Looks like the Democrats are positioning themselves to really hit the pedal to the medal next year with a new health care reform plan...that's more like Hillary's envisioning it seems. I'll take it, so long as it means overhauling the current system.

I'm not a fan of mandates, and I want single payer - but maybe this takes us on the first step to single payer...in fact it could be seen as highly likely to....


From Paul Krugman's blog:
Hopeful signs on health care

http://krugman.blogs.nytimes.com/2008/11/12/hopeful-signs-on-health-care/

Quote :

" This is very big news. One of the key questions about the new Democratic majority was whether Congress would try to play it safe, backing down on big ideas about reform, especially on health care. You can view the whole chorus about how we’re still a “center-right nation” as an attempt by the usual suspects to scare Democrats into scaling back their ambitions. But now Max Baucus — Max Baucus! — is leading the charge on a health care plan that, at least at first read, is more like Hillary Clinton’s than Barack Obama’s; that is, it looks like an attempt at full universality. (The word I hear, by the way, is that Obama’s opposition to mandates was tactical politics, not conviction — so he may well be prepared to do the right thing now that the election is won.) So this looks very good for the reformers. There’s now a reasonable chance that universal health care will be enacted next year! "

11/12/2008 3:00:15 PM

I too oppose man dates.

11/12/2008 3:06:15 PM

Personally, I'm worried that this will only exasperate our current problem of rising health care costs.

Paul Krugman himself has pointed out that Medicare and Medicaid might run into problems in coming years because paying for the health care of our aging populace in the face of rising health care costs will require significant tax hikes.

Do we really think that expanding the federal government's obligation to cover MORE people's health care costs is really the solution (this would be the result of creating the public insurance alternative and expanding medicaid as Obama and Hillary and Edwards proposed)???

11/12/2008 3:36:47 PM

Honestly, I'm just glad the issue is being discussed instead of being brushed under the rug.

11/12/2008 3:40:43 PM

Do you have a source? He also said and I quote that...

Quote :

" the United States spends far more on health care per person than any other nation. Yet we have lower life expectancy than most other rich countries. Furthermore, every other advanced country provides all its citizens with health insurance; only in America is a large fraction of the population uninsured or underinsured. You might think that these facts would make the case for major reform of America’s health care system — reform that would involve, among other things, learning from other countries’ experience — irrefutable. Instead, however, apologists for the status quo offer a barrage of excuses for our system’s miserable performance.the reality is that the best foreign health care systems, especially those of France and Germany, do as well or better than the U.S. system on every dimension, while costing far less money. But the best way to counter scare talk about socialized medicine, aside from swatting down falsehoods — would journalists please stop saying that Rudy’s claims, which are just wrong, are “in dispute”? — may be to point out that every American 65 and older is covered by a government health insurance program called Medicare. And Americans like that program very much, thank you. Currently every American 65 and older is covered by a government health insurance program called Medicare. And Americans like that program very much, thank you."

and

Quote :

"All the evidence suggests that it has finally become politically possible to give Americans what citizens of every other advanced nation already have: guaranteed health insurance. The economics of universal health care are sound, and polls show strong public support for guaranteed care. The only thing we have to fear is fear itself.... ...There won’t be a serious Republican alternative. The health care plans of the leading Republican candidates, such as they are, are the same old, same old: they principally rely on tax breaks that go mainly to the well-off, but will supposedly conjure up the magic of the market. As Ezra Klein of The American Prospect cruelly but accurately puts it: “The Republican vision is for a world in which the sick and dying get to deduct some of the cost of health insurance that they don’t have — and can’t get — on their taxes."

11/12/2008 3:46:23 PM

And as an aside, I think Jason Furman (one of Obama's economic advisers) has a better plan. Here is some excerpts that popped up through out the blogsphere. Furman's plan was actually similar to John McCain's to the extent that both sought to increase the share of health care costs (that individuals are responsible for if you want people to be responsible for their health, you can't totally insulate them from the costs of their actions) while using measures such as tax-credits to help lower income individuals afford health insurance.

Here's an exceprt:

Quote :

"Americans are frustrated with the unaffordability of health insurance, the effectiveness of health care, and the rising number of uninsured. One important contribution to all of these challenges is the increased insulation of Americans from the cost of their care. In 1965, roughly half of health-care expenses were paid out of pocket by patients; by 2006, that figure had declined to just 13 percent—lower than the average of other high-income OECD countries. This paper proposes a template for a progressive cost sharing plan that would require typical families to pay half of their health costs until they reached 7.5 percent of their income; low-income families would not have any cost sharing. The analysis shows that this template could reduce total health spending by 13 to 30 percent, reducing premiums by 22 to 34 percent without hurting health outcomes. "

http://www3.brookings.edu/views/papers/furman/200704hamilton.pdf

Interestingly, Paul Krugman actually probably would have agreed with Furman's analysis 10 years ago. In the updated version of his book "The Age of Diminished Expectations" he says that health care was starting to become more and more of an issue because people were spending too much on health care (partly because doctors were afraid to deny care even if it was unlikely to help the patient for fear of being sued in our messed up tort system). So you would think that he would like a plan like Furman's or McCain's because they both go a long way in reducing people's health care spending.

