Politics
Reasons to oppose health care reform
B-o-r-i-n-g. Yet another debate on television about health care reform. The only thing I found interesting this time was a graphic saying 83 percent of the American people feel satisfied with their current health care coverage and 71 percent think change is needed.
If that doesn’t make total sense to you, all I can say is welcome to America.
But for that 71 percent who think reform is needed — perhaps because they feel compassion toward the less fortunate or even un-American pessimism about their own future status — I can help to change your mind. Just consider these 10 Good Reasons to Oppose Health Care Reform:
1) You are so rich and so sure that you always will be that you don’t even need medical insurance.
2) You have great insurance right now. You are confident that you can always keep it and that it will continue to be affordable.
3) You trust that your insurance company will always say your current doctor is “in network” and will never tell you that you can’t go to that doctor or a specialist of your choice.
4) You have never questioned why your insurance company will only reimburse you $400 for a procedure that both your doctor and hospital and your friends who have had similar procedures insist cost $1200.
5) You just want to protest the idea that some people think end-of-life planning is a sensible idea. Or you just enjoy the creative nonsense that reform inspires among opponents and you want to encourage them to continue to entertain you.
6) You don’t feel any moral responsibility when you know that many people have no insurance because they are working but can’t afford it or because they have lost their jobs and have no income. You also don’t care that many other people are vastly under-insured. And you don’t mind continuing to subsidize costly, but often minimal, emergency room care for the uninsured.
7) You think if people have pre-existing conditions and are denied insurance, that is just their own tough luck.
8) You think opposing health care reform is a good way to show off your gun collection.
9) You hate Barack Obama and want to see the American president fail and think opposing health care reform is a good way to bring about a revolution.
10) You think voting against your best interest is cool.
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C Smith says: Keith your number 5 reason ,me being 65, is one of my concerns. If this option is available if “I” decide to use it is one thing but if I am required to make this appointment is quite another. How and when I die is between me and God and no business of the government. It is questions like this that has most people asking questions. Not one government official will stick their neck out and explain each part of the “new” health reform. This type of one sided and hidden controll had an example when President Obama recognized a young girl to ask a question about health care yet he has his own children strickly protected from the media. By the way this is how it should be but niether should he have asked a mother to expose her child to do what he is not willing to do.
Until all facts of health care are fully explained there will be opposition. -
Keith Graham says: C Smith: First of all, congratulations on making it to 65. And I wish many more for you. I’m 61 plus and consider every extra day a blessing at this point. I agree totally with you that how and when you die “is between (you) and God and no business of the government.” If any health care reform bill says otherwise, I would fight it bitterly. Sadly, Sarah Palin started a myth about the proposals under discussion. Sadder still, from my point of view, Johnny Isakson appears to have backed off of his own long time support for measures to support end-of-life counseling. Sadder than that, I doubt at this point that any bill that emerges from Congress will even touch on that issue. But both of my parents died in recent years, and the directives that they had worked out with their lawyer helped us deal with difficult decisions, based on their choices when they could make them for themselves. After they died, my wife and I drafted the most explicit documents we could with a lawyer to guide those who might have to make those decisions for us when the time comes. Everyone of a certain age needs those kind of directives, and the right bill out of Congress could have helped that happen. Too few people have such directives now. But, yes, I also agree with you, let’s get all the facts about whatever health care bill emerges out of Congress for all people to consider.
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jeff cochran says: It’s sad to see Isakson cave and seemingly get in line with the Palin approach. If the Republicans really wanted to influence the legislation, they would consider working together with the Democrats on a bill that would give Americans a sense that our representatives really are working for us. But I guess I’m dreaming…..
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Chris Wohlwend says: Well put, Keith.
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Marilynn Larew says: Great graphic! BTW, if you think universal health care doesn’t work, try talking to a Canadian, an English person or somebody from France, instead of asserting that their systems don’t work.
I do believe that the only way the European countries (oops! and the UK [we're not European]) got away with instituting universal care was that the insurance companies were flat on their backs because of WWII.
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Brenden says: And as long as the democraticalistas DO NOT attempt to nationalize/subsidize the system, DO support tort reform to decrease doctors’ legal liability costs, support insurance regulatory reform to normalize regulation, support competitive interstate insurance competition … then we can talk. Otherwise, **blank** ‘em.
Let’s not paint reform in absolute moral imperatives, or if we do so then let’s amend the constitution first. Let’s talk policy specifics costs, benefits, etc.
But your personal problems are yours alone.
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great article…..i am totally appalled that we even have to be in this conversation. it really shows america for what its prejudices are and lays an even deeper darkness that people don’t matter, but the almighty dollar, well, that is a different story after all ‘merika is the land of opportunity.
….this is a no brainer..bring on medicare for all..done deal..and then finally just finally…maybe the saying justice and liberty for all might finally bring a new dawning day. hope springs eternal. -
A few more reasons came to mind while I was reading this…
11) You receive campaign contributions raised by the medical insurance and pharmaceutical industries and private hospital corporations and have a dear friend who is one of the hundreds of K-Street lobbyists who have a job representing the medical insurance and pharmaceutical industries and private hospital corporations.
12) You are a government worker and fear you’ll have to accept the same insurance as private citizens.
13) You own stocks and mutual funds and fear that competition and reform in the medical sector will lower profits and stock prices.
14) You work for a private hospital and fear that the ridiculous retail prices you charge those without insurance will be made public.
15) You have faith that medical insurance industry executives are above operating their companies for self-benefit.
16) You are so depressed that you want to just die, but are afraid that healthcare reform will mean someone will save you.
17) You believe it is God’s will that poor people should suffer and die and saving them is the work of the devil.
