The hard fact of healthcare costs
The president's jubilation at passing a health care bill in the House of Representatives is understandable. It suggests the endgame is on.
But it is not going to become law as it stands. It doesn't stand a prayer of passing in the Senate. Joe Lieberman, who is an independent with a habit of flirting with both parties, says he will join a filibuster to prevent anything with a public option getting through.
To British eyes, this focus on the public option seems a little odd. It would just mean one government-run - but not government-funded - insurance scheme among many others. Some Republicans fear it is the thin end of the wedge and would lead, horror of horrors, to something like our National Health Service.
Of course to many of us Brits, the cry "keep government out of health care" just sounds a little kooky, on a par with "keep government out of defending the nation" or "keep government out of building roads". In Britain one of the main things the government does, one of the main reason people pay taxes, is for health care, so naturally the revulsion at it in the States seems a little strange.
In the USA, people fear this would lead to rationing of health care, which is how the stuff about "death panels" came about over the summer. Someone who wrote in to my last post on healthcare pointed that taxpayer-funded healthcare gives governments the excuse they wanted to pontificate about smoking or drinking. This is true, although government here does pretty well on the pontification and restriction front without what is called "socialised medicine".
But I think in the debate between all the different systems of health care one vital point is missed. Whether they are left, right or centre, they are becoming unsustainably expensive. It is after all the cost of the American system that leads many to conclude it needs radical overhaul.
At the debate's heart are two points. The number of people who don't have insurance, because they can't or don't want afford it. And the industry's reluctance to pay out for those with serious conditions. Private or public, it is a scarce resource, and that is what leads to rationing.
Some years ago, a UK government-sponsored report into the NHS said that it was a potential 'black hole" for spending. This is the depressing truth, born of amazing advances in medicine. People in the West live to have very expensive treatment for cancer and heart disease because they no longer routinely die of measles or TB. The longer we live, the more we need to spend on medical treatment. I don't see how any commercial or political fix can deal with this hard fact.
I’m Mark Mardell, the BBC's North America editor. These are my reflections on American politics, some thoughts on being a Brit living in the USA, and who knows what else? My 
~RS~q~RS~~RS~z~RS~02~RS~)
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Mark Why do you seem to have a problem with Lieberman voting on the issues rather than following a party line.
the objection that many have is wether the costs to the middle class will be less or that service will be as good. the fact that Pelosi and reid have not had an open dialouge during the bils formation can not be discounted.
As this vote was 215-210 and 39 Dems voted with Republicans it can be argued it is the Democratic majority who is not listening to the concerns of the people.
Put tort reform in the final bill and it would have a better chance of passing.
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I think that the real fear hear is that the net cost will NOT reduce ... just as our auto insurance did NOT reduce (as promised) when it was made mandatory.
Last week my pharmacist recommended a $3.00 OTC product that replaced a $167 tube of salve ... .3 ounce, I think.
Just how in the world can you get $167 worth of medicine in a 3/10 ounce tube ... and who is going to be willing to get off that gravy train?
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Sometimes it feels the USA lacks Society - people do not care enough about others - you see this in daily life where drivers cut each other up and will not allow cars out into a lane and now with healthcare for all.
It feels they lack the care for fellow citizens which is a strange feeling when in the USA as usually they are more polite in one to one contact etc.
Most USA citizens are not informed at all about the rest of the world and this comes across in this Healthcare scare issues.
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Since Sen. Lieberman became an Independent he has taken strong stands against Democratic initiatives on foreign and domestic policies. This is not an exception.
The issue is not so much the cost of the proposed program, we are currently spending an incredible $3B a year, 44 million Americans do not have healthcare coverage, many are under insured, and many are rejected or dropped because of pre-existing conditions.
The problem with the public option is that it is likely to work and be cost-effective, which would put the insurance industry out of business. The probability of that happening is simply unacceptable to the GOP because of the large donations they get from the insurance lobby but, most importantly, because of ideology. The idea of a government run program putting private industry out of business is tantamount to sacrilege.
Some reform will take place, but it will be a watered down version of what is being proposed and it will keep the for-profit insurance industry on the driver's seat.
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The problem in the US is the efficiency of use of the money, irrespective of whether it comes from private heathcare or public sources - the system is unbelievably more expensive than equivalent quality systems elsewhere. This is not necessarily fixed by Obama's plans, even if fairness (i.e. inclusiveness) might be improved. only a far more radical breakup of the medical insurance and legal defense cartels in the US would potentially gain efficiency. Improving fairness and efficiency, while maintaining quality, is theoretically possible given the waste (e.g. on paying for patented medicines when generics are available, or unnecessary extra operations, or the huge legal costs), but the political way to solutions is barred even more by vested interests. How did the US come to such a pass? Land of the "free"?
The argument about increasing cost as the population age are not necessarily true (yet) if you institute preventative plans, which are much more feasible with a nationally coordinated system than a piecemeal patchwork quilt - perhaps other nations will eventually set examples
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There are two different sides to the debate - the first one is ethical, the other is pragmatic. Ethically, surely everyone agrees that healthcare should be available to all. Ideally, society should support the healthcare needs of a severely disabled orphan as they grow into adulthood and old age, regardless of what that individual can contribute to society economically. The same principle should extend to individuals whose abilities limit them to low paying jobs. The only exception to this is people who are lazy and don't contribute to society as much as they can - you could argue that these people don't deserve guaranteed healthcare. But there both rich and poor people who fall into this category - e.g. people who inherit wealth without doing anything. Libertarians will argue that health care for vulnerable individuals should not happen through taxation, but through charitable donations made by choice. But ultimately this is largely a fine point - in a large complex democracy we have to make consensus decisions which go against the wishes of some - e.g. what language to speak, what side to drive on, etc. So having government healthcare for the vulnerable is just like having a charity driven by consensus. I don't see what the problem is - at least if it is under government control democracy can make the ultimate decisions.
As for the question of efficiency and resource allocation - this question applies to private healthcare too. A government can always contract out the healthcare to private companies if a private model is deemed to be more efficient.
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On the one hand, yes, health care costs will increase across the board as we get older.
On the other hand, the US health care system currently is immensely wasteful and overpriced - it delivers essentially the same service as the one in France, the Netherlands, or for that matter the UK, at about twice the price.
If I remember correctly from college health economics class, the major reasons American health care is so much more expensive on a per capita basis include:
1. More frequent use of expensive technology (such as MRI machines, operations instead of medication, etc.).
There is not much evidence that this has resulted in a greater quality of care, though due to demographic and measurement differences between populations in different countries it is hard to directly compare health care systems. It is in fact a general trend that the more a country relies on fee for service, the more costly its health care system is. This is a huge contributor to why the US is more costly than Germany and Canada which have global budgets for hospitals and lower incentives for costly procedures, and why Germany and Canada are more costly than the UK which puts physicians on salaries and tightly controls budgets.
In the 90's, when HMO's used extremely restrictive networks and refused care and put physicians on capitation instead of fee for service and used primary care physicians as gatekeepers to prevent (what they considered) overutilization, health care costs leveled out relative to GDP.
When highly restrictive HMO's were largely replaced with PPO and POS plans, cost growth resumed. There was enormous public backlash because of the lack of transparency and lack of patient choice, but there are elements of these sorts of policies in countries (such as the UK) where health care costs are extremely low. The NHS is very much like a giant but politically accountable HMO.
2. Lack of monopsonistic buying power, or lack of utilization thereof.
Pharmaceuticals and hospitals drain much more money in the US than other countries on a per service basis.
Physicians earn more in the United States than any other country in the world. Part of this has to do with expenses incurred in medical training, part of it has to do with the power of the AMA, and part of it has to do with the relative bargaining power between physicians and insurers.
3. On a much smaller scale, administrative inefficiencies. American insurance claims filing is generally pretty costly, and the individual insurance market itself is extraordinarily inefficient.
4. The American population incurs high rates of expensive chronic illnesses than the populations of most European countries do, partly due to unhealthier lifestyles.
If the US wants to decrease health care cost growth to put it more in line with other developed countries, then it should institute reforms to transition away from fee for service reimbursements while emphasizing group-based care organized around primary care physicians.
It also very much needs a monopsonistic buyer, either by strong state regulation or a single insurer.
The new bill does neither of these things, at least properly - so it doesn't really address the core problem from which all others derive, the cost inefficiency.
Given recent protests, the US electorate would probably not stand for the "horror" of state-controlled insurance, even though on the long run it would give them much better value.
It is very well established in economics that because of lack of information and time for choice in necessary treatment on the part of the consumer (patient), there is a failure of the free market in the health care sector showing an effective provider monopoly - and the only way to keep prices down is to institute and effective monopsony.
While the US has anti-trust legislation, I imagine it would be difficult to convince Americans that in some sectors, provider competition simply doesn't work.
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Yes it is stupid and ridiculous the attacks against government run health care. The negative information is cleverly disseminated by the vested interests in private health care. The distortions are downright disgusting and the gullibility of some of the public disheartening. Underlining this is the constant attention being paid by the media on the small number of vociferous right wing nuts. I have held signs on the streets along with others for health care reform, we encourage passerby's to honk their horns in support, and let me tell you they do.
The fact is that medicine costs are ridiculously high because the industry is protected and real competition doesn't exist. It would be singularly the best economic stimulus if a single payer system was created.
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First off, and I don't know who started this, but Americans do NOT have a right to health insurance that they cannot afford. Honestly, when I talk with my peers, the concern does not focus so much what the new system may cost, nor on what the quality of the health care will be, it is on the idea that the government is taking over yet another aspect of our lives - it's one more step toward socialism. Since the '80's, we have watched the government destroy industry in this country, our social security system...this idea that has been dog-heartedly promoted that we are now operating within a consumer based economy is a lie. It's a debt-based economy. If the past 3 decades should have taught us anything about reducing costs, be it health care or otherwise, then lesson would that the first thing we must do is put an end to government involvement in those systems. Whatever happened to Americans showing some personal responsibility in their lives and taking care of themselves? When I talk with people who support the idea of NHS in this country, it becomes readily apparent to me that they aren't for it because they want more affordable health care, what they want is cheaper health care so that the 42" plasma screen HD TV they want can become more affordable. Shameful.
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I am just sick and tired of this. Americans went to the polls and voted for change. Obama's key message was Health Reform and most Americans agreed thus his winning. Grow up and take your spoon as you wanted it with out health reform it should collapse for there is only so much that greed can get and buy you. The Health Industry has had its time and chance to prove and show how they wish to run things and what did it get us int the end?
I for one would appreciate a health plan that I can afford even while living abroad as I am dong now. I have health coverage where I live and it is modeled after Social care and guess what it is and was working until this current Government tried to introduce Western/U.S. type of health care. It was abolished via a referendum because we saw what is happening over the States.
Just give this a chance to start and then we can try to shape and create as it flows thru.
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¨There is a misunderstanding¨to use British understatement. We all pay for the current healthcare program, it´s just that forty million of us are denied benefits! We pay in taxes and deductions for the healthcare of politicians, public servants and the elderly. We also pay for private healthcare insurance whenever we buy a product or use a service. Companies simply pass on the costs, in the products and services they sell. They call it variable overhead.
Those people with banners ¨save out healthcare¨obviously have healthcare to save! Politicians like Lieberman are openly hypocritical when they say they will not agree to a public option, while enjoying a generous program at public expense.
How can any American, claiming that he is ¨loyal to his flag¨, live with himself when forty million of his fellow citizens are living in dread of becoming ill? Where is their sense of national unity?
Finally,when they suggest that those uninsured should be supported by the church and charities they are harking back to the days of the niteenth century poorhouse!
c
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There is a religious element of the anti abortion lobby. Some parts of america are so pro life that any abortion is murder and they don't want to fund abortions.
Apart from that is the old capitalist way of thinking, you don't get anything free if you need a service or goods or whatever, then you must give something back of equal value.
When you add money into it, which can be spent elsewhere, as cash is universally exchangable then the incentive is to skimp on healthcare.
longer we live the more we need to spend on it.
Easy when it's a motor car if it breaks you get it fixed or it may be cheaper to scrap it.
So an unemployed person has an accident and breaks leg, or suffers severe injury that costs a bill of of a hundred thousand or something doctors patch him up week later wins the lottery jackpot how much does he owe?
There has to be a fixed price but the doctor saved his life does he owe it all or just the cost of the materials skills and labor that got him back on his feet?
You can't measure or predict the value that you get is it cheaper to die or is it cheaper to heal?
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Of all the arguments bouncing around for and against the many versions of the health care bill that have been thrown around, I find it odd that so few people point out how very illegal the concept of a federally created and controlled "public option", aka health insurance business, is. The constitution clearly states the very limited powers of the federal government, and while some of them are sweeping statements, I'm hard pressed to find anything in there that says the feds can create and run a business on tax payer money. You might think this leaves a bit of a loophole, allowing the government to abscond with illegitimate powers claiming the founding fathers merely couldn't predict the future needs of a developing nation, so we just have to do "what is best for the people", or something like that. In fact, they do this on a nearly daily basis in the many departments and agencies of our steadily growing bureaucracy. Alas, the founding fathers did foresee such problems, and realizing the differing sets of opinions that come with the regional subcultures of large nations, they established a precedent in the tenth amendment, which goes something along the lines of:
"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."
All arguments of the morality of stealing from the rich to give to the poor (with an added 5.4% income tax coming soon for some those folks smart enough to make something of themselves) versus letting the unfortunate die in the streets aside, what legal right does this government have to start a business? How can a business that can run at a substantial loss create meaningful competition in a market with already uncommonly low profits for the market leader?
Also, a brief aside to Raceice in comment 3, you have struck the nail on the head as to what sets the USA apart from Europe. We are not a society, we are a whole bunch of individuals who happen to live near each other. For the most part we don't live in villages, we like being left to our own devices. I recall my first visit to Europe being so incredibly bizarre, not a single solitary house did I find in a month of traveling! Now I'm making sweeping generalizations with which a lot of Americans would disagree, but I'd wager many of those wouldn't comprehend the level to which Europeans have taken the concept of Society above Individuality.
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A potential point that some seem to miss is that, with American dollars spent for health care, the world's health care is improved. America funds medical innovation and new perscription drugs. America's defence of Europe and Japan mean more funds for those countries to fund social programs. Because the world gets a discount, America pays more.
I believe that the main objection to nationalised health care is that American's aren't ruled, they are governed. While most of Europe has been ruled by different means and different facations for hundereds of years, America has chosen to be governed. It may be an "American" thing that Europeans just don't understand. Freedom and liberty are a part of the fabric of America not something that was granted by a king or by the ruling elite.
American dollars support the world and bring innovation, improvement to the other nations of the world. We've fought and died for places where the world thought we should be involved (and some where the world thought we shouldn't be involved); Iraq, Afganistan, Bosnia, Somilia.
Maybe it's time to withdraw from the world, bring all of our soldiers home, save the money spent to rent bases, equip and train our men and women, and spend it on health care at home.
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4 dominick
"The problem with the public option is that it is likely to work and be cost-effective, which would put the insurance industry out of business. The probability of that happening is simply unacceptable to the GOP because of the large donations they get from the insurance lobby but, most importantly, because of ideology. The idea of a government run program putting private industry out of business is tantamount to sacrilege."
Well pu Dominick, and this raises the disturbing issue that many many middle and working class Americans will dislike something which could radically reduce their household spending and also provide better cover .... on what grounds .... some ideology that they have been told is the "American Way".
The people sacrifice a better more equitable future so the corporate fat cats can have a yacht.
It's too surreal for words.
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LIbertarian:
Nice thought about living alone and not together - but drive from Lakeshore Drive Chicago and after 3 hours and past about 2.5 million people you get to the wilds of Illinois and people who live separately- the other 2.5 million people are SOCIETY and I expect some 20% are not on health care insurance !!
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To put the issues simply, there are two serious problems with the current US health care system: it is monumentally expensive, and it doesn't cover enough people.
Attempting to cover more people without first containing costs seems very foolish to me. While the GOP has been MIA on this issue until recently, the Dems have shown to be hypocritical by refusing much needed tort reform to bring down the malpractice insurance rates, which are driving hundreds of doctors from their practices every year.
The current House bill won't pass the Senate. So more changes will come, and we have to wait to see what they will be.
On a related note, cancer survivability rates are the highest in the world for patients in the US. Note that thousands of people enter the US every year to get treatments that are unavailable in other countries. I don't believe that it's the quality of care that is an issue, but rather the cost and coverage.
Finally, it's important to understand that Americans have a near genetic distrust of government. We recognize that government run entities like the Post Office and Amtrack are bloated and inefficient, and we don't think that a group of bureaucrats giving orders is the answer to all problems.
I pay too much for health insurance, and since my salary has been frozen for at least a year [as has my wife's] I am pretty unhappy about the increase in my insurance rates that will kick in in January. Nonetheless, I'm not eager to see politics deciding my health care choices. There is a sane way out of this, but it's unlikely that the current crop of politicans will find it.
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In my mind, we already have "socialized medicine" in the US. If a person presents to any emergency room, they are provided the care they need (in-patient or out-patient) regardless of their ability to pay. This is already the law. The people with insurance end up paying for them with higher insurance rates etc. The only differences between health care paid for by the insurance companies and healthcare paid for by the gov't are a.) the insurance company takes it's big bite of profit out of the middle of the process; the government won't and b.) insurance companies can deny payment for needed treatment when they want; the government won't. Will it mean higher taxes? Absolutely. But higher taxes for everyone across the board for a worthwhile product. Probably much less than my monthly out of pocket payment for private insurance that often denies coverage for minor maladies. We need something now before we price ourselves out of business. Tort reform would help immensely!
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I have found U.S. healthcare across the nation to be widely available and of very high quality, when I take into account private care, but even discounted and inexpensive private care. I have also found it valuable to get second and third opinions on conditions as often the first is not adequate or even accurate. This indicates that despite bounty sometimes quality is lacking. One thing I feel sets U.S. healthcare apart from the rest of the world, however, is that the level of expertise on average is quite high. See a doctor in the U.S. and in those few actual minutes in their presence, they DO tell you a heck of a lot about why you two are conversing. It's simply not like that in most other places.
I think on the other hand, there is egregious waste on staffing costs from the administrative end, all the insurers having to liase with clinical staff burns huge amounts of dollars to have all those monkeys going round and round. Add to this the exorbitance of malpractice insurance due to massive but very real costs, and that's why we have a huge 800 lb. primate flogging things about...
I say make the insurers run the actual doctor's offices and eliminate that entire rung of the payroll ladder, enroll all the clinical staff in actual care-giving professions (techs, nurses, "G.P." doctors, etc.) fill the demand, lower the overall pay-structure with a glut of qualified individuals, and just why not? I belive the conservative chicken little call unfounded, indeed, if a private interest is superior to a public one, the public will hire the private for everyone's profit.
It would be superior to see something work and better still if the Pres. could gain the credit....
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Well done. However, a piece missing is the greed factor. A look at the mega-billion dollar health care industry and the hundreds of millions given to members of congress and another perspective jumps to the forefront - greed and pay back. We were once a nation that cared about each other. I believe CNN did a piece on those congressmen who have received huge sums to promote and protect the industry through industry campaign contributions. The lies, misinformation, fear mongering is totally disgusting. I personally would welcome a single payer system, a system similiar to that in Canada, Great Britian, or other "more civilized" nations around the world.
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Those of us in the U.S. with a conservative attitude don't trust that the government can run such a huge program efficiently. Social Security and Medicaire, famous liberal/social programs, have cost MANY times what they were projected to cost. They are both going bankrupt. Why would anyone think the government could run a public healthcare option that would not put a drag the economy by having to raise taxes to pay for it. State run health care has already been tried by several states in the U.S., all of them have failed miserably. Why would anyone think the federal government (famous for waste and fraud) can do any better.
I encourage those of you who support a public option to read an article in the Wall Street Journal that gives some interesting details on how the states that have tried this have failed @ http://online.wsj.com/article/SB10001424052748703298004574455560453947646.html
And of course I must trot out the usual argument - Why do people, politicians, heads of state, etc. from other countries come to the U.S. when they want treated? Because they don't have to wait 6 months to get treated, one of many reasons.
I think our current health care system could be improved. I don't think it needs to be scrapped and replaced with a government run (state or federal) program.
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President Obama ran on the promise to "reform" health care. He promised to provide coverage to those who could not afford it. He also promised to reduce costs and improve outcomes.
To now say that Americans voted for universal health care is not entirely true. There were so many promises made by Obama, it is hard to know who supported him for what.
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"In fact, they do this on a nearly daily basis in the many departments and agencies of our steadily growing bureaucracy. Alas, the founding fathers did foresee such problems, and realizing the differing sets of opinions that come with the regional subcultures of large nations, they established a precedent in the tenth amendment, which goes something along the lines of:
"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.""
Well said. I would say the marijuana prosecutions in CA and other states runs very contrary to this principle as well and I was glad federal prosecutors were told to stop this process.
"At the debate's heart are two points. The number of people who don't have insurance, because they can't or don't want afford it. And the industry's reluctance to pay out for those with serious conditions. Private or public it is a scare resource, and that is what leads to rationing."
I do not agree with the whole Insurance companies hate people with pre-conditions. I could see where if you had to switch health insurance they might try it, and that should be prevented, but if you were paying already you shouldn't have a problem. I personally know people who were like: "I am healthy, I don't need it". In my opinion, if you do not want to pay for it the whole time, you have no right to complain. I mean their point of view is ridiculous: I don't want to pay premiums ever month, but when I have this ridiculously expensive MRI scan to properly diagnose my cancer and I then have to pay for surgery and chemo that should somehow get covered. That seems like cheating the system and I think a company should be able to deny you.
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I am sure this will sound very small minded but I am convinced that there was an element of race in the controversy about the health care. I didn't think about it at first will all the hullabulloo at the town hall meetings but an American friend put it into my head and after that I got more and more convinced. I think many Americans don't like to see a black man in a position of power. Either consciously or subconsciously they resent it. And after I got to thinking that I went further and then I began to think 'who will benefit from the expansion of healt care?' And the answer is poor people, mostly, and that means more black people and deep down many Americans cannot bear to see equality emerging.
The deadly silence on Republican side of house and former comment of 'you lie' (remember?) make me feel there is an awful lot of resentment to the black man from Republican side of house. And I have seen and heard Glen Beck ... can anyone listen to his talk without seeing that there is huge resentment to black man and especially to his being so uppity as to meddle in insurance and the likes which were sources of great wealth to ... well mostly to already rich white people.
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I have two issues with the current health system in the US. One, it is horribly expensive and two, you pay and pay but when you need to have something covered for your health, the insurance company decides which medication you need or service you need and not you or your doctor because they decide what they will pay for. It is money thrown into a hurricane and you can only hope that some of it comes back. There needs to be more regulations about what a person is actually paying for and will receive and there needs to be a lowering of cost of procedures and malpractice insurance.
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17. omnibus09: "Attempting to cover more people without first containing costs seems very foolish to me. "
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Of course, it's foolish. The dems' idea of cost reduction is to cut fees paid to providers. I don't think they could have done a worse job addressing costs.
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19
"I have also found it valuable to get second and third opinions on conditions as often the first is not adequate or even accurate. This indicates that despite bounty sometimes quality is lacking. One thing I feel sets U.S. healthcare apart from the rest of the world, however, is that the level of expertise on average is quite high."
Well done - you have mangaed to contradict yourself in the following sentence.
