One other bit of McMegan’s post that bugged me was her elevation of single-payer as goal in and of itself, as if what interests reformers isn’t the health of the populace or the sustainability of the system but the aesthetics of the financing structure. “Look at that funding mechanism,” we’ll one day whisper in awe. “It’s just so redistributive.”
You get this occasionally from libertarians, and it’s always struck me as an availability bias error: Because the shrinkage of government is an end unto itself for them, they assume the expansion of government is an en unto itself for liberals. Liberals are just libertarians, but backwards, and without the “rtarian.”
That, however, isn’t true. Liberals want greater public involvement in health care because they’ve concluded the profit incentive doesn’t create optimal outcomes in this particular case. You can’t comparison shop during a myocardial infraction. You can’t walk away from the table while on a gurney. You don’t want to be in the position of second-guessing your doctors. You don’t want your neighbors going bankrupt because they failed to adequately save in their HSAs, not suspecting they’d get cancer at 32.
Health care isn’t like flat screen televisions — if I don’t have the former, I can die. If I lack the latter, I’ll be watching Entourage in slightly lower definition. On the other hand, I really wouldn’t want the government taking over the provision of flat screen televisions, as there the market works pretty damn well. The relevant variable isn’t the economic theory, but the good in question.
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If we do end enacting some kind of universal haeth care, I certainly hope the left will not complain about the product they get.
@1 We already have government health care. It’s called “Medicare,” and I like it. It’s much more efficient than private sector health care. In the government-run Medicare program, A&O (administrative and overhead) expenses are less than 1%, whereas under private health insurance, 25% of your health care dollars go to the insurance and claims processing bureaucracies instead of health services. Medicare is not only a better deal for the consumer, it’s more affordable, because it doesn’t waste billions of dollars supporting organizations whose only function is denying claims. Medicare actually pays your medical bills instead of taking your money to say “no.”
Health care is really not a good topic for libertarians or conservatives to argue their anti-government ideology, because the performance of the U.S. private health industry is so abysmal — to the point of being abusive — that it provides one of the most compelling examples of free market failure and one of the strongest arguments for government intervention in our country’s entire history.
@1 That is the beauty of Democracy, Libertarian. We, the people, can complain about it and change the parts that aren’t working. In the current system the only “people” that seem to have a voice as to what works and what doesn’t are the Insurance Companies and BigPharma. Their concern is their profit margin, the public’s concern is their own health. Which do you think will make changes that benefit the most people?
“Because the shrinkage of government is an end unto itself for them …”
I disagree with this aspect of Mr. Klein’s analysis. I think he misunderstands the libertarian/conservative mindset. Shrinking government is not an “end unto itself” for those folks. It’s merely the logical product of a deeper premise: That all government is bad.
This difference is significant, because if the belief that government can do no good is a foundational assumption of their political belief system, then it is going to produce errors all the rest of the way up the reasoning chain, in the same fashion that a mistake in the addition tables makes all the rest of your math work wrong.
In other words, if libertarians/conservatives believe that 2 + 2 = 3 or 5 or 1 or 0 or 7 — or any number other than 4 — then they’ll get the wrong answer … every time.
And that’s exactly what we’re dealing in the world of wingnuttery. Their fundamental assumptions and premises are wrong, so they come up with wrong answers — every time. Because they can’t get the basics right, they’re not right about anything, ever.
You see, Mr. Klein, to those folks the goal of “shrinking government” is merely a conclusion derived from the basic premise that “all government is bad.” It leads them to conclude that the answer to every problem is some sort of laissez faire approach that lets the market forces of greed and self-interest determine whether you get health care, at what price, and of what quality. Experience tells us the laissez faire approach to health care doesn’t work for the majority of people in our society, but ideologues are never deterred by either reality or fact-based reasoning. They simply deny the reality, and fix the “facts” around their reasoning — i.e., they make up phony facts to justify their faulty conclusion.
You can’t reason with people like that. You can’t persuade them. The only thing you can do is outvote them at the ballot box, strip them of power, stuff your fingers in your ears — and impose a rational, reality- and fact-based solution to America’s health care problems on them. It’s like dragging an ignorant child, kicking and screaming, away from a hot stove. In the end, after they grow up and realize the folly of their childhood misconceptions, they’ll thank us for having been good parents.
I heard a Canadian talking on The Ed Schultz Show a while back. He said one of the reasons Canadians are happier than Americans is because they don’t have to claim bankruptcy when they get sick.
Let the government do the things they should be responsible for, and do them as well as possible. If there is a contagious disease outbreak, I want my government functioning at 100% efficiency, not the 3% we get with Conservatives in control.
When Brown told Chertoff we were not ready for a major disaster, maybe Chertoff could have did something besides ignoring him.
One thing is for sure. If the Superdome Was full of nuns instead of the poor, it wouldn’t have taken 3 days to bring them water. Just saying……
Call the new program Christianized Medicine. You know, that Jesus dude that always talked about healing the sick…… Just saying……
UNIVERSAL HEALTH CARE
Snappy Comebacks to Common Objections
How can the key to our productivity be based on turning the best health-care system in the world over to the same people who gave us the IRS and the Postal Service?
I’m fine with turning it over to the people who gave us the interstate highway system, the Apollo moon landing, the Internet, the aviation industry and the computer industry. On those last two, it was many years of generous federal funding that enabled private industry to eventually be in a position to make profits in those fields. Boeing’s commercial aircraft division didn’t turn a profit at all for its first twenty years of existence. You should just thank whatever deity you prefer that Bill Gates bought MS-DOS instead of the TCP-IP protocol. Had a private entity decided to maximize profits at each step of information transfer back then, you would not be engaging in online conversation with anybody because the Internet would have been strangled at birth.
Why doesn’t anyone provide any details on how such a system would work or be paid for, and why do people from countries with universal health care come to the U.S. for health car, instead of waiting 9-12 months to get their free universal healthcare.?
That’s mostly mythology. Most foreigners who get medical care here are traveling or are semipermanent residents. We do get some medical tourism at major research hospitals, but China, India, Thailand and Cuba are the leaders there (reasonable quality at low cost). Our waiting periods are in fact on a par with those in the rest of the world, and longer for under- and uninsured people. That a few people have enough money to jump the queue here does not impress me in the slightest.
