The audacity of ignorance

[Zarathustra]

It's undeniable that access to health care depends upon cost. That's why my main argument has been to address that very issue: bring down cost. Meanwhile, the Democrats' approach has been to pretend that they can ignore the reason why access is limited, and just skip over that pesky detail. This is a recipe for bankrupting our country. The House bill doesn't even pretend to lower cost--just increase access.

So there are two approaches to this problem: ration care, or lower cost. My approach is more humane, more cost effective, more sustainable. If we lower costs, we don't have to ration based on age or the government's judgment of how useful you are to society (as Obama's health adviser has argued).

Now, back to the argument that "we ration." WE do not. People make choices that limit their financial capacities. That's on them. If you can't afford it, YOU are rationing your own health care. There is a huge, fundamental difference between the government telling you that you can't have something, vs you not working hard enough to afford it. Given that my entire family has access to health care for $40/month--less than most people spend on cable--I honestly don't see what the problem is. If there are some unfortunate people who can't bring themselves to give up cigarettes in order to purchase health insurance (or whatever the hell they're buying for $40/month that "rations" away their access), then screw 'em. They should straighten out their priorities. But for those who truly can't afford it, I've never once said that we shouldn't have some kind of safety net for them. If we implemented this safety net, then this argument about private sector rationing vanishes.

So why won't the Dems propose covering those people? Just cover the ones who need it. Why is that so hard?

[Lord Mhoram]

So people decide not to provide themselves and their families with the vital healthcare they need. Ohhh, I get it now.

Look, I see your point. But nobody would make a similar distinction when talking about rationing food, for example. Healthcare is rationed by our society in a way that is essentially similar. You get what you pay for. To make an argument against universal government coverage on the grounds that rationing is a bad thing is completely and utterly spurious. You just don't like who is doing the rationing. The insurance companies could change the way price brackets are set up so that price rationing would be less prevalent, but they don't because it'd be a bad business practice. That doesn't mean rationing isn't happening. It is, and everybody seems to agree on that issue. I don't see any commentators or policymakers making a similar argument as you (the smoker comment is classy by the way), and then having the audacity to assert their humanitarian superiority.

If healthcare is not rationed in our current system, does that mean that the system can't sustain the 45 million uninsured Americans? A non-rationing system would surely insure everyone that it can; it would have no need to exclude anybody by rationing its resources.

[sindatur]

So people decide not to provide themselves and their families with the vital healthcare they need. Ohhh, I get it now.

Look, I see your point. But nobody would make a similar distinction when talking about rationing food, for example. Healthcare is rationed by our society in a way that is essentially similar. You get what you pay for. To make an argument against universal government coverage on the grounds that rationing is a bad thing is completely and utterly spurious. You just don't like who is doing the rationing. The insurance companies could change the way price brackets are set up so that price rationing would be less prevalent, but they don't because it'd be a bad business practice. That doesn't mean rationing isn't happening. It is, and everybody seems to agree on that issue. I don't see any commentators or policymakers making a similar argument as you (the smoker comment is classy by the way), and then having the audacity to assert their humanitarian superiority.

If healthcare is not rationed in our current system, does that mean that the system can't sustain the 45 million uninsured Americans? A non-rationing system would surely insure everyone that it can; it would have no need to exclude anybody by rationing its resources.

Yes, the insurance Companies could change those brackets, and that's what some of us are waiting for, is for the Democrats to actually address it, head on in their solution, not demonizing someone already on board with the plan (That would be the Insurance companies running the "HillaryCare" character ads, saying a solution was on the table)

[Farsailer]

LM, the difference is that if the government decides to ration in Canada or the UK, the citizen has no choice in the matter, no local alternative available to him. This is where all the stories about people going overseas or across the border for care come from.

Whereas in a truly free market (we do not have such a market today!), I would have alternatives to one company not wanting to cover something; I would take my dollars and business elsewhere.

What alternative do I have when the government denies me? Appeal to my congressman? What lot of good that will do unless I'm connected.

[Lord Mhoram]

Farsailer,

What alternative do I have when the government denies me? Appeal to my congressman?

I understand that concern. Opt into your employer's insurance plan, buy a private one. I'm not advocating a single-payer system.

[Zarathustra]

So people decide not to provide themselves and their families with the vital healthcare they need. Ohhh, I get it now.

You really don't think people make this decision? Some guys don't pay their child support--you think it's not beyond them to skimp on health insurance? They buy booze and gamble away their children's future. They can't take this money and purchase health insurance instead? People eat fast food instead of cooking. People smoke 2 packs a day. People buy a new car instead of a used car. People buy drugs. Lottery tickets. All kinds of shit they don't need. Why do you think it's beyond them to blow money they could otherwise spend on health insurance? You don't think poor people blow money? They are some of the worst at blowing money. That's one of the reasons they're poor!

