more useful things, like firearms. Not to mention that most of our motorways do, in fact, have local speed limits (and the SPD is moving to do away with the few no limit stretches left).


Not saying Germany is more free than us

Not by a long shot.


Might be bad if you just spent a weekend in Amsterdam...

Weed and prostitutes aren't exactly my definition of freedom. I'm thinking in economic freedom, but also the freedom to possess useful tools, like firearms. Lower tax rates would be nice too, but I can dream...

[Tribesman]

I'm thinking in economic freedom, but also the freedom to possess useful tools, like firearms.
So Mars , what did you do that stops you from having a firearm in Germany?
Are you an ex-con, have a record of mental illnes or a history of violence or substance abuse?
If not then you are free to possess a useful tool.

[Evil_Maniac From Mars]

So Mars , what did you do that stops you from having a firearm in Germany?
Are you an ex-con, have a record of mental illnes or a history of violence or substance abuse?
If not then you are free to possess a useful tool.

I didn't say we were barred, did I? I said better access would be nice. And what is it about German law that could make me say that, since I am a law-abiding, sane citizen who has never taken drugs in his life?

[Beskar]

You're right there, but I think that you're going to have a very difficult time of finding a country more free than the United States.

Switzerland?

[Ironside]

Weed and prostitutes aren't exactly my definition of freedom. I'm thinking in economic freedom, but also the freedom to possess useful tools, like firearms. Lower tax rates would be nice too, but I can dream...

So a free country is a country were you pay very little taxes (economic freedom) and got an easy access to guns (useful tool)? That would be like Afghanistan or Somalia?

Is the PATRIOT act a sign of freedom?
Is camera monitoring, both private and public?
Is very liberal abortion laws a sign of freedom?
Is it a country with few laws?
Is it a country with few laws that you need to bother about?
Is it a country where the public information about people are enough for others to monitor and/or stalk people?
Is there a such as too much freedom?

So what is freedom? And more importantly, what is good freedom?

[LittleGrizzly]

So what some people really mean by freedom is freedom to do things I like... not just freedom to do stuff...

For one I would point out that America has quite strict drug laws.... far stricter than dictatorships like that of Portugal and Netherlands...

I now for one legalised drugs (or just decriminalised weed) would do wonders for my freedom... so excuse me for not joining in this gushing priase for 'the land of freedom'

More like the land of conservative freedom...

Ironside In the same way allowing any old nutter to grab any weapon he wanted would be freedom (or more freedom) giving an abortion at the last possible second would also be more freedom (wouldn't have the freedom to do that in most other countrys) having the freedom to do something isn't nessecarily always a good thing. Its a catchy buzzy word that people like to always attach to thier own side and accuse the other side of having less...

[Tribesman]

So what is freedom?
It is a word used by Mel Gibson, so I think it means "cut my head off"

[KukriKhan]

Becuase old people vote and there's fixin to be allot more of them. We need to scrape medicare and medicaid, it's like the worst of every system put into 1.

I really am sick of old people and there crap. I'm not paying millions of pesos to go to school only to have nana take it away down the road simply becuase she's old and gives Wethers caramels.


Seniors are jerks. all they care about is getting that check in the mail and they vote for whoever promises to uphold it.

You askme before we make more reform we have to either scrap medicare and social security or drastically reform it, before *shudder* the baby boomers get into the game. They ruined every other public institution they touched (schools)..... they are like a cancer, they just eat away.

Someday (not here, it'd derail the thread) we ought to look at this (the anti-senior sentiment) and see if it holds any water. I think I'm safe in predicting that such attitudes will be expressed more often, and more loudly, in the next 5-15 years.

[Strike For The South]

Someday (not here, it'd derail the thread) we ought to look at this (the anti-senior sentiment) and see if it holds any water. I think I'm safe in predicting that such attitudes will be expressed more often, and more loudly, in the next 5-15 years.

All seniors care about is their issues. They like to complain Obama is spending there grankids money when in reality they have been doing that for years! Social security, medicare, and most social legislation is all becuase senoirs vote en masse.

Dont get me wrong I love my nana but at the same time she is bankrupting the country.

I'm also not saying they should be put out to pasture either, I'm just saying we need to fix the system and everything should be on the table. Yet Medicare is like a sacred cow.

[Meneldil]

Weed and prostitutes aren't exactly my definition of freedom. I'm thinking in economic freedom, but also the freedom to possess useful tools, like firearms. Lower tax rates would be nice too, but I can dream...

