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Author Topic: The Case for Universal Health Care
The Pixiest
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No, the point of insurance is to spread risk. When they take on John as a customer while he's healthy, they charge him based on the odds of him getting sick.

It's a bet. They look at the books and see, spread over a large enough population, what they need to charge to make a profit. People who stay healthy till they suddenly drop dead from a heart attack = winning bet. People who die slowly from cancer/AIDS/Alzheimer's = Losing bet.

But like Vegas, they play the odds and make a profit.

To jack up the rates once someone becomes sick is like not paying on the bet.

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Badenov
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One of the things I've noticed about proponents of UHC is that they seem to be willing to accept any solution as long as it, in theory, provides medical care to everyone. And that's great. I'm for that. Here's the question that they are ignoring. Is the American Government *capable* of effectively and efficiently managing a healthcare system that provides care for everyone *and* drops healthcare costs? I have seen no evidence that suggests it is capable of doing this. I have only seen evidence that efficiency will drop and costs will, as a result, increase.

As an employee of a government contractor, I have to work very closely with the government. My paycheck is paid by the US government as directly as it can be without me being and actual government employee. I have spent the last 3 months waiting for the government to make decisions on my next work assignment. During that time I have had absolutely no work to do. So the government has paid the company I work for a considerable amount (I imagine it's close to 30000, though I am not certain. I receive roughly half of that).

In my dealings with government employees, I see evidence of constant in-fighting on the minutia of bureaucratic process. I have yet to find two government employees that agree on how the documentation for the work that we are contracted for is to be written. Because of that, all documentation is rejected the first time because it doesn't meet one person's unpublished criteria. Once it's rejected, it has to be rewritten to comply, and is sometimes handed to a different person who might reject it because their criteria is different from the other person's. Everything about how the government works is inefficient and requires far more people than it should. I have no doubt that the government *could* function on less than half the money it receives. Unfortunately, it's more than willing to spend every cent it's able to get and more.

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Christine
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Badenov: My husband works for an insurance company. If you want to trade horror stories about inefficiencies, we could, but let's just put it this way: The corporate world isn't any better at this than the government. It may seem like they should be due to profit motive but unfortunately, laziness takes over and they'd rather just jack up the rates rather than take simple steps to run their operation more smoothly.

I don't know that health care costs will go down with a UHC plan, but I doubt seriously that they would go up.

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FlyingCow
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quote:
It's a bet. They look at the books and see, spread over a large enough population, what they need to charge to make a profit. People who stay healthy till they suddenly drop dead from a heart attack = winning bet. People who die slowly from cancer/AIDS/Alzheimer's = Losing bet.
Ah, I see the misunderstanding.

They don't do this.

If they did this, the coverage for healthy individuals would be far more expensive, because they'd be spreading the risk over everyone. But they don't... they want to keep the healthy people insured, and want to avoid insuring people that will cost them money.

Why would they want to insure unhealthy people? It doesn't make any business sense. The ideal customer is someone who stays healthy, gets one checkup per year, has no prescription medications, a perfect family history, maintains a healthy diet/exercise regimen, etc.... that person is pure profit. They want to insure a lot of those people.

The sick people who cost thousands and thousands of dollars per year... they are not profitable. They want to avoid those people.

In fact, they can even go out of their way to overcharge and "purge" businesses that employ these people.

Now, I don't know if a government option is the answer, or if UHC is the answer, or what. I know the current system is badly broken and needs to be fixed.

I suppose some way of forcibly regulating prices and increases, preventing insurance companies from "pricing out" sick patients, and raising the rates for everyone to account for the increased cost might have some impact.

But that level of government regulation would be akin to a government take-over of the private insurance industry anyway, so I don't know how much more palatable it would be than a government option.

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kmbboots
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quote:
Originally posted by The Pixiest:
And how long before UHC becomes unsustainable just like medicare and medicaid?

If rationing is inevitable, and it sure seems like it is, shouldn't the people who are able to buy their insurance be the ones to benefit from their money?

Yes, it's awful to die untreated because you can't afford it... but imagine how awful it will be to die under treated when you COULD have paid for treatment, but under UHC it went to someone else.

