Health Care Politics

The issue is providing the best quality of care at the lowest cost. I'm not convinced that a government controlled plan would provide the same quality of coverage we have now.

Then explain how the rest of the western world can provide high quality health care for less than the US currently spends per capita.

What's your problem? Blackwater and Sandline employees are, by any definition, mercenaries.

As a matter of fact those mercenaries are off topic. So please leave them out of this thread.

Then explain how the rest of the western world can provide high quality health care for less than the US currently spends per capita.

I don't care how the rest of the world provides care. I care about how the US provides care and care about ensuring that the care the people in this country receive is high quality and affordable. With about 81% of the population currently satisfied with the quality of care they receive, by your estimate about 3% dissatisfied, and the remaining 16% either temporarily, chronically, or voluntarily uninsured, we just need to determine the best approach for making health coverage affordable for them. That's a decision the American people are more than capable of making.

Fine. I was assuming that the US was confident enough to look at how the rest of the world does things rather than acting as if it were the sole repository of wisdom.

Fine. I was assuming that the US was confident enough to look at how the rest of the world does things rather than acting as if it were the sole repository of wisdom.

Come now, this is just inciting anger for no good reason. It obviously isn't that anyone thinks they are "the sole repository of wisdom" and I am pretty sure this was known prior to that post, wasn't it?

How often is this the devolving basis for the deabte? "We do it, why can't you?" I have often sited a plethera of reasons why it isn't that simple of a question and why the logistics and culture are an intregal reason for not following suit.

More places in the world have high poverty, poor healthcare and illiteracy than have an NHS, should we just jump on that bandwagon as well? Just because others do it, is in and of itself no reason for anything, let alone adopting a highly unpopular and likely to fail government system.

I too am not aware of the United States trying to act like it only knows best. I have said that I am for nationalizing healthcare if it works. :relax:

Some Americans will just never accept it I am afraid. There are a number of Americans out there who do not like placing their healthcare in the hands of the government. I fail to see how this makes America some how arrogant which is what seems to be what is being implied here.

I fail to see how this makes America some how arrogant which is what seems to be what is being implied here.

Dismissing out of hand "I don't care how the rest of the world provides care" does tend to the arrogant end of the spectrum.

Dismissing out of hand "I don't care how the rest of the world provides care" does tend to the arrogant end of the spectrum.

I don't care how the rest of the world delivers care to it's people. As an American, how people in the UK or Canada receive care is none of my business. How it's delivered in my country is my business.

Dismissing out of hand "I don't care how the rest of the world provides care" does tend to the arrogant end of the spectrum.

Well I think you will find many Americans are willing to look and listen to Europeans and their system. I happen to be one of them.

However...there are going to be Americans who do not like the system and want no part of it. It is their right to feel that way. I do not see arrogance in that. Fear may be a more appropriate word to use here.

Well I think you will find many Americans are willing to look and listen to Europeans and their system. I happen to be one of them.

However...there are going to be Americans who do not like the system and want no part of it. It is their right to feel that way. I do not see arrogance in that. Fear may be a more appropriate word to use here.

Is there anything the government runs that would fail to inspire at least some reasonable fear of their running healthcare? Again, I have already listed some pretty big reasons that an NHS-style system would be much harder to have in the U.S. and they have nothing to do with whether or not we look at the Europian and other systems. None of them would be close to comparable in either size or logistical requirements, let alone cost.

We aren't ignoring them, but there is no real apples to apples way of using those observations, so we have to figure out our own way.

Ironic isn't it, if we suggest how someone else should do something we are arogant know it alls and if they suggest how we should do something and we don't follow their advice, again we are arogant know it alls. I am noticing a pattern here somewhere...

I don't care how the rest of the world delivers care to it's people. As an American, how people in the UK or Canada receive care is none of my business. How it's delivered in my country is my business.

This is what I don't get. If you want to be an isolationist that's all well and good. It has a fine history dating back to the sovereignty principle of the Treaty of Westphalia. (Basically, what a government does in its own country is its business only and everyone else should butt out.)

But, if that's a principled stand, it's hard to then say your government has the right to invade another country because they don't like the government.

Well I think you will find many Americans are willing to look and listen to Europeans and their system. I happen to be one of them.

However...there are going to be Americans who do not like the system and want no part of it. It is their right to feel that way. I do not see arrogance in that. Fear may be a more appropriate word to use here.

I'm not afraid of looking at the European systems. I just don't think that their systems could come lose to approximating the complexity of providing a similar system to a country the size of the US - both in terms of population and geography.

When discussing the American system I firmly believe that it's necessary to look at the facts and the data underlying the problems in our system if we're to provide sustainable solutions to them.

Is there anything the government runs that would fail to inspire at least some reasonable fear of their running healthcare? Again, I have already listed some pretty big reasons that an NHS-style system would be much harder to have in the U.S. and they have nothing to do with whether or not we look at the Europian and other systems. None of them would be close to comparable in either size or logistical requirements, let alone cost.

We aren't ignoring them, but there is no real apples to apples way of using those observations, so we have to figure out our own way.

Ironic isn't it, if we suggest how someone else should do something we are arogant know it alls and if they suggest how we should do something and we don't follow their advice, again we are arogant know it alls. I am noticing a pattern here somewhere...

I think a lot of the fear stems from Medicare being in debt which is government run. You have scared seniors out there who also feel that the care will be rationed. I am willing to listen to both sides of the argument. Morally I feel that people who cannot afford healthcare should have access to it and of course we need to clean up the private insurance companies too. The fees in some cases are outrageous.

I'm not afraid of looking at the European systems. I just don't think that their systems could come lose to approximating the complexity of providing a similar system to a country the size of the US - both in terms of population and geography.

Yes I have heard this argument too. I agree this is something I have often thought about myself.

I think a lot of the fear stems from Medicare being in debt which is government run. You have scared seniors out there who also feel that the care will be rationed. I am willing to listen to both sides of the argument. Morally I feel that people who cannot afford healthcare should have access to it and of course we need to clean up the private insurance companies too. The fees in some cases are outrageous.

I should note that everyone has access to health care - they just have to pay for it. Health insurance coverage helps by subsidizing the cost of health care and can make obtaining that care more affordable. Some people don't have health coverage because it's too expensive and bringing down the cost of health coverage should be the primary objective of any form of health care reform.

Chris's post (which you can find here)expressed concerns with some of the conclusions expressed in the article - conclusions I neither listed nor quoted. He didn't seem to have any concern with the actual life expectancy numbers which I pulled from the WHO data.

My concern was with their analysis of the data, and since they invented the number that you latched onto, I can't help but question their methodology in deriving the figure. The missing data and / or assumptions are sloppily done. It's a powerpoint presentation, and perhaps the verbal component that's missing filled it in, but I can't help but wonder.

Regarding your 80% / excluding liberal sources / etc, that number simply doesn't add up unless one makes the assumption that it's 80% of insured Americans are satisfied with their insurance. If you figure that 30% of the uninsured are happy to be uninsured and are satisfied with their insurance, then that's 70% of 45 million that aren't happy. That's 31.5 million. If one assumes that there's 315 million in the US, we're already down to 90% at best like their insurance. That requires a rate of satisfaction of 93.4% for the rest of the nation with their health care - which I find unrealistically high. But, if it's insured Americans that are happy, then that's a good argument for reform - that'll make many more currently uninsured happy with their health care.

My concern was with their analysis of the data, and since they invented the number that you latched onto, I can't help but question their methodology in deriving the figure. The missing data and / or assumptions are sloppily done. It's a powerpoint presentation, and perhaps the verbal component that's missing filled it in, but I can't help but wonder.

What number did they "invent"? The article cited WHO data listing the unadjusted and adjusted life expectancy figures for the US. According to the WHO, life expectancy adjusted in the US for non-health related incidents (like car accidents ) is slightly higher than Canada and the rest of "old" Europe. If you have concerns with how the the data was collected then I suggest you contact the WHO, because that's the source of the data.

Regarding your 80% / excluding liberal sources / etc, that number simply doesn't add up unless one makes the assumption that it's 80% of insured Americans are satisfied with their insurance. If you figure that 30% of the uninsured are happy to be uninsured and are satisfied with their insurance, then that's 70% of 45 million that aren't happy. That's 31.5 million. If one assumes that there's 315 million in the US, we're already down to 90% at best like their insurance. That requires a rate of satisfaction of 93.4% for the rest of the nation with their health care - which I find unrealistically high. But, if it's insured Americans that are happy, then that's a good argument for reform - that'll make many more currently uninsured happy with their
health care.

Feel free to click on the links provided in my post (which you can find here (http://www.cosforums.com/showpost.php?p=5406238&postcount=600), here (http://www.cosforums.com/showpost.php?p=5403411&postcount=527), and here (http://www.americanhealthsolution.org/fact-check-americans-are-satisfied-with-their-health-plans-2/)).

According to CNN (http://politicalticker.blogs.cnn.com/2009/08/05/cnn-poll-americans-split-on-obamas-health-care-proposals/), their poll surveyed 1,136 adult Americans questioned by telephone and showed that 74% were satisfied.According to Fox (http://www.foxnews.com/projects/pdf/072309_poll.pdf), their poll surveyed 900 registered voters questioned by telephone and showed 84% were satisfied.According to Zogby (http://www.zogby.com/soundbites/ReadClips.cfm?ID=18967), their poll surveyed 4000 adults and showed 84% were satisfied. Note that none of the polls limited their respondents to insured people but rather to adults or registered voters.

I'm not sure it's safe to assume that every person without health coverage would prefer to have it. According to the Census Bureau (http://www.census.gov/prod/2007pubs/p60-233.pdf) report which gave us the 47 million uninsured figure, about 9 million of them (or 3% of the total population) make more than $75,000 a year. Those people are in the top 25% of earners. Could it be that they're voluntarily uninsured?

According to that same report, there are about 8.5 million who earn between $50,000 and $75,000 (another 2.7% of the total US population). These people are in the top 50% of earners. Could it be that some percentage of them are also voluntarily uninsured?

Looking back at the same report, we see that there is a significant portion of the population which could qualify for Medicare, Medicaid, or SCHIP coverage but hasn't enrolled. But compulsory enrollment laws require that anyone who qualifies for Medicare, Medicaid, or SCHIP coverage be automatically enrolled if they show up at a medical facility in need of care. Could it be that some percentage of them prefer not to have coverage?

The number that they invented was the adjusted life expectancy number. I want to see their math. In front of me. Before I believe them. They did math with the WHO numbers, and that's analysis after the fact that the WHO does not provide. Any assumptions, etc, I want to see them all. Not just what they stated as their assumptions - I want to see the math.

As far as my assumption, your link that you provided didn't discard my assumption. So I dug deeper and started looking at the actual polls.
CNN: 12% uninsured in sample; which if we go by my last set of numbers works out to a slight undersampling of uninsured, but within the margin of error. Doing a bit of math arrives me at 80% satisfaction rate for insured in their sample.
The EBRI one (Note: The EBRI/MGA Consumer Engagement in Health Care Survey is an online survey of privately insured adults ages 21-64.) (from their pdf) they quote at 88% of insured are happy with their insurance plan. But digging just a layer deeper notes that 30% are "somewhat satisfied". This strikes me as 30% are OK with their plan but they wish they could do better. It's unclear if this is considered a scientific sampling or not - some online polls are scientific; others are highly unscientific. I'll give them the benefit of the doubt though and say they know what they're doing and do a proper pre-screen within the parameters they defined and I quoted.
The fox one, on the other hand, it's unclear a bit looking at page 9 of their pdf (http://www.foxnews.com/projects/pdf/072309_poll.pdf) whether uninsured are included. Compare questions 41 (do you have insurance) 42 (if you have insurance, do you like it), and 43 (quality of health care received). 9% of their sample didn't have insurance - a slight undersampling, but within margins of error, I think. Of those with insurance, 84% liked their insurance (excellent or good) and another 13% called it "fair" (open to interpritation whether that's a like or a dislike). Question 43 seems to have been asked of all, and it asked about the quality of health care received. 83% said good or excellent, and 10% said the open-to-interpritation "fair".

I don't have time to go through the other two, but I'd note that the Fox poll can be seen as 84% are happy with their insurance, if they have insurance, and 83% are happy with their health care. But it did not ask those without insurance specifically if it was voluntary or not. And they did not ask every voter if they were happy with their health insurance, since they did not ask that specific question of those without insurance - precisely the potential "hole" I was noting in my original post.

Finally, interesting analysis (http://www.politifact.com/truth-o-meter/statements/2009/aug/21/orrin-hatch/who-are-uninsured-hatchs-take/) of Orrin Hatch and others' statements about the 15 million being the true uninsured number. In short: they did the math right. Longer answer: the math had assumptions that make it very, very hard to know if this is the "true" number - especially the households over 75K bit, since 3 mid-20's people making 26K / year living in the same apartment counts as a household income of 78K for census purposes, for example. Basically, it muddies the waters a bit on those figures you're quoting to make the point that while the math is right the assumptions have issues that make it hard to know if the math is true.

One problem I have had with discussing the Health Care Plan is that there is no clear notion what we are actually discussing. To the best of my knowledge, there are at least three Democratic Health Care overhaul plans, plus I am aware of at least six Republican propsals to address most people's complaints about the health insurance system. And still Obama insisted we had to have 'the' program rushed through and passed before August was out.

I hear claims for and against the different programs and various denials that the different claims are accurate or not. This is no way for a Democratic Republic to operate. Obama promised transparency, but like the Stimulus Bill and just about every other initiative this year, the modus operandi seems to be to shove things through before the voters get any chance to have a look at or comment on proposals.

This Wall Street Journal piece shows the sort of problems responsible voters face:


President Obama has promised a "new era of transparency" in Washington, so perhaps he should talk to the Senate about getting with his program. On July 15, six weeks ago, the Senate Health, Education, Labor and Pensions Committee passed an amended $1 trillion health-care bill, with acting Chairman Chris Dodd calling it a "historic achievement."

Three weeks ago Republicans on the committee wrote Mr. Dodd "to reiterate our request for a full copy of the bill as amended, in the four-week mark-up." Mr. Dodd has refused to comply. The Senate bill that is available on the committee Web site is 790 pages long. While that is some 300 pages shorter than the House health bill, that's in part because it doesn't include nearly 200 amendments that passed when the committee redrafted the bill. Amended sections of the bill might as well be written in invisible ink.

The whole process was so haphazard that at one point during the committee mark-up Barbara Mikulski, the Democrat from Maryland, declared: "Giving me language on little pieces of paper on which I'm going to commit the sacred fortunes and honor of the United States for decades, this is not the way to go. We can't do this on the backs of envelopes."

We called Mr. Dodd's committee office last week to ask why the bill isn't posted, and a spokesman explained that it is still being "worked on." Will it be ready by October? "Don't count on it," the staffer said.

Meanwhile, President Obama has been saying that critics are "misrepresenting" his proposals. But who's to know what's reality and what's a myth when the public and Members of Congress aren't able to read a bill that would restructure one-seventh of our economy. We don't have any idea what the bill will cost or how many people it will provide insurance for, because the Congressional Budget Office can't score it. No wonder the public is increasingly skeptical of this entire exercise.


http://online.wsj.com/article/SB10001424052970203946904574301050879872972.html?m od=rss_opinion_main

According to Zogby, their poll surveyed 4000 adults and showed 84% were satisfied. Note that none of the polls limited their respondents to insured people but rather to adults or registered voters.

I just found a quote from the link you provided that directly contradicts the second sentance above.

Among those currently insured, Zogby reports, 84 percent are satisfied with their current health care.

This is precisely the hole I saw, questioned, and now in 2 of 3 I took the time to examine I found. The CNN poll had the lowest satisfaction rating, and they appeared not to only ask insured whether they were happy with their current insurance, they asked both. I wish I could access the full pool, in order to find out if they oversampled one side or the other - because in a vacuum that statement, while contradicting your claim, doesn't actually mean as much as I'd want it to, since if they oversampled certain demographics that'd swing it back the other way. Zogby is an "opt-in" system, I think, so it is inherently harder to randomize, but I think there's statistical ways for them to do so, so I won't hold that too much against them.

In general, I think that there's so many places for polls to "go wrong" that it's hard to place too much stock in any given single poll; however, I do like to make sure that when I see a poll result I see how it was arrived at, I see whether it was a "push poll" or not, and I see if there's any obvious holes or if the data interpritation was correct. I can't help it, the science side of me questions the methodology and the assumptions and the data interpritation. In this case, I've found a few holes, especially in data interpritation by secondary sources such as a couple of those linked.

I just found a quote from the link you provided that directly contradicts the second sentance above.

Glad you agree that statements like "the middle class gets screwed by the insurance companies" (http://www.cosforums.com/showpost.php?p=5405539&postcount=581) appear to be unfounded.

As for the rest, I'd hope that commitment to quality applies to statistics and polls posted by every person here.:whistle:

One problem I have had with discussing the Health Care Plan is that there is no clear notion what we are actually discussing. To the best of my knowledge, there are at least three Democratic Health Care overhaul plans, plus I am aware of at least six Republican propsals to address most people's complaints about the health insurance system. And still Obama insisted we had to have 'the' program rushed through and passed before August was out.

I hear claims for and against the different programs and various denials that the different claims are accurate or not. This is no way for a Democratic Republic to operate. Obama promised transparency, but like the Stimulus Bill and just about every other initiative this year, the modus operandi seems to be to shove things through before the voters get any chance to have a look at or comment on proposals.

This Wall Street Journal piece shows the sort of problems responsible voters face:

I've tried to focus my comments on the texts and amendments which have been published and are available on GovTrac or Thomas, but it is admittedly difficult given the Administrations dislike, in my opinion, for providing the text of bills to review. This circumstance certainly didn't happen in previous years.

Interestingly, the lack of transparency is pretty much throughout the federal government these days, not just Congress and not just for health care. There's been almost no reporting of lobbyist contacts regarding the stimulus even though reporting of such contacts was a much touted part of the stimulus bill. Elections, it seems, do have consequences.

Alright, I'm pretty offended at how my words got changed into support of a post that I hadn't even read yet, but I'll let that go for now.

Some interesting links of my own:
2004 survey (http://www.foxnews.com/story/0,2933,136990,00.html) of five countries. US came out lowest in satisfaction with health care, vs New Zealand, Canada, Australia, and Great Britain (perhaps the survey was english-only?). Wait times for weekend and night care was longest in the US, and only Canada fared worse for same-day appointments. Some good news was sprinkled in with the poll, too, but this poll suggests that one of the fears that opponents express about single-payer systems, in practice, isn't as big of an issue (time-to-treatment).

JD Power survey (http://www.jdpower.com/insurance/articles/2009-Health-Insurance-Plan-Satisfaction-Study) which breaks down the health care satisfaction into a "points" system, and only includes insured Americans. The average appears to be in the low 700 out of 1000 range, but wide regional disparities exist.

National Journal (http://www.nationaljournal.com/njonline/mp_20090629_2600.php) article analyzing some poll results. Their punch line at the end of their medicare / etc analysis:

So, the Americans experienced with "government-run" health insurance like what they have and don't want to change it, and younger Americans enthusiastic for change don't know what they're missing.

WaPo article (http://www.washingtonpost.com/wp-dyn/content/article/2009/07/21/AR2009072101677.html) claiming that cherry-picking of data is occurring, which is precisely the claim I am making too. The findings in the article are too numerous to list out line-by-line, but the one that interested me the most is the inverse relationship between health insurance satisfaction and health insurance usage.

The full 2004 survey is here (http://www.commonwealthfund.org/~/media/Files/Surveys/2004/2004%20Commonwealth%20Fund%20International%20Healt h%20Policy%20Survey%20of%20Adults%20Experiences%20 with%20Primary%20Care/IHP2004_topline_results%20pdf.pdf) and is very interesting. It looks as though in the US if you are insured you are more likely to get preventative treatment than in Britain (here we are generally expected to think about tests examinations for ourselves) I guess that is financial imperative. On the other hand very few respondents here report not continuing treatment because of the cost (4% in the UK, 22% in the US)

It would be interesting to see more recent figures - the present government has had a policy of raising the amount spent to reach the European average.

Den - I finally got to reading up about the HSA's, and as I see it your chief fear is that the minimum coverage provisions will effectively kill the HSA's, yes? Is that just a guess on your part, or is that written into HR 3200? I couldn't find anything on factcheck.org or politifact, and the only google searches I found were all blog results, which I don't trust on general principle (be they liberal, conservative, martian, or nutty).

The best I could find was this AMA fact sheet, page four (pdf (http://www.ama-assn.org/ama1/pub/upload/mm/399/hsr-hr3200-faqs.pdf))

Would H.R. 3200 eliminate health savings accounts?
H.R. 3200, as introduced, could be interpreted to eliminate this option. However, an
amendment was adopted during the House Education and Labor Committee markup that
would allow consumer-directed health plans and arrangements, including a highdeductible
health plan, to be considered as acceptable coverage under a current group
health plan for the first 5 years after the Act is operational.

The AMA notes nothing about beyond five years, and I think that if the HSAs continue to be popular that period would be extended. I think the five years is more a practical matter making sure that the HSA's also, in the end, meet the minimum standards, instead of a five year "stay of execution".