Look, I see your point. But nobody would make a similar distinction when talking about rationing food, for example. Healthcare is rationed by our society in a way that is essentially similar. You get what you pay for.

How is this any different for food? Poor people eat crap, rich people have a chef. This is a form of "rationing," too. So why not universal food coverage so we can all have a chef? Or so we can all eat filet mignon?

If food was so expensive that poor people couldn't buy it anymore, they'd stop smoking so many damn cigarettes. And stop buying cable. And stop buying cell phones. And iPods. Food has a sense of urgency, because you need it every day. Health care is easy to neglect when you are the kind of person who is only looking a quick fix, whether that's food or nicotine or portable music.

Are all poor people like this? No. That's why I say for those who truly need help, we should help them. But there are millions who want help simply because they don't want to stop being irresponsible.

If all poor people were responsible, hard-working, thrifty, non-smoking, non-fast food eating social heroes, they wouldn't be in such a mess now, would they? If they were saving their money, making wise choices, working hard, why would they need a government handout?

To make an argument against universal government coverage on the grounds that rationing is a bad thing is completely and utterly spurious.

No, it's not. To argue for a universal solution to a problem then only affects 15% of us is spurious. The people who can already afford their own health care shouldn't have their health care rationed by a bureaucrat just because 15% of the population isn't as responsible as they are. There's nothing spurious about that argument.

You just don't like who is doing the rationing. The insurance companies could change the way price brackets are set up so that price rationing would be less prevalent, but they don't because it'd be a bad business practice.

I agree that there is room for prices to come down. And the government could do some things to make that happen. That is the core of my argument.

And you're right: I don't like the government rationing my care for me when I can afford the care I need already. If they want to ration care for those people who can't afford it, fine, ration them all day long. They have no right to bitch because they are asking for a handout. BUT I'M NOT! I don't want a handout, therefore I shouldnt' have to put up with government rationing my care--which would happen in a single payer system.

That doesn't mean rationing isn't happening. It is, and everybody seems to agree on that issue. I don't see any commentators or policymakers making a similar argument as you (the smoker comment is classy by the way), and then having the audacity to assert their humanitarian superiority.

When did I assert humanitarian superiority? I'm making a pragmatic argument. I think a market solution makes more sense.

The reason you don't see policymakers making a similar argument is because a) Republicans are spineless, b) the media empahsizes Democrat solutions (ABC and NBC have refused to run anti-Obama commercials; and ABC gave Obama over an hour of exclusive, unchallenged coverage of during his health care "infomercial"), c) most politicians are horrible economists, even the Republicans. Most of them don't know much about either health care or the economy. You can tell because *both* parties have put us 10 trillion dollars in debt, and none of them have a clue about consumer-driven health care, even though professionals in the field know we're already moving this way. (Google it and see).

This is also another reason why politicians shouldn't be in charge of health care. Would you doubt a scientific theory on the basis of politicians not talking about it? Why do you assume the lack references to market solutions from "policymakers and commentators" is evidence that these solutions aren't tenable?

If healthcare is not rationed in our current system, does that mean that the system can't sustain the 45 million uninsured Americans?

There are a finite number of doctors and hospitals. However, that number is not fixed. It can increase--IF there is an incentive. Government price controls are not such an incentive. Government take over would disincentivize the profession, just as it has done in Canada.

A non-rationing system would surely insure everyone that it can; it would have no need to exclude anybody by rationing its resources.

Rationing systems try to insure everyone they can, too. The government single-payer system would do just that: insure everyone they can, but ration their care.

[Lord Mhoram]

Malik,

1) I'm not advocating a single payer system, nor are liberal policymakers; I'm advocating universal or near-universal coverage by government and private insurers;
2) Society is capable of making decisions that avoid the slippery slope problem you've mentioned. I don't see universal food coverage in countries that do have the single-payer system;
3) You don't like the idea of government rationing your care, but you are okay with the idea of people being denied coverage entirely because of stagnating wages and rising costs. I'm not mocking you, I respect your position. I understand it, I just don't share your values. And I call that rationing by the market, so I say that rationing is an inherent characteristic of all kinds of healthcare (except perhaps single-payer; does single-payer leave any uninsured?), so let's drop it as a criticism;
4) You asserted your humanitarian superiority when you said point-blank "My approach is more humane." That seems pretty cut-and-dry to me, especially since nobody spoke about being humane before that in this thread;
5) My point about sustainability is that if not everyone who can be covered is covered, then it will follow that some kind of rationing is being instituted if the system isn't working to capacity.

