Google Obama Health Care and you find almost nothing of substance.
What on earth is Obama's health care plan about? What is he proposing? There doesn't seem to be an existing thread dedicated to this topic (the flag page is related but different), and I'd like to know.
Because I honestly believe that our health care system needs to be improved. Costs are too high, dangerous drugs aren't regulated properly, and the patent laws are being abused.
I'm writing an article on some ideas that I have, and wonder if Obama is thinking the same way (which would be great!)
Posted by fugu13 (Member # 2859) on :
He didn't propose something in particular, he asked Congress to come up with something (edit: that meets certain general principles, which are covered on the whitehouse website in a page that comes up among the first few hits for most search terms I've tried). This has been made explicit. I don't think it was the best choice, but this has been well covered. I've heard it mentioned numerous times on NPR, for instance. The best way for you to find out what's happening with health care reform would be to start paying attention to good news sources.
Posted by Strider (Member # 1807) on :
Like Fugu said, Obama is not involved in drafting health care reform legislation.
Also, like fugu said, you can easily find the principles that Obama wanted included in the bill.
[ August 27, 2009, 10:47 PM: Message edited by: Strider ]
Posted by fugu13 (Member # 2859) on :
That's just the most mainstream house variant, of course. Most notably, there's also a Senate version.
Posted by Strider (Member # 1807) on :
sorry, yes the senate will end up having more than one version right?
Posted by Orincoro (Member # 8854) on :
:sigh:
We DON'T KNOW ANYTHING ABOUT THIS BILL!!! IT'S SOCIALISM! (Yes I'm aware you didn't say that).
I don't read the papers or follow the legislation in any active way, but I'M AFRAID OF SOCIALISM!!! (Again, aware these are not your words).
Read a newspaper, listen to a podcast, read an article (anyone here could find you 10 in 5 minutes even though you didn't find one), watch a youtube video, listen to the Obama radio address, or his televised and podcasted weekly videos, call your local news station and encourage them to do a synopsis, go to the library and ask the librarian to help you find relevant articles, tune into npr, abc, nbc, god forbid fox, msnbc cbs, cnn, sky tv, BBC, BBC World, radio 4, BBC Europe, BBC Mundo, Time Magazine, Scientific American, Forbes, Politico.com, RealClearPolitics.com, Slate.com, Facebook.com, or lean your head out the window and listen to the sound of the breeze rustling through the trees and whispering: "Death Panels... socialism...public option" I bet you'll be able to pick something up.
Now, if you want Ben Stein to sit you down, serve you a coke with ice, take out a dry-erase pen and go through the entire thing with you step by step, I bet that could be arranged.
Posted by Phanto (Member # 5897) on :
Well, orincoro, the official website says nothing.
This is absolute nonsense. I don't see any policies at all one those two pages beyond vague political phrases. That's why I posted here.
And all the things I've seen on TV talk about what this plan isn't. It isn't going to cost money. It isn't going to kill people. Heck, it isn't going to install restroom facilities on Mars.
Great.
Now what is it exactly?
Posted by fugu13 (Member # 2859) on :
You should up your reading comprehension. The White House has not proposed any particular health care bill. It has asked members of Congress to come up with specific proposals to address specific principles. This has been stated to you several times above. If you had actually read what we posted, you would know that if you want specifics on any particular health care bill, you should find it out from people like, oh, the member of Congress who proposed it. Or the text of the bill.
If you want to know something, pay attention when people tell you things that will let you find out.
Posted by scholarette (Member # 11540) on :
Phanto, I can see your frustration. I feel like right now, everything is in flux. A lot more deals will probably be going through and things will change even more. Even a fairly big picture question like is there going to be a public option is not really answerable.
Posted by Boris (Member # 6935) on :
Orincoro, are you capable of not being a sarcastic ass when you reply to someone?
Posted by Blayne Bradley (Member # 8565) on :
it didnt seem sarcastic to me.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by Boris: Orincoro, are you capable of not being a sarcastic ass when you reply to someone?
No more than you seem to be capable of not being an ordinary ass whenever you post anything.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by Phanto: Well, orincoro, the official website says nothing.
Phanto, this has been explained to you. Obama is not writing this bill. Congress is writing this bill. And it isn't finished yet.
Posted by Darth_Mauve (Member # 4709) on :
What is Obamacare about?
Its about making sure that fear of the cost will not deter any American from seeking good health.
Its about not letting the greedy deny life and health to the needy.
Its about freeing up health care options denied by our present system.
Its about the old idea that all men have inalienable rights to Life, Liberty, and the Pursuit of Happiness, and that the first amongst these should not be limited by ones bank account, or the "deal" ones employer created with their insurance company.
Its about getting what we pay for in the health care industry so that the US doesn't pay the most of all industrialized countries to get care ranked far, far, far from the top.
Posted by Phanto (Member # 5897) on :
Thanks for the clarification, fugu. Amazing that there is so much commotion and furor over something so vague and amorphous.
Posted by DarkKnight (Member # 7536) on :
It's about lofty ideas with no details, it's about promising everything to everyone with no added costs, it's about getting re-elected, it's about blame, it's about control, it's about power, it's about ramming a vague bill through that isn't what either side thinks it is and then figuring it all out later.
quote: Its about making sure that fear of the cost will not deter any American from seeking good health.
Its about not letting the greedy deny life and health to the needy.
Its about freeing up health care options denied by our present system.
Its about the old idea that all men have inalienable rights to Life, Liberty, and the Pursuit of Happiness, and that the first amongst these should not be limited by ones bank account, or the "deal" ones employer created with their insurance company.
Your ideas about what it is about leads more towards a vague idea of what universal health care should be. The plans proposed are not supporting the ideals you listed.
quote: Its about getting what we pay for in the health care industry so that the US doesn't pay the most of all industrialized countries to get care ranked far, far, far from the top.
WHO ranked France #1 in 2000 which is the last year they ranked health care. 10,000 heat related deaths in France Posted by FlyingCow (Member # 2150) on :
As tragic as that article is, I find it amazing that french people essentially kennel their elderly relatives for the summer while they go on vacation.
That's such a foreign concept to me.
Posted by fugu13 (Member # 2859) on :
Phanto: almost every major, controversial bill is just as fluid. There are plenty of potential inclusions in the bill to grasp on and talk about. They are in the news all the time (including from news sources that are very good with facts, such as NPR, the Christian Science Monitor, and many others). They are being picked over thoroughly be informed bloggers, who aren't terribly hard to find. If you want to get up to speed on what is in the bill, just like almost every other major, controversial bill that has ever been through Congress, pay attention.
All this thread has shown is that you haven't put much effort into that, but you're acting like the only reasonable system of legislation is one where people spoon feed you what the final form of a complicated bill will be when they don't even know themselves, because legislation doesn't proceed by fiat, but by compromise.
Posted by DarkKnight (Member # 7536) on :
quote: All this thread has shown is that you haven't put much effort into that, but you're acting like the only reasonable system of legislation is one where people spoon feed you what the final form of a complicated bill will be when they don't even know themselves, because legislation doesn't proceed by fiat, but by compromise.
Obama and the leaders of the Democrat party attempted to pass this bill quickly and without compromise.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by DarkKnight: WHO ranked France #1 in 2000 which is the last year they ranked health care. 10,000 heat related deaths in France
Yes, because we all know that a bare statistic with no context (and inviting people coyly to read the article, after you've delivered your chosen punchline is not context, it's manipulation), from six years ago up against an unrelated finding about a totally different topic produced by an international organization is really, quality rhetoric.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by DarkKnight: Obama and the leaders of the Democrat party attempted to pass this bill quickly and without compromise.
I want my elected representatives to carry out their legislation, attempting to do so without compromise. What do you want? A bill introduced with a lot of ellipses, and language like: "you know... if it's cool with republicans... or whatever." No- it's a debate, and you have state your case, not the case that will end up being.
You are treating compromise like cooperation, but they aren't the same thing. People who cooperate are not really on opposite sides, even if they have different opinions, but people who compromise *are*. As such, you can't start out with a compromise, you have to arrive at one. Nobody tries to fight a battle to a draw- you go for what you can get done, and not a bit less.
That said, are you seriously going to suggest that the Republicans were trying to a) cooperate, or b) compromise? Because I'm pretty sure they were trying to win.
Posted by fugu13 (Member # 2859) on :
Without compromise? I see multiple different versions of the bill, and numerous contentious amendments being offered (and some passed). That sure looks like compromise to me. That it isn't compromise you like isn't particularly relevant.
(And I should point out I don't like a lot of the contents of the bill. But try to look like an intelligent person when opposing it, please.)
Posted by Samprimary (Member # 8561) on :
Here you go guys.
In order to help clear up your confusion over a bill which hasn't even been conclusively drafted yet, you may read the plan on a napkin.
quote: Its about making sure that fear of the cost will not deter any American from seeking good health.
Its about not letting the greedy deny life and health to the needy.
Its about freeing up health care options denied by our present system.
Its about the old idea that all men have inalienable rights to Life, Liberty, and the Pursuit of Happiness, and that the first amongst these should not be limited by ones bank account, or the "deal" ones employer created with their insurance company.
Your ideas about what it is about leads more towards a vague idea of what universal health care should be. The plans proposed are not supporting the ideals you listed.
How not so?
The plan will remove the barriers of "Preexisting Condition" and "Not Insured" from everyone. They won't be afraid to go to the doctor because if the doctor finds something serious, they'll be driven to poverty or simply, with no insurance they have to sell the house for proper medical care.
The plan will replace corporate/insurance profit motivated gate-keepers on what is covered with medical experts (according to the language I've read) that will be motivated to allow treatments. If they deny to many the political backlash will see them removed. Now, if the insurance executive denies to many treatments, they get a bonus.
The plan will allow a choice of streamlined private insurance companies, or a public option, where the user--the patient--is the final customer. Hence the patient will be the one who has the final choice, not their employer.
At present we have a system where the insurance companies customer is the company that the patient works for. The patient has no options accept to except what is offered to them or go it alone and pay for it all themselves. This is called Medical Bankruptcy and is the most common form of bankruptcy in the country.
The right to Life, first of those offered in the Declaration of Independence, is best promoted by offering change to our present system.
Yet you do not like the changes offered.
I appreciate that anyone can not like the change offered because it isn't perfect. I appreciate that there are bits and pieces that must be fixed.
Great.
Fix them. Change them. The bills in the House and in the Senate are open to change.
But President Obama did not write the bills in the House or the Senate.
Don't confuse the legislation with what the President is seeking. However, unlike some earlier Presidents, President Obama knows the separation of powers. He understands Legislative, Judicial, and Executive Power should not be congealed into one, so he is waiting for the Legislative to do their job.
The question is, "What is ObamaCare". What is the Universal Health Care that President Obama is after.
My answer stands.
It may not be what we get, but its what Obama Care is.
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by DarkKnight: WHO ranked France #1 in 2000 which is the last year they ranked health care. 10,000 heat related deaths in France
What does that have to do with health care? Hundreds died just in Chicago in a four day heat wave not so long ago.
Posted by Badenov (Member # 12075) on :
quote:Originally posted by Orincoro:
quote:Originally posted by Boris: Orincoro, are you capable of not being a sarcastic ass when you reply to someone?
No more than you seem to be capable of not being an ordinary ass whenever you post anything.
Do you even realize how easy you are to manipulate?
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by kmbboots:
quote:Originally posted by DarkKnight: WHO ranked France #1 in 2000 which is the last year they ranked health care. 10,000 heat related deaths in France
What does that have to do with health care? Hundreds died just in Chicago in a four day heat wave not so long ago.
<edit>According to the article, about half</edit> of the deaths were in nursing homes, staffed by doctors and aides (i.e. employees of the national healthcare system). The nursing homes were short staffed because many of the employees were away on vacation.
I don't find it a particularly compelling argument, but it's not as irrelevant as it seems at first blush.
On the comparison to the '95 heatwave in Chicago that killed 600 people in 5 days: because the population of Chicago is about 1/3 of that of France, the actual rate of death was still significantly higher in France (even when you account for the longer time frame of the European heat wave).
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by kmbboots:
quote:Originally posted by DarkKnight: WHO ranked France #1 in 2000 which is the last year they ranked health care. 10,000 heat related deaths in France
What does that have to do with health care?
It's actually an argument in favor of health care reform, but he doesn't realize it.
"France can end up killing 10,000 elderly people due to systemic neglect in some facilities and their health care system is still better than ours and results in their seniors living longer and happier lives than ours, so, our system sucks just that much.
Posted by Strider (Member # 1807) on :
quote:Originally posted by Phanto: Thanks for the clarification, fugu. Amazing that there is so much commotion and furor over something so vague and amorphous.
That's part of the problem, the commotion isn't being fueled by anything legitimate. It's all scare tactics.
quote:Obama and the leaders of the Democrat party attempted to pass this bill quickly and without compromise.
Darknight, the fact that health care reform isn't going the single payer route is ALREADY a HUGE compromise for many many liberals. That's the big one, there are a myriad of others. I also have to point out the irony of Republicans complaining about a lack of compromise from the Democrats.
Posted by kmbboots (Member # 8576) on :
The population of Chicago* is about 8 million - about 1/8 of that of France. The Eurpean heat wave of 2003 lasted pretty much all summer; the 1195 Chicago heat wave lasted 4 days - maybe a week depending on how you count it. And summers in France are usually considerably milder.
This isn't about a failure of French healthcare so much as it is about a shortage of air conditioning and an indictment of the habit of warehousing the elderly while on vacation.
ETA * metro area. If you just count the city where most of the deaths occured, it is closer to 3 million.
[ August 28, 2009, 01:57 PM: Message edited by: kmbboots ]
Posted by DarkKnight (Member # 7536) on :
quote: Yes, because we all know that a bare statistic with no context (and inviting people coyly to read the article, after you've delivered your chosen punchline is not context, it's manipulation), from six years ago up against an unrelated finding about a totally different topic produced by an international organization is really, quality rhetoric.
Yopur response is totally meaningless and lacking any thought whatsoever. I can certainly help clarify for you the relation between the two articles but honestly the time spent is utterly worthless because you will choose to respond with disdain and contempt and lack any true substance. Reply if you wish but I shall no longer engage with you on this or any other topics not because you are more interested in the flowerly prose of your own response than any true discussion.
Posted by DarkKnight (Member # 7536) on :
quote: It's actually an argument in favor of health care reform, but he doesn't realize it.
"France can end up killing 10,000 elderly people due to systemic neglect in some facilities and their health care system is still better than ours and results in their seniors living longer and happier lives than ours, so, our system sucks just that much.
Or more likely the criteria set up to determine who has the best healthcare in the world is flawed.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by kmbboots: The population of Chicago is about 8 million - about 1/8 of that of France. The Eurpean heat wave of 2003 lasted pretty much all summer; the 1195 Chicago heat wave lasted 4 days. And summers in France are usually considerably milder.
This isn't about a failure of French healthcare so much as it is about a shortage of air conditioning and an indictment of the habit of warehousing the elderly while on vacation.
