one payer health care

[JohnRoberts]

Sadly...so many lives either lost or wrecked for what?  They all died in vain for a bunch of ingrates (No they didnt want anyone there..off key for a moment....does "Lawrence of Arabia ring a bell?" and now the greater Persia will be resurrected }


Can anyone say the word "blowback"??

?

Im so tired of this "bias" kind of thinking thats been going on and just to make a statement in the next elections I will vote for ANY independant to whom has the OPPOSITE points of view and I encourage others that are equally as fed up with the whole dog and pony show.  Both parties at this point benefit off of each other (GOP, winners take all in 2010 and 2012) I cannot be the only flaming Leftie that is aware of this.

Congress is held in lower regard than ......  everybody else.

Also in regards to the free market debate...are we saying that we should go back to the appalling work conditions that existed during the turn of the Industrial Revolution?  Before many evil communist "union thugs" put their lives on the line to make shure society wouldnt go back to serfdom??  Let's ask all those drug dealing migrant workers how much more wonderful life was before people such as Ceasar Chavez spoke out against the horrid work conditions...yes another evil communist.

My free market concern wrt health insurance is lining up the customer with the service provider.  Right now the service provider is paid by the insurance company who is working for the employer. The heath care provider is not working for the patient! The government proposal would make the service provider work for the government, still not working for the patient.

Insurance makes sense for catastrophic health events, and some safety nets support for the destitute, but for the rest of us who aren't destitute or in a coma, we need to be buying our routine healthcare on the open market, and paying for it from our own pocket.
==========

Unions served a purpose once upon a time but IMO have long since evolved into just another bureaucracy trying to insure their own survival and expanding power.

I am not opposed to collective bargaining, its a free country. Management just shouldn't make a promise it can't keep, like detroit's job banks (paying workers to not work), and legacy retirement costs.

Sure I do enjoy debating the issues of politics with you folks on this forum for the conversations never devolve into name calling and slinging horse dunn...I just have my views  and am set in certain ways on them, but one particular question I have thats itching and really looking forward to what answer I'll get is this...

Are there union groups established in the more "high tech/skilled labor" industries??  Correct me if i'm wrong but you will probably have a very difficult time trying find any union employees working for Google, Yahoo, or Altium, e.t.c

Actors, screenwriters, airline pilots, and even computer professionals (in the Philippines  8) )

It seems that if in industries to where there are plenty of union groups that if from the beginning company employers would of started out being paying workers honestly for what they're worth.. these labor unions wouldnt have the influence they have today, mind you living in a "right to work" state my whole life this is just an observation based on BOTH sides of that argument and yes I do apologize if my bias is a bit Left leaning....


I'd like to hear from those to whom are from places like Germany as well so they can tell us if what some of us elsewhere percieve as a "workers utopia" is somewhat accurate or just a bunch of hype

Ask our European friends how easy it is for young people to get a good job, when the companies must hire them for life? 

Oh and in regards to Iraqistan, let's not forget http://www.marxist.com/images/stories/saddam-rumsfeld.jpg
(dont mind the sarcasm and actually I do love Left Wing hypocrisy  more than the hypocrisy that comes from the right incase anyone gives a damn! )

In the past there were many alliances of convenience, where "the enemy of my enemy is my friend (for the moment)". Iran and Iraq were at war at the time IIRC. I believe there is less of that going on now, but there is still a lot of bad behavior that is tolerated to promote mutually beneficial trade relations. The Saudis still subjugate women by western standards and China is far from free, but we have more influence trading with them than not.

JR

 

[JohnRoberts]

Last night on CSPAN they interviewed the administrator of a non-profit hospital to get his POV on the healthcare debate. He made a few interesting points.

Right now he is compensated at approximately 80% of his actual costs for medicare patients. He make up the shortfall by charging other customers more to subsidize these medicare patients. If they expand government coverage to more of the population following a similar formula, he will have to cut back services and new equipment purchases. This is a non-profit hospital, so they have no profit to cut. If everybody stops buying the new equipment, people won't be motivated to design new improved equipment.

He mentioned another cost driver is general lack of living wills and family present in emergency medicine situations where they perform expensive life sustaining procedures because there is nobody saying they don't have to, when in many cases this life extension is just a brief postponement of the inevitable. Another angle on the tort reform/emergency medicine cost driver, when people come into the emergency room they run every test possible instead of selectively testing based on symptoms.

He said the only people who ever ask him what something costs is people without health insurance spending their own money. 