Of course, now a'days, Krugman says that our health care system is a mess because insurance companies are greedy and that we're only spending more because we have to fight with insurance companies to get any care at all (seriously). Do all "progressives" really think that all the problems in the world are caused by greed??

11/12/2008 3:52:12 PM

Kainen,

A source for what? Krugman's view that Medicare is likely facing a cost crisis that will force us to make hard choices? Yes, I have one.

Quote :

"Medicare, though often lumped in with Social Security, is a different program facing different problems. The projected rise in Medicare expenses is mainly driven...by rising cost of medical care, which in turn mainly reflects medical progress, which allows doctors to treat a wider range of conditions. If this trend continues...we may face a real long-term dilemma that involves all medical care, not just care for retirees, and is as much moral as economic. It may eventually be the case that providing all Americans with the full advantages of modern medicine will force the government to raise much more money than it now does. Yet not providing that care will mean watching poor and middle-class Americans die early or suffer a greatly reduced quality of life because they can't afford full medical treatment."

http://www.pkarchive.org/column/030504.html

His argument for these forces was even stronger in the 1997 edition of his book "The Age of Dimished Expectations". It's available for free on Google Books. Check out his section on Health Care costs (I suggest starting on page 71 or so).
http://books.google.com/books?id=awA0yp1V8c8C&dq=the+age+of+diminished+expectations&pg=PP1&ots=3eWyV2CXwl&source=bn&sig=K69mi0sMv4eEzJFLHEtK8kHXguc&hl=en&sa=X&oi=book_result&resnum=4&ct=result#PPA70,M1

Does anyone else think it's weird how much Krugman's analysis of this issue has changed in such a short period of time???? I mean, it couldn't possible be that he is trying to score political points with his recent articles instead of educating the public.

[Edited on November 12, 2008 at 4:16 PM. Reason : ``]

11/12/2008 4:03:33 PM

universal health care would be a nightmare here.

how many of our government organizations are well run?

11/12/2008 4:13:37 PM

^ universal health care is not the same as "government run health care." We're still a long way off from single-payer systems, but I'm scared we're getting close.

11/12/2008 4:17:08 PM

Yeah, that's it - thanks. I just wanted some context, and I got it....I agree with most of what is posted here.

I don't believe the problem is [wholly] represented by greed...but I do think the current system is unprincipled. For example, insurers have all the incentive in the world to mitigate risk by denying coverage to people with pre-existing medical issues. Their actions have led to quality medicine being more expensive and creates an impossibility for those that need the care.

Just a reminder that I believe health care is a right, and we're one of the only countries to not take care of it's people....and with premiums that have doubled since 2001 and expenditures as a nation per capita more than any other country in the world - tell me why we have worse health quality per person than other civilized/industrialized nations?

Premiums rise daily but with less and less coverage. It's broken. I think the closer we move to single payer the better off we are.

11/12/2008 4:17:54 PM

It's only "universal" in that it'd cover those who don't have coverage. Is there a scenario worse than our current system of emergency-room-as-family-doctor?

And I think we would all agree that preventative care is cheaper in the long run.

11/12/2008 4:19:59 PM

Quote :

"And I think we would all agree that preventative care is cheaper in the long run."

No such luck.

11/12/2008 4:24:43 PM

Even if we're working on the assumption that we shouldn't just let people die?

11/12/2008 4:26:49 PM

Boone,
Of course you would think that. For the more educated among us....

Quote :

"“It’s a nice thing to think, and it seems like it should be true, but I don’t know of any evidence that preventive care actually saves money,” said Jonathan Gruber, an M.I.T. economist who helped design the universal-coverage plan in Massachusetts [as well as Obama's health care plan]."

http://www.nytimes.com/2007/08/08/business/08leonhardt.html

Kainen,
If health care is a right, why not clothing? You couldn't really live without (particuarly not this time of year). Why shouldn't we have a "single-payer" system for this good as well? It is dominated by greedy producers. Why not socialize them too!?!

The reason we don't have these types of discussions for clothing (or a lot of other things you can't live without) is because the government has largely stayed out of the industry. It doesn't tell clothing manufacturers how much they should produce, what thread counts their shirts should be etc (which is essentially what state governments try to do with health insurance). Instead, it helps people afford clothing through tax credits and other income subsidies. Politicians realized they don't know jack shit about running a textile mill let alone the entire clothing industry, so they stuck to what they're good at--taxes and mailing checks. If we took that approach to health care, I think we would be a lot better off.

[Edited on November 12, 2008 at 4:40 PM. Reason : ``]

11/12/2008 4:37:06 PM

I dont believe anyone who is an adult has a right to healthcare. I dont have a right to own a car. I dont have a right to a mechanic's services.

That said, I see no reason why children should not be covered by some program.

If a person chooses to purchase healthcare, then great...but it is not a right like life, liberty and the pursuit of happiness.

[Edited on November 12, 2008 at 4:46 PM. Reason : ,,]

11/12/2008 4:45:05 PM

Quote :

"For the more educated among us...."

1. You classified Guinness as "good beer." Your snob card has been revoked.

2. "Even if we're working on the assumption that we shouldn't just let people die?"