[Khazduk]

Eric T. Cartman said:

Poor people piss me off!

[Zarathustra]

1) Obama is for a single-payer system, and he is advocating the public option in order to achieve this goal piecemeal. Liberal policymakers are indeed advocating a single-payer system, and I documented that in my Trojan Horse thread, complete with quotes from the Democrats (including Obama). But you demonstrate the tactical strength of ostensibly supporting a public option (when liberal really want a single-payer) because you have a built-in excuse to side-step criticisms of single-payer system. This is the reason the public option illusion was created, for this tactical reason! You are letting yourself be fooled by your own party. Do you think they were lying when they said they wanted a public option in order to gradually move us to single-payer?

Any point against single-payer systems is a reason to be against adopting the public option, too.

2) It's not a slippery slope argument I'm making. I do not fear an accidental slide into single-payer. I think it is entirely deliberate, and the people who created this idea have admitted this (again, I provided quotes).

3)

You don't like the idea of government rationing your care, but you are okay with the idea of people being denied coverage entirely because of stagnating wages and rising costs.

Absolutely not! You claim to not be mocking me here, that you understand my position, but I think you must be disingenuous on both counts. Didn’t you read where I said this: That's why I say for those who truly need help, we should help them.

If I think we should help them, then there's no way I'm "okay with the idea of people being denied coverage entirely because of stagnating wages and rising costs." For you to make a statement like this, you must completely misunderstand my position. Why else do you think I'm arguing that we must find a way to reduce cost? I am in no sense okay with people not being able to afford it. I also said:

I agree that there is room for prices to come down. And the government could do some things to make that happen. That is the core of my argument.

My entire argument is about increasing access by addressing the root cause which limits access (i.e. costs).

And I call that rationing by the market, so I say that rationing is an inherent characteristic of all kinds of healthcare (except perhaps single-payer; does single-payer leave any uninsured?), so let's drop it as a criticism;

You can call it rationing by the market if you want--but the government is responsible for the conditions which have made health care more expensive (I've outlined these in my market solutions thread). And individuals have contributed to their own financial status. So to invoke "the market" as if it's some active participant that works to limit care is to ignore both the government's role and the individual's role. I want to do something about both of those. Your solution addresses neither. Even with a public option, the laws which make the market less free and less competitive will still exist.

I can understand your desire to have us drop criticism of rationing by the government. It's quite damning to your cause. But just because there exists one kind of "rationing" in the private sector does not mean that the same kind will exist for the public option. You seem to be implying that these two kinds of rationing simply "cancel out," so we don't even need to talk about them. But as I keep saying: the government deciding who deserves health care is still something to be concerned about, despite the problems with the private sector. One problem does not justify creating a separate, additional, different kind of problem. Poverty does not justify increased government control over our lives.

Your desire to drop the rationing criticism depends on believing that all forms of rationing are equally distasteful and yet equally unavoidable. Neither is true. Private sector rationing is something individuals can overcome through their own effort. (People can actually make more money!) Government rationing can't be overcome, because you can't reverse aging. So a rationing that you have control over yourself, through your own effort, which isn't imposed by a bureaucrat, is infinitely more desirable than an imposed, legislated rationing by age. It is both easier to affect, and thus easier to avoid.

And finally, there is absolutely rationing in single-payer systems. Your definition of “rationing” seems to be limited only to “leaving some people uninsured.” This is ironic, because the kind of rationing in a single-payer system arises specifically because of everyone being covered. Rationing by the government is achieved by long waiting times and the government determining what kind of care you can have.

There's still quite a bit to say about rationing.

4) Okay, you got me there. What I meant was that we won't have to tell old people that they're not worth as much to society and ration their care on this basis.

5) What makes you think the system isn't working to capacity? Are doctors taking too many vacations? You think they derive their leisure time by refusing to treat poor people? Do you know how many hours a week doctors work?

You are conflating two issues: access to insurance, and access to health care. The two are not the same. Just because you have insurance doesn't mean there is a doctor waiting to serve you at this moment. You'll have to define "capacity," if we're going to talk about this meaninfully. If I read you correctly, you seem to define "capacity" in terms of how many people are covered by an insurance company.

