I completely agree that it doesn't go far enough.

7/31/2009 10:59:13 AM

Quote :

"The more money that has been spent on government-run healthcare, the less healthcare we have gotten. This kind of result is generally true of all government bureaucracies because of the absence of any market feedback mechanism. Since there are no profits in an accounting sense, by definition, in government, there is no mechanism for rewarding good performance and penalizing bad performance. In fact, in all government enterprises, exactly the opposite is true: bad performance (failure to achieve ostensible goals, or satisfy "customers") is typically rewarded with larger budgets. Failure to educate children leads to more money for government schools. Failure to reduce poverty leads to larger budgets for welfare state bureaucracies. This is guaranteed to happen with healthcare socialism as well. All government-run healthcare monopolies, whether they are in Canada, the UK, or Cuba, experience an explosion of both cost and demand — since healthcare is "free." Socialized healthcare is not really free, of course; the true cost is merely hidden, since it is paid for by taxes. Costs always explode whenever the government gets involved, and governments always lie about it. ~Economist Tom DiLorenzo"

7/31/2009 12:41:59 PM

^

7/31/2009 12:58:07 PM

It's not clear to me that we should let theoretical market forces dictate our healthcare. I mean, you want Hershey's and Willy Wonka to compete in a free market? Fuck it, I don't give a shit. As a consumer, candy isn't that important to me. But healthcare seems too important to be left up to the magic of market. And it isn't quite right to let our nation's health be a for-profit bidness. I know profits supposedly incentivize efficiency and result in a quality product, but profits also incentivize insurance companies to behave badly. And for each quality product out there, profit-oriented attitudes have also created a crappy corner-cutting product.

I dunno, it seems like we're being presented with two options: big ass corporations to have all our money and power over our health or a big ass government to have all our money and power over our health. And I wouldn't be so cynical about the corporations if they hadn't done such a shitty job thus far (and gotten wealthy doing it).

7/31/2009 1:42:42 PM

Quote :

" profits also incentivize insurance companies to behave badly"

profits also incentivize the government to behave badly

Quote :

"And I wouldn't be so cynical about the corporations if they hadn't done such a shitty job thus far (and gotten wealthy doing it)."

Again, what has the government done to make you feel any differently?

7/31/2009 1:43:47 PM

Quote :

"profits also incentivize the government to behave badly"

Perhaps. But at least the government is somewhat accountable to the people while corporations are entirely accountable to shareholders. Shareholders first, then sick people...it seems off when we're talking about healthcare.

Quote :

"Again, what has the government done to make you feel any differently?"

The potential for minimum administration costs really appeals to me. As wasteful as the government is, they rarely hand out million dollar bonuses to guys who "excelled" at their jobs (saved money by denying claims and lowballing general practitioners).

What I'm saying is that I'm willing to ignore economic ideology (let's be real--it's a faith) in order to get more people access to healthcare. It would be cool if we could try it out on a temporary basis, but I'm not naive...I know this will likely become a permanent government service, and I'm okay with that.

7/31/2009 1:56:10 PM

Bridget, I would argue healthcare is too important to create a government monopoly. If it refuses you then you die. Even a poor person can raise money to pay a doctor, either by selling the family car or charity, but not even a middle class person has a chance of convincing a bureaucrat to make an exception.

As it is, the argument in congress is not over market vs government, but replacing one single-payer with another single-payer. Both will still say no to patients, the only difference is that when an insurance company said no you could call the Media and get an exception or maybe work out a 50/50 payment plan. Now, when the government says no in accordance with the government list of unapproved treatments, it is illegal and no amount of media coverage will change their mind.

As for your fear of size, there is a third option you are ignoring. Your doctor can be as big as you want him to be. All you need to find is a private practitioner which owns his own business and all care decisions would be between just the two of you. Of course, such a relationship in the form of insurance (pay me an annual retainer and come see me as much as you want) is illegal, so if you fear size why not make that legal?

7/31/2009 2:03:52 PM

we're not arranging a single payer system so your point is rather moot.

those who wish to keep their private option may choose to do so and those who choose to go with the public competition may do so as well. i'm not seeing why this is 1) so hard for people to grasp and 2) why people are concerned about additional competition coming to market.