Population: my bad; I thought the Chicago Metro area had about 24,000,000, when it really only has about 10,000,000.
The Chicago heat wave lasted 5 days according to Wikipedia, and the European heat wave (according to the article) lasted from late July to mid August (i.e. about 20 days). Using the revised population estimates, the Chicago heatwave was more lethal (by about a factor of about 1.5).
As for the lack of air conditioning, again according to the article it seems to have been a calculated risk in which the French nursing homes chose to omit air conditioning in an attempt to prevent the spread of airborne infections.
And I agree, it isn't much of an indictment of the French healthcare system (except inasmuch as they chose not to install sufficient air conditioning in their facilities for emergency situations).
Posted by DarkKnight (Member # 7536) on :
quote: In France, morgues and funeral homes overflowed with bodies, hospitals struggled, and painful questions are being asked about attitudes toward the elderly.
"People have lost their sense of responsibility. They think the government is going to resolve every problem in their life," said Nadia Finkielman, lending moral support to a grieving friend at a Paris morgue where mourning families prepared to bury their dead.
Alerted by a caretaker who noticed her mail piling up, police in the Normandy town of Caen discovered the body of a 73-year-old woman Wednesday who lived alone and apparently died a month ago.
Some critics blamed families for leaving elderly relatives at home while they took August vacations. Health workers blamed understaffing and underfunding at hospitals and retirement homes.
"As a result of having counted the health costs for the French down to the last cent, we're today counting the dead," said Communist Party lawmaker Alain Bocquet.
quote: The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by SenojRetep: And I agree, it isn't much of an indictment of the French healthcare system (except inasmuch as they chose not to install sufficient air conditioning in their facilities for emergency situations).
True. I hesitate to get too smug any more regarding the preparedness of other countries for meteorological emergencies.
ETA: DarkKnight, if you were elderly and died alone, do you think that your insurance carrier would come looking for you?
Posted by Badenov (Member # 12075) on :
quote:Originally posted by Samprimary: Here you go guys.
In order to help clear up your confusion over a bill which hasn't even been conclusively drafted yet, you may read the plan on a napkin.
Thanks for providing that. It was very useful. From what I've read on the bill, it's essentially using bandages to treat a broken arm, if you'll forgive the medical analogy. Both sides of the medical industry are broken. They compete against each other, but they also rely on each other. Fixing one side will do nothing to solve the whole problem and may actually exacerbate the problem.
The current plan, while providing insurance for those who can't afford it, will likely result in increased insurance costs or decreased coverage on the higher end of the coverage spectrum. Insurance companies will have to find some way to offset the increased costs of insuring individuals who have not been taking care of their medical issues either because they can't afford to or because they just don't care about their health. People who refuse to visit doctors even if they can afford to incur some of the greatest un-paid medical costs because they have problems that go un-noticed until they end up in the hospital. Fixing only the insurance side of the equation may result in a *decreased* quality of health care for those who can currently afford good insurance, but just barely.
Fixing just insurance will not fix the problems in the medical industry. In fact, if everyone in the country has insurance, that may actually cause more problems as pharmaceutical companies realize they can charge more for their products because the insurance company will have to pay a larger percentage to meet government requirements.
Health care reform is not an easy problem, and the government is not even trying to solve the problem in its entirety. I honestly have no faith whatsoever in our government being *able* to solve the problem.
Posted by kmbboots (Member # 8576) on :
What would you do to fix the problem?
Posted by Phanto (Member # 5897) on :
Those look like some good suggestions, but they really only address the price of drugs and drug research.
Edited as it could apply to non-prescription drugs as well.
Posted by Samprimary (Member # 8561) on :
quote:Health care reform is not an easy problem, and the government is not even trying to solve the problem in its entirety. I honestly have no faith whatsoever in our government being *able* to solve the problem.
The current plan is an attempt to wedge the nation closer to being forced to accept UHC, so that it takes less time.
The president is absolutely in favor of a single payer system, but he knows that it would be impossible to implement right now.
This is just a tool towards implementing that. A solution buried within others.
Posted by Badenov (Member # 12075) on :
quote:Originally posted by Samprimary:
quote:Health care reform is not an easy problem, and the government is not even trying to solve the problem in its entirety. I honestly have no faith whatsoever in our government being *able* to solve the problem.
The current plan is an attempt to wedge the nation closer to being forced to accept UHC, so that it takes less time.
The president is absolutely in favor of a single payer system, but he knows that it would be impossible to implement right now.
This is just a tool towards implementing that. A solution buried within others.
I have even less faith in the government handling a universal health system. I have to work with the government every day. I've spent the past 2 and a half months waiting for the government to give me an assignment. I've been paid fully to sit in a cubicle and stare at the wall the whole time. If the government starts being a single payer for insurance, it'll take *years* for doctors to actually get paid. And if they run that system like they run the Army's Information Assurance program, people will be over their flu or dead from it before they get seen by a doctor.
Posted by natural_mystic (Member # 11760) on :
quote:Originally posted by Badenov:
quote:Originally posted by Samprimary:
quote:Health care reform is not an easy problem, and the government is not even trying to solve the problem in its entirety. I honestly have no faith whatsoever in our government being *able* to solve the problem.
The current plan is an attempt to wedge the nation closer to being forced to accept UHC, so that it takes less time.
The president is absolutely in favor of a single payer system, but he knows that it would be impossible to implement right now.
This is just a tool towards implementing that. A solution buried within others.
I have even less faith in the government handling a universal health system. I have to work with the government every day. I've spent the past 2 and a half months waiting for the government to give me an assignment. I've been paid fully to sit in a cubicle and stare at the wall the whole time. If the government starts being a single payer for insurance, it'll take *years* for doctors to actually get paid. And if they run that system like they run the Army's Information Assurance program, people will be over their flu or dead from it before they get seen by a doctor.
Has it taken you years to get paid by the government - or have you been "paid fully"?
Posted by kmbboots (Member # 8576) on :
Yes, Badenov, we get that you don't think that government can fix it.
Again, what would you do to fix the problem?
ETA: You have acknowledged that the system is broken.
Posted by Badenov (Member # 12075) on :
quote:Originally posted by natural_mystic: Has it taken you years to get paid by the government - or have you been "paid fully"?
Ask the contractor I work for. Would you like to have your health managed by government contractors? Cause that's how the government will handle it. It'll be a nightmare. The government's handling of contracts is awful, and it results in a *ton* of wasted tax funds.
As for fixing the problem, how about modifying the medical patent laws so they expire a number of years after FDA approval rather than expiring a number of years after patent approval (New medicines spend years under patent before being approved for sale.) so pharmaceutical companies can have some period recouping the investments they receive. And in turn, making it so medicines cannot be re-patented if they contain any of the same chemicals and are meant for the same purpose. Also, stop the practice of post-patent expiration lawsuits.
Develop a system of non-profit medical centers across the country. Grant tax cuts for medical supply and equipment companies that donate a specific percentage of their yearly production to non-profit medical centers and under-privileged individuals. Implement tax penalties for companies that don't. Give tax benefits to doctors who provide care pro bono or require doctors to work in a non-profit center for a certain period of time prior to running their own practice or working for a profit-based medical center.
Implement continued education requirements and yearly professional checks for doctors to improve quality of care and decrease the occurrence of mal-practice.
As it is, doctors are *required* to charge the same amount for all patients (even those without insurance) in order to meet insurance demands. This isn't an unfair policy, as it isn't really fair for an insurance company to have to pay *more* than someone who has no insurance, but the medical industry takes advantage of this by artificially inflating prices to offset losses. We can prevent insurance companies from penalizing doctors and hospitals for charging lower amounts to individuals who meet certain income requirements. Or set up an exemption system that allows doctors and hospitals to charge less for low income families. Or you could increase the amount of money doctors are allowed to write off on taxes for payments not received.
There are about a million ways we could solve the whole problem if we started being a little more creative and started focusing on the smaller problems rather than the entire broken mess. Right now we're just trying to do what Europe and Canada do. Sadly, that's never going to work in this country because those health care systems rely heavily on the robustness of the American health industry in order to maintain the quality that they do, whether good or bad. A good chunk of increased medical costs in the US is due to the health systems of other nations over-regulating the industry in order to prevent their UHC from going down the toilet.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Badenov: I have even less faith in the government handling a universal health system. I have to work with the government every day. I've spent the past 2 and a half months waiting for the government to give me an assignment. I've been paid fully to sit in a cubicle and stare at the wall the whole time. If the government starts being a single payer for insurance, it'll take *years* for doctors to actually get paid. And if they run that system like they run the Army's Information Assurance program, people will be over their flu or dead from it before they get seen by a doctor.
What you're doing at this point is abnormally noncompelling because it is an anecdote that I could use to say that it would be impossible for the government to run the military, the roads, the courts, the schools, the gravity systems, the management of sky traffic, the police, the fire departments, etc.
Even more rebukingly, this anecdote has to fight off the fact that we have the worst healthcare system than all the other modernized countries on earth, precisely because ours is the only one left that is not UHC.
It's anecdote versus boatloads of incriminating, well-researched and exhaustively recorded data that even gets to use entire other similar nations* as case studies.
*all of them, every single one, in fact, provide a pro-UHC case when analyzed. There's no counterexample within our prosperity bracket.
Posted by Badenov (Member # 12075) on :
quote:Originally posted by Samprimary:
quote:Originally posted by Badenov: I have even less faith in the government handling a universal health system. I have to work with the government every day. I've spent the past 2 and a half months waiting for the government to give me an assignment. I've been paid fully to sit in a cubicle and stare at the wall the whole time. If the government starts being a single payer for insurance, it'll take *years* for doctors to actually get paid. And if they run that system like they run the Army's Information Assurance program, people will be over their flu or dead from it before they get seen by a doctor.
What you're doing at this point is abnormally noncompelling because it is an anecdote that I could use to say that it would be impossible for the government to run the military, the roads, the courts, the schools, the gravity systems, the management of sky traffic, the police, the fire departments, etc.
Even more rebukingly, this anecdote has to fight off the fact that we have the worst healthcare system than all the other modernized countries on earth, precisely because ours is the only one left that is not UHC.
It's anecdote versus boatloads of incriminating, well-researched and exhaustively recorded data that even gets to use entire other similar nations* as case studies.
*all of them, every single one, in fact, provide a pro-UHC case when analyzed. There's no counterexample within our prosperity bracket.
The federal government *doesn't* manage the police, the fire departments, the majority of roads in this country, the courts (aside from the appellate), etc. etc. etc. States and cities do, with federal funds and smaller taxes. City roads, fire departments, and police departments are handled primarily with property and sales taxes, with some federal finance. State police and interstate roadways are managed with state sales, income, and business taxes. The Federal government doesn't do a very good job of managing our military. Military leadership is typically inept and incapable of performing much that is required of it. The federal government doesn't do a very good job of managing education.
The Federal government has severely mismanaged the entitlements we already have to worry about. The Social Security system is expected to go bankrupt within the next 2 decades and even if it *were* funded properly, it represents the world's *worst* turn around on investment. The Federal government doesn't do a good job of managing just about anything that it tries to manage. What seriously makes you think it can capably tackle *another* task?
Further, as I have mentioned, every single Universal Healthcare system in the world relies *heavily* on the fact that nearly 50% of all money made by pharmaceutical and medical equipment companies is made in the US. You take the United States out of the picture and the health care of the entire world *collapses*.
Posted by Samprimary (Member # 8561) on :
quote:The federal government *doesn't* manage the Police, the fire departments, the majority of roads in this country, the courts (aside from the appellate), etc. etc. etc. States and cities do, with federal funds and smaller taxes. City roads, fire departments, and police departments are handled primarily with property and sales taxes, with some federal finance. State police and interstate roadways are managed with state sales, income, and business taxes. The Federal government doesn't do a very good job of managing our military. Military leadership is typically inept and incapable of performing much that is required of it. The federal government doesn't do a very good job of managing education.
Okay, so the goalposts are shifting wildly now. First, you're saying "the government couldn't handle a universal health system."
Now it's "Well, that's different, I'm talking about the federal level." Okay, I guess if I were to humor that logic, all you've done is shift the obvious solution to 'have fifty separate UHC systems managed by fifty states.' Surely this more complicated system will apparently work, reincorporating all my counterexamples.
But I won't humor it, because I know that it is wrong.
quote:Further, as I have mentioned, every single Universal Healthcare system in the world relies *heavily* on the fact that nearly 50% of all money made by pharmaceutical and medical equipment companies is made in the US. You take the United States out of the picture and the health care of the entire world *collapses*.
This is a fantastically misguided statement that does not at all possess data that will back it up. The other nations that manage their own universal health care systems will continue to manage their own health infrastructures just fine, and there are some telling errors in your claim, such as the connotation that they rely on profits for the pharmaceutical companies. Given that we're not nationalizing pharmaceutical development in this or any proposal, it's fantastically irrelevant.
But, let's go down this road. You go ahead and cite this claim, show me anything empirical, any methodological data at all that purports to evidence it.
Posted by Badenov (Member # 12075) on :
"Okay, so the goalposts are shifting wildly now. First, you're saying "the government couldn't handle a universal health system."
Now it's "Well, that's different, I'm talking about the federal level." Okay, I guess if I were to humor that logic, all you've done is shift the obvious solution to 'have fifty separate UHC systems managed by fifty states.' Surely this more complicated system will apparently work, reincorporating all my counterexamples.
But I won't humor it, because I know that it is wrong." Oh, I'm sorry. I didn't know you were lumping State and Federal level governments into your interpretation of my experience with the *Federal* government that I have to work with every single day.
No, I was informing you that the "(Federal) Government" doesn't manage everything you stated it does. It manages very little of the infrastructure of the United States. If it did, I can assure you, it would be an even bigger mess than it is.
But as you argue, 50 separate UHCs won't work, because some states manage things better than others. And an attempt at state managed UHC has been attempted in limited capacities in some states and all have failed (Hawaii's bankrupted attempt at providing medical care for all uninsured children in the state comes to mind). A single UHC won't work because the federal government doesn't know what the hell it's doing. Ever.
"This is a fantastically misguided statement that does not at all possess data that will back it up. The other nations that manage their own universal health care systems will continue to manage their own health infrastructures just fine, and there are some telling errors in your claim, such as the connotation that they rely on profits for the pharmaceutical companies. Given that we're not nationalizing pharmaceutical development in this or any proposal, it's fantastically irrelevant.
But, let's go down this road. You go ahead and cite this claim, show me anything empirical, any methodological data at all that purports to evidence it. "
The medical industry requires a few things to work. Medicine, doctors, equipment, and facilities. Medicine and equipment are the most expensive of these things. UHC is able to negotiate extremely low prices for medications simply because pharmaceutical and medical equipment companies jack up the prices in the US to offset the losses that result in dealing with the UHC systems. They are able to break even almost entirely with sales in America. Everything foreign is profit, so they don't *have* to charge as much. And I can provide proof...On monday, when I have time to get links for the information I have found. As it is, my work day is done, and I'm not going to waste my personal time making a brick wall move. I'll do it on Monday, when the government is paying me to sit there and stare at the wall because it spends too much money. As for now, I'm going to go do something that's worth my time.