.... quality is lacking so you need a second or third opinion .... when you see a doctor the level of expertise is high.
Hmmmm!
also
"See a doctor in the U.S. and in those few actual minutes in their presence, they DO tell you a heck of a lot about why you two are conversing. It's simply not like that in most other places."
In how many other places have you seen a doctor?
Or are you just making sweeping generalisations on hearsay.
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Isolationist,
Being governed is something we are quite used to here in the UK. May I refer you to the Magna Carta (1215AD) that created the English "Parliament", the Petition of Right of 1628 AD and the Bill of Rights of 1689 AD. Its not 'just' an American thing.
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In ancient Rome when there was civil unrest or unresolvable problems the Senate would elect a "dictator" (etymology - one who tells us what to do)to make decisions in the best interests of the people, bypassing the political infighting of the political classes.
This position was held for 3 months, renewable until said issues were resolved. It was not invoked often, and in the 1st century BCE was abused by Sulla, Pompey and finally Caesar who had himself proclaimed dictator for life ..... but until then in general it had worked well.
Does the US need a dictator?
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Raceice:
Thought I'd play a little tag :)
And do those 2.5 million people between downtown Chicago and the Illinois wilderness consider themselves individuals, or parts of society? I dare say they prefer their own dreams of success over contentment with a structured place in the great societal fabric of the nation and rarely think beyond their relatively small social circles. Where I am from, most people in the city prefer to nurse their own hobbies and friendships behind closed doors. When I consider doing something, the question is more along the lines of, "what do I get from this?" than, "what greater good does this serve?". Now, there is a huge amount of community involvement, particularly in Chicago, but that community is limited to Chicago. Each suburb and district of Chicago has it's own set of needs and issues. The general community of Chicago has different needs and issues than every other community in a staggeringly large and diverse country. If the people of Illinois feel they would be better off with a publicly sponsored health insurance program, why not? I'm certain the state's constitution would allow for it, and it would take care of the needs and desires of the region with a lot more control in the hands of the people than if said program were in the hands of the federal government, which was the main gist of my previous comment.
Consider this; If every state were to oust the private insurers with public plans, it would be much more cost efficient than a unified federal program. Less bureaucracy upkeep and greater competition in the national market for medical supplies to drive down costs. More power in the hands of the individuals with a higher degree of accountability for those in official power. No risk for added burden to a national deficit poised to render this whole debate moot by way of inflation and currency depreciation. It is as though someone came along before us and planned it to work that way...but the folks in Washington prefer the opportunity for yet more power over maximizing the utility for the people who pay their salaries.
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re political donations
Perhaps all senators and congressmen should "declare an interest" before any vote relating to industries from which they had received funding.
It is corruption pure and simple. The purchasing of votes cannot be described as anything less.
The whole system is rotten to the core and the people lap it up..... panem et circenses .... more in common with Rome than you realised.
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Another thing the goverment could do is open up competition.
A parellel could be the auto insurance industry in Mass. For a long time Auto insurance companies did not want to operate here because of controlled insurance rates. This raised the majority of rates but gave special interests groups lower rates.
As soon as they opened up the bidding, my rate went down 25%. That is what hapenns when goverment is not involved.
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24. padlin: "The deadly silence on Republican side of house and former comment of 'you lie' (remember?) make me feel there is an awful lot of resentment to the black man from Republican side of house."
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Obama brought that one on himself. He insisted, emphatically, that health care would not be provided to illegal immigrants. Yet, the provision to verify citizenship had been removed from the draft bill.
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23 Tino
"I don't want to pay premiums ever month, but when I have this ridiculously expensive MRI scan to properly diagnose my cancer and I then have to pay for surgery and chemo that should somehow get covered."
Would you also advocate being able to opt out of fire service and policing.
After all your house doesn't burn down very often, and you don't get burgled every week ......
Your argument holds no water. You are simply seeking to defend a system which is indefensible in both moral and economic terms.
Has anyone else wondered if some of our fellow bloggers are plants from the insurance lobby? Just a thought - there are alot of new faces around.
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My main concern is that just about everything our government touches turns to crap rather quickly. If the people in DC were all good, moral, intelligent men/women, I wouldn't have as much of a problem with it. However, that's hardly the case.
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"A potential point that some seem to miss is that, with American dollars spent for health care, the world's health care is improved. America funds medical innovation and new perscription drugs. America's defence of Europe and Japan mean more funds for those countries to fund social programs. Because the world gets a discount, America pays more."
America is not a charity - the American-researched drugs that Europe, Japan etc. use are bought at market rates from drug companies whose prices more than cover their R&D spending plus a very healthy profit margin. Drugs don't exclusively come from America and shine down upon the rest of the world like a gift from a benevolent god - Europe for example has its own pharmaceutical industry comparable in size to the US's and those we do get from the US we pay for, fair and sqaure.
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It's interesting to hear people from outside the US question why Americans would not want a government-run health care system like they have. They assume that it must be the ignorance, selfishness, etc., of the citizens that keeps them from wanting their health care to be overseen by the government.
In fact, it's the citizens' belief that the government is run by ignorant, selfish -- and corrupt -- individuals that prevents them from handing over something as important as health care to it.
Rampant disdain for government is quite the norm here.
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34. RomeStu: "Has anyone else wondered if some of our fellow bloggers are plants from the insurance lobby? Just a thought - there are alot of new faces around."
******************
There are a lot of faces that don't believe that government-run health care is the way to go. Maybe you'll learn something.
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Since, as I understand it, the likeliest result is 1) there being no cap enforced on premiums, then to pay for the commitment to cover 'pre-existing conditions' premiums will increase; 2) if a 'public' insurance alternative is ruled out, then those least able to afford these increased premiums will be fined so they can afford insurance even less, I can't see what the 'free-marketeers' are so unhappy about. Doesn't this correspond to the 'American Way'? ("If you can't afford it, you've no right to it, so tough.")
I have a simple 'free-market' solution to rising health insurance costs. Now, I'm a socialist, so I have difficulty in really grasping this sort of perspective, and it starts from an egalitarian premise. Suppose we agree that medical conditions and illnesses do not afflict people through their choice. Cancer, for example -- or a disability like mine -- does not strike only those who can afford treatment for it; nor is it predictable; nor is it a life (or death) choice.
So, in order that treatment for these 'accidents of God' can be afforded by everyone, why not reduce the overall costs by not insuring people who require treatment as a result of a choice they have made themselves? for example, if you are injured as a result of driving carelessly, why should you not pay in full for the consequences? If you shoot someone in 'self-defence', or are shot, to use weaponry is a personal choice with all its potential consequences, why should you not yourself pay? If you break a leg skiiing, climbing, surfboarding or whatever, that too is entirely your choice, so why should you not pay? One might extend this; since the US armed forces are made up of volunteers who know what the risks of war are (or should) why should the state pay for the consequences of them being shot or blown up? Should not they also pay premiums commensurate with the risks?
That should leave enough money to treat those conditions that arise randomly and through no fault of those afflicted with them, and satisfy all those who argue that healthcare is not a universal right but a personal responsibility and one that the individual should pay for.
What seems to me to have gone missing and unaddressed in this whole debate is this simple problem: does the community as a whole regard the maintenance of life as a social duty and a right for every member of it, or not? (I can't really understand why so many people in a supposedly 21st century civilised country seem to think it is even an issue.)
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Is any bill passed by a government of the day not repealable by a government of another day? If yes, why all these acrimonious emotions about the passing of the U.S. Health Care Reform Bill, since that bill can be abrogated by the next government, of course, if it is a Republican government? Why do the doubting (intriguous) Thomases don't want to give that bill the chance to prove or disprove its worth?
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The American media has been scaremongering its population for a long time about long waiting times in socialised medicine- pointing often to the UK or Canada as examples but ***conveniently*** omissing nations like France, Germany, Netherlands, Scandanavia etc which have no longer waiting times than the USA.
As an ex-doctor in the UK, I was amazed by the amount of passing American tourists who we would treat in hospital for a wide array of things things like hernias and broken bones- technically they should have been charged but as its a state system noone really bothered with the papaerwork. Im sure many of these same American white-collar tourists, who were treated at the expense of the Britsih taxpayer would have been the same ones anti-social medicine.
Not to digress, the main issue with the US health care system is the exorbitant cost of care- which is oten more than twice than the equivalent procedure in Western Europe- I dont actually believe doctors salaries pay a large part in this- most doctors in the US probably deserve what they earn- they certainly work a lot longer hours than we do in Europe. The reason is the health insurance companies and Big Pharma who are to be the main beneficiaries of the current status quo. Their lobbying powers are only well to known (Btw, I would put an end to corporate lobbying if I had my choice).
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35. At 1:29pm on 09 Nov 2009, MorganKnives wrote:
My main concern is that just about everything our government touches turns to crap rather quickly. If the people in DC were all good, moral, intelligent men/women, I wouldn't have as much of a problem with it. However, that's hardly the case.
37. At 1:47pm on 09 Nov 2009, AndreaNY wrote:
In fact, it's the citizens' belief that the government is run by ignorant, selfish -- and corrupt -- individuals that prevents them from handing over something as important as health care to it.
Rampant disdain for government is quite the norm here.
So why not elect 'good moral intelligent men and women' or change your form of government to one that isn't "run by ignorant, selfish -- and corrupt -- individuals?" If they aren't fit to run something as benign as health care, why on earth do you trust them with wars?
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Everyone wants health care for everyone. I think the real issue is every State wants something different.And most citizens don't trust the federal government with Domestic issues which the federal government has caused problems for,Federal Bills are to broad and water downed because of the shear number of people to please just look at education like No Child Left Behind it has helped some states but hindered other states.They should give the States abilities to adapt the health care bills like Canadian system.Plus people don't realize good health care isn't evenly distributed.32 of top 100 hospital are in Michigan and Ohio alone.People in every state should have quality health care and hospitals.The abortion provision I don't understand GOP or BLUE DEMS,they say Government shouldn't tell private companies what to do but they are telling them they can't provide Abortion option for their private health care plans if they want federal money however I have no problem if people pay for own Abortion as long as Birth Control is covered.I have no doubt how my Senators Stabenow or Levin will vote.Lieberman isn't my Senator the people he represents need to contact him if they want health care or not.
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***Of course to many of us Brits, the cry "keep government out of health care" just sounds a little kooky, on a par with "keep government out of defending the nation" or "keep government out of building roads".***
Or keep government out of street lights, fire departments, police departments, sidewalks, law, constitution, and so on, and so on....
You are correct, there isn't a private or public option to end aging or medical advances. There is, however, a public option - as seen in every other developed nation that has public health care - a solution to decrease infant mortality rates, increase life expectancy and bring down health care costs by the thousands.
We, the U.S. of A., pays the most, rank 46th in the world with regards to infant mortality rates and 45th in the world with regards to life expectancy (according to our OWN CIA World Factbook)...this, from one of the richest nations in the world.
It's time that we as a nation weren't the laughing stock of the worlds developed nations. It's time that conservatives in the U.S. stop telling everyone about how bad the rest of the developed worlds health care is. Had these complaints been coming from the rest of developed world, they might read as legitimate. It's evident, in all the cries that the UK, Canada, France and the like have terrible health care system, that they really don't know what they're talking about...or, you know, we might HEAR these horror story style complaints from, ya know, the rest of the developed world that provide health care. Instead, we hear how those traveling abroad to the U.S. worry about getting ill or sick and not being able to make it back home without going bankrupt. Travel a little bit out of small town America - which I've been to and it's beautiful - and actually engage in conversation with some foreigners, set foot on foreign soil, ask them how they feel about their health care system versus ours. I have and it's almost across the board a general feeling of confusion to the rest of the developed world as to why there is such an upheaval with regards to keeping our citizens safe, healthy, and cared for. It's truly seen as quite absurd. Again, you'd have to care enough about the rest of the world to actually travel and see for yourself...and no, that doesn't mean seeing Russia from your house. My point being is that the admission that the rest of the worlds developed, public, government implemented health care systems are sub-par and down right oogedy-boogedy scary is quite contrary to what how those countries ACTUALLY - in general terms - feel about their systems, and in fact, in many cases they would make the same terrifying admissions about ours!
If we can pay our military to kill - which is absolutely NOT a commentary on the war's we're involved in, but a true and honest fact - than we SHOULD be able to pay for our own citizens health and well being.
P.S. - The conservatives had almost a year to present a cohesive plan, an option among options and they've failed to produce a BILL. Yes, they've had "proposals", but with all their bickering, all their divisiveness, they have yet to produce a bill, something that can be scored by the likes of the CBO as an alternative to the current push for healthcare reform.
It's time to put up or shut up...and honestly it WAS time, and they didn't.
P.P.S. - I stand corrected, they had 8 years, plus this year with a leader demanding health care reform and they did nothing but oppose, present detail void initiatives i.e. a cohesive BILL, and instead pandered to big business while trying to inject - for all their decrying of government involvement - government control into peoples personal sex lives, marriage, religion, and bodies...how strange.
They had their chance and blew it.
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When I was 17 I was diagnosed with tuberculosis. I have lived in Spain all my life, and have never travelled to a poor country. However, there it was, taking over my lungs and my blood. Thanks to the amazing national healthcare system we have in Spain, I survived - the medicines are around €60 a box (each month or less) plus I had a biopsy done in my lungs, blood analysis and visits to the doctor every month for a year, x-ray, CAT scans, my lungs were emptied every day (they were full of liquid), whenever needed and all the time I was at the hospital I was surrounded by professionals who made my stay there a bit easier, considering TB is something you have only ever heard happening to fair 18th century ladies. I say YES to a national healthcare system. I don't know whether my parents would have been able to afford all the procedures had we lived in the US.
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I always appreciate your British perspective. Other individuals have commented on much that is valuable as well. What I haven't seen yet is a discussion of the likely VAT tax that will ensue to pay for this new entitlement. There just aren't enough wealthy around to finance the endless healthcare wants of our nation. A VAT tax would definitely change the consumer based economy in the States and bring us more to the "pocket change" model of Europe. I, for one, enjoy reasonably priced well-made goods and the ability to travel affordably in the US. This just isn't the case in the VAT countries where everything is much more expensive and the population seems to be more pecuniary as a result. Germany is taking a hard look at the economic necessity of reducing healthcare entitlements and we in the US are heading in the opposite direction. Once in place, an entitlement is practically impossible to take back. I think these our some of our intuitive, or in some cases, conscious, fears of healthcare reform.
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"Would you also advocate being able to opt out of fire service and policing.
After all your house doesn't burn down very often, and you don't get burgled every week ......
Your argument holds no water. You are simply seeking to defend a system which is indefensible in both moral and economic terms."
I am not advocating opting out. I am advocating paying the premiums to receive service. My point was the people complaining about being denied coverage based on a pre-existing condition usually just didn't want to pay for health insurance when they had no obvious health problems. That makes no sense, as it implies you don't want to pay into the system but you still want to not pay the price when you end up needing a major procedure or perhaps AIDS meds.
There is nothing indefensible about expecting people who are supposedly concerned with their health to pay premiums so the insurance company will cover their procedures later. If people don't want to do that, they do not deserve coverage.
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Mark is spot on.
However, I don't know that is reason enough not to at least TRY to make the system more equitable on the very BASICS of distribution of basic healthcare...even while knowing that the 'basics' are an evermoving target as health care technology continues to gain in knowledge of lifesaving treatment options.
Even while I know that the possibility of financial gain is the fuel behind a debatable 'much' of this technology at least in the corporate model, as a 25 year veteran in both research and direct health care in the US, I am not satisfied to rest with the simplistic theory that 'socialization' (in basic terms, the elimination of for profit middle management; of which NONE of the current US bills proposed calls for directly) of the US healthcare system will necessarily eliminate all technological advances nor eliminate the dedication of those of us that are involved in this system that do NOT take in a large share of the corporate profit. The workers, and the researchers, if you will.
Otherwise we would have all chosen to go into finance. WE, as the specialists, did NOT choose our fields solely on the basis of profitable monetary gain. THOSE profits, btw, are largely channeled to not just the shareholders but disproportionally to the upper management that know little to nothing about the technology itself and would be useless without the knowledge and dedication of those of us doing the research; most of us that by comparison profit very little. Again, the corporate model, in a very real sense, as is true of the middle managers we call the 'insurance' industry...operate, while utilizing other people's time and knowledge that are actually creating the equity, for personal profit, not for the good of the world. And the beneficiaries of the technology, more and more, are of course...those with the equity to pay for the services.
I believe that they overestimate their own importance.
However, if we believe them (as is largely the case; as in the 1800's here in the US multitudes of poverty stricken white southerners were convinced to die in order to support a slavery system from which he himself did not profit); we create more and more, not an increase of democracy but rather an increasing oligarchy which though it claims to be a meritocracy; defines the 'merit' system and continues to primarily serve those with the most economic clout.
What seems to be the case in the US the more I pay attention; is that we are like a large litter of kittens, too many of which are going too hungry, clawing for our share of the food bowl. The better fed kittens feel that it is their right to take more, as they are stronger and more aggressive and the 'lazy' kittens deserve to starve.
The strangest thing about it all, is that there is plenty enough food to go around, if some kittens weren't hogging the food bowl and making sure that they could continue to eat more than their fair share because they had 'earned' it..of course, in their own opinion, they are getting only their just share.
When, in any oligarchy, was that not the opinion of those at the top of the food chain?
If health care technology should be utilized only by those that can afford to pay for it...and we have a growing number of the species that take more than their fair share of other people's time and other people's labor because by their share of amassed equity (gained by utilizing a system which they control) they have 'earned' it, what does that say about the course of the human race? Why should the rest of us be satisfied by that status quo?
Why should I be disturbed by such behavior of a nation that largely considers itself Christian?
What is to become of any religion when it ignores it's basic premisses and instead prostrates itself before Mammon and says that profit is the gage of all industriousness (which of course, is the measure of God) and all those that cannot amass profit deserve to die if they cannot avail themselves to acquiring the currency with which to feed and clothe themselves, let alone avail themselves of life saving technology to which they do not deserve as those of us do that can 'pay' for it?
Because that is exactly what we in effect ARE saying, no matter which way you want to rationalize while you are slicing that bread.
THIS, is the sign of the times, of which we were warned.
WHAT system are we protecting with our military which our politicians run; of whom ALL our tax money supports while disproportionately our poor die on the battle fields... a system of which more and more citizens are getting less and less a share...
I wonder if the Devil himself favors a 'meritocracy' system...
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Europe does have pharmaceutical industry however US pays more for those drugs too because when they give out treatments to 3rd World countries they make up costs on the backs of Americans.I however think US health care has more to do with number of Universities and Colleges and Graduates and Technology than whether or not our insurance is private or public.Besides younger Americans are tired of Military Compound around the world and will eventually fund less military for foreign nations.Obama was voted for by more X ers and Millenials than Boomers,he is a transitional President.That is why he wants less to do with Europe richest continent in the world,Cold War is over and people under 40 want to stop funding military like it's still the 80's however we still have Afghanistan and Iraq.But people under 40 want health care and eventually want to slow military BS to eventually pay for it.Plus health care plan won't take effect right away.We can pay for our own citizens if we aren't paying for military bases around the world that protect others plus probably have some change left over.Costs of protecting Europe from nobody in particular is expensive and wasteful spending.
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"In fact, it's the citizens' belief that the government is run by ignorant, selfish -- and corrupt -- individuals that prevents them from handing over something as important as health care to it.
Rampant disdain for government is quite the norm here. "
Then the greatest nation on earth needs more help than I thought
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Mark, you say it so well, to quote you, "In Britain one of the main things the government does, one of the main reason people pay taxes, is for health care, so naturally the revulsion at it in the States seems a little strange".
That is the fundamental problem with the UK National Health Service. In the United Kingdom, only 40 percent of the population of the UK pay taxes and the NHS, year-on-year, gets more and more expensive to run - currently costing the Government of the UK 600billion GDP across all health service delivery.
On the face of it, universal subsidised healthcare is a wonderful aspiration but the problem is that, as with all government funded projects/organisations, the people in these projects/organisation start to believe that money grows on trees, costs for the government-funded project/organisation spiral ever upwards and the 40 percent of the population end up seeing their taxes paid out more and more on these idyllic programs without actually seeing vast improvement in civic health or well-being.
Sooner or later, the NHS in the UK will be declared bust and healthcare rationing will start (in fact it already has regardinglimitation of certain prescription drugs and certain treatments, e.g. people over the age of 80 will only get 1 hip operation per hip but if the hip wears out then tough!.
Hence, in the UK, those who can, pay for additional healthcare privately and get better service, better treatment and better quality of life than they might do with the NHS perennial problems of treatment waiting lists, MRSA and people abusing the free health services available to them even though they have not contributed to the NHS.
In the USA, the US National Healthcare service will eventually go the same way (if it comes into being) - the idealism is to be applauded but the reality, when it comes home to roost, will be a healthcare service that is universal but of less good quality than the insurance-inspired healthcare that people pay for now - thus the US tax-payers will end up subsidising universal healthcare at the expense of their own healthcare as well as seeing their tax dollars spent less efficiently.
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TeacherBunzu: If yes, why all these acrimonious emotions about the passing of the U.S. Health Care Reform Bill, since that bill can be abrogated by the next government, of course, if it is a Republican government?
Are you really that naive? Once these things are put in place, not so easily undone. You can't just wave a 'magic wand' and reset back to the way it was before. Get real.
For those of you who really want government run health care, move to Canada or some other country that has it. If you really don't like the capitalist free market society that made the U.S. a great country, move to another country. Stop trying to turn the U.S. into Canada or any other country.
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ref #24
padlin wrote:
I am sure this will sound very small minded but I am convinced that there was an element of race in the controversy about the health care.
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It does sound small minded since Reid and Pelosi are white. There is a major difference and beliefs in philosophies on the role of goverment.
The polarizing part is the demonizing that anyone opposed to the Pelosi plan has to endure.
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29. At 1:20pm on 09 Nov 2009, RomeStu wrote:
Does the US need a dictator?
i've often thought there is a strong authoritarian--and in some ways submissive-- streak in the American psyche that would prefer one. Where else among supposedly civil societies do you get Generals being seriously considered (or putting themselves forward) as prospective Heads of State so often, for example, these days? Or military experience being seriously regarded as a qualification for a political career? How else do you explain these constant demands for 'leadership' instead of 'public service' in American politics?
There'd be no shortage of Brutuses if they did elect a Roman-style Dictator, that's for sure. They've already had one Nero fiddling while New Orleans drowned, and another dithering now, so Roman politics wouldn't be that novel . . .
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I am a strong believer in the NHS as I pay 13% of my salary to the UK Government in the form of National Insurance.
If the US were to increase the personal taxation of everyone by 13% then you should at least expect free health care as a result.
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I am a Brit that has lived in the US for 35 years and I still do not understand this Country. So many nice individuals, kind and generous, but no sense of community for the common good. This is partly explained by the political and economic power of the super rich and the large corporations and the way congress works, or rather doesn't.
It's fair to say that the American model of democracy is giving the the whole concept a very bad name and this battle over health care is just another example. The truth is that the American public can be sold on anything with enough advertising and some fear thrown in the mix and this is another successful campaign.
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43. At 2:05pm on 09 Nov 2009, squirrellist wrote:
"So why not elect 'good moral intelligent men and women' or change your form of government to one that isn't "run by ignorant, selfish -- and corrupt -- individuals?" If they aren't fit to run something as benign as health care, why on earth do you trust them with wars?"