He was not enthusiastic about the government proposal.

JR

 

[Emperor-TK]

1000 page + bill written by lawyers in legal-sleeze so congressmen and public can't decipher but other lawyers can then run with it.

Sounds like the last out-of-network paperwork we had to file to Aetna.  I'm not sure which I'd rather avoid, spending the 8 hours (literally) on the phone trying to get pre-certs for my wife's oncologist (every 6 months) or renewing my license at the old state-run Division of Motor Vehicles.  While I do wish things could be simpler, I don't think that even with a 1000 page bill things are going to be more complicated or more corrupt than the existing system.  If we had the same number of people writing/influencing the healthcare bill as we had writing our constitution, it would probably be a much simpler document. 

Maybe we should have a contest held by the Readers Digest to draft the best healthcare bill.  The top 10 plans get selected for a runoff election,  America votes.  We could franchise it to a reality show, America's Got Healthcare, which is really just a reworked version of a British idea....

 

[sodderboy]

I have been thinking that the bills should only be as many pages as the members of the deliberating body.
Just remember, Emperor, all those Yenta pages are due not to free market forces but to over three decades of federal and state legislation.  And the Yenta in your state has at least half of their rules different from the Yenta in my state.
The solution is not to make it more complicated.  A few layers of guano need to be scraped from the cave.

I received my property tax receipt yesterday and it further proves my layers theory.  Our "township" not only taxes me 10 grand but they get 11 mil from the state, and our school district gets 27 mil from the state.  The Receiver of Taxes will let me know how much we get from the feds.  My point is, why does all that dough have to flow down?  The amount wasted in the machine accounts for at least another 20% more than what we get.  Lower state and federal taxes by 30%, raise local property taxes by 100%, and send a few thousand fat-assed SEIU aparatchiks out to get real jobs. 
The same kind of waste will be even more with providing health care, I mean "competitive choice health insurance" centralized from the feds.  The flow should be more direct- from patient to doctor. 
If people got their full pay and had to buy their own health, unemployment, medicare insurance and pay their own taxes quarterly, we would not be in the mess we are.  But NO.  We have this nanny state where an employer has to play accountant and tax collector for the cities, state, and feds, and the "workers" do not have a clue.
Mike
 

 

[JohnRoberts]

I smell a rat not only in the language of this bill but all bills.. Laws should really be as simple as the constitution. Complexity is added to obscure some alternate agenda.

I had another thought about the customer relationship..  We the voters are the customer to be served by our politicians. We customers are always right. I get the sense that our politicians don't consider us their ultimate boss but the lobbyists and their party leadership.

Yes insurance is screwed up, but replacing it with government insurance will not remove the inherent flaws.

JR

 

[tubejay]

I'm OK with one payer healthcare as long as that one payer is some rich guy from Napa or fairfield county.

JR

Yeah, that's the problem, a lot of people are okay with it as long as they don't have to pay for it.  Unfortunately we will pay in wages, we will pay in jobs lost, we will pay by becoming a slow growth welfare state, and we will pay because our health care will become rationed, lousy, and expensive.  We may not see it in the form of rising premiums, but we will see it in the form of rising taxes, lost jobs, lower wages, and slow growth.

The answer for young people should be Health Savings Accounts, with catastrophic coverage.  My family, which consists of a wife and two kids, have an HSA, and we LOVE it.  I continue to pay the same amount as I was paying for my insurance before switching over, but the difference is that my catastrophic coverage costs about $160 a month, and I have a $1000 per person $4000 max deductible per year, plus we get our free preventative visits every year. 

I was paying $400 a month for a plan that had a $1000 total deductible before I switched to an HSA.  So I'm putting $240 a month into my Health Savings account now.  That's MY money.  That money didn't go to the bottom line of an insurance company, it went into my HSA account, which I can now invest in bonds while it sits there, use to buy glasses or any medical supplies, or use to pay for a catastrophe/the deductible if someone in my family is hurt.

If my family remains relatively healthy, we could very well be sitting on $150,000 to $250,000 by the time my wife and I retire.  What does that money do for us?  Well, it's set aside, tax free, to use when we hit 55 and want to retire.  Now, we'll be able to buy private insurance until medicare kicks in whenever we decide we want to retire.  Why more people don't switch over is mind boggling to me.  It's a much better deal, and it allows you to invest in your medical costs/insurance for when you want to retire.  If you don't do this, you'll either have to continue working until medicare kicks in, or pay through the nose for health insurance when you decide to retire. 