Posted by natural_mystic (Member # 11760) on :
quote:Originally posted by Badenov:
quote:Originally posted by natural_mystic: [qb]Has it taken you years to get paid by the government - or have you been "paid fully"?
Ask the contractor I work for. Would you like to have your health managed by government contractors? Cause that's how the government will handle it. It'll be a nightmare. The government's handling of contracts is awful, and it results in a *ton* of wasted tax funds.
My comment was specifically addressing the incongruity of your leaping from an anecdote about being paid for no work to the prediction that doctors won't be paid. Extrapolation from anecdotal evidence obviously has its problems, but it at least pretends to be evidence-based.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by Badenov: Do you even realize how easy you are to manipulate?
Posting an insult, waiting for a reply in kind, and then posting under your alt is some kind of deep game of manipulation? To what end? So far as I know, being a dick doesn't exactly qualify you as a master manipulator. It qualifies you as a dick.
Now, if the goal was getting me angry- fail. You don't merit, sorry. I mean, trust me, I wish I could work up a good head of steam about it, but you're such a tool, I like having you as a foil. So by all means, "manipulate."
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by DarkKnight:
quote: Yes, because we all know that a bare statistic with no context (and inviting people coyly to read the article, after you've delivered your chosen punchline is not context, it's manipulation), from six years ago up against an unrelated finding about a totally different topic produced by an international organization is really, quality rhetoric.
Yopur response is totally meaningless and lacking any thought whatsoever.
Isn't it funny the way that happens?
But no, no, take your ball and go home. The big bad people who point out your ridiculous crap are just plain mean bullies.
Posted by Boris (Member # 6935) on :
quote:Originally posted by Orincoro:
quote:Originally posted by Badenov: Do you even realize how easy you are to manipulate?
Posting an insult, waiting for a reply in kind, and then posting under your alt is some kind of deep game of manipulation? To what end? So far as I know, being a dick doesn't exactly qualify you as a master manipulator. It qualifies you as a dick.
Now, if the goal was getting me angry- fail. You don't merit, sorry. I mean, trust me, I wish I could work up a good head of steam about it, but you're such a tool, I like having you as a foil. So by all means, "manipulate."
Actually, I have to post under that name at work because that's the one logged in on my work computer. There's a whole big long story about that one, but I don't want to go into that. No other reason than that. Did you think that was part of the manipulation? That's funny. But anyway, I'm a tool towards you because you can't help being a jerk to people who don't agree with you. It's hilarious. I generally try to treat people with a bit of respect (I'll admit there are times I've gotten pissed off at the attitude and type of conversation on here...in particular the level of mockery handed out to conservatives by people like you)...You, on the other hand, warrant no such respect. Congratulations, we're both tools to each other, but you're a tool to just about everyone.
And thanks Samp, you've convinced me to do some pretty exhaustive research of my own on the effect of UHC around the world on the American health industry. I figure it'll take me about a week to complete while the government is paying me to do nothing. I'll let you know how it turns out.
"My comment was specifically addressing the incongruity of your leaping from an anecdote about being paid for no work to the prediction that doctors won't be paid. Extrapolation from anecdotal evidence obviously has its problems, but it at least pretends to be evidence-based. "
Natural, the government pays the company I work for a blanket amount to complete a contract. I am paid by the contracting company. As a result, my paycheck sees none of the bureaucratic lag that is inherent in dealing with the Federal Government. Doctors, on the other hand, would be forced to deal with paperwork and bureaucracy required with dealing with the US government (And let me assure you, the bureaucracy in the Insurance industry *pales* in comparison to the federal government). Most won't get paid for the work they do. Some will spend half their working lives dealing with the paperwork. Others will give up and pick another profession.
The end result, after having worked directly with the federal government for just 3 months, I am convinced that it is completely incompetent. Relying on incompetence for health care will just make it worse.
All that said, I'll start my research on Monday, Samp.
Posted by Samprimary (Member # 8561) on :
quote:UHC is able to negotiate extremely low prices for medications simply because pharmaceutical and medical equipment companies jack up the prices in the US to offset the losses that result in dealing with the UHC systems. They are able to break even almost entirely with sales in America. Everything foreign is profit, so they don't *have* to charge as much.
You didn't even have to get to the point where you dredge up data. I can already point out that you're wrong.
quote:in the past two years, we have started to see, for the first time, the beginnings of public resistance to rapacious pricing and other dubious practices of the pharmaceutical industry. It is mainly because of this resistance that drug companies are now blanketing us with public relations messages. And the magic words, repeated over and over like an incantation, are research, innovation, and American. Research. Innovation. American. It makes a great story.
But while the rhetoric is stirring, it has very little to do with reality. First, research and development (R&D) is a relatively small part of the budgets of the big drug companies—dwarfed by their vast expenditures on marketing and administration, and smaller even than profits. In fact, year after year, for over two decades, this industry has been far and away the most profitable in the United States. (In 2003, for the first time, the industry lost its first-place position, coming in third, behind "mining, crude oil production," and "commercial banks.") The prices drug companies charge have little relationship to the costs of making the drugs and could be cut dramatically without coming anywhere close to threatening R&D.
Second, the pharmaceutical industry is not especially innovative. As hard as it is to believe, only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on taxpayer-funded research at academic institutions, small biotechnology companies, or the National Institutes of Health (NIH). The great majority of "new" drugs are not new at all but merely variations of older drugs already on the market. These are called "me-too" drugs. The idea is to grab a share of an established, lucrative market by producing something very similar to a top-selling drug. For instance, we now have six statins (Mevacor, Lipitor, Zocor, Pravachol, Lescol, and the newest, Crestor) on the market to lower cholesterol, all variants of the first. As Dr. Sharon Levine, associate executive director of the Kaiser Permanente Medical Group, put it,
If I'm a manufacturer and I can change one molecule and get another twenty years of patent rights, and convince physicians to prescribe and consumers to demand the next form of Prilosec, or weekly Prozac instead of daily Prozac, just as my patent expires, then why would I be spending money on a lot less certain endeavor, which is looking for brand-new drugs?[4]
Third, the industry is hardly a model of American free enterprise. To be sure, it is free to decide which drugs to develop (me-too drugs instead of innovative ones, for instance), and it is free to price them as high as the traffic will bear, but it is utterly dependent on government-granted monopolies—in the form of patents and Food and Drug Administration (FDA)–approved exclusive marketing rights.
quote:And there is nothing peculiarly American about this industry. It is the very essence of a global enterprise. Roughly half of the largest drug companies are based in Europe. (The exact count shifts because of mergers.) In 2002, the top ten were the American companies Pfizer, Merck, Johnson & Johnson, Bristol-Myers Squibb, and Wyeth (formerly American Home Products); the British companies GlaxoSmithKline and AstraZeneca; the Swiss companies Novartis and Roche; and the French company Aventis (which in 2004 merged with another French company, Sanafi Synthelabo, putting it in third place).[5] All are much alike in their operations. All price their drugs much higher here than in other markets.
Novartis, Roche, Avantis, et al, do actually earn sizable profits from their sales to UHC countries in europe/australia/new zealand. These companies are not operating on a loss.
If Sweden is helping American pharmaceutical companies profit, your original assertion is dead in the water. It's a direct contradiction. The only thing you are defending is the blatant abuse of our populace by pharmaceutical companies intent on maintaining a profit margin possible only through the lobbied exploitation and artificial inflation of pharmaceutical prices in the only country that cannot allow its government to negotiate drug prices directly with the industry.
Ok. So, I've got you on this. But let's keep going.
quote:A single UHC won't work because the federal government doesn't know what the hell it's doing. Ever.
When you use absolutes like this, you're setting yourself up for failure. "The federal government doesn't know what the hell it's doing. Ever."
In Badenov land, The U.S. Postal service doesn't have an 83% approval rating and doesn't turn a profit. The National Park Service never works ever. Nor does the U.S. Forest Service. The Centers for Disease Control and Prevention does not work. NASA has never succesfully launched a spacecraft, nor can it be considered the world's pinnacle of space engineering and operations. Why? It's Federal. Federal never works. Badenov said so. The Census Bureau is an utter failure. So is the Food and Drug administration, with its better approval rating than election-eve Obama. And the National Institutes of Health. And how about that Federal Aviation Administration? It totally doesn't work. It doesn't manage higher air traffic than anywhere else in the world with a significantly low accident rate, because it's Federal. And Badenov assures us that anything Federal is a failure. Forsooth.
quote:I'll do it on Monday, when the government is paying me to sit there and stare at the wall because it spends too much money. As for now, I'm going to go do something that's worth my time.
Evidently I'm worth more than your useless career, so I don't feel too bad about your blatant projection. However, as long as you spend your life doing nothing in a useless job, you may have time to learn how to use the quote function.
Posted by Boris (Member # 6935) on :
quote: Evidently I'm worth more than your useless career, so I don't feel too bad about your blatant projection. However, as long as you spend your life doing nothing in a useless job...
Useless career...yeah. My job description is to go to Army bases around the world to ensure that IT departments are taking the proper steps to protect sensitive and secret information from people that would very much like to kill American soldiers by collecting that data. My "useless career" isn't exactly useless. However, I am pissed that the government has thus far spent well over 200,000 dollars directly on my employment over the past 3 months for me to have spent a total of 3 weeks actually *working*. You know why? Because the *Federal* government can't decide where it wants to send me. I've been assigned to three different army bases in the past three months. Each time, they change their minds and decide to send no one, ostensibly waiting for the end of the fiscal year before making a final decision. What this means is that 3 months out of each year, the government will waste a considerable amount of money letting things just sit there until they can get more money, even though they haven't finished spending the money they have. As a result, I have absolutely nothing to do.
As for your examples of good Federal government...Let's see...FDA...how many food and drug recalls have occurred over the past few years? Not exactly a spotless record there. Parks and Recreation...oh yeah. That one's hard to screw up. "Here's a whole bunch of land that people aren't supposed to do stuff to. Don't let them do stuff to it." NASA...half of their missions have been scrubbed, every shuttle launch lately is delayed by weeks and sometimes months because the Federal government refuses to fund it. The International Space station that cost 50 billion dollars, and isn't even *finished* yet, is scheduled to be deorbited within 10 years. We're going to be forced to rent space on Russian shuttles in the next few years because we have nothing to replace the current shuttle program with because the federal government has mismanaged them. The census bureau does it's thing once every 10 years. I expect it to be an utter failure due to the white house's demand for control this go-round, but at any rate, is it really difficult to count people? Air Traffic controller is ranked as the highest stress job in the US right now. Many controllers resort to amphetamines and other stimulants to get them through excessively long shifts of staring at a radar all day. It works only because if it doesn't, people die. The Postal Service, that is going bankrupt. Then there's the fact that each thing you mentioned is only *funded* by the federal government. Not directly controlled by it.
What you seem to be doing is equating approval rating with success. That's a logical fallacy.
And
quote: you may have time to learn how to use the quote function.
That better? By the way, making fun of people is totally a great way to win them over to your way of thinking. Jerks like you and Orincoro are the very reason I refuse to listen to liberals. By the way. What's your source on your quoted information? Not that I don't trust you and your source...Oh wait, I don't.
[ August 29, 2009, 02:40 AM: Message edited by: Boris ]
Posted by Launchywiggin (Member # 9116) on :
quote:Jerks like you and Orincoro are the very reason I refuse to listen to liberals
You refuse to listen to all liberals because a few of them are mean to you?
Posted by Boris (Member # 6935) on :
quote:Originally posted by Launchywiggin:
quote:Jerks like you and Orincoro are the very reason I refuse to listen to liberals
You refuse to listen to all liberals because a few of them are mean to you?
No. More because the majority of them I have ever talked to treat everyone else like they are inferior. Why don't you go ahead and look through these two particular liberals' posts. See how many of them are needlessly snarky and belittling.
Well, that and their ideas are almost universally incapable of working in that little thing we like to call "The real world."
Posted by TL (Member # 8124) on :
Liberalism isn't responsible for whatever's wrong with those two. See two people of any stripe behaving in a way you don't like: Blame the stripe?
Posted by Orincoro (Member # 8854) on :
We're Star Bellied Liberal Sneetches!
quote:Originally posted by Boris: I generally try to treat people with a bit of respect
Ok, let's run with this.
quote: Jerks like you and Orincoro are the very reason I refuse to listen to liberals. By the way. What's your source on your quoted information? Not that I don't trust you and your source...Oh wait, I don't.
Oh no, well that doesn't look so good.
quote: Yeah, see, people who make a habit of trying to piss people off regularly shouldn't ever try the whole tongue in cheek thing.
Also doesn't go with the "bit of respect" theme we've got going. Nor does this:
quote: That made no sense whatsoever. Try again please.
This one was in response to someone suggesting that you hadn't done your homework on a particular topic:
quote: Uhhh, yes I did. Thanks for playing, though.
That was rather snarky, don't you think?
Then of course, there was really nothing that compelled you to post in this thread in the first place, except, as you have freely admitted, you wanted to start an argument with me, and apparently with all foaming liberals and their dastardly reform and such nonsense. The best you've ever been able to muster on the topic is an appeal to authority (which you do often), claiming that your superior knowledge of government work affords you an advantage in understanding the consequences of reform. Just like having lived in Alaska gave you insight into Sarah Palin's inner motivations- these are rather poorly relateable positions because they assume that your portion of the argument can only be appreciated by you, and should therefore be accept by others as a matter of fact, rather than opinion. What's someone going to do? Tell you your job is different than you know it to be? No, so you think you win that point because there's nothing anyone can say back- and you don't realize it's because your point is meaningless to anyone but you.
I mean, seriously dude. I'm rude often, but at least I have the balls to admit it and not just kind of while away the time building up my intense hatred of specific posters*, so I can choose opportune moments to skewer them with my brilliantly subtle manipulative mind games. I just say what I want to say- it's not particularly deep. So please do scramble and find a way to take this and respond in such a way that you can try to make me feel uneasy at the brilliance of your foresight and cunning, as I have now fallen into your carefully laid rhetorical trap, and am ripe for... what?
Maybe a little: "how easy it is to draw you into a blah blah blah" Or, "so simple a matter to get your to show your true blah blah blah," or some other very portentous comment, made seemingly offhand. Please. I'm waiting with bated breath!
*Well, to be fair there is one I dislike more than the others, but it's not hatred, just a sort of morbid fascination.
Posted by Destineer (Member # 821) on :
quote:I'm rude often, but at least I have the balls to admit it and not just kind of while away the time building up my intense hatred of specific posters*, so I can choose opportune moments to skewer them with my brilliantly subtle manipulative mind games.
You're clearly conscious of your rudeness, and therefore of what you can do to make this forum a better place (stop being rude). So why not modify your behavior?
Posted by TomDavidson (Member # 124) on :
quote:I'll admit there are times I've gotten pissed off at the attitude and type of conversation on here...in particular the level of mockery handed out to conservatives by people like you.