That is an excellent question. Men and women of appreciable integrity are few and far between in high level American politics. There are a number of contributing factors.
1. The type of people who are desire such power usually aren't trying to do so for the meager hundreds of thousands in cash and benefits we afford each of them every year.
2. In order to climb very high up the ladder, you have to be in politics for a long time, weeding out a lot of people who managed to be successful in life and decide to give back to the people through civil service.
3. An absurd amount of our government is run by lawyers, the people trained to bend words and find loopholes to get what they want. (The house and senate combined for the 111th congress had 435/535 voting members who were lawyers).
4. The good old boys like to squeeze out up and comers who try to play it fair.
Additionally, I beg the question: What do lawyers who have never had jobs outside of the government know about actually running a business on a profit or a hard day's work? I'd venture they know very little, yet they are in command of interstate and international trade laws, not to mention the numerous other bits of control they awarded themselves when no one was looking.
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Spot on. Neither the government or the american public are willing to pay for the care they demand. As the lowest taxed western developed nation with the largest military budget the funding for this Obamacare will be on the never/never as long as the Chinese continue to cooperate.
As a surgeon I am paid half of what I recieved 20 years ago for many surgeries under medicare. A 90 year old female on her way to a fall vacation in the Bahamas complained of having to pay for her medications.She has survived breast cancer,colon cancer,ovarian cancer and more recently bladder cancer. Two of these diseaes were picked up in followup by expensive x-rays since they were asymptomatic. 30 years ago she would not have survived the first cancer.
With the baby-boom and increased life expectancy;for the sake of my children and grand-children perhaps rationing of some sort would be a good thing.
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@4 (DV): "The problem with the public option is that it is likely to work and be cost-effective, which would put the insurance industry out of business. The probability of that happening is simply unacceptable to the GOP because of the large donations they get from the insurance lobby but, most importantly, because of ideology. The idea of a government run program putting private industry out of business is tantamount to sacrilege."
I write this as a man whose nephew can't get health insurance from anyone. I certainly don't have all the answers, but I have a deep, abiding distrust in any concentration of power, because inevitably when folks have lots of power, they can't withstand the itch to use it, and inevitably folks eventually get hurt. What most folks don't understand is that that malady is common to both the government and the private sector.
Dominick, you may not be aware of this, but when GM was going through its reorganization throes, and was getting ready to close dealerships, there was a scramble here by a number of Congressfolks to make sure that "their" dealers were preserved through the transition. The precise same shenanigans will be exhibited (indeed, already ARE being exhibited) through the health-care debate, and they will be more intense because there will be more money at stake.
It's useful to recall Willie Sutton. When asked why he robbed banks, he answered simply, "'Cause that's there the money is." Same principle already applies here, and will apply here in the future. If government runs health care, you will see both of the following: (a) more "deals" cut with influential Congressmen and their buddies which they think are swept under the table, but which leach out and illustrate the corruption, (b) fraud and abuse on a massive scale (the Sutton principle in operation), and (b) increasing mounds of procedural nonsense which tries very hard to catch up to the fraud but never quite does (never mind the Congressional deal-making), and which drives costs farther and farther up. We've dealt with all three of these in Defense for the past ~40 years; health care will NOT be any different because there will be even more money there than in Defense. The Suttons go where the money is!
The reason this is a "sacrilege" is because our founders knew very well what happens when power is concentrated. There are real historical reasons why our Tenth Amendment calls for powers not explicitly granted to the Federal government to be reserved to the States, or to the People. Our founders didn't know about modern technology, or modern business finance, but they DID know about HUMAN NATURE. If powerful private corporations and other well-financed private interests had really existed in their time, I expect they would have written about them in the Constitution, but their focus was on government because it had been abusive.
The only way to even partially prevent the criminal behavior that normally accompanies a large concentration of power is DON'T SET UP THE CONCENTRATION OF POWER IN THE FIRST PLACE! We already allowed our corporate interests to become "too big to fail", and are reaping the "benefits" of that decision. Allowing any government to attain that level of power results in precisely the same behavior (abuse of power) because HUMANS ARE RUNNING IT.
Does this mean there's no answer? It means there's no perfect one, but in a world populated by humanity, the best answer has always been to diffuse power as much as possible, and match responsibilities to rights. It may not be particularly efficient, but it tends to be less abusive. If we restarted this discussion with those two goals in mind, we'd probably have already gotten to a solution that most folks would be willing to live with. It's far too late, though, this time around. We'll have to go through the government-run option first, and then when it hits the wall due to the weaknesses cited above, then assuming we aren't already defaulting on our debt, perhaps we can then restart the discussion around those two goals as a foundation.
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53. At 2:21pm on 09 Nov 2009, ADodger wrote:
For those of you who really want government run health care, move to Canada or some other country that has it. If you really don't like the capitalist free market society that made the U.S. a great country, move to another country.
Well, that's one solution. I don't think we've got room over here for the large number of people in the US who support it, though, Britain being (apparently) now one of the most densely populated countries in the world. Canada could be said to be a bit underpopulated, I suppose.
Why not the other way round? There are still a few other countries around that offer a purely market-based healthcare system with minimal or no government intervention.
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The free market fails in the delivery of public goods. If you take projections out for education, transportation, or health care you can always get to the squeamish black hole theory. That ISN'T what reforming the American Health Care system is all about except in the media. At home it is about equality. It is about creating a system wherein one class has access to the basic needs in life and the other services that class and takes whatever leftovers might come their way from the "Master's" table. America's basic premise has always been to strive for equality. To have Congress sanctify the double standard in the health care system, essentially effecting every citizen in the United States, is tantamount to turning around 180 and heading backwards to a feudal society where there are lords and there are peasants and the peasants have no real political representation.
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The problem is not just the high cost & how many uninsured... The problem is that even those WITH insurance are finding they pay the monthly premiums for years, and then when they need it, these mega-corporations find clever ways to deny covering claims, and you can spend your life fighting to collect. Would that make you feel protected?
We are all at their mercy with the current system.
See Bill Moyers' interview with former health insurance executive, now whistleblower at:
pbs.org/moyers/journal/07312009/watch.html
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13. At 11:59am on 09 Nov 2009, LIbertarian wrote:
"I find it odd that so few people point out how very illegal the concept of a federally created and controlled "public option", aka health insurance business, is. The constitution clearly states the very limited powers of the federal government, ..., I'm hard pressed to find anything in there that says the feds can create and run a business on tax payer money."
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So you are in favor of abolishing Medicare as well then?
Can you explain the difference between something being "illegal" and being "very illegal"?
Is it similar to the difference between being "a little bit pregnant" and "very pregnant"?
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" ..., what legal right does this government have to start a business? How can a business that can run at a substantial loss create meaningful competition in a market with already uncommonly low profits for the market leader?"
________
You must be out of your mind. The reason that the healthcare business has grown like Topsy is because it offers well above average rates of return. Ditto for pharmaceuticals.
There are dozens and dozens of government created corporations, including, for example two rather large financial institutions in the home mortgage business much in the news of late.
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Mendemus – Could I ask where you get this illuminating statistic from? “only 40 percent of the population of the UK pay taxes”
So 60% of the UK population don’t pay tax!?! Gosh I, and everyone I know seems to have been duped into that 40%. Also the NHS definitely will go bust if it cost £600 billion (by the way what does 600 billions GDP mean?), especially since the 2010 NHS budget is £110 billion. It seems that like your bizarre claim that the UK is some kind of partial tax haven you don’t really have any idea about financial figures. Actually it could be claimed that you are simply making figures up to back up your argument.
Makes me wonder about the bizarre claim that people over 80 can only have one hip replaced, especially since when I checked this ‘fact’ out I could not find any reference to it anywhere!
Other than these glaring mistakes obviously a very well thought out post I congratulate you!
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21. At 12:57pm on 09 Nov 2009, ADodger wrote:
"Those of us in the U.S. with a conservative attitude don't trust that the government can run such a huge program efficiently. Social Security and Medicaire, famous liberal/social programs, have cost MANY times what they were projected to cost. They are both going bankrupt."
__________
Ah, so you are suggesting that Social Security and Medicare should be abolsished?
Much support for that propositions among your friends, neighbours and colleagues, is there?
__________
__________
"Why would anyone think the government could run a public healthcare option that would not put a drag the economy by having to raise taxes to pay for it. State run health care has already been tried by several states in the U.S., all of them have failed miserably. Why would anyone think the federal government (famous for waste and fraud) can do any better."
__________
Well, that's really odd. Virtually every other industrialized nation has publicly funded healthcare that is vastly less expensive than healthcare in the US.
So, if publicly funded systems are "a drag on the economy", then how is it that the enormously much more expensive existing American private fee-for-service system isn't an even bigger "drag on the economy"?
Or, alternatively, how is it that Americans can't figure out how to run a publicly funded healthcare system the way that other countries do? Are you suggesting the Americans are somehow congenitally incompetent at running large enterprises? I would have thought there was an abundance of evidence to the contrary.
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Has anyone (I skipped to the end of posts) suggested that the "nuclear option may be used by the Democrats?
It is the using of a law (used by Republicans in the past) to implememnt simple majority of votes to end a filibuster? (duh why not..if its so important to the Senate?)
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The single biggest problem with American health care is also the reason it is so difficult to correct. MONEY.
Somehow, when it comes down to the lowest common denominator (money) logic disappears and facts no longer have validity in public debate.
The many factions involved in health care in America have billions of dollars at stake. They will do whatever they can to protect that stream of revenue. They have the power(money)and the will to subvert congress to their benefit. They spend millions on the best consultants available to influence public opinion. The rich get richer.........
Soon we will all be seeing television repeats (or a brand new Disney movie)about a greedy businessman and the plight of a family with a crippled child. That story was written in 1843 (In Great Britain) by a man who whose personal life was scarred forever by his childhood experiences linked to money (or the lack thereof).
Some lessons are never learned.
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60. At 2:45pm on 09 Nov 2009, arclightt wrote:
"the best answer has always been to diffuse power as much as possible, and match responsibilities to rights. It may not be particularly efficient, but it tends to be less abusive."
But you have described exactly what happens when people (either individually or corporately) refuse to accept responsibility for others and assert their own 'rights' (as they see them) at their expense. Forms of government have been developed over many millennia to try to control exactly those atavistic instincts.
What the US appears to have developed is a 'democratic' system in which corporations instead of each having a vote on their behalf as a single citizen--an idea sometimes mooted in the 19th century in Britain to deal with a similar prospect--have many according to their willingness to distribute money and rewards.
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48 tino
"My point was the people complaining about being denied coverage based on a pre-existing condition usually just didn't want to pay for health insurance when they had no obvious health problems."
Or that they did have insurance, then lost their job and now have to try to purchase new ins on the free market!!!!!
Not good for them.
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43 squirrellist
Great post
Welcome back - it's still crazy in here.
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14. At 11:59am on 09 Nov 2009, Isolationist wrote:
"American dollars support the world and bring innovation, improvement to the other nations of the world."
__________
Oh, please.
First, if you think that this is why healthcare costs more in the US than anywhere else, you need to take at least a first course in Economics. Price is a function of demand, not cost.
Second, do you really believe that non-Americans are not innovators in the field of medicine, and every other technological field as well? If you do, then here's and idea: Go to the US Patent and Trademark patent database, and download 100 consecutively numbered recently issued patents. You can pick any group at random.
Now take a look at where the inventors come from, and where the owners are based. I think you'll find that there is wide representation from virtually every major economy. Open your eyes, man.
Third, people who are sick and desperate for medical care have no bargaining power relative to healthcare providers. A single payer system, which is by far the best option, reverses that mismatch in bargaining power problem.
Even a "public option", if available to all, would soon function to bring prices down, although not as much as the single payer. Hence the industry opposition to the public option.
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lets see how many "keep Gov. out of Health care types say "keep Gov out of helping our hurricane devastated coast."
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[Of course to many of us Brits, the cry "keep government out of health care" just sounds a little kooky, on a par with "keep government out of defending the nation" or "keep government out of building roads".]
Ah - now there ya go, talkin' like a foreigner. Do you realize that there are lotsa' folks around here that think Big Gov should get out of the business of building roads and educating children? Heck, we already have plenty of 'Military Contractors' fighting *ahem* er... 'working' abroad... Maybe Big Gov should get out of Warfare Business, too!
(PS: I abhor this idea. It's Bloody Stupid, Johnson.)
[In Britain one of the main things the government does, one of the main reason people pay taxes, is for health care, so naturally the revulsion at it in the States seems a little strange.]
Duuuhhhh.... Remember "Taxation Without Representation"? Good Grief! That's why we OUSTED you Brits!
The Tea Party reference is based on this historical connection. It reminds us that we rebelled from a powerful government that made decisions on our behalf without giving a flying patootie what we actually needed, or cared about, or wanted.
Our Government was based upon REPRESENTATION for a reason. And, in recent generations, the 'average joe' around here hasn't felt very represented by our representatives.
Personally - I don't blame "Big Gov" for this, but I'm not everybody. Our folks on Capitol Hill are scrambling tying to show the people they actually "represent" their constituencies and that they're actually up there trying to get something done.
Heck, I figure a lot of young Poli Sci students are starting to eye up those DC Jobs... Maybe the Competitive Market is starting to work in DC? Hmmm.... very interesting...
I can't wait 'till I get to vote for a Senator who's a Black Muslim woman wearing a classy headscarf and sleeveless tops that show her Tattoos. (Words only. Image Tattoos aren't Halal.) That'd be sweet. I think she'd get the Black-Muslim / Philly-Hipster Vote in a heartbeat. Power to the People, baby.
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#63 Interested Foreigner
I'll go about the semantics of my classification of illegal and very illegal. Illegal is secretly or discretely breaking the law. Taking bribes, driving drunk, these kinds of things you try not to get caught doing. I think of very illegal as blatantly breaking the law, for instance the foundation of your government's intra-regulatory laws, also known as the constitution and it's amendments, and having the audacity to assume no one of consequence will stand up and say anything. You could call it arbitrary, but one simply is breaking the law and the other is infuriatingly unabashed disregard for the people.
Well, if abortion is still an option I would say pregnant, and if it has gone beyond that point I could see the distinction between pregnant and very pregnant.
The healthcare division of the insurance companies has a national average most recently reported between 2.2% and 3.3% profits. I'm not going to dedicate the time to find the individual firm data myself, but does that sound excessive to you? Pharmaceuticals has been absurdly out of control and I absolutely agree with you on that matter. I'd find a way to legally stop the price gouging in the USA, like starting some lawsuits with the WTC.
Yes, the government has dozens of corporations. No, not a single one of them is legal. The powers of the government are as follows:
1. Borrow money
2. Regulate commerce among the states
3. Regulate naturalization
4. Regulate bankruptcies
5. Coin money
6. Fix weights and standards
7. Punish counterfeiters
8. Establish post offices
9. Establish post roads
10. Record patents
11. Protect copyrights
12. Create federal courts
13. Punish pirates
14. Declare war
15. Raise an army
16. Provide a navy
17. Call up the militia
18. Organize the militia
19. Makes laws for Washington, DC
20. Make rules for the Army and Navy
See run multi-billion dollar corporations with taxpayer money in there?
Medicare? I don't recall that being constitutional (not federally mind you, states can do that), and I don't believe freedom is defined with "give us this tax money so we can give it to someone else or go to jail." That sounds a bit more like institutionalized slavery of the competent and successful to me, but I take this as a major insult, due to me being a libertarian. Not that I want elderly people to roll over and die, but why is it my responsibility in a free nation?
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35. At 1:29pm on 09 Nov 2009, MorganKnives wrote:
"My main concern is that just about everything our government touches turns to crap rather quickly. If the people in DC were all good, moral, intelligent men/women, I wouldn't have as much of a problem with it. However, that's hardly the case."
_________
But, of course, by contrast, everybody in the health insurance industry is suffused with a spirit of philanthropic goodness.
It boggles the mind how you can apply one yardstick to government provision of services, and be oblivious to the fact that if you applied the same yardstick to the private corporations that provide health insurance thay would appear in an even worse light.
Do you really believe that your health care insurer has anything like your best interests at heart?
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There is a major difference between American, Canadian and British health consumers with regard to treatment and results of treatment. This exhibited by the medical tort conditions in each country. I know as I have worked as a surgeon in all three. This is why the health care costs are so high in the U.S.A. Only in the U.S.A. would adverts appear on T.V. in which a sportstar invites you to attend a doctor to obtain free samples of viagra.The doctor visit be paid for by insurancs /medicare etc.
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51. At 2:18pm on 09 Nov 2009, RomeStu wrote:
"In fact, it's the citizens' belief that the government is run by ignorant, selfish -- and corrupt -- individuals that prevents them from handing over something as important as health care to it."
Stu - you missed one: As if the insurance companies are run by people who are any better? At least public servants have a clear mandate to serve the public.
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It is possible to improve health care and reduce costs at the same time. The most expensive aspect of health care is end-of-life care. This care often includes prolonged venilator use, tube feedings, painful treatments and other care that many of us (including me) would not want for ourselves. Nonetheless, unless a patient has explicitly indicated otherwise on a "living will" (aka advanced directive) doctors are compelled to do everything possible to prolong the life, regardless of its quality and the amount of suffering imposed on the patient. In essence, a large portion of health care is devoted to providing "care" that the individual would not have wanted for his or herself had they been able to express themselves. Because patients often have not considered the end of life issues while they were able to do so these choices are left to physicians and the patients families who, not knowing what the patient may have wanted, give consent to procedures which may cause great suffering with limited benefit to the patient. The choice should be left to each individual and made while they are competent to do so. A national campaign to encourage people to complete advanced directives would not only reduce the cost of the medical care devoted to end-of-life treatment but would enhance (by reducing unnecessary suffering) the life of the patient. Naturally, any individual who wishes to live as long as possible, regardless of the means used to reach this goal, should be respected. I only suggest that the wishes of those who would wish to die peacefully without heroic means which may only increase their suffering and reduce their dignity should also be respected, as is the case in Hospice Care.
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My family has, what is considered to be "good" insurance. Like many of my coworkers, I never gave it a thought because I was never sick and I rarely used it.
Since giving birth a several years ago, I realize I am ridiculously under insured. We have children with medical issues.
The percentage of out-of-pocket that my family pays is over 25% of our income. That is 25% of the income of 2 college educated adults in an upper middle income family. We know many, many other family in the same boat.
After the first couple of years of financial shock, we are now able to exist within our means. I have learned what my insurance company is supposed to be paying and how to file complaints when they do not pay or they do not pay the correct percentage. This is a frequent occurrence.
We, as a family, would like to get a break on the price of medical attention but that is not even the most egregiously insulting thing about the insurance industry. My children have pre-existing medical issues that will allow insurance companies to deny then coverage. (I have heard of many people being denied insurance for less involved medical issues than we have.) That means that I have to stay with my current company till they become adults to keep medical insurance for them. I have no idea what will happen when they become adults.
Even if the health care reform is only slightly better than what we have now, I support the change.
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ref #67
stellarBeloved wrote:
Has anyone (I skipped to the end of posts) suggested that the "nuclear option may be used by the Democrats?
It is the using of a law (used by Republicans in the past) to implememnt simple majority of votes to end a filibuster? (duh why not..if its so important to the Senate?)
____________________________-
I heard the threat of it being used when the Dems (notably Boxer) fillibustered abused the advice and consent for moninees. But does anyone know the last time it was used by either party?
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Is there anyone here making the argument that any publicly-run healthcare plan covers MORE people AND provides consistently BETTER treatment ACROSS THE BOARD (including both time to diagnose, accuracy of diagnosis, and time to treat) AND provides BETTER medical research for LESS cost than a privately-run system?
Looking at the back-and-forth here I sense that a lot of folks focus on one aspect or another, rather than looking at the whole. Some folks focus on the coverage, some on the treatment (good or bad), some on the research (better or worse).
What I think is going to be true is that every direction is going to cost us something. The private-sector approach has cost us coverage. The public-sector approach has cost us treatment (i.e. rationing). It isn't clear that the public-sector approach outstrips the private sector on research; I don't have a good feel for that.
I suspect that Mark's last two sentences are going to be the epitaph for this discussion, and add to that "the more there are of us".
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ref #51
Rampant disdain for government is quite the norm here. "
Then the greatest nation on earth needs more help than I thought
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There is a rason look at the corruption by many members who don't pay their taxes.
I would like to see a pledge by the 215 who voted for the healthcare bill to give up their govt funded plan. Because their salaries don't warrant goverment assistance.
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No one is claiming that American health care needs reform, but for too many people, the answer is more government involvement. One of the largest complaints about the current health care system is the unresponsiveness and the lack of accountability of the large health insurers. For those looking for improvement in those areas, the only entity with less responsiveness and accountability than large corporations is the federal government. How can people possibly entrust the government to efficiently distribute health care when the same government could barely distribute water to the Superdome after Hurricane Katrina hit New Orleans?
True reform that would help everybody is not found in greater government intervention. Europeans are used to governments subsidizing and running large portions of infrastructure; Americans are used to the innovation of private enterprise.
If government subsidies are removed and if we get the bureaucrats out of the way, it will allow health care providers to compete in an actual free market. Prices will universally fall; just look at the examples of health care that are not subsidized by government, specifically LASIK eye surgery and cosmetic surgery. Providers of those types of health care must compete with each other; it's no coincidence that prices have been falling in those areas in response to consumer demands. The very same mechanism can work in all areas of health care.
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34. At 1:28pm on 09 Nov 2009, RomeStu wrote:
"Has anyone else wondered if some of our fellow bloggers are plants from the insurance lobby? Just a thought - there are alot of new faces around."
________
It's interesting you mentioned that.
We have a poster here today who posted on this blog like a daemon in the months leading up to the Presidential election - dozens of posts per day.
And then after election day, her posts stops as if a tap had been turned off.
She has posted here fewer than half a dozen times, I think, (I could be wrong) in the year since then, and is now back in force today, full throttle.
There were other posters who had been hyperactive right up to election day, JohnAAA being one, for example, whose postings then ceased abruptly, apparently forever.
And then I realized that he must have been on contract, and when the contract ran out and he stopped being paid, presumably on election day, his posting stopped equally abruptly.
So I ask these questions:
AndreaNY: Are you on contract to monitor and post on this blog?
AndreaNY: If you are being paid, by whom are you being paid to post here?
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Just thought I'd say I particularly enjoyed Interestedforeigner's last post.
It WOULD appear that fee for service is considered NOT to be a drag on the economy because the delivery system is privatized and there is private profit therefore being made. Eliminate the current delivery system and those poor insurance companies must therefore go out of business and Uncle Sam will lose there portion of taxes. (or either they will have to find another insurance niche from which to profit; but one is led to believe that they are incapable of doing so)
Now, in order to 'understand' how insurance based fee for service delivery is NOT a drag on the overall economy you must ignore the fact that the cost of those not covered by this particular delivery system still get emergency health care and emergency hospitalization whose unreimbursed cost is then passed on to all consumers including the current delivery system which then passes on those costs to it's consumers.
And one must ignore the fact that private businesses pay more and more for employee health coverage via insurance premiums, which bites into non-insurance company productivity and creates a disadvantage for our US companies which use US citizenry labor...therefore the impetus to farm out jobs to people that don't 'cost' quite so much...