Low taxes and firearms are not my definition of freedom.


So what some people really mean by freedom is freedom to do things I like... not just freedom to do stuff...

That. Most american liberals are supporting the freedom to wear firearms and have low taxes. But the freedom of abortion, oh god no. And I'm not even talking about the Patriot Act.

[Banquo's Ghost]

Gentlemen,

The topic is The U.S. Health Care Debate.

Those who wish to discuss which nation has the most freedom are free to start a new thread.

Thank you kindly.

:bow:

[Lemur]

Looks like Chuck Grassley (http://theplumline.whorunsgov.com/senate-republicans/grassley-i-cant-back-bill-now-because-dems-might-do-bill-without-me-later/) has ruled out any possibility of compromise. I guess this is news. Maybe.


Grassley’s position really appears to be that a key reason he can’t back the bill now is that Dems haven’t sworn a blood-oath not to do a bill alone later if no bill emerges that can get “broad” Republican support. This amounts to asking Dems to promise in advance to do nothing at all in the event that a “broad” number of Repubicans don’t agree to get behind some kind of compromise bill.

By this standard, in order to satisfy Grassley’s definition of true bipartisanship, Dems quite literally must cede all their power and leverage in advance, even as Republicans are refusing en masse to back any proposal that can reasonably be called a compromise. That really is Grassley’s position, with no exaggeration.

[Papewaio]

It is a debate and less freedom was called as a side effect of the prescription drug UHC.

IMDHO:soapbox:I think that UHC = Less Freedom was a strawman argument. :strawman3:

I do however what to see how that is so, because I'm well known to having a couple of planks in my eye.

Like any government utility it does need to be paid for either by income or corporate taxes or by government bonds/investment. So restricting ones cashflow (by higher taxes) I coincide would impinge on personal freedoms as a by product of more taxes to pay for more health. But with transparency, accountability, focused spending (more money going to frontline and less to bureaucracy, non-elective not elective) the ROI for society (much like education) should be palatable to all citizens.

[Evil_Maniac From Mars]

IMDHO:soapbox:I think that UHC = Less Freedom was a strawman argument. :strawman3:


I agree with you there (it depends on what kind of UHC), but I disagree that America is less free than many other nations. In deference to Banquo, however, I won't defend my views further in this thread.

[Lemur]

Quote for the morning:


The problem is that the demand curve for drugs is vertical, or nearly vertical. Sick people will consume only the quantity they need to stay alive/healthy, but will pay any price for that. If pricing were left up to the market, supply and demand for patented, life-saving drugs would reach equilibrium at about 100% of the consumer's assets, plus five years of indentured servitude.

[Crazed Rabbit]

Quote for the morning:


The problem is that the demand curve for drugs is vertical, or nearly vertical. Sick people will consume only the quantity they need to stay alive/healthy, but will pay any price for that. If pricing were left up to the market, supply and demand for patented, life-saving drugs would reach equilibrium at about 100% of the consumer's assets, plus five years of indentured servitude.

Just like big agriculture does with food! Oh, wait...

So where did that quote come from? I want to know, so I can tell people about a case study in not understanding economics - not understand that if prices are severely high that a new player will enter the market undercutting prices. As long as there's not to much regulation inhibiting it.

CR

[Beskar]

not understand that if prices are severely high that a new player will enter the market undercutting prices. As long as there's not to much regulation inhibiting it.

CR

That is where Patent laws come in, also, start-up companies will stand next to new chance since they won't have the production or the means in-place. If there came a small rival, what the bigger comapnies would do, is undercut that new rival and drive them out of buisiness, or buy them through the stock-market, or make people sign exclusivity contracts, amongst other things. Other comapnies will try to ensure a monopoly and other things.

The market is not free and never will be free and only way to fix it would be lots of regulation and laws.

One only has to take a look at the African healthcare issue.

[jabarto]

Ever wonder why Americans allow the healthcare industries to shaft them over and over again? This link offers some insight.

http://www.tnr.com/article/books-and-arts/wealthcare-0

Basically, most people have bought that steaming pile of dung that is "the American Dream" hook, line and sinker, and believe that the reason that the insurance companies are where they are is through bootstrapping themselves up there, and so they should be repsected for that. I'm not kidding.