[Lord Mhoram]

Malik,

You have completely and utterly failed to substantiate the claim that a single-payer system is being created in the United States. What you see as a sinister "Trojan horse" I see as the Democrats compromising with the Republicans because of the lack of political viability of a single-payer system. Even the public option may not happen, although I think it will. I think the Democrats just want to reform the system, albeit with a strong government role. To do that they've been willing to not only drop the single payer (which many didn't even support) but also signal a willingness to compromise on the public option, although again I think that will be included. And how dare you ascribe to me my own beliefs? What I "really" want is the single-payer system? How do you know? I know what I believe, and I know what will be in the Congressional legislation.

It's not a slippery slope argument I'm making.

We were talking about healthcare, and this is what you said:

So why not universal food coverage so we can all have a chef? Or so we can all eat filet mignon?

In fairness I did bring up a food analogy. But what I just quoted is the very definition of a slippery slope (in which a "relatively small first step inevitably leads to a chain of related events culminating in some significant impact, much like an object given a small push over the edge of a slope sliding all the way to the bottom"). Now what do you think of the point that I actually posed? That society is capable of incrementalist change, and why don't single-payer societies have universal filet mignon?

That's why I say for those who truly need help, we should help them.

Frankly Malik, this is difficult for me to accept when you spent most of your last post ranting -- literally ranting, with caps locks and swears and tangents -- about poor people. However, let's accept that you're being sincere in your desire to help poor people. Fine. But I didn't misrepresent your position, as far as I can tell. You explicitly and unashamedly support the market dictating how healthcare is distributed, with some government repairs to how it's done through "market-based" legislation, and in doing so some people will be denied coverage when they can't afford it. That's literally an inevitable result of your position. You created a whole thread here about it. How did I misrepresent you?

Your solution addresses neither.

The public option does not fail to address the government's role in healthcare. It redefines it. That's a criticism I haven't heard yet. It fails to address the individual's role? How about the choice it offers the individual between private and the new public option?

But just because there exists one kind of "rationing" in the private sector does not mean that the same kind will exist for the public option.

If you're comfortable with the hypocrisy of explicitly supporting the private sector rationing care by setting prices which exclude people, but will rail against the government for rationing care by insuring everybody, then that's fine with me. It's quite damning to your cause of being "more humane."

So a rationing that you have control over yourself, through your own effort, which isn't imposed by a bureaucrat, is infinitely more desirable than an imposed, legislated rationing by age.

Some people cannot afford private insurance. For them, some insurance is infinitely better than none. And for them, private rationing is much harder to avoid.

What I meant was that we won't have to tell old people that they're not worth as much to society and ration their care on this basis.

Tell me where in this legislation anybody's "worth to society" is mentioned or determined. Don't private insurers make their decisions largely on a person's worth to their company (i.e., how much they can pay)?

What makes you think the system isn't working to capacity?

I'm talking about the uninsured. Is the system unable to insure them, or are the uninsured unable to pay for it? Let's leave what you think about the poor out of this question and talk about sustainability, not intent.

[Zarathustra]

Malik,

You have completely and utterly failed to substantiate the claim that a single-payer system is being created in the United States.

But I've shown that this is what our Democrat leaders *want* to do, and that they have openly acknowledged that the public option is a tactical way to achieve this.

From my Trojan Horse thread:

Rep. Jan Schakowsky (D-IL) at a Health Care for America Now rally: “And next to me was a guy from the insurance company who argued against the public health insurance option, saying it wouldn’t let private insurance compete. That a public option will put the private insurance industry out of business and lead to single-payer. My single-payer friends, he was right. The man was right.”

 Rep. Barney Frank (D-MA) told Single Payer Action: “I think that if we get a good public option it could lead to single-payer and that is the best way to reach single-payer. Saying you’ll do nothing till you get single-payer is a sure way never to get it. … I think the best way we’re going to get single-payer, the only way, is to have a public option and demonstrate the strength of its power.”

 Washington Post blogger Ezra Klein at the Democratic National Convention last year: “They have a sneaky strategy, the point of which is to put in place something that over time the natural incentives within its own market will move it to single-payer.”

 Noble Prize winning New York Times columnist Paul Krugman: “[T]he only reason not to do [single-payer] is that politically it’s hard to do in one step…You’d have to convince people completely give up the insurance they have, whereas something that lets people keep the insurance they have but then offers the option of a public plan, that may evolve into single-payer.”