I still, in the end, think that a public option should be available for those who don't have the means to invest in the HSA's (perhaps we could combine your idea of subsidizing the premiums or the "high deductible" with my wish for a public option and make one of the public option choices be HSA's), and those who for other reasons can't get an HSA with a high-deductible plan or other forms of insurance, and that way we can, as a nation, get the maximum number possible insured. That's why I support a public option - I see it as the most straightforward way to get all the uninsured insured.

Now why didn't the Dems think of the pet option:

If you put a pet option in the healthcare reform scheme, Republicans would be in a bind. It's one thing to oppose big government taking over from those little mom-and-pop insurance companies, but do you favor throwing Mr. Mittens out the car window when he gets old and feeble and needs an IV because he can't chew his kibble? You'd have weepy pet parents at town hall meetings waving photographs of kittycats in need of new kidneys, and finally you'd start to see some empathy. People love their animals, and if we could just agree that everybody in America should receive the same level of care enjoyed by an elderly golden retriever, we could be done with this and get ready for the World Series.

Salon (http://www.salon.com/opinion/keillor/2009/09/02/healthcare/)

Sad thing is, he's probably right.

Den - I finally got to reading up about the HSA's, and as I see it your chief fear is that the minimum coverage provisions will effectively kill the HSA's, yes? Is that just a guess on your part, or is that written into HR 3200? I couldn't find anything on factcheck.org or politifact, and the only google searches I found were all blog results, which I don't trust on general principle (be they liberal, conservative, martian, or nutty).

The best I could find was this AMA fact sheet, page four (pdf (http://www.ama-assn.org/ama1/pub/upload/mm/399/hsr-hr3200-faqs.pdf))



The AMA notes nothing about beyond five years, and I think that if the HSAs continue to be popular that period would be extended. I think the five years is more a practical matter making sure that the HSA's also, in the end, meet the minimum standards, instead of a five year "stay of execution".

I still, in the end, think that a public option should be available for those who don't have the means to invest in the HSA's (perhaps we could combine your idea of subsidizing the premiums or the "high deductible" with my wish for a public option and make one of the public option choices be HSA's), and those who for other reasons can't get an HSA with a high-deductible plan or other forms of insurance, and that way we can, as a nation, get the maximum number possible insured. That's why I support a public option - I see it as the most straightforward way to get all the uninsured insured.

Thank you for actually looking at that and researching. Yes, you hit it that it will go away as an option if anything changes in the plan (as all other plans will go away if anything changes on them) and even this amendment (and who can see the amendments? Not even the people voting on the bill), says we only get to keep it for 5 years. (I believe that is the case for any health plan peoplke have now that is not a public option.) And people who have no money (as Monster_Mom has pointed out several times) are eligible for Schip and Medicaid. But that as an option for even them would save taxpayers money (in my opinion) and help bring overall costs down instead of up (for all the reasons Monster_mom has stated concerning community pooling, etc.).

While we might not object to adding options, what is making people object so strongly is the way our current options are being taken away.

And here's an in-depth study of doctors' opinions on Obama/Kennedy care: (;))

The Allergists voted to scratch it, but the Dermatologists advised not to make any rash moves.

The Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve.

The Obstetricians felt they were all laboring under a misconception. Ophthalmologists considered the idea shortsighted.

Pathologists yelled, "Over my dead body!" while the Pediatricians said, "Oh, Grow up!"

The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.

Surgeons decided to wash their hands of the whole thing. The Internists thought it was a bitter pill to swallow, and the Plastic Surgeons said, "This puts a whole new face on the matter...."

The Podiatrists thought it was a step forward, but the Urologists were ****** off at the whole idea.

The Anesthesiologists thought the whole idea was a gas, and the Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to the *******s in Washington.

I still, in the end, think that a public option should be available for those who don't have the means to invest in the HSA's (perhaps we could combine your idea of subsidizing the premiums or the "high deductible" with my wish for a public option and make one of the public option choices be HSA's), and those who for other reasons can't get an HSA with a high-deductible plan or other forms of insurance, and that way we can, as a nation, get the maximum number possible insured. That's why I support a public option - I see it as the most straightforward way to get all the uninsured insured.
:hmm: I feel like I said almost exactly this and someone accused me of being uninformed despite the hours of research I did.

They were never "my arguments." This is not some personal matter to me, I think it's important that people understand why HSAs are not going to work as an alternative to universal health care. I think it would be just fine as an adjunct to whatever our new system ends up being, but to say that we should not proceed with a new bill and we should give everyone these savings accounts is irresponsible. That is all I have to say on the matter.

Based on the research I've done, it seems that HSA's wouldn't work as part of the public option. Not because they're not helpful or effective, but because the public option is based on a theory similar to Social Security where you have a larger pool of folks who pay for but don't use medical services combined with a pool of people who do use medical services. It's kind of like a pyramid with the premiums from a large base of people who don't use many medical services at the bottom supporting the decreasing number of people who do use medical services at the top.If you yank some portion of that bottom out and allow them to have low premium, high deductible plans then the pyramid can't stand.

In a really over simplified example - say you've got 15 people you cover. One of those people had a really bad year, had a couple of operations and ended up needing therapies and medication to get better. This poor guy had over $100,000 in medical expenses this year. Another lady in the plan had a great year and had her first child. The baby was born in the hospital with no complications and Mom and baby are doing great. Mom and baby's medical costs ran around $30,000. Three other people had minimal medical expenses for a couple of Dr Visits and tests for a total of about $1000 each. The rest of the people never saw their doctors and didn't get sick.

The total costs for this community is about $134,000, so, in order to break even this community would have to raise $134,000 in premiums and co-payments. In a community rated state that comes out to about $8,900 each per year ($740 a month).

But if 5 of those folks decide to go with a high deductible, low premium plan where they only paid $1,200 a year in premiums, then the remaining 10 folks would see their premiums go up to $12,800 a year each so that they could cover costs.

That's what's happened in some states with guaranteed issue and community rating but no mandates to enroll. People who don't generally use medical services don't bother getting health insurance because they know that if they get sick or hurt they can automatically enroll in a plan because of guaranteed issue and won't have to pay an arm and leg as a result of their medical condition because of community rating. In those states, because the pool of people enrolled and paying premiums into the programs are generally people with medical conditions who have to use medical services to survive, the cost of premiums is higher than the national average - sometimes quite a bit higher.

In order to keep premiums lower in any sort of public option, you have to have a larger pool of individuals who pay premiums but don't use many services to offset the cost of providing care to people who have to use lots of services.

That's not to say that I think HSA's are bad - because I don't. I think they're a pretty neat idea. But if the objective of the public option is to keep prices lower then you have to have folks paying into the system who don't have to use medical services to offset the cost of people who have to use medical services.

Maybe the person or committee who actually decides on what plan(s) are acceptable could make sure that they have at least one person familiar with HSA's. I think that having at least one person familiar with all types of currently popular insurance is only proper, that way no option gets railroaded out without proper consideration. If they look in five years (I think it'd actually be 7ish years because of the phase-in schedule, which would be right around the time of another presidential election), and the HSA public options are being cost-effective, I would have no objection to a separate pool for the HSA's and the more traditional plans would be in the "primary pool". That'd address the concerns of those who think that they wouldn't fit into the proposed reform and it'd also address the concerns of those who like their HSA and don't want to let it go.

Sentenced to death on the NHS (http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html)

A real life horror story reported by the UK's Telegraph...is this what's in store for the US if we pass Obama's socialist healthcare plan?

IMO, this adds to the fear factor that people rightly have when they think about the consequences of Big Government taking over healthcare.

Sentenced to death on the NHS (http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html)

A real life horror story reported by the UK's Telegraph...is this what's in store for the US if we pass Obama's socialist healthcare plan?

IMO, this adds to the fear factor that people rightly have when they think about the consequences of Big Government taking over healthcare.

(a) Obama is not planning to set up an NHS-style public health service, as he has made clear on several occasions, so I can't see the relevance of this article to the US debate
(b) Any evidence that the palliative care practices described in this article have arisen because the NHS is publicly funded? I think you will find, if you read the article, that the doctor who has raised these concerns is arguing for a change in policy within the NHS, not for the NHS to be disbanded. I don't think anyone in Britain is arguing that having a centralised, state-run health service leads to more deaths and almost nobody in the UK wants to switch from the system we have to one like the US. Every UK resident who has posted on here, whatever their political background, has been 100% behind the NHS, because it is an extremely popular institution which 99%+ of us like having. Even the Telegraph (bar the occasional columnist) is broadly supportive of the ideal of a state-run NHS, and the Telegraph is the most radically conservative "quality" newspaper we have.

Sure, the NHS is not perfect, but then nor are privatised health systems. At least nobody in the UK dies because they can't afford medical treatment or avoid visiting a doctor until it's too late because they are worried about costs.

I'm not saying you guys should have our system - you have your own traditions and logistical problems that may make a similar system inappropriate for you. But stop painting us as an example of a rubbish health system, because it's not a picture that I, or most of my compatriots, recognise.

I'm not saying you guys should have our system - you have your own traditions and logistical problems that may make a similar system inappropriate for you. But stop painting us as an example of a rubbish health system, because it's not a picture that I, or most of my compatriots, recognise.

Absolutly :tu: Well said Mel

A real life horror story reported by the UK's Telegraph...is this what's in store for the US if we pass Obama's socialist healthcare plan?


Probably not. The removal of 'the plug' so to speak on patients is still up to the next-of-kin in the UK, often taken in mind with the advice of doctors. The point is that the guidelines originally drawn up for terminal cancer patients by the Marie Curie centre have been extended to cover other terminal diseases and the actions of doctors who chose to follow these guidelines to the letter have been criticised. The article is called 'Sentenced to Death On the NHS' not 'Sentenced to Death By the NHS'

Also, the ending of a patients life through sedation follows through exactly the same way in the US. If the patient is unable to make the decision, it is left to the next-of-kin under advice from physicians.

And the NHS is not in anyway socialist as it is not the only insurer in the UK.

Unless some Americans abandon some basic absurdities in their reasoning when it comes to healthcare, they will never be able to have a factual and intelligent debate concerning the matter.

Nonsensical arguments which cannot be a part of serious healthcare debate are as follows:

1- "America has the best healthcare in the world"
2- "This will lead to socialism/communism/fascism"
3- "Obama is planning to take over our lives/families/souls"
4- "Death panels will kill us"
5- "Someone on FOX News said that......."
6- "Someone on right-wing radio said that...."
7- "Someone on a right-wing website said that...."
8- "Government bureaucrats will stand between us and our doctors"
9- "Government cannot run anything properly!!!"
10 - "Ronald Reagan once said that......"
11- "Healthcare should be a free market enterprise......"
12- "Healthcare is not a right"
13- "Jesus wouldn't have supported public healthcare"
14- "Texas should secede y'all"
15- "Obama isn't an American"
16- "(Republican/Blue Dog Democrat) said that......."
17- "In England/Great Britain/Other Inaccurate Name For the UK, they kill babies"

18- "Why should I pay for other people's healthcare/fire departments/police/public roads/public schools/armed forces...etc..."

And so on. There are many more, but those are the main points I hear uninformed and ideologically warped Americans using in the healthcare debate. If your arguments consist or include any of the above as what you consider a serious point, then you are in trouble.

1- "America has the best healthcare in the world"
2- "This will lead to socialism/communism/fascism"
3- "Obama is planning to take over our lives/families/souls"
4- "Death panels will kill us"
5- "Someone on FOX News said that......."
6- "Someone on right-wing radio said that...."
7- "Someone on a right-wing website said that...."
8- "Government bureaucrats will stand between us and our doctors"
9- "Government cannot run anything properly!!!"
10 - "Ronald Reagan once said that......"
11- "Healthcare should be a free market enterprise......"
12- "Healthcare is not a right"
13- "Jesus wouldn't have supported public healthcare"
14- "Texas should secede y'all"
15- "Obama isn't an American"
16- "(Republican/Blue Dog Democrat) said that......."
17- "In England/Great Britain/Other Inaccurate Name For the UK, they kill babies"

I have never once personally heard a Conservative utter any of those things. Nor have I heard that people who were pro-Obama care become anti-Obama Care because of such right wing extremism. So the thought that somehow this is what is "holding back" the US is frustrating to hear. This (http://pajamasmedia.com/blog/five-leftist-myths-about-health-care-reform/) is a great article that refutes nearly every single talking point the Liberals try to throw at conservatives and independants (such as myself). And contrary to your long list there are only 5 major talking points--everything else is just a spin on those main themes.

1. Republicans, who either believe the health care status quo is perfectly acceptable or are in the pockets of lobbyists who pay them to say so, are opposed to the very idea of reform and want to block any effort to fix our health care system. ...Of course, the right is not defending the status quo in any way, shape, or form in the health care debate. Rather, conservatives are simply offering alternative, market- and individual freedom-friendly solutions while seeking to prevent a fundamental shift in our nation’s economy from being enacted without the relevant legislation even having been read or carefully considered first.

2. President Obama’s health reform proposal is vastly popular among the people, representing the “collective will” of the American population....The fact is, the more time that passes, and the more Americans learn about the Democrat proposal, the less popular it becomes — a key factor in Obama’s failed effort to rush his “reform” legislation through Congress as quickly as possible.

3. Everybody in America hates their insurance provider and has stories of themselves or someone they know being screwed over by an insurance company....Much like the Obama “reform” plan has grown less popular as people have found out more about it, Americans’ opinions of their own coverage and care have improved as they have gotten a better look at the government-run alternative.

4. Republicans and “opponents of change” are employing scare tactics and peddling misinformation about the cost or contents of the health reform legislation in Congress and about President Obama’s proposal.....

This has been the party line for the Democratic National Committee, MoveOn.org, the SEIU, and the Obama administration since opposition to their health care overhaul proposals began to take root among the general population. However, the actions of those pro-ObamaCare organizations — which amount to employing actual scare tactics and waging a misinformation campaign against those citizens who have turned out at town hall meetings across the country to express their concerns about the proposed health overhaul — have not been those of victimized policy proponents, but of professional agitators whose only experience dealing with people is as part of smear campaigns and astroturfing efforts, and whose knee-jerk reaction to dissent is to declare it “dangerous” and to quash it.

5. Republicans are preventing health reform from taking place despite the best efforts of President Obama and Democrats in Congress. ....The Democrats got what they wished for — total control of Washington, D.C., and of the lawmaking and enforcing branches of government. However, liberals traditionally specialize in owning intentions, not results or consequences, meaning many are having difficulty accepting responsibility for enacting those policies they so steadfastly claim to support.

(I can't believe I don't know how to do the collapse thing yet :p)

18- "Why should I pay for other people's healthcare/fire departments/police/public roads/public schools/armed forces...etc..."

:sigh: Here comes the selfish card again...

Now as to the whole NHS style of health care--I'm surprised at how on one hand people who have NHS in European countries enjoy and approve of their healthcare then turn around and try to villify the US when statistics show that Americans are happy with our system--despite all the flaws. It seems like the NHS is held up as if to say "if we can do it why can't you" and further while at the same time saying the Obama isn't NHS style but supporting it anyway? I guess I'm just confused. Can someone explain?

I think, instead of taking individual polls in individual countries about whether or not people are happy with their health care and their health insurance (these are two separate questions in a society where not everyone has health insurance), the best polls would give the same exact questions to people in multiple countries to get a better relative metric. People in the US may say they are satisfied or elated with their health care, as may people in Britain, but a better comparison comes by asking people in the US and Britain the same questions. If it comes out that 90% of British people like their system and 80% of Americans like theirs, then that's a valid comparison - if they are given the same questions. If they aren't given the same questions, then that comparison is harder to make, because pollsters can and do influence the results of their polls with the phrasing of the questions (the best pollsters know this and mix up the order / phrasing / etc in order to minimize that effect).

I think that the tone of the list is probably a bit too confrontational, but I have, on these very boards, seen close relatives to many of the sentiments expressed on that 18 point list. Especially 1, 2, 3, 4, 8, 9, and 12. On liberal talk radio I've heard 13 quite a bit. So they are out there, in a less blunt tone (or in some cases a more blunt tone).

I can't speak totally for any British person, but I think that offense is taken twice. The first way in which it's offensive to say that because of some problem in the NHS system "Obama-care" (why is it termed Obamacare and not Pelosicare or Congresscare or any of that??) is that an NHS-style system isn't being proposed, so it's a moot point - it's like condemning someone for giving you a bad apple when in fact they handed you an orange. The second way in which it's offensive is many of the "horror stories" and vilification of the NHS-style system that we hear from health care opponents are demonstratably wrong or are at best isolated incidents instead of evidence of a systemic problem. I've seen people dismiss horror stories from the US health care system as being isolated incidents or not evidence of a systemic problem, and then they turn around and use examples from other systems in the exact manner they just condemned for the US system.

In the end, I'm a supporter of the reform out there now, but I do want a better bill than the one that's proposed, and I hope that negotiations with Olympia Snowe or within the Democrats produces a better bill. Not all ideas from the other side of the aisle are bad, nor are all the ideas in the bill good, but in the end I think it'll produce a better system than we have now. By all means, protect well-run HSA's and introduce tort reform in (or pass that as a separate bill). I hope, however, that if some of those elements aren't included that it doesn't get in the way of passage of something that I think will do more net good than harm.

I have never once personally heard a Conservative utter any of those things.

Then you have either been extremely fortunate or you haven't been paying attention to Republican politicians, their supporters in the media, and conservatives on message boards like this one.

I should also add #19 to my list.

"The credibility of anyone who uses the term "Obamacare" to describe health reform should be viewed with skepticism"

I doubt Brits refer to the NHS as "Bevancare"

I think that the tone of the list is probably a bit too confrontational, but I have, on these very boards, seen close relatives to many of the sentiments expressed on that 18 point list. Especially 1, 2, 3, 4, 8, 9, and 12. On liberal talk radio I've heard 13 quite a bit. So they are out there, in a less blunt tone (or in some cases a more blunt tone).

I think it's very confrontational. As far as close relatives..what exactly does that mean? What I see are liberals trying to reframe arguements with different words to make conservatives and independants shallow and mean. On these boards I too have seen the more extreme thoughts but by and large on this board I've seen people take the bills and read them and disect them. I've seen conservative posters ask questions that liberals can't or won't answer. I did not say that these absurd charges aren't out there. I am saying that those charges are not what drives the anti-reform movement and further do not make supporters become protesters.


I can't speak totally for any British person, but I think that offense is taken twice. The first way in which it's offensive to say that because of some problem in the NHS system "Obama-care" (why is it termed Obamacare and not Pelosicare or Congresscare or any of that??) is that an NHS-style system isn't being proposed, so it's a moot point - it's like condemning someone for giving you a bad apple when in fact they handed you an orange.

I'd love to name it Pelosi care but you have to admit that it doesn't have the same ring to it :p If an NHS style system isn't being proposed then why are European countries supporting the reform? How are they in any position to judge what is right in America? And I don't say that meanly only in that if they don't live it on a day to day basis then how can they make a determination either way? Isn't that the same thing they ask us not to do to their system?


The second way in which it's offensive is many of the "horror stories" and vilification of the NHS-style system that we hear from health care opponents are demonstratably wrong or are at best isolated incidents instead of evidence of a systemic problem. I've seen people dismiss horror stories from the US health care system as being isolated incidents or not evidence of a systemic problem, and then they turn around and use examples from other systems in the exact manner they just condemned for the US system.

I feel like Europe holds themselves up as the standard to be met. I believe America does as well. It's simply a two way street. It works for us. It may not work for you. Perhaps if both sides excepted that they are not the gold standard in the world none of this rhetoric would come to pass?


Then you have either been extremely fortunate or you haven't been paying attention to Republican politicians, their supporters in the media, and conservatives on message boards like this one.

That's because I form my own opinions. I don't need the media to tell me how to think.

I should also add #19 to my list.

"The credibility of anyone who uses the term "Obamacare" to describe health reform should be viewed with skepticism"

I doubt Brits refer to the NHS as "Bevancare"

Since you didn't respond to my post in it's full content I don't see how you can view me with skepticism. If anything it makes your original comments that much more suspect, imho.

That's because I form my own opinions. I don't need the media to tell me how to think.

That's wonderful, but if you try to deny that those arguments I listed have been made, then you run into trouble. You may personally not use those arguments, and that's good, but they are indeed being used by others.


Since you didn't respond to my post in it's full content I don't see how you can view me with skepticism. If anything it makes your original comments that much more suspect, imho.

I don't need to respond to your entire post. The areas of a person's arguments which generally avoid the arguments I listed may be fine. It's when people stray into using the listed arguments, that's when their credibility IMO suffers.

That's wonderful, but if you try to deny that those arguments I listed have been made, then you run into trouble. You may personally not use those arguments, and that's good, but they are indeed being used by others.


And I think you will find in politics that there are all kind of silly arguments used on both sides. Wouldn't you say?

And I think you will find in politics that there are all kind of silly arguments used on both sides. Wouldn't you say?

Absolutely.

I condemn silly liberal arguments just as much, such as left-wing 9/11 conspiracy theories for example.

That's wonderful, but if you try to deny that those arguments I listed have been made, then you run into trouble. You may personally not use those arguments, and that's good, but they are indeed being used by others.