There are people like Orincoro on here who aren't Orincoro? Who?
quote: No. More because the majority of them I have ever talked to treat everyone else like they are inferior. ... Well, that and their ideas are almost universally incapable of working in that little thing we like to call "The real world."
Yeah. I don't detect any sense of superiority in your tone at all, despite the idea that only your ideas work in "the real world" -- a real world that you, as a military contractor, obviously experience every day.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by TomDavidson:
quote:I'll admit there are times I've gotten pissed off at the attitude and type of conversation on here...in particular the level of mockery handed out to conservatives by people like you.
There are people like Orincoro on here who aren't Orincoro? Who?
Well of course you've completely discounted The Awesome Possum, as well as my evil mirror universe twin: Orocniro, though he's really the shy sort.
Posted by DDDaysh (Member # 9499) on :
It's amazing how enlightened we all are. I wonder what it would have looked like if we'd all been on a playground at age 10.
Posted by Orincoro (Member # 8854) on :
Children of the corn?
Posted by Lyrhawn (Member # 7039) on :
I generally believe that the government can do things far better than its given credit for, but I by no means think the government is perfect. As a rule, my personal philosophy tends to orbit around the idea that I'd prefer government screw ups to rampant private sector greed.
I know where the idea came from that government is inherently bad and the private sector can do anything better, but I'm amazed that in this day and age it still gets the reverence that it does.
What's the biggest government run and government funded organization not just in America, but on the planet? The US military. Near as I can tell (I'm not really a student of more modern US history yet, admittedly), we've never lost a war for logistical reasons, only political ones, and short of a military junta, there isn't a country on earth that doesn't have to deal with confrontations between the military and politicians. But is anyone going to make the argument that the military is underfunded? Undertrained? etc? Where do most of the cost overruns in the military come from? Generally it's from private sector companies promising one price for a piece of hardware, and then amazingly it ends up costing something dramatically higher. Thankfully Congress is finally getting serious about procurement, but this has been a problem for decades.
Taking a good look at the private sector, what's really there to hold up high over the head of government? A private health care system that is the butt of world wide jokes, denies coverage, discourages wellness in favor of reactionary treatment, that bankrupts millions a year and never seems to be making us, as a nation, healthier or happier. A banking system that damn near sank us into another depression, some would say specifically as a result of government taking a more hands off approach, due to rampant greed and stupidity in the private sector. Our waters are polluted, our trees cut down, vast tracts of land are barren wasteland, the air in places is toxic, all due to the rampant greed of corporations that don't give a crap about the country or the people, just their bottom line.
I'm not going to sit here and defend government as the be all end all, but what the hell is so damned special about the private sector? Near as I can tell, we're in a struggle for our lives against the private sector, and if not for the occasional government interference, a whole lot more of us would be dead now as a result of their apathy towards our general well being.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by Boris: As for your examples of good Federal government...Let's see...FDA...how many food and drug recalls have occurred over the past few years? Not exactly a spotless record there.
"Not exactly a spotless record" for doing the job it's supposed to do? That doesn't even make an inch of sense! The FDA has to recall food when and where the safety of food is compromised due to any issue. Sometimes (especially recently) the FDA's recalls are evidence of its prompt response to ill-managed internal safety protocol of private companies. This is a pro-feds argument, not con.
If you are having trouble finding ways to actually make the feds seem the villain, I have plenty of stories, plenty of well-researched examples of entrenched federal dysfunction that carry far more weight than your poorly researched mostly-anecdotal gripes. You can't just take these anecdotal and fact-poor ideas and apply them wholesale as an argument that the fed is incompetent in everything it does or tries to do, but you're doing exactly that.
quote:It works only because if it doesn't, people die.
Okay, let's say your statement is true. Then federally funded healthcare would ALSO work, because if it doesn't, people die.
You're accidentally throwing out comments which support me!
quote:The Postal Service, that is going bankrupt.
You have no idea what you're talking about! Most of what you're throwing at me is poorly researched and incorrect! For instance, the postal service is actually Self-Sufficient, which is the opposite of what you assert.
You're wrong!
quote:Then there's the fact that each thing you mentioned is only *funded* by the federal government. Not directly controlled by it.
You're dropping another one! A single-payer system, the form of UHC we intend to move towards, is also only funded by the federal government. It is also not directly controlled by it! Healthcare is still directly maintained and controlled by private functions and private ownership!
You're doing my work for me!
quote:By the way, making fun of people is totally a great way to win them over to your way of thinking.
Excellent statement; let's see if we can apply it to you. Perhaps making fun of people IS a great way to win them over. I will assume that you actually operate on that logic, so that's why you opened fire towards me with the insinuation that I was not worth your time, and now you're going to use that as your excuse for saying you refuse to listen to me and/or liberals.
If you start your counterpoints with derogatory assumptions about me, like that I am a "brick wall" and that I am worth less than your job where you sit and do nothing, expect me to treat you like you're not worth treating any more civilly than you do me.
Don't be a huge hypocrit. Don't act insulting towards me, and then whine when I respond in kind. : )
quote:What's your source on your quoted information? Not that I don't trust you and your source...Oh wait, I don't.
If you look carefully there happens to be a method of accessing it directly underneath it. It leads to another bit of commentary which cites its claims as well, leaving you with a wealth of sources.
I am very sorry that you do not trust someone who has so far as of yet been the only side in this debate to source and make corrections to completely factually bogus claims.
By the by, thanks for learning how to quote.
Posted by DarkKnight (Member # 7536) on :
quote: The Postal Service ended its fiscal year $2.8 billion in the red, battered by a faltering economy that cut the amount of mail being sent. Postmaster General John Potter said the agency is making sharp cuts in hours and overtime, but added there are no plans for layoffs. The mail being sent dropped by 9.5 billion items.
quote: We expect the new fiscal year to be another difficult one," Potter said, adding: "We're not panicking here."
By cutting back on spending the post office had a net operating income of $2.7 billion in 2008, but still ended up in the red because of the requirement for a $5.6 billion payment to a health benefit fund for retirees.
Even so, the $2.8 billion loss was well short of last year's $5.1 billion postal deficit.
quote: Potter said the agency plans to ask Congress to restructure the way it handles payments for retiree health care. A 2006 law requires the post office to create a fund to cover retiree health care, contributing several billion dollars annually for 10 years. At the same time the agency is paying about $2 billion annually for retiree health care.
The postmaster general said the agency would like to start funding retiree health care from the new account, which it will continue to build up. But it would like to eliminate the need to pay the extra $2 billion for current costs.
The Post Office isn't funded by a regular yearly influx of taxes but they have received billions and billions in bailouts to meet budget shortfalls. That Self Sufficent link goes to the Letter Carriers union page which is not really an independent source.
Posted by DarkKnight (Member # 7536) on :
quote: ETA: DarkKnight, if you were elderly and died alone, do you think that your insurance carrier would come looking for you?
No, but neither would my doctor. If you were elderly and died alone, do you think the federal government's UHC would come looking for you? Overwhelming odds are it would be a family member, friend, or neighbor noticing your absence or the reek of a decaying body long before any healthcare provider would be at your door.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by DarkKnight: The Post Office isn't funded by a regular yearly influx of taxes but they have received billions and billions in bailouts to meet budget shortfalls. That Self Sufficent link goes to the Letter Carriers union page which is not really an independent source.
In what way do you feel the example of the post office is more relevant to a discussion of health care than health care systems from other countries? The drift of the discussion has been here, for a long time, that health care specifically is an industry that obviously does not benefit in terms of outcomes from private control. No one has argued that of the post, and it's clearly not the case. I would love to know why you feel that indirect anecdotal information is more useful in this discussion than anything else, because it's been a theme.
Posted by Darth_Mauve (Member # 4709) on :
I am confused by the anti-arguments.
1) Having the Public Option will destroy all private insurance because it will be less expensive. Since it is not needing to produce a profit, it will be able to charge less.
2) The Government is too corrupt, confused, and inefficient to be able to run health insurance, so it will cause pain and suffering to all who partake.
How can both 1 and 2 be correct? If the Public Option is so much cheaper and better than the private option that people will come running to it, then it is doing a good job. If it is so bloated and terrible that it injures those its supposed to be supporting, only those who can afford no other option will use it, and jump to the private options as soon as they can afford to.
Boris, not all government agencies are equal. You have had issues with the Military. That does not mean that everyone does, or that every federal agency has similar issues.
I know that the present system is bankrupt. Do you agree that we need to change the present system? If so, how?
Posted by DarkKnight (Member # 7536) on :
quote: In what way do you feel the example of the post office is more relevant to a discussion of health care than health care systems from other countries?
I don't nor have I said anything like that in anyway. I did not bring up the USPS nor did I compare the USPS to UHC. You are confused. I'll try to help you although I am sure you will have your usual snarky response. I have not commented about anything on the US Postal Service as it relates to healthcare in anyway. I was providing additional information to Samp's claim that the USPS was self-sufficent. USPS is too different to be a useful example. I did want to correct the interpertation that the USPS is succesful moneymaking enterprise when it is not. Note how I did not make any references to health care, only to the fiscal solvency of the USPS. You made the inference to prove a point I am not making.
quote: The drift of the discussion has been here, for a long time, that health care specifically is an industry that obviously does not benefit in terms of outcomes from private control. No one has argued that of the post, and it's clearly not the case.
You mean health care specifically is an industry that obviously does not benefit in terms of outcomes from private control because of the way insurers are currently forced to run by regulations from state and federal governments. We do not know how private insurers would run if many restrictions, like being able to compete across state lines equally, were removed.
quote: I would love to know why you feel that indirect anecdotal information is more useful in this discussion than anything else, because it's been a theme.
I'd love to know why you feel that the information is less useful? Well, no, to be truthful I do not care one bit why you feel the information is less useful. You are going to draw conclusions I am not making in order to prove your point.
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by DarkKnight:
quote: ETA: DarkKnight, if you were elderly and died alone, do you think that your insurance carrier would come looking for you?
No, but neither would my doctor. If you were elderly and died alone, do you think the federal government's UHC would come looking for you? Overwhelming odds are it would be a family member, friend, or neighbor noticing your absence or the reek of a decaying body long before any healthcare provider would be at your door.
So what was your point in bringing it up?
Posted by Parkour (Member # 12078) on :
quote:Originally posted by DarkKnight: I was providing additional information to Samp's claim that the USPS was self-sufficent.
quote:Bailout the Postal Service? Your reader must be confusing us with the car companies and the banks. (Letters, Aug. 16, 2009)
The Postal Service isn’t asking for a bailout and Congress isn’t giving us one.
We’re used to making it on our own. Postal Service operations have not received or requested one dime of tax money in 25 years.
Yes, we are facing a $7 billion deficit this fiscal year. However, most of the shortfall is because a 2006 law requires the postal service to pay the Treasury more than $5 billion a year, every year, until 2016. This fund, which won’t begin to be drawn down until 2017, was created to pay future retiree health benefits. While we agree that this is a worthy ambition, it is also an extraordinary requirement. Agencies and corporations compelled to do this are as rare as hen’s teeth.
Yes, the Postal Service is asking Congress to reschedule this obligation. However that’s a reasonable request given the effects of the economy and the Internet on mail volume and revenue.
Like newspapers, the U.S. Mail is being hit from two directions at once: a contracting economy and the migration of hard copy communications to electronic alternatives — two things that are both outside our control.
Joseph Breckenridge U.S. Postal Service Communications Lawrenceville, Ga.
Even the private carriers like fedex are experiencing budget shortfalls. It's because of the retraction of the market. The USPS is responding to it like any private business would: reduction of supply infrastructure to re-calibrate themselves to demand in a new digital age.
So your year-old article does not actually contradict the statement that the USPS is self-sufficient.
Any more questions?
Posted by DarkKnight (Member # 7536) on :
quote: 1) Having the Public Option will destroy all private insurance because it will be less expensive. Since it is not needing to produce a profit, it will be able to charge less.
Depending on how the Public Option is setup and run, it can destroy private insurance. Imagine you are an employer and you must choose to provide health care to all of your employees. If all health plans must provide the same services but one does so at a lesser cost which one would you choose? A Public Option can operate at a loss, a private company cannot.
quote: 2) The Government is too corrupt, confused, and inefficient to be able to run health insurance, so it will cause pain and suffering to all who partake.
Except in the case where your health care insurer is not chosen by you but rather chosen by your employer. If you cannot chose another option because your employer provides you with the Public Option what will you do? In the current proposals, (and now you see how devasting this is) if you do not take your employers health insurance choice then, based on a sliding scale up from a total payroll of $250,000, your employer will pay 8% of the average employees salary to the government to help pay for health care.
quote: Do you agree that we need to change the present system? If so, how?
Allow everyone to deduct their health care premiums like you can do with employer based health care. We should work to end employer based health care the way it works now. Give the employee the money being spent by the employer on health care insurance, allow it to remain tax deductible and expand the deduction to include anyone who has health insurance. Health insurance companies can certainly still work with your employer to provide health care and you can choose them if you wish, but you woud also be allowed to choose any other health insurance provider you wish as well. The decision should be yours, not your employers. To be clear for those of you who just want to jump all over anyone saying anything but UHC! UHC! UHC! This is just one example and would not fix everything that is wrong with health care.
Posted by DarkKnight (Member # 7536) on :
quote: So what was your point in bringing it up?
quote: "People have lost their sense of responsibility. They think the government is going to resolve every problem in their life," said Nadia Finkielman, lending moral support to a grieving friend at a Paris morgue where mourning families prepared to bury their dead.
quote: The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.
Posted by Parkour (Member # 12078) on :
quote:Depending on how the Public Option is setup and run, it can destroy private insurance. Imagine you are an employer and you must choose to provide health care to all of your employees. If all health plans must provide the same services but one does so at a lesser cost which one would you choose? A Public Option can operate at a loss, a private company cannot.
As an aside, I am amused that people's objection over the public option all center around the fact that they're afraid that the government could provide the service for cheaper.
I wish I could be afraid of more services like that.
Posted by DarkKnight (Member # 7536) on :
quote: We’re used to making it on our own. Postal Service operations have not received or requested one dime of tax money in 25 years.
quote:
By law, the Postal Service is authorized to receive two types of appropriations from the federal government as reimbursement for its costs of performing certain services. These are for the public service costs incurred in providing a maximum effective degree of universal mail service and for revenue forgone which is reimbursement for providing free mailings to the blind and to overseas voters. In the early years of the Postal Service, a third type of appropriation, “transitional appropriations,” provided a means for the federal government to fund costs related to its obligations to the former Post Office Department (POD) and thereby shelter ratepayers from such costs. Workers’ compensation costs related to claims that arose prior to July 1, 1971, were the last known POD costs to have been reimbursed. In the Balanced Budget Reform Act of 1997, Congress transferred responsibility for those costs to the Postal Service and rescinded the section of Title 39 United States Code that authorized transitional appropriations to the Postal Service.