[Lemur]

So where did that quote come from?
Sorry I forgot teh linkie. You want cotext? Imma give you context. The quote was a response to this post (http://meganmcardle.theatlantic.com/archives/2009/09/a_susbidy_by_any_other_name_st.php):


I like new pharmaceuticals in the context of a market where supply is matched to consumer demand through a price mechanism. If people, in their role as consumers, decide that the new pharmaceuticals coming out aren't worth their price, and decline to buy them, I like that too.

What I don't like is the government stepping in and deciding what drugs are worth how much money. The government does not do a good job at setting prices. How do we know this? Generations of attempts at wage and price controls. Price controlled markets don't work well, whether the price controls are a ceiling or a floor.

To which a reader writes (http://andrewsullivan.theatlantic.com/the_daily_dish/2009/09/this-is-the-blogosphere-on-drugs-ctd.html#more):


The problem with Megan's position is that the demand curve for drugs is vertical, or nearly vertical. Sick people will consume only the quantity they need to stay alive/healthy, but will pay any price for that. If pricing was left up to the market, supply and demand for patented, life-saving drugs would reach equilibrium at about 100% of the consumer's assets, plus five years of indentured servitude. Maybe I'm exaggerating, but it would be ugly.

I take this personally. I have narcolepsy, a rare disease, and only one company manufactures the drug I need (Xyrem). It's an "orphan" drug: The monopoly is the government's incentive to make it available, otherwise no company would find the R&D investment worthwhile, given the small number of patients. However, without insurance, my monthly drug costs would be greater than my monthly earnings. What does Megan think about this?

"If people, in their role as consumers, decide that the new pharmaceuticals coming out aren't worth their price, and decline to buy them, I like that too."

What really bothers me is that medicine is literally the Econ 101 textbook example of vertical demand curves. How does Megan not know this?

[Lemur]

If it walks like a death panel, and it quacks (http://www.chicagotribune.com/health/chi-thu-problem-briana-rice-sep17,0,807488,full.column) like a death panel ...

When 17-year-old Brianna Rice was diagnosed with celiac disease in February, she had health insurance.

She doesn't now.

In the months that followed her diagnosis, her insurance company, American Community Mutual Insurance, combed through her medical records and ruled that her parents lied on her application last year.

In May, American Community not only canceled her policy, but also rescinded coverage all the way back to the day it started -- Nov. 1. [...]

After the teen's diagnosis in February, American Community reviewed her medical files and found reports of dizziness, elevated cholesterol levels, ongoing fatigue and a persistent cough.

On May 12, the firm sent the Rices a letter saying it was rescinding coverage.

"The coverage you applied for would not have been issued for Brianna if we had known this medical history at the time of application," the letter said.

Dale Rice said the insurance company cherry-picked from various doctors' visits, and that none of his daughter's health problems were ongoing. He attributed the dizziness to dehydration, the fatigue to his daughter staying up late surfing the Web, the elevated cholesterol to an inaccurate test, and said the cough is now gone.

None of the issues were serious medical problems, and none stuck out in his mind when he filled out the application, Rice said. He sent the Problem Solver a copy of Brianna's July 2, 2008, physical, which showed no major health concerns.

"[Insurance companies] look for anything that they could say 'you didn't tell us about,' " Rice said. "They hope that people just lay down and die and don't fight."

[jabarto]

Just another reminder why, for sanity's sake, I shouldn't be reading YouTube Comments:


Wake up people. A public health system is unamerican & any government regulation denies the function of the market. I know people will say the arbitrary & exorbitant costs of health care is the largest cause of personal bankruptcy & that those costs are indeed making the insurance companies huge profits while "black-mailing" the common folk with their health & lives but the market will have it's say. There might be some collateral victims who can't afford it but that's just what we have to accept. They're the weaker ones anyway right. Survival of the fittest, etc.
This is a Christian nation & the answer isn't hand-outs for those people you aren't responsible enough to afford health insurance but prayer. I don't want to have to hold the less fortunates' heads above water. I'm looking after myself & my family only. That's the American way.

[Beskar]

Just another reminder why, for sanity's sake, I shouldn't be reading YouTube Comments:

It is the American way indeed.

Though, I think Jesus would like to have a few words to any moron who repeats stuff like that, he was the Lord of Hand-outs and Socialism back in 24 A.D. Yes, that's right. Jesus was a socialist. He said for the Rich to give up their wealth and give it to the poor, bring equality and love your neighbour. Some how, all these Christians seem to forget this.