And you can not say that they are turning supporters away from healthcare. There is nothing that supports it. Statistics show that the more Americans learn about the legislation the less they like it. The first is unquantifiable, the latter is extremely quantifiable.


I don't need to respond to your entire post. The areas of a person's arguments which generally avoid the arguments I listed may be fine. It's when people stray into using the listed arguments, that's when their credibility IMO suffers.

You make a backhanded swipe at me over the term Obamacare and then refuse to acknowledge legitimate answers to your own post. It seems to kind of stall the debat going on wouldn't you think? And since you made the list in the first place it seems like a poor arguement to me.

I'm not sure comparing satisfaction in one country versus another is necessarily appropriate or entirely valid. All that those comparisons will show us is that people in country X are more or less satisfied with the health care they receive than people in country Y. While such a comparison makes for fodder to bash one another with, it does nothing to solve the problems in the health care industries in either country.

As I'm an American, my opinion about the NHS is totally irrelevant. My opinion about the American system is relevant. In that regard, I think that if the United States wants to find a solution to the health care "crisis" then we need to identify the problems in the system and find solutions for them.

And you can not say that they are turning supporters away from healthcare. There is nothing that supports it. Statistics show that the more Americans learn about the legislation the less they like it. The first is unquantifiable, the latter is extremely quantifiable.

Issues relating to the legislation could very well be related to the fact that it's either overly vague or overly complex. Legislative bills tend to be like that and are often lost on the average citizen. The fact that Obama hasn't been effective at all over promoting the reform may also be an issue.

You make a backhanded swipe at me over the term Obamacare and then refuse to acknowledge legitimate answers to your own post. It seems to kind of stall the debat going on wouldn't you think? And since you made the list in the first place it seems like a poor arguement to me.

It wasn't a backhanded swipe. It's was a fronthanded criticism of using such a term.

The list of 5 points you posted, largely consists of answers to strawmen arguments and in no way can be considered an answer of any sort to my postings.

Unless some Americans abandon some basic absurdities in their reasoning when it comes to healthcare, they will never be able to have a factual and intelligent debate concerning the matter.

Nonsensical arguments which cannot be a part of serious healthcare debate are as follows:

1- "America has the best healthcare in the world"
2- "This will lead to socialism/communism/fascism"
3- "Obama is planning to take over our lives/families/souls"
4- "Death panels will kill us"
5- "Someone on FOX News said that......."
6- "Someone on right-wing radio said that...."
7- "Someone on a right-wing website said that...."
8- "Government bureaucrats will stand between us and our doctors"
9- "Government cannot run anything properly!!!"
10 - "Ronald Reagan once said that......"
11- "Healthcare should be a free market enterprise......"
12- "Healthcare is not a right"
13- "Jesus wouldn't have supported public healthcare"
14- "Texas should secede y'all"
15- "Obama isn't an American"
16- "(Republican/Blue Dog Democrat) said that......."
17- "In England/Great Britain/Other Inaccurate Name For the UK, they kill babies"

18- "Why should I pay for other people's healthcare/fire departments/police/public roads/public schools/armed forces...etc..."

And so on. There are many more, but those are the main points I hear uninformed and ideologically warped Americans using in the healthcare debate. If your arguments consist or include any of the above as what you consider a serious point, then you are in trouble.

Pretty easy to see a pretty negative opinion of Americans in general, especially the Texans who are singled out, and the Fox news network singled out as well.

Let us consider this list point by point, shall we?

1. Pretty much every society has a group that considers their everything "the best in the world". That there is a small group of Americans who express that sentiment should surprise no one, but is that either important or noteworthy?

2. There is legitimate concern with government expansion and as other similar programs are indeed now socialized and the proponents are supportive of healthcare being socialized, there is a corelation that is somewhat valid. More valid than this dismissive attitude would seem to assert, anyway.

3. Hyperbole, pure simple hyperbole. It isn't that "Obama is taking over" anything, but that an expansion of government influence is undesirable to most Americans, even supporters are not wholeheartedly behind increased government intrusions, like open review of privledged tax information or health records by government on request.

4. This has been debunked and reargued again. The ambiguous source of this concern is overblown and is undefined, but this isn't legitimate in the deabte, IMO, so there is one valid point.

5-7. So ne news source can be referenced and no media assertion used to spur debate? I suppose the almost constant use of politico, CNN, and other editorial sources in this debate are equally useless or detrimental? Maybe they could be listed as well? I can see that there is a definite theme here that "right-wing" people are "uninformed and ideologically warped Americans", but that is aside from being rude, proof of ignorance. That you may not like the source doesn't invalidate it and frankly, who are you to suppose that it should?

8. Legitimate concren given the scope of the project and the fact that it does little to reduce staggering costs which ironicly are the chief complaint about the system in general. Is it far fetched that massive debt and eventual rationing would be a result of a public option? If not, what evidence is there that it isn't a reasonablely assumed outcome? Is there a program that doesn't eventually become a high expense lesser service once it is dominated by a "public option"?

9. Show me the counter-example to disprove this assertion. I have never said "Government can't run anything properly", but I surely don't believe they could run anything with this scope properly. I have repeatedly asked for the example that would counter this belief, but as yet have not been goven one. Maybe you can present one? If not, how is this not valid concern?

10. Reagan was an excellent President and is very well loved and remmebered. Quoting him to make a point isn't a negative. How is it evidence of "uninformed and ideologically warped Americans"? Aside from being disrespectful, that is downright silly as a conclusion.

11. Why shouldn't it be and moreover, who has a right to say that this is yet another instance of "uninformed and ideologically warped Americans "? Again, pretty arrogant and self-righteous to make that assertion.

12-13. Come on, seriously, who is using that argument? The argument is how much healthcare is a right and how should it be provided. As for Jesus, I haven't heard a comment from him so I suppose he isn't in this debate directly, we can all leave him out of it.

14. A joke? If not, well yeah, it is. Despite Texas being larger than many nations and having an economy that is equally larger than most nations, I haven't heard the secession talk over this particular issue. The y'all is stereotyping and derogatory, wonder if there is a rule about that here?

15. Again, this isn't a healthcare debate issue.

16. Quoting an elected official that someone respects that isn't in support of the Obama plan is "uninformed and ideologically warped Americans"? Too bad we aren't all indoctrinated effectively to only listen to one side, then the debate would be pretty quick, huh?

17. is this just for effect?

18. No one is asking "why", but "how can we". It isn't a matter of why should we for most people, but how are we going to be able to afford it without having poor healthcare. We made education a state provided option and now it is poor and dropping with costs ever rising, why would we expect a different outcome from a government healthcare option?


In short, the bias and attitude are evident, but the message is pretty self-serving and inept from this list. It shows an actual anger and lack of consideration for any but the author's own personal beliefs and opinions and actually berates people for disagreeing, especially if they do so using the opinion of people the writer obviously finds "unworthy" of being a source.

Sorry, but how arrogant and self-righteous does one have to be to even put a post like this on these threads? How often have less offensive and less deliberately demeaning posts been removed?

I'm not sure comparing satisfaction in one country versus another is necessarily appropriate or entirely valid. All that those comparisons will show us is that people in country X are more or less satisfied with the health care they receive than people in country Y. While such a comparison makes for fodder to bash one another with, it does nothing to solve the problems in the health care industries in either country


:tu: I agree.

Issues relating to the legislation could very well be related to the fact that it's either overly vague or overly complex. Legislative bills tend to be like that and are often lost on the average citizen. The fact that Obama hasn't been effective at all over promoting the reform may also be an issue.

Perhaps then we should overhaul the political system first?


It wasn't a backhanded swipe. It's was a fronthanded criticism of using such a term.

Oh so it was a deliberate insult?

The list of 5 points you posted, largely consists of answers to strawmen arguments and in no way can be considered an answer of any sort to my postings.

Since you don't care to expound or post links to back the assertation why make the comment?

In an effort to steer the conversation into less heated waters, here's the list of problems I've noticed with the American system.


Insurance companies cancel coverage or raise premiums to an unaffordable level when a person gets sick.
Insurance companies exclude coverage for pre-existing medical conditions for 12 months if you haven't had continuous coverage before you enrolled.
The cost of premiums is so high that some small companies can't afford to provide health coverage for their employees.
The cost of premiums is so high that some lower income employees can't afford to enroll in their companies program or purchase it themselves.
Because people don't have insurance they aren't getting the care they need for chronic conditions.
Because people don't have insurance, minor medical problems go untreated until they become emergencies.
Hospitals turn people away who don't have insurance.
Health care costs are rising really fast.


What else would you guys list?

Unless some Americans abandon some basic absurdities in their reasoning when it comes to healthcare, they will never be able to have a factual and intelligent debate concerning the matter.

Nonsensical arguments which cannot be a part of serious healthcare debate are as follows:

1- "America has the best healthcare in the world"
2- "This will lead to socialism/communism/fascism"
3- "Obama is planning to take over our lives/families/souls"
4- "Death panels will kill us"
5- "Someone on FOX News said that......."
6- "Someone on right-wing radio said that...."
7- "Someone on a right-wing website said that...."
8- "Government bureaucrats will stand between us and our doctors"
9- "Government cannot run anything properly!!!"
10 - "Ronald Reagan once said that......"
11- "Healthcare should be a free market enterprise......"
12- "Healthcare is not a right"
13- "Jesus wouldn't have supported public healthcare"
14- "Texas should secede y'all"
15- "Obama isn't an American"
16- "(Republican/Blue Dog Democrat) said that......."
17- "In England/Great Britain/Other Inaccurate Name For the UK, they kill babies"

18- "Why should I pay for other people's healthcare/fire departments/police/public roads/public schools/armed forces...etc..."

And so on. There are many more, but those are the main points I hear uninformed and ideologically warped Americans using in the healthcare debate. If your arguments consist or include any of the above as what you consider a serious point, then you are in trouble.

So it's OK if we say
1. Someone on CNN/MSNBC/CBS said...
2. Liberal said that...
3. Someone on the left-wing radio said...

Wickedly hypocritical.

Perhaps then we should overhaul the political system first?

I think it should have been done a long time ago.

Oh so it was a deliberate insult?

No, it was a criticism of a certain argument.


Since you don't care to expound or post links to back the assertation why make the comment?

The assertion is self evident. I don't need to deconstruct it in detail in a post.

Pretty easy to see a pretty negative opinion of Americans in general, especially the Texans who are singled out, and the Fox news network singled out as well.

Not Americans in general, nor Texans. But rather specific people who use the arguments I listed. As for FOX News, their bias is obvious.

1. Pretty much every society has a group that considers their everything "the best in the world". That there is a small group of Americans who express that sentiment should surprise no one, but is that either important or noteworthy?

It is important or noteworthy if such declarations are taken seriously.

2. There is legitimate concern with government expansion and as other similar programs are indeed now socialized and the proponents are supportive of healthcare being socialized, there is a corelation that is somewhat valid. More valid than this dismissive attitude would seem to assert, anyway.

There's a big difference between saying "Ok, this government program is in the vein of social democracy" and saying "it's a communism plot and takeover!"

3. Hyperbole, pure simple hyperbole. It isn't that "Obama is taking over" anything, but that an expansion of government influence is undesirable to most Americans, even supporters are not wholeheartedly behind increased government intrusions, like open review of privledged tax information or health records by government on request.

Already addressed in my response to #2

4. This has been debunked and reargued again. The ambiguous source of this concern is overblown and is undefined, but this isn't legitimate in the deabte, IMO, so there is one valid point.

I know it's not "legitimate in the the debate". That's why I criticise anyone that argument which has indeed been used by Palin and Grassley.

5-7. So ne news source can be referenced and no media assertion used to spur debate? I suppose the almost constant use of politico, CNN, and other editorial sources in this debate are equally useless or detrimental? Maybe they could be listed as well? I can see that there is a definite theme here that "right-wing" people are "uninformed and ideologically warped Americans", but that is aside from being rude, proof of ignorance. That you may not like the source doesn't invalidate it and frankly, who are you to suppose that it should?

News sources can be referenced, but preferably ones that can back up their assertions and reports. FOX News, Rush Limbaugh and WorldNetDaily are examples of right wing TV, radio and web-based sources which are suspect in terms of credibility.

8. Legitimate concren given the scope of the project and the fact that it does little to reduce staggering costs which ironicly are the chief complaint about the system in general. Is it far fetched that massive debt and eventual rationing would be a result of a public option? If not, what evidence is there that it isn't a reasonablely assumed outcome? Is there a program that doesn't eventually become a high expense lesser service once it is dominated by a "public option"?

Not a legitimate concern at all. Firstly it fails to acknowledge the presence of private insurance bureaucrats deciding who gets treatment or coverage, and doesn't bear any reality to systems such as the UK where a GP for example doesn't need to ask the government first before you make an appointment to see him. Cost debates are a different issue entirely. That is a legitimate concern which should be addressed logically.

9. Show me the counter-example to disprove this assertion. I have never said "Government can't run anything properly", but I surely don't believe they could run anything with this scope properly. I have repeatedly asked for the example that would counter this belief, but as yet have not been goven one. Maybe you can present one? If not, how is this not valid concern?

They run the Armed Forces, the police, the fire departments, the mail service. All of which are of huge scope. It relates to the rather odd American cultural trait among some of mistrusting or opposing government.

10. Reagan was an excellent President and is very well loved and remmebered. Quoting him to make a point isn't a negative. How is it evidence of "uninformed and ideologically warped Americans"? Aside from being disrespectful, that is downright silly as a conclusion.

Whether or not he was "excellent" depends on one's own perspective. Being remembered doesn't mean anything. Reagan himself spun a yarn about the evils of socialised medicine which simply appealed to irrational fears. Similar tactics are being used today.

11. Why shouldn't it be and moreover, who has a right to say that this is yet another instance of "uninformed and ideologically warped Americans "? Again, pretty arrogant and self-righteous to make that assertion.

I don't think there are many other nations in the Western world where segments of the population would seriously support privatising healthcare entirely. I think it is uniquely American in that regard.

12-13. Come on, seriously, who is using that argument? The argument is how much healthcare is a right and how should it be provided. As for Jesus, I haven't heard a comment from him so I suppose he isn't in this debate directly, we can all leave him out of it.

I favour leaving religion out of it, but the right wing unfortunately do not. The crazed Michelle Bachmann was talking about fasting and praying and slitting her wrists in an effort to bond together with like minded individuals to oppose healthcare reform.

14. A joke? If not, well yeah, it is. Despite Texas being larger than many nations and having an economy that is equally larger than most nations, I haven't heard the secession talk over this particular issue. The y'all is stereotyping and derogatory, wonder if there is a rule about that here?

The secession talk is very serious. Even the governor of Texas has jumped on that absurd bandwagon. It started with the ridiculous "teabaggers" and has carried over into the healthcare debate.

15. Again, this isn't a healthcare debate issue.

Not directly, but it does relate to the irrational mindset which is being used in the healthcare debate issue.

16. Quoting an elected official that someone respects that isn't in support of the Obama plan is "uninformed and ideologically warped Americans"? Too bad we aren't all indoctrinated effectively to only listen to one side, then the debate would be pretty quick, huh?

Yes, it's a problem, because most of the rather nonsensical arguments in Congress have been coming from Republicans and Blue Dogs. When one side is talking sense and other is spreading misinformation, no you don't have to listen to both sides.

17. is this just for effect?

Yes, as an extension of other silly arguments being used against Britain's NHS.

18. No one is asking "why", but "how can we". It isn't a matter of why should we for most people, but how are we going to be able to afford it without having poor healthcare. We made education a state provided option and now it is poor and dropping with costs ever rising, why would we expect a different outcome from a government healthcare option?

I have no problem with people asking "how". That's a legitimate area of debate.

So it's OK if we say
1. Someone on CNN/MSNBC/CBS said...
2. Liberal said that...
3. Someone on the left-wing radio said...

Wickedly hypocritical.

Not really since chances are you'd hear more factual arguments from those sources when it comes to healthcare, and other issues.

Moving onto a different topic, and in an overt attempt to CALM things down, have any of you read the list of the list of problems in the US health care system? If you haven't it's below for you to review and add or edit.

If you were the ruler of my great country, what would you propose to address the concerns listed below and why do you think your solution would be effective at resolving the problems?



Insurance companies cancel coverage or raise premiums to an unaffordable level when a person gets sick.
Insurance companies exclude coverage for pre-existing medical conditions for 12 months if you haven't had continuous coverage before you enrolled.
The cost of premiums is so high that some small companies can't afford to provide health coverage for their employees.
The cost of premiums is so high that some lower income employees can't afford to enroll in their companies program or purchase it themselves.
Because people don't have insurance they aren't getting the care they need for chronic conditions.
Because people don't have insurance, minor medical problems go untreated until they become emergencies.
Hospitals turn people away who don't have insurance.
Health care costs are rising really fast.

Let's keep the hypocritical statements to a bare minimum. I'm not a mod, but I know how much it hurts the conversation/debate when we start inserting wickedly hypocritical statements like that. I really find that your post, AldeberanBlack, is very offensive, very biased, and very close-minded. Let's get on with healthcare and health insurance in the US, please? Ah, let's get to Mom's post right above mine.

ETA: I would add to Mom's list that health insurance is hard to understand so maybe they should make it so that a layperson like me knows what they're looking for and at when purchasing health insurance.

My post would only be offensive to those who use the arguments I listed.

The only real response I've received to my list is "But...I don't personally use those arguments!"

And I have no problem with those of you who don't. My problem is with those who do.

My post would only be offensive to those who use the arguments I listed.

The only real response I've received to my list is "But...I don't personally use those arguments!"

And I have no problem with those of you who don't. My problem is with those who do.

And that's just it isn't it? Not everyone does. You are stereotyping here or at least that is how it is being recieved.

If everyone can't listen to Mom's idea, followed up nicely by Leah, then I'll close the thread or take formal disciplinary action. Like in the rules of the DoIMC. Understood?

Is that scary enough? :whistle:

And that's just it isn't it? Not everyone does. You are stereotyping here or at least that is how it is being recieved.

Well that's my point. Not everyone does, and that is great. If someone does not use the arguments I listed, then I have no problem with them, like I said.

Healthcare debate is too important to allow people who do indeed use the arguments I listed to hijack it with nonsensical tangents which do not hold up to scrutiny. Only by facing those who use those arguments, can more reasonable people have a sensible debate.

If a person doesn't use those arguments, they have nothing to worry about since they don't fall into the catagory of people I was identifying.

If everyone can't listen to Mom's idea, followed up nicely by Leah, then I'll close the thread or take formal disciplinary action. Like in the rules of the DoIMC. Understood?

Is that scary enough? :whistle:

Yep. :love:

I wanted add something about the high cost of prescription drugs but can't figure out how to word it for the list. What would you all suggest?

In honor of Pfizer paying 2.3 billion fine for illegal marketing, Pfizering?

Insurance companies cancel coverage or raise premiums to an unaffordable level when a person gets sick.

Insurance companies exclude coverage for pre-existing medical conditions for 12 months if you haven't had continuous coverage before you enrolled.

The cost of premiums is so high that some small companies can't afford to provide health coverage for their employees.

The cost of premiums is so high that some lower income employees can't afford to enroll in their companies program or purchase it themselves.

Because people don't have insurance they aren't getting the care they need for chronic conditions.

Because people don't have insurance, minor medical problems go untreated until they become emergencies.

Hospitals turn people away who don't have insurance.

None of these would be an issue with public healthcare.

Health care costs are rising really fast.

This is the one issue which poses a problem to both private and public healthcare. Reducing bureaucracy and unnecessary levels of administration would be a good first step. Another would be to encourage a healthier lifestyle/wellness culture among the population of a country itself.

In honor of Pfizer paying 2.3 billion fine for illegal marketing, Pfizering?

:lol: Maybe that'll get the ED adverts out of SpongeBob re-runs......

Insurance companies cancel coverage or raise premiums to an unaffordable level when a person gets sick.
Insurance companies exclude coverage for pre-existing medical conditions for 12 months if you haven't had continuous coverage before you enrolled.
The cost of premiums is so high that some small companies can't afford to provide health coverage for their employees.
The cost of premiums is so high that some lower income employees can't afford to enroll in their companies program or purchase it themselves.
Because people don't have insurance they aren't getting the care they need for chronic conditions.
Because people don't have insurance, minor medical problems go untreated until they become emergencies.
Hospitals turn people away who don't have insurance.
Health care costs are rising really fast.


Wow, I take one little week off and we go bonkers. ;)

Okay, please bear in mind that I'm a simple consumer of insurance and I don't have a good understanding of the macroeconomic associations of the industry.

Insurance companies cancel coverage or raise premiums to an unaffordable level when a person gets sick.

-As part of a portability regime, institute a 60 day "cooling off" period before a policy can be canceled. Actually, the time frame should be enough to allow the patient to buy into a high risk pool. One other idea is kind of a "you break it, you buy it" principle. If the policy holder gets sick while covered by the plan, the plan can not be canceled.

Insurance companies exclude coverage for pre-existing medical conditions for 12 months if you haven't had continuous coverage before you enrolled.

-First, eliminate length of continuous coverage as a requirement. Second, I would support the insurance companies or the states creating a high risk pool to cover those with pre-existing conditions.

The cost of premiums is so high that some small companies can't afford to provide health coverage for their employees.