The Postal Service remains authorized to request up to $460 million for public service costs. This is the amount authorized by the Postal Reorganization Act of 1970 and is not intended to represent the present cost of providing universal service. The Postal Service has neither requested nor received reimbursement of its public service costs since 1982, which may be viewed as a “savings” of $11.0 billion to the U. S. government and taxpayers. In 1971, the final year of the POD prior to creation of the Postal Service, appropriations totaled almost 25% of total POD revenue.
This year the Postal Service recognized a revenue forgone reimbursement of $99 million to fund free mail for the blind and for mailing overseas voting materials. This accounted for 0.1% of total Postal Service revenue in 2006. Because legislation delayed payment until future years, this amount remains in accounts receivable at the end of the year. Additionally, in 2002 and 2005, the Postal Service received four appropriations from the federal government to help fund costs related to homeland security and emergency preparedness.
They carefully use the word 'operations' to make thier statement true. The USPS has received appropriations.
Posted by scholarette (Member # 11540) on :
quote:Originally posted by DarkKnight:
quote: It's actually an argument in favor of health care reform, but he doesn't realize it.
"France can end up killing 10,000 elderly people due to systemic neglect in some facilities and their health care system is still better than ours and results in their seniors living longer and happier lives than ours, so, our system sucks just that much.
Or more likely the criteria set up to determine who has the best healthcare in the world is flawed.
So, what criteria should be used to determine the best healthcare. The studies I have seen look at life expectancy, outcome after diagnosis with certain problems, infant mortality rates and patient reported satisfaction with treatment. The US ranks low in all of these, though we are very high in cost of care and number of tests performed. And while one might argue that performing more tests is a good indicator of care, there is more and more research indicating that the high number of tests actually on average decreases health. The tests can be invasive and the number of false positives are high, leading to more invasive care which is often not necessary. Invasive, unnecessary treatment leads to a less healthy population.
Posted by DarkKnight (Member # 7536) on :
quote: As an aside, I am amused that people's objection over the public option all center around the fact that they're afraid that the government could provide the service for cheaper.
I wish I could be afraid of more services like that.
The 'cheaper' remarks do not mean the government actually runs things using less money but rather they can use other tax revenue sources, like Social Security, to pay for any over-expenditures in the Public Option. Obama could raise taxes on everyone, or just some people, and direct that money to the Public Option to keep the costs artificially low. Does that make more sense?
Posted by DarkKnight (Member # 7536) on :
quote: So, what criteria should be used to determine the best healthcare.
To make it painfully clear to some...or rather one of you....the quote I am posting is what WHO used to determine the rankings of best health care systems in the world. Scholarette referenced my earlier post so I am clarifying what the WHO's criteria was, and not what criteria I think should be used to determine the best healthcare.
quote: WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs).
quote: The studies I have seen look at life expectancy, outcome after diagnosis with certain problems, infant mortality rates and patient reported satisfaction with treatment.
Can you provide a link, especially with all of the criteria used in the study?
Posted by Parkour (Member # 12078) on :
quote:Originally posted by DarkKnight: The 'cheaper' remarks do not mean the government actually runs things using less money but rather they can use other tax revenue sources, like Social Security, to pay for any over-expenditures in the Public Option. Obama could raise taxes on everyone, or just some people, and direct that money to the Public Option to keep the costs artificially low. Does that make more sense?
No, this isn't what I'm talking about at all. The groups lobbying against the public option are actually afraid that the government could provide cheaper coverage because the government has better buying power and could leverage its own power as a distributor in order to control costs. It is a monopsony effect virtually identical to the power that Wal-Mart wields in leveraging its size as a distributor in order to regulate the costs of its supply.
This is entirely separate from operating at a loss. The insurers' argument against the public option was them saying that this element in itself would be unfair to them because they would be unable to compete against a single provider monopsony the likes of which the government could provide even as a self-sufficient entity.
They additionally posit the "it can operate at a loss" argument to engender further fear and uncertainty against the offer. The issue is the same. They have to stop the government because it makes good business sense to maintain their control over the markets, because capitalism would ensure that they lost market share if a provider came along that was able to provide the same service for cheaper. they have to manipulate the playing field through lobby to ensure that it stays conductive only to their business practices and their profit. the welfare of the people is irrelevant to them beyond that.
Posted by Parkour (Member # 12078) on :
quote:Originally posted by DarkKnight: They carefully use the word 'operations' to make thier statement true. The USPS has received appropriations.
Source please.
Posted by DarkKnight (Member # 7536) on :
quote: Source please.
USPS website Posted by Orincoro (Member # 8854) on :
quote:Originally posted by DarkKnight: They carefully use the word 'operations' to make thier statement true. The USPS has received appropriations.
So? The section you posted clearly explains why the Postal Service would need extra money outside its revenue stream, because it is required to provide services not assigned to private companies. Makes sense to me.
Posted by MrSquicky (Member # 1802) on :
Did you read what those appropriations were for?
Free mail for the blind, overseas voting, and homeland security/emergency preparedness.
Or, to put it another way, the government gave them money for services that the government wanted them to do. That's actually evidence in favor of them being self-sufficient, not the contrary.
Posted by erosomniac (Member # 6834) on :
Squicky beat me to it. Dag, yo!
Posted by scholarette (Member # 11540) on :
I meant to say, the US ranks low in those measures, not that any specific study looked at all of them to rank the US. So, if you look up infant mortality, the US is ranked pretty low (number 33). Of course, the infant mortality rates do have some potential problems, based on differences in classification. Our under 5 mortality rate is also pretty high in comparison to other countries. http://www.prb.org/Datafinder/Topic/Bar.aspx?sort=v&order=d&variable=28
For overall life expectancy, the US is in the 30s. http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy While that is a wiki ref, you can go to the source easily enough (which are like 100 page documents, hence why I linked to wiki instead of source).
Posted by Lyrhawn (Member # 7039) on :
Two things:
1. Comparing the US to France as far as health care systems go, and as far as health care reform goes, is a bit like apples and oranges. No one is suggesting that America become anything like France's system, where the government controls every aspect of the system, employs all the doctors, etc. The most liberal plan, for single payer, still just turns the government into a giant insurance company, but doesn't take over the infrastructure itself. It's comparisons like that, by fear mongering by point out the flaws in systems that we aren't even considering becoming, that ruins honest debate.
2. There was a fascinating article in TIME magazine at the beginning of this month about the US infant mortality rate. Half of all us infant deaths occur in very preterm babies, those born before 32 weeks. Late preterm babies, those born a week or two early, have a 99% survival rate. The mortality rate for babies who aren't preterm is less than 3. Our high numbers seem to be highly linked to preterm births, but no one really knows what causes preemies to be born. The rate of premature births has risen from 9.4% in 1981 to 12.7% in 2007. Given that they are such a higher factor in the mortality rate, a rise in the rate of premature births and a drop in the overall infant mortality rate is rather impressive over the years. Also, preterm babies are born in much higher numbers to black mothers (four times more than white mothers), and strangely, in much higher numbers in the south as compared to the north and west. Scientists are speculating there's a relationship between the health of the mother and preterm births, but there's no conclusive evidence yet. More research needs to be done, but it would seem that until we can crack this mystery, our infant mortality numbers aren't going to do anything dramatic when 2% of all live births cause 50% of our infant mortality figures.
Posted by DarkKnight (Member # 7536) on :
quote: So? The section you posted clearly explains why the Postal Service would need extra money outside its revenue stream, because it is required to provide services not assigned to private companies.
Private companies are not required to provide any services or accomodations to the handicapped? Private companies are not forced to comply with updated codes and regulations? If private companies are required to change their services the government provides all the money necessary to ensure those changes occur? All private companies enjoy the same tax exemptions the USPS does? Delivering mail is outside of their revenue stream?
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by DarkKnight:
quote: So? The section you posted clearly explains why the Postal Service would need extra money outside its revenue stream, because it is required to provide services not assigned to private companies.
Private companies are not required to provide any services or accomodations to the handicapped?
I don't believe so provided such accommodations are either never required, or completely unfeasible. I'm not an expert on that, but if you are, please enlighten us. But anyway, these were not the requirements I was referring to. I was referring to such items as special training to deal with threats of terrorism, handling free government mail, and other duties the post office fulfills as part of its functioning as a governmental organization, which is payed for out of its revenue, but is not related to profitability. Private companies are subject to many of the same things, so I am not sure whether or not the Post is subject to more.
quote: Private companies are not forced to comply with updated codes and regulations?
They are, and again I am not an expert in this field, but I believe the post office is subject to specifically different codes and regulations than private businesses. Again, if you know differently, please share your information.
quote: If private companies are required to change their services the government provides all the money necessary to ensure those changes occur?
No, but those private businesses don't do free work for the government. Since your quote points out that such things as official gov. mailings and ballots are not paid for directly (though they are required of the post office to handle), but carried over on the balance sheets of the Postal Service as owed, and the money is then supplied via an appropriation (though I don't understand why that is), the government is simply paying the post office through the back door to supply "free" service out the front. However, the money has been taken out of their revenue stream and still appears on the books as owed. Again, this is according to your quote as I understand it, and I don't personally comprehend why things are done this way. If you are the expert on this, go ahead and clarify for me.
quote: All private companies enjoy the same tax exemptions the USPS does? Delivering mail is outside of their revenue stream?
Well, yes I believe Fedex and DHL enjoy numerous tax exemptions. Once again, I am far from an expert on this, but isn't the average nominal tax rate for a major US corporation near 0.01%?
I don't really feel the burden should be on me to defend the Postal Service, because you haven't made a very convincing case that it loses money. You've pointed out that it gains appropriations, but you haven't justified your reasoning for concluding that this makes it a money-losing proposition. Again, when I say a "money losing proposition," I mean that I suspect that the Post spends no more money above its revenue stream than would have to be spent by other government organizations, or payed directly to the Post for services rendered, if, for example, the Post was suddenly privatized.
What I'm interested in knowing is this: for providing the public service that the post office provides, does it take in enough revenue to pay the costs of those services and all administrative costs related to that service? Non-related administrative costs that result from specific requirements of the government with the Postal Service as a special case would not be included in this equation I'm talking about, particularly if those requirements decreased the Post's profitability while increasing its costs, and having no effect on the portion of its work that involves the everyday, ordinary flow of postal traffic.
I would tend to expect that if you had such damning information, and if the post was really hemorrhaging money, rather than a more complicated scenario, you would share it with us. I don't have to be a tax attorney or an economist to know that these points you've made are not very good ones, or that they at least beg far more important questions that you are being coy about, because you would seem to rather damn the Postal Service by implication than direct evidence.
And even if, after all those caveats, the postal service *still* loses a little money in the long term? I'm not for privatizing it, and I'm ok with it losing money to do the service it does. The government maintains a monopoly over certain portions of the mail for a very good reason, and I'm not afraid of that. I think the real wallbanger for me is the constant need of some people to imagine how every sector of our economy can maximize profitability, without considering the long term consequences of that kind of movement. It is very difficult to predict what a privately controlled industry is going to do over the long term, and the government does need to insure that a number of its vital functions are continued despite changes in markets and businesses. Privatization reduces to absurdity: we could privatize everything, and then find in 10 years that our most basic services have been downsized. Maximum profitability and efficient money generation do not *necessarily* build to last.
[ September 01, 2009, 09:13 AM: Message edited by: Orincoro ]
Posted by Lyrhawn (Member # 7039) on :
Both FedEx and UPS got a lot of help from the government when they first started offering air service (before they just started buying up small airlines) in the form of loans and surplus planes.
But I think DK, what people are talking about in relation to duties of the USPS are duties over and above what a regular company must comply with. Yes, UPS and the others have to have ramps for handicap access and stuff like that, but they don't have to go through the extra security measures, training and services that the USPS is required to by law, and that's added expense.
Posted by Christine (Member # 8594) on :
For the record, I receive books on tape through the mail that ship with free postage because the materials are for the blind and physically handicapped. (I'm legally blind.) Those books aren't even small -- they come in plastic containers that hold either 4 or 6 cassette tapes. Your tax dollars pay for that -- thanks! Posted by Parkour (Member # 12078) on :
DK, by now it should be very obvious to you that the USPS is something that can fairly be considered self-sufficient.
Can you admit it and move on?
Posted by MrSquicky (Member # 1802) on :
quote:Private companies are not required to provide any services or accomodations to the handicapped?
I'm not sure how we went from "providing free mailing for deaf people" to "any services or accommodations to the handicapped".
The list we had was:
* Provide free mailing to deaf people * Provide free overseas ballot mailing * Unspecified homeland security issues
If the government is forcing private companies to offer free services in accordance with government programs, I'd very much expect the government to be subsidizing those services.
And the government did provide funding and support for private companies to deal with homeland security issues, although obviously we don't really have a complete basis for comparison.
The US Postal Services provides, on the whole, very good service and is self-sufficient. But that may only be because reality has a distinct left-wing bias.
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by MrSquicky: The US Postal Services provides, on the whole, very good service and is self-sufficient. But that may only be because reality has a distinct left-wing bias.
Almost socialist, you could say.
Posted by MrSquicky (Member # 1802) on :
At some point, I think we're going to realize that market capitalism isn't the best model for every undertaking.
I mean, I'd rather have a government involved program that does a mediocre job of providing health care* to what we have now, where insurance companies do a good job of their main goal of denying people medical care. Setting up a system where the people running it have goals that are almost directly opposed to the good of the people using that system never made much sense to me.
Posted by Samprimary (Member # 8561) on :
Okey, it's tuesday afternoon. I guess boris ain't found the evidence what he was mighty sure he would find.
I'm gonna call it.
CLAIM: every single Universal Healthcare system in the world relies *heavily* on the fact that nearly 50% of all money made by pharmaceutical and medical equipment companies is made in the US.
STATUS: busted
CLAIM: You take the United States out of the picture and the health care of the entire world *collapses*.
STATUS: busted
Posted by kmbboots (Member # 8576) on :
quote:Originally posted by MrSquicky: At some point, I think we're going to realize that market capitalism isn't the best model for every undertaking.
Sooner rather than later, please.
Posted by fugu13 (Member # 2859) on :
Except there are markets that objection appears to apply to that function perfectly well without being run by the government, such as car insurance.
Posted by Orincoro (Member # 8854) on :
And car insurance is required by the government... so then there's that.
Posted by MrSquicky (Member # 1802) on :
You think car insurance functions perfectly well?
How many people here are happy with their car insurance?
Posted by MattP (Member # 10495) on :
quote:How many people here are happy with their car insurance?
(raises hand)
The fact that it's mandated and largely comoditized means that insurance companies are forced to compete on price and service. It's not all roses, but it's a way better situation than we have with health insurance.
Posted by TL (Member # 8124) on :
I should think that if it wasn't legally mandated, the competition on price and service would create far cheaper and better options for consumers.