People, who suggest that universal health care would ease the strain on American companies have not studied basic economics. The money for universal health care has to come from somewhere, and would be funded by ever higher taxes on companies and individuals. Additionally, any product or service that is considered ‘free’ will be abused and over-used (hence the strain on our emergency rooms, which treat everyone, regardless of ability to pay, and get overloaded with cases that should be handled by normal office visits). There is no free lunch.
Countries with universal health care don’t have overused emergency rooms precisely because they have universal care. Given that we spend twice as much per capita as these countries, it is just nonsense that we need more money. We just need to spend what we are already spending more productively. We are already paying for universal health care; we just aren’t getting it.
Why don’t you go live in those nations if you think universal health care is a good thing? England and Ireland both have income taxes that range just under 50%, and on top of that because so much of income tax is eaten up by health care they have a 20% value-added tax for purchased goods. Most doctors in Ireland are from India because the Irish doctors have moved to the U.S.
People in England and Ireland show no great desire to have our health care delivery system, particularly since the poorest British enjoy better health than the wealthiest American demographic.
http://www.ncpa.org/sub/dpd/in.....le_ID=3289
I’m hard-pressed to find even one thing that government could do better or cheaper than private enterprise. Private enterprise must yield to the bottom line and spend accordingly, whereas governments merely increase taxes higher and higher to cover expenses regardless of how high they get.
I can think of quite a few things that the government does better and cheaper—fire and police protection, roads, water and energy, for starters. Three competing fire departments in a city would give you vastly worse service for far more money, just like our current health care non-system. Ever since Benjamin Franklin founded our first public fire department, nobody has been stupid enough to try that, but we do know what happens to health care costs in towns of similar size that have more than one hospital. Two hospitals means higher costs and three means even higher costs. That’s because health care economics is like fire department economics, not like iPod and home entertainment center economics.
15% of the population accounts for 85% of all health care costs, and in any given year 50% of the population has NO health care expense at all. That means that you are somewhat more likely to get expensively sick or injured than you are to have your house catch fire, but not by much. Though neither is likely to happen to you, either could happen to you or to anybody. We don’t push the entire burden of supporting the fire department onto only those people who have fires. It makes no more sense to stick mainly sick people with most of the burden of supporting the cost of health care. Unfortunately, private insurance exists only to do that to the greatest extent that they can get by with, which is why it is such a disaster. Let’s have no more cherry picking–put everybody into the biggest and cheapest risk pool of all, which is all of us.
As Enron and Reliant have demonstrated, maximizing profit in the energy industry is at its root a criminal enterprise. They found that they could make more money by withholding power than by supplying it, so that’s what they did, just as insurance companies make more money by denying care as often as possible. Note that publicly owned utilities in California didn’t have any brownouts during the manufactured ‘crisis’. Using private health insurance is like hiring someone to tap into your power line between the meter and your house and siphon off as much as they can get by with. Isn’t it about time that we realized that all infrastructure (health care, energy, fire protection, etc.) is a public good that should be either owned by or closely regulated by the public? (This of course does not rule out subcontracting the provision of some public goods to private entities where appropriate. That seemed to have worked fine with the interstate highway system.) Investment in the public good is the foundation of private opportunity.
Compare the U.S. with Canada for a glimpse of universal health care. Here, you can get any procedure done virtually on-demand, yes, as long as your insurance covers it or you can pay out-of- pocket. But in Canada, you have to wait sometimes years for critical operations such as bypasses, etc. How many Canadians cross the border so they don’t have to wait those years?
Not as many as you think. If the operation is in reality critical, you don’t have to wait. I’m fine with waiting in line for expensive treatment if whatever condition I have isn’t going to kill me any time soon. Most Canadians who have treatment here are either people who are traveling or wintering here or whom the government purposely sends here because it’s cheaper for them than maintaining unused capacity. A few years ago, my lab’s old thermal analysis equipment finally gave up the ghost. We looked at the demand for that service and decided not to keep it in house because we didn’t have enough work to justify the capital investment. Odd that behavior which is considered good business practice in the private sector is considered evidence of abysmal incompetence when governments do it, no?
If you live in Washington or any other state bordering Canada, you probably know that there is quite a bit of traffic in the other direction. Canada had to institute a more stringent ID requirement in the mid 90s because hospitals in some cities in Ontario had a caseload that was 5-10% American freeloaders. Health Care for All-Washington has compiled a list of Canadian doctors willing to see Americans on a cash-only basis. If you live close enough, you can get treatment at about half what you would have to pay here.
http://www.healthcareforallwa......fault.aspx
This is not just poor people either. Lasix eye surgery was introduced in Canada earlier than in the US, but even though we have now caught up, it’s still popular for middle-income Americans to go to Canada for this treatment. They often aren’t doing it to save money because they make a vacation out of it. For the price of the surgery alone here (twice what it costs in Canada), in Victoria you can get a weekend with high tea at the Empress, a visit to Butchart Gardens and some nice wool sweaters and Tlingit carvings plus the surgery.
Part of the problem here is an utter lack of understanding of the economics by most of the discussant. Ms. Clinton is one of the few pols who have put enough time and effort into this to understand why we have a problem:
Here are a few facts:
1. The current system is NOT a free market. Private and free are not the same thing. The system we have now is private, largley, but there are tremendous incentives at many levels to create bureaucracies that are not themselves market dependent.
2. Medicare and the VA are bargains, BUT both are subsidized. Medicare subsides come fomr their fiz=xed charge structure that effectively raises ev ery one elese’s medical care bills.
3. Preventive medicine RAISES health care costs.
4. Medicine has an non reducible component of expensive labor. As efficiency goes up in a society, many labor costs bare decreased. Anthing that is labor intensive needs to compete with this more efficent market .. as a result labor costs MUST rise.
5. We are in the midst of a revolution in biology. This can reduce costs, but the most promising reductions in costs are in third world countries with a lot of infctious disease. In the US as we learn tot reat more diseases, we also create costs.