-Eliminate state mandates that keep consumers from buying a policy from across state lines. Introduce true competition, much like we do with 529's for school costs. You can shop any state's 529 plan to get the best deal.

Secondly, eliminate employer provided insurance. Allow consumers to purchase a plan that is personal to them or their family with a la carte options. The plans follow the consumer, and are not at the whims of a company trying to keep costs contained.

The cost of premiums is so high that some lower income employees can't afford to enroll in their companies program or purchase it themselves.

-Provide either tax credits or HSA options to allow low income people purchase plans on their own. Do not rely on the employer (or the government).

Because people don't have insurance they aren't getting the care
they need for chronic conditions.

-Obviously the key is insure more people, but it must start with better competition within the free market by taking out the mandated coverage that people neither want nor need. If I don't want accupuncture coverage, take it out.

Because people don't have insurance, minor medical problems go untreated until they become emergencies.

-I don't know about this one, but I will say that I've had good experiences with Urgent Care centers, kind of a 7-11 for minor things. Done at volume (one on every corner like a drug store, hey, why not have them IN the drug stores?) will give us economies of scale to bring prices down.

Hospitals turn people away who don't have insurance.

The reason they do that is because the costs are never recouped The idea is insure more people.

Health care costs are rising really fast.

Take a comprehensive approach. Look at competition, prevention, and TORT REFORM! Eliminate the high premiums of Med Mal insurance. Put a cap on PUNITIVE damages (not compensatory) and stick to it. In a previous post I cited at least $30 Billion per year in savings.


So, I'm no rocket scientist, but my ideas are around loosening special interest mandates and really opening things up. If I live in Florida and I want to by an Arizona company's plan, let me. Just like we have to be good consumers when selecting Auto insurance, we need to be good consumers with our health insurance.

I think if the individual has more "skin in the game" around policy selection and payment, you will find the insurance companies bending over backwards to get that business.


Oh, and I'm a member of the vast RIGHT WING conspiracy.

Wow, I take one little week off and we go bonkers. ;)

:yuhup:

Insurance companies cancel coverage or raise premiums to an unaffordable level when a person gets sick.

-As part of a portability regime, institute a 60 day "cooling off" period before a policy can be canceled. Actually, the time frame should be enough to allow the patient to buy into a high risk pool. One other idea is kind of a "you break it, you buy it" principle. If the policy holder gets sick while covered by the plan, the plan can not be canceled.

Insurance companies exclude coverage for pre-existing medical conditions for 12 months if you haven't had continuous coverage before you enrolled.

-First, eliminate length of continuous coverage as a requirement. Second, I would support the insurance companies or the states creating a high risk pool to cover those with pre-existing conditions.

I had though that perhaps allowing more group sponsored pools might help. Because the pool has negotiated pricing that applies to every person in the pool, then because the increases costs of caring for someone during an illness will be absorbed across the community and the effect on the individual wouldn't be as pronounced.

More pools could come from membership organizations and associations. Maybe state and federal governments could open their employee pools to the general public. Many of the policies offered in state and federal government employee benefits packages require coverage for pre-existing conditions so that might help with the next item on the list.

The cost of premiums is so high that some small companies can't afford to provide health coverage for their employees.

-Eliminate state mandates that keep consumers from buying a policy from across state lines. Introduce true competition, much like we do with 529's for school costs. You can shop any state's 529 plan to get the best deal.

Secondly, eliminate employer provided insurance. Allow consumers to purchase a plan that is personal to them or their family with a la carte options. The plans follow the consumer, and are not at the whims of a company trying to keep costs contained.

I like that idea as well.

The cost of premiums is so high that some lower income employees can't afford to enroll in their companies program or purchase it themselves.

-Provide either tax credits or HSA options to allow low income people purchase plans on their own. Do not rely on the employer (or the government).

It's funny - current tax laws encourages businesses to provide health benefits by allowing employers to deduct the cost of that benefit from their taxes. But tax law punishes individuals who purchase their own insurance by not allowing them to deduc the cost of their private individual plan from their taxes.

I think that employers who provide a group benefit should be allowed to deduct the cost of that benefit from their taxes and individuals who purchase private coverage for themselves and their families ought to be able to deduct it from their taxes. I like to idea of giving credits to people below a set income level to encourage them to buy their own coverage.

Because people don't have insurance they aren't getting the care
they need for chronic conditions.

-Obviously the key is insure more people, but it must start with better competition within the free market by taking out the mandated coverage that people neither want nor need. If I don't want accupuncture coverage, take it out.

Good points.

Because people don't have insurance, minor medical problems go untreated until they become emergencies.

-I don't know about this one, but I will say that I've had good experiences with Urgent Care centers, kind of a 7-11 for minor things. Done at volume (one on every corner like a drug store, hey, why not have them IN the drug stores?) will give us economies of scale to bring prices down.

And with more people having access to affordable coverage, more of them will get the appropriate treatment when they need it.

Hospitals turn people away who don't have insurance.

The reason they do that is because the costs are never recouped The idea is insure more people.

I agree.

Health care costs are rising really fast.

Take a comprehensive approach. Look at competition, prevention, and TORT REFORM! Eliminate the high premiums of Med Mal insurance. Put a cap on PUNITIVE damages (not compensatory) and stick to it. In a previous post I cited at least $30 Billion per year in savings.

Good suggestions.

I'm not saying you guys should have our system - you have your own traditions and logistical problems that may make a similar system inappropriate for you. But stop painting us as an example of a rubbish health system, because it's not a picture that I, or most of my compatriots, recognise.


In this case, The UK's Telegraph are posting the criticism of the NHS. Given the level of concern by many in the US regarding the consequences of socialised medicine, such stories (if true) only serve to heighten said concern.

In this case, The UK's Telegraph are posting the criticism of the NHS. Given the level of concern by many in the US regarding the consequences of socialised medicine, such stories (if true) only serve to heighten said concern.Then shouldn't we be focusing on the positives as oppossed to the rare or obscure negatives then? Why not focus on the benefits an NHS-style system has instead of trying to find everything that's wrong with it? Yes, there are negatives with any system, but we should see if the pros outweigh the cons, not the other way around.

Health care costs are rising really fast.

Take a comprehensive approach. Look at competition, prevention, and TORT REFORM! Eliminate the high premiums of Med Mal insurance. Put a cap on PUNITIVE damages (not compensatory) and stick to it. In a previous post I cited at least $30 Billion per year in savings.I agree with most everything you listed here, but this I really agree with! I feel that this the main problem with our system...the Med Mal Insurance. They really should put a cap on it. :tu:

By the same token why focus on just the good? NHS isn't bad, but it's not perfect. If we were to implement it in the US (and I'm not saying we are, this is a what if thing) it would be the good and the bad, so we'd have to look at both.

Then shouldn't we be focusing on the positives as oppossed to the rare or obscure negatives then? Why not focus on the benefits an NHS-style system has instead of trying to find everything that's wrong with it? Yes, there are negatives with any system, but we should see if the pros outweigh the cons, not the other way around.

Why not just focus on the issues facing the US and ideas for fixing them?

I agree with most everything you listed here, but this I really agree with! I feel that this the main problem with our system...the Med Mal Insurance. They really should put a cap on it. :tu:

So Med Mal is a real thing? It's not just a term Gator coined (sorry Gator)? Can you explain it a bit more? Does Med Mal have anything to do with TORT reform? While I know lots of people support tort reform, I haven't been able to find anything that demonstrates how much, if any, savings would come from Tort Reform. Or am I just confused and in need of a nap?

Why not just focus on the issues facing the US and ideas for fixing them?



So Med Mal is a real thing? It's not just a term Gator coined (sorry Gator)? Can you explain it a bit more? Does Med Mal have anything to do with TORT reform? While I know lots of people support tort reform, I haven't been able to find anything that demonstrates how much, if any, savings would come from Tort Reform. Or am I just confused and in need of a nap?

On point A, I agree, which is why to me that I think that when others bring up issues with a foreign system that the current bills are not trying to emulate it is an unfair attack on the bills that just ends up misleading people into opposing it for reasons that are false. If we aren't trying to introduce a Canadian or British system, then saying that the US proposed reform won't work because of long wait times in Canada or because of some issue in the NHS system is an invalid attack to me.

On point B, I think Med Mal is "medical malpractice", which to me would tie in with tort reform. A punitive damages cap and a careful rewrite of the law to make it harder for frivolous lawsuits to gain traction would be valuable. I think that by giving judges wider latitude to throw out lawsuits and to order plaintiffs to pay the entirety of the doctor's legal fees might work; but I'd feel more comfortable with that if we had a few M.D. / JD's in the judiciary.

My view on tort reform has always been it should be included, but it isn't the big panacea some make it out to be, and other cost-control measures have to be included.

On point A, I agree, which is why to me that I think that when others bring up issues with a foreign system that the current bills are not trying to emulate it is an unfair attack on the bills that just ends up misleading people into opposing it for reasons that are false. If we aren't trying to introduce a Canadian or British system, then saying that the US proposed reform won't work because of long wait times in Canada or because of some issue in the NHS system is an invalid attack to me.

On point B, I think Med Mal is "medical malpractice", which to me would tie in with tort reform. A punitive damages cap and a careful rewrite of the law to make it harder for frivolous lawsuits to gain traction would be valuable. I think that by giving judges wider latitude to throw out lawsuits and to order plaintiffs to pay the entirety of the doctor's legal fees might work; but I'd feel more comfortable with that if we had a few M.D. / JD's in the judiciary.

My view on tort reform has always been it should be included, but it isn't the big panacea some make it out to be, and other cost-control measures have to be included.

No doubt that there isn't one single panacea that will solve the issue. I think there has to be a multi layered approach. That's why I was really intrigued by the Feingold-Graham plan from last year that took a laboratory approach to the problem by setting up five year experiments to get empirical data on what worked and what doesn't. We didn't get here overnight and the "solution" won't be gotten to overnight.

I like most of Gator's ideas. I really like having the medical insurance be the responsibility of the individual, not the employer. My last employer went through a period of 4-5 years changing insurance companies and coverage every single year! I never knew what my plan covered because it changed so often. And if they had given me the money they were spending on my insurance, I could have gotten my own plan that I was happy with and had money left over:a win-win situation! (I know this because I got quotes and was about to do so despite not getting any tax breaks or reimbursement from my employer just so I could have reliable coverage I understood that wasn't changing with the weather.) And that was before HSAs had been instituted (or at least before I had heard of them). I would love to get my own health insurance as I do my own car insurance, home owners insurance, etc. Let me choose the company and plan that best suits my needs. And drop minimum coverages. I had a hysterectomy in 1995. I don't need pregnancy or birth control coverage. If I want a plan that covers chiropractors and acupuncture, let me pay for that; if I don't, don't force me to. Personal choice, personal responsibility, personal tax breaks. (Unless we move to the FairTax, where all that is moot...but that's another discussion. ;))

And I far prefer debating the issues over insulting the debaters. I appreciate those who are rising above that to make this discussion meaningful.

In this case, The UK's Telegraph are posting the criticism of the NHS. Given the level of concern by many in the US regarding the consequences of socialised medicine, such stories (if true) only serve to heighten said concern.

Like the US, the UK has its left and right leaning media. In this case a Conservative-aligned newspaper is posting criticism of a service presently run by a center-left government. I take it all with a pinch of salt. What you want to ask yourself is what happens when a Conservative government is forced into running a socialised health service enjoyed by all. The last time it happened in the UK, our system was run into the ground through cuts & underinvestment and I'm yet to be convinced a future Conservative government wouldn't do the same.

Like the US, the UK has its left and right leaning media. In this case a Conservative-aligned newspaper is posting criticism of a service presently run by a center-left government. I take it all with a pinch of salt. What you want to ask yourself is what happens when a Conservative government is forced into running a socialised health service enjoyed by all. The last time it happened in the UK, our system was run into the ground through cuts & underinvestment and I'm yet to be convinced a future Conservative government wouldn't do the same.
I would say it's a certainty - they hate it because it shows there is such a thing as society yet recognise it is incredibly popular

My great concern with the NHS (from personal experience) is that they put far too much effort into keeping people alive towards the end of life even though their quality of life is rubbish (I read somewhere that 80% of expenditure is on the last year of life though I can't verify it) I've made quite sure I've produced a living will (what some people in the US call going before a death panel) because I don't want it to happen to me if I am incapable of making my wishes clear. From actually reading the Telegraph article (something I would rarely admit to doing) it seems to me that the doctors complaining are exactly the sort of practitioners I want to avoid - it reads as though they would do anything to keep a body breathing whatever the suffering it is experiencing. Death is the natural end to our lives not something to avoided for as long as possible.

In this case, The UK's Telegraph are posting the criticism of the NHS. Given the level of concern by many in the US regarding the consequences of socialised medicine, such stories (if true) only serve to heighten said concern.

What Morgoth said.

Also (as I also said in my previous post, but which you chose to ignore), in this particular article, the Telegraph were not criticising the NHS in total, they were criticising one current NHS policy, and reporting the concerns of a group of doctors who are also within the NHS. So, basically, they were supporting one element within the socialised medical system against another element, not advocating privatisation. And, as Morgoth pointed out, attacking the current government's health policy, not the idea of a state-funded NHS per se.

At no point, according to my understanding of the article, did the Telegraph say or imply that this particular policy is a result of the NHS being a "socialised" system. If you can find a point where they say that, please point it out.

I still feel you are making a fairly basic logical fallacy by assuming that because

(a) The NHS is a state-run, tax-funded health system
(b) There are problems with some elements of the NHS

then it must necessarily follow that

(c) those problems are the direct results of the NHS being a state-run, tax-funded health system

As Mundungus has already pointed out, the issue of palliative care policy has nothing to do with state control or funding levels. These people are not being killed off because the NHS can't afford to look after them! It is simply the fact that the current trend in UK medicine is to offer palliative care rather than remedial treatment to patients who have been diagnosed as terminally ill (on the grounds that it is more humane and in the patients' best interests - something which Dung agrees with. I'm less sure). Even in private systems such as that in the US, medical colleges and doctors' organisations promote certain models of good practice and not others and there are certain trends or policies in treatment, some of which later prove to have been misguided (e.g. the use of lobotomies to treat mental illness in the 1950s).

Again, I would ask, if you have any evidence that the palliative care policy is a result of the NHS being "socialised", please cite it.

What Morgoth said.

Also (as I also said in my previous post, but which you chose to ignore), in this particular article, the Telegraph were not criticising the NHS in total, they were criticising one current NHS policy, and reporting the concerns of a group of doctors who are also within the NHS. So, basically, they were supporting one element within the socialised medical system against another element, not advocating privatisation. And, as Morgoth pointed out, attacking the current government's health policy, not the idea of a state-funded NHS per se.

At no point, according to my understanding of the article, did the Telegraph say or imply that this particular policy is a result of the NHS being a "socialised" system. If you can find a point where they say that, please point it out.

I still feel you are making a fairly basic logical fallacy by assuming that because

(a) The NHS is a state-run, tax-funded health system
(b) There are problems with some elements of the NHS

then it must necessarily follow that

(c) those problems are the direct results of the NHS being a state-run, tax-funded health system

As Mundungus has already pointed out, the issue of palliative care policy has nothing to do with state control or funding levels. These people are not being killed off because the NHS can't afford to look after them! It is simply the fact that the current trend in UK medicine is to offer palliative care rather than remedial treatment to patients who have been diagnosed as terminally ill (on the grounds that it is more humane and in the patients' best interests - something which Dung agrees with. I'm less sure). Even in private systems such as that in the US, medical colleges and doctors' organisations promote certain models of good practice and not others and there are certain trends or policies in treatment, some of which later prove to have been misguided (e.g. the use of lobotomies to treat mental illness in the 1950s).

Again, I would ask, if you have any evidence that the palliative care policy is a result of the NHS being "socialised", please cite it.


My issue with the NHS and how it would or would not apply to health care in the US has nothing to do with the perception, whether right or wrong, of its efficacy for the people it serves.

No doubt, in any long standing bureaucracy, one could find egregious issues of malfeasance. The Guardian article, in many respects, is no different from the issues found at Walter Reed Hospital under the VA.

My issue is with the fact that the NHS is the UK's largest single employer in terms of number of employees and right up there with being one of the largest employers in the world. That's to serve 60 Million citizens.

What must the cost and infrastructure look like to service 300 Million? Even more telling, if we accept the numbers of uninsured being bandied about by Obamacare supporters (47 Million, including illegal aliens), that would be like adding the NHS (with cost and infrastructure) to the Federal Budget, and where does that money come from?

Morgoth, do you have an estimated annual budget for the NHS? Is it underfunded or on the way to bankruptcy like Medicare is here in the US?

Morgoth, do you have an estimated annual budget for the NHS? Is it underfunded or on the way to bankruptcy like Medicare is here in the US?
I'll jump in since Morgoth has to work for a living. In 2005 (the latest I could find) the UK spent $3065 per head per annum; the US spent $6347. (that's around £90 billion in total here - the budget for 2007. Since you have five times our population it would be £450 billion in the US - $675 billion) Since health outcomes (age of death, infant mortality, maternal mortality etc.) are marginally better here you have to wonder where the American money goes

Our figure is around the western European average so it's difficult to argue that it's underfunded. There is of course a constant worry about medical inflation being higher than general inflation but we have the advantage that the NHS is an almost monopoly provider of prescription pharmaceuticals and can get a very good deal from the manufacturers. I read elsewhere that this will reduce innovation in the drug companies but it doesn't seem likely to me - between 15 and 20% of the leading drugs in the world were developed here and all the major companies have R&D facilities here.

But comparisons between the NHS and any proposed US system are irrelevant - the administration is not proposing anything like it for you.

If the VA is so bad why have so many members of Congress been treated at Bethesda ? (including Senator McCain)

The VA isn't "so bad" in general, but it got a pretty big black eye around certain facilities a few years back. In reference to why per head cost is so high, in my opinion, it's in the overhead required to get reimbursement, no matter who the source. The bureaucracy in Medicare alone is tremendously cost intensive.

Having been a US Naval officer myself, I can tell you Bethesda is NOT a VA facility. It is a Naval facility. The VA maintains a separate and distinct infrastructure. If I remember correctly, Bethesda does not handle VA cases, only active duty and members of the government. A few years ago, an expose, much like the Guardian article, came out on some VA facilities around cleanliness, staff indifference and general neglect.

No doubt, in any long standing bureaucracy, one could find egregious issues of malfeasance. The Guardian article, in many respects, is no different from the issues found at Walter Reed Hospital under the VA.

Private corporations also screw up sometimes, not just long-standing public bureaucracies.

My issue is with the fact that the NHS is the UK's largest single employer in terms of number of employees and right up there with being one of the largest employers in the world. That's to serve 60 Million citizens.

What must the cost and infrastructure look like to service 300 Million? Even more telling, if we accept the numbers of uninsured being bandied about by Obamacare supporters (47 Million, including illegal aliens), that would be like adding the NHS (with cost and infrastructure) to the Federal Budget, and where does that money come from?

Morgoth, do you have an estimated annual budget for the NHS? Is it underfunded or on the way to bankruptcy like Medicare is here in the US?

I find it odd (and, actually, implicitly quite insulting) that you address this question to Morgoth when responding to my post.

The NHS's budget last year was just over £90 billion:

http://www.nhs.uk/NHSEngland/aboutnhs/Pages/About.aspx

And, yes, admittedly, it is facing financial struggles, largely because of the cost of coping with the ageing population, and the fact that the retired are outnumbering the working taxpayers contributing to the funding, but alcohol-related injury/illness is also a huge drain on NHS resources:

http://news.bbc.co.uk/1/hi/health/8091427.stm

Having said that, medical care is expensive, no matter who's footing the bill, and if it were employers/individuals/insurance companies, rather than the government, I can't see that that would take the problem away. I already avoid getting the care I need in terms of eye care and dental care because that has not been free on the NHS to anyone other than those on benefits since the 80s (I think I last went to the dentist in 1991).

If medical care were no longer government-funded for anyone other than those on benefits, I just wouldn't be able to cope, as I am sure I wouldn't find a private insurer who would charge as little as the £120 a year I currently pay to the government in National Insurance.

As I have repeatedly said, though, I don't know that a system like ours would be right for the US, which is a much larger country with a different history, and I'm offering no opinion on that, as it's not my country.

And, yes, admittedly, it is facing financial struggles, largely because of the cost of coping with the ageing population, and the fact that the retired are outnumbering the working taxpayers contributing to the funding, but alcohol-related injury/illness is also a huge drain on NHS resources:


I guess if you are to compare figures you have to factor in exactly what are the main drains on resources in the states. I remember OldLupin posted some figures pointing that road accidents are far more of a problem in the US. However, on our side of the pond, alcohol related injuries are higher than well, pretty much anywhere in western europe except a few of the more northern countries.

I think we have exhausted the apples to oranges nature of existing NHS and the proposals being made. In short, we have still not been doing much debate on the actual Bill(s), or the immediate stated goals of the Bill(s) that are in play. This isn't meant as an insult to anyone as I have repeatedly been guilty of debating apples to oranges, though I haven't actually engaged in belittling either system.