Posted by Orincoro (Member # 8854) on :
What about the prospect of fewer people paying for insurance would increase competition on price? Because in a strict supply and demand model you'd be right, but in an insurance model, the larger pool of consumers drives the cost down. If people weren't required to carry insurance, the pool of insured people would include fewer people, but at a higher risk of making claims, partly because there would be uninsured people driving, but also because higher risk drivers would be more likely to seek insurance, especially older people and younger people. Insurers would also have the option of seeking out and accepting only low risk drivers, pushing the marginal or high risk customers either into no insurance, or higher premiums they are less likely to be able to pay. The existence of these populations of high risk drivers in the insurance system means that the prices for insurance for low risk drivers goes down, but if you eliminated the requirement, insurers would have less competition for high risk customers, and the rates for low risk customers would go up as a result. Smaller pool of customers = finding ways to capitalize on a smaller market.
It's similar to the health insurance problem, The main difference being that low risk driving customers are more likely to have car insurance than low risk medical insurance customers are- the effect of removing one tier of the market is to destabilize it, raising prices and lowering overall coverage.
Posted by fugu13 (Member # 2859) on :
MrSquicky: if you don't like car insurance (or home insurance, or life insurance, or business insurance, or numerous other insurance markets that certainly seem to function quite well), perhaps you'd consider all the "club" memberships out there. The same "counterargument" seems to apply from a naive perspective for every business that derives most of its income from ongoing membership fees.
But strangely, people voluntarily and frequently participate in such businesses. The businesses, and the insurance companies, do have incentives to provide the services they've promised, because they still have the possibility of ongoing income, and the PR damage from displeasing a consumer for a legitimate reason can be huge.
Of course, that doesn't apply to health insurance now, because we don't have anything like a free market in health insurance right now. Instead, the government makes it so job-bundled health insurance is discounted relative to unbundled health insurance (and I bet they thought making health insurance "cheaper" was a good idea), meaning that people don't really have the option to switch health insurance when it doesn't deal with their problems, unless it becomes so bad they're willing to switch jobs as well -- assuming that's even a reasonable option.
I don't think just removing those subsidies of job-bundled health insurance would be enough, though that's a very important step. There are other barriers to health insurance portability that need to be addressed (and could be in a fairly straightforward manner), such as preexisting conditions and group eligibility, but they're very addressable in a way consistent with a free market.
Posted by Tstorm (Member # 1871) on :
quote: You think car insurance functions perfectly well?
How many people here are happy with their car insurance?
I've got no reason to complain about mine...yet. Then again, the last time I needed it was 9, almost 10, years ago.
Posted by scholarette (Member # 11540) on :
I love my car insurance. I think it is government run too- USAA. I know you have to be military or a military brat to get it.
Posted by MattP (Member # 10495) on :
I have USAA as well. It's not run by the government though. It was started by army officers to self-insure themselves because they were considered "high risk" by conventional insurance companies.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by fugu13: MrSquicky: if you don't like car insurance (or home insurance, or life insurance, or business insurance, or numerous other insurance markets that certainly seem to function quite well), perhaps you'd consider all the "club" memberships out there. The same "counterargument" seems to apply from a naive perspective for every business that derives most of its income from ongoing membership fees.
But strangely, people voluntarily and frequently participate in such businesses. The businesses, and the insurance companies, do have incentives to provide the services they've promised, because they still have the possibility of ongoing income, and the PR damage from displeasing a consumer for a legitimate reason can be huge.
Of course, that doesn't apply to health insurance now, because we don't have anything like a free market in health insurance right now. Instead, the government makes it so job-bundled health insurance is discounted relative to unbundled health insurance (and I bet they thought making health insurance "cheaper" was a good idea), meaning that people don't really have the option to switch health insurance when it doesn't deal with their problems, unless it becomes so bad they're willing to switch jobs as well -- assuming that's even a reasonable option.
I don't think just removing those subsidies of job-bundled health insurance would be enough, though that's a very important step. There are other barriers to health insurance portability that need to be addressed (and could be in a fairly straightforward manner), such as preexisting conditions and group eligibility, but they're very addressable in a way consistent with a free market.
What do you think of the Wyden-Bennett Healthy Americans Act? I think it does a better job of solving the portability/security issues you point out than do any of the other House or Senate bills.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by fugu13: MrSquicky: if you don't like car insurance (or home insurance, or life insurance, or business insurance, or numerous other insurance markets that certainly seem to function quite well), perhaps you'd consider all the "club" memberships out there. The same "counterargument" seems to apply from a naive perspective for every business that derives most of its income from ongoing membership fees.
As you subsequently addressed, health insurance is a different animal in terms of both how it has been handled and gummed up by government involvement, as well as how it has been allowed to run itself into the ground through lack of regulation.
A lot of other types of insurance offer a more approximately static model for the insured. Any house can burn, and anyone can have a car accident, with relatively slight statistical variance. But a 60 year old is not twice as likely as a 20 year old to have a heart attack, or get cancer, it's closer to 50 or 100 times as likely (offhand guess)- and health insurance offers an array of statistical variances so wide, we can hardly expect a for-profit business not to seek an advantage by over-insuring the young, and discouraging the elderly from seeking care.
It comes down to some of the simplest of tactics, like allowing providers to send their hospital bills directly to patients in the mail so they will be frightened by the amounts being paid. Lend as much weight as you prefer to this anecdotal perspective, but following my father's last ride in an ambulance after an episode of insulin induced psychosis, the 6,000 dollar medical bill that arrived at our house embarrassed him, and he has subsequently refused ambulances despite having needed them. I don't have access to a stat on that if one exists, but it at least happened once.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by Tstorm:
quote: You think car insurance functions perfectly well?
How many people here are happy with their car insurance?
I've got no reason to complain about mine...yet. Then again, the last time I needed it was 9, almost 10, years ago.
My only quibble was that my premiums were twice those of all my sisters and my parents, despite mine being the only perfect driving record in the family, and me being the only member of the family never to be in any accidents. I got maybe 200 bucks off for good grades in high school, but it was still a marked difference in rates, even after my older sister totaled a car, and I drove for 8 years with nothing more than a parking ticket.
Posted by fugu13 (Member # 2859) on :
quote:as well as how it has been allowed to run itself into the ground through lack of regulation.
Lack of regulation doesn't make a free market. In any business, if companies are given significant advantages unrelated to their ability to provide services, this results in a perverse market.
And, of course, health insurance has constantly been one of the most regulated businesses in existence.
And if you've been paying attention to what I've said here and elsewhere, you'd know there's a fairly simple answer (several, actually, but I'll just list one I currently like) to the "differences in risk" assessment: have the government use simple criteria to divide the population into large groups. Any insurance company that insures more than N members of a group must insure anyone in the group.
(As an aside, your characterization is wrong. Such differences in risk exist in several of the markets listed. Some businesses are hundreds of times more likely to go out of business than others, for instance, and your assessment of the variance in car accident probabilities is incorrect, if one considers the same variables the car insurance industry does).
Senoj: I haven't had time to look through the bill yet, but I'll try to find some.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by fugu13: Senoj: I haven't had time to look through the bill yet, but I'll try to find some.
Even if you only have a chance to look at the wikipedia entry I would be interested in your impressions. Or anyone else's, for that matter. To me it seems a much more rational approach than the bills being pushed by Democratic leadership. Or the Republican-favored bill (Coburn-Ryan Patient's Choice Act, which cribs liberally from Wyden's bill, but strips some of the most important (IMO) sections).
Posted by MattP (Member # 10495) on :
It's definitely better than what we have now but I don't see anything about pre-existing conditions or portability.
I don't like the religious exemption. Mandating coverage is a tax and we don't grant religious exeptions for other taxes. I worry that we'll see a lot of young, healthy people discovering that they have a religious objection to healthcare which will end up making the program cost more for everyone else.*
*EDIT: Unless the opt-out is only for care, not for payment.
[ September 02, 2009, 04:22 PM: Message edited by: MattP ]
Posted by SenojRetep (Member # 8614) on :
Because the Act would shift the tax benefit from an employer to the employee, it would effectively solve the portability problem (with the caveat that because it is administered in state groups, moving from one state to another might result in policy change).
Also, according to Sen. Wyden's summary:
quote:Previous and existing health problems, occupation, genetic information, gender and age could no longer be used to determine eligibility or the price paid for insurance.
I don't have an issue with the religious exemption. I think it's unlikely that many people would use that as a loophole, but perhaps I'm hopelessly naive.
Posted by DarkKnight (Member # 7536) on :
quote: I love my car insurance. I think it is government run too- USAA. I know you have to be military or a military brat to get it.
short commercial....I had to use my USAA insurance recently...and it was first class service. They paid me the full retail price for my SUV quickly, with no change in my rate at all. Another great side benefit is when GEICO or anyone else calls and asks me who my insurance company is, I tell them USAA, and they say Thank You and hang up!!
Posted by scholarette (Member # 11540) on :
DarkKnight, when I first got insurance on turning 18, I figured I would probably go with USA. But I wanted to be responsible and do some price shopping. They often asked me who my current insurer was and when I said USAA, they said, why are you calling us?
Posted by Samprimary (Member # 8561) on :
I guess ex post facto I'll just dump some interesting information in here even though it's no longer contesting anybody :/
quote:BETHESDA, MD – A comprehensive data set of all new chemical entities approved between 1982 and 2003 shows that Europe is pulling further ahead of the United States in pharmaceutical research productivity.
The study, "Global Drug Discovery: Europe Is Ahead," was published in Health Affairs.
While the U.S. share of approved new drugs did increase in between 1993 and 2003, as compared to the previous decade, that simply reflected the fact that the pharmaceutical industry poured more of its research dollars into American labs, said study author Donald Light, a professor of psychiatry at the University of Medicine and Dentistry of New Jersey.
Over both decades, the U.S. share of approved new drugs lagged behind its share of research funding.
On a dollar-for-dollar basis, Europe was more productive than the United States in discovering new drugs, and the European productivity advantage was greater in the period from 1993 to 2003 than it had been in the period from 1982 to 1992.
Japan outstripped both Europe and the United States in pharmaceutical research productivity over those 20 years.
quote:
"Congressional leaders and others concerned about high prices of new patented drugs will be heartened by this analysis, because lower European prices seem to be no deterrent to strong research productivity," Light wrote.
He cites previous research showing that pharmaceutical companies are able to recover research costs and make a "good profit" at European prices, and he rejects the notion that Europeans are "free-riding" on American pharmaceutical research investments.
Apparently, a government research institution can afford to put more money into pure research due to the fact that it is not constrained by the need for short-term profits nor is it competing for cash out of the budget against large-scale advertising.
Posted by twinky (Member # 693) on :
quote:Originally posted by fugu13: Except there are markets that objection appears to apply to that function perfectly well without being run by the government, such as car insurance.
If you don't have car insurance, in theory you can't drive. Car insurance is insurance for something you can choose to do. It's not as though you can be barred from living if you don't have health insurance. The cost of caring for the uninsured in the health care industry exists. The cost of repairing the cars of uninsured drivers only exists insofar as the uninsured drive, and non-car-insured people drive far less commonly than non-heath-insured people live.
Added: That is to say, car insurance may function well in the market of prospective drivers, but that doesn't inherently make it a good model for health insurance.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by twinky: If you don't have car insurance, in theory you can't drive. Car insurance is insurance for something you can choose to do. It's not as though you can be barred from living if you don't have health insurance.
If you don't have car insurance, and you drive, in theory you should pay for any damage you cause. Similarly, if you don't have health insurance and you get sick you should, in theory, pay for your own medical costs.
In practice neither of those things happen because society absorbs the costs, particularly for those who would be financially devastated by facing the consequences of their misfortunes/bad decisions (automotive or health-wise). In the case of health care, both because of the relative size of the costs and because of the relative lack of control over getting sick, it makes sense for a fair society (particularly a wealthy one) to absorb more of those costs.
But I see the difference between the two as one of degree, not one of kind.
<edit>Rereading I see your point more clearly. You can chose not to drive. If you don't drive you will never find yourself in a situation where you are liable for an accident. No matter what, you might find yourself in a situation where you are responsible for a health-care situation. I retract most of what I said.
However, you are still able to exercise some degree of control. Making good health decisions doesn't eliminate the possibility of finding oneself liable for health-care costs, but it makes it much more unlikely. You can't get to zero (like with driving), but you can get closer. I think the tension between holding people responsible for their poor health decisions and recognizing that some illness is unavoidable is a worthwhile discussion to have, and one that has been notably absent from all the dialog I've seen in the current push. One of the reasons I like the Wyden-Bennett bill is because it preserves individual autonomy and responsibility to a much greater degree than do the other Democrat-sponsored bills.</edit>
Posted by Noemon (Member # 1115) on :
Well said, Raja.
Posted by fugu13 (Member # 2859) on :
(edit: addressed to twinky, of course)
I'm not sure where I see an objection in there. All that means is that if someone can't afford health insurance without assistance, we should make sure they can afford it. A subsidy I have repeatedly come out in favor of. Where in what you said is anything that would make a private health insurance market not a reasonable (and even desirable) method of making sure people have access to care?
Posted by fugu13 (Member # 2859) on :
Also, the comment about everyone needing health care applies quite well to numerous other things we don't expect the government to provide directly for everyone. Such as food and shelter.
Posted by The Rabbit (Member # 671) on :
quote:Originally posted by fugu13: Also, the comment about everyone needing health care applies quite well to numerous other things we don't expect the government to provide directly for everyone. Such as food and shelter.
Those are very poor analogies for several reasons.
First off, while everyone needs food and shelter, no one need a 5000 sqft house or $30/lb filet mignon. In developed countries, the fraction of the food and housing market that goes to meet basic human needs is relatively small so the market forces of supply and demand can work reasonably well. The same is can not be said of health care. With very few exceptions, health care is not a luxury and the difference between expensive treatments and inexpensive treatments is not a matter of aesthetics. While many people choose to go without preventative health care, there are long term consequences to those choices that can have severe impact on the persons length and quality of life as well as the over all cost of health care for the community.
Second, as a community (through the government) we do have programs like food stamps, housing vouchers, homeless shelters, food kitchens to make sure that every person has their basic food and housing needs met. We don't expect that the community pay for those who want huge houses or gourmet meals, but we do pay to make sure everyone has access to the basics.
Posted by Parkour (Member # 12078) on :
quote:Originally posted by fugu13: Also, the comment about everyone needing health care applies quite well to numerous other things we don't expect the government to provide directly for everyone. Such as food and shelter.
Not really.
quote:The moral-hazard argument makes sense, however, only if we consume health care in the same way that we consume other consumer goods, and to economists like Nyman this assumption is plainly absurd. We go to the doctor grudgingly, only because we’re sick. “Moral hazard is overblown,” the Princeton economist Uwe Reinhardt says. “You always hear that the demand for health care is unlimited. This is just not true. People who are very well insured, who are very rich, do you see them check into the hospital because it’s free? Do people really like to go to the doctor? Do they check into the hospital instead of playing golf?” For that matter, when you have to pay for your own health care, does your consumption really become more efficient?
heath care is very very different from food and shelter.
read this. Posted by malanthrop (Member # 11992) on :
There has been little substance in any of Obama's promises. He's going to give everyone healthcare, create green jobs for all, save the environment, end the war and bring peace and harmony to the world. He's still in campaign mode. He's had the most prime time conferences of any president in the same period and people are beginning to see through the empty promises. "Change you can believe in"....what does that mean? Anything you want it to. The problem is reality is sinking in accross the country and more and more people are losing "Hope" in his empty promises. We didn't elect an accomplished leader, we elected a community organizer. Community organizers almost always fail to improve their communities but are effective at rallying support for their own economic and political power. One only needs to look to South Side Chicago to see our president's accomplishments as a community organizer.