And one must ignore the fact that 10 percent of all Americans have filed bankruptcy in the last 10 years and that a major factor has been health care expenses.
Americans can't figure out how to run a public health plan because the insurance industry doesn't WANT them to and will commit however much money to lobbying that they CAN in order to divide the rank and file voters. Distrust of the government is the main fear they are able to inflame.
We already KNOW how Congress will vote...they will vote accordingly to whomever is paying the most amount of money into their election and re-election campaigns and as long as rank and file voters are divided in their opinions and don't organize to lobby accordingly any bill that is written will likely favor established private enterprise industry over the long term public good...as no one can really agree on what the public good actually IS...except that we all 'want' what we feel like we deserve...like Medicare...despite the complaints about how inefficient the government runs healthcare, I haven't seen many people that qualify opting OUT...wonder WHY?
Whatever you do, DON'T take away my Medicare!!!!! I earned it!!
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Interesting medical news tidbit:
(they were chatting about it on NPR Philly this morning)
Philly has a fairly large Pharm Research and insurance industry. Some folks around here are kinda nervous. Some aren't.
Apparently, the 7 yr patent on certain highly money-making drugs will be ending just as the market has been turning down. In preparation of this, philly's big bio has been 'downsizing.' So, there are a lot of Biologists, Pharmacologists, and Lab Techs who have been collecting unemployment and aren't feeling much "Corporation Loyalty."
Apparently also, HR groups are starting to crop up around town trying to help said unemployed people as they get new jobs... with smaller pharm & bio groups that are appearing.
There is some concern that the medical information industry will ship overseas. There are also a lot of out of work &/or underpaid bio-lab people who realize that they'll have to be enterprising if they want to continue working in their rather specialized fields.
Interesting, isn't it?
Remember the IT Crash as codes became common? It was followed by many small furry programmers coding in dark basements coming up with new software systems.
I wonder if we'll see similar entrepreneurial endeavors hitting bio-science technology...
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75. At 3:21pm on 09 Nov 2009, LIbertarian wrote:
"Yes, the government has dozens of corporations. No, not a single one of them is legal."
"Medicare? I don't recall that being constitutional..."
"Not that I want elderly people to roll over and die, but why is it my responsibility in a free nation?"
_________
Well, you certainly can't be faulted for being inconsistent.
But I do believe that both the legislative and executive branches of government are going to be in for a surprise when your news gets to them.
I'm thinking it's not going to go over really well.
Good luck with that, anyhow.
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65. At 2:56pm on 09 Nov 2009, David Murrell wrote:
"Mendemus – Could I ask where you get this illuminating statistic from? “only 40 percent of the population of the UK pay taxes”"
I thought of taking that on, but it involves explaining VAT. So I'll try, though I can't be bothered with looking for the actual figures and percentages.
Since (dear American readers especially) in the UK (in common with the rest of the EU, though the amount and what items are taxable vary from country to country) tax is payable on everything we buy, except for food, books and children's clothing (memo to self: must get even slimmer, but how do you shrink your feet?) probably 90 per cent of the population pays tax in some form, since obviously this even includes kids who buy DVD's, games and download from iTunes.
And, of course, everyone who receives a state benefit also pays, unless somehow they only buy cold food and books and manage to live without clothes, electricity, gas, a phone or computer. Apparently 60 per cent of the UK population is managing to do that according to Mandemus, but I haven't worked out how to join the majority either. . .
The NHS is funded from general taxation, including VAT and income tax, not a specific single tax.
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I think most people still don't talk about this issue in a way that properly frames the dilemma for Americans. The cable news' folks mire the discussion in an "us vs. them", democrat v. republican, liberal v. conservative tone that does not advance the debate. If you walked up to most Americans and asked them how they felt about healthcare, they'd most likely just spout off whatever they've heard someone say that comes from "their" political team. This issue is important enough that we need to get past party lines and critically discuss the issue.
This issue is complex, but I feel like there are two main concerns Americans have. We want to take care of our fellow citizen, yet we don't want to sacrifice our holy individual liberty. Ensuring the health of our friends and neighbors may rank so high on a list of a voters priorities that it becomes the ultimate moral imperative. For others, maintaining complete individual freedom becomes the number one goal politically. While we all don't fall at the extreme end of either of those positions, the gray area in between is where we position ourselves in this debate. There are important ideas that will follow from wherever an individual's perspective takes them.
I don't buy as much the free market ideas here, because, let's face it, our health does not revolve around consumers making choices. While the market plays some role in developing new treatments, sick people going to the emergency room don't think in the same terms as shoppers at a mall. Individual liberty, which is often convoluted with the free market in America (and usually the two walk the same path), does play a role here. If our tax dollars are the single thing funding our healthcare, and we want government officials to be stewards of those tax dollars, then we need government to control other areas of our lives. What we eat, how we indulge, how fit we are, become issues that government necessarily must begin to control. If not, we risk putting all of our salaries into a big pot to take care of our laziness as individuals. Government control of our appetites must follow a government run healthcare option, for better or worse.
Those that want to maximize this liberty, however, must vote that course with full knowledge of the cold-hearted nature of that position. Sure, we can live as a nation embracing individual liberty and personal freedom, but we must know that there are some in our world that cannot afford the basics, who will suffer because of that position.
Right now our health care plans involve the government too much for those wanting freedom, and too little to make their controlling the healthcare industry worthwhile. We need to get off the fence and move one way or the other, but each of us needs to critically think about the decision. That critical thinking needs to come from honesty with ourselves, however, and not the party lines we hear from cable news.
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I apologise this might not be relevant but Libertarian raised an interesting point, according to him/her it is (very) illegal to set up a large corporation funded by the taxpayer, he/she gave a nice list of the government could do to illustrate this. It got me thinking where does that leave NASA? If you can do it to put a man on the moon surely you can do it to keep a man healthy?
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It is clear from many of the postings that citizens of other countries know more and care to know more about the internal workings of the US, than its own citizens.
It is also clear that most people, let alone Americans, have forgotten the polio drama of the 1950s. The health insurance, medical, pharmaceutical, and petroleum industries (from which so many pharmaceuticals are made), learned a very big lesson: DON'T CURE ANYTHING OR YOU WILL LOSE MONEY! THAT is the philosophy under which the delivery of health care in the United States has functioned ever since. The very next year after kids stopped coming down with polio, iron-lung makers, brace manufacturer's and other adjunct related service providers went the way of the dinosaurs. This philosophy includes making the worst possible edibles available for consumption, advertised for maximum profit-making and desirability for children; encouraging minimum activity for the masses, while glamorizing physical activity and athleticism across media; making stupidity popular, nay necessary for the survival of an entire generation of adolescents who don't know any better; in short, interest in almost anything beyond the ends of our noses bores us to death. How did we become this way? It was carefully planned and inculcated into the bone marrow of our society. We ARE a society. We are a society of unashamedly uninformed, uninterested, idiots who embrace our own stupidity with both arms, and stand ready to defend it at all costs. THAT is why ordinary people can be sold a bill of goods by the LOBBY machines so easily. There are rooms filled with young, ruthless, insensitive MBAs sitting around trying to figure out the next big lie and how to sell it to people who are the victims of their own failure to pay attention to government until they think it threatens their particular insular life. How do we come to this pass? Simple, we have been taught that we are the most deserving people on the planet. So it is all right with most of us if we use up the majority of the planet's resources. We see misery in the rest of the world, and even in our own back yards, with homeless people, many veterans, no less, who sacrificed to permit us to be stupid, and we step over or around them, and condemn them for their condition. As for other countries, that's their problem. Why can't they pull themselves up by their own bootstraps. We have become blind as a people. Our national education system teaches us selective history, and we hate even that.Children are no longer required to behave at home, or in school, because apparently someone must have discovered that some child, somewhere has keeled over dead from sitting down and shutting up.
These behaviors are encouraged and reinforced by the Advertising Establishment in order to continue to sell us things and ideas.
And we Americans are nothing if we are not buyers. And yet, peculiarly, I love my country passionately. I am just old enough to have seen what it was in its best days, and lament them.
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84. At 3:34pm on 09 Nov 2009, leemil4 wrote:
"If government subsidies are removed and if we get the bureaucrats out of the way, it will allow health care providers to compete in an actual free market. Prices will universally fall; just look at the examples of health care that are not subsidized by government, specifically LASIK eye surgery and cosmetic surgery. Providers of those types of health care must compete with each other; it's no coincidence that prices have been falling in those areas in response to consumer demands."
This is an entirely false analogy and springs from imagining that health care is a consumer good. Laser eye or cosmetic surgery is entirely optional. You can live with glasses, a broken nose, or wrinkles instead. Fixing a broken leg or cancer is not (if you want to stay alive) and you can't.
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"I think that the real fear hear is that the net cost will NOT reduce ... just as our auto insurance did NOT reduce (as promised) when it was made mandatory. "
Bill 2 I'd go along with that.
Here's the deal We need a car.
one that works, but we are not doing so well.
Do we wait till the cadilac of our dreams turns up at the right price, or do we buy a junker and fix it as and when there is a problem.
Most of america seems to want to wait for the caddy.
Mean while Gherkin Lieberman and the GOP say they will not support anything with a public option.
That is a rather closed minded way of entering a debate. It smacks of some bought off fool who has to repay the help he got in the elections.
9 avian bird flu
"it is on the idea that the government is taking over yet another aspect of our lives - it's one more step toward socialism."
wow there's some new angle I'd never thought of.
;)
GOOD
11 "Finally,when they suggest that those uninsured should be supported by the church and charities they are harking back to the days of the niteenth century poorhouse!"
yep they really mean" I hope someone else will help them because I'm not going to.
If all think like that how does the church help?
13 You big hairy fibber.
the constitution says NOTHING that would preclude a health system and does say that the state should look after the "general welfare"
"I'm hard pressed to find anything in there that says the feds can create and run a business on tax payer money."
look harder at your constitution.
I see nothing that says "shall not look after the general welfare of it's people."did see the bit where it said
" We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the GENERAL WELFARE, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America."
We have argued this time and time again. the problem with this debate is the few rabid crazy people that keep insisting on repeated lies. time and time again. them same people that complain about other nations brainwashing.
Only a total deceiver would argue that "General welfare" did not include health of the people. Especially when the environmental toxins of or industry and "free" markets is causing the very illnesses so many suffer from.
18 Greta post.
Tort reform though would make little difference.
the perceived torts are a fabricated issue by the industry.
There really are not so many to be that big a difference. we did discuss this before on this site (lol many times)
The Insurance industry that insures Doctors is merely behaving like all insurance companies in all sectors. they are making up the costs to justify their high prices.
That is what the insurance industry does.in the absence of regulation.
Then they blame the litigious society because americans fall for that one all the time.
All those frivolous law suits to do with people tripping over others coffee tables is what feed this acceptance that the rates were put up for any reason other than. THEY COULD.
Insurance reform maybe but the torts are there for when your doc screws up and the settlement is so low that you will be out of money for continued treatment.
The malpractice insurance rates are based on fiction. Malpractice Insurance reform is what is needed.
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"Life time caps" people.
and people want to talk death panels.
" LIFE CAPS"
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A government run insurance policy is insane .... but the answer is a lot simpler ....
1. The US Govt, should create a "Minimum Health Care Law", much like the Swiss LAMAL (Law on Illness), which creates a standard basic healthcare format which is identical for each citizen regardless of which state / region / age / sex / precondition / income bracket. The premium also needs to be regulated by government (unlike the Swiss format which is regulated by private companies) so as to ensure that each citizen pays the same regardless (principle of community solidarity). This is the only OBLIGATORY insurance and covers a range of conditions and treatments.
2. Over and above this OBLIGATORY insurance, The Insurance companies individually create their own "Complimentary Insurance/s" which is paid for by the individual according to desire / coverage required / Private ....etc. Insurance Premium/Rate is calculated according to what is being insured. Here the wealthy can pay for their desired Private Clinics / Treatments abroad or whatever and taking nothing away from the quality of healthcare provided for those who choose not to have this option or only part of it.
3. Probably the most damaging aspect to any healthcare programme in the US ... be it Democrat or Republican ... is the out of control MALPRACTICE lawsuits and the absurd OVERKILL on technology ..... to kill a fly, you need only a swatter, not an atom bomb !! These are the primary drivers that push the healthcare costs up.
4. Lastly, There needs to be a MASSIVE Nationwide drive to curb the US's wanton lifestyle towards junk foods, poor weight control and High Depression and psychotic illness rates. Harness these and the health costs will fall into line and be affordable to everyone.
What is suggested here is simply a law. Equal for everyone and applicable to every citizen. Working People for whom income would be severely leopardised if paying the full premium could benefit from a partial subsidy from the state they live in. The only fed govt intervention is where, economically, people just cannot afford the BASIC Healthcare Premium. These people benefit from the government funding, but based on the social Service format-[Applied through a Social Service] ... which I believe is a form of personal (interest free) debt and theoretically to be reimbursed when fortunes change.
Here you would have an inclusive programme which is still privately run, but governed by the lawmakers as regards to the BASIC Healthcare. It should also be written into the constitution so as to prevent such a law being repealed by a change of government.
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I have CFS/ME and it "cost" me a lot of brain usage for today to register so I could make this comment, my first.
For a good, short summary of the reason why US Representative Dennis Kucinich (who is married to a woman from England) voted "NO" on the health care bill, see www.democracynow.org where he was a guest this morning with Jane Hamsher (founder of www.firedoglake.com a blog). He is a major supporter of SinglePayer and she has written recently very movingly on breast cancer and what the bill will not cover. Today she speaks about the antichoice/antiabortion amendment to the bill.
I'm a regular listener to the BBC Worldwide Service as can get it on radio in NYC and a regular reader of this BBC website for the 2 years that I've been online.
I am referring to the legislation just passed as a Potemkin Village: a fake facade. I read many of the comments. Many have no clue as to how bad health care in the US. I know the limits of NHS because I have an e-pal in England who also has severe ME/CFS. (On the politics of illness, see Hillary Johnson's Op Ed in the NYTimes, Oct. 22, 2009, "A Case of Denial".) Note: I have health care as a senior citizen, Medicare. Medicare for All or Single payer is what the majority of Americans want for all people in our country. It is the politicians who are ignoring us. It is a minority who are against and getting much media play, also called "astro turf" = fake grass roots groups. Also see www.afterdowningstreet.org and www.pnhp.org (The latter is Physicians for a National Health Program.)
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The progressive's complaint with Joe Lieberman is not that he is "principled," but that he is actually "The Senator from the Great State of Israel" who part times as a lobbyist for the insurance industry.
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It is strange and also saddening to see how citizens in the US has been misled. Having an insurance company that has to respond to the share-holders demands of returns, can not be better than letting the government deliver healtcare for all citizens. Study the system as it is in Scandinavia and in England and some other European contries. Healthcare for all from birth to the grave. The US can well afford this as it is supposed to be the richest country in the world.
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29 Stu
"Does the US need a dictator?"
didn't we just have one? ;)
Isolationist.
here's the deal.
How about you taking all the other like minded isolating yourselves and letting those decent minded americans with some concern to do the being nice part.
The likes of you travelling will not help the image america has,19
Of the 5 minutes I spent talking to a doc he said " Yes you are right it is infected" wow I went in and said "It's infected give me a script for anti biotics" (do most americans think america invented anti biotics?)
So how was that informative?
He then asked if I was up for socialised docs and I said " sure" we briefly discussed the idea that british doctors had to go to soup kitchens for breakfast ,lunch and dinner they were so poor, then I left and got a bill for $150 for 5 minutes of answering his questions about the health system in the UK.
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Stu move to the country in the states and you probably are opting out of fire brigade help.
Pay extra get covered.
Rural fire-fighters are more often than not volunteers in the states.
Brave people and worth every once of respect one can give.
But the system says let it burn if no risk to life or other structures or the forest.
"You moved out of town."
PS just pointing it out no need to rant in defence people.
Nibbler good to see you back I hope the Hols were fun.
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It doesn't stand a prayer of passing in the Senate.
I didn't realise that Mark was a shill for Lindsey Graham!
The American people voted for change and amongst that change was healthcare reform. Those Democrat senators who vote against it will be remembered when their next election time comes around.
#19. l33t_sh1tz0r: "One thing I feel sets U.S. healthcare apart from the rest of the world, however, is that the level of expertise on average is quite high. See a doctor in the U.S. and in those few actual minutes in their presence, they DO tell you a heck of a lot about why you two are conversing. It's simply not like that in most other places."
How many "other places" have you ever had occasion to visit a doctor? Had you mentioned each of those countries then your remark might have some validity, but to make such a sweeping generalisation indicates am emotional and possibly political response. However, earlier in your post you wrote:
"I have also found it valuable to get second and third opinions on conditions as often the first is not adequate or even accurate. This indicates that despite bounty sometimes quality is lacking"
which negates the other part. If it is necessary to have three opinions (not an inexpensive undertaking) that indicates to me that the first ("they DO tell you a heck of a lot") was virtually useless. Which is highly unlikely.
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75. At 3:21pm on 09 Nov 2009, LIbertarian wrote:
"Not that I want elderly people to roll over and die, but why is it my responsibility in a free nation?"
So you won't mind in the least when you are too old and weak to belt a woolly mammoth over the head and bring back a nice rump steak and your younger relatives decide to take your furs and kick you out of the cave in the middle of winter without food and water to fend for yourself?
(Or when you trip over a tusk some fool left lying around and break your leg? Why should anybody in your 'free nation' feel any responsibility to feed or care for you while you're lying there annoying everybody with your moans and groans?)
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43 Squirrelist
What you socxialists don't understand is that though I may be poor now One day I will be rich. I buy lottery tickets every week. I get minimum wage and so I invest half in the lottery. One day I'll be so rich the pinko commies will be after my money. I don't want that then, so just in case I'll never vote for someone who says they will raise any taxes.
Tino
"My point was the people complaining about being denied coverage based on a pre-existing condition usually just didn't want to pay for health insurance when they had no obvious health problems. "
wow you are new aren't you.
MOST PRE EXISTING CONDITIONS WERE DIAGNOSED.THAT IS WHY THEY ARE PRE EXISTING. CHANCES ARE IF THAT IS THE CASE THE PEOPLE SAW A DOCTOR. (CHANCES ARE).
CHANCES AGAIN ARE IN FAVOUR OF THEM BEING INSURED AT THAT TIME.
PEOPLE LOOSE A JOB THE COVERAGE GETS DROPPED AND THEY HAVE A "PREEXISTING CONDITION"
THEY ARE THEN PREVENTED FROM GETTING FURTHER CARE BECAUSE THEY SOUGHT IT EARLIER.
PEOPLE WITHOUT CARE HAVE NO PREEXISTING WHEN THEY SIGN UP SO ARE OK.
THEY CAN SIGN UP.
ALSO GENETIC TESTING WILL SOON BE AVAILABLE TO ALL (already is).
better cut the volume don't want people to hear this.
If genetic testing comes in as is the supposed right of insurers there will be huge groups excluded.
This issue of pre-existing conditions and denial of service prevents people from seeking tests that may be very helpful in the long run for genetically carried issues.
Rather not know and be able to see a doc than know and be left out and stressed.
Sorry if some of that was a tad loud but some people seem to need to see a doc about their hearing.
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I should have said in my earlier comment that only 40 percent of the United Kingdom population pay Income Tax which is still the main revenue of the National Government.
My error in that regard has vexed a few people who then promptly went on to suggest that everyone in the UK pays tax because of Value Added Tax.
The problem with assuming that VAT has anything to do with the funding of the NHS is that VAT is fool's gold as all income from VAT and Customs Duties has to be paid to the EU to fund that other glorious socialist venture to which the United Kingdom is now tied irrevocably.
Thus, my original point was that 40 percent of the population of the UK who pay Income Tax and, therefore, in employment and who contribute National Insurance levy for social benefits and the NHS are THE people I was talking about who find that it is their taxes and their contributions that subsidise an ever-increasing-in-costs but ever-decreasing-in-quality NHS.
As regards the 600billion GBP - my error was adding one too many zeroes and, therein, I admit mea culpa but then my critics were then kind enough to point out the cost of the NHS has, as I maintain is due to ever-increasing-costs of the NHS, now risen to over 100Billion GBP from the figures to which I had head knowledge.
The main thrust of my argument is that the NHS is a government sponsored quango that drains money from the national exchequor and will continue to do so until such time as the amount spent on the NHS cannot be afforded by the Income Tax payers of the UK. At that point in time healthcare will return to basics for the poor and privately-funded healthcare for the more wealthy. Similar in many ways to the way that final salary pension schemes have had their day as they are no longer capable of being funded by those in employment and contributing into such schemes.
The furore over my earlier comment passed over the main point I was making which was that the USA is embarking on a fool's errand seeking universal healthcare as the same ever-increasing costs of universal healthcare that besets the UK's NHS will, inevitably, beset the USA model of universal government subsidised healthcare regardless of the good intentions of President Obama and his supporters.
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52 what crud
"only 40 percent of the population of the UK pay taxes"
yea them babies and pensioners are bleeding us hard workers dry.
pathetic
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91. At 3:51pm on 09 Nov 2009, David Murrell wrote
"I apologise this might not be relevant but Libertarian raised an interesting point, according to him/her it is (very) illegal to set up a large corporation funded by the taxpayer, he/she gave a nice list of the government could do to illustrate this. It got me thinking where does that leave NASA? If you can do it to put a man on the moon surely you can do it to keep a man healthy?"
Same thing. Lots of that taxpayers' money went to private enterprise companies didn't it? Just like this trillion dollars will go to private insurance and pharmaceutical companies. So it's free enterprise and the American Way really; not like (gasp) nationalisation.
(Must be, or NASA, being an incompetently government-run organisation by definition would obviously never have landed a mushroom on the moon. Ah. Wasn't there something about how flags fly and shadows and things, now I think about it?)
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#9 AvienMael1
Americans do NOT have a right to health insurance that they cannot afford.
It's funny how Americans have a right to a gun but not healthcare. What sort of society values gun ownership over the basics. Does healthcare not count in the pursuit of happiness? Sounds like people are told what happiness is for them to pursue. I'd rather keep the freedom I have in the UK: freedom from worrying about costs if I'm ever being unwell or have an accident; and freedom from worrying about my health insurance premiums. If I'm ever unhappy about my care in the NHS my elected representatives will be hearing from me!
I feel more able in my pursuit of happiness in not having to worry about healthcare costs. It's time the 40 million Americans without healthcare told Congress that if change doesn't come from above it will come from below. They should erect a guillotine outside Congress just to remind it who their masters are!
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(I thought my comment went thru for moderation. Am redoing as can. Low on tech skills due to severe CFS/ME and late start online - 2years now, and senior citizen.)
Some of the comments are excellent and many more are full of wrong "facts". I suggest folks read/listen to/see US Rep. Dennis Kucinich on www.democracynow.org this morning for why he voted "NO" against the health care bill. It is excellent. He also has comments on www.truthdig.com and Jane Hamsher, his fellow guest on Dem.Now, has a posting on her blog today www.firedoglake.com She is a breast cancer survivor and has been writing about the new legislation will keep many women with breast cancer from getting meds. Folks in England do not know how bad US health care is. I read the BBC News daily and listen as can to BBC World Service on radio in NYC, where it is less and less available.
Kucinich, who is married to a woman from England, was a candidate for the Dem. party's nomination for Pres. in 2008. I voted for him in the Primary. I am calling this health care legislation a Potemkin Village: fake facade.