7/31/2009 2:10:01 PM

Quote :

"Perhaps. But at least the government is somewhat accountable to the people while corporations are entirely accountable to shareholders. Shareholders first, then sick people...it seems off when we're talking about healthcare."

No corporation makes money for shareholders by convincing its customers that it will leave them to die. That is why the vast majority of those with insurance are happy with it: it may not pay immediately, but it almost always pays. As I said, government run plans don't work this way: when they say no, persisting on the issue can land yourself in jail.

Quote :

"The potential for minimum administration costs really appeals to me. As wasteful as the government is, they rarely hand out million dollar bonuses to guys who "excelled" at their jobs (saved money by denying claims and lowballing general practitioners)."

You need to ask how they minimize administration costs. A large chunk of these costs are voluntarily incurred by private insurance in the prevention of fraud. Not fraud in the sense of prior conditions, they spend a lot of money tracking that down too, but fraud that does not provide any healthcare to anyone in the form of treatments that are never performed for patients that do not exist. Not to mention chronic healthcare abusers that call ambulances to take them across town.

As someone recently said: "Soon, you may be on the hook for paying for a limitless supply of health care for these people." http://forums.studentdoctor.net/showthread.php?t=257985

These problems are real and must be dealt-with by any system we create, because there is not a limitless supply of resources to throw at the problem. As it punches a bigger and bigger hole in the budget, congressmen will begin to worry about having enough money for their pork projects, and they will start cutting corners to make up the difference. Following their track record, rather than spend more money to track down fraud congressmen are more likely to cut back on cancer treatments for grandma.

IRSeriousCat, exactly. There is not going to be any difference between the government plan on offer and existing insurance with the only exception being that government plan losses are borne by tax payers. As such, all of Bridgets arguments about refusing treatment are irrelevant, the government plan will say no just like any other plan. In my opinion the only difference will be that it will be more likely to say yes to criminals and less likely to yield to media pressure on individual cases.

7/31/2009 2:23:00 PM

^^^
Exactly. It's the government in the first place that has made insurance companies and doctors so expensive and limited.

Quote :

"It's not clear to me that we should let theoretical market forces dictate our healthcare. I mean, you want Hershey's and Willy Wonka to compete in a free market? Fuck it, I don't give a shit. As a consumer, candy isn't that important to me."

The market forces aren't theoretical, it's just that for so long the market hasn't really been a market -- it has been unduly affected by unnecessary and harmful laws. When this "market" fails, all the liberals scream, "See? Capitalism doesn't work!", but it wasn't capitalism or the free market that failed -- it's the mix of capitalism and government bureaucracy that failed.

Quote :

"But healthcare seems too important to be left up to the magic of market. And it isn't quite right to let our nation's health be a for-profit bidness. I know profits supposedly incentivize efficiency and result in a quality product, but profits also incentivize insurance companies to behave badly. And for each quality product out there, profit-oriented attitudes have also created a crappy corner-cutting product."

This misses the real issue. You imply that the market is just this one particular thing you've observed, and not a more flexible set of options. Have you heard of alternative corporate charters? There are corporations that, while still being 100% private capitalist for-profit entities, aren't driven entirely by profit. These types of corporations have long been corned out of the market by the extremely large mega-corporations (that everyone but lonesnark types hate,) with the assistance of the government (laws that only benefit large corporations, lobbyists, etc.) In other words, it isn't capitalism that's the problem -- it's government. We need to get rid of laws that punish everyday people, small companies and these alternative ways of doing things while rewarding the corrupt, way-too-large, and way-too-profit-driven mega-corporations. You see, these other ways of doing things (read: real bottom-up capitalism,) challenge the control held by the mega-corporations. The government is the only thing keeping the mega-corporations in control. And yet you and others want to give them both more control? Fucking crazy!

Quote :

"I dunno, it seems like we're being presented with two options: big ass corporations to have all our money and power over our health or a big ass government to have all our money and power over our health. And I wouldn't be so cynical about the corporations if they hadn't done such a shitty job thus far (and gotten wealthy doing it)."

This is your problem. There are more than two options.
Another huge option would be changing the laws so big ass corporations don't exist as they currently do. Take away the power of government to create and form symbiotic and parasitic relationships with these big ass corporations. Allow alternative corporations to step up and compete on a fair playing field.

Excess of, and improper use of, government, is, and has always been, the problem.
If you don't like big ass corporations, you will hate big ass government.