[ September 03, 2009, 01:59 PM: Message edited by: malanthrop ]
Posted by The White Whale (Member # 6594) on :
Maybe it'll help hone down your general statements a little. I mean, really?
quote:"...create green jobs for all, save the environment, end the war and bring peace and harmony to the world."
No wonder you don't like him so much. You seem to think he's promised to save the world single-handily.
Posted by natural_mystic (Member # 11760) on :
quote:Originally posted by The Rabbit:
quote:Originally posted by fugu13: Also, the comment about everyone needing health care applies quite well to numerous other things we don't expect the government to provide directly for everyone. Such as food and shelter.
Those are very poor analogies for several reasons.
First off, while everyone needs food and shelter, no one need a 5000 sqft house or $30/lb filet mignon. In developed countries, the fraction of the food and housing market that goes to meet basic human needs is relatively small so the market forces of supply and demand can work reasonably well. The same is can not be said of health care. With very few exceptions, health care is not a luxury and the difference between expensive treatments and inexpensive treatments is not a matter of aesthetics. While many people choose to go without preventative health care, there are long term consequences to those choices that can have severe impact on the persons length and quality of life as well as the over all cost of health care for the community.
Second, as a community (through the government) we do have programs like food stamps, housing vouchers, homeless shelters, food kitchens to make sure that every person has their basic food and housing needs met. We don't expect that the community pay for those who want huge houses or gourmet meals, but we do pay to make sure everyone has access to the basics.
I agree with your first point. Your second point doesn't really go against the analogy, and, in any case, fugu has said he is for subsidies- my understanding is that stamps and vouchers are instances of such.
Posted by Lyrhawn (Member # 7039) on :
If he didn't have to go through Congress to achieve those aims, I imagine he would have already done it all by now.
I only blame Obama for part of what I think should have been done by now and hasn't been. I blame another small part on Democrats not being able to get their act together. But mostly I blame obstructionist Republicans who are more concerned with political positioning than with the actual welfare of the nation.
Posted by twinky (Member # 693) on :
quote:Originally posted by fugu13: I'm not sure where I see an objection in there. All that means is that if someone can't afford health insurance without assistance, we should make sure they can afford it. A subsidy I have repeatedly come out in favor of. Where in what you said is anything that would make a private health insurance market not a reasonable (and even desirable) method of making sure people have access to care?
The fact that the market insurance model works for car insurance doesn't imply that it will work in other dissimilar markets. It doesn't imply that it won't work, but that's hardly an argument for doing it.
The best way to evaluate proposed health care reforms is to compare the effects of similar reforms on the health care systems of other countries, not to compare the proposed reforms to unrelated industries.
quote:Originally posted by SenojRetep: However, you are still able to exercise some degree of control. Making good health decisions doesn't eliminate the possibility of finding oneself liable for health-care costs, but it makes it much more unlikely. You can't get to zero (like with driving), but you can get closer. I think the tension between holding people responsible for their poor health decisions and recognizing that some illness is unavoidable is a worthwhile discussion to have, and one that has been notably absent from all the dialog I've seen in the current push. One of the reasons I like the Wyden-Bennett bill is because it preserves individual autonomy and responsibility to a much greater degree than do the other Democrat-sponsored bills.
I think having everyone covered is a precondition for holding that discussion. As it is now, the people least able to make responsible health choices are also the people most likely to be uninsured -- that is, the poor.
Posted by malanthrop (Member # 11992) on :
Maybe it'll help hone down your general statements a little. I mean, really?
quote:"...create green jobs for all, save the environment, end the war and bring peace and harmony to the world."
No wonder you don't like him so much. You seem to think he's promised to save the world single-handily.
Very insightful. I didn't realize he made FIVE HUNDRED promises during his campaign...wow. What I find very insightful are the 40 the site indicates he has kept: No. 15: Create a foreclosure prevention fund for homeowners - He created the "fund" but is it getting to the people? Is this new government program working to stem forclosures? No. 33: Establish a credit card bill of rights -- like this on. No. 36: Expand loan programs for small businesses --- again, created another government program. How are small businesses doing, are they opening or closing up shop? No. 40: Extend and index the 2007 Alternative Minimum Tax patch - "If you reach a certain minimum income level, you have to pay this tax regardless of your deductions and exemptions." In other words, he raised taxes. No. 58: Expand eligibility for State Children's Health Insurance Fund (SCHIP) - yep you can make 80k a year and get govt healthcare for your kids. No. 76: Expand funding to train primary care providers and public health practitioners - ok, student loan program. No. 77: Increase funding to expand community based prevention programs - not suprising a community organizer would throw money at community organizations. I'm sure they're non-partisan like ACORN. No. 88: Sign the UN Convention on the Rights of Persons with Disabilities - ok, I'm sure disabled children in China will be safe now. No. 125: Direct military leaders to end war in Iraq - On "my first day in office, I would give the military a new mission: ending this war" BO - I'm quite sure the objective of any war is to end it by winning. We're still there, good thing he restated the end objective of war is to end the war. No. 134: Send two additional brigades to Afghanistan - Fitting, expand another war. No. 174: Give a speech at a major Islamic forum in the first 100 days of his administration - Did a lot of good. I can sure tell Iran likes us now but you can't blame a guy for trying...speeches are all he knows. No. 222: Grant Americans unrestricted rights to visit family and send money to Cuba - Lets help out our communist comrades to the south. No. 224: Restore funding for the Byrne Justice Assistance Grant (Byrne/JAG) program - Economic stimulus money for crime prevention programs. No. 225: Establish an Energy Partnership for the Americas - Ok, uh we have a free market but I'm sure we're going to convince Venezuala to stop drilling for oil and put up wind turbines. No. 239: Release presidential records - He reduced the timeframe for record releases of OUTGOING presidents. Gives him more ammo to continue blaming Bush. No. 241: Require new hires to sign a form affirming their hiring was not due to political affiliation or contributions. - Uh, ok, unless you're a white house Czar. No. 278: Remove more brush, small trees and vegetation that fuel wildfires - great idea, maybe California will stop burning if the environmentalists don't challenge in court...wait, they already have. Go delta smelt. No. 290: Push for enactment of Matthew Shepard Act, which expands hate crime law to include sexual orientation and other factors - If you commit a crime make sure it's against a white christian male or you'll get the book thrown at you. No. 307: Create a White House Office on Urban Policy - Community organizing the inner city from the white house. No. 327: Support increased funding for the NEA - Funny, the White house was in a conference call with the Non-partisan NEA recently calling on them to create art to push the president's policies. Wow, propoganda at work. Isn't that a tax exempt violation of law? http://www.washingtontimes.com/weblogs/watercooler/2009/aug/27/art-obamas-sake-nea-pushes-white-house-agenda/ No. 332: Add another Space Shuttle flight - One more flight before the shuttle is cancelled. I'm sure this will stimulate the economy. No. 334: Use the private sector to improve spaceflight - Wasteful programs like this should be private sector...the government should only run healthcare, autos, banks and energy. No. 345: Enhance earth mapping - Ok, whatever. No. 346: Appoint an assistant to the president for science and technology policy - Another Czar Holdren.. Great Guy http://www.foxnews.com/politics/2009/07/21/obamas-science-czar-considered-forced-abortions-sterilization-population-growth/ No. 356: Establish special crime programs for the New Orleans area - Throw more money at the epitome of Liberal power failures, maybe Detroit and South Side Chi Town will get some help...Blemish on the record of Democratic power. No. 359: Rebuild schools in New Orleans No. 371: Fund a major expansion of AmeriCorps - Brown Shirts No. 391: Appoint the nation's first Chief Technology Officer - Yeah, an IT Czar...didn't they consider this: http://www.computerworld.com/s/article/9137294/Bill_giving_Obama_power_to_shut_Web_takes_on_new_tone I know, from right wing Computer World magazine. No. 411: Work to overturn Ledbetter vs. Goodyear - I thought we had a separation of powers? The president is working to overturn the Supreme Court? Wow, what a great guy. No. 421: Appoint an American Indian policy adviser - Indian Czar, it's time to community organize the Native Americans. There has to be a few million votes there if we promise them gov't hand outs. No. 427: Ban lobbyist gifts to executive employees - But they can be hired by Obama. No. 452: Weatherize 1 million homes per year - (low income homes). I just replace my windows and upgraded my attic insulation, glad my tax dollars will pay for someone elses home improvements. No. 458: Invest in all types of alternative energy - Green Jobs...solar, wind and bio. No. 459: Enact tax credit for consumers for plug-in hybrid cars - Govt gives $7000 to help people buy cars they otherwise do not want. No. 480: Support high-speed rail - good idea No. 498: Provide grants to encourage energy-efficient building codes - "Give federal money to states that enact building codes the federal govt wants. Will create a competitive grant program to award those states and localities that take the first steps in implementing new building codes that prioritize energy efficiency, and provide a federal match for those states with leading-edge public benefits funds that support energy efficiency retrofits of existing buildings." States rights are undermined by federal dollars. I've seen this before....raise your drinking age and lower your speed limits or you'll lose federal funding for roads. No. 502: Get his daughters a puppy - The world is saved. He spent longer making this decision than any so far. No. 503: Appoint at least one Republican to the cabinet - Kinda reminds me of the statement, token black guy. No. 507: Extend unemployment insurance benefits and temporarily suspend taxes on these benefits - this has run out. No. 513: Reverse restrictions on stem cell research. - OK
Posted by Samprimary (Member # 8561) on :
Before you think of replying with anything to any part of that, remember: you will be replying to Malanthrop, a man who strenuously resists correction or tact to an absurd degree.
Posted by The White Whale (Member # 6594) on :
The way data flows through your brain and becomes opinion is truly amazing.
Posted by Lyrhawn (Member # 7039) on :
That was highly entertaining, malanthrop.
You should take that show on the road. You could open for Lewis Black.
Posted by fugu13 (Member # 2859) on :
Getting back to subjects related to health care . . .
First, the reason I brought those particular other markets up was because of the assertion that a free market does not make much sense for health care for a particular reason -- a reason that applied to all of those markets. Come to think of it, I could also bring up the relatively free market for many kinds of health care that exists in Canada. The mentions of food and shelter were just asides.
However, some of the objections to them were not as substantial as they seem. There are many parts of health care that are more optional than is being suggested: for instance, the availability of personal trainers.
And yes, twinky, it would be good to compare this reform to existing ones. This reform would keep health insurance tied to employers, absent the small possibility a "public option" is included in the bill, that would still be intended to cover a relatively small percentage of people.
In contrast, a requirement that people obtain insurance meeting certain minimal conditions combined with subsidies for poorer people, elimination of pre-existing conditions clauses, elimination of the employer insurance subsidies, and mandatory all-group coverage when covering more than a minimal number of people would far more resemble the single payer systems in several other countries that deliver better results than the US currently does. Additionally, it would be likely to draw upon the efficiencies that we have strong evidence are created in any market with properly allocated rights, information availability, and low transaction costs.
Posted by The Rabbit (Member # 671) on :
Please don't feed the troll. This has been a more or less interesting debate and I'd hate to see that change.
Posted by twinky (Member # 693) on :
To keep things focused, I'm just going to respond to one bit:
quote:Originally posted by fugu13: In contrast, a requirement that people obtain insurance meeting certain minimal conditions combined with subsidies for poorer people, elimination of pre-existing conditions clauses, elimination of the employer insurance subsidies, and mandatory all-group coverage when covering more than a minimal number of people would far more resemble the single payer systems in several other countries that deliver better results than the US currently does.
Has anyone actually objected to this type of reform in this thread?
Added: And when the crap did you pass my postcount? Posted by fugu13 (Member # 2859) on :
Given that it involves private insurance companies doing all the insurance providing, I'm pretty sure all the people objecting to private insurance as a way of providing health care are objecting to that type of reform.
And it appears I passed your post count at least a year or two ago Posted by twinky (Member # 693) on :
I meant to say objected specifically to this proposal, rather than a blanket objection to a bill without a public option or a bill that isn't a wholesale move to single-payer/universal health care.
I certainly agree that your proposal would be far superior to your system as it currently stands, and it seems reasonable that a comparatively incremental approach to reform would have a better chance of success than a wholesale changeover (not that the current bills contain the latter).
I'm not convinced it would stop insurance companies from dumping high risk/high load members; these people would be dumped down (or held at) the minimum coverage level rather than being cut off completely. Depending on the minimum coverage level for catastrophic or chronic care, that might not make a very big dent in health-related bankruptcies unless the proportion of people who are currently dumped due to preexisting conditions (as opposed to some other excuse) makes up the lion's share of the dumping.
Posted by fugu13 (Member # 2859) on :
Your objection can be dealt with in two ways: make the minimum required insurance level include most of the basic care options considered essential, and don't let companies price discriminate within groups. An insurance company can't kick a person down in coverage if they're required to cover the group the person is a part of at the same price for anyone who chooses to purchase.
Posted by The Rabbit (Member # 671) on :
quote:There are many parts of health care that are more optional than is being suggested: for instance, the availability of personal trainers.
I've never even heard of a health insurance plan that covered personal trainers but that is beside the point. Optional is a loaded word. Setting a broken leg is "optional", even if it means being crippled for the rest of your life. Taking antibiotics for sepsis if optional, even if it means you die in a few days. What do you consider "optional medical care"? Are annual physicals "optional"? How about high blood pressure medication? mamograms?, anti-depressants?, well baby check ups?, immunizations? hip replacement surgery? pain killers?
Studies do in fact show that people use less health care if they have to pay for it. The problem is that it isn't luxury items they are going with out like personal trainers and cosmetic surgery. Those items make up only a miniscule fraction of health care costs. When people have to pay more for medical care, they cut back on preventative treatments that would in the long run save money system wide and result in better health outcomes. That is a large part of why the US pays twice as much as other developed countries for health care and yet has worse outcomes.
Consider for example emergency medicine. If someone is having a stroke or a heart attack, getting treatment fast is critical and can make an enormous impact on both the cost of treatment and the success of treatment. The fastest treatment comes if you call the paramedics and an ambulance. That's true even if a friend can drive you to the hospital in under a minute because ambulance patients get treated faster in emergency rooms than walk ins. But an ambulance ride costs thousands of dollars and you can't be certain it will make a difference so most people I know simply would not call 911 or an ambulance unless they had no other options.
Financial considerations do not lead people to make wiser user of medical care over the long run. Every study that has looked at it has found the same thing.