[Evil_Maniac From Mars]

Yes, that's right. Jesus was a socialist. He said for the Rich to give up their wealth and give it to the poor, bring equality and love your neighbour. Some how, all these Christians seem to forget this.

:laugh4:

Wrong.

Jesus was not a socialist, because he wanted people to do this voluntarily.
On average, the right gives more to charity than the left, and in America this is by quite a significant amount.
Essentially, Jesus said that if you help people out, you will be rewarded. He didn't say that the government should help everyone out for you.

Somehow, socialists seem to forget this.

[Beskar]

Essentially, Jesus said that if you help people out, you will be rewarded. He didn't say that the government should help everyone out for you.

Ever heard about the Rich man, Camel and Eye of the Needle?

Give it away, get rewarded and go to Heaven. Don't and say hello to down below. Choice is an illusion.

[Evil_Maniac From Mars]

Ever heard about the Rich man, Camel and Eye of the Needle?

Give it away, get rewarded and go to Heaven. Don't and say hello to down below. Choice is an illusion.

I'm going to go with a solid "no" again.

[Banquo's Ghost]

I fear the "Jesus - Poster Boy for Socialism or Aristocratic Paternalism, We Haz It?" tangent may divert us rather speedily from the complexities of the U.S. Health Care Debate.

:focus:

[Crazed Rabbit]

Sorry I forgot teh linkie. You want cotext? Imma give you context. The quote was a response to this post (http://meganmcardle.theatlantic.com/archives/2009/09/a_susbidy_by_any_other_name_st.php):

To which a reader writes (http://andrewsullivan.theatlantic.com/the_daily_dish/2009/09/this-is-the-blogosphere-on-drugs-ctd.html#more):


The reader contradicts herself. So the firm has a monopoly on the one drug that can help her. That doesn't mean they charge $1000 bucks for a day's medicine. A textbook monopoly firm will charge enough to gain the most profit. That is not equal to charging the highest legal price, however. And she acknowledged that the firm charged high prices to gain back their investment, not because they're seeking indentured servants.


If it walks like a death panel, and it quacks like a death panel ...

Like I said, an insurance firm should have only 30 days or so to reject patients on those grounds.


The market is not free and never will be free and only way to fix it would be lots of regulation and laws.

:laugh4:

CR

[Beskar]

I fear the "Jesus - Poster Boy for Socialism or Aristocratic Paternalism, We Haz It?" tangent may divert us rather speedily from the complexities of the U.S. Health Care Debate.

:focus:

True, but you forget, Jesus gave a free health care service to everyone who was with him. :laugh4:

So Jesus was was a proponent of Universal Healthcare.

[LittleGrizzly]

On average, the right gives more to charity than the left, and in America this is by quite a significant amount.

Isn't quite alot of this money directed in political ways ? or is that discounted...

I would hardly call giving Israel money charity (or at least no more than giving Hamas money is charity)

Same goes for the opposing camps in the abortion war...

Is this money adjusted for different wealth between countries ? (obviously if you have more you can give more)

Amount of millionaires and billionaires ? (they can give away half thier money possibly without having an effect on thier lifestyle, the average man cannot)

Population adjusted also ?

Also im sure alot of religious donations go towards keeping churches going and recruiting new members...

Theres alot of charity with selfish motivation behind in, with America's paticularly hostile debates on some issues its high levels of religious belief and religious fervour (the televangelicals spring to mind) and its closeness to Israel could add up to a decent share of its contributions..

[Strike For The South]

It is the American way indeed.

Though, I think Jesus would like to have a few words to any moron who repeats stuff like that, he was the Lord of Hand-outs and Socialism back in 24 A.D. Yes, that's right. Jesus was a socialist. He said for the Rich to give up their wealth and give it to the poor, bring equality and love your neighbour. Some how, all these Christians seem to forget this. .

Jesus has nothing to do with this. The people who most vhemently oppose reform are not doing so becuase of Christian beliefs. I can't count how many times my church help pay bills for massive medical procedures for members of my church.

Saying Jesus was a socialist and then making some glib point about how Americans are to dumb to realizes this only shows your ignorance.

[Beskar]

Jesus has nothing to do with this. The people who most vhemently oppose reform are not doing so becuase of Christian beliefs. I can't count how many times my church help pay bills for massive medical procedures for members of my church.