Quote :

"What I'm saying is that I'm willing to ignore economic ideology (let's be real--it's a faith)"

You just can't get past this, can you? The market is not a faith. The ONLY REASON you and others think that it's inadequate, is because the only instances you look at are these evil big ass corporations. The ONLY REASON they "run the show" is because they are improperly backed by the government. Smaller and newer (read: progressive,) ways of doing things are stopped before they can even try... because the big ass corporations lobby the government to make one-sided rules that allow them to stay in power. It is not corporations, per se, that's the problem -- it is not capitalism, per se, that's the problem. It's how they manifest -- and right now, the government and not the people has control over that. A free market means people have that control. Right now, and for most of the recent past, we have not had a free market... we've had a government-corporate-oligopoly. It is 100% wrong to suggest that the failures of this government-corporate-oligopoly imply anything about the free market.

Quote :

"the government is somewhat accountable to the people while corporations are entirely accountable to shareholders. Shareholders first, then sick people"

So... you really haven't heard of other forms of corporations, have you? You think they are simply this one thing. Really... why wouldn't it occur to you that the private sector is capable of forming corporations that aren't entirely accountable to shareholder profits? These alternative corporations can very much be "sick people first, then profits" but the mega-corporations essentially make their own laws and can keep the bottom-up progressive capitalists under their thumb. And again, IT'S THE GOVERNMENT that allows this. CHANGE THE LAWS. LET THE PRIVATE SECTOR FREELY ACT. DO NOT RESORT TO SOCIALIST-STYLE POLICY.

[Edited on July 31, 2009 at 2:57 PM. Reason : ]

7/31/2009 2:37:39 PM

pretty much i don't want to pay for your healthcare

more incentive needs to be placed on primary care and preventative care, how to do the latter i don't know, but that alone could cut costs significantly across the spectrum of time.

7/31/2009 3:34:07 PM

Quote :

"A nationwide system where there is no denial of claims for the purpose of keeping high profit margins forces the other companies to be more reasonable in their outlays."

You mean like Medicare? Oh, wait, they deny a shit-ton of claims, too. Damn...

Quote :

"And then there's the argument that the Post Office hasn't put Fed Ex, DHL, Mailboxes Etc., out of business. The National Parks system hasn't put Disney World out of business. Freddie/Fannie didn't put all the other private lenders out of business either (though they were very weakly government controlled)."

The Post Office sure as hell put every other MAIL DELIVERY service out of business. Either way the USPS is not a comparable "business" to FedEx, DHL, and the others.
The National Parks system is not comparable to Disney World.
And Fannie and Freddie might not have put the other lenders out of business, but they sure as hell had a huge competitive advantage as witnessed by their cheaper capital costs. Oh, and they almost destroyed the entire economy. So, yeah, bad example for you.

Quote :

"You're presupposing that no one will want extra coverage that the government doesn't provide, which is a pretty dumb assumption."

So then what happens is that the gov't system is so shitty that people have to buy extra coverage in order to actually get healthcare. And the poor won't be able to afford coverage that actually gets results. And that is different from today... how?

Quote :

"Everybody keeps saying we don't want the government involved in health care," Scheiner said in an interview. "But the government is involved in Medicare, and it works."

I know, right? It works so well it is bankrupting the nation! Hot damn, let's expand it!

Quote :

"But healthcare seems too important to be left up to the magic of marketincompetent hand of the government."

Quote :

"profits also incentivize insurance companies to behave badly"

Actually, ill-conceived gov't mandates combined with the desire not to go out of business have "incentivized insurance companies to behave badly."

Quote :

"What I'm saying is that I'm willing to ignore economic ideology (let's be real--it's a faith) in order to get more people access to healthcare."

If you gave in to economic ideology, then more people would actually have access to healthcare. And they'd have access to healthcare that was worth a damn, to boot!

Quote :

"those who wish to keep their private option may choose to do so"

Until you want to choose something different. Then you've gotta pick the gubment plan. It's in the bill. Nice try.

Quote :

"why people are concerned about additional competition coming to market."

Simple, because, as a congressman so eloquently put it, "Government competes with the private market in the same way that an alligator competes with a duck: it EATS it."