The majority of Americans want Medicare for All/Single payer. See www.afterdowningstreet.org and www.blackagendareport.com for analyses not from the Right wing.
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hard core radical christian fundamentalists would throw out health care for all because they don't believe in abortion.
And people keep saying america is not a fundamentalist nation.
Philly mom POWER TO YOUR PEOPLE.
Solidarity.
http://www.youtube.com/watch?v=EdgQELNjD6A
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This has very little to do with fear of rationing, except by the uninformed proles who hearken to hyperbole about 'Death Panels'. Health Care is already rationed in America, it's rationed by cost. If you have money, you get treated, until you run out of money, at which point you're both broke and dead. A public option would do nothing to change that. A public option won't preclude wealthy individuals from stocking up on private insurance or stop desperate people from emptying their bank accounts for non-approved procedures.
What this IS about is the private insurance industry trying to remain in business. Not because people won't want to pay for better health care, that's not an issue. What's going to choke out private insurance is the Wal-Mart effect. Picture the insurance market as a bunch of competing regional chain stores. They each negotiate with local suppliers to get th best rates they can to price their services, lowering their cost to provide the care that they sell. A government option has the ability to immediately attract millions of patients from their regional option to the public option. The regional operators lose revenue and bargaining power, becoming weaker. The public option, with more access to revenue, gains improved bargaining power with suppliers, since doctors still need to pay their bills. Result: the eventual demise of private insurance as we know it in this country.
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"This is an entirely false analogy and springs from imagining that health care is a consumer good. Laser eye or cosmetic surgery is entirely optional. You can live with glasses, a broken nose, or wrinkles instead. Fixing a broken leg or cancer is not (if you want to stay alive) and you can't."
I don't know. I mean, I definitely see your argument, but I am not sure it would work like that because (as you say) we as 'consumers' do not choose/purchase the casts and such directly, but we DO purchase health insurance as consumers. It is more like buying a car. You decide on your make/model/options and then you are stuck with it until you upgrade/sell it or whatever. If competition was increased in the insurance sector, via allowing purchases across state lines - NOT by introducing a public company that could stand to survive with a running loss - I think that prices would go down.
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"He then asked if I was up for socialised docs and I said " sure" we briefly discussed the idea that british doctors had to go to soup kitchens for breakfast ,lunch and dinner they were so poor, then I left and got a bill for $150 for 5 minutes of answering his questions about the health system in the UK."
Do you not have health insurance or something? My co-pay for a GP is $25. Pretty decent price to pay to have a professional check you out and make sure it isn't something worse and to leave with an antibiotic that will fix you.
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Before we all go off on tangents, keep in mind that Libertarian is expousing extremely conservative views on Constitutional interpretation; not to say whether or not his views may have any validity in the reasoning process; but his claims that government 'bureaucracies' (at least I assume this is to what he is referring when he mentions our government 'owning' corporations) are necessarily the equivalent to private corporations is in itself an unsupported opinion with no legal constitutional or judicial precedent.
Also his personal conclusion that they are unconstitutional and therefore illegal is just not supported by either a literal interpretation of the United States Constitution NOR by judicial precedent. Technically it isn't illegal until the Supreme Court says that it is. If some people feel strongly otherwise; feel free to take the issue to the Supreme Court.
I am supposing (and guessing he will correct me if I suppose wrong) that according to the classic libertarian argument; we have no more business funding NASA with tax money than we do the health of the American people whether by a public health option or by our current public health system which provides for public innoculations and education and the like.
I like the idea of little government in theory; however, as I've become acquainted with history and seen how human nature pretty much without exception ALWAYS results in the powerful taking advantage of the weak and with the population density being what it is, pure libertarianism theology if actually effected would be unfortunately simply a prescription for social chaos leading to some form of totalitarian extreme when the 'fittest' have leveraged enough power for themselves to dictate to the rest of the population.
Human nature isn't going to change but so much regardless of the type of government. The most we can hope for is a reasonably democratic government that encourages a reasonably informed electorate and whose chosen public servants make an honest effort to protect the rights of the weak as much as those of the strong; in doing so, some individual 'rights' MUST be curtailed when they affect the rights of OTHERS. This area of gray is what we should be discussing; not the right of a population to form a social institution which upholds the rights of life, liberty and the pursuit of happiness for ALL of the human beings living in that population. That SHOULD go without having to be said in this century in the richest nations of the world; and if it cannot...then we must examine what has gone wrong with the direction of our society, which began with such high ideals.
Anything less, and we have lost the qualities by which enlightened men have defined as 'civilization'.
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#99 Fluffy
. . . then I left and got a bill for $150 for 5 minutes of answering his questions about the health system in the UK.
That must be the entrepreneurial spirit in US healthcare I keep reading about!
;-)
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You mention that the hard fact is that since people are living longer, more medical treatment is a result of this, while I agree, this could be addressed through cheap preventative measures such as eating healthy and exercising, though, the trick then is to make those popular here in the states. A great majority here are jovial slaves to convenience, though I would say that there is an attitude of change(towards exercise, and eating right contemporaneous with the "green" trend that is so hip right now), but I fear that it might be just a fashion trend.
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Philip Shaw wrote:
The progressive's complaint with Joe Lieberman is not that he is "principled," but that he is actually "The Senator from the Great State of Israel" who part times as a lobbyist for the insurance industry.
____________________-
So and you fluff have to disparage one of the great Senators of the last century because he is Jewish. Unlike many Senators Liebermann looks at the issue instead of party line. Something senator Obama rarely did.
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99. At 4:20pm on 09 Nov 2009, fluffytale wrote:
"we briefly discussed the idea that british doctors had to go to soup kitchens for breakfast ,lunch and dinner they were so poor, then I left and got a bill for $150 for 5 minutes of answering his questions about the health system in the UK."
Must remember to call at the local Salvation Army instead of the surgery next time. No wonder I have to wait 48 hours for a non-urgent appointment sometimes if my GP has to spend all that time queuing for a bowl of soup. Or should I take a sandwich, do you think? Glad to see American doctors avoiding malnutrition.
I swear the Atlantic gets wider by the week.
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93. At 4:00pm on 09 Nov 2009, squirrellist wrote:
"This is an entirely false analogy and springs from imagining that health care is a consumer good. Laser eye or cosmetic surgery is entirely optional. You can live with glasses, a broken nose, or wrinkles instead. Fixing a broken leg or cancer is not (if you want to stay alive) and you can't."
It is this very treatment of health care as NOT a consumer good that leads to high prices. If health care centers weren't subsidized, they'd have to act like a business and compete with other health care centers for all kinds of care. People need food to eat, too, but it's still considered a consumer good, is it not? Why can't the price function work with health care, too?
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107. At 4:52pm on 09 Nov 2009, dceilar wrote:
#9 AvienMael1: Americans do NOT have a right to health insurance that they cannot afford.
# 107: dceilar wrote:
"It's funny how Americans have a right to a gun but not healthcare."
__________
Amen.
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107. At 4:52pm on 09 Nov 2009, dceilar wrote:
"It's funny how Americans have a right to a gun but not healthcare. What sort of society values gun ownership over the basics."
So if you can't afford the cure--or a fatal dose of a drug --it's easy and cheap to end the misery. Or shoot loads of other people out of frustration. Or your granny, of course.
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Mark: '"Some Republicans fear (the public option) is the thin end of the wedge and would lead, horror of horrors, to something like our National Health Service."
Mark, I have got to say, I am getting really fed up with you repeating and repeating this sentiment in seemingly every single entry on health care reform that you write. Do you even read your responses? If you had, then you would have noticed fairly quickly that the majority of the rational, free-thinking American people agree with you that the Republicans reasons for opposition are simply immature and childish, not to mention baseless. Most of us know that the NHS, while certainly not perfect, works just fine for the overwhelming majority of the British people. In fact in the MPT (Maryland Public Television) program '"Sick Around the World" (a documentary chronicling the health care systems in the US, UK, Germany, Japan, and I believe France,) a British doctor who was being interviewed by the documentary's American host, when he was being given the run down of the American people's fears about government-run health care, politely informed him that 95% of the British people are happy with the health care they receive. I know its diffacult, but I urge you. Please don't get worked up over the Republicans attacks on the NHS and the Canadian systems. A huge transatlantic rift had already been created back in the summer over this issue which spawned many hurt feelings on both sides. The Republicans mean no harm to you or the British system, they're merely trying everything in the book to stop any semblance of health care reform in the US getting passed because that would mean (horror of horrors) that they would have to find another sourse of campaign funding aside from the health insurance corperations. And since (as you sighted) "death pannels" and "socialising of medicine" didn't work, they turned to attacking our friends in the international comunity. But I assure you, its in no way directed at you, and entirely directed at those who God forbid want to improve the lives of their fellow man.
And while we're on the subject, I mean no offense to anyone, but I feel it is worth pointing out. And it is that yes the Republicans vehemently apose health care reform now; which in my opinion is wrong. But back in 1948, when the NHS was created, the Tories aposed its creation as well. Of course anyone feel free to correct me if I'm wrong, but it is to my understanding that they were just as unhelpful and in fact obstructionist in the creation of the NHS as the Republicans are being today with our health care system. And I guarantee
you, that had the technologies of instant comunication existed back then (I.E. the internet, cell phones, television etc,) that the world would know about, and look on with just as much passionate bewilderment and amusement the UK and its turmoil as the world does the US today. So perhaps not all of the laughter is justifyed?
Of course to many of us Brits, the cry "keep government out of health care" just sounds a little kooky, on a par with "keep government out of defending the nation" or "keep government out of building roads". In Britain one of the main things the government does, one of the main reason people pay taxes, is for health care, so naturally the revulsion at it in the States seems a little strange."
Understated like a true Britain. But for the record, I wholeheartedly and unreservedly agree with this sentiment. Health care is seen as a right, not a privilege by all Democrats, and would be by Republicans if they had been getting their campaign funding from people aside from health insurance companies. That is why since 1943, yes, 5 years before you tryed (for the first time I might add) and succeeded in providing universal health care coverage for your people, that we had first tryed, and have been trying ever since to get universal health care in this country. You British don't know just how luck you are to have the peace of mind you have when it comes to health care coverage. Relish it. It is a very rare thing indeed.
"America can always be relyed upon to do the right thing...after it has tryed every other conceivable alternative."-Sir Winston Churchill
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#95, digit. What a ridiculous suggestion. That bill would take up far too few pieces of paper.
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Mark, you have stated the exact problem with the American health care system in general: the cost.
It is great that people are living longer, but it shouldn't matter. The cost for health care, whether it is an infant, child, adolescent, teenager or adult, is expensive.
Health care quality in America is among the best in the world. There are even people from other countries that come here for surgeries and such. But why is it that America's own people cannot afford health care?
Is it that Americans are just more sick and unhealthy these days? I don't believe that. I believe that the health care system has simply had free reign to drive up the costs as much as they can to make as big of a profit as they can in recent years.
As much as President Obama and Congress have talked and talked about health care in USA, they have never talked about the reasons why health care is expensive and how to bring the costs down. In essence, they are avoiding the poisonous snake that bit us. But to put the snake in a fence doesn't mean that the snake won't escape somehow. It will just wait to rear its ugly head toward us again.
The only way to fix health care so that it effectively provides treatment to all Americans is to name what makes health care so expensive and adjust these high costs to moderate ones.
This is something that President Obama and Congress fails to address, which is a big mistake.
There needs to be an open investigation into how and why health care is so expensive and why we don't charge standard rates.
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#102 squirrel
Good to see you back. Been busy gathering nuts for the winter? There's quite a few nuts here, but not the pleasant kind, Nuts for Greys me thinks!
It sounds like many people are told what freedom is (which is a bit of a contradiction). So we shouldn't be too surprised if they make crazy comments like Not that I want elderly people to roll over and die, but why is it my responsibility in a free nation?, and other half-witted comments.
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menedemus
"The furore over my earlier comment passed over the main point I was making which was that the USA is embarking on a fool's errand seeking universal healthcare as the same ever-increasing costs of universal healthcare that besets the UK's NHS will, inevitably, beset the USA model of universal government subsidised healthcare regardless of the good intentions of President Obama and his supporters."
No ne missed your point they just thought you a fool, or they wished to ignore your crud.
OLD and young. remember there has never been a fully working population because some are too old and some too long.
I can see we should introduce Child labour camps and geriatric labour camps to keep them earning an paying their own way..
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RomeStu #51: '"Then the greatest nation on earth needs more help than I thought."
We're not the greatest nation on earth. Well, only to the narcissists we are.
You're right in the sense that blind disdain for, and hatred of one's government is of course never helpful and certainly never moves a nation forward, but a healthy mistrust of one's elected officials is crucial for a democracy to function properly.
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The recession, lack of jobs and high unemployment is what is driving this health care crisis today. Before the recession hit, Americans still had difficulties paying high prices for health care, but it was different, because the majority of Americans all had good jobs, many of which helped pay for health care of their families.
The leading employer during this recession is Wal-Mart, which guarantees low costs at a high price: health insurance offered to only some employees.
As our factory jobs with health insurance have left, Americans have been forced to drop their health insurance and unable to afford it. Now, most of the jobs available in the USA do not offer health insurance nor do they pay well enough for a person to afford it.
So the biggest reason why people cannot afford health insurance is because they can't afford it, due to having a low paying job or a job that does not offer health insurance.
This is a major, major problem. For the millions of people Obama and Congress want to insure, how is it that these people will be able to afford health insurance, if they still have low paying jobs or jobs that do not have health insurance?
To fix the problem of people not being able to afford health insurance, President Obama and Congress must create more high paying jobs with health insurance benefits. Otherwise, these laws will still not help people to be able to afford health insurance.
Affordable Health Insurance= High Paying Jobs
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'112. At 5:05pm on 09 Nov 2009, Tino wrote:
"He then asked if I was up for socialised docs and I said " sure" we briefly discussed the idea that british doctors had to go to soup kitchens for breakfast ,lunch and dinner they were so poor, then I left and got a bill for $150 for 5 minutes of answering his questions about the health system in the UK."
Do you not have health insurance or something? My co-pay for a GP is $25. Pretty decent price to pay to have a professional check you out and make sure it isn't something worse and to leave with an antibiotic that will fix you.
---------------------------------------------
you strange "logic " at it again.
I get what you are asking but not because of your words.
No I do not have health insurance.
What is your point.
That you pay $25 after HOW MUCH OF A PREMIUM?
I got anti biotics I saw the doc. He thought a universal care system would be better .
FYI.
The brit docs are also professional and cost a smaller percentage of your income than the americans doc.(who by the way charge up to 7 times the amount for the same treatment for those that pay by cash and are not part of an HMO.Only place in the World where cash is more than billing)
As to my health care
I worked for 6 years in the states for a republican. He wouldn't even pay for me to be covered if I got injured on the job. I'd have to sue him.
he wouldn't even pay SS on me so I have to pay out of my money the whole lot as if I were an independent contractor charging 25-70 bucks an hour.
So I get paid 12 and pay a higher rate of tax than most at 12 because he was not making his contributions.
So I can sue him over that as well.
Great one day when I get rich I'll be able to afford that lawyer.
Tax inspectors welcome. I'll give you a dodgy bloke for free.
Go nail him to the wall.
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88. Interestedforeigner:
["Not that I want elderly people to roll over and die, but why is it my responsibility in a free nation?" (Libertarian #75)
-- Well, you certainly can't be faulted for being inconsistent.... Good luck with that, anyhow.]
Thank you, Foreigner Dear. You see the holes in the libertarian cheese? The logical gaps in the paradigm speak silent volumes, don't they?
I would like to point out that - just as many Democratic voters are closet Greens (like me) - there are many Republican voters that are closet Libertarians.
I'm kinda thinking that "The Republican Machine" is starting to pander to Libertarian paranoia in order to rouse popular support against health care reform. Kinda scary, really.
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98. Dresi wrote:
[It is strange and also saddening to see how citizens in the US has been misled. ...Healthcare for all from birth to the grave. The US can well afford this as it is supposed to be the richest country in the world.]
Agreed. But, you forget a the unwritten Golden Rule in American Power:
"He who has the Gold makes the Rule"
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InterestedForeigner, #76:
[But, of course, by contrast, everybody in the health insurance industry is suffused with a spirit of philanthropic goodness...Do you really believe that your health care insurer has anything like your best interests at heart?]
-- ding ding ding ding... give that man a prize. InterestingForeigner has just removed the green glasses of OZ.
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You know, I'm really hoping this plan goes into affect soon. I could work part time, provide for my kids, and be home when they get home from school...
See, I'm only working full time because I need the Medical Insurance. Srsly.
As soon as I can, I'm hoping to go part time, clip coupons, and help my kids with their homework... Wow, I could even make healthy food for dinner, too! I'd have time for the back-yard garden... Whadda concept.
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114. At 5:10pm on 09 Nov 2009, dceilar wrote:
#99 Fluffy . . . then I left and got a bill for $150 for 5 minutes of answering his questions about the health system in the UK. That must be the entrepreneurial spirit in US healthcare I keep reading about! ;-)
112. At 5:05pm on 09 Nov 2009, Tino wrote:
My co-pay for a GP is $25.
Being a (Brit) socialist who doesn't really comprehend this tooth-and-claw kind of capitalism when it's applied to health (as fluffy has reminded me) I see, however, you've hit on something.
Fluffy should obviously, in the same entrepreneurial spirit, bill his doctor for 200 dollars for the expert consultation. (Plus an additional 50 or so 'ignorance premium' for having to cope with such egregious misconceptions.) Seems to fit the general ethos with an acceptable kind of percentage profit.
Funnily enough, last year my GP asked me if I had any ideas about politely persuading patients to spend less time on those rather consuming consultations when they say "Oh and by the way I have this pain in my chest. . ." as they're about to leave after they've just spent ten minutes on ingrowing toenails or something. I gave her a couple of ideas and joked afterwards I should have billed her for my professional time, but being the NHS it would have been a bit like taking money from myself to pay myself. . .
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Gherkin you wake up just dying to tell a lie don't you.
"116. At 5:11pm on 09 Nov 2009, MagicKirin wrote:
Philip Shaw wrote:
The progressive's complaint with Joe Lieberman is not that he is "principled," but that he is actually "The Senator from the Great State of Israel" who part times as a lobbyist for the insurance industry.
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So and you fluff have to disparage one of the great Senators of the last century because he is Jewish. Unlike many Senators Liebermann looks at the issue instead of party line. Something senator Obama rarely did."
Have I just changed positions on healthcare because I found out Lieberman was on the side of the right?
NO
I will disparage him for all sorts but we had that debate yesterday and TODAY it is on health care.
You asked you got an answer. that is enough of that discussion. go back to the old thread if YOU will not let it drop.
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#104 Men
Similar in many ways to the way that final salary pension schemes have had their day as they are no longer capable of being funded by those in employment and contributing into such schemes.
The main reason final salary pension schemes had their day is because the employer did not contribute into the pension when they should. With years of them not paying their share they were faced with a huge deficit. Governments were the same. They spent the pension money so they could cut tax and spend with the aim to keep right wing nut jobs voting for them.
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117 The private system in the UK is based on this principle.
You take the same doctor in the same hospital some soup and a good cheese butty and you get treated right away.
Pudding looks after the after care.
remarkable system.
Chocolate cake , then you've got them fighting over you.
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"The president's jubilation at passing a health care bill in the House of Representatives is understandable"....he's saved the insurance and pharmacetical corporations, once again! "To British eyes, this focus on the public option seems a little odd. It would just mean one government-run - but not government-funded - insurance scheme among many others"...and they're absolutely right, it is odd, not just a little but very odd - and grossly unfair. As Rep. Dennis Kucinich of Ohio, a true progressive (unlike arch-conservative Obama), who voted against the bill in the House for progressive reasons, aptly explained his vote: "We have been led to believe that we must make our health care choices only within the current structure of a predatory, for-profit insurance system which makes money not providing health care. We cannot fault the insurance companies for being what they are. But we can fault legislation in which the government incentivizes the perpetuation, indeed the strengthening, of the for-profit health insurance industry, the very source of the problem." It's not just, "to many of Brits, the cry 'keep government out of health care' just sounds a little kooky"...it sounds that way to many Americans, too. But you'd never know that from the reporting on this issue in the corporate press, which craftily trys to portray the only alternatives as a right-wing Obama insurance plan that would actually greatly increase private profits for insurance giants or an ever further right-wing non-plan by a reactionary kook like Lieberman with no public option, even a bad one. But if "the debate between all the different systems of health care one vital point is missed. Whether they are left, right or centre, they are becoming unsustainably expensive. It is after all the cost of the American system that leads many to conclude it needs radical overhaul." It's not only the cost, it's the unfairness. Rationing favors the rich. Both points are addressed in a single-payer universal plan. As Rep. Kucinich notes, "Clearly, the insurance companies are the problem, not the solution. They are driving up the cost of health care. Because their massive bureaucracy avoids paying bills so effectively, they force hospitals and doctors to hire their own bureaucracy to fight the insurance companies to avoid getting stuck with an unfair share of the bills. The result is that since 1970, the number of physicians has increased by less than 200% while the number of administrators has increased by 3000%." As he further notes, "An amendment which would have protected the rights of states to pursue single-payer health care was stripped from the bill at the request of the Administration." So you can see just whose side corporate waterboy Obama is on and why he is so "jubilant". Mr. Hope and Change has effectively killed off any significant single-payer public option for the forseeable future. And with it, all the extensive social and economic benefits of a not-for-profit, single-payer health care system.
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pursuit of love.
Them tories still occasionally throw themselves on the knife of getting rid of the NHS.
it is fun to watch, a decent blood sport.
but that was back in the old days that they opposed en mass.
Just after a war when the country owed the next 60 years to the states .
But it still passed.
If you go further back you will find that he used to put prisoners in a big wicker cage shaped like a man and burn them.
But we changed.
127 Illinoisan.
them high paying jobs that allow people to pay for health care.
Can we all have one?
will we give the janitor equal pay ?
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130 SWEET. Cheers Nib.
I'm off to the lawyers to see if they will take my case for a percentage.
gold gold gold gold gold gold gold gold.
Now I can buy some more guns with what I have left to protect me self.
I've been trying to find out how much money has been spent on guns and ammo since the elections.
I reckon it would be illuminating. but alas I have some frogs to create.;)
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squirrelist (#55) "Where else among supposedly civil societies do you get Generals being seriously considered (or putting themselves forward) as prospective Heads of State so often, for example, these days? Or military experience being seriously regarded as a qualification for a political career?"
The last US president for whom his military record was a significant qualification was Eisenhower, who was president in the 1950s. As commander in the European Theater, he managed a large, complex enterprise, which was an excellent qualification for the presidency.
We don't elect generals that often anymore, and fortunately we passed up the opportunity to elect Gen. MacArthur.
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116. At 5:11pm on 09 Nov 2009, MagicKirin wrote:
"So and you fluff have to disparage one of the great Senators of the last century because he is Jewish. ..."
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Magic, give it a rest.
I like Lieberman well enough, but he is wrong on this one. Really wrong.
Being wrong on this particular issue does not have anything to do with whether or not he is Jewish.
You didn't like the smack at his support of Israel. Big deal. We know there are lots of people who do not support Israel, and who disagree with Joe Liberman's position with respect to Israel. There's nothing new there, and certainly nothing relevant to today's discussion. By responding, you're dragging in the whole Levantine-rathole issue out of left field. Don't go there, just ignore it and move on.