How fair is that?

Pix, not so long ago I would have agreed with you. The unfairness of such a thing would have made me livid. The I came to realize that "fair" is overrated. Life itself is not fair. It is not fair that I was born to parents who did a good job raising me and that some are born to parents who don't or can't - any more than it is fair that some people will never have to work for a living and that some people will never be able to. It isn't fair that cancer strikes some people and not others. Nor is it fair that some people can eat anything and not gain an ounce and that some have nothing to eat. Or that I can sing but not do calculus. You get the idea.

It isn't fair that some people get billions of dollars in exchange for "managing" a company into bankruptcy while others work their whole life at low wage jobs to have it all wiped out because of illness.

None of it is fair. It's a lottery. We aren't going to be able to make it fair. The best we can do, I believe, is to make it the kind of world we would want it to be if we had no idea who we were going to be.

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Darth_Mauve
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At first I was going to say that if Insurance Companies are going to work, and you don't trust the government to work, who do we trust?

Then the third idea did strike me...let the market truly take over.

The problem is that companies buy the vast majority of insurance that we use. As such there is no ultimate consumer that the insurance company must please.

The doctors and providers are the ones that deal with the patients.

The complainers are the patients, rarely the people in human resources at the company that buys the insurance.

Right now a $10 toy given away to the purchasing/human resource people, and a lot of sincere looking people, is all it needs to counterbalance the grief that an employee gives them when the insurance company turns down a $20,000 medical bill.

So lets make it simple. As of 6/1/2010 it will be illegal for any company, corporation, or employer to offer medical insurance to their employees.

The employees, millions of them across the country, will become the clients of the insurance companies. The insurance companies will have to find ways to sell their products to the people that they will then service.

Retail solution to a wholesale problem.

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The Pixiest
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Mauve: that's the way it should be anyway.

Then we could choose our insurance based on what we want rather than absurd package deals.

For instance, I'd take catastrophic care with a large deductible that never pays for any sort of "alternative medicine."

I can buy my regular medication. I can pay for my doctor visits. It's Cancer or Alzheimer's I'm worried about. Not broken bones and colds.

And I'm for damn sure not going to use Homeopathic, or eastern or herbal medicines to try to fix what ales me and it annoys me I'm helping pay for those who do.

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The Pixiest
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Cow: I know they're doing that. And it's fraud. and it should be fixed. But we don't need UHC to fix it.

Boots: We can't make it fair but we should strive to make it fair. While giving voluntarily of one's own wealth to help another might be good, stealing from someone to help another is neither fair nor good.

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kmbboots
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But, Pix, that our "own wealth" is ours has, for the most part, very little to do with "fair".
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The Pixiest
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boots, dear, we work for it, we save it, we don't frivolously blow it, we don't spend it on meth, alcohol or other drugs, we don't commit crimes and go to prison, we plan for the future, we skip fun things that are too expensive...

Our wealth is ours because we're responsible. To take it away for those who do not do all those things is downright evil. Further it rewards laziness, drug use, crime and frivolous wastes of money. Simply because there's no reason to work hard and be frugal.

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TomDavidson
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quote:
Our wealth is ours because we're responsible.
And yet many people are wealthy who are not so responsible, and many people are responsible who are not wealthy. I don't think you're going to be able to prove a strong correlation there.
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Katarain
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I have heard that argument before, to put it crudely, that the lazy good-for-nothings don't deserve health care because they haven't earned it. They should get a job and pay for it themselves. My problem with that argument is it does not cover every reason why someone might not be able to pay for health care.

Let's say that the concept is a legitimate one, that lazy good-for-nothings don't deserve health care. I'm willing to let them benefit from the system so that the rest of the people who can't afford it but do deserve it can have it.

(But then, I don't think anyone should have to pass any sort of test to prove worthiness for health care--monetarily or otherwise.)

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The Pixiest
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Tom: True, there are those who did not work for their wealth or scammed for their wealth. Those type of people make headlines but they're not really the norm.

And there are those who came to responsibility late in life. Didn't pay attention in school or didn't realize that you have to major in something that makes money... they ended up poor.