The point is, the actions being considered in Congress are potentially life altering and will have an impact on everyone, regardless of how their healthcare is handled today. My question is in line with what was posted above. If there is a "public option" how will the vast majority be able to afford private insurance and still pay for a large public insurer?
Is it unreasonable to assume that there would be a mass migration from private insurance to public if that option is created? If not, why not? If we will in effect have to pay for the public option regardless, (see public education) who will still pay for the private option even if it is in theory still available? I ask this because, as presented, this is being viewed as a supplimental option in the market, but in reality isn't it almost certainly going to become the primary source of healthcare for the vast majority of the nation? What prohibits this becoming a 300,000,000-400,000,000 person coverage plan? If it does become such a plan, is there any realistic expectation that it will be well run, cost efficient or capable of serving that many people? Especially if the government doesn't intend to employ the doctors?

Is there a counter-balance in the Bill(s) to avoid a mass expansion or to account for a tax funded competitor that can operate at a huge loss indefinitely? I haven't seen that provision in my read-throughs, though I will admit they have been pretty superficial. In effect wouldn't all health providers actually be almost immediately in jeopardy of disappearing? If not, how can they continue if the vast majority of people use the "public option" and the for the rest they have to compete not only against their peers, but an entity with incredible financial advatage?

We may not have an NHS-style health system proposed directly, but in realistic net effect, isn't the likely outcome of what is being debated pretty likely to be a hybrid of an NHS in short order? Is that really feasible in the U.S.?

I guess if you are to compare figures you have to factor in exactly what are the main drains on resources in the states. I remember OldLupin posted some figures pointing that road accidents are far more of a problem in the US. However, on our side of the pond, alcohol related injuries are higher than well, pretty much anywhere in western europe except a few of the more northern countries.

I think the sprawl and high rural populations contribute to health issues as well. Lots more driving, including more distance daily, lots more obesity and more geographical seperation from medical facilities. The U.S. has more population outside large sities than in them. All of that is a factor in healthcare, life expectancy and general health. Of course, all nations have factors that weigh heavier in their culture as well.

All of this makes life expectancy and length of life hard to decifer for purposes of defining healthcare, IMO. I would assume that the NHS tries to increase prevention, but the expenses of these factors are ever present. I understand that they do an admirable job though. I think the nature of the issues in the U.S., might make them more difficult and expensive, but that is only my opinion.

I guess if you are to compare figures you have to factor in exactly what are the main drains on resources in the states. I remember OldLupin posted some figures pointing that road accidents are far more of a problem in the US. However, on our side of the pond, alcohol related injuries are higher than well, pretty much anywhere in western europe except a few of the more northern countries.

I found the same stats as Lupin - apparently American's are really bad drivers. Our traffic fatality rates are much higher than those in the Europe. Alcohol and substance abuse are thought to be major contributing factors.

The VA isn't "so bad" in general, but it got a pretty big black eye around certain facilities a few years back. In reference to why per head cost is so high, in my opinion, it's in the overhead required to get reimbursement, no matter who the source. The bureaucracy in Medicare alone is tremendously cost intensive.

Having been a US Naval officer myself, I can tell you Bethesda is NOT a VA facility. It is a Naval facility. The VA maintains a separate and distinct infrastructure. If I remember correctly, Bethesda does not handle VA cases, only active duty and members of the government. A few years ago, an expose, much like the Guardian article, came out on some VA facilities around cleanliness, staff indifference and general neglect.

I will just say my experience with the VA on the part of my father who is a veteran was very poor. Lots and lots of paperwork and still waiting to be seen. It was ridiculous what he had to go through. He has almost no hearing in one ear and while that isn't life threatning it did disgust me how he was treated. Now it is at the point where he no longer cares so he just walks around and deals with limited hearing.

Of course this is just my own personal experience and there are many more stories out there that are positive and have great outcomes. My grandfather who is a ww2 veteran was treated well. So I guess where you find bad you can find some good.

If there is a "public option" how will the vast majority be able to afford private insurance and still pay for a large public insurer?
Is it unreasonable to assume that there would be a mass migration from private insurance to public if that option is created? If not, why not? If we will in effect have to pay for the public option regardless, (see public education) who will still pay for the private option even if it is in theory still available? I ask this because, as presented, this is being viewed as a supplimental option in the market, but in reality isn't it almost certainly going to become the primary source of healthcare for the vast majority of the nation?

I think the theory is that you will be able to retain your private insurance if those companies come down on their pricing due to having to be competitive with the public plan. It's not stated directly in the bill, of course.

Now where it gets confusing is how much more affordable will the public plan be? And what are the care limits? Will you get the same amount of care that you would from your private insurance for less? Or will you get more for less? Or will you get less for less? If you get the same or more for less then of course people will not want the private insurance. I think the rub is this. Or at least it is for me. I am already, through my taxes, paying for Medicaid/care. If I should be able to prove I have private insurance I should either get a tax credit or should be exempted from paying taxes into the private option. And it's not because of some fairness issue. As you so rightly point out how many people can afford to pay taxes into Medicaid/care, a public option, and a private insurer even if the private insurer does come down in price?

I find it odd (and, actually, implicitly quite insulting) that you address this question to Morgoth when responding to my post.


Melaszka, no offense was intended, considering I thought this was a general discussion. I'll be sure to exclude everyone else when I respond to your posts.

So, Melaszka, given the remainder of your post, do you really think you only pay 120 (was that pounds?) per annum, or do you weigh in the amount in taxes that you pay?

You see, Melaszka, in my opinion, that's the problem with the current US system AND a proposed "public" option. The consumers tend to think that these fees are low cost or "free" when, in fact, they are not.

Melaszka, today, in the US, employers foot a good percentage of the cost of premiums, costs the employees do not see. In a public option, that burden would be born by the taxpayer. In my humble opinion, Melaszka, this is where the whole "entitlement" mindset comes from.

Melaszka, do you really believe your true costs for health care is what you pay out of pocket per annum?

I'd be willing to bet that we're not bad drivers per se - we just drive so much more that the number of traffic-related deaths ends up higher. If you normalize it to a "per kilometer" or "per mile" basis, the fatality rate would end up different. Thus, if we drive 5 times as many miles as an average British person here in the United States and we have 3 times as many traffic deaths, we'd actually be safer drivers per average distance. (putting my own numbers in)

ETA figures, I found the table (http://en.wikipedia.org/wiki/List_of_OECD_countries_by_traffic-related_death_rate) in my quick google search. We in the US are middle-of-the road in per billion vehicle-km deaths. (9 deaths; compared to 6.3 in Britain, 10.1 in New Zealand, etc - western European countries still end up a bit lower than the US but most of the rest of the world is higher).

I'd be willing to bet that we're not bad drivers per se - we just drive so much more that the number of traffic-related deaths ends up higher. If you normalize it to a "per kilometer" or "per mile" basis, the fatality rate would end up different. Thus, if we drive 5 times as many miles as an average British person here in the United States and we have 3 times as many traffic deaths, we'd actually be safer drivers per average distance. (putting my own numbers in)

Interesting point, for sure. I think folks in the UK are more prone to use the very extensive public transportation system as well, while in the US the mindset seems to have a wanderlust mentality and a more limited mass transit infrastructure.

(I continually admire the extensive nature of the Tube.)

Interesting point, for sure. I think folks in the UK are more prone to use the very extensive public transportation system as well, while in the US the mindset seems to have a wanderlust mentality and a more limited mass transit infrastructure.

(I continually admire the extensive nature of the Tube.)

I put an ETA in where I found the actual link - it's somewhat of a mixed bag, but the normalization brings us much closer to the European countries than the "per 100,000" numbers.

I think the theory is that you will be able to retain your private insurance if those companies come down on their pricing due to having to be competitive with the public plan. It's not stated directly in the bill, of course.

The hook of it lies there, however. How is the government option able to be competitive? Because in the first 3 years it's got huge taxpayer subsidies to offset costs. In addition to that, the government which runs the government option, gets to dictate terms to the insurance companies.

How is that an equal playing field? It'd be like playing a team that gets to define the rules that suit it whenever it wants and gets to wear your shoes and protective gear to boot.

We all want to help those 10 - 15 million American who are chronically uninsured. But doing so by tying the hands of those who have insurance isn't the right approach, in my opinion. Perhaps a better approach would be to open the state and federal employee health benefit plans to the general public. Give people whose income falls below a set threshold an additional subsidy to help them pay for their coverage.

It's still a government option, because the people who need help affording insurance will get it, but people who already have coverage won't have their plans adapted to meet government mandates. Because most state and federal plans cover pre-existing conditions and mandate community pricing within the state or federal employee pool, high risk individuals will be able to enroll in lower costing coverage and will get additional financial assistance if they qualify.

Then we can address ways to have more competition (by allowing people to buy out of state plans and allowing membership organizations and associations offer medical benefits) so that people can move away from their employer sponsored plans to more individually controlled plans which aren't tied to their employer.

Melaszka, today, in the US, employers foot a good percentage of the cost of premiums, costs the employees do not see. In a public option, that burden would be born by the taxpayer. In my humble opinion, Melaszka, this is where the whole "entitlement" mindset comes from.

I can't answer for Melaszka, but I suspect her reaction will be the same as mine:

"Entitlement"????? :huh:

Healthcare, in my opinion, is not a luxury. :huh: Any decent government will care about providing decent healthcare. And poor people should have the same access to excellent healthcare as rich people do.

I do not have a sense of 'entitlement' about the excellent health care I have always received from the NHS. You won't find me moaning about having to wait a while if I go to my local GP for a minor ailment, like a nasty cough or 'flu symptoms, or a regular check-up.

There are citizens in both my country and yours who do have a massive sense of entitlement, I have no doubt of that, but if you are describing my country's health care system as one big system of 'entitlement', then I most emphatically disagree with you.

Expecting our hospitals to be clean and efficient is hardly entitlement.

And I am more than happy for my taxes to pay for our national healthcare.

Other things my taxes go towards, I'm not so thrilled about. The NHS? -- I will always be happy, as a UK citizen, to fund that.

I can't answer for Melaszka, but I suspect her reaction will be the same as mine:

"Entitlement"????? :huh:

Healthcare, in my opinion, is not a luxury. :huh: Any decent government will care about providing decent healthcare. And poor people should have the same access to excellent healthcare as rich people do.

I do not have a sense of 'entitlement' about the excellent health care I have always received from the NHS. You won't find me moaning about having to wait a while if I go to my local GP for a minor ailment, like a nasty cough or 'flu symptoms, or a regular check-up.

There are citizens in both my country and yours who do have a massive sense of entitlement, I have no doubt of that, but if you are describing my country's health care system as one big system of 'entitlement', then I most emphatically disagree with you.

Expecting our hospitals to be clean and efficient is hardly entitlement.

And I am more than happy for my taxes to pay for our national healthcare.

Other things my taxes go towards, I'm not so thrilled about. The NHS? -- I will always be happy, as a UK citizen, to fund that.


Good for you! I'm glad that you find no problem with paying taxes towards something that you find rewarding and well run.

As for me, IMO, health care may not be a luxury, but it is hardly a right. The government has no clear obligation to provide, nor as a citizen, should I expect it to be provided, no more so should the government be expected to tell me what I will earn, what I should do with it and what I should own.

That is why in the US Constitution, the Bill of Rights puts constraints on the government, not on the people. In no place in the Constitution does it say "and the Federal Government shall provide for and ensure all citizens their right to free health care."

Given that the NHS has been an institution in play since the WWII era, I have no doubt that it's been institutionalized as a given. That is not what's in play in the states. So, like I said earlier, good for you. Satisfaction and delight with a system is a good thing. That makes you willing, as a citizen, to pay the tax rates you pay.

For me, I am not willing, because I think I'm a better arbiter of where my health care dollars go than a federal bureaucracy that has NEVER demonstrated fiscal prudence, regardless of party and time frame.

Interesting point, for sure. I think folks in the UK are more prone to use the very extensive public transportation system as well, while in the US the mindset seems to have a wanderlust mentality and a more limited mass transit infrastructure.

(I continually admire the extensive nature of the Tube.)
I don't think that's really it. Most places in the US don't have good public transportation, or in places where they may have it, but it's an inconvenience and more convenient to have a car.

For example, I live in a Suburban area. There are bus stops near by, but, for where I would usually go, the buses don't because there are no stops in those areas. So, if we had to go to like the grocery store, we'd just hop in the car.

My cousins live on a busline. They have one very close to them, but, neither of them have stops near where they work, so, once again, a car is needed.

Now, when my parents lived in New York, my mother said that they walked pretty much everywhere because everything was in walking distance, as well as the subways and the buses. The public transit was also very reliable. My aunt, who's up there now, didn't buy and own a car until about three or four years ago. She only got it so that they could travel out of the state and take road trips or go on vacations. For regular everyday use, it's rare that they use it, unless they have to haul stuff someplace.

So, I don't feel that people wouldn't use public transportation, it's just that aside from big cities, it's usually pretty crappy or unreliable or inconvenient.

Gator, I'm going to play devil's advocate here with the whole "if it's not in the constitution we can't do it then".

Where in the Constitution did it say the government can do the following:
-Build roads
-Prohibit drugs
-Regulate drugs
-Open web sites
-Set up medicare and medicaid
-and on and on and on and on and on and on...

If the many wise judges and lawyers and congressmen / congresswomen and presidents throughout history hadn't allowed the these and so many more to be Constitutional, we'd have had to blow it up entirely and have a new document which explicitly deals with every technological advance. However, by allowing the Constitution to encompass these things, and so much more, we've avoided having to redraft it repeatedly and instead we're left with the Constitution being relevant 230 years later. If these steps hadn't been taken, then I think that we'd be on "The United States Constitution, v.50" by now.

My point? I absolutely think that it's Constitutional to provide health care to all. We as a society are not doing our most vulnerable any good by not providing it. Not every idea in the current bill is good, nor are all ideas by those on the "other side" bad, but I think the end result will be a heck of a lot better than what we have now.

Chris, you're right, in that, providing it may be Constitutional. I'm not saying that it isn't. My point is that Health Care is not a RIGHT. Neither are paved roads, drugs, or Medicare.

I think this idea that basis of providing health care, based on a perceived right is part of the problem, because folks who have not been engaged in paying for health care do not realize the intrinsic cost. By establishing an entitlement that becomes perceived as a right, there is then an imperative to pay for it by any means necessary, namely from the so-called "rich".

What's next in the litany of "rights"? Should, then, a government be responsible for providing its citizens all their needs from cradle to grave? What are intrinsic limitations on government then? Senators, Congressmen, Presidents are all humans, so who are they to determine the course of my life any more than me?

These things will be paid for at the point of a gun (if you don't believe that, try not filing a tax return and paying your income taxes), so we'd better be darned sure that the solution is what is best for the majority (not for all) and what makes the most sense for the environment in the country (and not focus on what works and doesn't work elsewhere.).

Good for you! I'm glad that you find no problem with paying taxes towards something that you find rewarding and well run.

I most certainly am. :cool:

As for me, IMO, health care may not be a luxury, but it is hardly a right. The government has no clear obligation to provide, nor as a citizen, should I expect it to be provided, no more so should the government be expected to tell me what I will earn, what I should do with it and what I should own.

I find that fascinating. Not a 'right'. And yet you expect your government to provide an adequate national defence. You expect your government to provide decent, free education for all ... don't you? (Maybe you don't. :) I'm just enquiring.)

And, also, you expect your insurance company to provide for you, and to pay out when you have a chronic, or terminal, illness. And so you should, because you've been paying them an awful lot of money to do so.

I think I am missing something here. :hmm:

Satisfaction and delight with a system is a good thing. That makes you willing, as a citizen, to pay the tax rates you pay.

It most certainly does. :cool:

If the NHS needs reform, I would look to a mix-and-match system like France (whose healthcare system is much admired) or Canada.

But not to the US.

For me, I am not willing, because I think I'm a better arbiter of where my health care dollars go than a federal bureaucracy that has NEVER demonstrated fiscal prudence, regardless of party and time frame.

But you are happy to entrust your thousands of dollars to an insurance company that may well refuse to pay out for a pre-existing medical condition. :hmm:

I think this idea that basis of providing health care, based on a perceived right is part of the problem, because folks who have not been engaged in paying for health care do not realize the intrinsic cost.

Yes. We. Do. :cool:

We think it is a burden worth bearing. That is why we defend it so passionately.

Thank you. :)

Chris, you're right, in that, providing it may be Constitutional. I'm not saying that it isn't. My point is that Health Care is not a RIGHT. Neither are paved roads, drugs, or Medicare.

I think this idea that basis of providing health care, based on a perceived right is part of the problem, because folks who have not been engaged in paying for health care do not realize the intrinsic cost. By establishing an entitlement that becomes perceived as a right, there is then an imperative to pay for it by any means necessary, namely from the so-called "rich".

What's next in the litany of "rights"? Should, then, a government be responsible for providing its citizens all their needs from cradle to grave? What are intrinsic limitations on government then? Senators, Congressmen, Presidents are all humans, so who are they to determine the course of my life any more than me?

These things will be paid for at the point of a gun (if you don't believe that, try not filing a tax return and paying your income taxes), so we'd better be darned sure that the solution is what is best for the majority (not for all) and what makes the most sense for the environment in the country (and not focus on what works and doesn't work elsewhere.).

I take a libertarian approach to limited government myself. But on the grounds of heatlhcare where does it become an issue of doing the right thing for people who can't do for themselves? I look at healthcare in a compassionate way. Perhaps that's the wrong way but it just seems very wrong to allow some people to go without simply because of their circumstances.

I am not saying nationalizing healthcare is the answer but I do believe in helping people when it comes to keeping them healthy and possibly saving their lives. What would you do for the poor or even the middle class who cannot afford healthcare for their family?

I'd be willing to bet that we're not bad drivers per se - we just drive so much more that the number of traffic-related deaths ends up higher. If you normalize it to a "per kilometer" or "per mile" basis, the fatality rate would end up different. Thus, if we drive 5 times as many miles as an average British person here in the United States and we have 3 times as many traffic deaths, we'd actually be safer drivers per average distance. (putting my own numbers in)

ETA figures, I found the table (http://en.wikipedia.org/wiki/List_of_OECD_countries_by_traffic-related_death_rate) in my quick google search. We in the US are middle-of-the road in per billion vehicle-km deaths. (9 deaths; compared to 6.3 in Britain, 10.1 in New Zealand, etc - western European countries still end up a bit lower than the US but most of the rest of the world is higher).
OT but this is my area of expertise. Calculations of deaths per billion vehicle kilometres are notoriously unreliable because whilst the number of deaths is fairly easy to establish the distance travelled is essentially an estimate based on insufficient data. The US does well on vehicle occupant deaths on this measure but much less well on pedestrian and cyclist deaths (Like Britain you tend to drive rather than walk or cycle, hence the death rate is disproportionately high)

I am wondering what people think about H.R. 3200 School Based Health Clinics (http://en.wikisource.org/wiki/H.R._3200/Division_C/Title_V/Subtitle_B)?

Some critics say that it opens the door to Planned Parenthood (http://www.examiner.com/x-11483-Dallas-Republican-Examiner~y2009m8d15-Health-Care-Reform-Would-Allow-Planned-Parenthood-Clinics-in-Schools)in schools.

In July 2009, Sen. Barbara Mikulski (D-MD) admitted in a subcommittee meeting that Planned Parenthood would be designated an "essential community provider," which would put them in line to qualify for federal funding for abortions, and potentially, administration of school based health clinics.

Politifact says no-way (http://www.politifact.com/truth-o-meter/statements/2009/aug/07/liberty-counsel/school-health-clinics-would-not-provide-abortions/).

And the Obama Admin is apparently willing to drop it. (http://www.nytimes.com/2009/09/03/health/policy/03care.html?hp)

White House officials said Congress could also drop proposals requiring the government to create school-based health clinics and collect nationwide data on health and health care by race, sex, sexual orientation and “gender identity.”

Supporters of the House bill said such data would help reduce “health disparities,” but critics said they feared the government could assemble a database that posed a threat to personal privacy.

What do you think about the article? Would you be willing to see it dropped if it meant coming to some sort of bipartisan deal or do you see it as an essential part of the bill that should not be tampered with? Were you aware of the provision?

ETA: Mom, this kinda comes from the Obama thread about government intrusion in schools.

I find that fascinating. Not a 'right'. And yet you expect your government to provide an adequate national defence. You expect your government to provide decent, free education for all ... don't you? (Maybe you don't. :) I'm just enquiring.)

"Providing for Common Defense" is in the preamble to the Constitution and a collective responsibility however, free education is not. In fact the Federal Department of Education doesn't teach a single student, provide a single textbook or graduate a single class. Public education is a matter for localities and even then, could stand some competition from the private sector, so no, I don't expect a "free" education.

And, also, you expect your insurance company to provide for you, and to pay out when you have a chronic, or terminal, illness. And so you should, because you've been paying them an awful lot of money to do so.

I think I am missing something here. :hmm:


Yes you are, because not only am I paying money, but so is my employer. The idea that paying a fee for service may seem alien, but in a free market as the consumer, I am empowered to pick and choose the vendor of that insurance. So yes, the expectation is that I get what I pay for. I pay for life insurance, but do I expect to collect on it? I pay for auto insurance, but do I REALLY want to get in an accident to make sure I get my "money's" worth. Probably not, but that is for me to decide.