That isn't what this string is about. It's about healthcare.
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The USA healthcare reform debate is simple: it's about whether or not corporations will continue to drain the country's wealth for healthcare. Remove the profit motive and your insurance, pharmaceutical, medical device, private hospitals, MDs, etc. are reduced to actually having to serve the public instead of enriching their corporate officers and large shareholders.
The debate here is about whether we're going to corporate fascism continue to run our country, or whether the people's interests are going to served by government.
So far, I'd say the big money boys are winning, as usual.
Wish us luck.
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The real issues:
-Open more Medical schools so that more qualified applicants (even if they fall out of the "affirmitive action" category) may attend. Right now there just aren't enough schools for all students.
-Keep the government out of what should be a competetive industry. The government should consider revamping their current government run healthcare program "Medicaid" which pays exhorbitant fees, in fact any fees for any amount billed even if they are bogus claims for non-existant people. Change for the sake of change and their own agenda to include government should not be the goal of new healthcare.
-Suspend immigration until the immigrants currently in America gain an American identity, learn the history and espouse our ideals and meld into society as other immigrants had done in previous generations. This will alleviate pressure on the current Medicaid system.
-The current health case system is not broken, it just needs the right changes to help improve it and those won't come from more government mandates as it takes good old fashioned competition in business to make things work.
I get a real kick out of comments from people whose countries have socialized medicine yet haven't felt the impact of waves of immigration and misuse of services. Some people need to learn that you don't go running to emergency room for a headache when you should take an asprin. They also need to learn how to eat properly and not with abandon, and if they are on public assistance they should not use their food stamps to buy soda, cakes and between-meal snacks. Such things may well be learned at home with proper concern from knowledgable and caring parents who can ready and write and learn. I can speak with first hand knowlege from having lived among these folks. Some others can't.
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To address a question posed by some in these comments I felt the need to clarify. Many people have brought up the fact that we as Americans don't trust the government to make these decisions for us. This mistrust is more from the fact that people do not feel that the national government can adequately address the needs of the individual than it is from a lack of faith in our elected representatives. Due to a combination of the level of bureaucracy needed to administrate from a national level and the sheer number and range of the effected demographics, people feel that they as individuals would be better served by making their own decisions. People feel that those decisions are theirs to make and that someone sitting in a cubical in DC could not properly address the concerns of the people it oversees.
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137. At 6:14pm on 09 Nov 2009, GH1618 wrote:
"The last US president for whom his military record was a significant qualification was Eisenhower, who was president in the 1950s. As commander in the European Theater, he managed a large, complex enterprise, which was an excellent qualification for the presidency."
(And he showed an ability to deal diplomatically with difficult (British) subordinates, to boot.)
_______
"We don't elect generals that often anymore, and fortunately we passed up the opportunity to elect Gen. MacArthur."
_______
You got that one right, for sure.
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"This is an entirely false analogy and springs from imagining that health care is a consumer good. Laser eye or cosmetic surgery is entirely optional. You can live with glasses, a broken nose, or wrinkles instead. Fixing a broken leg or cancer is not (if you want to stay alive) and you can't."
It is this very treatment of health care as NOT a consumer good that leads to high prices. If health care centers weren't subsidized, they'd have to act like a business and compete with other health care centers for all kinds of care. People need food to eat, too, but it's still considered a consumer good, is it not? Why can't the price function work with health care, too?
You obviously don't work in the medical field here in the US. In general, the field is subsidized with insurance, private and public...because without the leverage of a guaranteed payor the whole system as it currently exists would collapse just as the real estate markets have collapsed. Only the smallest rural hospitals are subsidized to any degree by government tax write offs when they lose money to indigent expenses.
Other than that, in what way is health care NOW not treated as a consumer good? Seriously. You can buy here whatever you can pay for...the difference between cosmetic surgery and heart surgery is that...one you can live without, another you cannot...one is voluntarily paid for directly...the latter is subject to being paid for by insurance. Think of the insurance (private and public) system as the equivalent to the private commodity trading network which supports other commodities.
Only hospitals are legally required to provide indigent care and only in certain situations. Otherwise health care in the US is very much a commodity. EMTALA is why a hospital emergency room cannot turn anyone with a verified medical emergency down. This is where the system does not treat medical care like a commodity; this is why emergency rooms are getting more and more patients seeking care. In order to make money to stay afloat, smaller hospitals are investing money in areas in which reimbursement pays well...outpatient surgery, MRI equipment...this is an example of a health care facility treating health care like the commodity that it is...knee surgery won't save a life...but they can and do bring a good slice of Medicare and private insurance reimbursement into a facility according to the current fee for service structure used by most of our reimbursement, ie, leverage systems.
We wonder why costs get higher and higher. Technology, the investment in technology, and paying and training personnel that can utilize it are expensive. There will ALWAYS be plenty of demand when it comes to a person seeking to save his life or the life of a family member IF there is a way to get it...ie, access.
As far as cost containment goes...our current leverage system isn't well suited for cost containment; as there is no end to consumer demand. Again, via leverage, instead of paying providers directly out of pocket; we buy (or are awarded on the basis of age and citizenship or citizenship and financial need) policies which pay the providers FOR us.)
Payments differ from policy to policy, but they are basically set payment schedules generally fee for service awarded to the PROVIDER. Not so much fee for service for the policy holder. If we buy a policy, and have a health care need, we see a health care provider. We expect our policy to pay as agreed. For those of us that have an employer subsidized policy, there is little to no reason to voluntarily adjust our demand because our policy price is standardized within reason (much more standardized than if we buy no insurance and take the chance that we won't NEED an expensive hospitalization, for instance). Insurance companies have leverage of numbers; preferred providers agree to accept insurance reimbursement on a fee per service schedule knowing that they will make their income by volume of patients with this insurance; it is those outside of the insurance networks that are charged the very highest fees because they have no leverage.
If every one of us had to pay out of pocket for knee surgeries, cataract surgeries...with so few people able to pay out of pocket...the system could not support as many providers...there would likely be fewer providers in many areas of the country and those that existed would serve the more affluent in society. Demand simply because of inability to afford the care would drop, but so likely would the delivery capacity. You ignore the reality that the providers in this system have a very high overhead as compared with other industries in the form of expensive education (minimum 11 years of privately paid for education in the US) as well as the regulation burdens on the medical industry. No one here on this board has pointed out the fact that the UK system provides medical training to it's physicians and gets in return 10 years of public service; but here in the US the educational system is also privatized. Most likely this will be something that will have to be addressed in the future in the US or under any type of reform at all access is going to be pressured.
The days when one could simply hang out a shingle and hawk tonics and call it health care are long over with or without torte reform; the very cost involved in becoming a provider in this network necessitates that these providers take in enough income to justify their educational and operational expenses.
Without leverage to enable utilization and support the provider network, society would then have an increasing problem with ACCESS.
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Gary come now.
They do put themselves up for re-election quoting military service as a qualification.
we weren't asleep last year.
IF cheers.
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#104. Menedemus: "only 40 percent of the United Kingdom population pay Income Tax which is still the main revenue of the National Government."
Would you care to justify that statement with a link which indicates that 60% of wage earners pay no income tax? Of course children do not pay, neither do those who are unemployed. Your choice of wording suggests that you might not be British - income tax is the primary source of funding for almost all Western governments - and what is the "National Government"? The last time such a name was used was in 1945 under Winston Churchill. No-one can tell me that the present Labour Government is any kind of coalition, which is what a "National Government" means.
"the NHS is a government sponsored quango that drains money from the national exchequor (sic) and will continue to do so until such time as the amount spent on the NHS cannot be afforded by the Income Tax payers of the UK."
Quango is the acronym for a "quasi non-governmental organisation". The National Health Service was set up as and is now the responsibility of the Department of Health. It is not a quasi anything. By your logic the Army, Air Force and Navy are quangos - who do you think pays for them? The taxpayer of course. It would be political suicide to disband the NHS since Britons (of which I am one) believe that healthcare is a right, along with education and other governmental programmes. It may be changed, with added charges as has happened before, but there will remain a national healthcare system for a very long time.
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43. squirrellist: "So why not elect 'good moral intelligent men and women' or change your form of government to one that isn't "run by ignorant, selfish -- and corrupt -- individuals?" If they aren't fit to run something as benign as health care, why on earth do you trust them with wars?
*************************
Our many politicians want to retain their power (ex., position). To do so, they cater to their constituents -- voting and contributing. Each state has its own constituents. What is good for one state or group of constituents may not be good for another.
It comes down to competing interests. That's why individuals retain as many rights as possible. To make sure they are not subjected to the vagaries of politics and the forces of other competing interests.
Now, people rail against the insurance companies but fail to acknowledge their own interests, which are to receive services when they want and, sometimes, to avoid paying for services they don't think they'll need. Why else would people who were the basis for the reform of health care (ex., the uninsured) now be fighting the mandate to buy affordable insurance?
The size of the US is another factor that differentiates us from any single country. Do you know how large the economy of just one state, California, is?
This is why I would fully support health care reform on a state level. It's manageable, measurable and small enough to allow for innovation. The thought of another federal bureaucracy, participation in which may not be negotiable and by whom medical practices may be dictated (ex., by expert panels based on outcomes-based medicine stats) is anathema to me.
And before anyone swears that none of this will happen, please read the bills. President Obama has sworn that things would be a certain way. His words have not always been in sync with the details of the bill. Thus, when President Obama promises that I'll be able to keep my insurance, I don't take him seriously. I cannot. He has not been reliable.
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Ian Baurne #57: '"I am a Brit that has lived in the US for 35 years and I still do not understand this Country. So many nice individuals, kind and generous, but no sense of community for the common good."
On what level do you mean? On a governmental level? If so then yes, sadly there is a bit of truth to that. Although I feel it important to point out to you that while we don't yet have universal health care, government funds and runs, and is expected to fund and run all the institutions that it does in every other civilised country (I.E. police, firemen, public schools etc.) However, if by "no sense of community for the common good" you mean on a charitable level, then I urge you to look into one or two of the many charities in this country and then get back to me. It is my belief that individual Americans have to be so "kind and generous" because government has a seemingly tougher time looking out for the common good in this country than our western friends do.
"This is partly explained by the political and economic power of the super rich and the large corporations and the way congress works, or rather doesn't."
Undoubtedly. But the way "Congress works or rather doesn't" is a result of our founders and how they set up the governmental structure of this country, and not anything any Wall Street executive
threw at any Congressman. Unlike parlament, the Congress is entirely detached from the Executive branch of our government. As such, the president can have at any given time a majority of either his/her (one day) party in it to work with, or a majority of the opposition party to contend with. It is designed like this on purpose so that there is a constant tug of war between the White House and Congress, because the founders feared that if the system were designed with too much predictability and aquiessence of the Legislative branch of the government, that the Executive could potencially be given, or take, too much power, thereby leading us down a very slippery slope toward dictatorship. For one who's lived here for 35 years, I would think you would have already known this.
"It's fair to say that the American model of democracy is giving the the whole concept a very bad name and this battle over health care is just another example."
There is no doubt in my mind that had we had a parlamentary system of government, we would have had universal health care decades ago. But alas, you've got to work with what you have.
"The truth is that the American public can be sold on anything with enough advertising and some fear thrown in the mix and this is another successful campaign."
This statement makes you sound as though you are someone who's never been here, and who forms his opinions of us based on Hollywood and George Bush. Are you sure you've lived here for 35 years? Because if you have, I have no doubt that you would have realized that the ignorant of the American public, and unfortunately there are a lot of them, can be sold on anything. But it takes the informed amongst us a little more than advertising and fear mongering to sell us on any product.
Don't fool yourself, there are a lot of ignorant in Britain as well. Think before making such sweeping generalizations about Americans' intelligence, please?
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ref #138
IF you really need to look at the posts I respond to before making statements.
Because these posters do disparge Liberman and other Jews on this board.
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124. At 5:35pm on 09 Nov 2009, dceilar wrote:
#102 squirrel
Good to see you back. Been busy gathering nuts for the winter? There's quit9e a few nuts here, but not the pleasant kind, Nuts for Greys me thinks!
Thanks; and to fluffy. similarly. Been showing the (red) flag elsewhere, and currently attempting to grow more fur because of a cold caught as a result of swapping 20-odd degrees (C) for 12 rather suddenly. (The [red] comrades of course are rallying round helping to feed it, while the greys of course are just yelling "Tough, why don't you pay us to collect nuts for you instead of being parasitical?")
Apropos of this debate, if the system over there is that wonderful (all those billions in profits devoted to amazing cures that wouldn't be possible under any form of socialised medicine. as I keep reading, then why isn't there a cure for my cold yet?
And if a system that relies almost entirely on private health insurance (Belgium) charges me twice as much at the chemist's for the same paracetamol and decongestants as it does in the UK, then all I can say is 4 sneezes for socialised medicine.
(Sorry. 'Cheers'.)
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146. At 6:39pm on 09 Nov 2009, AndreaNY wrote:
"What is good for one state or group of constituents may not be good for another."
But in terms of health care, it must be. A carcinoma in California isn't different to one in Colorado.
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#147. PursuitOfLove: "Don't fool yourself, there are a lot of ignorant in Britain as well. Don't fool yourself, there are a lot of ignorant in Britain as well. Think before making such sweeping generalizations about Americans' intelligence."
Read that again: Think before making such sweeping generalizations - about the British.
#148. MagicKirin: "Because these posters do disparge Liberman and other Jews on this board."
Nonsense! You're seeing disparagement of those of the Jewish faith where none exists. Just because someone disagrees with Mr Lieberman does not mean they are anti-Jewish. If you were around when Joseph McCarthy carried out his witch hunt, I'll bet you saw Communists behind every door.
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I remain amazed at some of the comments. Read the latest issue of the New England Journal of Medicine. US healthcare, except for the rich who don't require insurance anyway, is mediocre by world standards. Life expectancy is nowhere near the best and the iatrogenic death rate is a world scandal (See the Institute of Medicine publication To err is Human). Also the original preamble to the US constitution (not the later amendments that brought in the right to bear arms) reads as follows.
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
Note the bit on welfare. I think I rest my case. or is there an amendment saying that welfare (a.k.a. Health in most definitions) is no longer a right of US citizens?
I reliase that many republicans have a deep seated hatred of government and government run bodies, but then the Bill of Rights, and their right to bear arms, should lead them to lobbying to disband the Army, Navy and Air Force so they can sort out the bad guys for themselves.
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"Undoubtedly. But the way "Congress works or rather doesn't" is a result of our founders and how they set up the governmental structure of this country, and not anything any Wall Street executive
threw at any Congressman."
I really doubt that the Founders of our Constitution were prescient enough to foresee the Breton Woods agreement; the International Banking System and the Federal Reserve, or the modern definition of a corporation in which the latter is treated legally as an individual with the same rights accorded to individuals including but not limited to the right to give money to Congress as a form of 'free speech'.
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137. At 6:14pm on 09 Nov 2009, GH1618 wrote:
We don't elect generals that often anymore, and fortunately we passed up the opportunity to elect Gen. MacArthur.
But both (Generals) Wesley Clarke and Colin Powell were being promoted as potential presidential candidates, weren't they? And McCain and his supporters, let alone his party, weren't exactly downplaying his 'military' qualifications for the job, were they?
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148. At 6:53pm on 09 Nov 2009, MagicKirin wrote:
ref #138
"Because these posters do disparge Liberman and other Jews on this board."
________
Well, the posting you responded to did not "disparage" anyone other than Senator Lieberman, and I'm not sure that making a comment on his support for Israel actually amounts to "disparagement", even if it was intended to be. There are lots of voters who may actually support Senator Lieberman for that very reason.
Unlike some of the things here that the moderators have refused to take down, (including an astonishingly ignorant and highly offensive comment relating to Adolf Hitler that genuinely was holocaust denial), this comment can hardly be considered a general disparagement of Jews, and is well within the realm of fair comment. I have certainly heard of one senator who was refered to as the "Senator for Microsoft" and another as "the Senator of General Motors", and yet a third (quite some time ago) as the "Senator for Texaco".
Senator Lieberman is a great and well known supporter of Israel. That is undoubtedly true. It is also undoubtedly true that some posters here don't like that. Fine. That's their right. It is just as true that Senator Lieberman's constituents can take (and presumably have taken) that into account at the ballot box. Apparently it doesn't bother them, they keep re-electing him.
The point I'm trying to make to you is to stop getting hung up on this stuff. This kind of comment simply does not rise to the level of meriting a response. It is static noise that is irrelevant to the current topic.
Let it go.
Move on.
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squirrelist (#154) "But both (Generals) Wesley Clarke and Colin Powell were being promoted as potential presidential candidates, weren't they?"
Yes, and Gen. Clark washed out relatively early, despite being bright (a Rhodes Scholar) and having a distinguished military career. Gen. Powell would have been a stronger candidate, I think, by virtue of having been Secretary of State as well as a distinguished military officer. He is no dummy himself, being smart enough not to want the job. Who knows how well he might have done, had he run.
McCain's credentials are entirely as a Senator. Of course any candidate's military background is cited (see John Kennedy, for example), but that alone would never have brought him mention as a presidential candidate, as it did for Eisenhower.
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InterestedForeigner (#155) "I have certainly heard of one senator who was refered to as the "Senator for Microsoft" and another as "the Senator of General Motors", and yet a third (quite some time ago) as the "Senator for Texaco"."
Don't forget the "Senator from Boeing," "Scoop" Jackson of Washington.
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Hard Fact of health care cost in the UK as against elsewhere? but people of a given age are actually getting healthier than the previous say ten year cohort and will continue to do so. for some time. Drug cost fall as the patents run out and surgical practice improves dratically if you insist they they compare notes. But if you insist on every test in book (because the patient will sue you if you haven't and something goes wrong) and you pay top rate when in real life a junior does the job and you actually like staying in hospital a long time ... well of course you cost will rise.
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~We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.~
Some on here continue to go to this phrase as the basis for concluding that the federal government owes each citizen the right to take care of their health needs. Notice, however, that 'promote' does not equal 'provide', as is used in the clause mentioning common defense.
Judicial decisions in the states, largely relying on the 10th Amendment--the last of the U.S. Bill of Rights, leave several areas of government function solely to state governments. They generally are considered education, police protection, and health providers. Over time, federal laws that have encroached into these areas are said to have violated the 10th Amendment, and are therefore stricken.
The federal government has increased its ability to get involved in such areas by what is known as the "commerce clause" to the U.S. Constitution, but its legal value is considered dubious by some legal scholars. In short, it allows Congress to be involved in certain areas that the Constitution does not otherwise allow its involvement, such as making laws affecting the general criminal code, if its involvement is needed to better control 'Interstate Commerce'.
The idea behind leaving certain government functions to the states and others to the federal government may be becoming outdated by some voters' standards, but at least that was the reasoning when the U.S. was founded and what the courts have relied on throughout the years. As such, the preamble to the Constitution and Bill of Rights collectively could not be used to adequately justify sweeping healthcare reform, which I think is the point a previous poster was trying to make about the legality of Congress creating such entities.
More likely, however, such changes will rest on the commerce clause of the Constitution, so that's where you should begin your point of reasoning. Either that, or the U.S. citizens should begin to think about adding another Amendment to concretely make healthcare rights more than something we discuss on the internet and something that exists in reality.
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I had the honor of speaking at the mass of a English friend who's illness was similar to mine the only difference being I live in America and was covered under the present insurance system. Otherwise a friend of mine would have had the same oppertunity to speak at a mass held for me. One for health care reform. Go Obamah Go.
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David_Cunard #150. . .
I wasn't making generalizations about the British people. I merely said that there are ignorant people in Britain. There are. That is a fact. Just as there are ignorant people in America, Canada, everywhere. Re-read Ian's comment which I copyed and pasted and then re-read my response to it. I think I was fairminded despite the fact that I was mildly offended by it.
You need not be so defensive.
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I was in Britain this summer and the headline was the consideration of a law that would require Brits to pay 20,000 pounds upon retirement to the government for healthcare. I could not believe what I was reading but then I remembered I was in Europe where people believe Govt. should take care of them. I was also amazed at all of the tourists shops and eateries that closed even when the sidewalks were full of tourists. But then I thought perhaps you don't need to work hard if Govt is taking care of you. I was glad to return to America, the land of the free. But alas, the downfall of the US has officially begun. In a country where everyone laughs at the ineffeciency of Govt. and holds their privacy sacred and is founded upon prinicples of limited Govt, we are now going to turn over another 16% of our economy along with life and death decisions to Govt. officials. Approximately 48% of our economy will be controlled by the Govt - perhaps we can offically call ourselves socialist like our Dear Leader with another 3%. It's a sad time. Some day, I or a family memeber will need to turn to the Govt for life-saving surgery and will be put on a waiting list. I can only hope I have the money to go to India to have it down like so many Canadians with money now escape to the US to have surgeries they need to survive.
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Opponents of the federal health care plan like to cite the Tenth Amendment to the US Constitution (see post #159) in their cause, but there are actually very few successful challenges based on that amendment. This objection was raised with regard to Social Security and decided in that case by the US Supreme Court in 1937:
http://www.ssa.gov/history/court.html
I expect any health care plan that can be enacted will pass Constitutional muster as well.
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159
"Some on here continue to go to this phrase as the basis for concluding that the federal government owes each citizen the right to take care of their health needs."
Another deceitful tactic employed by the right on this argument.
You guys on the right said the constitution Forbids health care. That it is unconstitutional.
your comment here is clear deceit because you know full well that the quote in question is being used too illustrate that there is NO prohibition on health care despite what you think.
People have gone on to mention the other things we are taxed to pay for and cite that the wording does suggest that active promotion is required to meet the constitutional requirements.
The question then is . Does the active promotion include the inclusion of a health system that could be used to actively engage in promoting the health of people.
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cjwd #153: '"I really doubt that the Founders of our Constitution were prescient enough to foresee the Breton Woods agreement; the International Banking System and the Federal Reserve, or the modern definition of a corporation in which the latter is treated legally as an individual with the same rights accorded to individuals including but not limited to the right to give money to Congress as a form of 'free speech'."
I know that they weren't. Noone can predict, on such a grand scale, what is to come in the future. But if you re-read my post, you'll see that I acknowledged Ian's point that the reason why there is a lack of a sense of community in the US is due to corperations and rich people inundating Congress with money in the hopes of Congress then taking up their causes, and that this in turn leads to ordinary Americans being made to feel as though their concerns and desires don't matter to Congress. But I went on to explain in great detail, and still stick to that explination, that the main reason why Congress doesn't work as affectively as, say, Parlament, is due to the governmental set-up of our country, put in place by our founders. Now you're of course free to disagree with me, and I would love to hear your thoughts, but I believe those to be the reasons why things are the way they are.
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161 hell yes! did you read the reply from that kook that mark refers to in his piece?
Gary
Again are you pretending that they did not try to claim that Mc Cain was a better "commander in chief" because of his military background.
Or that the republicans made a huge deal out of his service at every opportunity to get the vote of the military.
or that Sara palin didn't use it to stump for him at all them rallies (between the calls of incitement)
I reckon they did make a big deal out of it. they wanted a tough image.
Yes he engaged in politics as well, but that, military record was brought up many times.
LAW I missed that debate.
was it a serious debate?