I'm sure it's cheaper to not diagnose cancer early, and just let people die when the cancer's become cost-prohibitive to combat. It's nearly free, in fact.

I'm just curious what the costs would look like if our healthcare system were a system that actually valued human life. Would preventative medicine still be more expensive?

Quote :

"I dont believe anyone who is an adult has a right to healthcare. I dont have a right to own a car. I dont have a right to a mechanic's services."

It's much easier to swallow once you accept healthcare as an extension of a natural right (life).



[Edited on November 12, 2008 at 4:54 PM. Reason : ]

11/12/2008 4:50:06 PM

Quote :

" I'm sure it's cheaper to not diagnose cancer early, and just let people die when the cancer's become cost-prohibitive to combat. It's nearly free, in fact."

It depends if you factor in the value of the person or not. If they're young and a high producing member of a company then their value could be immensely larger than their treatment in the long run.

11/12/2008 5:00:02 PM

Boone,

It's cheaper to fight cancer if you diagnose it early, but that doesn't mean it is cheaper in the sense of reducing that person's health care expenditures. After all, even if they don't spend all that money fighting the cancer, they will likely spend even more money on other medical expenses because they will live longer (old age is expensive).

But I'm seeing a disturbing trend in this thread--the idea that "we" (as if the government represents society) should spend however much it takes to make people's lives as long as possible. I seriously doubt Boone would be making the same arguments for fighting crime--spending as much money as needed to prevent every crime in America. Why? Well because he's a bleeding heart that finds force distasteful, even in defense of the innocent. But also because no one wants to devote 80% of their pay check to fighting crime.

We live in a world of scarcity folks. There are only so many doctors, hospital beds, nurses, MRI machines, etc to go around at anyone time. If I spend an hour with a doctor, that's one less hour for someone else to spend with him. That means that SOME PEOPLE SIMPLY WILL NOT GET CARE NO MATTER WHAT WE DO. The only thing we can do is decide how to allocate the resources.

This is exactly how it is in Canada too, where they ration health care with wait lines instead of dollar bills. This is simply the world you live in. And nothing can change it.

[Edited on November 12, 2008 at 6:03 PM. Reason : ``]

11/12/2008 5:38:31 PM

wait... didnt you used to be Hillary's #1 Fan?

11/12/2008 5:52:12 PM

^ No?

11/12/2008 5:58:12 PM

Quote :

"But I'm seeing a disturbing trend in this thread--the idea that "we" (as if the government represents society) should spend however much it takes to make people's lives as long as possible. I seriously doubt Boone would be making the same arguments for fighting crime--spending as much money as needed to prevent every crime in America. Why? Well because he's a bleeding heart that finds force distasteful. But also because no one wants to devote 80% of their pay check to fighting crime."

That's a silly analogy. Obama's plan wouldn't do anything resembling what you're describing.

I think a much more fitting analogy would be "universal police protection."


We live in a world of scarcity folks. There are only so many doctors, hospital beds, nurses, MRI machines, police officers, jail cells, patrol cars etc to go around at anyone time. If I spend an hour with a doctor police officer, that's one less hour for someone else to spend with him. That means that SOME PEOPLE SIMPLY WILL NOT GET CARE PROTECTION NO MATTER WHAT WE DO. The only thing we can do is decide how to allocate the resources.

This is exactly how it is in Canada the civilized world too, where they ration health care police protection with wait lines slower response times instead of dollar bills. This is simply the world you live in. And nothing can change it.




[Edited on November 12, 2008 at 6:07 PM. Reason : and way to break the thread, nimrod. I'm 1650x' here, and I still have to scroll.]

11/12/2008 6:03:53 PM

^ Um. I wasn't talking about Obama's plan (in fact this thread isn't even about Obama's plan at all except as it realtes to the one being formulated by congressional dems).

I was referring to your and Kainen's idea that "health care is a right", which apparently implies that we spend "whatever it takes" to protect people from ever not receiving care.

And with regards to your edited version of my bolded text, THAT'S EXACTLY MY POINT! Police protection is no different than any other service, including medical services. Crime prevention resources are scarce and have to be rationed. IOW: NOT EVERYONE CAN BE PROTECTED AND WE CAN'T PREVENT ALL CRIME.

So thanks for totally missing the obvious point I was making.

[Edited on November 12, 2008 at 6:22 PM. Reason : ``]

11/12/2008 6:21:36 PM

Quote :

"I was referring to your and Kainen's idea that "health care is a right", which apparently implies that we spend "whatever it takes" to protect people from ever not receiving care."

"Whatever it takes" (which of us used those exact words?) to cover everyone. Not to ensure everyone's covered for everything ever, as you are implying.

Quote :

"So thanks for totally missing the obvious point I was making."

I don't think it's me who missed the point, here.