What else does the HSA do for me?  It makes me a buyer.  Meaning, when I go to the doctor, I ask, what does this cost?  Is there a generic cheaper alternative? 

Finally, the government adding a single payer option will slowly destroy private insurance.  Obama himself said it in 07 when he was speaking to a more liberal audience.  If I were kind, I'd say president Obama is merely being coy, but if I were being truthful, I'd say he's lying when he says that you can keep your insurance if you want to.  No no no.  YOU can't.  Your employer can if THEY want to.  However, if your employer decides to pay the perfectly reasonable fee of 7 or 8 percent or whatever, and kick you off your health insurance, THEY are free to do that.  YOU therefore won't have a choice but to go on the government dole and become another welfare case with your hand out, taking money from people who deserve it, because they earned it, to subsidize the government "option". 

Who are these rich people we want to continually rape to pay for all of this nonsense?  Oh yes, they are the small businesses and employers that are the backbone of the economy.  Gee, do you think that if you take more cash from small businesses/employers that there just MIGHT be a chance they may no longer be able to afford to keep you hired?  Maybe not you, but your neighbor.  Every dollar you take out of the private economy is a dollar destroyed, a job lost, or a wage cut.

Government doesn't run ANYTHING efficiently.  Not a thing.  Not even the military.  Yeah, we have the best military in the world, but it also costs a FORTUNE, because the majority of bureaucrats involved are either corrupt or inept.  Either way, it never works like it's supposed to, and they ALWAYS spend all of the money in the good times, and borrow in the bad.  It's a bad deal for everyone.

There are plenty of reforms that I'm all for, but a single payer government run monstrosity makes no sense.  We have all the evidence in the world that governments are terrrrrrrrible at running these things, yet we still want to punch ourselves in the eye repeatedly. 

 

[Emperor-TK]

We have all the evidence in the world that governments are terrrrrrrrible at running these things, yet we still want to punch ourselves in the eye repeatedly. 

I think that is open for debate, and IMHO, that is where the debate should focus.  This isn't the first time anyone has ever implemented a government involved health care system.  There is a large mass of data out there already, no extrapolations are required.  You take The UK, I'll take Germany.  I'll meet you at Medicare.  Let's leave Orwell and Rand out of it.

 

[JohnRoberts]

Unfortunately the public debate of this has been reduced to talking points, or more appropriately "scary points".

Looking at this from the common ground (I hope), we all agree there is room for improvement. Nobody is opposed to reducing cost, or improving the quality of healthcare.

Why is it so important to make such broad sweeping changes all at once? Why not begin by addressing smaller problems first and then build on those successes.

How about passing a law that US citizens shall be allowed to buy drugs at the same cost as citizens of every other country. Unfortunately this may raise prices elsewhere if their low prices don't cover the actual costs when applied here too.

Standardize insurance regulation at the federal level so all the sundry state buracracys aren't needed and we can break up the local insurance monopoly/duopolies.

Rationalize taxation on corporate vs private health insurances.

Properly fund medicare... paying doctors and hospitals less than their costs is not a good long term way to save money and deliver good services.

I believe we can come up with a better way as we have been doing for a couple hundred years in governance. I see no reason to copy other's good but not great systems.

This is important enough that we should be thoughtful and go slow, not Rahm through whatever the extreme wing of one party thinks is right. I am kind of glad that Tom Daschle can't handle his own taxes any better or this may already be law. He was waiting in the sidelines ready to hit the ground running, but blew that momentum when he couldn't pass what should have been a rubber stamp confirmation.

There are many very difficult issues that I don't expect the public to grasp (like rationing) when the politicians aren't even willing to discuss it in anything less than hyperbole. There are actually some profoundly interesting economic calculus involved. There isn't enough gold in the world for all of us to get every procedure possible, the question is do we get some say about our destiny or leave it to others.

I was talking to a young kid at the gym the other day and while he was pretty well informed (and surprisingly conservative) he didn't get the rationing thing.  The way I tried to describe the problem to him is say we both need a new liver/kidney, but there is only one available. I am 60 and he is in his early 20's. Who gets the organ? While that suggests the scope of the problem, I don't feel the answer is leaving such decisions to government bureaucrats. Note: I plan on dying when I run out of money, and since I don't have Steve Jobs money, I need to take good care of myself.

JR

 

[sodderboy]

You take The UK, I'll take Germany.  I'll meet you at Medicare.  Let's leave Orwell and Rand out of it.