The bottom line is the system is broken. Fixing it will require a very able politician and an open mind. Will the fix involve some sort of free market? I hope so for obvious reasons. The question is not how to get rid of the free market but how toreenginer the free market so it acually works.
6 FSMP
Americans CAN’T claim bankruptcy when they get sick. The Bankruptcy Act of 2005 sewed up that little “loophole.” Godless Communists think getting sick is a reason to weasel out of paying your debts! Thanks Joe Biden and every Republican.
6 “If the Superdome Was full of nuns instead of the poor, it wouldn’t have taken 3 days to bring them water.”
Why do you say that?
On the other hand, if the place had been full of oil-company executives, Bonesmen and high-roller Publican campaign donors, you could bet your britches they’d have choppered ’em all out in a matter of hours.
7 SJ
By and large interesting adn well-taken points. I disagree on a couple:
I am in a very good employer-sponsored program, and it, too, has a fixed payment schedule for member physicians. This is a very common contruct. While one could look at this as “raising everyone else’ rates” one might ask who “everyone else” is. If you mean “the uninsured,” then I guess we should damn well insure them and save a boatload of money. I think what it really means is another point you make: it’s not a “free market.” The part of this market I am talking about is actually one of pools of buyers of medical services who receive group rates, essentially.
I think it is fair to say that preventive medicine has a cost, and that to the extent that one adds more preventive medicine services to their health-care asks it is an additional cost, but overall the research shows pretty well that preventive medicine ends up preventing a number of large downstream costs, so in the long term I think you would find a generous and robust program of preventive medicine is cheaper that doing without. As everywhere else, there is room to argue about what programs and what specific services provide the most benefit at the lowest cost.
#2 Roger Rabbit – Hoooahhh!
It has never made sense to me that if you do not have health care that you end up paying three times what the insurance companies have to pay. The uninsured are getting totally screwed with the current system.
@12 or what ever.
I use an allergy eye drop that costs $75.00 (I pay $15 of that). That drug costs the uninsured around $115.00. It’s available in Canada for $37.00 US.
WTF????
http://www.canadapharmacy.com/.....uctid=1713
http://www.amerimedrx.com/patanol.htm
Roger @ 2,
Have you had a chance to look into long-term care benefits under Medicare? You might be surprised on how little Medicare covers in that arena.
I suppose you liberals will get your national health program someday: the world’s headed that way. I just don’t want to hear any complaints once you get the system you want. It may not be the Bluebird of Happiness you’re all hoping for.
@13
I suppose you liberals will get your national health program someday: the world’s headed that way.
The world’s been that way. Most industrialized nations have had systems that cover everyone for years, and their systems are cheaper than ours and yield higher satisfaction ratings than ours. We’re the exception in that we don’t cover everyone, and it’s STILL more expensive per person.
Lee,
I hope you like what you get.
“I hope you like what you get.”
Sure hope so, because what we have now sucks donkey balls.
What Libertarian, and others of his ilk fail to realize is that we already have a jim-dandy socialized medical system here.
If you are uninsured and indigent, and show up at the ER with a toothache, you will likely be turned back because the problem is not life-threatening.
When you show up 6 weeks later with an abscess, then and only then will you be treated.
Who pays for the costs of an abscess being lanced, bed time in a hospital, etc.? Yep. You and me, people with proper jobs who actually pay for our health care.
Preventative care in the form of antibiotics when it was a small problem would have been cheaper, but that would be socialized medicine, and that would be extremely wrong and against market principles.
7 “We are in the midst of a revolution in biology.”
Stephen, that’s one revolution that’s been going on since a long, long time before even you and I were born.
Hmm… I’m not going to pretend to know how this works.
If you don’t have insurance the cost for Patanol eye drops is $115. Rengence will pay a pharmacy $75. An American, regardless of insurance, can order Patanol from Canada for $35 US.
If you have sinus allergies Zyrtec is OTC in Canada and can be scored over the internet for $29 US for 100 pills. My insurance wont even cover Zyrtec. Back in the day when it was covered Zyrtec cost me $20.00 for 30 pills.
I would called myself a Progressive Libertarian. So I believe that there are places government should keep their mitts out of, and others where government must be involved.
Here is the simple test of the reality of universal health care. Simple equate doctors to either fireman or police officers. If you feel that it would be acceptable to privatize fireman and police officers, then I would accept your position to keep doctors as privatized. If you feel that a fire department shouldn’t have to respond to a fire at your house if it is on fire unless you have paid into a fire department fund, then I could support your position on free market health care.
Many people (e.g. Gov. Huckabee) think that if people would just take better care of themselves physically, then we wouldn’t have a health care problem. Based on this, those who aren’t healthy are to blame for health care costs. If a faulty electrical appliance causes the fire in your house, is it your fault? Should you be responsible for paying the costs for the fire department to respond to the fire at your house?
This would be a completely dysfunctional system for our fire and police departments, yet this is the rationale for our current health care system. Blame those who get sick, blame those who even may be more predisposed to health conditions than others, blame those who get sick as a result of intense work environments than cause stress related illnesses.
Our health care system is broken. It is designed to punish the sick, and it doesn’t even reward the healthy, because for the insurance model to work, the healthy must subsidize the sick. No matter how you look at it, it doesn’t work. No one is going to shop around for the best fire department. No one is going to get a price quote from a police department to investigate a break-in at their residence. To consider such a reality as rational is ridiculous.
Governments job is to work for the common good. The common good in this case is having to worry about health care, like you worry about needing the police or fire department. When you need it, they will be there regardless of how much you pay in taxes, regardless whether you are employed or unemployed, regardless whether it was your fault or not.
For those who would call this position liberal, I too at one point believed that health care was a personal responsibility and should not be subsidized. Then I found myself married, with children, and unemployed due to no fault of my own because the company I worked for went under. I became sick and unable to look for work, and my kids needed to see the doctor as well, but we couldn’t go until I found a new job with a medical plan. At that point I realized that I had become a member of society who was suffering, and that there were millions more like me. I realized the selfishness of my previous belief. I realized that making a judgment as to another’s condition and the worthiness of assistance was worth about as much as used toilet paper.