11/12/2008 6:27:32 PM

Quote :

"In his plan, Mr. Baucus makes these proposals: ¶People age 55 to 64 should be able to buy Medicare coverage if they do not have access to a public insurance program or a group health plan. More than four million people in this age group are uninsured. ¶Medicaid would be available to everyone below the poverty level, providing at least seven million more people with access to the program. In many states, adults with incomes well below the poverty level — $17,600 for a family of three — are ineligible for Medicaid. ¶The State Children’s Health Insurance Program would be expanded to cover all uninsured youngsters in families with incomes at or below 250 percent of the poverty level ($44,000 for a family of three). This would raise the income limit in about half the states. Mr. Baucus would also make it easier for many legal immigrants to qualify for Medicaid and the children’s health program. Under current law, such immigrants are generally barred from the programs in their first five years in the United States. He would lift that ban. More than half of all Americans receive coverage through employers, and Mr. Baucus said he wanted to halt the erosion of such coverage. He would offer tax credits to small businesses to help them defray the costs of providing health benefits to employees. To make insurance more affordable for those who buy coverage on their own, Mr. Baucus would offer tax credits to individuals and families with incomes at or below four times the poverty level ($70,400 for a family of three). Only 10 percent of the uninsured have incomes above that level, he said. "

http://www.nytimes.com/2008/11/12/washington/12health.html?_r=2&oref=slogin&oref=slogin

Thats a lot of money the government is gonna throw at the problem. Any idea of how it will actually reduce the cost of health care, rather than just subsidizing it for certain demographics? Because our pitiful cost : benefit ratio for healthcare goes well beyond the strain of the uninsured on our emergency rooms. We have the most expensive doctors, drugs, and procedures in the world, and a lot of money is wasted in insurance company overhead and profit.

[Edited on November 12, 2008 at 6:35 PM. Reason : 2]

11/12/2008 6:31:18 PM

I appreciate the good productive discussion here....but we're getting into territory covered by the other big health care thread you started socks....you drew the exact same analogy and I answered it there. At the time I talked about how although health care may not in a strict sense be a 'right' it certainly though is a 'responsibility'...and morally one that I think is important.

Using 'rights' in the sense of 'freedoms' is really bogging down my argument because you are doing exactly what I expect you and libertarians, conservatives to do - draw an analogy that doesn't really compare. For instance, education is not a 'right' by the strict sense of the word...it's an obligation though of any composed society. Clothing is not a 'right', it's an obligation. If there is someone naked in the street, as a society we are obligated to try to help them out with a shirt...and we do. Same way with food. That's how I see healthcare, an obligation or responsibility that our people are entitled to.

Try to understand the difference, I probably shouldn't have said the word 'right' because this always happens.

11/12/2008 6:38:24 PM

so, here's a question, Kainen.

If we were able to make it so that people could afford routine health care on their own without a gov't program, would you accept that?

I ask this because many of the problems alleged to exist with insurance exist only because it is practically necessary to have insurance in order to afford any kind of health care. So, in trying to get people insurance, we are treating the symptom and not the problem. The problem is that health care is expensive, not that insurance is expensive.

^ And, for the record, we are not obligated at all to provide anyone a fucking shirt. We really shouldn't be obligated to provide an education for anyone. The more "obligations" you make, the more the government must infringe on people's actual rights in order to meet those "obligations."

11/12/2008 7:13:05 PM

Kainen,

But we do not give people shirts or food by socializing those industries as you were suggesting earlier (single payer health insurance). Instead we provide them with various forms of income subsidies. I don't see why health care should be different.

PS* Education is an exception, but how many people celebrate the quality of public schools? Competition would improve schools the same way it would improve health care.

[Edited on November 12, 2008 at 8:05 PM. Reason : ``]

11/12/2008 8:03:56 PM

Quote :

"It's only "universal" in that it'd cover those who don't have coverage. Is there a scenario worse than our current system of emergency-room-as-family-doctor? "

So what happens as premiums and costs skyrocket for riskier individuals and insurance companies start dropping them because the government plan will cover them?

11/12/2008 8:16:11 PM

and he is ignoring the fact that as the government covers to costs for more people, this will drive the cost up for those who aren't covered for the government, thus making it harder for even them to pay for their healthcare. That, frankly, is what has happened thanks to medicare and medicaid and sCHIP.

11/12/2008 8:24:00 PM

^ I am not sure how that follows. There is a reasonable arguement that expanding coverage will reduce private costs because it reduces indigent care.

Quote :

"We live in a world of scarcity folks. There are only so many doctors, hospital beds, nurses, MRI machines, etc to go around at anyone time. If I spend an hour with a doctor, that's one less hour for someone else to spend with him. That means that SOME PEOPLE SIMPLY WILL NOT GET CARE NO MATTER WHAT WE DO. The only thing we can do is decide how to allocate the resources. This is exactly how it is in Canada too, where they ration health care with wait lines instead of dollar bills. This is simply the world you live in. And nothing can change it. "

While I agree with most of your points here I am not sure that some people will get no care no matter what. There is a strong argument that much of the care that is provided has a very low marginal health benefit and that reducing it could be done with little effect on health outcomes. For example, there is evidence to suggest that MRIs are overused, that advanced medical technology such as proton therapy costs a lot but provides little marginal benefit.

As part of the argument we can point to systems such as the French system which uses less technology but has better outcomes.

This is a complex issue and I am not sure where I stand. My gut says something along the lines of the Furman plan but I know a lot of smart people who have been thinking about this more than I who push single-payer.