Posted by malanthrop (Member # 11992) on :
"First they ignore you, then they ridicule you, then they fight you, then you win" Ghandi
What stage are we at now in this country?
Posted by MattP (Member # 10495) on :
"But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright brothers. But they also laughed at Bozo the Clown." - Carl Sagan
Posted by malanthrop (Member # 11992) on :
That statement doesn't apply to me directly, it's obvious it applies to conservatives in general at this time, in our country.
Posted by twinky (Member # 693) on :
quote:Originally posted by fugu13: Your objection can be dealt with in two ways: make the minimum required insurance level include most of the basic care options considered essential, and don't let companies price discriminate within groups. An insurance company can't kick a person down in coverage if they're required to cover the group the person is a part of at the same price for anyone who chooses to purchase.
Given the system as it exists in the US now, if I lived there I imagine I'd consider that a satisfactory reform, if coupled with your original proposal.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by The Rabbit: Financial considerations do not lead people to make wiser user of medical care over the long run. Every study that has looked at it has found the same thing.
^
Listen to this.
This is true. People get less-wise care, then they later incur absurd costs within a broken care system.
Posted by DarkKnight (Member # 7536) on :
quote: Has anyone actually objected to this type of reform in this thread?
Several people have stated they want single payer, which is not exactly saying they object to those ideas but single payer does make them irrelevant
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by fugu13: In contrast, a requirement that people obtain insurance meeting certain minimal conditions combined with subsidies for poorer people, elimination of pre-existing conditions clauses, elimination of the employer insurance subsidies, and mandatory all-group coverage when covering more than a minimal number of people would far more resemble the single payer systems in several other countries that deliver better results than the US currently does.
I actually would object to the elimination of the employer subsidies. You'd charge more to the people who were responsible and doing what they should have been all along. I'm all for the rest of it (again, without the conflict of interest of a government plan), but that part I find a bit insulting.
Posted by fugu13 (Member # 2859) on :
The largest problems with our health care system are because of the employer subsidies. Because employer-subsidized health care is so much cheaper, other health care providers than the one available through your employer basically can't compete for your health care.
This means people have to switch jobs if they want to switch health care, and many people have health care plans that do not effectively meet their needs. This means that health insurance companies have very little incentive to meet the needs of insured people, and a lot of incentive to meet the needs of companies (which frequently don't line up).
Not removing subsidized employer health care is the largest factor influencing insurance companies to ignore the wishes of health consumers.
Also, it doesn't charge more to people who have been responsible in the least. If a company isn't paying a large chunk of health care dollars, those dollars go back into the compensation pot (almost certainly as salary).
Subsidies are tempting. They always sound like they're making things cheaper. But not only are they always taking money from someone else in order to make it cheaper for the subsidized person, they can restructure a market in a way that harms everyone, and they frequently do, something seen over and over again.
Posted by DarkKnight (Member # 7536) on :
quote: I actually would object to the elimination of the employer subsidies.
Would you still object if the eliminated employer subsidies went directly into the employees check?
Posted by twinky (Member # 693) on :
quote:Originally posted by DarkKnight:
quote: Has anyone actually objected to this type of reform in this thread?
Several people have stated they want single payer, which is not exactly saying they object to those ideas but single payer does make them irrelevant
Fugu pointed that out, and I clarified above.
What do you think of Fugu's proposal?
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by fugu13: This means people have to switch jobs if they want to switch health care, and many people have health care plans that do not effectively meet their needs.
Maybe this is the bit I don't get. What does any insurance do other than establish a cheap copay for the doctor, lower the cost of your perscriptions, and cover hospital stays? I don't think I've used enough health care or seen enough insurance plans to get why there would be a difference.
As for Dark Knight's suggestion that I'd actually get the money instead, I'm ambivilant. Sure, it's nice to get more money, but if my employer gets a better deal because they're insuring 100+ at a time, I may not get enough to make up the difference in what I get now.
Posted by Orincoro (Member # 8854) on :
quote:Originally posted by AvidReader: I don't think I've used enough health care or seen enough insurance plans to get why there would be a difference.
Suppose you or a member of your family suffered from a malady that was expressly not covered by your insurance, or your insurer refused to pay for procedures you or your doctor felt were important, but you could not afford yourself. It could be something as simple as feeling that you need coverage for psychiatry, but not having it covered.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by Orincoro: Suppose you or a member of your family suffered from a malady that was expressly not covered by your insurance, or your insurer refused to pay for procedures you or your doctor felt were important, but you could not afford yourself. It could be something as simple as feeling that you need coverage for psychiatry, but not having it covered.
I thought they all did that?
Let's face it, if insurers were interested in offering what the patient wanted, they'd offer supplemental packages. I've got accidental death and dismemberment, long term disability, and turned down the optional cancer insurance. If they're not offering it now as an extra, I'm not sure I trust them to come out with better packages because you're buying your own.
And while I trust my employer to pass along at least most of what they pay for my insurance, I wouldn't have trusted my last one. I'm willing to bet if you do away with the employer subsidy, most Americans will never see a penny of it.
It goes back to the greedy CEO/indifferent board problem we've been ignoring for the past couple decades. If we deal with that, maybe we can trust business as a whole to do right by their employees. At the tail end of a recession is not when I'd put my faith in employee bargaining power.
Posted by Orincoro (Member # 8854) on :
I don't disagree, just trying to point out why a system that offers vastly unequal standards of coverage would be inherently problematic. The solution in the states to this problem has been to ignore it. Not a great plan, but it's an American tradition. As Churchill said: "You can always count on Americans to do the right thing - after they've tried everything else."
Posted by AvidReader (Member # 6007) on :
But coverage will always be unequal. Even if we went single payer, there isn't enough money to give every American access to the best treatments. I have no idea what criteria the government would use to decide who gets all their treatments and who just gets some. The one advantage to the current system is we all know better jobs mean better benefits. We can plan around that.
Of course it's not fair. But no system we can devise will ever be fair. People with more money get better stuff because they can always afford to go around the rules if they have to. No plan can change that fact until we find a way to do away with finite resources.
Posted by fugu13 (Member # 2859) on :
AR: a few things. First, if two employers stop offering health insurance, and one rolls the (many thousands of dollars) they were paying for health insurance into wage compensation and the other doesn't, do you think the second one won't suffer significant disadvantages? It isn't like they aren't choosing to pay the health insurance premiums in the first place. If you feel they're so greedy as to not offer in pay what they're paying in health insurance, how on earth do you explain that they're offering health insurance?
The idea that people in bad jobs should be subject to bad health care is abominable. It is not something that can be "planned around". Moving to a system where prices are equalized across large, overlapping groups, people can choose which available health insurance to buy without being cornered into purchasing just one option by price insurance, health insurance companies can offer varied products (such as how they cover prescription medication, hospice care, supplemental programs like smoking cessation, et cetera) that drive competition, and those who cannot afford health insurance due to their income are given assistance would do much to rectify the sorry state of healthcare we have now. Keeping things tied to employers is unlikely to make any significant dent in the current health system, because health insurance providers will continue to have near-monopoly service provision ability, and perverse incentives to please companies instead of provide good health care coverage (since quitting a job is very costly for an employee -- everything up to that limit is profit that can be captured by the company).
Posted by dabbler (Member # 6443) on :
There are a lot of differences between health insurances.
- Copay to see PCP - Copay to see Specialist - Copay to see out of network provider - Requirement or no requirement to see in-network - Copay for emergency room visit - Deductible for hospital stay - Copay for prescriptions - How hard it is to be prescribed certain meds under your insurance (pre-authorization requirements) - Whether Mental Health is treated under a Parity agreement (in which mental illness is reimbused like all other medical illnesses)... this will be federally mandated but I don't think it's taken effect yet. - How well therapy vs med management for Mental Health is covered (copay, number of visits, deductible) - How insurance treats hospitalizations (how quickly do they stop paying, or how cutthroat are they) - Do they cover things like nutrition consult, benefits for gym membership, things like that
That's all I could think of from the top of my head.
Posted by scholarette (Member # 11540) on :
A big difference I have noted is which doctors you can see. Right now, I am having fun picking out a dentist with my new insurance plan. Right now, I am switching doctors because my health care plan changed.
Posted by AvidReader (Member # 6007) on :
quote:Originally posted by fugu13: AR: a few things. First, if two employers stop offering health insurance, and one rolls the (many thousands of dollars) they were paying for health insurance into wage compensation and the other doesn't, do you think the second one won't suffer significant disadvantages?
If people are already having a hard time finding work and no word has come on when we can expect to see new jobs created, no. Not really.
quote: If you feel they're so greedy as to not offer in pay what they're paying in health insurance, how on earth do you explain that they're offering health insurance?
I think not offering it at all under the current system would be hard for most big companies. I think many people who want to work for a large company are interested in the stability, so health insurance is a big draw. I also think the minute a handful manage to do away with it without the employees all leaving for other jobs, the rest will follow suit.
Honestly, if the single payer crowd gives it another decade or two, the idea of employer provided coverage may be downright passe.
quote: The idea that people in bad jobs should be subject to bad health care is abominable.
Well, what it should be and what's possible are two different things here, in my opinion. Again, when we fight for finite resources, the people with more resources people want will always win. Even if your employeer isn't part of things, how much money you make - and can afford to spend - will still determine how good your coverage will be.
The exception would be the single payer system, and again, I have no idea how they would divide things. Do we continue to give better care to rich people since they pay more taxes? Do we give it to the young since they have the most earning potential left? Do people with dependants get first priority? Any way we slice it, it's still unfair to someone. Money seems as good as any standard to set at random.
Posted by fugu13 (Member # 2859) on :
Yes, money is a fairly reasonable standard, once we're above basic care. Tying health insurance to place of employment actively defeats that, making it so health care is determined less by money and more by a person's chosen/available career paths. The system I've proposed would make money a far more potent force in helping people receive health care. The system you're supporting allows insurance companies to capture more of a person's income without giving them proportionally more care, since there's such a barrier to switching to insurance that would fit their needs better.
quote:If people are already having a hard time finding work and no word has come on when we can expect to see new jobs created, no. Not really.
The proposed plans in Congress wouldn't go into full effect for years. We aren't creating a health care plan for the next year or two, we're creating a health care plan for generations.
Posted by AvidReader (Member # 6007) on :
I'm off for an out of town weekend. I'll check back in around Tuesday.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by fugu13: The system I've proposed...
Fugu-
Did you ever look at Wyden's plan? If not, you should. It is nearly point for point what you've proposed here.
Posted by fugu13 (Member # 2859) on :
I've looked it over some. Many of the parts of it make sense. I don't see any reason to institute an employer tax to subsidize health care; that should be dealt with using the current tax system (changing rates as needed), not by adding new taxes.
If I'm reading it right, the minimum level of care for a plan might even be too high, but better to err on that side.
I'm not sure that requiring insurance companies to enroll everyone makes sense. My rough approach is to have the government divide the population into very broad, overlapping groups using simple demographic data. Any insurer who insures more than N people in a group (N would need to be tuned, of course) must be available to everyone in that group. This would result in many large insurance companies required to cover anyone, a few medium insurance companies that aren't yet required to cover anyone, but are required to cover large parts of the population, and a lot of small insurance companies offering specialized things that can pick and choose. I suspect it is in those companies that a lot of innovation would happen, eventually reaching the big companies.
It would also prevent a company trying out a new system from suddenly having to cover a huge number of people overnight.
I would also prefer it if the questions of physician compensation were left more to the market. Government involvement in physician compensation has had pretty severe negative effects in several other countries.
But yes, overall, from overview information, I like the plan.
Posted by SenojRetep (Member # 8614) on :
quote:Originally posted by fugu13: I'm not sure that requiring insurance companies to enroll everyone makes sense. My rough approach is to have the government divide the population into very broad, overlapping groups using simple demographic data. Any insurer who insures more than N people in a group (N would need to be tuned, of course) must be available to everyone in that group. This would result in many large insurance companies required to cover anyone, a few medium insurance companies that aren't yet required to cover anyone, but are required to cover large parts of the population, and a lot of small insurance companies offering specialized things that can pick and choose. I suspect it is in those companies that a lot of innovation would happen, eventually reaching the big companies.
Yeah, when you mentioned that earlier I thought "that's a better idea."
I wonder if the principle would be too difficult to sell in legislation, though. "Cover everyone; no exceptions" is cognitively much simpler. There's complexity not only in tuning "N" but also choosing the right "groups," since demographics can be sliced and diced in so many ways.
Posted by Samprimary (Member # 8561) on :
quote:Originally posted by AvidReader: Honestly, if the single payer crowd gives it another decade or two, the idea of employer provided coverage may be downright passe.
That's my theory, anyway.
Posted by AvidReader (Member # 6007) on :
Yahoo's got an article up on a new healthcare compromise. I hadn't seen this one before, but I admit I've just been skimming the plans. I think my favorite part is this:
quote: Insurers would be required to release their administrative costs included in premiums and profits. That provision is designed to help customers determine whether they are getting a fair deal at a good price.
This I love. It provides really important information to consumers without getting terribly intrusive into the business. It's like when my charity I donate to sends me the anual pie chart of where the money goes.
Honestly, that's what I'd love to see most of all. If the insurance companies really think their prices are fair, why not break down their costs for us? And if they don't want us to know where the money's going, it probably is time to get a non-profit doing the same job.
I really hope something along those lines ends up in the final bill.
Posted by DarkKnight (Member # 7536) on :
I don't understand why the press keeps saying time is running out for healthcare reform. So if we don't pass something this instant we have lost our last, best hope? If nothing passes, it can't be brought up again?
Posted by Darth_Mauve (Member # 4709) on :
DK, right now we have it on the top of our todo list, with a congress and a president both interested in making a big change.
But if it gets defeated, and the Dems lose ground in the Senate after the next election, there won't be the same drive to get it done.
And those suffering under the system as is, will continue to suffer. (I don't mean just the uninsured, but he small businesses that have to turn over more and more of their profits to keep their employees insured, the doctors who fight as hard as the patients to get paid and coverage, etc.)
It will have gone down twice in 20 years to viscous defeat.
It won't be resurrected again until some major disaster leaves people dead due to bad health care.
Posted by TomDavidson (Member # 124) on :
I love the idea of "viscous defeat." It's actually a fortuitous typo.
Posted by The Rabbit (Member # 671) on :
quote:Originally posted by TomDavidson: I love the idea of "viscous defeat." It's actually a fortuitous typo.
In 9 AD (2000 years ago) in a battle the lasted from Sept. 9 through Sept. 11, the Roman General Varus and three Roman legions were defeated by Germanic tribes lead by Hermann (also known as Arminius). Archeological evidence recently discovered near Osnabruck Germany, suggests that the Germanic tribes maneuvered the Roman legions into a swamp where they were forced by the mud and quick sand to break ranks. I think "viscous defeat" describes it very well. (and its timely to boot).
Posted by Darth_Mauve (Member # 4709) on :
I just get this sinking feeling that I'm stuck in my own typos.
Posted by Orincoro (Member # 8854) on :
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