“Someone told me this was a Trojan horse for single-payer. Well, it’s not a Trojan horse, right? It’s just right there. I’m telling you. We’re going to get there, over time, slowly, but we’ll move away from reliance on employer-based health insurance as we should, but we’ll do it in a way that we’re not going to frighten people into thinking they’re going to lose their private insurance. ”

“I happen to be a proponent of a single payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”

So, as I've shown, this isn't my invention. This comes straight from the Trojan Horse's mouth. Obama, Dems in Congress, liberal commentators, and the Yale professor who came up with the idea all EXPLICITLY state that the public option is a sneaky way to move us into a single-payer system. For you to describe this as my own "sinister" interpretation completely ignores the evidence I've provided from the people who are advocating exactly what I'm reporting!!

What you see as a sinister "Trojan horse" I see as the Democrats compromising with the Republicans because of the lack of political viability of a single-payer system.

And how is that inconsistent with what I've said? I've been saying that it's strategy all along.

And how dare you ascribe to me my own beliefs? What I "really" want is the single-payer system? How do you know? I know what I believe, and I know what will be in the Congressional legislation.

I didn't. I said "liberals really want single-payer."

Now what do you think of the point that I actually posed? That society is capable of incrementalist change, and why don't single-payer societies have universal filet mignon?

Completely irrelevant. No one ever stated a fear that the government will have universal filet mignon. And the lack of this happening doesn't bear on the issue of public option evolving towards single-payer at all. The failure of the former to happen does not imply a failure of the latter happening.

Frankly Malik, this is difficult for me to accept when you spent most of your last post ranting -- literally ranting, with caps locks and swears and tangents -- about poor people.

I didn't rant about poor people. I ranted about people who make themselves poor through their choices. The set of all poor people contains the latter set. If you can keep those distinctions straight, you'll have no problem accepting my position.

You explicitly and unashamedly support the market dictating how healthcare is distributed, with some government repairs to how it's done through "market-based" legislation, and in doing so some people will be denied coverage when they can't afford it. That's literally an inevitable result of your position. You created a whole thread here about it. How did I misrepresent you?

You misrepresented my position by stating that I have no problem with people being unable to access health care through stagnant wages, etc. I think it's a huge problem. One that I've spent a lot of words to propse how to fix it.

I have no problem with market solutions, which entail "the market" dictating how health care is distributed, as you said. But this does not imply I have no problem with the status quo. While it's true that some people will be denied coverage if they can't afford it, I want to shrink this number drastically--by addressing that issue directly--and then have a government safety net for the much smaller number who still can't afford it even after all my maket solutions have been maximized. So that covers everyone. And it does so with a minimal government involvement.

Your solution addresses neither.
The public option does not fail to address the government's role in healthcare. It redefines it. That's a criticism I haven't heard yet.

You misunderstand. The public option doesn't address the government's current role in limiting the free market options (which is what I was talking about). It leaves those laws as is, and merely puts a government option in place to compete with private options (which it has hampered with its legislation).

It fails to address the individual's role? How about the choice it offers the individual between private and the new public option?

Again, you seem to have forgotten what I was talking about here. It fails to address the indivual's role in limiting their own access to health insurance through their own choices which have led to their failure to purchase it. Whether this is due to truly not being able to afford it, or if they can afford it and choose to spend the money on something else, it doesn't matter. The point remains: the government option does nothing to help them make better choices which can alleviate either of those issues.

If you're comfortable with the hypocrisy of explicitly supporting the private sector rationing care by setting prices which exclude people, but will rail against the government for rationing care by insuring everybody, then that's fine with me. It's quite damning to your cause of being "more humane."

Again, you are ascribing to me motivations I don't have. I'm not fine with the private market "excluding people." I'm arguing to get more people covered.

Some people cannot afford private insurance. For them, some insurance is infinitely better than none. And for them, private rationing is much harder to avoid.

Which, again, is the point of making it more affordable. If I repeat this enough, surely you will notice.

Tell me where in this legislation anybody's "worth to society" is mentioned or determined.

I provided ample evidence that this is Obama's health advisor's position. No one wanted to comment on it. It's in Plissken's thread about the bill, if you want to read it yourself. No, it's not currently in the legislation as it stands. But we're having an ideological debate, in addition to the debate over the unfinished legislation.

Don't private insurers make their decisions largely on a person's worth to their company (i.e., how much they can pay)?

No one is told by a private insurance company that they can't have health care based upon some bureaucrat's determination of public worth. There are people who can't afford to purchase the service. However, individuals have power *themselves* to alter this situation. That decision rests in the hand of the person who wishes to purchase it, not a top-down decision made by government.

While it's true that there are practical limits to how much any individual can change their financial situation at any given time, this limit is simply a fact of life, not a manufactured limit produced by government control. And it's a limit we can help them overcome through market reforms.