11/12/2008 8:36:02 PM

^ kwsmith2,

What I was saying was that we don't have enough health care resources for everyone to have equal access to them. Like I said, if I spend an hour with a doctor, that's an hour someone else cannot spend with the doctor. This implies that someone will have to go untreated. Now maybe we can rellocate resources toward uses with higher marginal benefits, but that is a different question.

Quote :

"For example, there is evidence to suggest that MRIs are overused, that advanced medical technology such as proton therapy costs a lot but provides little marginal benefit."

Very good point and one that Paul Krugman made in The Age of Diminished Expectations. He used it as an example of how we spend virtually unlimited amounts on people with insurance even though the benefits of much of these expenditures are questionable.

http://books.google.com/books?id=awA0yp1V8c8C&dq=age+of+the+diminished+expectation&pg=PP1&ots=3eWyV4A1um&source=bn&sig=Qn36G0eStwrqIL5hRkLor0Bi_SE&hl=en&sa=X&oi=book_result&resnum=4&ct=result#PPA71,M1

Now, as Krugman also points out, if a person was actually paying for their medical bills themselves they probably wouldn't spring for these procedures that promise such small benefits. That's why Furman's expanded cost-sharing scheme seems like such a good idea to me.

[Edited on November 12, 2008 at 9:47 PM. Reason : ``]

11/12/2008 9:44:58 PM

Shouldn't we be over-joyed that gov't healthcare is right around the corner? After all, that's part of the hope and change.

Forget the fact that there are going to be fewer doctors coming out of medical school. That massive rationing will occur. That the "duty to die" will be thrust upon the elderly voters in Florida and elsewhere who were scared that the republicans were going to take away their social security.

The democrats are going to take away their lives.

11/14/2008 12:22:27 PM

Earthdogg, stop spewing semi moonbat, and highly retarded garbage without any evidence to back the matter up.

The US is ranked under practically ever other industrialized nation (all of which offer UHC) in healthcare quality.

Thats a clear QED to every junk argument you've made so far.

Unless you have some sterling evidence that doesn't rely on random strawmen, then stop posting on this matter.

11/14/2008 4:29:57 PM

Oh no, not this shit again.

The World Health Organization, the one that keeps ranking the US down at the bottom of industrialized nations in healthcare, is driven by ideology and anything but objective.

They use 5 measures to determine their rankings, but only 2 of them are actually measures of health care, life expectancy and responsiveness. The funny thing is that the US ranks 24th overall in life expectancy and 1st overall in responsiveness, but yet somehow ends up 37th in overall care. Thats because the WHO uses socialistic measures like "Fairness in financial contribution" as measures of health care. Honestly, how the fuck is "Fairness in financial contribution" a measure of health care? How do they even judge it?

It's nonsense, and repeating the WHO rankings only perpetuates this nonsense. Insured Americans receive superior care to just about everyone else in the world. Yes, we have a problem with the uninsured, but the idea that our health care system is horrible has gotta stop. It's horribly expensive, but that's mostly because we pay for the best doctors, the best drugs, and the most expensive equipment, and all of it is available right away. That kind of service costs money.

[Edited on November 14, 2008 at 5:09 PM. Reason : 2]

11/14/2008 4:53:12 PM

SandSanta,

Despite what some partisans would have you think, it's actually very difficult to show that universal health care systems result in better health outcomes. Much more difficult than just pointing out that French live longer than Americans or other metrics like that.

A person's health is a function of many things--diet, exercise, genetics, environment, etc--beyond just whether one has insurance or whether the state pays for your access to health care.

Greg Mankiw had an NYT column earlier this year that had a pretty take down of the most popular statistics used by proponents of universal health care.
http://www.nytimes.com/2007/11/04/business/04view.html?_r=1&partner=permalink&exprod=permalink&oref=slogin

Here is my favorite excepts (that's probably relevant to the unnamed stats you have mind).

Living Longer In Canada Doesn't Mean Canadians Recieve better Health Care.

Quote :

"The differences between the neighbors are indeed significant. Life expectancy at birth is 2.6 years greater for Canadian men than for American men...These facts are often taken as evidence for the inadequacy of the American health system. But a recent study by June and Dave O’Neill, economists at Baruch College, from which these numbers come, [b]shows that the difference in health outcomes has more to do with broader social forces. For example, Americans are more likely than Canadians to die by accident or by homicide...Americans are also more likely to be obese, leading to heart disease and other medical problems. "

Infant Morality Rates Don't Tell You Much Either.

Quote :

"In the United States, 7.5 percent of babies are born weighing less than 2,500 grams (about 5.5 pounds), compared with 5.7 percent in Canada. In both nations, these infants have more than 10 times the mortality rate of larger babies. Low birth weights are in turn correlated with teenage motherhood. (One theory is that a teenage mother is still growing and thus competing with the fetus for nutrients.) The rate of teenage motherhood, according to the O’Neill study, is almost three times higher in the United States than it is in Canada. Whatever its merits, a Canadian-style system of national health insurance is unlikely to change the sexual mores of American youth."