Spineless @ 20
Excellent analysis. I, too, respect many aspects of the libertarian (that’s intentionally with a small “l”). The least government is frequently the best government. But, at the same time, we are a community. I do believe in something called “the common good.” Sometimes, we need to pay for others just because.
Lee-
I’m afraid the simple analysis in your post is just too complex for the “Big Thinkers” that troll hee to grasp.
Maybe you should dumb it down for ’em next time.
@20
Good for you, you came to an understanding of how it works, and a rational conclusion on how it should be changed.
Many people have similar experiences and learn nothing, continuing to parrot an ideology that told them what was “right”.
I get a kick out of the wailing letters from the people who have long been on company paid insurance, who shriek that with “socialized medicine” they can’t pick their own doc, etc. Of course, now that many of them are into the mandatory
HMO stuff,they can’t pick their doc anyway, but still they shrill against “socialized medicine”.
I have a friend who worked for the UW Med School. Broke his leg while under the plan of Group Death. Never saw a physician. Cast applied by a PA, all follow-ups by same,
But, BY GOD, IT’S NOT SOCIALIZED MEDICINE!!!
@13 “Have you had a chance to look into long-term care benefits under Medicare? You might be surprised on how little Medicare covers in that arena.”
Is this supposed to be an argument in favor of our costly, inefficient, and ineffective private health system — or an argument in favor of expanding Medicare?
@15 I’m confident we’ll like it better, because it would be hard to do worse than what we have now, even if we tried.
It’s interesting to see the righties try to defend our commie health care system. They’d be screaming to high heaven if a gas station raised the price of their gas because the person at the pump in front of them couldn’t pay for his gas. But that’s exactly how the commie helath care system foisted on us by the private sector works.
All the fucking losers who are running for moonbat nomination for preznit are running on a platform of retreat and socialism.
Do you guys REALLY think that will work? Are you fucking kidding me?
@19 “Hmm… I’m not going to pretend to know how this works.”
Here’s how it works, Michael. The drug companies need a captive customer base to recover their costs of bringing these drugs to market. No, I’m not talking about R&D — most drug companies spend less than 10% of their gross revenues on R&D. I’m talking about marketing costs. Persuading you (and doctors) that you actually need all these fancy name-brand drugs to make your dick stiffer or to cure “restless leg syndrome” costs buckets of money — typically 50% to 60% of a drug company’s total revenues.
@22 “So I believe that there are places government should keep their mitts out of”
Absolutely. What books I check out of the library is none of the government’s goddamn business until they’ve got enough probable cause to believe I’ve committed a crime to get a search warrant from a judge.
For those of you who forgot, here’s what Roger Rabbit REALLY thinks about healthcare:
I like Castro’s system better. He confiscates the employer’s property, shoots the employer, and the workers get quality health care for free. We need something like that in America.
Commentby Roger Rabbit— 3/19/06@ 3:42 pm
Ironic that those who screech the loudest about “big brother government” are its principal authors.
[Deleted – off topic]
@32 They shoot bet welshers, too! Suck on it.
[Deleted — Darryl, see HA Comment Policy]
@30
I figure I don’t need to move to Canada as long as I can order my allergy pills and eye drops online from Canada. Way cheaper.
@22 “For those who would call this position liberal, I too at one point believed that health care was a personal responsibility and should not be subsidized. Then I found myself married, with children, and unemployed due to no fault of my own because the company I worked for went under. I became sick and unable to look for work, and my kids needed to see the doctor as well, but we couldn’t go until I found a new job with a medical plan. At that point I realized that I had become a member of society who was suffering, and that there were millions more like me. I realized the selfishness of my previous belief. I realized that making a judgment as to another’s condition and the worthiness of assistance was worth about as much as used toilet paper.”
I have my own anecdote. This is a case I remember from my days as a government lawyer. A veterinarian lost his job and health insurance when his employer went out of business. Four days later, catastrophe struck: His wife collapsed from a cerebral aneurysm. After 3 years in a coma and $2.5 million of medical bills, she died without ever regaining consciousness. This poor man had to file for bankruptcy and of course he lost his home, savings, and everything he had worked for. He had to get his own medical care, and medical care for their kids, paid for by Medicaid.
Now here’s the Republican health care plan. You can no longer bankrupt medical debts. If something like this happens to your family, you will remain financially enslaved to your medical creditors for the rest of your life. That’s the conservatives’ vision for the future of our country.
Why would anyone in the right mind vote for those bastards?
Here’s another thing I don’t get.
Where I work we are not in the business of providing health insurance or care, yet we have a FTE that deals with heath insurance and health care issues. We’d love for someone other than us to provide heath insurance so that we could put that person to work actually doing what we do.
Why are people so apposed to creating a system where businesses can do what they do and not devote resources to heath care?
Anybody got any room freshener?
We’ll have to make do with that as long as Goldy encourages Marky to come here to shit…
@23 “The least government is frequently the best government.”
In some contexts, yes. But in many other contexts, no. We need government regulators to protect us from business, because business will not protect us from business.
Business exists for one reason, to make a profit. Often the easiest way to increase profits is to cheat customers by selling them shoddy products.
Under the Republican Contract With America, the food we eat isn’t safe. We don’t know where it came from. We don’t know what’s in it. The only things we can be sure of is that our food isn’t being inspected, there’s no enforcement of food safety laws, and if it makes us sick the Republicans want us to pay the medical bills ourselves instead of suing to make the businesses that sold us the dangerous food products pay our medical bills.
Why the hell would ANYONE vote for these people?
@29 You can’t even pay a $100 gambling debt … and you want to tell us how to run the country?
One last thing I don’t get.
Employers with good heath insurance have lower rates of sick leave, higher productivity and better employee retention yet many companies are gutting their heath insurance plans. I thought high levels of employee retention and productivity were a good thing? We allow employees to stay on the clock for most shorter doctor visits, it keeps the employees happy and healthy productivity up. Plus, it costs us about $8,000 (hiring, training, lost productivity) to replace an employee that quits.
Cutting heath benefits is a case of short term gain, long term pain, why do it?
@34 “So Rabbit… ‘educate’ me a little… Explain to me the concept of ‘free’. I can’t wait to hear”
Free is when you get something without paying for it, for example, when you make a bet with someone and then welsh after losing the bet.