[rdhopeca]

This makes a ton of sense to me regarding this whole health care fiasco.

www.youtube.com/watch?v=G44NCvNDLfc

[Avatar]

Health care is easy to neglect when you are the kind of person who is only looking a quick fix...

Yes, but, (not having read the rest of the thread), it's also easy to neglect when you're worried about where your next meal is coming from.

(I know you're generalising to an extent when you say people choose those financial circumstances...I have a different context to you I guess...where I come from, poor people are really poor. Like $25 a month poor.)

--A

[Lord Mhoram]

Malik,

Obama was in favor of a single-payer system, and ideologically he may continue to be. I don't have a crystal ball to tell me. What I have is the legislation he's supporting, and he's trying to get a bill through Congress, and with the public backlash against government intervention in healthcare, he's had to compromise his position. He wants a bill passed, and if that means dropping aspects that are politically unpopular, he's shown his willingness to do so. Hacker, whom I've quoted extensively myself at the beginning of this thread, is not a policymaker. In fact many of his prescriptions for healthcare reform, which I agree with wholeheartedly incidentally, have not been followed because of various obstacles in the political process. In short, quoting President Obama saying he was in favor of the single-payer system before he was even President, or quoting a political scientist, albeit an influential one, doesn't prove anything. It shows that people involved in the process may favor it, not that the process itself will result in it. That is a considerable difference.

I've been saying that it's strategy all along.

You think there's something wrong with the President compromising his strategy to the will of the voters and Congress? What is wrong with that strategy?

No one ever stated a fear that the government will have universal filet mignon. And the lack of this happening doesn't bear on the issue of public option evolving towards single-payer at all. The failure of the former to happen does not imply a failure of the latter happening.

Now you're being plain disingenuous. You raised the question of why universal filet mignon oughtn't follow from the principles of universal healthcare. I answered your question, but now you think it's "irrelevant"?

I said "liberals really want single-payer."

What liberals? Why am I not included? I thought we were talking to each other here.

While it's true that some people will be denied coverage if they can't afford it, I want to shrink this number drastically--by addressing that issue directly--and then have a government safety net for the much smaller number who still can't afford it even after all my maket solutions have been maximized. So that covers everyone. And it does so with a minimal government involvement.

Aside from technical differences, how is this approach any different, in principle, from what we have now (a mixed approach involving private insurers and a public safety net)? Furthermore, how is it even different from the public-option approach, which also addresses the issue of the uninsured directly and leaves room for private insurers?

The public option doesn't address the government's current role in limiting the free market options (which is what I was talking about).

Fair enough. But it seems to me that the introduction of the public option will have an effect, albeit an artificial one (similar to subsidization in the defense industry for example), on the way the market works. Once the public option offers certain benefits, private insurers will have to respond comparably to compete. This seems to me to address the role the government plays in the way the healthcare market functions. Although I'm certainly not against legislation on some of the market issues you've mentioned.

The point remains: the government option does nothing to help them make better choices which can alleviate either of those issues.

I don't see why not. Look at Massachusetts: thanks to Masshealth, many of the previously uninsured -- half of that number in fact -- has opted into their employers' plan; the other half has gotten Masshealth. See my post in the market solutions thread in response to criticisms of Masshealth. These are excellent choices, compared with the previous status quo of no viable choices at all.

Which, again, is the point of making it more affordable. If I repeat this enough, surely you will notice.

I've noticed. Don't pretend that principally we're apart on this. Everyone wants costs down.

I provided ample evidence that this is Obama's health advisor's position.

That's nice, but that doesn't mean anything when it comes to the legislation. You know there's a difference between isolated comments and positions of those in government, and the effect and results of government policy itself, right? How does this legislation determine a person's worth in society?

No one is told by a private insurance company that they can't have health care based upon some bureaucrat's determination of public worth.

So again we come down to the fact that you can support a system in which a private bureaucrat can make such a decision, but when a government one makes such a decision it's unacceptable. Again, fine, but there's no principled difference.

[Zarathustra]

MediaMatters, "Myths and Falsehoods about Healthcare"

MYTH 1: There is no health care crisis

CLAIM: The health care system currently works fine, and only a purportedly small number of uninsured people would benefit from reform.

. . .