Saying Jesus was a socialist and then making some glib point about how Americans are to dumb to realizes this only shows your ignorance.

I was quoting this:

Wake up people. A public health system is unamerican & any government regulation denies the function of the market. I know people will say the arbitrary & exorbitant costs of health care is the largest cause of personal bankruptcy & that those costs are indeed making the insurance companies huge profits while "black-mailing" the common folk with their health & lives but the market will have it's say. There might be some collateral victims who can't afford it but that's just what we have to accept. They're the weaker ones anyway right. Survival of the fittest, etc.
This is a Christian nation & the answer isn't hand-outs for those people you aren't responsible enough to afford health insurance but prayer. I don't want to have to hold the less fortunates' heads above water. I'm looking after myself & my family only. That's the American way.

Those churches who do indeed help others, are going the right way about it. That was my comment, not ignorance. You have to put it in context, because moving it out of context doesn't look right.

[Strike For The South]

Then I aplogize an he's wrong

[Evil_Maniac From Mars]

Isn't quite alot of this money directed in political ways ? or is that discounted...

I've never heard charity as referring to political parties.


I would hardly call giving Israel money charity (or at least no more than giving Hamas money is charity)

The State of Israel is not giving to charity, giving to things like Israeli hospitals is (and should be).


Is this money adjusted for different wealth between countries ?

This is an American-only statistic for now.


Amount of millionaires and billionaires ?

It is adjusted as a percentage.


Also im sure alot of religious donations go towards keeping churches going and recruiting new members...

Sure, and Churches give a lot of money to the poor as well. You're also forgetting that the Christian left is as big as the Christian right, if not as vocal.

Long story short, the right gives significantly more than the left, in America, based on percentages.

[Don Corleone]

Almost as if according to the Pelosi/Hoyer/Reid/Emmanuel playbook, the healthcare debate in the Org has dropped to the same silent levels elsewhere in society (last post was 6 weeks ago?) What better time to launch the final version of the bill and schedule a rush vote on it?

So, despite promises of posting the material 72 hours prior to a scheduled vote online, Nancy Pelosi finally authorized web publication of HR 3962 (the so-called Affordable Health Care for America Act) in the middle of the night last night.

Due to dissmenination from the staffs of various House members committees, certain information is already known. For example checking in the bill, (http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3962:) you can see that all Americans will now be required to belong to a "qualified plan" or contribute 2.5% of their salary to a mandated federal health insurance program. Failure to do so will incur tax liabilities for all uncovered members, and if the IRS determines it to be willful (at their discretion, with no burden of evidence), the offender(s) can be fined $250,000 and jailed for up to 5 years.

http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3962:

Despite being over 1990 pages (8.5" x 11" or A4) when printed out, and only having been released to the public late last night, the vote is tentatively scheduled for later today.

Rumored (and undenied) provisions include: -coverage for elective abortions by all qualified plans; -linguistic & cultural sensitivity counselers at border stations across the southwest. Note: I have NOT had time to investegate these claims, but they come from Lou Dobbs, not Glenn Beck. (At least, Lou Dobbs is my source on them, I have no earthly idea what kind of hay Glenn Beck or Rush are making with this).

:wall: This is exactly what I feared.




“H.R. 3962 provides that an individual (or a husband and wife in the case of a joint return) who does not, at any time during the taxable year, maintain acceptable health insurance coverage for himself or herself and each of his or her qualifying children is subject to an additional tax.” [page 1]

- - - - - - - - - -

“If the government determines that the taxpayer’s unpaid tax liability results from willful behavior, the following penalties could apply…” [page 2]

- - - - - - - - - -


“Criminal penalties

Prosecution is authorized under the Code for a variety of offenses. Depending on the level of the noncompliance, the following penalties could apply to an individual:

• Section 7203 – misdemeanor willful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year.

• Section 7201 – felony willful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years.” [page 3]

[Strike For The South]

Oh dear. What an abortion of legislation.

[Louis VI the Fat]

Oh dear. What an abortion of legislation.I would comment on that, but I was taught Americans prefer I don't by my linguistic & cultural sensitivity counseller.

[drone]

Well, after last week it's clear that they need to rush to get this passed before the midterm elections next year.

Pelosi is such a tool...

[KukriKhan]

Oh dear. What an abortion of legislation.

Open yer wallet, Strike. They're gonna get some cash out of you (and your 18-25 brothers), one way or another.