I'm not sure you would get the humour if it were a joke.
PS as someone mentioned americans take all sorts of advantage of travelling abroad for cheaper affordable treatment. there are no Poor people coming here (USA)to scrounge over inflated procedures .
Maybe a few rich ones that have a tummy tuck to think of.
Squirrlist
time for a hot totty .;)
Hope the cold leaves.PS them Belgium's seem to like the frogs. I'm sending 25 more;)
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10th amendment.
seems to say the feds will only look after what the constitution allows them to look after.
well back to the preamble.
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Here is what the US Supreme Court concluded in Steward Machine Co. v. Davis in 1937:
In a 5-to-4 decision, the Court held that the tax under the Social Security Act was a constitutional exercise of congressional power. The Court found that the tax was uniform throughout the states and did not coerce the states in contravention of the Tenth Amendment. The Court took note of recent unemployment statistics from the years 1929 to 1936, maintaining that "[i]t is too late today for the argument to be heard with tolerance that in a crisis so extreme the use of the moneys of the nation to relieve the unemployed and their dependents is a use for any purpose narrower than the promotion of the general welfare. . .The nation responded to the call of the distressed."
From: http://www.oyez.org/cases/1901-1939/1936/1936_837
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Senator Lieberman has received large contributions from the insurance industry, and his wife has been employed in the pharmaceutical industry as a lobbyist. We hope that he will reconsider based on what is right and not follow the money!
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Here's an interesting summary of Tenth Amendment cases:
http://www.law.cornell.edu/anncon/html/amdt10_user.html
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nurtz usa
Using the emergency service in port jervis ny gave me an experience to remember! Itook my son who was under stress with a high temperature.We waited almost one hour before being attended. The doctor arrived and spent less than five minutes examinimg my son and writing a prescription. Of course no discussion of follow up!
I received a bill for $135.00 in the mail.I explained that I had no insurance since I had recently lost a business (Bush Sr. recession )
They hounded me for literally years,until I left the country in fact.
I now live on Brasil and have used their emergency service. I have always been attended quickly and given all the necessary tests. They give whatever drugs are needed and give a follow up date.This service is free to all Brasilians and legal residents.
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Col.VikTim
UChristian?
NoLoveHere
DarwinRules
A.S.K.Darwin
Not_UsAll!
CantAffordItDontDeserveIT
What the devil makes anyone think that we Americans have anything in common enough to desire - or even to identify - a common good? The ONLY things many of us Americans have in common are:
- the pursuit of the unrealistic 'rags-to-riches' dream;
- the desire to be left 'alone' to pursue that dream, or to do whatever we please - within or without the law;
- the belief in the superiority of anything 'American', especially its military (with the huge exception of cars);
- the belief that America can do no wrong on the world stage
- the extreme skepticism of anything 'un-American', such as universal health care.
There is absolutely NO SENSE of common good, whatsoever. That's because of
the Red Scare: Communism & Socialism.
Before the fall of the Soviet empire, there were two diametrically opposed, but mutually offsetting evils on the planet: communism vs. capitalism. Unfortunately for the world, most Americans saw the fall of communism as vindication of the righteousness of pure capitalism. The world never got a chance to see a more practical, centrist approach to economics that exists somewhere in the middle BETWEEN those two extremes. Ronald Reagan, the president at the time, believed in 'trickle-down' economics, where the 'haves' given their heads would create wealth and opportunities to be shared with the 'have-nots'.
Ri-ight!
So, now the haves, who've perennially bemoaned big government regulation and intervention in their affairs, have been bailed out by - guess who? Big government! But they are not yet quite ready to extend credit or loans to the have-nots, or even the investments required to create jobs. Never mind the enormous spreads between their cost of money and the interest they're already charging borrowers for things like credit cards.
And so, the 'freedom' to pursue those riches unfettered by any obligating 'common goals', such as health care for all, is still the holy grail for many Americans.
Americans don't even have the sense know that they're no longer competitive in the world market precisely because of the inclusion cost of things like health care in the pricing of American goods and services. Businesses in most competing countries don't have to factor that into the costs of their goods!
But no! We can't have the economic pendulum swinging back away from capitalism toward that other dreaded extreme, now can we?
It's too bad that so much energy has to be spent just convincing Americans of the need for, and benefits of universal health care that there's no stomach left for tackling the more challenging issues around financing it and reducing costs.
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This comment was removed because the moderators found it broke the House Rules.
The specific reasons that healthcare professionals in the US are often against the Public Option is because they don't solve either of the problem the author mentions. In the USA, we have long associated Socialism with increasing costs, and have no counter example in our government programs as you may have in the UK or France or the Netherlands. The new healthcare legislation is fiscally on-par with past inflationary federal programs. In other words I'm not against this because "socialism is bad", I'm against it because it is introducing the worst features of socialism into an already bad system.
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169. At 9:41pm on 09 Nov 2009, RalphG wrote:
"Senator Lieberman has received large contributions from the insurance industry, and his wife has been employed in the pharmaceutical industry as a lobbyist. We hope that he will reconsider based on what is right and not follow the money!"
As I understand it, a majority of Senator Lieberman's constituents (note: constituents not merely those who voted for him) support the very aspect of the bill his 'conscience' tells him to oppose. Voting against the desires of the constituents he represents does not apparently give his conscience the slightest twitch.
If this is 'representative government' what, or who, exactly is he representing? This is not an issue of morality and conscience, as it would be were he say, a Quaker, and asked to vote for a war. Surely, the proper course is to abstain, not oppose, if we are to allow at all--other than those few occasions when personal moral scruples exist and which voters should have already taken into account--that an individual should (as an elected representative) put his own values before those of his constituents.
If an elected politician is exercising his 'conscience' on behalf of an industry without a vote, then why should he actually be allowed to vote at all if he is influenced more by payments than by his constituents? Should voters have to club together to offer a more substantial honorarium than, say, for the sake of argument, an insurance industry paid to get what they might reasonably expect by simply having voted?
Purely hypothetically, if 60 per cent (more than 1.2 million, I think) of an electorate support the public option, and an elected representative's conscience is influenced, equally hypothetically, by 2 million dollars' worth of campaign contributions, then three dollars from each should restore the proper balance back to the electors. That's the logical conclusion.
It also seems reasonably cheap, merely the price of a couple of hamburger meals, I dare say. Not much of a financial sacrifice for the greater good even in these hard times.
Equally hypothetically, were an elected senator to be influenced by, say, 2 million dollars of contributions from the supporters of a foreign country and advocates of its policies, then, should the supporters of another wish to influence a tender conscience, then they also know how much to raise.
I'm quite taken with the possibilities. Why bother with ballot papers? Why not, at election time, just ask people to put dollars in, and whichever candidate gets most at the end of the day wins? If dollars, not votes, ensure fidelity, this seems an obvious and effective electoral reform. Perhaps voters could even demand their money back if disappointed?
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173. At 10:45pm on 09 Nov 2009, MagicKirin wrote:
"I googled that claim it is from unrelliable sources or in the case of Rachel Maddow a liar. The other sources were the Daily Kos and the Huffington Post.
So untill I see a relliable source. . ."
Since I've involved myself in this, and I should have anticipated this sort of objection, my source is opensecrets.org, which appears to be trustworthy; certainly individual financial credits and incomes gathered together in its compiled tables can be verified elsewhere if you care to take the time and trouble.
(Even a partisan supporting Mr Liebermann on Politico on the fifth of November used figures exactly the same as theirs, albeit rather selectively, shall we say, so I would think that enhances the trustworthiness of that source.)
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The common theme of these posts, and the debate in general, seems to me to be cost. As an Australian, the last thing that would occur to me if got ill would be the cost. Maybe the cost of taking a few or more days off work but never the cost of the care. How do you put a cost on care?
I have learned a couple of things from reading the posts, the most surprising thing is perhaps the individualist nature of American society. It is famed to be individualistic but it still surprises me that it was not diluted by the emigration from, generally, collectivist societies. One would imagine a far more moderate viewpoint. Secondly, I seem to associate the right wing in America with Christianity. I seem to recall the Bible exhorting us to care for our neighbour, to look after the sick and the poor. The parable of the Samaritan rings a bell. And yet, the very opposite is being claimed by a number of posters here. "Why should I be responsible for someone else falling ill?" was a memorable post. That I do not understand.
However, the point made about how good the US system is until your illness, or your children's illness, sucks all the money out of your account remains the best one for me: why not add the worry of losing your house and possessions to the worry about whether your child will survive?
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174. At 10:49pm on 09 Nov 2009, Jay from the USA wrote:
"In the USA, we have long associated Socialism with increasing costs, and have no counter example in our government programs as you may have in the UK or France or the Netherlands."
But you do, don't you? Don't you still have state or municipally-owned and run water utilities, for example? Public transport systems? And state and locally owned and managed schools? Ditto fire brigades and police services? (As we do in the UK in the case of the latter to some degree, which is not the case in France, for example, where they are national entities and effectively part of the armed forces.) Isn't that a kind of socialism for the common good?
I've never quite grasped why these never figure in these arguments. Have the costs of these services run massively out of control everywhere as a result? Or have all become unaffordable to their users? They seem, from what I am told, often in many places to be run with great parsimony--not to say meanness--on the contrary.
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To me, this talk of socialism, death panels, etc, is all completely misleading. For that matter, even the argument of health care being expensive is a bit of a red herring. People will charge what the market will bear, so instead of asking why the insurance companies charge so much, it would be more correct to ask why they can afford do.
But even that is a side issue, really. If, as is often claimed, 75-90% of Americans are having trouble paying for decent healthcare (depending on who is doing the citing) then 75-90% of Americans are placing the country at direct risk from diseases like H1N1. 75-90% of Americans are costing their employers and their country money by not having the money to take care of illnesses or injuries before they become a problem. 75-90% of Americans are at extremely high risk if swine flu mutates to become as deadly as the 1918 Spanish Flu or the more modern example of SARS.
Ultimately, this goes back to the argument of the Industrial Revolution that Robert Owen (founder of Owen's College, now the University of Manchester) was involved in. Back then, giving the poor education was seen as socializing it. Mill workers didn't need to know anything! In the end, it turned out that spending money on education and welfare actually boosted profits. Which is why Britain's industry (a relatively well-educated workforce) dominated for so long. It's also likely why Japan is overtaking America today - an intelligent workforce will always surpass human donkeys.
Paying now to profit later clearly does work. It pays to have a huge number of Americans physically (and mentally) healthy. They can do more, be more, longer and harder than any sick population could ever achieve, no matter how hard you crack the whip. Healthy Americans can figure out more efficient ways to do things, those who are really too ill to work but have to aren't going to care.
Yes, there's diminishing returns. You can't keep piling on resources and getting your money's worth. Then it becomes a moral and ethical issue as to what you do next. But America's nowhere near that point. And if there's something immoral about a "death panel", I'd hardly call letting the base on which American civilization rests to rot "moral". What insanity leads a person to think that just by ignoring 200,000,000 or so people, their early and completely pointless deaths are any less a decision? Deciding to ignore is still deciding. Choosing not to give health coverage is still a choice. But instead of a death panel of doctors making one or two difficult decisions, we now have a death panel of Senators making over two hundred million choices. This is better? On what planet?
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176
This is extremely irritating.
By rather inattetentive cutting and pasting I see I have inadvertently repeated what may be a libel. I make no claim whatsoever as to the veracity or otherwise of Rachel Maddow nor any imputation of her professional integrity, nor do I either endorse or agree with the quoted statement.
And, BBC mods, you might have seen that first time round and saved me the embarrassment.
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There's quite a bit of banter about whether Federal Gov has the authority to implement or drive private sector industry.
I hear that. There is an understandable precedent that must be considered as we allow Federal Gov to move in this direction.
Well - My Two Cents:
I was raised in the land between DC and Richmond, where we often debated State v. Federal power. It was as tough a discussion then as it is now.
-- Personally, I think that Federal Gov is VERY useful for managing specific areas in order to protect the overall health and welfare of all people, across all states. The FDA is a good example. Civil Rights are another example. Banking oversight was a good example of useful federal management that worked until it was relaxed.
THIS IS IMPORTANT:
Providing the opportunity for adequate health care is just as important to public health as the FDA.
What does it matter if our Gov tells us what drugs are safe, if we can't afford to take them because of a feudalistic insurance program?
sigh...
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#162. LAW12193: "I was in Britain this summer and the headline was the consideration of a law that would require Brits to pay 20,000 pounds upon retirement to the government for healthcare. I could not believe what I was reading but then I remembered I was in Europe where people believe Govt. should take care of them."
You don't have the full story. Under the law as it stands, all those who require long-term health care are to have it provided by the NHS. This was upheld by the High Court in the case of Coughlan -v- North and East Devon Health Authority in July 1999. It is commonly known as "the Coughlan Judgment". It's too complicated to retell here, but those whose primary need is a health need must be funded by the NHS: simply being old doesn't qualify. Subsequently, in response to four complaints to the Health Service Ombudsman, this was again upheld and the authorities concerned eventually paid the estates of the complainants (who had died in the interim) the amounts they had paid out (with interest) for care homes and the like. The present government and its Department of Health have grappled with the increasing costs of long-term care and carried out a consultation with regard to eligibility criteria and which became the National Framework, the standard for determining whether funding should be provided. Sadly, in the majority of cases it has been denied and patients (e.g., dementia sufferers) have been obliged to sell their home whereas those with terminal cancer or are in a permanent vegetative state do not. There has been widespread dissatisfaction with the way the Framework has been implemented because it is so easy to mark a patient down and thus disqualify them from funding.
The payment of a lump sum would guarantee that a patient would receive fully-funded NHS healthcare for the rest of their lives, a vast difference to the present manner in which care is determined. Americans do not understand that not all health care is provided free at the point of need - and the elderly have had a particularly bad time. The former prime minister and his colleagues promised to make the lot of the elderly a better one, but failed to keep the promises made in their manifesto published in 1997. (Not surprisingly, given their earlier undertaking, a similar promise to hold a referendum on the Lisbon Treaty evaporated as well.)
It is not a case of "believing that the government should take care of them" but the result of legislation passed in 1946 which guaranteed health care as a right of the British people. It was in response to the Beveridge Report which suggested ways to counter the five Giant Evils of illness, ignorance, disease, squalor and want. As now in America, the people wanted to change the system which had prevailed until after WWII. Because the parliamentary British system ensures that MPs vote the party line, the measures were passed despite opposition from the Conservative Party and the medical profession. Half-a-century later, the world, including Great Britain, is far different from what it was in the 1930s and the British government is attempting to streamline the NHS system. By ensuring that it receives an income stream, this is for the NHS a better arrangement than at present. Whether it would find acceptance by the courts is another matter.
Incidentally, it must be remembered that healthcare is considered to be just as much a right as education, a point overlooked by American critics.
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A proposal on health care:
Make health insurance mandatory and non-employer based. Each individual will acquire his/her policy from a private company of their choice. The cost of health care will be tax deductible and/or the Government will simply write a check to cover the expense if you're unable to make a quarterly premium payment.
By doing this everyone will be covered and reimbursed for their cost, your coverage is transportable, health care will remain a private industry except as regulated, corporations would not have health care costs which would improve competition and workers salaries, no need to fear government control, and the government will not be burdened with administering an industry they're unqualified to run.
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179. At 00:16am on 10 Nov 2009, imipak wrote:
"Paying now to profit later clearly does work. It pays to have a huge number of Americans physically (and mentally) healthy. They can do more, be more, longer and harder than any sick population could ever achieve, no matter how hard you crack the whip."
I think why some of us get so mystified by the seeming inability in some quarters to accept what we think of as self-evident is we don't recognise a kind of American Malthusianism that must derive from being a country primarily populated by immigration ( (voluntary or involuntary) over most of its formal existence as a political entity. Simply, if you can replace labour (dead or incapacitated) by yet more immigration, almost perpetually, why should preserving the health and abilities of the existing population at any one time matter? It's of no economic importance, if replacements are always readily available.
Of course, you create a perpetual (though varying) underclass with all the tensions that can imply, and you can see those too in the way immigration, Hispanics and "illegal aliens"--and all the latter and clearly some of the former are being specifically excluded as an underclass-- have become a part of this whole healthcare debate this year.
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183. At 00:50am on 10 Nov 2009, rodidog wrote:
A proposal on health care
In other words, the system that operates in many European countries. Which no-one in Congress appears to have paid much attention to. Or if they did appeared to think was too radical and dismissed. And which so many of us think ought to have been looked at seriously eight or nine months ago. Too late now.
Maybe that's for the next US Health Bill in another 75 years or so. By which time, of course, the Europeans may well have come up with something better. Or different, anyway, since they are all already looking towards the population, health and finance implications of maintaining universal health care to the middle and end of this century with somewhat furrowed brows. And have been for a good decade in fact.
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#185 squirrellist,
I'm not sure my proposal is similar to other European models. My proposal is based on the fact that government would not be involved in health care beyond regulations which already exist. What the government would do is make "private" health insurance mandatory and the cost of insurance tax deductible. If this already exist in Europe, let me know. I would be interested in reading up on it.
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177 Richard
"I have learned a couple of things from reading the posts, the most surprising thing is perhaps the individualist nature of American society. It is famed to be individualistic but it still surprises me that it was not diluted by the emigration from, generally, collectivist societies. One would imagine a far more moderate viewpoint."
Please, do not make the same mistake that many on both sides of the American health care debate, and overgeneralize. In fact, almost all polls show that a majority are in favor of some kind of government health care program. I'd suspect that even more would favor it if there weren't (legitimate) concerns about our national financial situation.
American society is just to broad to make sweeping categorizations like this one. Large numbers support either extreme, and most would probably range somewhere in the middle.
Many in America's self-conception of us as a society, for better or worse, doesn't allow even consideration of the idea that the government is an instrument of the people, for the people, by the people. One of the most basic tenets of our founding, and it has been lost for who knows what reason- perhaps in the long perceived crusade against Communism, which used similar language. It's a substantial danger for any democracy when a substantial number of citizens start to see government as something apart, something foreign and enemy to their beliefs. If the government is a direct expression of the people, and the people do not trust the government, then whence democracy?
I just don't buy it. People in Europe and elsewhere have had socialized medicine, education, etc. for nigh on half a century or more, and still retain the same basic rights and democratic freedoms that the U.S. does, and remain competitive economically.
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187 Via-Media
I guess the first thing that is different is the concept of the "nanny state", perhaps even the concept of the nanny? Over millennia, Europe has grown up with the idea of Feudal lords, absolute monarchies, etc., and the concept of having someone or something looking over you and protecting you is ingrained. America was born with the concept that the nanny was wrong, authority was wrong and should be distrusted. Australia had a different birth and we inherited the concept of a nanny state without the millennia of feudal lords before it; but then maybe we are more conscious of our roots?
Without generalising though, America is the most individualistic society on Earth, which is surprising because your population and ours came from roughly similar backgrounds. Me? I'd live without the guns and with the health care!
As far as the relative economies go, you are right, it can be surprising that other countries are as successful. But look at any number of places that don't have democracy and the people are still happy!! Someone above mentioned that the US is constantly a laughing stock to the other OECD countries. I am not sure that that is fair, but people don't yearn to move to America in the same way that they used to. It really needs to reinvent and "re-brand" itself. Comments like the one quoted (Why should I care if someone else is sick?) are really old-brand America.
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I get a kick out of all the comments about "socialized medicine" and "government-run" programs. I guess Medicare and Medicaid must not qualify as socialist programs, sort of like the way Fannie Mae and Freddie Mac didn't. One has to assume that the people who view the public option as something new have been hiding in a cave somewhere for the last 40 years.
It should be noted that the top 3 items in the discretionary budget are defense, DHHS budget (including Medicare/Medicaid), and interest payments on the debt. Fully 45% of the US population owes their living directly or indirectly to federal spending. Eisenhower's "defense industrial complex" is now familiar to most people, but federal subsidies have also built the monster pharmaceutical industry we have today - a "private" evil in many ways beyond any government control.
That said, comparing public health care in Europe to the same alternative in the US simply isn't valid at face value. The US has an ignominious history of grossly mismanaged public expenditures - including corruption that could make a Nigerian bureaucrat blush. "Europeans can do it, therefore we can" could be a blithe recipe for a new disaster.
Via-Media makes another amusing point:
"If the government is a direct expression of the people, and the people do not trust the government, then whence democracy?"
You're right - the US government is a direct expression of my desire to see General Motors, Lehman Brothers, Citibank, B of A, and a bunch of other big companies succeed at any cost. They are indeed "too big to fail" and the rest of us are simply too small to matter. Get real.
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150. squirrellist:
"What is good for one state or group of constituents may not be good for another."
But in terms of health care, it must be. A carcinoma in California isn't different to one in Colorado.
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I wasn't talking about specific medical treatments, which also vary, I believe, by state to some extent. I was referring to the differing needs of each state and, thus, their competing interests. They have different industries, geography, demographics, even cultures. Elected officials will work to meet the specific needs of their states. Farming legislation is one example. Financial regulations another. Other than sharing a "D" or "R", they all compete against each other for dollars.
Governors have to actually manage to a budget and balance the competing interests within their own borders, which gives them experience that doesn't necessarily exist in Congress. I think they're the only ones capable of actual reform.
As for your carcinoma comment, I'd not expect treatment to be uniform across the US. Where, then, would the newer protocols be discovered?
Also, people in the midwest may respond differently to chemo than those in the northeast because of their different lifestyles and cultures. I'd hope an oncologist would figure out how to maximize treatment based on his audience.
The variation in prices is crazy, though. Some providers (ex., hospitals and doctors) are able to get a lot more money out of insurance companies than others. They mustn't have many insurers negotiating for their services, which allows them to charge more. Other than cutting payments to providers across the board, I don't think dems have addressed this aspect of costs.
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187. Via-Media: "It's a substantial danger for any democracy when a substantial number of citizens start to see government as something apart, something foreign and enemy to their beliefs. "
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Yes, but don't Americans trust their own elected officials while being suspicious of all the others? Just like with their doctors.
When the elected officials behave like kids in a candy shop, it's wise to question them. Likewise, when they watch out for certain interests over others, one would have to be crazy not to question them.
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188 Richard
You point out one of the basic, fundamental flaws in the anti-government rhetoric: we set up our own government, and we can't trust the government, so "we have met the enemy, and he is us."
How about another, formerly in-favor Republican maxim: "trust, but verify?" Build systems that have safeguards and protections, protect the independence of the press, fight the imperial presidency- and look out for the General Welfare? Teddy Roosevelt was a Republican, and the Muckrakers independent journalists... It's quite possible to have government for the people, and to guard against abuse, too.
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189 David
I think you might have missed my point. My comment about government being the direct expression of the people was directed at the premise of the anti-government crowd that big government is in and of itself, by it's very nature, something to be feared and hated.
But, in a more philosophical sense, maybe we do get the government we deserve, at least as a purported democracy. If we do not care enough about education to train children in civics and history and social responsibility, if we make it so that politics is boring, and most people are apathetic about what happens in the county seat, or Harrisburg, or Washington, DC- should we be surprised if vested interests creep in with the lure of money to influence our elected representatives' votes?
If we as a society are that disinterested in what happens in politics, do we even have a right to object if things go awry?
If we are so uneducated and politically illiterate as to be swayed by demagogues speechifying with catchy soundbites and easy-to-remember slogans (never mind if they're true,) do we not get the political system we deserve?