Medicare- you mean the program with something over a 50 billion buckarooney unfunded responsibility going out into the future?  And that is with pensioners already paying hundreds a month for Medicare deductible coverage?  Don't fall into the trap.  It is not about your health, it is about their control of it.

UK- where in any country of the kingdom the government spends over 50% of the GDP, and over 70% in Wales?  And a 15% VAT?

Germany, with their 19% VAT.  Can you imagine that on top of whatever taxes you pay now?  That will have me forging my Chinese plowshare into a sabre!

There is a reason, that even though the world is filled with wonderful countries and beautiful people, that a majority of technological innovations, especially in health matters, came from those sweating and straining themselves in the US.  Many who had to leave their home countries to come to the US.

My goal is to have congress pass little more than "Iran is bad" type declarations until the end of 2010, and little more after that unless it is to reverse the binging course of the last 20 years.

Good to have you at the table, Jay!  Next rounds on me everybody.
Mike

 

[SSLtech]

[quote author=JohnRoberts]
Unfortunately the public debate of this has been reduced to talking points, or more appropriately "scary points". [/quote]
Wise words there.

-BOTH sides are using 'fear' to sell their ideas, and -since healthcare industry Lobbyists currently outnumber congressmen by SIX-TO-ONE, it doesn't take a genius to work out that someone is playing defense though.

Of course, I notice more 'fear' being pandered by the AM radio entertainers, but I recognize that it's only natural that I would do so, of course.

[quote author=JohnRoberts]Looking at this from the common ground (I hope), we all agree there is room for improvement. [/quote]

Well, I certainly think so, and I believe that most thinking people would do so.

-I am however rather concerned that the Republican radio is still banging on that "we in the USA have the best healthcare system in the world"... To listen to the message being rammed out of dashboard speakers all across the continent, I fear that many people are swallowing that there is NO need for 'improvement', which is now being re-branded as simply "change".

[quote author=JohnRoberts]I was talking to a young kid at the gym the other day [...] he didn't get the rationing thing.  The way I tried to describe the problem to him is say we both need a new liver/kidney, but there is only one available. I am 60 and he is in his early 20's. Who gets the organ? While that suggests the scope of the problem, I don't feel the answer is leaving such decisions to government bureaucrats.
[/quote]

I understand that, but it raises two things I'd like to comment on.

Firstly this subject has most definitely been co-opted by the 'fearmongering' members of the right as an easy way to get their point across to people who otherwise haven't perhaps thought about it too much, and it's always easier to raise a rabble if you can persuade them that 'bad guys are headed this way'... and the idea of "evil guv'mint men in their evil suits" coming to unplug Granny because she's no longer got enough productive days left ahead of her gets easy traction.

The assertions by the Republican side have included the claims that "we'd become like the UK, where they have 'death panels' who decide which people live and which ones die". -This is a lie. There have also been assertions made that Stephen Hawking would have been 'killed' by the National Health service, since he doesn't meet the criterea for being "worth saving" -This too is a lie, since Stephen Hawking (as well as other similar sufferers who DON'T have the benefit of an famously enormous genius) IS indeed covered and treated under the NHS.

-I've no doubt that those pushing the single-payer option are lying also... -I just haven't been so drenched in their message, so if my reaction is overly one-sided, I recognize this; -please forgive me.

Secondly, I think that the particular example of bureaucrats deciding who gets a single donor kidney doesn't hold up as a good one. -NO health administration, whether large or small, public or private, capitalist or socialist, can EVER fix that problem. Unless the guv'mint FORCE the requirement for dead people to be raided for their parts, neither option makes another organ available, so one of you will still die. If the decision is made by who has the most money, perhaps you have rather more at your disposal than the college kid who still has student loans hanging over his head. -Is that better? No, of course not. (-Well, for you and the electronic/DIY community it would be, of course... and I'd probably prefer it!) but no solution fixes the real problem, and that's not what we should be talking about.

"Healthcare"  is big business. -Actually, to say that demeans it. It's gargantuan business. They LIKE the idea of 'bidding wars' for limited resources, and they like that they hold the aces.

I personally find it to be beyond larcenous that -as an example of how things are at the moment- when my wife was expecting, our doctor's visits contained a breakdown of costs, with a table showing the billing for insured versus uninsured costs.

For one visit (I forget the exact nature, some ultrasound/general checkup thingy) the table showed that the cost would be $2000. -HOWEVER, for patients with insurance, the cost would be $700. -Of that $700, I think our insurance covered something like $650 and we co-paid the other $50.