18) You believe in evolution and this is an effort to circumvent survival of the fittest.
19) The just love to play monopoly and want to see how the game will end.
20) You believe in personal responsibility and you personally are responsible for blaming the opposition party for all your problems. -
Good article. In response to Brendan quickly, tort reform is something that can be used to bring republicans to the bargaining table, but it is not a panacea for fixing a broken system. Sarah Palin and others have argued for this type of reform. Even if you get rid of every malpractice suit in existence, it would not make a dent in increasing health care costs.
In this country, morality is as important a commodity as liberty. I believe it’s morally wrong NOT to provide a safety net for those that cannot provide one for themselves. Affordable health care coverage is a huge part of that safety net.
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MaryCan says: Great article, Keith… I don’t agree with all the pundits, though, that if we don’t get health reform right now, it won’t happen. Know what’s coming up?
The end of 2009, and as this year ends, just like at least two decades now, insurance plans everywhere will announce the coverage they’re dropping (oops), and the increases in your premium even though you’re covered through your employer (uh-oh), and you know what? It has already been announced that (a) Social Security benefits will not see an increase for 2010; however, (b) Medicare premiums will increase. Double hit there, folks, sorry about that.
But at least our elected representatives will get their usual payraises, and their insurance coverage will be stable. Just knowing that helps me rest better at night. Hang tight, Senators, we’re going to take care of you. You betcha!
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C Smith says:
Keith it took a while to get back (alzhiemers attachs when least expected)
but I do agree with the promotion of the adult generation keeping “their house in order”. We have the same legal arangement but with children it needs to be updated periodicle. That is the fun of getting old to threaten to take them out of the will. Some of the younger readers and pertisapants might not find this funny but any one over the age of sixty knows exactaly what I mean. Some day one family member will emerge as my main care taker and wheather or not they feel compensated when I die is if I “win the lottery or not”!!! ya-ha-ha -
Great list, Keith. I’d like to add one more reason to oppose health care reform.
11. You love living dangerously, and think our national security should be undermined by rigged-for-profit insurance scammers who cover our health care like Bernie Madoff covered finances.
I think Georgia’s Senators would agree with this reasoning, since they already wasted trillions of our tax dollars on exhorbitant defense contracts and “homeland security” programs that can be undone in a day by our current lack of health care.
Saxby Chambliss and Jonny Isakson were quick to bail out rich investors who might have missed a few bets in the financial markets, but our good senators aren’t so concerned for the millions of Americans whose lives are at risk when they can’t afford to see a doctor.
Thanks so much Senators, for running up a ridiculous debt for totally worthless national security measures, and for passing on your thrill for living dangerously to the rest of us, too.
Maybe we should all stop covering our coughs when we’re around you – just to make it even more exciting.
And if you want a glimpse of the real war on terror – hang out with a family trying to caring for a critically ill loved one, who couldn’t afford to keep paying a health insurance premium that was more than half his income. And wish them luck with the cancer.
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Brenden says:
I accept that you don’t understand this simple but true economic maxim: the optimal allocation of social welfare is best achieve through competitive markets. Like it or not, healthcare is business where technology more than anything drives outcomes. Technology is simply a function to produce more outputs with fewer inputs. Technology is advanced only by risk-takers. People only undertake risks when there is a reward.
Here is an example of invidious liberal argumentation designed to silence debate and dissent…
“You believe it is God’s will that poor people should suffer and die and saving them is the work of the devil.”
I believe that able-bodied and minded people need to provide for themselves. That plundering the private property of the most productive to re-allocate it to the least productive is morally abhorent. The implications to overall productivity and risk-taking will destroy our society. But you claim the moral absolute that “God is on your side.”
This thin, sad form of absolutist argumentation undermines your premises and conclusions.
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Marion Delgado says: Iceland followed the Brendans of the world over a cliff, because whenever anyone brought up the fact that they were destroying their society and even their economy with market fundamentalism, the Brendans of their society told them they didn’t understand the simple truths that those capitalists could see, but never had to prove, because science and morality and facts take second place to capitalist dogma, because they can pay people to bury those things under a huge pile of propaganda and shout down everyone who isn’t on board.
At some point, some day, Americans are going to have to pay attention to that man behind the curtain. And grow up.
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hurray to marion…one way or another the civil liberties of all must count!
and as to growing up…there’s a dilmma..why grow up when even your country is not accountable? -
Brenden says:
Cuba, Myanmar, Soviet Union followed the Marions of the world.
Your polemical meaningless references again emphasize the intellectual bankruptcy of your position. You don’t refute my points because you cannot, and again you want to brand me a heretic according to your leftist, collectivist standard as you inveigh against “capitalist dogma” and “market fundementalism.”
Whaah, whaah, jokers…
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Oh, Brenden. My invidious argument was no such thing. Just a suggestion in a list of suggestions to help those who haven’t yet decided why they are against healthcare reform. In no way did I intend to suggest my additions were complete.
Though I’m still baffled why you seem against the reform part of healthcare reform. Accepting your premise for the sake of argument that the optimal allocation of social welfare is best achieve through competitive markets, it seems to me that the only route back to the competitive markets is to begin reforming the anti-competive forces in the market. I say start with the under age 65 insurance monopoly, you seem to suggest starting with the over 65 and the under the poverty line government monopoly. Just a different starting place toward the same end.
One of the problems, of course, is the healthcare market (like most others in our economy) has grown so large for so long with so many embedded layers of regulation (each with their own lobby), provider contracts, self-dealing and anti-competitive subsidies (tax policy, governing boards, public service commissions, medical school education policies, subsidies, etc. ad nauseum), bad habits and powerful players, that it is a complicated undo. Whatever the approach to reform, it must be done with concern to improve our existing system, not dismantle it wholesale, as chaos would be created in advance of your optimal allocation (though, arguably, that might be preferable).
We have had more than a generation creating this stand-off of the monopolies (though I would argue that the problems of today was not created (nor hindered) by the Medicare, Medicaid or the VA, the lack of sustainability was inevitable with a private system allowed to consolidate to the extent that it has). The insurance industry seems to be very happy with the government monopoly providing the coverage to the aged, infirmed and poor (abled-bodied or otherwise) while closing their regulatory eyes as their monopoly has become entrenched. The government (more accurately, the taxpayers who pay for it or will on top of their own increasing healthcare costs (that would be an excellent addition to the list, lets’ make it reason #21)), on the other hand, isn’t so happy with their increasing share of the most expensive healthcare users.
Something has to give. The courts surely won’t help lead us to a simple solution (just too many state laws involved). I believe an answer is in extending a non-subsidized public option (let people buy-in to Medicare on a pro-rata basis) as a competitive measure for those of us being killed by the under 65 monopoly. Do this, level the playing field of regulation, and both will become more competitive. Do this long enough and then dismantle the government version (neither of us believes that would happen) or spinning it off as a public utility.
But this argument is just sport. What is going to happen is apparent to most of us: the bill that passes won’t be liked by either of us, won’t hinder either monopoly, will likely patch a few things that are broken (which will be good and maybe worth the debate) and create huge new subsidies for the under 65 monopoly that will make it even less sustainable than it already is (let’s make that reason #22).
Maybe we should just take the trillion dollars and hedge the system on Wall Street. That’s right, we can’t do that because it would ultimately be backed by AIG which is owned by us. We’re screwed.
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Brenden says:
I don’t agree with your point that there is an “under-65 healthcare monopoly.” There are multiple competitive health insurance providers. I’ve had different coverage from Aetna, BCBS, etc., through the years. The extent to which monopolist forces exist, however, is the fault of the federal gov’t: who won’t let premium holders buy out-of-state plans, who won’t nationalize insurance regulation and who won’t normalize medicial liability law (note: I’d like to see the states adopt the measures through legislative processes like the UCC). These three items prevent competitition by added legal compliance costs and stack the deck for the monopolists. Encouraging more providers to enter the marketplace should lower costs as the market becomes more competitive. As health insurance becomes cheaper, more people will obtain it. All those nefarious K-Streeters you fear so greatly exist to sustain the uncompetitive monopolist advantage and these regulatory barriers to entry. How can you say I’m against reform? It’s just that the reforms I believe to be the most effective toward supporting a competitive marketplace don’t fit in the anti-competitive collectivist model.
I guess I would support a “non-subsidized public option” but that is so economically unfeasable as to be useless. How could the gov’t possibly cover the millions people uninsured without subsidizing it? Worse still, a subsidized public option will drive all the “evil” insurance companies out of business, or serving only the wealthiest 1-percent. If the public option is involked, starting at the bottom of the labor pay scale, employers will drop their employees if there’s a “public option” to provide healthcare (an entirely rational decision). Individuals will face choices to buy extremely expensive private insurance or take the gov’t brand X. You see where this is going: eventually the gov’t will take over the entire market. The gov’t will then dictate prices to doctors and other service providers, reduce their revenue and bankrupt them. Thus fewer doctors and worse care.
Indeed, something has to give. But it shouldn’t be the American taxpayer who already gives plenty. Healthcare is not a natural right or a civil liberty. It is a fee-based service in need of investment to advance. I think our society has made appropriate allocations to the aged, infirm, young and veterans (though administered their benefits poorly). Beyond those groups, no one should be given anything.
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Wow! Now there’s an argument so void of human decency, it’s almost entertaining!
By Dickens, Brendan, I think you may have a compatriot in old England who’d agree with you. If the plight of the poor is so wretched they’d rather die, then, “they had better do it, and decrease the surplus population.”
God forbid you might have to pay a penny of your profits to help those who didn’t excel with their wealth, as you have so proudly done. Congratulations, Man! You have earned the right to spit down!
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S. Baggett says: #23. You love the fact that management realizes that you cannot risk losing your job because it could mean permanently losing insurance, even if you find another job. You enjoy using more and more of your paycheck for less and less coverage, as a bargaining chip. The idea of being in a weaker negotiating position really turns you on.
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Brenden says:
The crybaby left fails to realize the true font of conservative/republican/”extemist” opposition to universal healthcare. For decades the federal gov’t has grossly overstepped its constitutional limits to infringe on individual liberty. Both parties are responsible. For too long the State has over extended its citizens’ resources. For too long the State has offered gold-plated benefits with one hand and plundered and pillaged the treasury with the other. There are too many useless federal bureaucrats and too much useless regulation design to syphon productive resources to bureaucrats, lobbyists and politically connectetd. This was not anything close fo the vision of what the founders had in mind. The end result is that it will no longer be possible for individuals to be productive and sustain our society. It’s only through individual freedom, hard work and intellect that this country is as great as it is, and our federal gov’t is trying to snuff that out. Particularly the current regime because of their typical leftist bent to buy off the political support of the unproductive by looting the resources of the productive.
I think I speak for more than a few people when I say this universal healthcare/public option mess is about the last straw, the red line, the line in the sand beyond which we not tolerate any further gov’t intrusion and mismanagement. That is why to your eyes these actions seem extreme. Although in your perverted worldview people who don’t agree with you can be simply dismissed as racists or extremists or whatever suits your hollow emotive, non-rational political belief system.
None of you have ever defended this option on the grounds of Constitutional law or offered a sensible way of supporting this plan economically. Instead you bleat, “Racist” and dismiss.
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Mike says: The REAL reason to oppose change: you’re over 65 and you already HAVE socialized medicine, and you LIKE it. So why share it with anyone else?
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Brenden: We’ve had the discussion before on the limited choices state by state (I say monopoly, you might say oligopoly). In most states, about 80% of your “competitive” market is controlled by one or two providers. They seldom cover the aged and certainly don’t cover the non-paying – fits my description. LIke you, I’ve had coverage with different carriers through the years – one provider pulls out, sells to another, who a few years later is bought by another, who decides to quit covering individuals. The fact you and I have had continued coverage, in spite of insurance provider consolidation, makes us fortunate. It is not proof of success for a failing and non-competitive system.
As to the “non-subsidized public option,” last year the Congressional Budget Office estimated cost of allowing those 62-64 to buy in to Medicare at $7,600 (based on 2011) and it included prescription coverage. I’m suggesting we extend a buy-in for ages 0-64. Add up the costs, divide by those covered, and send me a bill for my coverage. Medicare is paid for with payroll deduction. I assume that could be applied for those who opt-in. Employees choosing private or public should be treated equally by employers. I suspect that once the young and healthier among us join in, the average cost will be less. It should be.
Now as to government takeover, this is far from a done deal or eventuality. I can’t imagine anytime soon that our union brothers and sisters will give up their private plans any quicker than those in your pay grade will. Your vision is different from mine. I expect a public option that has some limits on benefits with private insurance being available, just as it is with Medicare, to cover the gaps or allow some to sit in first class.
I see a system where government – including state government, will recognize the need for GP’s and physician specialty areas that aren’t being met and create incentives in our education system to create more capacity, not less. I cannot imagine a system when government will begin cutting reimbursement (don’t let your government hands touch my Medicare. Hopefully, some procedures not producing results would be eliminated. It is more likely, and is the case in the House bill, that there will be incentives for results (though results require reporting which cause some to believe that responsibility to achieve results would be better faith-based). No, I don’t see fewer doctors and professional associates. I expect more. I also expect that once there is market demand for preventive and basic care, that a whole slew of new private ventures and coops will spring up and compete for those patients – creating more access to basic care then we have now. I also expect in the years to come, that some of the regulation will become national and allow for private insurance companies to offer more competitive programs. And yeah, I can see a promised land where Medicare is not the exclusive and untouchable contract with our seniors so that changes can be made to make it sustainable.
As to rights… we live in a time where the good intentions of our lawmakers to prevent the denial of treatment by our subsidized providers to those in need have become at odds with those governments who reimburse, those taxpayers who write the checks and those economists who are aghast at the amount healthcare represents in our economy (18% of GNP with a bullet). We must get control of the cost increases – too many of which are the direct result of anti-competition. We must find ways for all of us to have access to preventive care (I seriously resent paying for an elaborate procedure today that could have been prevented by some generic meds and a little exercise a few years before). We must get rid of the layers of non-productive clerical paperwork pushers and must make some compromises on privacy. We must start reporting accurately what works and what doesn’t. We must quit screaming about things that don’t matter and start screaming about things that do.
Finally, as to rights and the uninsured. We could be a country where healthcare is a right, but we haven’t chosen to be. But sometime issues are about more than arguments before a court. Not about rights, but about fairness or goodness, a golden rule or some other nebulous standard you just believe is right or important. Some may disagree, but I believe it is not right for a person to work for 30 or 40 years, support family, pay taxes, save for retirement, live within the laws, be a good neighbor, get cancer or some other life-changing/stopping disease and then lose everything, including the ability to even pay for the meds needed to sustain life or to remain a productive and tax-paying citizen, but I do. In fact, I feel it is more important than many other funded priorities – for example: the wars; the F-22; new highway construction; corn subsidies; golden presidential helicopters and platinum congressional jets, etc. – well, you get the idea and I bet you have your own list. For me, it is about priorities. This one – healthcare, should come before many we now fund.
So what do we do for the uninsured – the “46-million” depending on how you count them? Add them up and send them a bill for their share. Those who cannot pay should be progressively subsidized. We do most of this already through Medicaid and the insane method where providers charge retail for the uninsured and put their hands to the states out for reimbursement.
Do we tier (provide different levels of care) the system as we do with Social Security where benefits are based on what you put in the system? Yes, if we must in order to afford it as long as we can insure basic care. Do we require all to have health insurance (private or public) as we require all to be participate in Social Security? Yes, we must. I despise mandated requirements, but we must.
Brenden, I had written to this point before your last comment. Your rhetoric and threats do you an injustice. Your labels are as unfair as those you rally against. My perverted world view now includes pity for yours.
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Brenden says:
Assuredly some other race-baiting collectivist will soon provide pretense to crystalize our arguments anew. But until then, off we go…
1) Ah, the monopolist argument, a classical liberal false equivalence: capitalist = monopolist. First, never forget newspapers are monopolies (or were). Um, JOA. Um = evil. Never heard many complaints about those. Anyway having demonstrated a real one, there is no “monopoly” in healthcare. You’ve retreated on this point, saying instead that companies are buying and selling, then dropping policy holders out of fear of paying for claims. Suffice to say there IS competition but there are problems. OK, no more monopolist fear-mongering I hope.
2) I don’t know why you keep citing Medicare as some useful, functional model. It’s bankrupt! Or at least will be 10-20 years, also according to CBO. Yes, its members may like it but we, the taxpayers, cannot afford it. I’m NOT saying chuck it, but certainly freeze eligibility. Lee, explain how extending insolvent gov’t programs helps.
3) How does the gov’t “create more capacity” in the med education system? Even if the state makes medical school free, the demanding cirriculum is self-selecting. You earn more with far less academic effort in other fields. Rational people choose accordingly. I know doctors who advise their children NOT become doctors because of decreasing pay. A few altruistic doctors pursue the field for social reward alone. The collossally vast majority of them do it for the money. The gov’t cannot “manufacture” doctors. We must highly reward them because the field is risky and difficult. If med school were free, this would still be true. And if med school is free, who pays the faculty, what happens to excellence in medical training and innovation? Again ruined by socialism. The remaining costs of the substandard system are fobbed off to productive taxpayers.
4a) I’ve tried in vain to educate you on this point: “I cannot imagine a system when government will begin cutting reimbursement.” As it relates to price discovery, it is IMPOSSIBLE for the gov’t to know better than a practicioner how much any procedure costs. The practicioner went to med school, buys equipment, employs personnel, etc., to provide the service. Thus, only the practicioner knows the MARGINAL capital, labor, etc., required to recoup the MARGINAL revenue for an additional patient or service. MARGINAL cost reflects the price of a given procedure; the price reflects the equilibrium point between supply and demand. Rational, see? Price can be discovered only by means of risk-taking (cost) and market participation.
4b) How could the gov’t possibly discover prices? The only way is 1) undertake a costly system of price polling practicioners which obviously implies all these market practicioners are already there so why bother (you bother only if you think they’re stealing. Are doctors thieves, Lee?) or 2) hire all the doctors. Lee: 1) or 2)?
4c) You say “I can’t imagine anytime soon that our union brothers and sisters will give up their private plans any quicker than those in your pay grade.” Business will refuse to pay for healthcare because a “public option” exists. In the long run (after the strikes) the workers at the low end of the wage pool will get dropped from employer coverage and fobbed off on the public system. Gov’t share of premium holders will grow at the expense of private insurers. Gov’t reimbursements will skew toward budgets of low-wage premium holders and thus “government will begin cutting reimbursement.” QED. Class warfare rhetoric noted. Class dismissed.
5) This statement is just plain weird: “I also expect that once there is market demand for preventive and basic care, that a whole slew of new private ventures and coops will spring up and compete for those patients – creating more access to basic care then we have now.” There is no question of demand for “basic care” right now — that’s why we’re having this discussion. Are you saying people are waiting for some gov’t initiative to insist upon “basic care”? That’s absurd.
6) “We must get control of the cost increases – too many of which are the direct result of anti-competition”. On this point you and I are just plainly from other planets. I am from Earth. The costs RESULT from anti-competitive GOV’T intervention; they increase in direct proportion to the level of intervention. This quote, “I seriously resent paying for an elaborate procedure today that could have been prevented by some generic meds and a little exercise a few years before.” This evokes the invidious Obama quote about doctors chosing procedures by profit margin; clearly you agree. Wrong! Doctors do so only to the extent they’re forced to protect themselves from legal liabilities and regulations promulgated by … who, whom?… the courts and legislatures! And the “non-productive clerical paperwork pushers”? What sane business owner is going to create for themselves a perpetual regime of costly makework? Absurd that anyone could think a private venture would do so. (I know… I know… it’s a conspiracy of insurance companies, lobbyists and EEEVIWW WEEPUWICANS to make doctors do all this paperwork so they can plunder Medicare).
7) And this bit of naivete: “So what do we do for the uninsured – the “46-million” depending on how you count them? Add them up and send them a bill for their share.” Dear God, Lee, that we could. You should know better. I know all of you who’ve read this far are familiar with income disparities in this country. Well, what about tax disparities? Netting aggregate subsidies with taxes below the poverty line, THE POOR DO NOT PAY FEDERAL TAXES in this country. Only the middle-class and rich pay taxes, especially at prgressively higher rates of income. Again aggregating payments and subsidies, wealthy and near-wealthy pay ALL FEDERAL TAXES. Leftist dogma that catipulted Obama to power essentially insists upon redistributing gains of the rich to the poor by plunder and transfer. Only those who can pay get a bill, Lee. T’was ever thus.
8) How to pay? Insurance companies exist to offset risks of one asset with another. I do it: this is difficult, complicated work that involves creating mathematical models, making assumptions and interpreting them. Then taking a risk with private assets. It can fail, given risk limit parameters. But we are experts at doing it, and so rewarded. Untested politically-connected weasels are not! What has gov’t done in terms of risk management? Forced banks to lend to individuals who possess high default probabilities, then take their mortgages and guarantee them to create liquid market for assets backed by those same mortgages. It wasn’t AIG, it wasn’t Lehman who did this — it was the United States gov’t thru Fannie and Freddie that did this.
9) As it relates to moral outrage. You say “I believe it is not right for a person to work for 30 or 40 years, support family, pay taxes, save for retirement, live within the laws, be a good neighbor, get cancer or some other life-changing/stopping disease and then lose everything.” As you know, that person makes an (X) amt of money in his life, then demands an (X + infinity) amount of medical care for himself, family, etc., forever. This train of logic does not end, ever. The need is INFINITE, the resources are finite. How the hell do you pay for that? Well, you, Lee, publicly advocate for a gov’t to demand the resources of those who (for now) can pay and (you ASSUME forever) transfer that wealth to those who cannot. Who’s committing the moral outrage?
You, Lee. And all who think like him.
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1) Ah, the restate and misrepresent argument, a classic conservative tactic. Your demonstration of a “real one” is a poor choice as newspapers never monopolized speech or news or advertising. The markets in which newspapers competed in the US have always been free, entry easy and distribution varied (town crier, mail, broadcast, billboards, now internet). Nor did I retreat – the buying and selling I referenced was the progression of consolidation that lead to the non-competitive environment in each state that now exists.
2) In simplest terms, Medicare is a insurance program. Each participants is a policyholder. In its present form, the policyholders paid-in (at least theoretically) during their working years for this permanent health insurance (yes, our elected leaders irresponsibly spent the surplus years as they did with Social Security leaving the plan underfunded by present day workers – but that does not make it less of a functional model). Costs for healthcare has exploded. Private insurance just keeps passing on the increases. Medicare has not. The failure has been in Congress.
Expanding the eligibility to younger and healthier policyholders will (there are too many to list here):
A) lower the average policyholder expense for Medicare which could be used to begin addressing long-term funding;
B) those workers would benefit from a lower annual insurance premiums (even the present day per policyholder cost of Medicare coverage is much lower than is currently available) while at the same time generate revenues which could (theoretically) be properly invested to meet the long-term needs of the permanent coverage;
C) create demand with a viable and consistent funding source for preventive care which will, among other things, lower costs for providing delivering preventive care and impact lower overall costs by preventing the need for expensive procedures;
D) lower employer costs making them more competitive or viable;
E) provide dependable and projectable costs for states now using ridiculous methods for indigent reimbursements;
F) force policy makers to streamline healthcare filings while also creating a database that allows tracking to help determine what medical services actually work over lifetimes which will help generations to come;
G) force private insurance companies to be more competitive and responsible to their policyholders;
H) get the elephant out of Congress they can start working on fixing regulation and nationwide standards to allow private insurance companies to compete nationally;3) Creating capacity (increasing the number of doctors and professional assistants) can be achieved by providing incentives for students to study and practice in under served practice areas via tuition grants; earned student loan forgiveness; providing loans for practice start-up and equipment; etc. It isn’t quick. It isn’t easy. But take a quick glance at the unemployed college graduates right now – many are qualified and who’d love to find a way to a career.
4a) You made my point. The government already participates in the system, among other ways, operating the military system, the VA, sponsoring research, etc. Plus, none of this is in a vacuum. The provider industries have plenty of voice on the hill.
4b) Doctors wear the white hats in this. The current reimbursement formulas have forced doctors to specialize, own or invest in labs they feed and order procedures – they aren’t thieves, just trying to make a living and support the incredible overhead required of our present system and the archaic filing requirements. It won’t be a simple matter to fix and the new incentives in the House bill are far from perfect. And sure, the government hires some doctors (primarily Military contractors). But Medicaid reimbursement is no worse than what comes from private insurance providers.
4c) Maybe, professor. The extent to which you are right, depends on how it is set up. For instance, 1/2 of social security is paid for by employers. No reason to think something similar shouldn’t apply equally to an employee choice of private or public option.
5) It is a weird statement. However, your reaction suggest just how out of touch you are to what is going on. This healthcare initiative is not about the poor or just the uninsured. It is about those who were middle class and those lower middle who decide every day whether to buy food or medicine. Basic healthcare is a luxury most of us simply cannot afford. Sure there’s demand for basic care, but not at the current prices of our existing delivery system. It is absurd.
6) Well, greetings, earthling. You sure have a messed up healthcare system. The costs have been a result of the patchwork government system working in a mutual suicide pack with the private system. The lack of support from both sides of the aisle that has prevented reform for 50 years is why costs are escalating so dramatically.
I regret that I didn’t communicate better – I resent the procedures because I resent that basic care wasn’t available to those who needed it. I certainly don’t fault the doctors for that.
The paperwork is part a privacy issue; part an arcane system; part a conspiracy (pharma, hospitals, doctors) to cloak results-based medicine; and part an excellent example of something that should have been changed a decade ago except for Congress’s unwillingness to reform anything to do with healthcare. There’s plenty of blame for both sides of the aisle.7) Perhaps this is best covered at another time in a story about poverty, the working poor, the barriers, the disincentives for productive labor, why those of among us who are poor choose to be so, why almost 40 million Americans live in poverty and this years stats aren’t out yet, why we have so many in prison, why we have so many drop out of high school, etc. My comment sounds naive, but I do know the disparities you list.
8) I do not dispute this point – the success of the previous two administrations (Clinton and Bush) at dismantling banking regulation that led to the problems at Fannie and Freddy did create the financial crisis we find ourselves in. That said, healthcare (along with food and water) is not something that people can give up easily. The “risks” taken by the private assets you speak of, are less about the markets and more about when they take the last dollar of the last among us trying to get well (projected to be sometime in 2018).
9) You are just wrong. The need is finite. It is the escalation of healthcare costs that is presently infinite.
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Brenden says:
Lotsa good stuff here, Lee. Keep going!
“Costs for healthcare has exploded. Private insurance just keeps passing on the increases. Medicare has not. The failure has been in Congress.”
–Insurance companies increase cost because healthcare is more expensive everyday, thanks to advances in technology that solve myriad more maladies. As you say, the gov’t is not willing to pay for those advances, putting a greater burden on the private sector to fund them (along with all the indigent care, etc), thus additional price increases.
“Expanding the eligibility to younger and healthier policyholders will (there are too many to list here):
A) lower the average policyholder expense for Medicare”–Expanding eligibility ADDS cost. How do you not understand that?
“B) those workers would benefit from a lower annual insurance premiums (even the present day per policyholder cost of Medicare coverage is much lower than is currently available) while at the same time generate revenues which could (theoretically) be properly invested to meet the long-term needs of the permanent coverage;”
–Where is this “new” revenue coming from? From the people paying too high insurance premiums now, or the people paying fixed prices to the gov’t? So you propose to take the people paying too-high prices and have them pay fixed gov’t prices. This statement implies subtraction, not addition. (“Properly invested” by Fannie Med or Dr. Fannie, maybe?… I’m grabbing my Fannie right now, where my wallet is).
“C) create demand with a viable and consistent funding source for preventive care which will, among other things, lower costs for providing delivering preventive care and impact lower overall costs by preventing the need for expensive procedures”
–Like a good collectivist, you’ve gotten this precisely backward. Supply follows demand. You want something that you don’t have, and someone figures out how to deliver it in an exchange. Demand then Supply.
–”Viable and consistent funding source.” = taxes“3) Creating capacity (increasing the number of doctors and professional assistants) can be achieved by providing incentives for students to study and practice in under served practice areas via tuition grants; earned student loan forgiveness; providing loans for practice start-up and equipment; etc. It isn’t quick. It isn’t easy. But take a quick glance at the unemployed college graduates right now – many are qualified and who’d love to find a way to a career.”
–So you’re saying load up our med schools with the unemployed? That’s really, really stupid. Most people don’t become doctors or nurses because they’re too dumb or lazy (that’s why I’m not a doctor, anyway). Not for lack of gov’t programs.
And. You. Actually. Said…
“force private insurance companies to be more competitive and responsible to their policyholders;”
Oh, God, that’s just effing hilarious — “Be more competitive or we will shoot you!”
And of course…
“The “risks” taken by the private assets you speak of, are less about the markets and more about when they take the last dollar of the last among us trying to get well”
–Here lies the rub of your denigration of private enterprise. At your core, you believe the holders of capital obtained it by means of plundering the less fortunate rather than uncoerced voluntary exchange. From this false premise, you justify plundering them by means of gov’t coercion. Marxism 101. But I understand your rambling blithering nonsense as pretense for justified looting and not how you wish it to be perceived, i.e., noble do-gooderism. Keep it up, though! Obviously I enjoy reading it.
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I didn’t write that that gov’t is not willing to pay for those advances. What I intended for you to understand is that Medicare’s long-term financial problems is partly because Congress hasn’t raised the Medicare tax rates rates as provider costs have increased.
A) Expanding voluntary opt-in eligibility will increase revenues that offset those costs.
B) The new revenue to Medicare would come from voluntary opt-in.
C) Supply fails when demand cannot be sustained due to unacceptable prices. Viable and consistent funding source = voluntary opt-in premiums.
3) Unemployed recent college graduates sounds like an excellent source of doctors, professional assistants and nurses. The unemployed are not necessarily dumb or lazy. They are just unemployed. Your comment otherwise is “really, really stupid.”
Oh, Brenden. You caught me there. Using “force” to mean creating more competitive market conditions. I must be more articulate or you can shoot me.“
As to the rub of denigration, I didn’t take Marxism 101, I took Common Sense 400. My rambling blithering nonsense was aimed at drawing attention to how the cost of heathcare as a percentage of our economy has increased from less than 5% when I was born to 17.6% today and still rising. It is not sustainable. It is damaging our way of life and our ability to do business. The cold war ended. Get over it.
Happy you stopped by. -
elizabeth says: You guys are a bunch of moron! NO HEALTH CARE!!!
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4. It is all about freedom, if you decide to let the government care for you then you must do what the government says when it comes to your health and welfare. When daddy “The government” is paying the bills then you follow daddy’s rules. Are you ready to be told what activities are acceptable, no motorcycles, no rock climbing any thing they consider dangerous with be either taxed to the point where it is not affordable or it will be illegal. How about what you eat. Same thing, no fried chicken, burgers or ice cream, well they won’t make it illegal but they will tax it to the point making it unfordable. If you do not believe me, check your cigarette tax. They are actually trying to do this with soft drinks now too. Good bye freedom.
5. The truth is that the government must prioritize care for those that they care for. So if you are old and past your years then maybe it doesn’t make sense to pay for a new hip. Money is a factor in this decision. No they will not have a death panel, but they will let some die that could have been cared for. This is a reality. It already happens, check the CDC site, the current priority list for the H1N1 Vaccine. They will always have a reason for the order, but the true is they can not afford enough vaccine or service for everyone so a formula is created to care for the “Most important people” first. Hope you are not at the bottom of the next list.
BTW, We have know about the H1N1 Swine flu for over a year and they have still yet to get the vaccines to people. Great job man “The Man”, government you can’t even get a flu vaccine out and distributed in ample time. How will you run the whole heath care system? -
1. The day you let the government take something from someone else and give it to you be careful, because tomorrow they will be taking something from you to give to someone else and it may not be your money.
2. Legal immigration to the US is one of our greatest assets. Some of the world’s hardest working and brightest minds come to the US to start businesses and create jobs because capitalism cultivates creativity and ingenuity. Well if we provide free health care for every person in the US, then we will have to close our boarders. In 2008 1,046,539 people legally immigrated to the US. That number will surely grow if health care is free. The government will be forced to closed the boarders. 3. The government already runs some very important programs like, the DMV, the Post Office and Amtrak. As you know these businesses are not only losing money for us but they are some of the most inefficient and frustrating to deal with. If you like the poor service and long waiting times of the DMV, you’ll love the government run health care program. -
David -
4. I applaud your ideals, but “daddy” is you and me and the millions of others who vote, pay taxes and are involved in the people’s government. It is your right to disagree with policy or specific actions. You should hold “daddy” accountable for bad practices and work to get them fixed. If you fear that your motorcycle is going to be taken away, I encourage you to do something about it. Write your representative or go see them. Get a petition going. Put a sign in your yard. Talk to others who fear their motorcycles are going to be taken away. Organize. Demonstrate. Raise some money. Hire a lobbyist. Bribe a Congressman. I bet you can do something about it. I wasn’t aware motorcycles were in jeopardy. Or rock climbing. Or fried chicken, burgers or ice cream. They tax cigarettes because cigarettes cost society and there aren’t enough people against taxing it. Good luck with that one.5. No one on government run health care insurance is dying because they have been refused service. Each day many who rely on private insurance do because they are denied coverage or can’t pay the exorbitant co-insurance costs.