And there are those with the pseudo-wealth of credit cards. They aren't wealthy no matter what kind of car they drive. They're in debt.

But the hard working middle class and upper classes who are there because they scrimped and saved and worked for it should not be looted to pay for those unwilling to do the work.

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kmbboots
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Ah, Pix, have you never known poor people who do the best they can?

Sure, all those things you mention play a part in wealth, but such a small part compared to sheer dumb luck and opportunity.

An example, my brother-in-law and sister have done everything right. Worked hard, saved, bought a modest home in poor condition and basically rebuilt it. After 20plus years of being a stellar employee, he has lost his job because - through no fault of his - the company has downsized and kept the cheaper employees. My sister, despite her lupus, works three jobs. My BIL does handyman work for neighbors.

Of course, they have lost their insurance. My sister can't get her medications any more. My brilliant straight-A student niece has had to drop out of college. They are teetering on the edge of losing their home.

No meth, crime or frivolity involved.

Now the grandson of the guy who started the company that downsized my BIL, despite having never worked for the company - or anyone(and being plenty frivolous) - is set for life.

And that is a fairly mild example of what is going on all over.

It isn't fair that vets who come home so broken that they can't work or people with genetic mental illness end up living on the subway. How is it their fault?

We, in this country, tend to think of wealth as an indicator of virtue. It really isn't.

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The Pixiest
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I've been laid off twice myself... I've even had my meager savings wiped out by sickness (I didn't default on what I owed either, I put it on my credit cards and suffered.) I've been so poor I fretted so much about the price of a big mac I couldn't enjoy it.

And when I got out of school, we were in the middle of a recession and I couldn't find a job for 10 months. When I did, it paid less than I was making while working through school.

I can't address the case of your BIL. I don't know what other circumstances exist there and I can't speculate without being potentially insulting. (and you're the last person here I'd want to insult.)

As for veterans, we owe them our thanks, our support and free medical care for life. They put their lives on the line for us.

btw, people who don't deserve/understand their wealth tend to blow it. For example, lottery winners tend to go through their winnings and end up back at work in something like 5 years. (I know.. citation needed and I don't have one.) Unless that gentleman's grandson has an accountant with the power to reign in his spending, don't be surprised if "set for life" ends with him living in a ditch.

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Mucus
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Or to put it in more statistical terms, the US isn't actually all that socially mobile. Your parents have a very heavy influence on your earning potential.

For example:
quote:
The truth is that the US sits with the UK at the bottom of the international league table of social mobility.

Family background has as strong an influence on socio-economic opportunity in the classless United States as it does in the supposedly hidebound class-ridden UK.

http://news.bbc.co.uk/2/hi/americas/8162616.stm

With the more concrete results here:
quote:
Countries differ in the extent
to which family economic
status is related to labour
market success of
children in adulthood
More than 40% of a father’s
earnings advantage is
passed on to sons in
France, the US, Italy and
UK, less than 20% in
Canada, Finland, Norway
and Denmark

http://www.irpp.org/events/archive/20081128/corak.pdf
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kmbboots
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I'm not insulted (not would I be, I would just answer your questions).

And I don't think that you are "bad" for thinking that way. As I said, I used to as well. It just isn't the sort of thing that you get till you get it.

I just know that it is a "there but for the grace of God (or fate or whatever) kind of world.

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FlyingCow
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quote:
Cow: I know they're doing that. And it's fraud. and it should be fixed. But we don't need UHC to fix it.
Well, first off, the current bill on the table is not the same as Universal Health Care. It is creating a parallel government-run option alongside existing insurance companies - much like the tax-subsidized US postal service exists in a world with FedEx and UPS.

BUT, more to your point, I think, is that you feel the government shouldn't be in the health care business. That's fair.

Though I think the regulatory changes that would be needed to "fix" the current system and wrangle the existing insurance companies would be such top-down pressure that it would be as though the government was in charge of all the insurance companies.

You would need to force the insurance companies to do things like taking customers they don't want to insure, raising costs on healthy customers evenly, forcing a tiered payment structure among all companies to enforce fairness, etc.

I don't know if all of those things are even constitutional.