But you are happy to entrust your thousands of dollars to an insurance company that may well refuse to pay out for a pre-existing medical condition. :hmm:

If I'm picking the company I'm entrusting that money too, absolutely. Perhaps you'd want the government to decide what car to purchase or what food to buy, instead of "entrusting" your money to those horrid manufacturers and farmers, yeah?


Yes. We. Do. :cool:

We think it is a burden worth bearing. That is why we defend it so passionately.


Bully for you! But who are you, or any other citizen to decide that it's a burden that I should bear? My point is that is very easy to spend other people's money, the fruits of their labors. Are there disadvantaged? Absolutely. Do they need help? Absolutely. That's why I give a lot money to my church and charities. They do a better job in the compassion department.


Thank you. :)

You're quite welcome. :tu:

today, in the US, employers foot a good percentage of the cost of premiums, costs the employees do not see. In a public option, that burden would be born by the taxpayer.

I wanted to comment on part of Gator's quote because it highlighted what, to me, is one of my biggest concerns with the Democrats proposal for a government option.

The Democrats proposal doesn't just set up mechanisms whereby additional resources will be provided to those who qualify to obtain insurance. It mandates that plans which are currently sponsored and subsidized by employers fall under federal control. In order to pay for the government option, it then taxes employers who continue to provide subsidized medical benefits to their employees. Employers are offered an out, if the cost of providing a medical benefit to their employees exceeds 8.5% of the employees annual salary then they can dump their health benefit and just pay a, 8.5% fine into the government option.

That stinks if you have an employer sponsored plan or you're an employer. Why? Because as an employer you'll be paying taxes on something you got to deduct before. Most employer will simply pass that increased cost on to their employees or cancel their coverage and pay the fine.

As an employee you're looking at an average 40% increase in the cost of your medical benefit (the average corporate tax rate is 40% in the US) or total loss of that benefit if your employer dumps coverage. You may be able to purchase a plan from the government option, but you won't be getting your employer subsidy anymore so it'll cost more than it did before.

About 5% of the US population is chronically uninsured, according to the Kaiser Foundation. According to groups looking at the issue, the Democrats plan will eventually result in almost every American having to go to the government option for coverage, except those employed by really large companies or those with union benefits. I'm more than happy to do what I can to help people who can not afford coverage afford it. But not if it means that I'll lose my coverage.

IAbout 5% of the US population is chronically uninsured, according to the Kaiser Foundation. According to groups looking at the issue, the Democrats plan will eventually result in almost every American having to go to the government option for coverage, except those employed by really large companies or those with union benefits. I'm more than happy to do what I can to help people who can not afford coverage afford it. But not if it means that I'll lose my coverage.I shall take you up on that offer. :p I'm a Type II Diabetic, haven't had insurance since about 2003, was rejected because I am a diabetic for private insurance, too young for Medicare, made too much for Medicaid (barely), and now unemployed and can't get pretty much any consistent care, which a diabetic needs (consistency). What do you propose? Have a job you can offer a person who has to constantly go back to school, so she won't have to default on student loans and just get in-school deferments? :evil:

If I'm picking the company I'm entrusting that money too, absolutely. Perhaps you'd want the government to decide what car to purchase or what food to buy, instead of "entrusting" your money to those horrid manufacturers and farmers, yeah?

This is hardly an apt comparison. :huh: Owning a car is a luxury! :err: Something we Westerners (mistakenly) take for granted! My health care is NOT a luxury. :cool:

Are there disadvantaged? Absolutely. Do they need help? Absolutely. That's why I give a lot money to my church and charities. They do a better job in the compassion department.

But that's a different issue: surely you are not expecting your church to provide for the medical care of your fellow citizens? :hmm:

Four years ago my dad (who is in his 80s) had a heart attack. The drug the NHS paramedics gave him at the scene probably cost the NHS £600. It cost my family nothing. It probably saved my father's life. Then he had surgery at an outstanding NHS hospital -- and four years later he is doing very well.

If your church would pay for the entirety of my father's treatment in hospital, and the treatment of every other person needing acute medical treatment, then ... wow. :D

And I'm an evangelical Christian who believes whole-heartedly in the church showing compassion, and I support many charities.

This is hardly an apt comparison. :huh: Owning a car is a luxury! :err: Something we Westerners (mistakenly) take for granted! My health care is NOT a luxury. :cool:



But that's a different issue: surely you are not expecting your church to provide for the medical care of your fellow citizens? :hmm:

Four years ago my dad (who is in his 80s) had a heart attack. The drug the NHS paramedics gave him at the scene probably cost the NHS £600. It cost my family nothing. It probably saved my father's life. Then he had surgery at an outstanding NHS hospital -- and four years later he is doing very well.

If your church would pay for the entirety of my father's treatment in hospital, and the treatment of every other person needing acute medical treatment, then ... wow. :D

And I'm an evangelical Christian who believes whole-heartedly in the church showing compassion, and I support many charities.

I give to many charities too. Salvation Army being one of my favorites but what you are saying is correct. No charity regardless of size and money intake would be able to pay for all the medical costs of every under priviliged citizen who is without health insurance. It's just not possible.

Oh my goodness! is it possible to discus the health care reforms proposed in the US without being rude about other countries systems or those citizens who are happy with those systems? Because that would be really nice if you could. :)

Oh my goodness! is it possible to discus the health care reforms proposed in the US without being rude about other countries systems or those citizens who are happy with those systems? Because that would be really nice if you could. :)

To whom was that addressed? I don't recall belittling any other system. If I did, I apologize.

"Providing for Common Defense" is in the preamble to the Constitution and a collective responsibility however, free education is not.

Promoting "the general welfare" is also in the preamble.

welfare noun 1 the health, comfort, happiness and general wellbeing of a person or group, etc

Chambers (http://www.chambersharrap.co.uk/chambers/features/chref/chref.py/main?title=21st&query=welfare)

welfare n. 1. health, happiness, or prosperity; well-being.

AHD (http://www.usconstitution.net/glossary.html#WELFARE)

welfare noun 1. the good fortune, health, happiness, prosperity, etc., of a person, group, or organization; well-being: to look after a child's welfare; the physical or moral welfare of society.

Dictionary.com (http://dictionary.reference.com/browse/welfare)

welfare noun 1 the health, happiness, and fortunes of a person or group.

OED

Promoting "the general welfare" is also in the preamble.

welfare noun 1 the health, comfort, happiness and general wellbeing of a person or group, etc

Chambers (http://www.chambersharrap.co.uk/chambers/features/chref/chref.py/main?title=21st&query=welfare)

welfare n. 1. health, happiness, or prosperity; well-being.

AHD (http://www.usconstitution.net/glossary.html#WELFARE)

welfare noun 1. the good fortune, health, happiness, prosperity, etc., of a person, group, or organization; well-being: to look after a child's welfare; the physical or moral welfare of society.

Dictionary.com (http://dictionary.reference.com/browse/welfare)

welfare noun 1 the health, happiness, and fortunes of a person or group.

OED

WAB, I appreciate the effort, but three points:


I never said providing health care was unconstitutional, just that I oppose it
While those definitions are great, using today's vernacular and context, I wonder what it was meant in 1789 when the preamble was actually written. More research may show you something very different.
It mentions Health, Happiness and Fortunes...so should we sacrifice two of these to ensure the third?

Healthcare, in my opinion, is not a luxury. :huh: I think most if not all of us agree with that, it's just that we don't all agree that health insurance is a right not a privilege. This bill is on the insurance part, not the care part. Of course, without insurance many people don't get the care they need. But, that's nothing we can do. There's only so much we can do to make a person visit the doctor.

Just so it doesn't get buried amongst everything else I'd like to know people's opinion on school based health clinics. You can read my original post with all my links here (http://www.cosforums.com/showpost.php?p=5409603&postcount=694).

Wab, one more thing on the notion of "promoting the general welfare"...here's what James Madison, one of the authors of the Constitution had to say about it:


"If Congress can employ money indefinitely to the general welfare,
and are the sole and supreme judges of the general welfare,
they may take the care of religion into their own hands;
they may appoint teachers in every State, county and parish
and pay them out of their public treasury;
they may take into their own hands the education of children,
establishing in like manner schools throughout the Union;
they may assume the provision of the poor;
they may undertake the regulation of all roads other than post-roads;
in short, every thing, from the highest object of state legislation
down to the most minute object of police,
would be thrown under the power of Congress....We re the power
of Congress to be established in the latitude contended for,
it would subvert the very foundations, and transmute the very nature
of the limited Government established by the people of America."

Source: Liberty Quotes (http://quotes.liberty-tree.ca/quote_blog/James.Madison.Quote.3254)

The idea of "welfare" as we know it today had no context back then and definitely was not intended for Congress to usurp power they didn't have.

WAB, I appreciate the effort, but three points:

[LIST=1]
I never said providing health care was unconstitutional, just that I oppose it

It's not just constitutional, it's a responsibility of government right up there with deffense.


While those definitions are great, using today's vernacular and context, I wonder what it was meant in 1789 when the preamble was actually written. More research may show you something very different.

Defense was something entirely different too. The framers and revolutionaries (based on their writings) would be horrified by the size of the standing army in the US. ""A standing military force, with an overgrown Executive will not long be safe companions to liberty." -- Madison

Maintaining a small non-standing force was the whole point of the 2 ammendement.

I think most if not all of us agree with that, it's just that we don't all agree that health insurance is a right not a privilege. This bill is on the insurance part, not the care part. Of course, without insurance many people don't get the care they need. But, that's nothing we can do. There's only so much we can do to make a person visit the doctor.

Well, judging by your previous posts all we have to do is allow universal insurance and people will never leave.

I think most if not all of us agree with that, it's just that we don't all agree that health insurance is a right not a privilege. This bill is on the insurance part, not the care part. Of course, without insurance many people don't get the care they need. But, that's nothing we can do. There's only so much we can do to make a person visit the doctor.

Yes but that is where the problem lies. If they have no insurance and cannot afford to see a doctor out of pocket how can we make them go?

Just so it doesn't get buried amongst everything else I'd like to know people's opinion on school based health clinics. You can read my original post with all my links here (http://www.cosforums.com/showpost.php?p=5409603&postcount=694).

When you say school based health clinic do you mean a clinic on a college campus or something put in a high school?

The idea of "welfare" as we know it today had no context back then and definitely was not intended for Congress to usurp power they didn't have.

If it had no context back then, it wouldn't have been a word because words rely entirely on context.

And the welfare-health nexus goes right back to its origins in Old English: "being well".

If it had no context back then, it wouldn't have been a word because words rely entirely on context.

And the welfare-health nexus goes right back to its origins in Old English: "being well".

Then I would suggest we are looking at the wrong words. I think perhaps we look at the difference between "PROVIDE" for the common defense, and "PROMOTE" the general welfare.

Promoting the "being well" state of the general populace is different from PROVIDING (read paying) for it.

When you say school based health clinic do you mean a clinic on a college campus or something put in a high school?

It doesn't say specifically highschool or college however it does expressly state:

``(3) School-based health clinic.—The term ‘school-based health clinic’ means a health clinic that—
``(A) is located in, or is adjacent to, a school facility of a local educational agency;
``(B) is organized through school, community, and health provider relationships;
``(C) is administered by a sponsoring facility; and
``(D) provides, at a minimum, comprehensive primary health services during school hours to children and adolescents by health professionals in accordance with State and local laws and regulations, established standards, and community practice.

Bolding mine.

I don't think we can solve the question what can and should be done to improve heath care in the US by arguing over the meanings of the word welfare.

I think it's time to get back on topic here already.

It doesn't say specifically highschool or college however it does expressly state:



Bolding mine.

Oh, I thought maybe it was something you came up with to discuss. But, no, it's in the bill. OK, gotcha.

Perhaps paradoxically, nationalised health care here has forced private insurers to be more competitive in what they offer because most of the big life-saving stuff is done in the public system. Casualty cases are taken to the nearest public hospital and the only benefits of being private come if you want to pay for non-urgent and elective surgery to be done sooner than would otherwise be the case in the public system (although in my experience that's a matter of months).

I shall take you up on that offer. :p I'm a Type II Diabetic, haven't had insurance since about 2003, was rejected because I am a diabetic for private insurance, too young for Medicare, made too much for Medicaid (barely), and now unemployed and can't get pretty much any consistent care, which a diabetic needs (consistency). What do you propose? Have a job you can offer a person who has to constantly go back to school, so she won't have to default on student loans and just get in-school deferments? :evil:

What's your background? My husband's company is hiring. So is the government and they have offices all over the place. :)

What you and red have described has convinced me more and more that whatever reform we develop has to provide affordable coverage to people who don't have coverage but do have existing medical conditions that need treatment.

The state and federal employee health benefit plans are community rated and guaranteed issue (which means every person in the plan pays the same prices for the same level of coverage and enrollment can't be refused because of a medical condition). They also require that pre-existing conditions be covered from day 1. Perhaps if the state and / or federal government opened those plans to the general public then you'd be able to get coverage at a cost you could afford. Maybe a tax credit of some other sort of subsidy would make enrolling in one of those plans more affordable.

Flimsey - I'll read up on the school based clinics and get back with you.

** Edit *** On school bases clinics.

The idea sounds great, but I'm concerned about 2 things - privacy and parental rights. As my child's mother I have a strongly vested interest in the medical care my child receives. To my knowledge, the law prohibits medical practitioners for dispensing medical advice to minors without parental consent. The only instances where that requirement has been lifted is for birth control.

I also know that in some economically disadvantaged areas, a school based, government funded clinic is the only medical care those kids receive. I don't necessarily have a problem with school based clinics in economically disadvantaged areas, but think that if medical care is going to be provided to those children that it ought to be provided only with parental notification and consent.

I find the concept of the school clinics interesting. I need to read up on it, in the link provided though to give a better opinion on it.What's your background?All the odd jobs I've had, have consisted of data entry, education, word processing, and clerical. Went to school for Social Science, Liberal Arts, and Computerized Accounting over the years.My husband's company is hiring. So is the government and they have offices all over the place. :)That's cool. I noticed that about the government jobs too. There's one thing I came across that's supposed to help you wit that, but you have to pay a fee for it to get the job listings. I told them that I'm flat broke with a maxed out credit card and have about $1 in my checking account and $5 in my savings so that the account won't close. lolWhat you and red have described has convinced me more and more that whatever reform we develop has to provide affordable coverage to people who don't have coverage but do have existing medical conditions that need treatment. Yep, pretty much. I always felt that all working citizens, at least, should be allowed to get or have affordable access to health care.The state and federal employee health benefit plans are community rated and guaranteed issue (which means every person in the plan pays the same prices for the same level of coverage and enrollment can't be refused because of a medical condition). They also require that pre-existing conditions be covered from day 1. Perhaps if the state and / or federal government opened those plans to the general public then you'd be able to get coverage at a cost you could afford. Maybe a tax credit of some other sort of subsidy would make enrolling in one of those plans more affordable.That would be very nice. For the most part, I'm for most anything that'd make the insurance affordable.

I find the concept of the school clinics interesting. I need to read up on it, in the link provided though to give a better opinion on it.All the odd jobs I've had, have consisted of data entry, education, word processing, and clerical. Went to school for Social Science, Liberal Arts, and Computerized Accounting over the years.[FONT="Times New Roman"]That's cool. I noticed that about the government jobs too. There's one thing I came across that's supposed to help you wit that, but you have to pay a fee for it to get the job listings. I told them that I'm flat broke with a maxed out credit card and have about $1 in my checking account and $5 in my savings so that the account won't close. lol

I just sent you an owl with the federal jobs link. Best of all - it's FREE!!! ( I figure shouting about something that's FREE is OK). :)

There's an interesting clip on Youtube of Al Franken discussing healthcare in a calm and rational manner - highlighting the problems and some of the possible ways through (amusingly it was titled "Franken talks down angry mob" - they don't look that angry to me)

SCNs7Zpqo98

Senator Baucus has posted his white paper providing an outline for health care reform. Here's the link to it

http://finance.senate.gov/healthreform2009/finalwhitepaper.pdf

I read somewhere that the CBO has estimated it's cost at $900 billion over 10 years, but I'll need to find a source to verify that.

Here's a link (http://www.politico.com/news/stories/0909/26822.html)to a story on it. I don't think the 900 billion tag is a CBO price - they don't have one up on their health section or front page of the website. As I guessed a while ago, co-ops is the central theme of the bill.

I think the breakdown is that it'll cost $900 billion in 10 years, but Baucus claims it's deficit-neutral, so his "fund-raising" provisions make up that gap. We'll see if the CBO agrees (or if they don't agree because they don't put some of the fund-raising or cost-cutting projections into their assessment), but I believe Baucus wants any changes to be offset appropriately to keep it deficit-neutral.

Seems Sarah Palin has something to say on the issue of health care reform. An op-ed she drafted was published ("http://online.wsj.com/article/SB10001424052970203440104574400581157986024.html#m od=WSJ_hpp_sections_opinion"[) in the Wall Street Journal today, and in it she takes on many of the misrepresentations we've been hearing about the Democrats Health Care Reform proposals.



First, ask yourself whether the government that brought us such "waste and inefficiency" and "unwarranted subsidies" in the first place can be believed when it says that this time it will get things right. The nonpartistan Congressional Budget Office (CBO) doesn't think so: Its director, Douglas Elmendorf, told the Senate Budget Committee in July that "in the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."

She also takes on the much reported (and distorted) death panels.

Now look at one way Mr. Obama wants to eliminate inefficiency and waste: He's asked Congress to create an Independent Medicare Advisory Council—an unelected, largely unaccountable group of experts charged with containing Medicare costs. In an interview with the New York Times in April, the president suggested that such a group, working outside of "normal political channels," should guide decisions regarding that "huge driver of cost . . . the chronically ill and those toward the end of their lives . . . ."

Given such statements, is it any wonder that many of the sick and elderly are concerned that the Democrats' proposals will ultimately lead to rationing of their health care by—dare I say it—death panels? Establishment voices dismissed that phrase, but it rang true for many Americans. Working through "normal political channels," they made themselves heard, and as a result Congress will likely reject a wrong-headed proposal to authorize end-of-life counseling in this cost-cutting context. But the fact remains that the Democrats' proposals would still empower unelected bureaucrats to make decisions affecting life or death health-care matters. Such government overreaching is what we've come to expect from this administration.

She then goes on to discuss the effect of the reform on the deficit and the highly likely, in my opinion see above for why, probability that the Democrats proposed reforms will result on declining wages.

Finally, she hits on what she thinks real reform ought to look like

Instead of poll-driven "solutions," let's talk about real health-care reform: market-oriented, patient-centered, and result-driven. As the Cato Institute's Michael Cannon and others have argued, such policies include giving all individuals the same tax benefits received by those who get coverage through their employers; providing Medicare recipients with vouchers that allow them to purchase their own coverage; reforming tort laws to potentially save billions each year in wasteful spending; and changing costly state regulations to allow people to buy insurance across state lines. Rather than another top-down government plan, let's give Americans control over their own health care.

I'm a real fan of HR 3400 - though I do believe that it needs some tweaking . I think it offers the opportunity to change the health coverage industry from being employer and insurer controlled to individually controlled and that the refundable credits provided to qualifying families will make coverage more affordable. I'm concerned about the state run high risk pools because I'm not sure they'll be as effective as we hope they will be at bringing down the cost of coverage for high risk individuals. Maybe opening the state and federal employee benefit plans to the general public would provide that protection.

I'm still 100% confused as to how she can still label them "death panels", but I don't possess the ability to change her mind on that phrasing. Oh well. It's likely out of the bills anyways but next time she sees President Bush she may want to quiz him on why he signed into law a bill (http://swampland.blogs.time.com/2009/08/13/oh-those-death-panels/) that includes the same exact provision. (Thomas (http://thomas.loc.gov/cgi-bin/cpquery/?&dbname=cp108&sid=cp108d60yh&refer=&r_n=hr391.108&item=&sel=TOC_2103579&) link for the same)

The only difference between the 2003 provision and the infamous Section 1233 that threatens the very future and moral sanctity of the Republic is that the first applied only to terminally ill patients. Section 1233 would expand funding so that people could voluntarily receive counseling before they become terminally ill.

It's distortions like the "death panel" one that made me more of a supporter of HR 3200 than I had been before. If someone lies to me about what's in it, and I catch them in that lie, my natural instinct is to side with the side of truth. Ross Douthat (http://www.nytimes.com/2009/09/07/opinion/07douthat.html)'s take is interesting.

Apparently Obama's speech (http://www.politico.com/news/stories/0909/26907.html) tonight does give a nod to malpractice reform and it'll strongly endorse but not mandate a public option. That is, if Politico's sources are right :p.

Food for thought (http://well.blogs.nytimes.com/2009/09/09/prolonging-death-at-the-end-of-life/).

I think a lot of this comes down to "Who do you trust?"

On one side, we have those who seem to trust the mega-health corporate world with their health.

On the other side, we have those who think Government would be best to get involved and regulate and handle health care more intimately.

This is where I have to stand back and look at the overall picture.

First, the open market seems to have failed us, in my opinion. Why go and fail again.

Second, what we have is a corporate run health care system that already seems to have it's own "death panels" per say, by incorporating pre-existing conditions or raising premiums on those who have they deem unprofitable because they've become sick.