Fix this when you get elected, OK?

[Don Corleone]

So, the bill passed, 220-215. One Republican, John Cao, a freshman from a Democratic district in New Orleans crossed the line to vote for it, 39 Democrats risked Nancy's wrath by voting against it. Their political lives are now not worth a plug nickle, as MoveOn.Org is already actively seeking primary challengers to unseat them.

Last minute changes:

-Conservative Democrats, led by Rep. Stupack inserted a clause into the rules committe that blocked the language that would have required insurance companies (public options or private plans) to provide coverage for elective abortion. The language on this ammendment was included in the final bill, as was a reinstatement of the "conscience clause", a law that prevents facilities from requiring doctors and nurses from performing elective abortions if it runs against their morals. Democratic House leaders are vowing to have Stupack's ammendment stripped from the final bill in the reconciliaiton bill with the Senate, or by line-item veto in the White House, returning a requirement to fund all elective abortions and removing the legal protections for the "conscience clause".

-An ammendment which would have blocked the ability for undocumented workers to participate in the healthcare exchange was removed in order to secure the bill's support by the Hispanic Caucus. Undocumented workers will now be allowed to participate in the government sponsored health care exchanges (the House bill did not have a public option, but the senate one does).

-Nancy Pelosi took a victory lap by introducing a bill and seeing it passed, on a 219-216 vote, that required Republican House members to wear a button depicting a castrated elephant, with the words "We LOST" under it, for the remainder of the 111th Congress (through January, 2011). It will now be a Class A misdemeanor, punishable by a $50K fine and 90 days in jail for a member of the House Republican Caucus to come to the House floor without the button prominately displayed on a lapel.

(Just kidding on that last one).

Seriously, whether you're for Nancy's bill (I'm not talking about actual Health Care Reform) or against it, I'm curious what any of the rest of you have heard about the final version.

Or does anybody even know?

[jabarto]

Can anyone tell me if it's true that insurance is now mandated but nothing has been done to cap premiums? Every source I've read today gives me teh impression that the bill is just a giant handout to the reigning corporate oligarchy.

[Don Corleone]

Can anyone tell me if it's true that insurance is now mandated but nothing has been done to cap premiums? Every source I've read today gives me teh impression that the bill is just a giant handout to the reigning corporate oligarchy.

Yes and no...

Insurance companies got kicked in the goonies....

-They're not allowed to deny coverage for any pre-existing conditions.

-They're not allowed to drop coverage for people while in the midst of being treated for a chronic illness, even if they stop paying their premiums.

-They're now required to charge the same premium to anyone, regardless of their health status.

-Their anti-trust exemptions have been revoked, which means they're not longer allowed to negotiate fixed pricing targets with hospitals and doctors, who are now free to charge whatever they want.

-They are now subject to regular congressional sub-committee review panels.

But, no price caps on premiums were introduced. They just have to charge everyone the same rate. If they had done as you suggest, forcing mandatory premium maximums onto them, in light of all the coverage requirements I listed above, no health insurance company could have survived.

Just out of curiosity, do you know how insurance actually works? :inquisitive:

[jabarto]

Yes and no...

Insurance companies got kicked in the goonies....

-They're not allowed to deny coverage for any pre-existing conditions.

-They're not allowed to drop coverage for people while in the midst of being treated for a chronic illness, even if they stop paying their premiums.

-They're now required to charge the same premium to anyone, regardless of their health status.

-Their anti-trust exemptions have been revoked, which means they're not longer allowed to negotiate fixed pricing targets with hospitals and doctors, who are now free to charge whatever they want.

-They are now subject to regular congressional sub-committee review panels.

But, no price caps on premiums were introduced. They just have to charge everyone the same rate. If they had done as you suggest, forcing mandatory premium maximums onto them, in light of all the coverage requirements I listed above, no health insurance company could have survived.

Just out of curiosity, do you know how insurance actually works? :inquisitive:

I misspoke, I didn't mean literal caps, more like controls. You know, something to keep the prices reasonable so that the bill isn't just a blank check to the insurance industries.

[Don Corleone]

The bill that just passed the House is anything but a blank check to the insurance companies.

Seriously, do you understand how insurance (of any form) works? Insurance companies collect premiums from a large pool of insured, on the assumption that the majority of them will have no claims, or that their claims will be less than their total in premiums.