11/14/2008 5:20:04 PM

Quote :

"For example, Americans are more likely than Canadians to die by accident or by homicide...Americans are also more likely to be obese, leading to heart disease and other medical problems. ""

It's easily possible too that if more people have healthcare and go to doctors, the doctors will tell them to lose weight, causing a "broader social force" that leads to Americans living longer.

We can already see how the push in the media and gov. has caused people to buy more fuel efficient cars, and is leading to the demise of full-sized SUVs as we know them.

It wouldn't take too much for similar mechanism of social engineering to make Americans live healthier lifestyles too.

11/14/2008 5:25:16 PM

You and your goddamned social engineering.

11/14/2008 5:39:01 PM

It's the fastest way to a Star Trek-like society.

11/14/2008 5:42:03 PM

Quote :

"I am not sure how that follows. There is a reasonable arguement that expanding coverage will reduce private costs because it reduces indigent care."

To be fair, the "costs" stay the same. It's just that because the government will be footing the bill more often, and it pays less than everyone else for the same thing, then the prices will have to go up accordingly in order for the doctors to cover their own costs.

Quote :

"It's easily possible too that if more people have healthcare and go to doctors, the doctors will tell them to lose weight, causing a "broader social force" that leads to Americans living longer."

Really? Tell me how that's working out right now. Tell me how it's working for smoking and drinking. Really, are you that stupid?

11/14/2008 6:47:32 PM

Oh it's you, the slow one again

Quote :

"Tell me how it's working for smoking and drinking. Really, are you that stupid?"

How timely is this article
http://www.webmd.com/smoking-cessation/news/20081113/smoking-rate-is-declining-in-us

Quote :

""This is the lowest level since the late 1920s, at least," Glynn tells WebMD. "We've gotten back to where we were more than 80 years ago." The CDC says cigarette smoking prevalence has been dropping steadily among Americans 18 and older since it began keeping records in 1965, when 42.4% smoked. The proportion dropped below 30% for the first time in 1987, when 28.8% of Americans smoked."

It's say it's going great. Fantastic even - inversely proportional to the level of your stupidity and anger.

11/14/2008 6:59:25 PM

Quote :

"Oh it's you, the slow one again "

burro's not slow, he's just lazy.

He'll spout his gut feelings as fact, without doing a quick google to see if he's even remotely in the ball park. My hope is that he's just using us for free research.

11/14/2008 7:35:06 PM

yes. doctors saying "quit smoking" has really worked. People aren't smoking because smoking is no longer the popular thing to do, as well as the fact that you are practically hated by the hippies if you smoke. It has nothing to do w/ doctors telling their patients not to smoke.

Likewise, people aren't going to lose weight just cause their doctor tells them to. Hell, we have so many drugs today that are all about not changing your dietary and exercise habits. Obviously doctors aren't getting through to people, so there's no reason to think they will start now.

But, by all means, continue with your ad hominem when someone calls out wishful thinking. It really does make you look smart

11/14/2008 7:44:46 PM

Quote :

"We can already see how the push in the media and gov. has caused people to buy more fuel efficient cars, and is leading to the demise of full-sized SUVs as we know them. "

Not that I don't think media or .gov can have an effect on demand for these sorts of things, but I'm fairly certain that $4 / gallon gas has more to do with fuel efficiency and declines in SUV sales than media or .gov propaganda.

11/14/2008 8:08:58 PM

moron

Quote :

"It's easily possible too that if more people have healthcare and go to doctors, the doctors will tell them to lose weight, causing a "broader social force" that leads to Americans living longer."

Apparently you have no heard of something called the public education system. We already provide YEARS of nutrition and health education to kids from K-12. The problem is not a lack of information. Please do understand that a high calorie, low exercise diet will make them fat. The problem is that there is a wide variety of environmental factors that the government cannot easily fix (for example: more people are moving to office work).

For a good take on why Americans are getting fatter (though mind you this isn't America's only health concern), I recommend you check out economist Eric Finkelstein's popular book on the subject (backed up with plenty of data).
http://www.amazon.com/Fattening-America-Economy-Makes-Matters/dp/0470124660

Quote :

"We can already see how the push in the media and gov. has caused people to buy more fuel efficient cars, and is leading to the demise of full-sized SUVs as we know them."

Are you serious!?!?!?! The government has been lecturing people air pollution and fuel efficiency FOR YEARS. Yet people did not actually act on this information until, duh, THE PRICE OF GAS WENT UP!

Do you honestly think it's a fucking coincidence????

Quote :

"It wouldn't take too much for similar mechanism of social engineering to make Americans live healthier lifestyles too."

It honestly amazes me when I hear real people talk about this--as if the motivating factors of their fellow human beings are so simple that they can be easily maniputlated (or "engineered") to yield desired behaviors. It's simply mad!

[Edited on November 14, 2008 at 9:20 PM. Reason : ``]

11/14/2008 9:19:17 PM

Quote :

"It honestly amazes me when I hear real people talk about this--as if the motivating factors of their fellow human beings are so simple that they can be easily maniputlated (or "engineered") to yield desired behaviors. It's simply mad! "

For the masses, this is a concept that's been proven countless times over.