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scifibum
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quote:
The best we can do, I believe, is to make it the kind of world we would want it to be if we had no idea who we were going to be.
I just want to remark that this is a beautifully expressed idea.
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kmbboots
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Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).
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Blayne Bradley
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The Canadian Government Provincial and Federal does a fairly good job at it.

Lots of people should see Sicko, it exaggerates the awesomeness of Canadian UHC a bit (hard to do as afterall we are awesome) but I find it its his best movie and makes up for him being something of an ass in Farenheit.

But the point is that American HC is terrible terrible evil that focuses on profit not on care and that while in the US UHC won't probably be as good as Canadian or European HC its better then whats there now.

Businesses abuse the people, lets trust bust them.

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Vadon
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quote:
Originally posted by kmbboots:
Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).

Pretty sure you're thinking of John Rawls. [Smile]
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Orincoro
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quote:
Originally posted by The Pixiest:
Orincoro: Then there's no sense in us debating. You'll take UHC no matter how bad it is.

"I'll give you the final word... ... you're an idiot"
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kmbboots
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quote:
Originally posted by Vadon:
quote:
Originally posted by kmbboots:
Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).

Pretty sure you're thinking of John Rawls. [Smile]
That isn't where I heard it, but yes, it certainly fits.
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Orincoro
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quote:
Originally posted by The Pixiest:

But the hard working middle class and upper classes who are there because they scrimped and saved and worked for it should not be looted to pay for those unwilling to do the work.

(Edit: I'll amend the personal attack)

To put it mildly, that disgusts me. That's a hatefully arrogant thing to say. I really hadn't seen any indication of this kind of petty selfishness and misanthropy from you before this issue came up. Now it's written all over everything you write.

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kmbboots
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Orinoco, that was wrong, hurtful, unnecessary and not useful.
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Orincoro
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Probably you're right.
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Blayne Bradley
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quote:
Originally posted by Orincoro:
quote:
Originally posted by The Pixiest:

But the hard working middle class and upper classes who are there because they scrimped and saved and worked for it should not be looted to pay for those unwilling to do the work.

To put it mildly, you disgust me. When and how did you become such a hatefully arrogant person? Because I really hadn't seen any indication of this kind of petty selfishness and misanthropy from you before this issue came up. Now it's written all over everything you say.
I think it would be more useful to the debate to point out WHY Ayn Rand is NOT to be taken seriously and focus on the discussion as to why it is ethical for those with more to care for the those with less. Could be wrong but I think Utilitarianism I think may provide some of the better thoughtout arguments.
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ClaudiaTherese
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quote:
Originally posted by kmbboots:
Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).

[Smile] A favorite of mine, too. [Even if we know it's not J Rawls!]:

quote:
As a thought experiment, the original position is a hypothetical designed to accurately reflect what principles of justice would be manifest in a society premised on free and fair cooperation between citizens, including respect for liberty, and an interest in reciprocity.

In the state of nature, it might be argued that certain persons (the strong and talented) would be able to coerce others (the weak and disabled) by virtue of the fact that the stronger and more talented would fare better in the state of nature. This coercion is sometimes thought to invalidate any contractual arrangement occurring in the state of nature. In the original position, however, representatives of citizens are placed behind a "veil of ignorance", depriving the representatives of information about the individuating characteristics of the citizens they represent. Thus, the representative parties would be unaware of the talents and abilities, ethnicity and gender, religion or belief system of the citizens they represent. As a result, they lack the information with which to threaten their fellows and thus invalidate the social contract they are attempting to agree to.




[ August 13, 2009, 07:01 PM: Message edited by: ClaudiaTherese ]

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katharina
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It may not be in the bill, but the President himself has raised the possibility of a panel deciding what will and won't be given.

quote:
Folks who really want to stick it to Obama and sow hysteria about "death panels" will extract this from Obama's same fateful interview with David Leonhardt of the Times (my emphasis):

THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

DAVID LEONHARDT: So how do you — how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.