REALITY: Roughly 25 million Americans were underinsured in 2007. According to Cathy Schoen, senior vice president of The Commonwealth Fund, "From 2003 to 2007, the number of adults who were insured all year but were underinsured increased by 60 percent. Based on those who incur high out-of-pocket costs relative to their income not counting premiums despite having coverage all year, an estimated 25 million adults under age 65 were underinsured in 2007." [Testimony from Schoen before the Senate Health, Education, Labor and Pensions Committee, 2/24/09]

The underinsured do not receive adequate care and face financial hardship. Schoen explained that the "experiences" of the underinsured were "similar" to those of the uninsured, noting that "over half of the underinsured and two thirds of the uninsured went without recommended treatment, follow-up care, medications or did not see a doctor when sick. Half of both groups faced financial stress, including medical debt." [Schoen testimony, 2/24/09]

This is a point that has gone uncontested and unexplained. The term, "underinsured" is itself a myth. It's just a code word for people with high deductible plans (CDHPs, which Farsailer and I have shown in my Market Solutions thread are actually bringing down costs and providing better care, if anyone is interested to read the evidence). It's a way to demonize the strongest competition to the Democrats' version of reform. People with high deductible plans aren't under-insured. They have just as much coverage as everyone else. High deductible plans are simply a way for you to consider how healthy your family is, and how much risk you want to take on yourself. Older people, or people with expensive chronic conditions probably won't decide to take on this risk (unless they have saved enough money over the course of their lives such that $3000-$5000 isn't going to bankrupt them). This type of plan is for younger, healthier people who can afford to take on the risk of a higher deductible, in order to drastically reduce their premiums. Again, I must repeat that my family is 100% covered for $40/month, including all preventive care. That's $10/per person. We pay less for health care than we do water, or electricity, or cable, or food, or any other bill we have. This isn't a plan that will bankrupt poor people.

The vast majority of younger, healthier people aren't going to have a catastrophic health problem that will necessitate putting up the $3000-$5000. To describe this entire group of people who choose to have a high deductible plan as constituting a crisis-level of inadequate coverage is a gross exaggeration and mischaracterization. If most of that group aren't going to have a catastrophic problem, then the high deductible will never be an issue. Yet, to phrase their coverage as "underinsured," it creates the false image of all these people having inadequate coverage. That's simply not the case. The only way this can be described as a crisis is if one assumes that every single family with a high deductible plan is going to have to fork over the money for that deductible--which is ludicrous.

Sure, for the tiny minority of young, healthy families who do happen to experience a catastrophic health issue (and thus must pay their deductible), it's going to cost them between $3000-$5000. But that's less than most families spend on a car, to save your life. If cars don't bankrupt people, neither will saving your life. And hospitals will work with you to pay this money in installments. And, if the government really wanted to help people, it could help that tiny fraction to pay this deductible. THAT'S NOT A CRISIS.

Finally, it's a matter of choice. The reason the number of "underinsured" people are going up is because people are choosing to go with CDHPs. They are recognizing a good deal. They are saving a crapload of money. Consumer-driven plans are catching on, thus the numbers for this group are going up. It's not a crisis, it's market reform.

If they want a low-deductible plan, they can fork out the extra dollars on premiums, just like people with car insurance can choose to purchase full coverage, instead of merely liability coverage. To describe these free choices as a crisis is just irresponsible. They aren't receiving inadequate care. If you look at the stats in my Market Solution thread (article posted by Farsailer on the last page), you can see that for this group preventive care is going up, compliance with chronic treatment is going up, at the same time costs are going down. That's the facts. The above "crisis" is the myth.

[Cail]

NFL head injuries a hot topic in Congress

FOOTBALL
NFL head injuries a hot topic in Congress
'Federal scrutiny' is called for as a House panel hears from former players who have suffered dementia after repeated blows to the head. The NFL's Roger Goodell emphasizes safety improvements.

Reporting from Washington - Congress on Wednesday waded into the debate over revelations that former NFL players may suffer from memory-related disorders at a much higher rate than the population at large.

In a House Judiciary Committee hearing, representatives heard stories of former football players who had struggled with homelessness, depression and an inability to perform basic tasks after suffering hundreds of blows to the head during their careers. But some present criticized the conclusions drawn from a report highlighting memory-related diseases among the players and emphasized changes the NFL had made to protect players.

"The causes and pervasiveness of these football injuries warrant federal scrutiny," said committee Chairman John Conyers (D-Mich.), who called for the league to release its injury data for an independent review. "These are not the types of risks these players or their families associate with the game of football."

A retired-player quality-of-life study commissioned by the NFL found that former players between the ages of 30 and 49 experience memory-related diseases at a rate 19 times higher than men who did not play, according to an analysis of the study by the New York Times.

The study's authors, however, cautioned against drawing such conclusions, warning that it was not designed to assess whether football players had higher rates of dementia than the population at large.

But for other people studying brain injuries among football players, even without the NFL's study, the evidence is clear: Players are destroying their brains.