Now of course that seems like a good deal, -right? -We're getting 'two grand's worth of treatment' for fifty bucks! -But that's not what I find detestable. -What I find indefensible is that if you have insurance you only pay $700, but if you don't have insurance you pay $2000. That's beyond distateful, that's IMMORAL. -And in other businesses, it would be ILLEGAL!

Let's say it's no longer a doctor's office, but it's a car body repair place. -Let's say that I've been in a small scrape which was somene else's fault, and that the other motorist's insurance is going to cover the cost of repairs. -I need a new bumper, a tail light, some paint, clearcoat and buffing to finish. -Now the guy at the repair place might say something like "well, we can use the original manufacturer tail lights, the super-expensive paint (because of course that's what you want, -right?) and do a super-tidy job, but with all the time that takes, and the labor at $100/hour, it's gonna be two grand." -And that's fine. -But suppose I didn't have uninsured motorist cover and I had to pay for it with MY insurance -which would raise my premiums as a result-  I might feel that the extra couple of grand over the next few years might cause me to 'hunt for less expensive options'. -the car body shop owner knows this, and wants the business, so he might say: "Look, we use the same paint for everything, you don't have all that much money, but we don't want you to take your business elsewhere, so we'll do it for you at a lower rate -perhaps for cash only, so it doesn't go through the books, and we can do it for $700 instead... -We'll make it up by 're-balancing' the cost of other repairs so we come out about the same... -deal?"

Well he can't do that legally... -At least I don't THINK he can do that in the USA; -I've never looked it up, but under UK law it's most definitely considered fraud.

So... if one example of 're-balancing costs' for the same basic treatment is fraud because it's not morally equal, why then should it EVER be permissible for the same practice in medical billing?

I asked the doctor, and he told me that 'insurance companies use their size and "group buying power" to negotiate a discount'.

It's egregious. And I agree fundamentally that if the eventual customer (the patient) had to pay, the price would be influenced downwards. -The NHS in Britain has many flaws and this is one of them also. -But having lived and been treated under BOTH systems for a number of years, I have to say that the US system is NOT the best in the world. -Anyone who wants to use that rabble-rousing slogan should be forced to go to Switzerland, then look me in the eye and say the same thing.

I'm not claiming that either side has the right answer; far from it. -But among one of the very worst options is allowing things to remain as they are. Healthcare in the US favours the wealthy... thank the lord I am fairly well off.

Respectfully,

Keith

 

[Emperor-TK]

>>>Medicare- you mean the program with something over a 50 billion buckarooney unfunded responsibility going out into the future?  And that is with pensioners already paying hundreds a month for Medicare deductible coverage?  Don't fall into the trap.  It is not about your health, it is about their control of it.

Medicare seems to be a very popular program across both aisles.  So what our the prospects for getting it back on track?  I'm sure how far off track it is surely depends on who you ask.

>>>Germany, with their 19% VAT.  Can you imagine that on top of whatever taxes you pay now?  That will have me forging my Chinese plowshare into a sabre!

I'd take 19% VAT if it came with free medical for life (if they threw in some infrastructure repair and gave me a paid month off a year from work).  If my 19% got me a half assed compromise where everybody looses but the corporations, I'd be right behind you with my Chinese steel.  It makes me a little nervous to here that some pharma and insurance companies are behind the reform initiative.  I wonder who's blood they smell in the water.

>>>There is a reason, that even though the world is filled with wonderful countries and beautiful people, that a majority of technological innovations, especially in health matters, came from those sweating and straining themselves in the US.  Many who had to leave their home countries to come to the US.

Are there statistics out there that support this, on a per capita basis?  How can you measure "innovation" anyway?  By the number of patents filed?  Sounds like there's a lot of wiggle room there to make a point.  Greenland provides the world with more medical innovation than the US on a per capital basis.  There, that was easy.... now let me go find a study and cherry pick some data to support my claim.  BTW, we only sweat and strain more than other nations because we are fatter, not because we are more industrious.  Our condition drives research in new cholesterol medications, bariatric procedures, genetically modified insulins... wait, I see your point, you might be right. 

>>>My goal is to have congress pass little more than "Iran is bad" type declarations until the end of 2010, and little more after that unless it is to reverse the binging course of the last 20 years.