So Obama "suspects" that the legislative process will produce some sort of independent group that can give non-determinative "guidance" on end-of-life care for the chronically ill, with an eye towards saving money. Just don't call them death panels!

http://justoneminute.typepad.com/main/2009/08/there-he-goes-again.html/
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Orincoro
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quote:
It’s not determinative
And there you have it. An independent group set up find ways of saving money. Brilliant. It's 1984! It's 1984! There are independent groups! It's not determinative! A single line in an interview that is not concerning actual litigation is more telling than everything discussed within that litigation or by the countless legislators and officials who mght preside over that system, NOT TO MENTION THE VOTERS! FUR RLZZ> OH NOOZZZ WE HAZ TEH DEPTH PANULLZZZZ!!!

(edit: I'm Srsly)

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ClaudiaTherese
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Oops, just saw Rawls was already suggested and declined.

Was on a dying computer and missed it -- ah well. Still, good to jog my memory. I like Rawls.

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scifibum
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do you mean "legislation" there where you wrote "litigation", Orincoro?

I think Obama was only stating the obvious: when you have a limited pool of resources, something/somebody will have to decide where to allocate them. So what? Would it be better if he publicly fantasized that everyone will get the equivalent of millions of dollars worth of care for as long as they care to continue receiving it?

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Vadon
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quote:
Originally posted by ClaudiaTherese:
Oops, just saw Rawls was already suggested and declined.

Was on a dying computer and missed it -- ah well. Still, good to jog my memory. I like Rawls.

I like him too. [Wink]

The only time I've heard him referenced in a nonacademic medium was the West Wing when Will Bailey was trying to justify the tax increase on the wealthy to his interns. Perhaps that's where you've heard it?

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Orincoro
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quote:
Originally posted by scifibum:
do you mean "legislation" there where you wrote "litigation", Orincoro?

I think Obama was only stating the obvious: when you have a limited pool of resources, something/somebody will have to decide where to allocate them. So what? Would it be better if he publicly fantasized that everyone will get the equivalent of millions of dollars worth of care for as long as they care to continue receiving it?

Should we also fool ourselves into believing that the equivalent doesn't *already exist* in the private sector?
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kmbboots
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Could have been. Could have been on a T-shirt. It likely was Rawls or Rawls-derived. I just didn't know it was Rawls.
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katharina
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I didn't expect you to acknowledge the plausibility of it, Orincoro. Goodness knows people will lie to themselves to an amazing degree in order to keep thinking well of themselves.
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fugu13
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The President raised the possibility of a panel deciding what will and won't be given when he specifically said such a panel wouldn't decide what will and won't be given?

quote:
And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance.

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Blayne Bradley
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quote:
Originally posted by Orincoro:
quote:
It’s not determinative
And there you have it. An independent group set up find ways of saving money. Brilliant. It's 1984! It's 1984! There are independent groups! It's not determinative! A single line in an interview that is not concerning actual litigation is more telling than everything discussed within that litigation or by the countless legislators and officials who mght preside over that system, NOT TO MENTION THE VOTERS! FUR RLZZ> OH NOOZZZ WE HAZ TEH DEPTH PANULLZZZZ!!!

(edit: I'm Srsly)

you spend too much time on Encyclopedia Dramatica.
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AvidReader
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quote:
Originally posted by FlyingCow:
Well, first off, the current bill on the table is not the same as Universal Health Care. It is creating a parallel government-run option alongside existing insurance companies - much like the tax-subsidized US postal service exists in a world with FedEx and UPS.

Is now a good time to point out that the post office is millions in debt? </tongue in cheek> I'm only nervous about the government option in conjunction with the universal insurance requirement. Telling people they have to buy insurance when you know the only plan they can afford is yours is conflict of interest. I much prefer the non-profit idea I'd heard floated around. But I work for a credit union, so I'm biased towards the non-profit approach.

quote:
Though I think the regulatory changes that would be needed to "fix" the current system and wrangle the existing insurance companies would be such top-down pressure that it would be as though the government was in charge of all the insurance companies.
I suppose that depends on what it would take the insurance companies and doctors to renegotiate. If they won't do it without government pressure, than I suppose the market has left us no choice and it's corporate Darwinism at work. But maybe they just need a few incentives. Maybe groups that negotiate better prices for doctors that coordinate care and promote wellness could get a spiffy tax break or grant dollars. I guess I'm not convinced we need the stick yet when a carrot might suffice - and doesn't seem to have been tried.