It's the visionaries and pioneers that drive society, not the average masses. Just take any (and pay attention) psychology (or statistics) class and you're realize this.

and I wasn't saying that easier health care access will definitely make Americans choose better lifestyle choices, just that the excerpt you posted that said:

Quote :

" The differences between the neighbors are indeed significant. Life expectancy at birth is 2.6 years greater for Canadian men than for American men...These facts are often taken as evidence for the inadequacy of the American health system. But a recent study by June and Dave O’Neill, economists at Baruch College, from which these numbers come, shows that the difference in health outcomes has more to do with broader social forces. "

is wrong, because there's no reason these "broader social forces" couldn't also come to affect Americans as well.

[Edited on November 14, 2008 at 9:33 PM. Reason : ]

[Edited on November 14, 2008 at 9:33 PM. Reason : ]

11/14/2008 9:29:29 PM

^ Yes, it has clearly been proven how easily governments can manipulate the behavior of its citizenry. Just ask King George III, King Louis XVI, Abraham Lincoln, Chiang Kai-Shek, the Romanovs, Brezhnev, Gorbachev, FUCK ask George W Bush etc etc. OMG BUT THOSE ARE SO DIFFERENT (they weren't Democrats)!!!

Listen, if the lesson you got from your psychology courses (or fucking statisitcs!?!?) was that people are easily controlled or manipulated by a benevolent government, then YOU DIDN'T LEARN ANYTHING.

And speaking of "benevolent governments", one reason I'm skeptical of extending government power over our personal lives is that there is no guarantee their motives will be virtuous (check out public choice theory). And oddly enough, most Democrats I know agree with me...WHEN THEY TALK ABOUT BUSH! 4 years ago, Dems were so worried about military tribunals, warantless wiretaps, and the President tramping on our freedoms. But now that our party is in power, it will be all rainbows and hope and change!!!! Give the more power, because now it will use it for good and the evil Republicans will never gain office again!!

Fuck that shit. The whole party has turned into a bunch of loons.

[Edited on November 15, 2008 at 1:39 AM. Reason : partisan fucking elitist bullshit]

11/15/2008 1:22:21 AM

Quote :

"Personally, I'm worried that this will only exasperate our current problem of rising health care costs. "

I think health care costs are going to keep rising no matter what happens. There is nothing to pull them down. It is not like you sit down to decide on the cheapest hospital while you are having a heart attack.

I just hope they can do this without stifling innovation.

11/15/2008 10:28:53 AM

thoughts?

http://www.consumerwatchdog.org/patients/articles/?storyId=25468

Quote :