SCANDALOUS!!! SCOURGE THOSE CAPITALIST PIGS!!!!

Wait... how about the minority that I didn't mention above? Well, for them, their health (or for that matter, liability) bills might come to 3x, 5x, 10x, maybe more than what they paid in premiums.

People pay (and grumble, granted) health care premiums not because they expect to come out even on the deal, they do it because "what if...". If my costs incurred exceed my means to pay, I'm covered.

If you force the insurance companies to take a haircut on premiums, and simultaneously force them to up their coverage on everyone, you don't have an insurance scheme, you have a wealth transfer.

I'm no apologist for the insurance industry. They've done a lot of malevolent things to gain what I would say is a well-deserved nasty reputation. But don't kid yourself into thinking that money comes out of thin air. An insurance company isn't a cookie jar. If you try to force it to be one, it will simply divest of its health care holdings, and you and I will be paying the health care costs for an Orange County divorcee who believes she needs a 4th reconstructive nose job and breast implants.

If you really want to "reform" health care, you need another oversight committe looking at not-for-profit hosptials that turn 28% profit numbers and doctors that order 3 MRI's to make the loan payment on their sailboat.

And putting an end to WhoCanISue.Com, (http://www.whocanisue.com/) a website dedicated to helping people who don't even have a case sue anybody, anywhere, any time with no downside risk, wouldn't hurt either. Lemur likes to point to the actual legal cost of lawsuits (most of which get settled btw, specifically to keep the legal costs down) and say "It's not that bad, let the ambulance chasers have their fun", but it goes well beyond that. Doctors and hospitals, who need no encouragement on the matter, end up ordering many more diagnostic tests then even they deem sane, just to keep the slathering lawyers at bay.

[jabarto]

The bill that just passed the House is anything but a blank check to the insurance companies.

Seriously, do you understand how insurance (of any form) works? Insurance companies collect premiums from a large pool of insured, on the assumption that the majority of them will have no claims, or that their claims will be less than their total in premiums.

SCANDALOUS!!! SCOURGE THOSE CAPITALIST PIGS!!!!

Wait... how about the minority that I didn't mention above? Well, for them, their health (or for that matter, liability) bills might come to 3x, 5x, 10x, maybe more than what they paid in premiums.

People pay (and grumble, granted) health care premiums not because they expect to come out even on the deal, they do it because "what if...". If my costs incurred exceed my means to pay, I'm covered.

If you force the insurance companies to take a haircut on premiums, and simultaneously force them to up their coverage on everyone, you don't have an insurance scheme, you have a wealth transfer.

I'm no apologist for the insurance industry. They've done a lot of malevolent things to gain what I would say is a well-deserved nasty reputation. But don't kid yourself into thinking that money comes out of thin air. An insurance company isn't a cookie jar. If you try to force it to be one, it will simply divest of its health care holdings, and you and I will be paying the health care costs for an Orange County divorcee who believes she needs a 4th reconstructive nose job and breast implants.

If you really want to "reform" health care, you need another oversight committe looking at not-for-profit hosptials that turn 28% profit numbers and doctors that order 3 MRI's to make the loan payment on their sailboat.

And putting an end to WhoCanISue.Com, (http://www.whocanisue.com/) a website dedicated to helping people who don't even have a case sue anybody, anywhere, any time with no downside risk, wouldn't hurt either. Lemur likes to point to the actual legal cost of lawsuits (most of which get settled btw, specifically to keep the legal costs down) and say "It's not that bad, let the ambulance chasers have their fun", but it goes well beyond that. Doctors and hospitals, who need no encouragement on the matter, end up ordering many more diagnostic tests then even they deem sane, just to keep the slathering lawyers at bay.

You're blowing this all out of proportion.

All I did was ask if the clause that mandated you to own health insurance made it in to the final bill (I honestly didn't know) and if so, was anything done to control costs. Because if not, than the insurances companies can charge whatever they want and if you can't pay it you get fined, hence the "blank check" analogy.

[Don Corleone]

By the way, I'm not opposed to the core of the bill that got passed. On the surface, the bill sounds a lot like the Corleone plan I unveiled 2 months ago (require coverage of everyone, subsidize those that cannot afford it). Requiring universal coverage is the one thing that you can do to make certain insurance companies can keep up with all the other demands, and also is the best way to provide coverage for all Americans.

I'm just disgusted with a 1992 page bill getting released 24 hours before its voted on so that a dozens of other items, that have nothing to do with "reforming health care costs" can get rolled into it.