In all of this I find at least one point upon which I can agree with the wingnuts on both sides: we simply have to care, have to watch what is happening, have to use our minds, and have to share our voices.
And, with that bit of optimism, I'm off.
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When the present system can be all inclusive for the same people who are not presently included and they want to nix it, there is one big reason why.
The accounts of health care falling directly under government rules and the same while not necessarily being all funded is a paradox. \
One example of how this and some previous governments account for federal workers on one platform and regular tax paying folk is clear.
While any funding (including the health care bill funding) can be tapped for any reason at all and used for almost any idiotic purpose, we don't get that option.
The funding for defense of this country seems quite self explanatory at a glance and yet John Kerry can not only use it or appropriate from it toward the Kennedy Institute but He can do it even before we reach next year. This and much more which is designated for defense. So what happens If and when we do finally have no real money? I know that we know that, but somehow they don't know it? When we have a water, oil, gas or other emergencies, we are told to conserve and what do they do? Hey we are the feds those rules don't apply to us! If this care bill is good for the US, I really do not know, what I do know is that it is staring off quite a few billion dollars short. Yet we are told that the science and calculation that our leaders have, surpasses all credible and logical understanding of of even our best mathematicians(except for the ones working with the bill). I have seen magicians make an Island disappear and do levitating tricks and know we will all see Obamagic. Hey Bullwinkle, watch me pull a rabbit out of my hat, OH, well, close enough Rocky. (short from a cartoon)
My buddy Chavez is gearing up for war and Iran is trying to punish the US by holding on to 3 stray Americans. If all this killing at home and within our military and allies continues, especially at the rate it has been going, we are all going to have to volunteer, without pay. I am glad I can take my mind out of war just to rant on health care. Listen folks If I offended anyone here, well you don't have my address anyway so Pheeeww! I'm probably safe. If I should get sick though, I'll let them know a month in advance just to be sure i'm covered. Anyway I said what I believe is true and you want to verify some of this and more, look in the New York Post page 19 (too much pork in the D.C. diet) Nov, 9 2009. But we knew from before that, that was the case.
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President Obama promised us a well reasoned plan that would provide a uniquely American solution to America's health care financing problem. Instead what we got from the House of Representatives was a 2000 page manifesto that nobody had a chance to even read let alone study and understand. It was thrown together at the last minute by poltical hackery. It's hard to believe it will pass in the Senate, it nearly didn't pass in the House. But even if it becomes law, it's hard to see how it will survive a constitutiional test in the courts. It is one thing to require you to buy car insurance if you choose to own and drive a car, to buy a dog license if you choose to own a dog. But how can it be constitutional to fine you if you don't buy medical insurance?
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193 Via-Media
maybe we do get the government we deserve
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Wasn't the whole point of Obama coming in that he was/is a fresh breath, untainted by the whole corrupt system, that here at last was a politician worthy of America? Or am I just being naive and foreign?
Perhaps the dictator idea was a good one.
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We started off by having great scientific discoveries which would allow people to live longer and healthier and apparently succeeded.
Now since it worked too good we want to tell them that they should not complain because that's all they get. When you get a script and one that the doctor wrote you (who would still be laughing as soon as you left) and the pharmacist looks at you kind of weird like, and says to you, sorry but you need to have this pre approved by the insurance company, and you call them, they say that item is not covered unless your life depends on it, then you go back to the doc and he tries to keep a straight face and looks like he is worried about you, but not really because he knew it already. Then you ask what can we do and that is when he tells you to come back next week and we will see! If you are still alive by then...
Try to get a copy of the bill your senator stuck you with during yesterdays lunch and bring it to the pharmacy and ask why they can have lunch that costs more than your monthly rent and you can't get a script filled.
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One more thing about other countries having their socialized medicine doing good. If that is true then good for them, however those countries are not spending gazillions of tax dollars waging wars the way the United States of America is doing.That would be at least the one reason which leaves money left over for paying health costs. Assuming the government workers are not taking luxury trips or spending money without concern for the people, this same system would work anywhere. The people who enjoy the benefit of working with our government have very little regard for anyone else but themselves, making some exceptions of course. Yes they earn a degree and yes they campaign and another yes they get elected or appointed, but once they do, the I'm all set mentality takes over and when that fails, they have to do what they see the others doing. During the Clinton administration, there was so much money available in the government that when Bush came into Office, it disappeared quickly and thereafter things rolled down like S_it. If we didn't like war so much we could afford health care from east to west.
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libertarian: I also am from Chicago. In your great Social awareness, have you noticed, the tremendous amount of foreclosures in the chicago, Cook County, Real Estate Market? DID not the Congress and Senate step in and extended first time home buyers credits of $6000.00 per buyer? And recently renewed this. AS you say, this should have occurred at the State level, like Federally mandated Health Insurance. Of course you are very astute, and realize that like most states except for two are in debt! Illinois has over $ 2.9 billion in debt. Your easy solution that if the state wants health insurance for all in Illinois fine! By the way how will they pay for it? And is it not unconstitutional, per your perspective for the Fed to fund Home buyers? In addition, statistical analysis shows, that by the end of 2011, 68% off all mortgages in Illinois, will be worth significantly less than what is owed, or "under-water". With job losses increasing, a high % will go into default, or people will simply walk away. Than God that Constitutionally our Government, has no obligation to help State subsidize Homeless shelters, yet they do it anyway, ILLEGALLY! And they are Also ILLEGALLY using your and my money to fund first time home buyers! Also thank God the Constitution provided for All of our Elected reresentatives to receive the best Health Care in America, or DID IT? Or did they vote Socialized Health Care for themselves, paid by all Americans out of our Tax dollars? This I find confusing, maybe I am an Idiot, and do not realize, that they truly care, that all Americans, have the same Health Care they do? But then why so much debate, anger and division? Am I missing something? I think not! I think the have will never truly care about the have nots until they lose what they have! Our founding Fathers did not have federally payed for Health care. The first President George Washington, at the time, was the most wealthy individual in America, married into the Tree family via his very wealthy wife. President Thomas Jefferson was a very wealthy Plantation and slave owner. Only John Adams, was of meager means, and yet his son also went on to become President. Their were no lobbyists, Pac groups, pac committees. The Executive Branch was much stronger than the watered down powerless version it is today. Special interest groups, ETC: have corrupted our Founding Fathers versions of what Congress and the senate would be, simply a set of check and balances to prevent, the possibility of a dictatorship. Not a complete grid-lock to any kind of substantial progress. I have lived in Chicago for 52 years, the people I know have dedicated their time to improving the city through, Illteracy programs for the poor, college funds for the dis-advantaged, the Salvation Army, the Goodwill, Chicago City Lights, The Chicago American Cancer Society. they did not and do not live in these so-called isolated social bubbles your experience is limited to. The world is as small, or as big as you live it! Out of your Payroll you already pay along with your employer contributions unemployment taxes, do not use this, should you need this, in essence this is Socialistic! Also In your payroll elect, not to pay Social Security, this too is Socialistic! Also in your payroll refuse to pay Medicare, this too is Socialistic!. Tell your employer who is mandated to pay huge premiums for your Work-mans Compensation, to stop this socialistic agenda now! Chicago has Toll-Roads, Stop paying these fees, that are state, with Federal Road Subsidies, and take side streets. Be wary of free Health Screens! Just another Federal or State Socialist Ploy! Stay away from free-vaccination centers, simply, Federal experiments designed to test secret chemical war-fare biological compounds. Watch out for Federal Highways and rest-stops, free public transit, all an excuse for the true red blooded American not to pay his or her own way. Who gave the Fed and the States, the authority to use our tax dollars for such useless nonsense! Federal and State Parks! Who needs them, again a waste of tax payer dollars, why we could sell them to corporations, and get this Country out of Debt!
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I like that post...we can have guns but not healthcare(NO. 107)---
BUT, its because guns are so much cheaper...not meant to be funny..(cuz its not that funny)
So, this IS very unprecedented--
at least since the L B Johnson days ..does anyone else remember that era and the "Great Society?"
Wow, if this thing goes through the Senate, and actually works....what WILL the Republican party do?
(it could bring back "liberalism" in America, and reverse a 4+ decade conservative era...)
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"I don't see how any commercial or political fix can deal with this hard fact."
I do. We have it or we get rid of capitalism. End of story. Now watch capitalism make sure we keep it. Is that clear? Because at the end of the day what is more important!
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#188. Richard: "Comments like the one quoted (Why should I care if someone else is sick?) are really old-brand America."
At the beginning of the public debate, none other than Bill O'Reilly expressed the same opinion. He and many of his viewers would and do agree with the sentiment. Yet he and they have no quarrel about educating the children of others: why should single people pay for children when they have none? It's the same premise, but single people realise that it's for the public good that education be provided. Similarly, it would be for the public good if there were to be universal healthcare.
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The healthcare bill will levy a $15,000 fine or imprison anyone who refuses coverage, period. Its right there in black and white. Yes, despite the Democrats best efforts to keep the public from reading this legislation, we've seen it and know it for what it is - another step toward socialist fascism. What I find unbelievable is how all the devoted liberals who back everything Obama's team is doing behind closed doors, in full defiance of constitutional authority, were the same people marching and foaming at the mouth when Bush was doing almost the exact same thing. Anyone who supports the anti-American gangsters currently occupying the White House aren't merely useful idiots - they are traitors to their country. And believe me, those of us standing up for freedom will remember who they are.
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Well, Im not going to address the above comment..203, will someone else tell him about Big Lies ..as a sign of extreme fringe thinking, quickly, ....now?
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This comment was removed because the moderators found it broke the House Rules.
There have been a few comments how the U.S. ranks between 13th to 36th in various social measures. True ... until you get to age 65. The social health measures of those over age 65 in the U.S. rank among the best in the world. That's because after age 65 US citizens get access to the U.S. universal health care program called Medicare.
Cost control is imperative. There is an innovative example of a way out of the cost problem. Following WW I, the U.S. government forced Marconi to give up its U.S. radio patents, and the other U.S. radio patents were consolidated, (often bought out), under RCA. One of the spoils of victory was that the German radio patents were freely available and were also used by RCA. RCA then turned around and, using very generous licensing agreements, licensed their technology patents to anyone who wanted to manufacture with them. U.S. radio industry flourished and there was an immense amount of innovation.
No, no one is manufacturing with medications. However, the RCA business example is probably the way toward cost-effective basic medicine for everyone: a pool of government controlled patents held and generously licensed by a private company for sales. The key phrase is basic medicine. This does not include multi-thousand dollar cancer treatments that extend life for six weeks. My point is not to give a plan here but to point to the moment in history when the chaotic, distorted and stymied radio business in the U.S. was set right through a seemingly non-capitalism technique.
When I was eight years old, I developed pneumonia. It was misdiagnosed at first. By the time another doctor was called, my lungs were filling with fluid, I had a raging fever and shivering so badly I could hardly take a breath, my back and chest ached and I didn't want to breathe it caused my body to be racked so badly with coughing. By the time the doctor arrived, I was sitting at the kitchen table in my pajamas, gripping the edge of the table, staring out the kitchen window trying to take another breath. I was immediately wrapped in blankets, driven to the hospital and after a lot of commotion, went to sleep in an oxygen tent and awoke with tubes in me. My bottom soon ached from all the penicillin jabs but within two or three days I began feel aware of what was going on around me.
I owe my life to that British discovery, penicillin. At the time it saved my life, penicillin cost about thirty cents a dose. I have no doubt if it had been necessary, my mother and father would have put our house up for sale to raise the money to save my life. It wasn't necessary, though. Nobody was charging that kind of money.
The United States, in terms of medicine, was still operating by an ethic of social and community responsibility, (that grew out of the first medical miracle, public health), instead of free market capitalism.
My father also had what was then called major medical insurance that covered my entire hospital stay which lasted about two weeks. My father doesn't recall what he was paying for it but he said a) it was small enough he didn't miss it and b) his father had insisted he buy a major medical policy. After my pneumonia, he needed no further urging.
Free market capitalism is really a deceptive name to justify the lawless "state of nature." It is totally inappropriate for medicine in an ethical society. As Thomas Hobbes pointed out in his "Leviathan" of 1651, the core responsibility of any government is to provide security. This is easily extrapolated to both health and to refereeing the economic system so it is not dominated solely by ogres of greed.
The experiment needs to end. Governments cannot unleash the scourge of free market capitalism in health care. We used to have a community ethic. We still have our ability to innovate. We have business models from the past and we have the example of Medicare's success. The British have shown the way twice, once with how they handed penicillin over to the world and once with national health care that works. Maybe the U.S. contribution will be innovative methods to keep medical costs truly affordable so all future adults and youngsters have access to life-saving medicine as I once received. Jumper
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What a great writer, no. 206 is...are you a professional writer, Mr. Global Jumper?...I don't know whether I agree with you (I do) or am I just hypnotized by your words?
Oh well...
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ref #176
I went to your source Open Secreats the cover page only seems to attack opponents of Obama and republicans sorry does not pass muster
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Post 206. Global Jumper.
Interesting & informative.
Thanks.
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202 David_Cunard
Sorry, I don't have any idea who Bill O'Reilly is? He is not a household name here in Australia...
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203 psycros
Just an observation: Whenever Republicans are in power, they govern: things go well all is good, things go not so well it is never their problem. When the republicans are out of power, they turn into - it seems to an outsider - a raving bunch of jealous, vicious, scratch-your-eyes-out mob of bitter losers. I cannot recall the republicans being gracious or supportive in opposition.
Maybe that is just the way the news is portrayed abroad, but certainly it is borne out by comments like psycros'. I can't recall seeing similar invective from a democrat.
"And believe me, those of us standing up for freedom will remember who they are." I mean, what is that all about??? Anyone have memories of Mississippi burning?
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85. Interestedforeigner:
AndreaNY: Are you on contract to monitor and post on this blog?
AndreaNY: If you are being paid, by whom are you being paid to post here?
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Could you possibly be this ignorant?
This became an echo chamber. It's refreshing to see more diversity in the views. For you to suggest that posters with opposing viewpoints are somehow suspect tells me that you have little understanding of the range of viewpoints that exists.
You need to broaden your knowledge base. Really.
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177. "Why should I be responsible for someone else falling ill?" was a memorable post. That I do not understand.
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A libertarian mindset takes some getting used to. I like the website "Reason.com". It's another world. The comments are hilarious. Very sharp.
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204. stellarBeloved: "Well, Im not going to address the above comment..203, will someone else tell him about Big Lies ..as a sign of extreme fringe thinking, quickly, ....now?"
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Pelosi's bill doesn't shield citizens from criminal penalties. Are you familiar with the exact penalties and for what behavior they will be imposed?
Perhaps you could justify your implying that psycros is a liar.
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1/3 of workers in the US get no sick pay.
Most service industry.
1.5 million vets get NO coverage.
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#210. Richard: "Sorry, I don't have any idea who Bill O'Reilly is? He is not a household name here in Australia..."
Aren't you fortunate! If what you write is true, then I'm surprised since the channel on which he appears is owned by your own Rupert Murdoch and who owns many media outlets in Australia. O'Reilly claims to be an independent voice but most people view him as a kind of broadcasting Pauline Hanson.
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#213. AndreaNY: "Pelosi's bill doesn't shield citizens from criminal penalties."
Shouldn't that be civil penalties?
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David (#189), debt service is not "discretionary." Neither are Medicare and Medicaid. These are "entitlements."
Discretionary Budget
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ref #202
I am surprised you are quoting O'rielly. But as you are; you may want to listen to his entire view on the debate.
He believes there should be reform, but that it should be open and explained how it should be paid. He also lays most of the problems at Nancy Pelosi and Harry Reid for shutting outthe Blue dogs and the Republicans
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216. David_Cunard:
#213. AndreaNY: "Pelosi's bill doesn't shield citizens from criminal penalties."
Shouldn't that be civil penalties?
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Both. Through the Tax Code, I think. Hard to ascertain at this point.
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215 David_Cunard
Aren't you fortunate! If what you write is true, then I'm surprised since the channel on which he appears is owned by your own Rupert Murdoch and who owns many media outlets in Australia. O'Reilly claims to be an independent voice but most people view him as a kind of broadcasting Pauline Hanson.
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I think we regard Rupert Murdoch as a very successful export. No, really, you're very welcome!
Bill O'Reilly certainly hasn't made it down here, but if he's the same as Pauline Hanson then he would tend to concentrate on stopping the immigrants coming into America. Hanson only sung one tune, although it was pretty nasty.
We don't have anything like the Fox network over here. ABC (as in Australian Broadcasting Corporation) and SBS provide hard news and the other channels cover the fete openings and weather. But we don't have either politics or religion here, so there's nothing much to talk about. The commercial channels really don't discuss much. They'll expose a con artist from time to time and get upset when a foreigner insults one of our women. But apart from that it is all sport - Aussie rules, league, union, cricket of course, swimming, etc.
And beer.
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This bill does allow anti trust laws to be applied to the insurance industry and the medical mal practice industry .
GREAT NEWS.
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221. At 4:17pm on 10 Nov 2009, fluffytale wrote:
This bill does allow anti trust laws to be applied to the insurance industry and the medical mal practice industry .
GREAT NEWS.
And meanwhile, as anyone with a little common sense and even less cynicism about the profit motive could have predicted, the price is going up.
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#222 Squirrellist
What these health insurance companies are doing reminds me of a certain country that likes to 'create facts on the ground' when they eventually start to negotiate!
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The entire problem with the current health care system rests with the greedy, callous for-profit insurance companies. My representative (Democrat) voted for this bill as "better than nothing and a step in the right direction." No. You do not get where you need to go by wasting all your time, energy and money on heading in the wrong direction. I will be supporting his Progressive challenger in next year's election.
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223. dceilar
Exactly, the similarities between certain styles of capitalism and the practice of certain states have struck me in the past, but let us hope your reference is elliptical enough not to attract Puff the Magic Dragon. . .
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First step is a warning, second a fine, third after continued disregard, a crime. Some would leave criminals to the sharks and sea monsters. The bleeding hearts stop hemorrhaging when it is their turn. Obama a racist, and O'Reilly a saint. Lou Dobbs a reasonable person, Rachel Maddow a nut and so and so. We tell children to respect others and show them how not to.
I am going to be really surprised if all this mess turns into something positive. Cutting costs is the function of those who are already living right on the edge of poverty. Spending is our wonderful leaders jobs. did i forget Glenn Beck, nope, He is a face and epitome of clowndome, Spewing sulfur and ashes among other unmentionables. The thing that I feel ok about is that even though I know He is a clown, I check out his rants, and that because without some kind of ridicule and pressure, our immaculate government would feel free to do some of the things he talks about. Voting for change and just plain voting seems to get us nowhere nowadays. Lots of people are realizing this. We may need to go back to square one. The enemy is everywhere, outside, inside and waiting to strike. I feel confident that many feel this way and not just me. Some may feel like they can discharge their belief upon others and that way, kind of instruct them into a renewed perspective and that won't work.
People are more determined today than any other time in a long time.
this because they are tensed and stressed or stressing about our direction. Usually I can get a few people to smile here and there. Lately less so. One co worker asked another, hey, how come you are not smiling, to which she said my husband has cancer so what is there to smile about. Sometimes our good cheer backfires on us. With good health, it is so much easier to smile, even in a bad economy.
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The health care debate is very complicated, so I can understand why some Democrats might decide that they dislike the public option and vote against it. However, I would also expect some Republicans to conclude that the need to expand coverage is so pressing that they will support the legislation as it is. A reasonable speculation is that the Republican leaders are coercing such Senators and Congressmen not to support it. I wonder whether some parts of the public will decide that the Republicans are putting politics ahead of the public health. Will the Republicans have a price to pay for this?
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The part that I find so absurd in this entire debate is that the politicians treat the existing Medicare system for people over 65 years old as a good thing, yet the moment that it is suggested that the exact same system be extended to younger people, it suddenly becomes a tool of Communism and an abomination. How is it at the same time moral to give government medical care to older people who aren't necessarily even retired, and yet not moral to give it to anybody younger, even if they ARE retired? This strikes me as total hypocrisy.
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#228 ijuinkun
This strikes me as total hypocrisy.
Yep! You got that right!
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215. At 3:16pm on 10 Nov 2009, David_Cunard wrote:
#210. Richard: "Sorry, I don't have any idea who Bill O'Reilly is? He is not a household name here in Australia..."
“aren’t you fortunate! If what you write is true, then I'm surprised since the channel on which he appears is owned by your own Rupert Murdoch and who owns many media outlets in Australia. O'Reilly claims to be an independent voice but most people view him as a kind of broadcasting Pauline Hanson.”
Bill O’Reilly is the only one on FOX that even approaches their self-awarded [and at variance with objective truth] title of “fair and balanced.” Then he got so far to the right I couldn’t stand even watching BillO! Now extrapolate how truly right-wing the rest of the FOX “news” team is.
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The big illusion is when ther are only 2 choices for president of the US and is quite the easy thing to conspire and say to one another, ok, you win and let me be in your administration in a high position. Neither one loses and we are the nuts who fight about who should be pres. I don't have the answer, all I can do is think about the questions. One classic example is the Floon campaign. Also look at Hillary Clinton and she wanted to be pres. Now she is working with the pres. Even McCain once in a while agrees with Obama. Anyone here seen the movie the Island? That is us and we want to go to the Island. Except there is no Island. It is a place where they take your body parts and give them to the rich people to allow them to live longer and healthier. So go ahead and join the organ donation foundation. Lies, Lies and then some more Lies. Seek the truth, and when you find it, IT, Shall Set you Free.
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Many have asked, “Why should anyone wish to entrust their health into the hands of the state?”
Why should anyone wish to entrust their health care into the hands of people who would make a profit and get bonuses for denying it?
My insurance company denied essential tests for almost a year, making for the condition becoming more serious and the eventual operation more expensive. And as for my pain and suffering, what's that when compared to profits?
The companies have far more motive to provide overpriced healthcare or none at all because they make their money that way than the government. That also explains why our healthcare in the US is more expensive and inferior.
The cure is, at the very least, tight control on the salaries, bonuses, profits and procedures of the insurance and pharma industries. That might not be as good as a single provider government [but as independent as possible] system, but essential to a reasonably good private care system.
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"I will be supporting his Progressive challenger in next year's election."
Wow I hope he has declared so you know who you are supporting before you endorse them.
Maybe you like throwing votes to the wind.
Not moving fast enough for you. rather the quick imprudent style of GW,, No a "progressive" no matter who they are.
Sound like a libertarian to me.ME ME ME.
The insurance industry is restricted.A bit.But better let NOTHING happen and just complain about details till the cows go home.
"No. You do not get where you need to go by wasting all your time, energy and money on heading in the wrong direction."
Not unless the only path there just happens to not be in a linear straight line directly between A and B.
there is the possibility that the path winds in the wrong direction a few times but ends up where you need to be. But the path that looks like it is heading in the right direction ,isn't. that is the basis of a funtime for some, the Maze.
So "Apparent wrong direction" may be appropriate but "wrong direction" is a little bit jumping the gun.
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The rest of the world has to realize that the US congressman and senators (legislative bodies) do not represent the common people of this country. They, as seen in the health care issue) represent those with big money who contribute heavily to their personal income and election campaigns. Global warming, threats to this country and the world are all fantasies unless they will make money for what President Eisenhower called the military industial complex. Now one can add the insurance and oil industries.
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