@29
Actually, they’re not running on that at all.
@45 Redneck can rant all he wants. All we have to do is run on Bush’s record.
#41 Roger Rabbit says:
Maybe working for the government and not having your own business never taught you that selling a shitty product or giving lousy service is the best way to become a government employee.
Like I’ve said numerous times, government employees suck. Like you said rabbit, no inspections & no enforcement. What are all these paid by taxpayer employees doing to earn their piece of my tax dollar? Not a thing!
#46 Roger Rabbit says:
Good point about bush’s record, it’s not like the democrats have anything the country would be interested in voting for.
The health care system in place is not free-market by any means. It evolved from wage-controls during WWII, when employers realized that health care benefits were exempt and started offering them as a way to compete for employees. The unwieldy system we have has evolved from a succession of one gov’t fix after another–not free market. Clearly the system we have is not very pretty and we need to move in the direction of either market-oriented solutions like MSA’s or a single payer system. It is wrong-headed to say that our health-care system is an example of free-market failure, because we don’t have a free market system.
I had to go to DMV coupla weeks ago. I sat there for 3 fucking hours to do 10 minutes worth of administrivia so I could give a gummint parasite a few bucks to do some meaningless fucking work.
The place was full of people who are not native Murkans like me. They spoke every fucking language on the planet bucep English.
And I’m thinkin to myself… this is what Hillary and McCain want the health care system to look like. Hillary and her fucking socialized medicine and McCain and his fucking amnesty program.
So the end result is opening the borders so everyone in the fucking world can come here to get “free” health care that I pay for, while I sit there and suffer.
And this is your vision? Fuck that. I want no part of it. And neither do most Murkans.
Lee: if the distinction between TV production and health care production is that the latter may be a matter of life and death, do you think that other life/death items also need to be nationalized. For example: fire extinquishers, guns intended for self-defense use, food, exercise equipment (lack of exercise WILL shorten your lifespan, i.e. kill you)?
About 25% of health care spending goes to health problems caused by behavior: smoking, alcohol, diet, seat-belt (non)use, overexposure to sun, unprotected sex, etc. As gov’t involvement in health care goes up, expect to see nanny-state legislation do the same. Obviously this is already occurring to some extent (seatbelts, cigs).
If people see their taxes skyrocket because of the unhealthy choices of others, whether risky sex, poor exercise, or whatever, there will be pressure to impose gov’t controls on that behavior.
Yeh we would all like Hillary care, but it is all locked up in a tight seal so no one will know how this will work or how much massive more tax dollars it will consume.
I’d love to wait 2 years for a simple procedure as they have to in most other socialist countries.
No thanks!
#52 wutitiz says:
Only 25%? Links? I bet it’s much higher just for overweight people. Increased costs are also for old people, life expectancy has expanded along with health care costs. Check out hospitals and see the ratio of overweight&old people to others.
If socialized medicine worked than millions of people who dont have it would be flooding the countries that do have it. Socailism fails everytime it’s tried.
Hey, isn’t MTR’s trip to the DMV off topic.
Here are some comments regarding a democrat run institution the Seattle public schools http://forums.seattletimes.nws.....38;t=18972.
@51
Lee: if the distinction between TV production and health care production is that the latter may be a matter of life and death, do you think that other life/death items also need to be nationalized. For example: fire extinquishers, guns intended for self-defense use, food, exercise equipment (lack of exercise WILL shorten your lifespan, i.e. kill you)?
No, not at all. You’re not quite grasping the bigger picture here. No one is saying that we need to nationalize the production of CAT scan machines or rubber gloves or defribrilators. What we need to do is to recognize that individual medical care requires a different system than just allowing for market competition. You’re correct to a certain extent that we do not have a true free market system (a true free market system would be an utter disaster, imagine having to haggle with doctors when you get cancer). What we have is a system where we’ve allowed for the only motivator to be profit. What we need are two competing systems – one that is driven by profit and another one that is taxpayer funded, free, and tasked solely by providing adequate care. These two systems then should compete with each other. The taxes on the for-profit side should be set based upon how many people opt for the latter (so, if 20% of the public is served by the public system, the for-profit sides taxes will be lower than if 30% use the public system).
@52
About 25% of health care spending goes to health problems caused by behavior: smoking, alcohol, diet, seat-belt (non)use, overexposure to sun, unprotected sex, etc. As gov’t involvement in health care goes up, expect to see nanny-state legislation do the same. Obviously this is already occurring to some extent (seatbelts, cigs).
This hasn’t really happened as much in Europe, though. We started cracking down on cigarettes long before the Europeans, even while their governments were more heavily involved with their health care. That also goes for alcohol, where Europeans are much more relaxed (and especially about unprotected sex). I’m not sure where you get these notions that the welfare state will lead to more nanny statism (we went over this on another thread), but there’s no factual or historical basis for it. As I mentioned there before, the most nanny state countries in the world are Muslim nations in the Middle East, and they don’t have a fraction of the welfare state that their neighbors in Europe do.
@55
If socialized medicine worked than millions of people who dont have it would be flooding the countries that do have it. Socailism fails everytime it’s tried.
Um, this has been happening in Europe for a long time (and I personally know people who’ve moved from the US to Canada for that reason).
@8 Daddy Love
I am in a very good employer-sponsored program, and it, too, has a fixed payment schedule for member physicians.
It would be interesting to know the numbers but I suspect your corporate plan bargains with the providers while Medicare legislates what is allowed. W/o being sure, I would guess that you are subsidizing medicare (as am I).
Of curse we ALL subsidize the uninsured.
overall the research shows pretty well that preventive medicine ends up preventing a number of large downstream costs, so in the long term I think you would find a generous and robust program of preventive medicine is cheaper that doing without.
There is a mathematical issue here. First there are at least two very different major efforts in preventive med .. children vs. adults. Preventing disease in children is VERY efficient in art because it not only cuts health care costs BUT adds productive workers who pay for their healthcare.