quote:
You would need to force the insurance companies to do things like taking customers they don't want to insure, raising costs on healthy customers evenly, forcing a tiered payment structure among all companies to enforce fairness, etc.
Right now, the insurance companies seem willing to agree to take pre-existing conditions if everyone has to buy insurance. While many boards and CEOs are probably happy to fiddle while Rome burns, I do think enough want to save the industry and ensure future profits to make some changes. What we could really use is a way of telling one group from the other and encouraging HR departments everywhere to only use the latter. Enough money changing hands might be all it takes to ensure the system we want to see.

quote:
I don't know if all of those things are even constitutional.
Well, that's a different problem. I'm not sure how we'd know until we tried it. I suppose it'd be FDR all over again. Keep putting something out there until something sticks.
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Darth_Mauve
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Kath, that quote from the President is suggesting an independent group of ethicists, scientists, and doctors to help determine where we should and should not draw the lines on coverage. It won't say, "You can't have that procedure" only "we can't pay for it." Other options from donations to private pay would be available. The panel are to recommend, with no enforcement listed.

Do you see why claiming that is a "Death Panel that would kill my Down Syndrome Baby" is a lie?

Do you see that such panels exist now, but without the ethicist, the public oversight, or the independent doctors--but with the accountants and bean counters who are determining profits.

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Orincoro
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quote:
Originally posted by katharina:
I didn't expect you to acknowledge the plausibility of it, Orincoro. Goodness knows people will lie to themselves to an amazing degree in order to keep thinking well of themselves.

I didn't expect you to have any real sense of proportion. And you don't!
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Samprimary
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quote:
Originally posted by The Pixiest:
The government never does things better or cheaper.

This is completely untrue and is the second startlingly untrue statement which you have based your opposition to UHC upon.

Your conclusions are broken because they follow from very bad premises such as that one,

quote:
the government is a monopoly with no incentive to reduce waste.
that one,

quote:
It is absolutely INSANE to think that the government can handle this more efficiently than the private sector.
that one (especially considering that this apparently 'insane' notion is actually strongly evidenced by every single other high-income nation on earth and that a case directly rebutting your statement is presented in this very thread), etc
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DarkKnight
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I read this on AARP's website and it is pretty interesting to me.
AARP
quote:
HOW IT'S PAID FOR: Revenue-raisers include: $544 billion from a new income tax surcharge on single people making $280,000 a year and households making $350,000 and above; $37 billion in other tax adjustments. About $500 billion in cuts to Medicare and Medicaid. About $200 billion from penalties paid by individuals and employers who don't obtain coverage.
Those numbers seem very optimistic to me. The $200 billion from penalties is a little frightening as well.
quote:
REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.

So if you fail to have health insurance for a day you are penalized for it? Now I see how they can raise $200 billion in tax penalties.
From HR2300:
quote:
SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.

`(a) Tax Imposed- In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of--

`(1) the taxpayer's modified adjusted gross income for the taxable year, over

`(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.

This is from the AARP website:
quote:
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt.
I find this to be a little misleading. If I reading the bill correctly, Employers, on a sliding scale up from $250,000, MUST pay 8%. If you choose not to have health insurance from your employer (ie. covered by spouse's insurance) then your company, depending on payroll, must pay an average payroll amount of 8% to the Health Insurance Exchange Trust Fund. So even though you are covered by health insurance you are still going to lose a percentage of your salary to pay for health care. The exact percentage could be higher than 8% unless your employers spreads the tax across all employees.
quote:
SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.

(a) In General- A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution--

(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and

(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.


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Christine
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quote:
Originally posted by The Pixiest:
boots, dear, we work for it, we save it, we don't frivolously blow it, we don't spend it on meth, alcohol or other drugs, we don't commit crimes and go to prison, we plan for the future, we skip fun things that are too expensive...

Our wealth is ours because we're responsible. To take it away for those who do not do all those things is downright evil. Further it rewards laziness, drug use, crime and frivolous wastes of money. Simply because there's no reason to work hard and be frugal.