7/31/2009 5:44:57 PM

Quote :

"You mean like Medicare? Oh, wait, they deny a shit-ton of claims, too. Damn... "

do they? 80+% of people on medicare approve of the way it is run. it's one of the most popular (if not the most popular) federal programs.

7/31/2009 8:02:24 PM

^Do you realize how hard it is to get Medicare though? Or how many people who really need it don't understand the process enough to appeal a denial?

7/31/2009 8:35:33 PM

Quote :

"do they? 80+% of people on medicare approve of the way it is run. it's one of the most popular (if not the most popular) federal programs."

no they don't. They approve of the cost to them. Give me a program that gives me fairly top-notch care at no perceived cost to me, and I'd be pretty fucking happy, too. By the way, you didn't comment on the fact that Medicare DOES deny a lot of claims. way to try and divert the issue.

7/31/2009 8:59:38 PM

I'm not sure where people are getting the idea that denials would be any lower under a government-run plan.



http://www.boston.com/business/healthcare/articles/2009/05/28/insurers_ranked_on_payment_records/

[Edited on July 31, 2009 at 9:53 PM. Reason : .]

7/31/2009 9:53:14 PM

get out of here with that evidence and logic, man...

7/31/2009 10:00:16 PM

http://www.nytimes.com/2009/08/02/us/politics/02hulse.html?_r=1&hp

anyone else think they are going to use reconciliation? there was like one week in may or so where it got a little press, but then just went away. guess we'll have to wait til oct 15

8/2/2009 1:00:03 AM

great points burro and nilly.

Let me ask a question. The govt has a history of dealing/handing money and programs.. JUST LOOK AT IT.

Expandings govts role in healthcare is like putting Bernie Madoff in charge of SS. Then justifying it by saying he made some people very happy, and it worked for awhile. When Bernie basically is going to jail for providing a private SS scheme. Ironic huh. Just look at thier track records. The govt role in healthcare keeps expanding, always with the promise to lower costs...yet here we are.

And medicare is going bankrupt and is completely underfunded. Going by "popularity" of a program that is shifts virtually NO costs to the consumer while ignoring the actual dollars of the program is fucking childish sarijoul. Frankly I expected more from you, your thoughts are usually backed with logical thinking. I think a program where people got cars for 10 dollars, or got 4500 for an old car that isnt worth that would be popular....oh but who cares if we dont have the money to support it.

8/2/2009 10:24:31 AM

if health care is for everyone, then everyone should pay


its a luxury, not a right

8/2/2009 2:14:49 PM

If god didn't want poor people to get sick and die, he wouldn't have made them so poor.

8/2/2009 2:19:21 PM

what does that have to do with anything

8/2/2009 2:22:13 PM

Heath care is a luxury. If you can't afford it, you don't deserve it. Therefore, poor people deserve to get sick and die. LOGIC, BRO.

8/2/2009 4:12:24 PM

Quote :

"The market forces aren't theoretical, it's just that for so long the market hasn't really been a market -- it has been unduly affected by unnecessary and harmful laws. When this "market" fails, all the liberals scream, "See? Capitalism doesn't work!", but it wasn't capitalism or the free market that failed -- it's the mix of capitalism and government bureaucracy that failed. "

Because the "free market" as you seem to want it lead to a lot of corruption and monopolization, which lead people to use the government to keep things in check. A pure free market doesn't exist anywhere because it can't exist for long before corruption takes over.

A "hybrid" government monitored free enterprise is the most stable system, which is what we have.

anyway...

http://www.google.com/hostednews/ap/article/ALeqM5g5ewCvsGcSPBeHJurb6qYZLVU8OgD99QQ2OG0

Quote :

" FACT CHECK: Distortions rife in health care debate Confusing claims and outright distortions have animated the national debate over changes in the health care system. Opponents of proposals by President Barack Obama and congressional Democrats falsely claim that government agents will force elderly people to discuss end-of-life wishes. Obama has played down the possibility that a health care overhaul would cause large numbers of people to change doctors and insurers. To complicate matters, there is no clear-cut "Obama plan" or "Democratic plan." Obama has listed several goals, but he has drawn few lines in the sand. The Senate is considering two bills that differ significantly. The House is waiting for yet another bill approved in committee. A look at some claims being made about health care proposals... "

[Edited on August 2, 2009 at 6:31 PM. Reason : ]

8/2/2009 6:30:45 PM

Quote :

"Quote : "do they? 80+% of people on medicare approve of the way it is run. it's one of the most popular (if not the most popular) federal programs." no they don't. They approve of the cost to them. Give me a program that gives me fairly top-notch care at no perceived cost to me, and I'd be pretty fucking happy, too. By the way, you didn't comment on the fact that Medicare DOES deny a lot of claims. way to try and divert the issue. "

In the link Hunt posted, Medicare was ranked very high, with private insurers.