Then we have the government run health care: Medicare/medicaid and the Veterans Administration. They seem to be doing well...I haven't noted any *death panels* there.

I have to conclude that I am more afraid of what we have now than what I see the government run programs doing.

And, as far as Palin, I'm surprised anyone gives her credibility anymore but I suppose she has her followers.

As far as HR3400...how are you going to pay for the massive tax credits to be given out like manna from heaven to the people (more to the wealthy than the lesser)? Decreasing the income of the U.S. at a time when this country has a lot of debt to pay down, doesn't seem very responsible. The only way you could pay for it is by cutting spending elsewhere in the government or watch the deficit further balloon. What would be cut...Medicare? Social Security? Infrastructure repairs?

Sorry, I just don't care for this route at all. I do see how the upper tax brackets would like this, though. That doesn't mean it's good for the country, however.

I disagree that the current system has failed us. Our life expectancy is approximately the same as much of Europe. Our long term survival rate from cancer is higher than much of Europe - significantly higher in some of the more common forms of cancer (like breast, colon, and prostate cancer).

That's not to say that our current system doesn't have problems - like costs that are so high that some people with illnesses and lower income people can't afford it, and lack of portability which ties people to jobs they may not like if they have good coverage.

We need to address those problems, and there are solutions I've seen which do, but tossing the system in favor of one which the government controls is a very bad decision, in my opinion.

For the life of me I can't find a cost estimate for HR 3400, but one link (http://larrymwalkerjr.blogspot.com/2009/09/empowering-patients-first-act-hr-3400.html) I did find mentioned that part of the "cost offset" is an annual one-percent non defense discretionary spending step down. (Incidentally, everything I found is blogs)

I'm reading that line to mean that HR 3400 would permanently stop the growth in spending from all other departments of the governments. As someone who indirectly receives his rather paltry paycheck from the federal government (through NIH and NSF grants, with the value to the government being the research results that I and other grad students generate that then become publicly available instead of hidden behind patents), this rather concerns me, since it may mean that the NIH budget is permanently going down, instead of even just keeping pace with inflation. I think that, if I am reading this correctly, it explains a lot of why Democrats are ignoring the bill, since this could be read as a trojan horse which is capable of permanently stifling any innovation or funding or anything that the government would want to do in the future.

If this is an incorrect reading, or if someone has a better source, by all means, love to see it. In all honesty I'd feel better if I found out that this particular blogger got it wrong, and I'm shown compelling evidence that he got it wrong.

I disagree that the current system has failed us. Our life expectancy is approximately the same as much of Europe. Our long term survival rate from cancer is higher than much of Europe - significantly higher in some of the more common forms of cancer (like breast, colon, and prostate cancer).

That's not to say that our current system doesn't have problems - like costs that are so high that some people with illnesses and lower income people can't afford it, and lack of portability which ties people to jobs they may not like if they have good coverage.

We need to address those problems, and there are solutions I've seen which do, but tossing the system in favor of one which the government controls is a very bad decision, in my opinion.

I agree about the problems with our system being mainly the costs. While we have the unfortunate stories I think for most the quality of care is excellent.

Still I feel morally there needs to be some kind of system in place for people who cannot afford healthcare. Medicaid is only for a few covering mostly children. If you go to the ER they will take you and by law have to treat you. That is not preventive care though as in having access to a regular doctor is.

I am going to watch the address to congress tonight.

I disagree that the current system has failed us...
It certainly has failed "me"...what's the saying? All politics are local.

I'm reading that line to mean that HR 3400 would permanently stop the growth in spending from all other departments of the governments. As someone who indirectly receives his rather paltry paycheck from the federal government... this rather concerns me, since it may mean that the NIH budget is permanently going down, instead of even just keeping pace with inflation. I think that, if I am reading this correctly, it explains a lot of why Democrats are ignoring the bill, since this could be read as a trojan horse which is capable of permanently stifling any innovation or funding or anything that the government would want to do in the future.


Exactly--allowing the government to be drowned in the proverbial bathtub and allowing us to return to across the board deregulation and corporate rule (my opinion) and goes along with nobel prize winner, Paul Krugman's visionary 2003 piece: The Tax Cut Con (http://www.nytimes.com/2003/09/14/magazine/the-tax-cut-con.html).

I think a lot of this comes down to "Who do you trust?"

On one side, we have those who seem to trust the mega-health corporate world with their health.

On the other side, we have those who think Government would be best to get involved and regulate and handle health care more intimately.

This is inaccurate. On side isn't saying the "trust the mega-health corporate world" by oposing large government expansion and intervention. That distorts completely the ideas of reform coming from the side I can only assume this is intended to describe. As for the definition of the other side while much more flattering, they are supporting a "public option" which is basicly making the government a publicly funded mega-health corporation.


This is where I have to stand back and look at the overall picture.

First, the open market seems to have failed us, in my opinion. Why go and fail again.

How has the open market failed us? Open markets and competition have been the single greatest factor in the rapid advance of society in the history of man and they have failed us? The markets haven't failed us, the providers and our means of obtaining healthcare have failed us and need imediate revision and reform, but that isn't what is being proposed in a "government option". On the contrary, the structure will stay the same, it just will eventually only have one provider. As I believe that provider will actually increase cost and decrease service, as they have always done with similar programs, I don't think it is a viable solution for anyone.


Second, what we have is a corporate run health care system that already seems to have it's own "death panels" per say, by incorporating pre-existing conditions or raising premiums on those who have they deem unprofitable because they've become sick.

Then we have the government run health care: Medicare/medicaid and the Veterans Administration. They seem to be doing well...I haven't noted any *death panels* there.

That is because you have never faced an MMRB. They are more of a firing squad, so I suppose you are right, but seriously, are any of those even close to within budget? Are any of those better than private insurances? In short, don't they already provide a lesser product for a higher price? Why is expanding that a good deal for anyone, even the uninsured?

I have to conclude that I am more afraid of what we have now than what I see the government run programs doing.

That is, IMO, because there is an unrealisticly utopian idea of what a government plan would atually be. I think it is contrary to all evidence to somehow expect that a "government option" will be a solution to any of the problems with healthcare or anything else for that matter.


As far as HR3400...how are you going to pay for the massive tax credits to be given out like manna from heaven to the people (more to the wealthy than the lesser)? Decreasing the income of the U.S. at a time when this country has a lot of debt to pay down, doesn't seem very responsible. The only way you could pay for it is by cutting spending elsewhere in the government or watch the deficit further balloon. What would be cut...Medicare? Social Security? Infrastructure repairs?

Is this serious? Tax credits would be more expensive than the government becoming a massive health insurance provider? How? That isn't decresing the income of the U.S., it is putting money back into the economy and deminishing the personal burden of health insurance costs. We just spent 3 trillion (with a "T") dollars on non-descript "stimulus" and tax credits is going to hurt us because of spending, but a massive beauracracy will be a positive? I am all ears to hear the magic economic principals in play on that one.


Sorry, I just don't care for this route at all. I do see how the upper tax brackets would like this, though. That doesn't mean it's good for the country, however.

This is the typical liberal crock. The upper tax brackets? It will help everyone who buys healthcare. I mean, it is always good for investers and industry to have available money for expansion and investment as that is the core of our economy, but just like with the mischaracterized "tax cuts for the rich" the advatage is more important to the middle class and poor than to the rich.

To a family that makes $55,000 a year, $5000 is more than $50,000 to a 1 million dollar earner. $50,000 is more money, but the $5000 is more important and for every $50,000 person there are tens of thousands of $5,000 people who really need that tax credit. Just like the Bush tax cuts, for every high dollar person who got to keep more, there were tens of thousands got more back including the increased earned income credit which really helped a lot of middle class people.

The point is, we need to stop this paranoid concern with what everybody else gets and understand when something will benifit us as well. We also need to remember that the infrastructure, roads, military and other functions of the government are almost entirely financed by these "top tax brackets" as well as most of our jobs and benifits. If you are getting in proportion more benifit from a tax credit or tax cut than they are, which is almost universally true, you are in all actuality getting more for less and a better deal. That the numbers are bigger at the top is a byproduct of all the numbers being bigger.

Ah, I found a more reliable source (http://covertheuninsured.org/legislative_bill/hr-3400-price) for the HR 3400 "funding". And, I think in a nutshell, the mode of funding the bill is the biggest reason Dems will never go along with it:

Financing
Discretionary spending would be reduced; unused discretionary funds appropriated in the American Recovery and Reinvestment Act of 2009 would be rescinded and numerous provisions of that Act would be repealed, including increased Medicaid funding, premium assistance for COBRA benefits, and Medicare and Medicaid health information technology funding. Medicare and Medicaid disproportionate share hospital funding would be reduced if bill results in a decrease in the rate of uninsured of more than 8 percentage points). The bill also includes anti-fraud and abuse provisions

I think that the stimulus package "repeal" and the discretionary spending cuts are the biggest points of contention, along with the repeals of the various spending on medicare and medicaid provisions that were in there. I myself could be directly hurt by the stimulus package repeal, since my lab is likely to receive NIH Challenge grant funding but that funding hasn't been disbursed yet. Thus, HR 3400 would have a chilling effect on some rather cutting-edge research that was expected to be funded; and PI's have already begun hiring people based on this expected funding, and to cut that out would be catastrophic to the scientific community with the corresponding avalanche of adjusted funding until you get stuck with people (like my old advisor) who lose all funding but haven't lost all their ideas.

To be fair, I like several of the provisions in HR 3400, and I think that tort reform (though not quite to the extent mandated in HR 3400 - FDA approved products should still be able to be sued with the burden of proof being on the plaintiff to prove that the drug company covered up bad data) and the cross-state insurance buys (though I think that if there's conflicting state laws the insurance policy bought in, say, Texas from a Louisiana provider must be "OK" by Texas state laws, etc, etc). I also likely have little or no issue with the fraud and abuse and anti-double-dipping clauses, with the "likely" being solely because I don't know the exact provisions, only the descriptions. I'd like to see a further beefed-up Medicare fraud task force (Holder has been expanding Bush's AG's efforts in this area), and writing that into the bill would be fine by me.

For Baucus' idea, which is apparently quite close to what Obama will talk about tonight (http://www.msnbc.msn.com/id/32752036/ns/politics-health_care_reform/), I wonder how the co-ops would work in terms of being able to buy-in across state lines, etc, etc. The devil's in those details. Politico also mentioned that Obama might endorse or allow tort reform (I linked that article earlier).

ETA: I fully realize that to some people HR 3400's mechanism of funding may even be the best part of the bill. I just disagree :p.

I can't believe that someone in the chamber just yelled at Obama and called him a liar.

That was some legislator named Congressman "Wilson" from South Carolina, they are saying (msnbc).

I'm watching MSNBC as well. Joe Wilson is his name.

I guess we don't have to worry about the exclusion of catastophic insurance plans anymore.

Instant analysis on politifact (http://www.politifact.com/truth-o-meter/subjects/health/) gives Obama a 1 for 2 on "true". Preventive care doesn't actually save money (though I quibble a bit with both MSNBC and politifact on their methodology - they consider only the total cost in the end, where it's accurate to note that for the patients whose disease is caught early the cost goes down). I imagine they'll add more as they can, the two they already rated were easy pickings since they'd already rated them before.

ETA: 2 out of 3 now; they added "no death panels" to the "true" column. I bet he'll have a few more "falses" and a bunch more "trues" in the end.

Text of speech (http://m.www.yahoo.com/_ylt=Ag37f0VZ9LScliNqNGAvrHmbvZx4;_ylu=X3oDMTNlcGk wMWY3BGEDMDkwOTA5IG5ld3Mgc3BlZWNoIGxpdmUgdARjcG9zA zEEZwNpZC0xMTkxNgRpbnRsA3VzBHBrZ3YDMTIEcG9zAzQEc2V jA3RkLWZlYXQEc2xrA3JlbC10aXRsZQRzbHBvcwNGBHRlc3QDN zAx/SIG=11per70ns/**http%3A//news.yahoo.com/s/ap/us_obama_health_care_text) is up on various sites.

Personally, I think that McCain, Grassley, and Hatch didn't appreciate the second round of "kudos". I don't think McCain minded the first one.

Interesting that he is going to give an executive order or something similar to investigate the pilot malpractice reform proposals.

Why is it that when conservatives cite examples of poor care by govt-run health care elsewhere, poor running by our govt of post office, VA, Medicare, etc., our examples are dismissed out of hand as one-offs, exceptions, localized problems, whatever and don't count, but a few people on here get to cite their personal health care bad stories and those aren't one-offs; those are to be considered examples of the failures of our system? I don't argue that Redhart and CBW in particular haven't gotten all they wanted from health care, but there are many of us on here who are happy with our health care. Why are you allowed to say your experiences show "the system has failed us" but we aren't allowed to say it works for the most part but needs a bit of tweaking and reform from our experiences? Do I want you to get better care? Of course! Do I want to wholesale throw out our current system that is working for the majority in an attempt to allow a govt that can't keep its current health care programs (or any other program) solvent take over and run the health care choices of everyone? No! People have been arguing that we shouldn't run down the UK health care system because of a few stories since most of the country is very happy with the program; yet we are not allowed to make that same argument for the current system in the US. It does have problems and could be fixed, but many of us believe it could be fixed or at least improved without govt taking over any more power or authority. There are other options. How about more low-cost clinics for uninsured? Provide more health care; leave the insurance alone.

Also, why do people always talk about "paying for" tax cuts when every time this has been done, govt revenue has increased? Every time! What is there to pay for? Increased revenue doesn't have to be paid for, but the problem is that the govt spends all it gets and more. Always! I get so disgusted by hearing people talk about "paying for tax cuts" when if they check history, they'll see that they increase govt revenues, not decrease them.

Excuse the rant. I'll step down off my soapbox now. http://i382.photobucket.com/albums/oo261/DenMuggle/Smilies/soapbox.gif

Den, on the tax cuts assertion, factcheck (http://www.factcheck.org/askfactcheck/have_tax_cuts_always_resulted_in_higher.html) took it on in 2008 and disagreed with you.

I cringed when I originally heard Obama use the postal service analogy; that wasn't the best he could use. But the VA one I think works, and it's a health care system. Medicare is still quite popular, too; and perhaps the 80% that both parties agree on would include keeping Medicare but trying to cut rising costs (NOT cutting their budget; rather, arresting rising costs - both parties say the same thing in different terms).

I thought Obama made a good case that he wasn't throwing the whole system out; rather, he was adding a layer for those who were uninsured and trying to make the system for those who are insured better. And now that Baucus has mostly outlined his plan, I think that's the one to focus on since it's the one that has the best chance of coming into law.

It looks like Joe Wilson from SC has already apologized...a lot:
http://www.cnn.com/2009/POLITICS/09/09/joe.wilson/

He appears to be taking heat, even from his own party, on his outburst during the Presidential address to congress. Beyond this, probably should be discussed on the congressional thread. So, I simply leave the article at this point.

CNN Poll: Double-digit post-speech jump for Obama plan (http://politicalticker.blogs.cnn.com/2009/09/09/cnn-poll-two-thirds-of-speech-watchers-favor-obamas-proposals/) Just thought I'd share. What was important was to clearly explain his goals and rationales. He had to let the country understand what was at stake. He had to cut through all the hysteria and deliberate lies of the last month or so. Most people do fear loss of their insurance. Most people have seen their insurance rates skyrocket. Most people do know folks who have lost everything due to health costs.

Red and I are hardly the only ones with concerns about health care access and cost. Red and I are not the exception, we are very commonplace.

For clueless Brits like me, the BBC has provided a useful guide to the healthcare system in the US and Obama's plans for reform:

http://news.bbc.co.uk/1/hi/world/americas/8160058.stm

Do I want you to get better care? Of course! Do I want to wholesale throw out our current system that is working for the majority in an attempt to allow a govt that can't keep its current health care programs (or any other program) solvent take over and run the health care choices of everyone? No!
Well good, then you should support the President, because he doesn't want the government to take over the health care choices of everyone. Nobody really does. So when you're suggesting this is the logical result of the president's and a Democratic Congress's plan, I hope you're willing to admit that it's just partisan rhetoric.

Well good, then you should support the President, because he doesn't want the government to take over the health care choices of everyone. Nobody really does. So when you're suggesting this is the logical result of the president's and a Democratic Congress's plan, I hope you're willing to admit that it's just partisan rhetoric.

Your right, the president's speech was nothing more than partisan rhetoric, full of half truths and out right falsehoods. All he did was prop up HR3200 which was the source of angst in August. He made no move to clarify issues. The sum total of his speech was to bash opponents and tell them he's coming after them.

Nice.

The AP, hardly the bastion of conservative thought, went into great detail on how misleading the President was. He didn't move the ball, he just staked his ground with no compromise.

Fine, Mr. President. Then pass the bill. You don't need nor do you have my support in this. I HOPE YOU FAIL. (I guess that makes me unAmerican.)

The AP's take on the President's speech. (http://news.yahoo.com/s/ap/20090910/ap_on_go_pr_wh/us_health_care_fact_check)

I HOPE YOU FAIL. (I guess that makes me unAmerican.)

Why? Because you don't think the plan will work, or because even if the plan works you think it's still wrong?

And, here's a link to the AP Fact check (http://news.yahoo.com/s/ap/20090910/ap_on_go_pr_wh/us_health_care_fact_check). I think the accounting "sleight of hand" that Obama is using with the circular logic about why he doesn't need to account for some of the money (because his 10 year budget already accounted for it) is perhaps the one thing that is of real note in there. Joe Wilson's claim that Obama is a liar about covering illegal immigrants was debunked by pretty much everyone (he picked the wrong spot, if he yelled it out on the preventative care line, then he'd be right, though I do quibble, as I noted before, with the methodology used there). Of the seven items the AP listed in their fact check, it's running about 50/50; hardly a condemnation of the speech and quite in line with the recent standard from US presidents.

Politifact is up to five items ranked; and factcheck is still working on their article (ie, they don't have one up yet but their own history suggests they'll have a long essay up later today).

Well good, then you should support the President, because he doesn't want the government to take over the health care choices of everyone. Nobody really does. So when you're suggesting this is the logical result of the president's and a Democratic Congress's plan, I hope you're willing to admit that it's just partisan rhetoric.

Is that how you heard it? So if there is a "government option" why would most people continue to keep their health insurance? Even in the language of the speech, if I changed jobs, why, and more importantly, how, would I be able to justify in my limited budget a move from the "government option" back to private insurance when I have to effectively pay for both? Of course he didn't directly say the government was taking over healthcare, he minimized the government action and maximized private insurance while in effect forwarding a plan that would effectively eliminate private insurance over time.

There is the posibility of a choice, just like with education, or military/VA or medicare, but the choice is unrealistic in nature. If the options are pay for government care and in addition buy private care or use the government care you are already paying for, what choice is really available for the vast majority of people? That isn't rhetoric, it is reasonable cause and effect. What in anything said prohibits that exact outcome and what in history or human nature would stop that chain reaction?

I thought he was offering tax credits and automatic medicaid enrollment, along with a hardship waiver provision, in order to help people afford it.

I thought he was offering tax credits and automatic medicaid enrollment, along with a hardship waiver provision, in order to help people afford it.

He is, yet is that in any way likely to keep the costs lower to the individual than the combined costs of both public and private? As having some form of insurance will be mandatory and lack of private insurance will mean mandatory enrollment in a federal program of one sort or the other, how can paying for both be realistic? I, not unlike most people, would all but have to stop paying for private insurance and opt for the federal program just because of cost. Not to mention, I would head-hunt an all pay employment because partially paid benifits wouldn't mean very much to me any more.

I don't see myself as unusual in this regard, which would put the onus on employers to drop expensive benifits plans, pay into the fund and up the income of desirable employees. While that sounds like a good deal up front, it ends up being a net loss once taxation is implimented to cover the staggering costs that will follow and in higher pay brackets, there is higher percentage of tax. Good way to increase revenue, except that as it is a net loss with inflation, we actually have less purchasing and product demand, which drops the economy in total.

Again, what stops that chain reaction in realistic terms? I didn't hear the restriction of the government option that made its use in this way prohibitive, nor did I hear anything to make me believe that mass enrollment in such an option wouldn't be imminent if provided.

Some other things puzzled me about the President's speech (http://www.huffingtonpost.com/2009/09/09/obama-health-care-speech_n_281265.html):

Instead of honest debate, we have seen scare tactics.

Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result.

Got that? If you oppose any tenet in HR3200 (I'm assuming that his "plan" since he didn't reference any other), then you are using scare tactics, but "MORE WILL DIE AS A RESULT" reflects a sense of urgency.

This exchange will take effect in four years, which will give us time to do it right.

Hang on a second. What about all those people that are going to die??? The President can't have it both ways.

I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.

Probably a nit pick, but really, since when are profits part of "overhead"? Oh, we're talking about a President who has NEVER been in the private sector, never had to be answerable to investors and actually PARTICIPATED in a corporation, so I'll forgive his apparent ignorance.

The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud...Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.

Got that? There's "hundreds of billions" in waste and fraud in Medicare and Medicaid. Quick question, Mr. President, if you've identified "hundreds of billions" in waste and fraud, um, why not just eliminate it now? Why not have the administration actually enforce the law instead of waiting the four years?