This is the heart of the libertarian philosophy -- that those who have many have (generally) earned it and those who haven't have (generally) done something wrong. It's the part that sounds nice on paper. Unfortunately, in real life I have seen no such clear breakdown of who has wealth and who doesn't based on level of responsibility. Even though we theoretically live in a society with "equal opportunity" the vast majority of us end up in approximately the same social class as our parents. We have approximately the same opportunities they did. Knowing the right person still is a better way to get a job than actually being competent. Plenty of people who have middle class jobs are useless and weigh their company down and plenty of them don't get fired because they go out to lunch with the boss and know how to brown nose. My father has a government job and calls it "welfare for the middle class" because of all the people who do nothing and yet earn a paycheck.

I had more thoughts but I gotta go...

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Jenny Gardener
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Part of the challenge is that it actually IS more profitable for society to help people be well, but most folks (including those In Charge) want immediate results. There's a cultural challenge. In order for long-term prosperity, people in the short term have to see how their small actions contribute to the whole picture. For instance, people are discovering that small actions like reusing bags at the grocery store and turning off the lights can help everyone be better off in the long run. But it is a little late, considering the Big Picture, to stop or reverse climate change. We're in the midst of it, and the best we can hope for is mitigation. I think the same thing is happening with health care. Our population is huge, and resources are limited. Regardless of wealth distribution, some people are GOING TO DIE from not being able to access the care they need when they need it. The difficult decisions must be made. The question is, who will be put in the position to make those decisions? Government, medical professionals, insurance company executives, families, or individuals? Personally, I think that each individual capable of making a decision should have as much control over his or her health decisions as possible.
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Blayne Bradley
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Hahahahahahhahaha! Glenn Beck is funny! Hes saying your about to lose the best healthcare system in the world YET 16 months ago he was talking about how terrible the US system is.

hahahaha!

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kmbboots
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Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart. [Wink]
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Orincoro
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quote:
Originally posted by Christine:
Even though we theoretically live in a society with "equal opportunity" the vast majority of us end up in approximately the same social class as our parents. We have approximately the same opportunities they did. Knowing the right person still is a better way to get a job than actually being competent.

As a total aside, I find it interesting to be the product of one parent who lived in low class poverty, and another parent who grew up in what 1950's California would have termed upper middle class surroundings. I suppose if you do the math, I should statistically be driven towards the middle, and what's even more interesting is that my parents encourage all of their children in their higher education pursuits, *none* of which was in what could be called a money making field of study.

That said, I'm slightly ashamed to admit that I could probably get myself on the staff of a couple of different US Senators and Representatives through family connections. I probably would have had to pursue a different course in college, but it would have been doable. I won't, for a lot of reasons, but I could were I inclined to. I think Pix or Kat would have a hard time disagreeing with the idea that I probably wouldn't be the best person for that job, and yet I know I could get it.

In regards to what you've said Christine, I entirely agree. The theory is nice sounding, but is completely blown away in practice. It's also far too anarchistic and barbarian for my personal sensibilities. It's really never outside the realm of possibility for anyone to lose everything they have, no matter how careful and diligent and honest and hard working they've been. You could be framed for a murder tomorrow, or struck with an incredibly expensive disease, and be completely devastated by it, financially and emotionally. Would that be your fault? Would you be to blame for the murder and the disease because you didn't live in such a way that such a thing would never happen to you in any circumstances? Or are you willing to roll the dice in life just for the chance of getting ahead partly on luck, and then slamming the door on those who never got the least bit lucky?

Pix, you've suffered from depression right? Somebody helped you to get over that, didn't they? In your head, did that person do so in order solely to profit from your successful treatment? Had you been stuck in the hands of an incompetent person, or a person who had betrayed your trust, would you have been at fault for that, in the condition you were in? At what point did your personal responsibility for the turnout end? Or has no one ever helped you, not really, in anything in your life?

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Orincoro
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quote:
Originally posted by kmbboots:
Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart. [Wink]

The guy has started naming threads after TV Tropes topics, so I think we're not seeing any attempt at subtlety here.

Which is fine with me- Blayne's gotten funnier since he started reading a little more widely.

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