"Senator Max Baucus, Leading Architect of Health Care Reform, Received More Industry Contributions Than Any Other Democrat WASHINGTON D.C. -- Health insurers and pharmaceutical manufacturers contributed $5.5 million to the top 10 recipients in the U.S. Senate and House of Representatives during the last two election cycles - a period in which health care reform dominated political discourse, according to the nonprofit, nonpartisan Consumer Watchdog. Health insurers contributed $2.2 million to the top 10 members of the U.S. Senate and House. Drug manufacturers contributed $3.3 million to the top 10 recipients in each legislative body. In all, health insurers and drug manufacturers contributed $24,220,976 to the current members of Congress in the last two election cycles. Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, who has become the leading architect of health care reform in Congress, received more campaign contributions from the pharmaceutical and health insurance industries than any other current Democratic member of the House or Senate. Senator Baucus received $183,750 from health insurance companies and $229,020 from drug companies. At last week's White House summit on health reform on March 5, Senator Baucus said that the insurance companies and drug companies had told him they would help drive a solution. Baucus's own plan would require every American to show proof of insurance, with those who do not receive coverage from an employer or are not in Medicaid or Medicare forced to buy a private health insurance policy. Failure to show proof of insurance would result in tax fines. This is the insurance industry's favored policy. "When the engineer of the health care reform train is getting more fuel from the HMOs and drug companies that any other Democrat on Capitol Hill, you have to wonder who is really driving the train and whether average Americans will be tied to the tracks," said Carmen Balber, Director of Consumer Watchdog's Washington D.C. office. "HMO and drug company money will sour the President's plan for affordable, accessible health care if these industries' backers on Capitol Hill allow their financial interests to drive the debate." Consumer Watchdog's analysis ranks industry contributions to members of the 111th Congress in the House and Senate. Totals for former Senators Clinton and Biden and President Obama are not included in the rankings. In 2007 and 2008, President Obama raised $928,316 in contributions from individuals employed by the health insurance industry, and $1,068,200 from those employed by the prescription drug industry. However, President Obama did not raise any of this money from industry PACs (political action committees). Top 10 Senate Recipients of Top 10 House Recipients of Health Insurer Money Health Insurer Money Senator Amount Representative Amount McCain, John (R-AZ) $251,834 Cantor, Eric (R-VA) $113,850 McConnell, Mitch (R-KY) $200,200 Camp, Dave (R-MI) $112,923 Baucus, Max (D-MT) $183,750 Pomeroy, Earl (D-ND) $104,500 Lieberman, Joe (I-CT) $101,400 Boehner, John (R-OH) $101,200 Chambliss, Saxby (R-GA) $98,600 Deal, Nathan (R-GA) $100,000 Collins, Susan (R-ME) $96,500 Towns, Edolphus (D-NY) $87,750 Kyl, Jon (R-AZ) $90,450 Rogers, Mike (R-AL) $74,000 Warner, Mark (D-VA) $89,700 Blunt, Roy (R-MO) $72,800 Hatch, Orrin (R-UT) $85,903 Ryan, Paul (R-WI) $69,000 Nelson, Ben (D-NE) $83,300 Tanner, John (D-TN) $68,500 Top 10 Senate Recipients of Top 10 House Recipients of Drug Co. Money Drug Co. Money Senator Amount Representative Amount McCain, John (R-AZ) $294,603 Barton, Joe (R-TX) $187,100 Baucus, Max (D-MT) $229,020 Dingell, John (D-MI) $180,300 McConnell, Mitch (R-KY) $225,200 Boehner, John (R-OH) $156,125 Lieberman, Joe (I-CT) $196,540 Frelinghuysen, Rodney (D-NJ) $152,850 Hatch, Orrin (R-UT) $186,900 Clyburn, James (D-SC) $145,514 Spectre, Arlen (R-PA) $179,650 Buyer, Steve (R-IN) $141,350 Mendez, Robert (D-NJ) $147,243 Cantor, Eric (R-VA) $135,600 Enzi, Mike (R-WY) $134,500 Rogers, Mike (R-AL) $133,946 Kyl, Jon (R-AZ) $118,350 Blunt, Roy (R-MO) $133,500 Cornyn, John (R-TX) $115,900 Gerlach, Jim (R-PA) $131,660 Download the full analysis: -- Contribution Summary - This spreadsheet allows the user to rank members of the House and Senate by the level of contributions they received from each industry. Click here to view. -- Contribution Pivot Table - This spreadsheet allows the user to sort the data by recipient, donor, party, house, and state. Click here to view. Health Insurance Reform The two issues of health insurance reform currently under debate on Capitol Hill that most directly impact health insurance companies are the so-called "public option" to join Medicare and the mandatory purchase of health insurance. As a candidate, President Obama promised to provide a "public" health care option to any American as an alternative to private health insurers. At times, Obama has discussed "the public option" as though it would be a stand-alone plan like Medicare, which directly pays doctors and hospitals. The option to join Medicare, regardless of age, would be beneficial to Americans because by almost every measure, Medicare is cheaper and more effective than private plans, according to government and academic research. For example, Medicare spends 2% of revenue on overhead; private insurers typically spend 25% to 27% for overhead and profit. Health insurers heavily oppose giving Americans of any age access to Medicare. Insurers, on the other hand, support a plan to require all Americans to buy private health insurance policies. Under this model, the government would not regulate what insurers could charge for a policy or guarantee minimum benefits. Read Consumer Watchdog's letter to the U.S. Senate describing the benefits of a "public option" giving universal access to Medicare and the pitfalls of the individual mandate. Prescription Drug Reform Central to the health reform debate for drug companies is whether Medicare will be allowed to negotiate bulk discounts on prescription drugs. Currently the program is barred from doing so. President Obama has pledged to allow Medicare to bulk purchase, which would require Congress to pass a new law. Drug companies strongly oppose such a change. Polls A national poll in December 2008 conducted by the marketing survey company CARAVAN for Consumer Watchdog found that only 16% of U.S. voters support, and 53% oppose, requiring every American to provide proof of private health insurance or face tax penalties or other fines. Read about the poll here. A second opinion research poll for Consumer Watchdog in January 2009 found that, by contrast, 65% support giving every American of any age the option of joining Medicare, and 60% are willing to pay more in payroll deductions for this option. Read about the poll here. "

3/11/2009 7:47:53 PM

^the part on baucus turned me off because hes one of the few dems that doesnt want the amount you can deduct for giving to charities to decrease...which is where 318 billion of healthcare is supposed to be generated from...they make it sound like hes in the medical lobbys pocket when he is against the plan to fund ~1/2 of it

3/11/2009 8:09:23 PM

just bc someone has free health insurance gives no gurantees that they will behave responsibly.

Ask an on call OBG how many medicaid girls they have show up for birth that have had no prenatal care and they no NOTHING about. Will be an interesting experience for most of you guys.


Let govt cover LESS, will provide people will more choices, lower costs, while maintaining innovation and quality of care.

Everyone agrees healthcare costs are rising right? I can think of several procedures that have not only gotten cheaper (50% in some cases) but gotten far more advanced with technology over the last decade... the big difference? non-covered services.. people actually pay for them.. holly shit.

You see the idea of collectivism is that everyone should have the same thing.. and if I can afford to have this and you cant.. then neither of us should have it. So it forces quality down.

You can use all your stats you want, I always remember my stat professor saying you can make the numbers say whatever you want, but show me another country with the excesses we enjoy here, the fatty food, lazy life style, total abundance.. hell our poor are obese. Then ask yourself why people come to this country for healthcare from the stat superior systems?

Oh, one more thing, hospitals should be able to refuse care based on diagnosis. Stops a lot of this BS.

3/11/2009 9:06:30 PM