Last one, but okay, follow me on this.

On August 10th in a town hall in New Hampshire, the President said this (http://www.nytimes.com/2009/08/12/us/politics/12obama.text.html?_r=1):

"I don't have to explain to you that nearly 46 million Americans don't have health insurance coverage today. In the wealthiest nation on Earth, 46 million of our fellow citizens have no coverage."

Last night he said:

We are the only advanced democracy on Earth - the only wealthy nation - that allows such hardships for millions of its people. There are now more than thirty million American citizens who cannot get coverage. In just a two year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone.

Apparently "doing nothing" eliminated 16 million uninsured from their problems in one month. At this rate, why not just "do nothing" for two more months and everyone will be insured???

Of course that's absurd, but if we don't know the extent of the problem, how can we fix it?

One more note: 14,000 lose their coverage a day, right? We wait 4 years for the President's plan, and voila, you have another 15 million uninsured. Hmmmm.

I thought HR 3400 had similar provisions, except for where they set the cutoffs for medicaid and tax credits, but that HR 3400 didn't account for what happens if someone over the medicaid enrollment cutoff tries to buy private insurance with the tax credit but cannot. The Obama / Baucus plan appears to address this loophole by setting up insurance exchanges and by keeping open the idea of a public option - a safeguard that, unless I'm mistaken, the republican plan lacks.

I take it your "double paying" complaint is the subsidizing of others' insurance through taxes along with however you buy your own insurance. I don't understand, however, how that'd be different if we take HR 3400 - you'd still be subsidizing others' through taxes. And both plans leave open the option to buy private insurance - the Republican plan through existing marketplaces and the Baucus / Obama plan through a new marketplace designed to overcome some of the shortcomings of the existing marketplaces. Thus, unless you oppose both plans, I don't see how the alternative is actually different (leaving open the possibility that your income range is in the range where the Republican plan gives a tax credit and the Democratic plan does not, if such a range exists).

ETA to gator: Good explanation of the new figure, from the article I linked previously (which I think you were referring to earlier, but I can't be sure, but it is the AP's factcheck):

OBAMA: "There are now more than 30 million American citizens who cannot get coverage."
THE FACTS: Obama time and again has referred to the number of uninsured as 46 million, a figure based on year-old Census data. The new number is based on an analysis by the Kaiser Commission on Medicaid and the Uninsured, which concluded that about two-thirds of Americans without insurance are poor or near poor. "These individuals are less likely to be offered employer-sponsored coverage or to be able to afford to purchase their own coverage," the report said. By using the new figure, Obama avoids criticism that he is including individuals, particularly healthy young people, who choose not to obtain health insurance.

For the life of me I can't find a cost estimate for HR 3400, but one link (http://larrymwalkerjr.blogspot.com/2009/09/empowering-patients-first-act-hr-3400.html) I did find mentioned that part of the "cost offset" is an (Incidentally, everything I found is blogs)

I haven't been able to find anything on the CBO cost estimate for HR 3400. From what I understand for calling Congressman Pince's office, the only way the bill will be costed by the CBO is if the Speaker approves it and she has not.

Like you I found the same supposition about cost offsets and the 1% non defense cut in spending. But I couldn't find any sources to back that up, just links to commentary from other bloggers.

In the federal government spending is assumed to increase each year at the rate of inflation, if for no other reason than federal employees get an automatic Cost of Living Adjustment (COLA) each year equal to the rate of inflation (military pay, BTW, is excluded from this automatic increase). So if the inflation rate is 3% then the budget for every federal agency, organization, or department will increase by 3%.

If we assume that the chatter from non-sourced blogs is correct, and HR 3400 could be paid for with a 1% non-defense cut in spending, then that would mean that the increase in each federal budget, except defense, would be the rate of inflation less 1%. So if inflation was 2%, then each budget would increase by 1%. If the rate of inflation was .5%, then each budget would decrease by .5%.

Either way, with the deficit as large as it is and China starting to balk at buying more of our debt, we're going to have to cut spending.

EDIT*****

I thought HR 3400 had similar provisions, except for where they set the cutoffs for medicaid and tax credits, but that HR 3400 didn't account for what happens if someone over the medicaid enrollment cutoff tries to buy private insurance with the tax credit but cannot. The Obama / Baucus plan appears to address this loophole by setting up insurance exchanges and by keeping open the idea of a public option - a safeguard that, unless I'm mistaken, the republican plan lacks.

See - this is what happens when I gossip with a neighbor halfway through a post!

HR 3400 calls for the creation of state run high risk pools for people whose premiums provided through an employer, membership organization, or association sponsored plan exceed 1.5 times the national average. Most high risk people can not obtain coverage because their existing medical conditions result in premiums that are so high they can not afford them. This provision provides access to affordable coverage for them and their families through the state run high risk pools because the only standard necessary to qualify for inclusion into the pool is premiums that exceed 1.5 times the national average.

Thanks for the latter clarification Mom. Personally, I'd have no issue with either a federal-run or state-run system of pools. I'd like to have a federal option which has to accept people (exception: those convicted of medicare / medicaid / etc fraud can be left out, for all I care) whom all other plans fail to accept. The federal-run might have a better economy of scale for negotiating with companies, etc, but the state-run may have a better idea of the conditions in a given state. Perhaps a hybrid where the states (either by region or as a whole) negotiate the contracts but the plans are run state-by-state could be put in place. Combine that with the ability to buy a LA plan in TX, for example, and I'm fine with it. My biggest problem with HR 3400 is the system of funding, since I can assure you that directly or indirectly I would be hurt by that, since it could have a catastrophic unintended effect on NIH funding, which me and most other graduate students in science in the United States are highly dependent on.

To expand on my parenthetical statement above...I think it'd be a nice deterrent on fraud if anyone convicted of major fraud in a jurisdiction can never get insurance within that jurisdiction ever again. Mean-spirited? Perhaps. But a heck of a deterrent.

Thanks for the latter clarification Mom. Personally, I'd have no issue with either a federal-run or state-run system of pools. I'd like to have a federal option which has to accept people (exception: those convicted of medicare / medicaid / etc fraud can be left out, for all I care) whom all other plans fail to accept.

I totally agree. I think we need to make sure there's some sort of help for people whose medical conditions result in really high premiums. State run plans could be separate plans or they could be opening the state employee health benefit plans to state residents (because most of those plans have guaranteed issue and community rating within that given community).

Funding is a very big issue for all of the plans. Since the CBO hasn't estimated the cost of HR 3400, there's really no way to know how much it might cost. It could be that it could be funded with a .5% cut in non-defense spending or a 2% cut. It could be that what we saw was just some guy in his basement tossing out speculation that got picked up and developed a life of it's own. I have no clue.

I thought HR 3400 had similar provisions, except for where they set the cutoffs for medicaid and tax credits, but that HR 3400 didn't account for what happens if someone over the medicaid enrollment cutoff tries to buy private insurance with the tax credit but cannot. The Obama / Baucus plan appears to address this loophole by setting up insurance exchanges and by keeping open the idea of a public option - a safeguard that, unless I'm mistaken, the republican plan lacks.

The Republican plan lacks a "public option" and a mandatory insurance clause for a reason. The plan is designed to make access far easier and less expensive, but it doesn't presume to force anyone to do something against their will. It also requires at least a minimal effort on the part of the individual to shop for health coverage. These are important destinctions, IMO as they are symptomatic of overall philosophy about this subject.

I take it your "double paying" complaint is the subsidizing of others' insurance through taxes along with however you buy your own insurance. I don't understand, however, how that'd be different if we take HR 3400 - you'd still be subsidizing others' through taxes.

First of all, that wasn't a complaint, it was an observation. Second of all, it isn't a matter of subsidizing others it is a matter of funding an entire beauracracy that would be a publicly funded healthcare provider while still paying for private care, which as I stated before, would be impractical for most people in the same way education "double pay" is impractical for most people. Maybe I wasn't clear enough that this is a predictable outcome to the proposed "public option" and the cause to effect relationship that facilitates that end.

And both plans leave open the option to buy private insurance - the Republican plan through existing marketplaces and the Baucus / Obama plan through a new marketplace designed to overcome some of the shortcomings of the existing marketplaces.

Again we come back to the question: is there really a choice? If a public funded health provider becomes available, as I have already said, then it would quickly become a primary option, despite any effort to minimize private insurance costs. It will be less expensive because of government financial support, or it will be useless and unbelievably expensive if it is solely funded from premiums from people who already can't get market insurance.

Of course mandating that everyone will have insurance and that providers will have no option to refuse massive liability clients, has no chance of reducing insurance costs on the private market. The public option would quickly become the primary option for most people. What would posibly stop that from happening? Where is the status quo reached where the "public option" is left as a suplimentary insurance and how is that funded?

Thus, unless you oppose both plans, I don't see how the alternative is actually different (leaving open the possibility that your income range is in the range where the Republican plan gives a tax credit and the Democratic plan does not, if such a range exists).

It is very different, for reasons I have expressed repeatedly. The "public option" is the single factor I completely reject. I think I have more than once expressed why and even ask for contrary ideas as to any flaw in my assessment, but as yet have not recieved any. It is simply the difference between manipulating the market for advantage and bypassing private provision with government's direct intervention.

We already pay for benifits through the state for our fellow Americans. I have no problem with that. I have a serious problem with overpaying and under-recieving because of government intervention. As I see that as an almost inevitable outcome, the government's "public option" is just plain bad, IMO, terribly, horribly bad.

There seems to be some disconnect in what I am saying and what is being replied. I am not sure if that is due to my not being clear or deliberately ignoring the main onus of what I have been posting, but hopefully my issue with the plan is more plain now than it was before.

Im afraid I still don't see the difference (double-payment-wise, not mandated insurance-buy-wise) between receiving a tax credit under the Baucus / Obama plan or getting enrolled in medicaid vs receiving a tax credit under the Republican plan or getting enrolled in medicaid, with the tax credit under both plans being used to help buy coverage. In either regard taxpayer money is being used to subsidize insurance buys (tax credits) or medicaid. This is true independent of whether the public option exists or not - even without a public option taxpayer money is going to be put into the system to help out those who are less able to buy plans. If you're not a recipient of the tax credit, you're going to be double paying via subsidizing others' tax credits and medicaid payments either way. If you are a recipient of the tax credit, then you're not going to be double paying unless the tax credit doesn't get you all of your money refunded by the government, in which case you're in a fuzzy grey area in which it's individual-situation dependent.

The biggest difference I see is that the Baucus / Obama plan leaves open the alternative to have a public option (though Obama did not mandate it, he just endorsed it - big difference there), which I like because of my aforementioned (and apparently rejected) argument that there has to be an alternative available for those who get rejected by all. This could also work by mandating that the state or federal-run co-ops / pools have to accept the patients being rejected by the insurance companies now - I'm open to that idea. I know that the state pools are designed to be for these patients, but unless it's an absolute mandate, there's the wiggle room. I want to make sure that there isn't a way for the state co-ops to wiggle out of covering a patient like there are ways for the insurance companies to wiggle out now.

The entire idea behind making everyone pay into the system (hardship waiver-grantees excepted) is that gives the biggest possible pool so that the premiums, etc can remain the lowest possible. The mechanism the Baucus plan has apparently chosen to ensure compliance is similar to that of the Netherlands and a few other countries where there is a penalty for not carrying insurance. I can see how some people, especially those around my age, don't like the "must have" provision, since we tend to think we're invincible. I think a better solution may be to require those receiving the tax credit to buy insurance, with the tax credit being revoked if no insurance is bought (aka the tax credit is pocketed), and if those above the income line for the tax credit don't want insurance or want only "catastrophic illness insurance", that's OK, since they presumably have the means to pay for themselves. And anyone who is below the threshold to automatically receive medicaid should be automatically enrolled, so if they, say, show up at the ER then they're already covered, even if they didn't know it.

***

As to why Obama doesn't sign an executive order to implement the cost savings now? My best guess is that some of them require a law change instead of just an executive order.

***
Politifac (http://www.politifact.com/truth-o-meter/article/2009/sep/09/obama-speech-health-care-reform/)t's article on the speech is kinder than the AP one, for two reasons: first, Obama cleaned up a couple small factual inaccuracies that had been in there before, and second because they don't tackle the issue of payment for it. Though I do want to know more about the provision he mentioned where automatic cost-cutting measures in other areas kick in in the event that the health care reform is costing too much. Details would be nice.

The biggest difference I see is that the Baucus / Obama plan leaves open the alternative to have a public option (though Obama did not mandate it, he just endorsed it - big difference there), which I like because of my aforementioned (and apparently rejected) argument that there has to be an alternative available for those who get rejected by all. This could also work by mandating that the state or federal-run co-ops / pools have to accept the patients being rejected by the insurance companies now - I'm open to that idea. I know that the state pools are designed to be for these patients, but unless it's an absolute mandate, there's the wiggle room. I want to make sure that there isn't a way for the state co-ops to wiggle out of covering a patient like there are ways for the insurance companies to wiggle out now.

Ok, I'm confused. I'm not sure what you mean by a mandate. A mandate by who, against whom, and for what?

Under the Republican plan states would be required to set up high risk pools and would be given seed money to do so. Those pools could take whatever form the states believe best address the needs of their residents, but each state would be required to set one up. Residents would be eligible to enter the high risk pool if the cost of premiums from plans offered by their employer, a membership organization, or an association exceeded 1.5 times the national average. Whether an individual chooses to enroll in one of those plans or not is left to the individual rather than mandated.

Under the Democrats plan insurance companies are required to accept any person who applied and are required to offer community rated plans (which means the same price will be paid by every person in that plan no matter what medical conditions they may or may not have). Further, every person in this country is required to obtain basic coverage - whether they want it or not.

I'm not sure if that clarifies what needed to be clarified or whether anything even needed to be clarified, but I hope it helps!

The entire idea behind making everyone pay into the system (hardship waiver-grantees excepted) is that gives the biggest possible pool so that the premiums, etc can remain the lowest possible. The mechanism the Baucus plan has apparently chosen to ensure compliance is similar to that of the Netherlands and a few other countries where there is a penalty for not carrying insurance. I can see how some people, especially those around my age, don't like the "must have" provision, since we tend to think we're invincible. I think a better solution may be to require those receiving the tax credit to buy insurance, with the tax credit being revoked if no insurance is bought (aka the tax credit is pocketed), and if those above the income line for the tax credit don't want insurance or want only "catastrophic illness insurance", that's OK, since they presumably have the means to pay for themselves. And anyone who is below the threshold to automatically receive medicaid should be automatically enrolled, so if they, say, show up at the ER then they're already covered, even if they didn't know it.

Since the Democrats plan doesn't have tax credits, I'll assume this is about the Republic plan (though I may be wrong cause I'm just really confused about what we're talking about).

Under the Republican plan the refundable tax credit is only available to qualifying individuals for paying health insurance premiums. The deduction is likewise only for the amounts actually paid by an individual for insurance premiums. If you try to deduct or file for a credit for costs you didn't incur, then you committed tax fraud and could go to jail.

Medicaid is currently available to anyone whose income is under 1.33 times the federal poverty level (and other requirements). Enrollment in Medicaid and SCHIP is automatic if you show up at a medical facility. So if you show up at a hospital and need care and you qualify for Medicaid or SCHIP, you'll be automatically enrolled. That's the current law and I don't think that will change with either plan.

Politifac (http://www.politifact.com/truth-o-meter/article/2009/sep/09/obama-speech-health-care-reform/)t's article on the speech is kinder than the AP one, for two reasons: first, Obama cleaned up a couple small factual inaccuracies that had been in there before, and second because they don't tackle the issue of payment for it. Though I do want to know more about the provision he mentioned where automatic cost-cutting measures in other areas kick in in the event that the health care reform is costing too much. Details would be nice.

Details on this would be very nice because when we're talking about health care automatic cost cutting measures implies rationing to me because that's the only substantial way to cut costs quickly.

a) I was talking about the state plans having to accept any person people from their state, instead of them being set up for high-risk patients and then they'd find a way to reject someone who applied for it. I presume that would be the goal, but I want to make sure the language of any co-op is clear that there isn't a way to reject coverage unless the person has been convicted of major medical fraud. According to the summary I link below, the co-ops will be state-based under Baucus' plan.

b) I was talking the Baucus / Obama plan, not HR 3200. According to the white paper and other reports, it's got tax credits in it, unlike HR 3200. I'm making a bet now that the final bill will be far closer tot he Baucus proposal than HR 3200 so that's why I am focusing on it. Obama's speech last night also made it the "Obama / Baucus" or "Baucus / Obama" plan to me. Best summary (http://www.cbsnews.com/blogs/2009/09/08/politics/politicalhotsheet/entry5295501.shtml) I could find fast, though the picture of Baucus is simply horrifying (someone at CBS news must dislike him). Tax credits from 133 to 300% of the poverty line (sliding scale), interstate insurance shopping in 2015, co-ops, tax credits for < 25 employee small businesses, a fee (not to exceed the tax credits given) to employers with > 50 employees who don't give health coverage with the idea being that the company still pays for it but the individual gets coverage via a co-op, and a few other things are the highlights. They use the term "Health Flexible Savings Accounts", which confuses me because it merges the HSA and FSA concepts in my mind; maybe it's just for the FSA's. That needs clarification to me.

c) I think it's an open question whether it's cost-cutting within the health framework or outside of it or both. Thus, it doesn't necessarily mean rationing to me, and besides, the government has a relatively low bar to jump over when it comes to being better than some insurance plans (not all - some are quite good, but some aren't) when it comes to "rationing" care. Other ways to cut costs would be to freeze the increase in medicare reimbursements to docs for a few years, to cut a few items from the defense budget, to freeze NASA or NIH or FEMA or some other program's budget, etc. I don't automatically think rationing, but maybe that's because I have less fear and less automatic distrust of the government than some. But, details would help clarify.

ETA: It's about darned time factcheck (http://www.factcheck.org/2009/09/obamas-health-care-speech/) got theirs up. Again, generally high marks, they note that Obama's careful rewording on the number of uninsured (citizens instead of residents now) and the Medicare vote from earlier this year ended up far more accurate than the DNC ad or other materials. Biggest demerit? Same as on politifact and the AP - the paying for the plan. Second biggest? Factcheck doesn't like the 1000 / family figure for ER visits by uninsured; they claim it's more like 200 / family, and they think that it cuts into hospital profits.

And, factcheck's fact check of Boustany's response (http://www.factcheck.org/2009/09/boustanys-response/). False claims? 53 new bueurocracies (they quibble with the term bueurocracies while giving marks for the descriptions of each position the House Republican Conference provides), and the tort reform saving $$, since their research has shown that states which implement tort reform don't get savings out of it (rather unfortunately). They also re-knock the $500 billion in cuts claim that they've repeatedly said is false. They don't like the phrasing of the $600 billion in taxes on job creators.

Your right, the president's speech was nothing more than partisan rhetoric, full of half truths and out right falsehoods. All he did was prop up HR3200 which was the source of angst in August. He made no move to clarify issues. The sum total of his speech was to bash opponents and tell them he's coming after them.
I wasn't commenting on the president's speech, so I'm at a loss to respond to this. I haven't heard or read the speech, but I've had the impression from listening to commentary that as usual most people heard only what they wanted to hear. Glad to see you confirm that.

Is that how you heard it? So if there is a "government option" why would most people continue to keep their health insurance? Even in the language of the speech, if I changed jobs, why, and more importantly, how, would I be able to justify in my limited budget a move from the "government option" back to private insurance when I have to effectively pay for both? Of course he didn't directly say the government was taking over healthcare, he minimized the government action and maximized private insurance while in effect forwarding a plan that would effectively eliminate private insurance over time.

There is the posibility of a choice, just like with education, or military/VA or medicare, but the choice is unrealistic in nature. If the options are pay for government care and in addition buy private care or use the government care you are already paying for, what choice is really available for the vast majority of people? That isn't rhetoric, it is reasonable cause and effect. What in anything said prohibits that exact outcome and what in history or human nature would stop that chain reaction?
How I heard what? You also seem to have misunderstood. I was responding to the post I quoted. I find it remarkable that you like so many others are able to not only know the motives of Congress but predict what they will do on some unforeseen slippery slope.

I also find it amusing that simultaneously people argue that a) the plan is practically done and it's being rammed through and b) all these terrible things might happen that aren't actually in the bill but will be some day. Like the outburst that the President was lying about illegal immigrants being covered under a public plan. Clearly this is not in any of the plans being considered if I can trust my own reading and reporting, but opponents just know that the public plan is being designed to allow them to sneak in under the radar. That's the kind of rhetoric I'm talking about--no content, just angst. Whatever the president said to Congress.... well.... irrelevant.

Apparently "doing nothing" eliminated 16 million uninsured from their problems in one month. At this rate, why not just "do nothing" for two more months and everyone will be insured???

He said no such thing as anyone who is honest and understands English will realise. Almost 46 million is more than 30 million, however you count.

Wow aren't we just a couple of fluffy bunnies in here, commenting and responding to each other in the most friendly way!

Time for a new thread. Preferably one with out doubting people's honesty etc.

If anyone has suggestions for version 2, please owl Chris with your suggestions.

Version 2 is here (http://www.cosforums.com/showthread.php?t=122690).