It would probably be a 1000+ page document loaded with pork (speaking of cholesterol, does legislative pork contain the good cholesterol, or the bad one?)  "Proposal 4873a-s111, Iran is Bad, mmmkay" would wind up setting up a $300B stimulus plan to fund lobbyists, declare CO2 illegal, and extend gun rights for toddlers.

 

[JohnRoberts]

I try to avoid partisan rants, but I understand the urgency from the right to resist being steamrolled into the far left's wet dream plan.

Since I am that guy getting billed the full $2000, yes it is obscene (I paid more than that for my MRI out of pocket). The real cost is hundreds not thousands of dollars.  I don't see the proposed plan as a fix for that. I want to pay a fair price to the DR or hospital for actual services and manage my healthcare. I have been in the army, I know what it's like being treated like cattle.

One question I have for you, if you were paying the $500 or less that Ultrasound should cost out of pocket would you spring for it or perhaps go old school? Many of us were born without our parents knowing the babies sex. And modern X-Rays are pretty low exposure while i'd leave the baby be, unless a problem is indicated.  I appreciate modern technology for real problems but suspect some of this stuff is over used because it's there, or perhaps out of malpractice CYA fears. Sorry this is getting too personal so I'll get back to a general discussion.

My point about the rationing is it always goes on, and always will. There is no magic solution for it. It is being used as a scare point by those trying to block this IMO "too much- too fast" expansive healthcare overhaul. Seniors have already seen and probably experienced the inadequate compensation of doctors/hospitals for medicare and projected insolvency of that system. If they want to be responsible, fix friggin medicare first.

Where is all the money going to come from? (Carbon cap and tax?)

While I am certainly not pleased with the status quo, there is lots we can and should fix, without busting up what is good about what we have now. This should be a long term project with incremental tweaks not a federal takeover of 1/6th of our economy. I have already posted several things we could address that should reduce costs and improve care.

Watch what they do, not what they say (both sides, and me too).

JR 

 

[SSLtech]

No I'm good with all that, John.

No, nothing was too personal, don't worry. -And if anyone gets it, I knew that you would. I believe that you too see that this is broken, and -I'm certain- would work toward a sane solution. I'm just annoyed by the rhetoric -from both sides- which perverts this opportunity. I suspect that the rhetoric is happily designed to fan the fire away from the real productive meat of the issue, by currently vested interests and would-be future ones.

-And I'm sure it's a COMBINATION of CYA/excessive litigation and 'over-selling'.

I tend to listen to AM radio as my way to listen to 'the other side', but I have to say that I'm disgusted by the level of 'entertainment' vitriol which is being presented as informative debate... Good lord those guys need to shut up just as badly as Franck, Pelosi etc. I tend to spend 4 or 5 days at a time listening to the several AM offerings, but I have to switch back to npr when the white-knuckle-grip-of-death marks in the steering wheel leather threaten to become permananent.

Cap and tax is -and always was- an excuse by some to upset the checker-board and then profit from the inevitable 'land-grab' which follows. It's a horrible way to fix the basic problem, but some fix is necessary. -We need to drop cap-and-trade and get real... -Oh, and drive smaller cars (they're actually more FUN, guddammit!) insulate houses better, and not leave the lights on and water running... but common sense is TOO much to hope for.

Keith

 

[JohnRoberts]

I appreciate the mutual admiration society and the respect is returned.

I suspect in the days before television cameras in every meeting room our legislators may have enjoyed at least a few similar thoughtful exchanges.  It would be nice if the political process was less like a contrived reality show where only one team wins. This is like a bad sibling rivalry.  We are all on this boat together.

JR

 

[ENS Audio]

I try to avoid partisan rants, but I understand the urgency from the right to resist being steamrolled into the far left's wet dream plan.

Well if maybe they conducted themselves in a civil manner, probably the rest of us would take "Middle America" more seriously, except if they're protesting then to me I dont see a problem with unruly behaviour but in a townhall debate where our "civil society" comes to meet they should act with a bit more class instead of acting like guests on an episode of the Jerry Springer show....it's freaking embarrasing just as how people were acting to whom were in opposition to the Iraq war.

Acting like an uneducated a*hole transcends "party lines" IMO....

despite my opposite views on these issues I am with you on the 2010 elections...let's vote these bastards out of office and vote ONLY for and ANY person running as an independant even if you disagree with their views on the issues...heck at this point even if theres an independant thats a "bible thumping-right to lifer"....even they will get my vote if they're W/ an "I" next to their name.