[CountArach]

-Conservative Democrats, led by Rep. Stupack inserted a clause into the rules committe that blocked the language that would have required insurance companies (public options or private plans) to provide coverage for elective abortion. The language on this ammendment was included in the final bill, as was a reinstatement of the "conscience clause", a law that prevents facilities from requiring doctors and nurses from performing elective abortions if it runs against their morals. Democratic House leaders are vowing to have Stupack's ammendment stripped from the final bill in the reconciliaiton bill with the Senate, or by line-item veto in the White House, returning a requirement to fund all elective abortions and removing the legal protections for the "conscience clause".
It should be noted that this was already law since the 1960s (From memory...) and that the vote simply reaffirmed the existing law.

[Crazed Rabbit]

Good God, we're getting :daisy: in the :daisy: with a :daisy: pipe.

Jail time (http://online.wsj.com/article/SB10001424052748703399204574505423751140690.html)for those who don't but the insurance Pelosi deems necessary! Huge debt incurred. Taxes raised. A great deal of government control of insurance of the practice of medicine. Mandates and idiotic rules destined to raise rates. No ability to buy interstate insurance. Individual insurance still taxed. And the best possible result is a slightly higher percentage of people with insurance.

This isn't about healthcare; it's about control.

CR

[jabarto]

Good God, we're getting :daisy: in the :daisy: with a :daisy: pipe.

Jail time (http://online.wsj.com/article/SB10001424052748703399204574505423751140690.html)for those who don't but the insurance Pelosi deems necessary! Huge debt incurred. Taxes raised. A great deal of government control of insurance of the practice of medicine. Mandates and idiotic rules destined to raise rates. No ability to buy interstate insurance. Individual insurance still taxed. And the best possible result is a slightly higher percentage of people with insurance.

This isn't about healthcare; it's about control.

CR

You know that the interstate insurance thing is there for a reason, right? If it were an option, the companies would all relocate to the state that allows them to shaft consumers the most.

Also, what exactly is the problem with government control of medicine? It works in every othe rcountry that's tried it.

Not that I'm not disputing most of the rest of what you said , mind you...

[Louis VI the Fat]

-Nancy Pelosi took a victory lap by introducing a bill and seeing it passed, on a 219-216 vote, that required Republican House members to wear a button depicting a castrated elephant, with the words "We LOST" under it, for the remainder of the 111th Congress (through January, 2011). It will now be a Class A misdemeanor, punishable by a $50K fine and 90 days in jail for a member of the House Republican Caucus to come to the House floor without the button prominately displayed on a lapel.

(Just kidding on that last one).Oh Don! We knew you were just kidding on this one - we all know the bill was passed 220-215, not 219-216.

[Don Corleone]

So, I'm not exactly sure what Democrats were trying to do in terms of limiting health care costs in this bill, as they seemed to go the other way, every time.

One of the biggest reasons health care in America is so expensive is because the decision makers either don't know the true cost (the patients) or have a vested interest in running the cost up (doctors & hospitals). Industry experts (from industry and academia), have hailed high deductible plans with savings accounts as one of the single best and most innovative ways to curb spiraling health care costs..... give the patient a little skin in the game before they sign up for a series of expensive diagnostics even the doctor admits they don't really need.

But the bill passed last night completely guts the health care savings accounts (capping them at $2500 and removing the ability to use them to pay for medication), which will steer people away from high deductible plans and move them back to traditional PPO/HMO plans.

Stranger yet, no lobbying constituency asked for this. This was a bone the Democrats tossed to themselves, unless that was the price the AMA secretly expressed in private for support of the bill (as they benefit from patients moving back to "let somebody else pay" models).

For a group that claims they want to control health care costs, it's hard to see their sincerity based on items like this... :dizzy2:

[Don Corleone]

Other provisions instruct federal officials to “give priority” to construction of Indian health clinics in Minnesota, Nevada and New Mexico; provide scholarships for training veterinarians, among others; and require health plans to pay a fee — perhaps $2 a year for each subscriber — to finance research comparing the effectiveness of different treatments.

I can see the clinics on Indian reservations, probably long overdue (though the procedural purist in me who loathes omnibus bills would argue it should be a seperate bill), the mandated industry-funded effectivity studies I could see other way...

But veterinary scholarships?????:furious3::furious3::furious3: