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.

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.

“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.

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.

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.

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.

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.

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!