BUT preventive medicine for older foks is a loser. Why? When you look at costs to society you wnat to know something very simple … how much do we pay out each year for health care? As the number of older people increases this number goes up hugely because older people do not earn money and have worse health. The steady state cost per individual remains the same , pretty much, because older people die slowly, at high cost. The incidence of death per individual is (sadly) always the same even if we live longer. So prevention RAISES heath care costs in three ways:
a. the older you are the sicker you will be
b. the more years you live the more you cost society
c. many forms of prevention are themselves expensive when one figures total costs over an extended life span.
Bottom line, we are getting t the point where longevity has a cost. We are living longer, so that costs id going up.
We should encourage folks my age to smoke!
@20 ArtFart
Stephen, the(revolution in biology) has been going on since a long, long time before even you and I were born.
Sorry my friend. Come share a beer some Tuesday and I will tell you a bit about what is happening. There has never been a scientific explosion in nay field that compares with what is now happening .. at least in the sense of new knowledge.
W/O giving a sermon, I can’t begin to tell you about it all but we are now very close to having powers that rival those tradionally assigned to Deities. We routinely read the Deeity’s words .. not in some messed up biblical form but direct from the source. And we can change those words.
@56
He tied health care into that comment eventually, even though it was completely idiotic and incredibly racist.
@22
Thanks for the great comment. It’s a shame that we have a bunch of idiots like Stamn and MTR who can’t hang with the big dogs.
You could justify removal of anything by MTR on sanitation or public health grounds.
@58 SJ
Jeez, SJ, you really are an excellent antidepressant.
I think I’ll just mix a couple grams of cyanide in with my glucosamine tonight and solve some of the country’s health care woes…..
@64
As soon as I get tired of fucking your mom.
65
He HAS a mom?????
@47 “Maybe working for the government and not having your own business never taught you that selling a shitty product or giving lousy service is the best way to become a government employee. Like I’ve said numerous times, government employees suck. Like you said rabbit, no inspections & no enforcement. What are all these paid by taxpayer employees doing to earn their piece of my tax dollar? Not a thing!”
As usual, you don’t know what you’re talking about. Enforcement of food and drug laws is lax because Bush put idealogues in charge of those agencies with an agenda of NOT enforcing the laws!
Take meat inspection, for example. Bush slashed funding for federal meat inspectors. But he went even farther than that; he attempted to privatize meat inspection. Under Bush’s scheme, the inspectors would be employees of the companies whose meat they’re supposed to inspect — but their salaries would still be paid by taxpayers, because the companies would get direct federal subsidies for the inspectors’ salaries! What kind of fucking enforcement is that?!!
Stamn, you just don’t want to admit that Republicans are assholes who enrich their buddies by letting business screw consumers. Unless you own a giant agribusiness or a meatpacking plant, you’re voting against yourself by voting Republican.
Here’s some specific examples of Republican bullshit:
“Statement of CFA’s Carol Tucker Foreman on Settlement Of Nebraska Beef Case and Funding Food Safety with User Fees
“Last week started with good news for consumers. Agriculture Secretary Ann Veneman announced a $42 million increase in the food safety budget for fiscal year 2004. It ended disastrously, when we learned that, in fact, there is likely to be less money spent on meat inspection in the future.
“The Bush Administration has put tax cuts for millionaires ahead of safe food for consumers. … The much ballyhooed increases in food safety funding are a fraud. The Bush Administration’s 2004 budget counts on user fees paid by industry to support a major portion of the meat inspection budget – far more than the announced increases. Consumer groups have always opposed ‘fee for service’ inspection. It’s what it sounds like, a program to serve the needs of industry, not protect human health. … In the end, the Administration’s obsession with cutting millionaire’s taxes will result in less money for meat inspection next year. …
“If the Bush Administration … ‘privatizes’ meat inspection …, the [Agriculture] Department is … more likely to put the interests of meat companies ahead of human health. Consumers will not benefit from inspectors viewing the owners of meat plants as the source of their paychecks.
“USDA’s actions in the Nebraska Beef case are equally ominous. It has agreed to allow the slaughterhouse to remain open after Nebraska Beef argued in court that the Agriculture Department has no authority to enforce either … inspection … or standard sanitary operating procedures. The company had a stack of violations for fecal contamination, dirty plant conditions, and condensation dripping onto surfaces where meat is prepared. …
“Nebraska Beef’s lawyers argued that closing the plant would be bad economics, harming cattlemen who sold livestock to the company, and the owners of the plant. They simply rejected the argument that filthy conditions that threaten to generate foodborne disease are a reason to stop production. USDA’s settlement is a capitulation to the demands of a substandard plant. … The settlement suggests the Agriculture Department has no authority to close any plant based on public health considerations. … Now every plant in the nation knows that, for practical purposes, USDA can’t shut them down for food safety violations. …
“So, this week, the Food Safety and Inspection Service suddenly has less money and less authority to protect the public from unsafe meat and poultry. The Bush Administration has effectively cut its budget and … put human health at end of the food chain. It allowed a filthy meat plant to keep operating and put a tax cut for millionaires ahead of human health by proposing to privatize meat and poultry inspection.”
http://www.consumerfed.org/rel.....03beef.txt
“The U.S. Department of Agriculture (USDA) ignored repeated food safety violations at a Pennsylvania … plant, and in 2002, Listeria-contaminated turkey meat from the plant killed eight, sickened more than 50, and caused miscarriages and stillbirths ….
“The lead USDA inspector for the plant knew about Listeria contamination and other filthy conditions prior to the outbreak, but the agency declined to take action, according to individuals who worked inside the plant. On the contrary, USDA gave advance notice of Listeria testing, which is supposed to be unannounced, allowing the plant … to perform special cleanups.
“Vincent Erthal, a USDA inspector who worked the night shift at [the plant], requested enforcement action in August 2002 and provided two years of documentation of widespread sanitary problems at the facility. Unfortunately, agency higher-ups looked the other way.
“When the … story received media attention, Elsa Murano, USDA’s undersecretary for food safety, attempted to discredit Erthal, claiming ‘he has not produced any proof, any evidence’ of USDA negligence …, and seemed to imply that he was responsible for the outbreak because he didn’t push ‘harder to blow the whistle.’
“Enforcement actions against improper drug advertising have dropped dramatically during the Bush administration, coinciding with a policy issued at the end of 2001 that positioned the agency’s office of chief counsel as a clearinghouse for all notices of violations.