We all may be partisan one way or the other, but to me its really important to not forget we all belong to the same country and have the same concerns of how to fix things but this anger being stirred up will only make things worse and thus NOTHING will be accomplished.

 

[JohnRoberts]

I refuse to vote for people who can't win...  As I see it we have two parties to choose from with a chance of being elected (Lieberman was an exception but his party left him.). The extremes of both parties are unacceptable. Within both of these parties we have centrist individuals and extreme.  I might even consider voting for a centrist from the wrong party, if i could be confident that person would behave.

Right now the congressional leadership drunk with power and not very receptive to the push back from middle America.

I'm waiting for the sweetheart press to turn against them, that will get very ugly... but not for a while yet.  2010 can't come soon enough.

JR

 

[ENS Audio]

I refuse to vote for people who can't win...  As I see it we have two parties to choose from with a chance of being elected (Lieberman was an exception but his party left him.). The extremes of both parties are unacceptable. Within both of these parties we have centrist individuals and extreme.  I might even consider voting for a centrist from the wrong party, if i could be confident that person would behave.

Right now the congressional leadership drunk with power and not very receptive to the push back from middle America.

I'm waiting for the sweetheart press to turn against them, that will get very ugly... but not for a while yet.  2010 can't come soon enough.

JR

In the past I would agree with the fact no 3rd party would ever have prominence...but I dunno this time around :-\

 

[JohnRoberts]

I guess I will continue my soliloquy about this.

I am not ready to change my position but I heard a few interesting data points from another CSPAN interview. This from a strong proponent of single payer, who was more thoughtful and presenting statistics from his research (he was pimping a book he wrote critical of the US system). While I didn't agree with his tone, data is data.

One data point that resonated with me was that US health insurance companies consume some 30% of every dollar that passes through their fingers, compared to even our own government run medicare at roughly 3%.

Besides profit, the US insurance companies spend money on advertising and probably a lot of effort to deny payments. It is certainly less work to just approve everything. This doesn't include the huge paperwork burden our insurance companies put on Drs to actually get paid for services rendered.

So this appears to be one piece of low hanging fruit. The worst insurance overhead from a competing western health insurance system was Germany at 5.5% but it is worth note that the German health insurance is "private" not government run. Arguably our social security/medicare is more socialist that their system.

We have non-profit hospitals, I guess we could use more non-profit insurance companies.

He rehashed several of the same problems I have been listing, malpractice insurance and JIC excessive testing, drug costs being higher here than in other countries, etc. I am in favor of tort reform but I guess one could argue that is depriving lawyers of their livelihood.

The crux of the problem IMO seems to be powerful groups (with strong lobbies and influence) who have carved out very profitable revenue streams from our healthcare industry, that are not productive or in the best interest of the whole.  Free enterprise and profits are powerful motivators that have served us well in the past to bring our nation great progress and wealth, but even free enterprise needs a little parenting now and then in the interest of the public good (health).

** Perhaps private health insurance needs to be helped to succeed as a non-profit.
** Drug companies need to remain motivated by profit motive to bring us new drugs, but they don't need to be selling the exact same drugs in other countries for so much less than they do here. This is called dumping in other industries. One world price for drugs. Let the costs be shared by all.

Drug companies shouldn't be allowed to pay generic drug makers to not compete against their more expensive drugs, or subsidize co-pays. While there is some slight educational value to all their advertising, the incessant boner medicine ads are just annoying.

** Tort reform, Doctors who kill or main patients by negligence or worse need to be held accountable, but reasonable guidelines need to define what is considered good practice of medicine. I have argued before for wider use of expert systems to collect patient experience from the entire system and distill this into a preferred treatment for given symptoms. Doctors could vary from this proscribed expert system treatment but then expose themselves to liability. There is no reason for Drs to practice like the lone ranger in this 21st century, use knowledge management tools do work smarter and better.

It is not trivial to unwind these powerful forces influencing our healthcare system. I remain unconvinced that the current administration will fix this with sweeping legislation strongly influenced by, and very likely written by, the very same powerful groups that are parasitically sucking much needed wealth from our current health care system.

So I am still favoring a more modest incremental approach to this, fixing one problem at a time. While we can point fingers at the health insurance industry as bad guys there will be massive dislocation of wealth, as these are widely owned public companies.  Some of the sound bites thrown out by the administration sound good, I just don't fall for head fakes...  It's going to take time a more effort than they have spent on this to get it right.

Happy labor day...  No union rants?  :

JR

Note: I haven't independently confirmed the statistics but they sound reasonable.
 

