The U.S. Health Care Debate

[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...

[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:

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:

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 American children had no insurance at all. Not what you would expect from a protected class. Likewise, in 2007 President 43 vetoed 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 American children had no insurance at all. Not what you would expect from a protected class. Likewise, in 2007 President 43 vetoed 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.

[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 American children had no insurance at all. Not what you would expect from a protected class. Likewise, in 2007 President 43 vetoed 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.

[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 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 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 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. 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. 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 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?

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...