“From December 2001 to September 2002, the Food and Drug Administration (FDA) issued just 19 ‘notice of violation’ or ‘warning’ letters (an average of just two per month). In the three previous years, FDA sent 253 of these letters to manufacturers, or almost 85 per year.
“This decline came at the same time drug advertising skyrocketed. Ads aimed at doctors increased by nearly 20 percent in 2002, yet FDA actions directed at such promotions decreased by almost 80 percent. Likewise, direct-to-consumer advertisements submitted for FDA review increased by 75 percent in 2002, yet FDA enforcement actions in this area decreased by nearly 50 percent.
“Daniel Troy, FDA’s chief counsel, explained this discrepancy by claiming the agency’s oversight is focused on fewer, more complicated cases; however, when pressed by a Boston Globe reporter, he could not offer a specific example. The drug industry, which gave $5.7 million to 2000 Bush campaign efforts, faces virtually no deterrent to misleading consumers.”
http://www.sensiblesafeguards.org/copoff.phtml
The truth is, there’s only one political party that protects consumers from dishonest businesses and dangerous products — and it ain’t the GOP.
@48 “it’s not like the democrats have anything the country would be interested in voting for”
Let’s see if voters are interested in this:
Protecting Social Security and Medicare from being looted by Republican “privatization”
Protecting consumers from dangerous food, drug, and toy products
Preserving the right of injured consumers to sue manufacturers and distributors of defective products
Affordable health care
Fair wages
Safe workplaces
Establishing and enforcing fair lending practices
Enforcing securities fraud laws
Competently-run disaster relief
Effective airport screening
Efficient air traffic control
Community policing and crime reduction
Protecting employee pensions
Republicans have fallen on their asses in each and every one of those areas, and a long list of others. In fact, there isn’t a single fucking thing that Republicans have done right in the last 6 1/2 years! Conservatives can’t run a kindergarten let alone a government. Only ignorant fools vote for Republicans.
The best comment is above when they said we pay for covering everyone, we are just not getting the coverage. The insurers take their take off the top, and 47 Million go without insurance, hoping like hell they don’t get sick. The insurers get 30% to 40% off the top to deny as many people benefits as possible. Sound fair?
From what I understand the VA is “socialized” medicine, and once someone gets into the system they are in pretty good hands. I know Marvin hates “govment employees”, so I wonder what he thinks of VA doctors? Coast Guard pilots? Firemen? Yeah, I thought so.
Marvin, the only thing worse than a government program, is a private company doing the same thing even worse, for twice as much. Maybe the libertardians will figure this out some day. (See Walter Reed Hospital)
What doesn’t work is paying your CEO 1.7 billion dollars for a year’s salary denying people benefits that were promised.
I heard a girl on Thom Hartmann talking about earning $60,000 a year, and then she got cancer. She lost her job, and could not buy insurance until she had 2 years cancer free, and it was going to be $1,500 a month with a high deductible then. Can you afford $18,000 a year for health insurance while unemployed, knowing cancer may someday return?
Unfortunately it is not just Republicons taking handouts from PHarma, and HMO’s. It sure was Cons that shoved the Plan B down our throats though. No negotiating drug prices. And they call it free market. Makes me want to puke.
Americans need to demand “christianized” medicine. That Jesus guy mentioned healing the sick a couple times If I remember right. Every other industrialized country gets it. Why do we need to put up with the sucky system brought to us by the mainly right wing freaks? Make health care a zero profit 100% care industry, and find a way to do it. If you don’t agree, better hope you don’t get sick, and become a creditor slave. Better yet, if you don’t like the idea of socialized (shared cost) medicine, I hope you never get cancer. You will be the first one in line waiting for a “handout” won’t you.
Um, Really. Yeah that’s the first place people think of when they are in dire need of heart(or any other major one after that) surgery….Cananda. Hehehehehe Get this guy a tin foil hat. hahahahhaha
[Deleted – Comments must be in English]
[Deleted – Comments must be in English]
Factless lying again: “47 Million go without insurance”
Liberal Kaiser Family Foundation: 8.8 – 13.2 million uninsured.
Where do you get your “facts”?
@72
Source:
http://www.signonsandiego.com/.....verty.html
Thank you for typing that comment in English, but you’re still wrong.
@72
Oh, and by the way, here’s the Kaiser Family Foundation’s website where it says that there are 46 million uninsured Americans:
http://www.kff.org/uninsured/index.cfm
Are you the stupidest person on the planet?
Are you [Pudster] the stupidest person on the planet?
What’s worse, that he is or that he isn’t?
Dan Rather @ 55:
If socialized medicine worked than millions of people who dont have it would be flooding the countries that do have it. Socailism fails everytime it’s tried.
May I present for your amusement and edification, the Great Global Migration Chart of who is going where in the world:
http://www.nytimes.com/ref/wor.....APHIC.html
Note that the bubbles are raw numbers of migrants, legal, illegal, and otherwise. The US has the largest bubble, because Hello! we’re the world’s largest industrialized country.
Canada took in only 1/5 the number of migrants the US did, but with 1/10th of the base population, ergo, twice as many per capita.
There is also very little illegal migration there. The Mexicans and Chinese who hang out in front of the Home Depot waiting for a pickup truck to come by needing workers? Doesn’t exist here. The migrants are largely legal, largely professionals or business owners, and largely middle to upper-middle class. In short, they could go anywhere they wanted, and chose to go there.
Please back up your assertions with some common-sense knowledge of how the world actually works, rather than your fantasyland that everyone on the planet makes a beeline for the United States.
Re: Democrats running on so-called “retreat and socialism.” I think we have a winning platform
CBS News Poll. Aug. 8-12, 2007. N=1,214 adults nationwide. MoE ± 3 (for all adults).
“From what you have seen or heard about the situation in Iraq, what should the United States do now? Should the U.S. increase the number of U.S. troops in Iraq, keep the same number of U.S. troops in Iraq as there are now, decrease the number of U.S. troops in Iraq, or remove all its troops from Iraq?”