"In layman's terms, hitting your head thousands of times appears to create a disease that slowly and quietly causes your brain cells to die," said Chris Nowinski in submitted testimony. Nowinski is the co-director of a Boston University School of Medicine center that studies the type of brain trauma under discussion. He's also a former college football player who suffered concussions.

Dr. Ann McKee, a neuropathologist who works with Nowinski, testified that all 11 of the former collegiate and professional football players' brains she had examined showed "severe" signs of degradation. Before they died, many of the players had suffered from memory loss and emotional disturbances.

The witness panels featured NFL Commissioner Roger Goodell as well as the head of the players' association and several retired players, including New York Giants standout Tiki Barber.

Goodell emphasized that, under his tenure, the NFL had made safety improvements such as changing the rules to ban certain kinds of hits and improving helmet technology.

He also highlighted the "88 Plan," named for former star John Mackey, who wore number 88 and now lives in an assisted-living facility because he suffers from dementia. Under the plan, the NFL gives up to $88,000 a year to former players who need nursing-home care due to brain injuries.

Goodell's refusal to acknowledge a direct link between playing football and brain disorders led an incensed Rep. Maxine Waters (D-Calif.) to call for revoking the NFL's antitrust exemption.

"You're always studying. You're always trying. You're always hopeful. I want to know what's going on in the negotiations to deal with this problem," said Waters, whose husband played in the NFL for six years. "I think the responsibility of this Congress is to take a look at your antitrust exemption."

I really didn't know where to put this, but it's certainly ignorant.

Two wars. Banking crisis. Unemployment. Health care. and so on.....

And Congress is wasting time with this?

When are people going to wake up and vote every single incumbent out?

[Zarathustra]

Cail, I respectfully submit that you're missing the point . . . while this might look like an obscene, pointless, and frivolous intrusion into the free choices of grown men (who make millions, btw, and can afford whatever health care and safety equipment they want), what you're really seeing here is a new source of tax revenue.

How much do you want to bet that this is the ground work for a new tax on sports events? Tickets, broadcasts, etc.

Anyway, I'm (halfway) joking. It seems pretty stupid to me. There's no problem too small that the mightiest government in human history can't waste time trying to solve. Given that they only work 3 days a week, I wish they'd prioritize a bit, too.

But I'm glad you brought this thread back up to the top. My last post went unanswered. Probably unread.

[Plissken]

It was stupid when it was steroids in baseball, it's stupid now.

[Rawedge Rim]

Let's see, the goal of Universal Healthcare (socialized medicine), from what I've read and heard in the media, is to insure that all Americans have some form of medical insurance.

Now according to research, there were only 43 million Americans in any given year that were not covered by some form of insurance. Yet even after the infusion of 800,000,000,000 dollars into this morose, there will still be 23 million Americans not covered.

Money to help cover that 800,000,000,000 will come from reductions in medicare funding. (the 62 and older crowd are gonna love this)

Employers will be forced to offer healthcare to it's workers, or suffer a tax penalty as a result. (hope the bottom line on some of these business' isn't to close)

Everyone will be forced to have an insurance policy or suffer a tax penalty (hope food and rent doesn't become a real issue)

If you have a "Cadillac" insurance policy (a policy with GREAT coverage), then you will be forced to pay a tax on that policy to fund the public option.

As to the "Public Option" as it's called now, where the US government starts it's own insurance company (I'm assuming built on the model of medicare) to compete with private insurance. Since the government is not obliged to at least break even or show a profit, I personally don't see how private insurance can compete, as private insurance has a duty to it's shareholders and employee's to at least break even or show a profit.

If the "Public Option" is so inexpensive so that it can compete with Private Insurance companies, then why would employers not drop thier private coverage and opt for the "Public Option" for thier employees, thereby improving thier bottom line, while shifting the cost of health care to the public?

With the rampant corruption and graft in Medicare (and on the state level, Medicaide), what makes DC believe that this is not going to be a problem with the "Public Option"?

What makes DC believe that the cost of Universal Coverage will be not go up, and not be way underguesstimated like Medicare was?

And finally, by thier own admission, when it's all said and done, the proponents of "Universal Coverage" admit that 23 million people will still not be covered even after spending 800,000,000,000 dollars.

Am I missing anything here?

[ParanoiA]

"You're always studying. You're always trying. You're always hopeful. I want to know what's going on in the negotiations to deal with this problem," said Waters, whose husband played in the NFL for six years. "I think the responsibility of this Congress is to take a look at your antitrust exemption."

Am I the only one disturbed by that threat? What does antitrust exemption have to do with player safety? That sounds like an abuse of power to me.