The U.S. Health Care Debate

[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.

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

[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 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
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.

[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.

[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.

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.

[Lemur]

As per usual, The Onion 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. That's awesome.

[ICantSpellDawg]

As per usual, The Onion 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

[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.

[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.

[Lemur]

Apparently Tort reform 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.

[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.