 

[sodderboy]

Healthcare in the US favours the wealthy... thank the lord I am fairly well off.

Think about that first part everybody.  I will respectively pass on the huge target that is the second.

Who do you work for?  Do you favor the poorest employer in your industry or the richest?  Why are they rich?  Do they strive to be the best they can be, just like you do?
Or if you work for yourself, do you strive to work for rich people or poor people?
Do you strive to work for the mediocre?

Is there ANY country where "healthcare" does NOT favor the rich?  Even in the tightest of communist regimes everything including "healthcare" favored the Party, the rich, the bourgeoisie.  Oh yeah, sorry, straw man.  The Cuba argument is a total joke.  Their system TOTALLY favors the rich, the few that have the controls of government there.

And that is the real debate here.  It's not $20 doctor visits.  Do we go further into government control or try to hold the slide down the soft gooey slope of the nanny-state a la the UK or Canada?

If the majority of a country is only a coalition to vote themselves more bennies from the government, then they are lost.  Their spirit will never rise above mediocrity. 
We are very close here, especially with the tens of millions of BOOMers headed into retirement.  Many have not done diddly to fund their retirement except pay into the empty ponzi scheme that is Social Security.  And their "healthcare" has already been managed by the government, both sides of the isle, who have foolishly blown it over the decades.
How could ANYONE think that THIS time they will get it right.  Oh yeah, we got it dialed-in now!  For Teddy, sniffle. . .
Mike

 

[Emperor-TK]

In your first example, I found myself with a 100% different experience than you.

>>>Who do you work for?  Do you favor the poorest employer in your industry or the richest? 
I work for the poorest by choice (a 10 employee start-up).  I used to work for the richest (7000 employee global corporation).

>>>Why are they rich? 
Based on momentum from market share obtained in the 1980s-1990s.

>>>>Do they strive to be the best they can be, just like you do?
Absolutely not, which is why I left.

>>>>Or if you work for yourself, do you strive to work for rich people or poor people?
I had a commercial project studio and worked for whoever could pay me or barter something cool.

>>>>Do you strive to work for the mediocre?
Absolutely!  Without the mediocre, I would have lost 90% of my business!  BTW, usually the rich people WERE the mediocre ones, like a 45 year old lawyer with a pre-CBS strat, a tweed bassman, and a tin ear.

>>>Is there ANY country where "healthcare" does NOT favor the rich? 
Yes.  UK, Canada, Germany, France, etc.  They all have their faults, but come on, favoring the rich?  Can't we get to the real issues?  There are good points against implementing a system similar to any of these systems.  This is not one of them.

>>>Even in the tightest of communist regimes everything including "healthcare" favored the Party, the rich, the bourgeoisie.  Oh yeah, sorry, straw man.  The Cuba argument is a total joke.  Their system TOTALLY favors the rich, the few that have the controls of government there.
Two non democratic totalitarian regimes.  Yes, straw men.

>>>And that is the real debate here.  It's not $20 doctor visits.  Do we go further into government control or try to hold the slide down the soft gooey slope of the nanny-state a la the UK or Canada?
I appreciate your opinion, but your words are insulting.  Nanny state, really?  Please leave that rhetoric for the cable news jocks.  That tone automatically kills the possibility of a real discussion.  Leave that BS for those fascists down in Texas.  (see......... )

>>>If the majority of a country is only a coalition to vote themselves more bennies from the government, then they are lost. 
It's that simple to you what's going on?  I wish it were to me.

>>>Their spirit will never rise above mediocrity.
All because they favored a health care reform bill?  Aww shucks.  I had better be more careful about what legislation I agree with to avoid that spirit-trap.

>>>>We are very close here, especially with the tens of millions of BOOMers headed into retirement.  Many have not done diddly to fund their retirement except pay into the empty ponzi scheme that is Social Security.
Now THAT is a real point of concern that needs to be discussed. 

>>>>And their "healthcare" has already been managed by the government, both sides of the isle, who have foolishly blown it over the decades.
Huuuuuh?  Can you elaborate please?  We all know that Archduke Ferdinand is REALLY the one to blame....

>>>How could ANYONE think that THIS time they will get it right.  Oh yeah, we got it dialed-in now!
Because many people don't agree with you in your assertion that government has had a strong influence on our healthcare system in the past.

>>>>For Teddy, sniffle. . .
I can't tell your true sentiment, but in the context of you post, this sounds really mean and insulting.

Mike