You are misinformed on the CDC argument. The vaccine is grown in chicken eggs and, along with the testing, it is a time intensive process. They have the funding, they just cannot make it fast enough to meet the demand. Their efforts, so far, is on a scale and at a speed beyond anything that has ever been attempted. The order of distribution is required to take care of people most at risk and most in danger. On that basis, I am overjoyed that I’m at the bottom of the list. While the CDC has been following variations of the evolving strain now called H1N1 (our “free” industrial pig farms caused it by feeding their pigs the remains of infected pigs and overusing anti-biotics) for a couple of decades, it wasn’t April 2009 that it was found to be contagious between people. My hat’s off to them – Great job man – “The Man” who is us.
You got a point on immigration. We do need to do something. Love to hear your answer. None of the bills being considered in Congress provides any health care funding for illegals. That’s a myth. As is the silly idea of securing our borders. As is the idea that the bills will provide free healthcare – healthcare insurance will continue to cost and continue to cost a lot. The bills are simply (well, complicatedly) intended to make it more affordable, stop the abuse by private insurance companies, make it more competitive and more fair. Important goals.
David, I don’t know what the government has taken from you and given to someone else or what they have given you that they took from someone else, but we are all in this together. I’m not my brother’s keeper, but I love him just the same.
I know you are worried that the quality of service you are getting at the DMV (generally run by state highway departments); the Post Office (an independent agency of the federal government required to operate even in small towns on Saturday regardless of snow, rain or gloom of night without tax support); or Amtrak (a government-owned corporation that has been starved by lack of government maintenance and competes with the heavily gas-tax subsidized car/truck industry). The lines at my DMV weren’t so long the last time I went and the people I met were very helpful and awfully nice in spite of having to serve customers who were as angry as you. The post office people are just great. I can’t imagine how they can get a letter delivered point to point for less than fifty cents or why they do. Amtrak, I love Amtak. Wish they went more places more often for less money, but what a delight to jump on the train and go. If my health insurance company cared about me as much as DMV employees, Postal workers or those on Amtrak, I will love it.
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Brenden says:
Evil or stupid? Here: stupid. Lee tries to convince us that Medical care should be run like the Post Office and Amtrak. That would be funny if he was joking, but he makes a really salient point obviously without intending to do so. These are the folks he wants to cure our cancer, fix our broken bones, innovate our technology, help us grow and prosper and extend our lives. Yep: the Post Office and Amtrak. Oh. My. God.
Here are some facts about these institutions. Let’s “unpack” this, like they say on NPR to sound smart.
Lee, the post office is a money-losing monopoly (I thought you hated those) that puts the taxpayer on the hook for its mismanagement of operations. According to the GAO, http://www.gao.gov/products/GAO-09-475T, the USPS asked for $25 billion because — surprise! — the internet makes its operations obsolete and they’re losing money in the economic downturn. Further, it offers gold-plated gov’t health and retire benefits that it wants to fob off entirely to Uncle Sam. I’m not complaining about my mail service per se, but this is yet another of Lee’s tired attempts to justify economic plunder and gov’t control that will (accidentally?) destroy the country. He completely ignores the economic and political realities of his comparison. He figures since his Christmas cards arrive on time for the low, low price of 44 cents — well, maybe that will work with his liver transplant, too. Lee, it costs the taxpayers a hell of a lot more than 44 cents for that card to arrive to your home. Stupid or evil? Verdict: stupid.
Now, Amtrak. “Similarly, while Amtrak has recently reduced costs, revenues are declining faster than costs, leading to operating losses exceeding $1 billion annually.” Source: GAO (Oct 2005 and I doubt things have dramatically improved since). I could go on. But please everyone who reads this needs to know is that people like Lee and the millions of plundering socialists who, for lack of a better term, **think** just like him want our healthcare institutions turned over to the gov’t that runs a railway system in extremely limited parts of the country at annual billion dollar losses. Look what they do to postal delivery and train service. These are the Marxists’ standard of quality service and efficiency. Sure, the mail gets there. But at what cost? They just spent $25,000 per clunker on that worthless program.
Maybe the DMV is OK. Thank Sonny and our Republican Georgia legislature made a priority to fix it.
Last, plundering socialists who don’t care how much your gov’t wastes, please watch the attached link from “60 Minutes.” It’s about Medicare fraud. The upshot: there’s a lot. The gov’t spends millions on attempting to rein it in, but the problem worsens each year and so that money is completely wasted. So guess what: they want Obama to spend billions on fraud prevention. Not one dollar of this money will pay for a single stich, band-aid, rubber glove, nothing in terms of real healthcare. Billions of dollars spent in fraud prevention for nothing. Remember, ANY private practicioner would not just go reimbursing payment requests because a regulation told them to do so. They would know their patients and policy holders. They took the risk and have an economic incentive to watch against fraud. The gov’t cannot legislate that.
http://www.cbsnews.com/video/watch/?id=5414400n&tag=contentMain;contentBody
Lee, a gov’t takeover will destroy healthcare. It will leave every person in the country more vulnerable. Our lives will be shorter. Our economy will shrink. Innovation will evaporate. Our liberties will be restrained. In fact, Barry, Nancy and Harry know this and couldn’t care less. There is nothing more behind the public option than to have the gov’t control the citizens’ lives. That’s what they’re really after anyway.
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Chester Tkach says: Good point, Brendan. Obama and Pelosi just can’t keep spending money on programs that already aren’t paid for. Where will it end? Inflation will kill us, if the crappy medical care doesn’t first.
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