Increase/Same 30%
Decrease/Remove All 61%
Unsure 9%
ABC News/Washington Post Poll. July 18-21, 2007. N=1,125 adults nationwide. MoE ± 3. Fieldwork by TNS. RV = registered voters
“Who do you trust to do a better job handling the situation in Iraq: Bush or the Democrats in Congress?” Options rotated
Bush 32%
Democrats In Congress 55%
Both (vol.) 1%
Neither (vol.) 11%
Unsure 1%
http://www.pollingreport.com/iraq.htm
CNN/Opinion Research Corporation Poll. May 4-6, 2007. N=1,028 adults nationwide. MoE ± 3.
“Do you think the government should provide a national health insurance program for all Americans, even if this would require higher taxes?”
Yes 64%
No 35%
Unsure 2%
http://www.pollingreport.com/health3.htm
@77&78
I don’t think we have established the the pudster is ON THIS PLANET…
@71 Facts
“Americans need to demand “christianized” medicine. ”
NO, PLEASE NO!!!!!!
Gad, crucifiction, trial by fire, witch burnings, chaining. slavery, cultural genocide, gelding, ,,,,,,
transubstantiation.
anything St. Augistine believed in.
GAD!!! No.
Can I have my medicine on challah instead?
#77 Lee says:
46 million, almost 1 out of 6 people. Look at your friends, how many of them don’t have health insurance? How many on this board don’t have health insurance?
I googled looking for the breakdown of the uninsured, couldn’t find anything. I’m guessing the majority are illegal immigrants, people choosing nice things over health care and young people feeling they don’t need it YET (if not for union healthcare, I never would have spent the money until I was in my 30’s).
Nice link. Did you check any others out?
Chart 2 What bothers people about their own health care
The quality of care you receive – 89% satisfied
The quality of communication with you Dr. 87% saisfied
Your ability to get emergency medical care 83% satisfied
Your ability to get a dr’s appointment 82% satisfied
Your ability to see top-quality specialists 79% satisfied
Your ability to get non-emergency treatment without having to wait 73% satisfied
Your ability to get the latest treatments 78% satisfied
Your health care costs 57% satisfied
http://www.kff.org/kaiserpolls/upload/7572.pdf
Lee@77 & ATJ@78: This is my original post 07/27/2007 at 5:28 pm
““So what is the true extent of the uninsured “crisis?” The Kaiser Family Foundation, a liberal non-profit frequently quoted by the media, puts the number of uninsured Americans who do not qualify for current government programs and make less than $50,000 a year between 13.9 million and 8.2 million. That is a much smaller figure than the media report.”
http://www.businessandmedia.or.....53509.aspx
@83 I do not know enough of the provinence of the poll to know what it means, but I ‘spect such a poll depends entirely on the choice of populations.
So, I thought it would help if I just did a quick survey of my relative … up to first cousins:
On medicare 8
On medicare w/o employer insurance 6
Average cost per year for part B in latter group … $20,000
self insured 6
Average cost per year latter group (per person) … $25,000
Employer insurance 14
Average costs not covered by insurance/year …. $2500
(numbers are my best estimates)
There is a lot of guess work here. FWIW the pay ranges above range from 2 people under 65 who are not currently employed or children. Other wise pay ranges from about 20k to over 200k. It includes ~30 people and no one is uninsured. So this may be a typical data set for a middle class family. Average cost is between
My guess is that we are typical of a middle class family? While no one is uninsured, there are a number of people kin the list who would be effectively bankrupted if they had an ilness not covered completely.
More to the point the average cost with govt contributions to our care, is around 25,000. I have not looked at how this compares with other countries but it does suggest that
healthcare is consuming a huge part of what would otherwise be disposable income of one sort or another.
This is my original post 07/27/2007 at 5:28 pm.
So? It just demonstrates that you’re stuck on stupid. Get past it. Come on; I’m rooting for you. I don’t think you really can, but give it the old college try. You might surprise both of us.
If you restrict the number of uninsured to some number less than the actual number of uninsured, the number you claim will be smaller than the actual number of uninsured. That new number is something other than the actual number of uninsured.
I know this is tough for you to understand, but, please, try to keep up; the rest of the class is getting bored.
@83 & @84
Do you idiots not know how to read?
who do not qualify for current government programs and make less than $50,000 a year
This is what is called a qualifier. It means that when you set restrictions on a total, it returns you a number less than the total. You’re still wrong about denying the fact that there are 47 million uninsured people in the country.
Marvin, are you challenging that figure? It really doesn’t matter who makes up that figure, the bottom line is that if any of those 47 million people get a serious illness requiring long-term care, THEY ARE FUCKED. This is a situation that does not exist in any other first world country.
From the Talking Points used by marvin:
” The number of the uninsured who aren’t citizens is nearly 10 million on its own, invalidating all the claims of 40+ million “Americans” without health insurance.”
Maybe true but remember that we have resident aliens employed legally in the US too.
” But according to the same Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of $46,326.”
Well, considering that health insurance costs about 20-30 thousand a year if you are not part of a group, just how does a family with $46,326 pay for coverage for … err ahh 4 people?
” Subtracting non-citizens and those who can afford their own insurance but choose not to purchase it, about 20 million people are left – less than 7 percent of the population.”
Choosing not to be covered is exactly the issue. These folks still get sick and we, the taxpayers or we those who are insured pay their bills.
” The Kaiser Family Foundation, a liberal non-profit frequently quoted by the media, puts the number of uninsured Americans who do not qualify for current government programs and make less than $50,000 a year between 13.9 million and 8.2 million. ,,,, Kaiser’s 8.2 million figure for the chronically uninsured only includes those uninsured for two years or more. …That is a much smaller figure than the media report.”
What is the point here? The point they make is that is OK to go uninsured because most folks are only uninsured for few months between jobs? Gee if that is all the problem howsa about extending unemployment insurance to cover health care?
And there are about 8 million who are not covered ever??? Is that chopped liver?
What may be true is that the 46 million figure is larger than “real.” What IS true that by any measure there are a lot of unprotected folks, that American industry is fucked by a cost covered by taxes elsewhere, that at least 30% of Americans are never protected, and that the frequency of bankruptcies due to health insurance is rising.