Quote :

"I'm not sure where people are getting the idea that denials would be any lower under a government-run plan. http://www.boston.com/business/healthcare/articles/2009/05/28/insurers_ranked_on_payment_records/ "

The way medicaid is run is different than what the current health plan calls for, but this just further shows that giving the current uninsured/underinsured a better option shouldn't affect anyone else. If you want to stick with a private plan under the new plan, you have that option. If you look at other regions on the payerview website, medicare does very well (and is ranked #1 in the south). Obviously there are factors that explain this, just as there are factors that explain MassHealth being where it is for Massachusetts.

8/2/2009 6:42:00 PM

Quote :

"Heath care is a luxury. If you can't afford it, you don't deserve it. Therefore, poor people deserve to get sick and die. LOGIC, BRO."

i understand the premise, BRO, i understand the logic BRO

do you understand its not a right, BRO?


the real deal is, everyone short of bums asking for money on the street can contribute .. and even they make money to throw in

you give what you can, i mean this isnt for a free lunch, its only .. your health and life ... if youre going to benefit, u got to pay ... welcome to capitalism kids!

[Edited on August 2, 2009 at 6:59 PM. Reason : ]

8/2/2009 6:56:14 PM

Quote :

" Because the "free market" as you seem to want it lead to a lot of corruption and monopolization, which lead people to use the government to keep things in check. A pure free market doesn't exist anywhere because it can't exist for long before corruption takes over. "

You have that backwards. Allowing government the power to manipulate commerce in the first place creates an incentive for incumbent firms to use government as a tool. If we did not extend such powers in the first place, firms would have to answer to their customers in order to succeed.


Regarding health care as a right – if health care is a right, why has it been thought of as such only in the past century? True rights are intertemporal. They do not come into being merely because of the capacity to pay for them. In other words, why did our forefathers miss this one?

8/3/2009 7:14:22 AM

http://news.yahoo.com/s/ap/20090803/ap_on_go_pr_wh/us_economy

O rly? Who saw that coming?

8/3/2009 10:00:06 AM

"No one is talking about a government take-over of health-care"

Yea right....

http://www.youtube.com/watch?v=p-bY92mcOdk

8/3/2009 11:10:32 AM

Hunt, those numbers can be spun in any direction. Someone could just as easily say that those claims are denied so much more often because the government is better at filtering out spurious claims and that the payouts are only 30 days worse (in the 50s) than the best (in the 20s) which is hardly a big deal in the world of business transactions.

I'm not saying any of those things are true, I'm just saying "lies, damn lies, and statistics."

8/3/2009 1:30:13 PM

Regarding women's suffrage as a right – if women's suffrage is a right, why has it been thought of as such only in the past century? True rights are intertemporal. They do not come into being merely because of the capacity to pay for them. In other words, why did our forefathers miss this one?

8/3/2009 1:33:39 PM

^^Adding 30 days to receivables outstanding has huge implications for cash-flow management.

^ Our society's decision not to grant women the right to vote doesn't change the fact that voting, itself, was considered a right centuries ago. (i.e. if health care were considered a right by our forefathers, they would have granted it to white, male landowners.)

[Edited on August 3, 2009 at 1:56 PM. Reason : .]

8/3/2009 1:55:22 PM

Quote :

"You have that backwards. Allowing government the power to manipulate commerce in the first place creates an incentive for incumbent firms to use government as a tool. If we did not extend such powers in the first place, firms would have to answer to their customers in order to succeed."

This is not accurate. Just look at turn of last century America, where real monopolies dominated certain markets.

When a company owns every aspect of an industry, it's irrelevant what the customers "want" when everything they can get is from one company.

8/3/2009 4:44:47 PM

Quote :

"If you want to stick with a private plan under the new plan, you have that option."

Not exactly. Employers are actually taxed at higher rates if they keep their current private plans. Citizens who don't opt in are also taxed. I don't think people should be penalized for not opting into the new system should there be one.

8/3/2009 4:55:02 PM

^^There are very few examples of true monopolies that sustained themselves without the aid of government. For 99% of businesses, the above is accurate.

8/3/2009 6:18:18 PM

Quote :

"Allowing government the power to manipulate commerce in the first place creates an incentive for incumbent firms to use government as a tool. If we did not extend such powers in the first place, firms would have to answer to their customers in order to succeed."

I agree that the collusion of big government and big business helps to expand one another's powers at the detriment of the people; however, I would argue that business corrupts government moreso than government corrupts business.

8/3/2009 11:06:22 PM

Quote :

"True rights are intertemporal. They do not come into being merely because of the capacity to pay for them. In other words, why did our forefathers miss this one?"

I agree with this statement completely. In fact, this is exactly why healthcare isn't a right. Medicine as we know it today didn't even exist at the time of our forefathers. Back then,bloodletting was considered a cure for various ailments, and what ultimately killed George Washington. If your doctor suggested bloodletting today to cure you of (whatever), you'd run the fuck away.

Medicine/Healthcare is a function of technology, and is completely opposite to being intertemporal.

[Edited on August 3, 2009 at 11:31 PM. Reason : asdf]

8/3/2009 11:29:28 PM

Quote :

"business corrupts government moreso than government corrupts business"

True, but government's involvement is a precondition. (e.g. if government was largely impotent in regulating businesses, Google would see no need to hire a lobbyist) If we ramp up government's involvement in health care, there is much from history to suggest corporations will ramp up their lobbying efforts.

[Edited on August 4, 2009 at 6:51 AM. Reason : .]

8/4/2009 6:50:30 AM

Perhaps Pelosi and Friends could have used all the money they are handing away like lollipops with Ca$h 4 Clunker$ in order to fund their healthcare initiative.




New Cars vs New Health Care Program we definitly have our priorities straight

8/4/2009 8:51:31 AM

Quote :

"do they? 80+% of people on medicare approve of the way it is run. it's one of the most popular (if not the most popular) federal programs."

medicare and medicaid only work on the back of private insurance. They reimburse 80% of the COST (not charge) of care (how in the f' is that sustainable) while private insurance reimburses 140% of the cost.

8/4/2009 9:08:13 AM

Quote :

"while private insurance reimburses 140% of the cost."

Where are you getting this number?

8/4/2009 9:15:38 AM

http://www.realclearpolitics.com/articles/2009/06/30/alice_in_medical_care_97231.html

This article pretty much sums up the problem. Medical care is not cheap no matter what plan you use to cover the cost. The only way the cost of something could go down is if the government says, no surgery can cost more that $10,000, no medicine can cost more than $100, no test can cost more than $500, mal practice insurance can only cost $5,000 per year, and and no one can be awarded more than $20,000 dollars in a mal practice case. This isn't possible though and will never happen.

8/4/2009 1:12:21 PM

^^

Quote :

"Where are you getting this number?"

Sorry, I meant 140% of medicare reimbursement. It's actually between 130-140%. This is what I hear from providers I work with/learn from as a lowly 3rd year MD student. I was a business major at state and have an interest in the business of medicine so I'm always asking questions when I get a chance regarding stuff like this. I'll dig something up if I have time later.

[Edited on August 4, 2009 at 1:46 PM. Reason : a]

8/4/2009 1:43:38 PM

LOL! Two illustrative videos:

Paul Krugman--the hero of some of you--self-pwning:

http://www.youtube.com/watch?v=3EPd2i4Jshs

"Sen. Arlen Specter, Secy. Sebelius Mobbed to Kill Health Care at Philly Town Hall"

http://www.youtube.com/watch?v=Yc362U69lms

8/4/2009 4:41:56 PM

Mobs make smart decisions.

8/4/2009 4:51:09 PM

[Edited on August 4, 2009 at 4:56 PM. Reason : Smug. ]

8/4/2009 4:55:31 PM

I can tell you've earned your roll-eyes merit badge.

8/4/2009 5:20:02 PM

^ GG on your misdirection attempts.

8/4/2009 5:41:56 PM

8/4/2009 5:46:41 PM

8/4/2009 5:48:35 PM