I agree, sort of. Although current healthcare reform is very simply the *minimum* we can do... keeps private markets, eliminates PEC clauses. But avoids the death spiral that elimination of PEC clauses would cause by mandating everyone have insurance. Keeps it rational by subsidizing for those who can't afford it. It's a very centrist policy, practically written by Romney. And it's got this ridiculous, uninformed aura of spin on it as though it's single-payer.
The problem in this case isn't the policy... it's all of the lying about the policy. Death panels? C'mon...:-/
I see no reason they'd switch from MS products if they work properly. Having used both MS Office and OpenOffice, I'd rather pay for MS Office than use OpenOffice, I'm pretty sure most desk jockeys would feel the same way.
Desk jockey, here. And just to be clear... have you ever used Office 2007? That's what made me switch to OOo.
The plural of anecdote is not data, but in any case, I'm sure if everyone realized they could get a free MS-compatible software suite, fewer would spend the money. The wallet is a powerful motivator.
And just wait until Microsoft extends the open standard in proprietary ways... remember IE6? This is why people want to motivate others to move away from Microsoft's software.
Interesting ideas about courts, and I'm inclined to agree on most points.
The one objection I have is the idea that we can't fix overprescription of drugs and procedures. We can most certainly fix this, but there are several facets to the problem:
First, there's the culture of CYA procedures and defensive medicine. We can fix that with some kind of tort reform.
Second, there are the pay-for-procedure mechanisms that motivate doctors to overprescribe and overtreat... after all, if they make more money for doing more procedures, why wouldn't they? We can eliminate this perverse incentive if, for example, we can ensure that doctors do not have ownership stakes in the firms/hospitals at which they practice.
Third, instead of salarying doctors (a viable alternative considering point 2), we ought to pay them based on their results. This is how Mayo works, and they get some of the best results at some of the cheapest costs.
As it turns out, this problem goes away with true single-payer, but there may be a way to incorporate these regulations into the system we have, given that Mayo works so well on the same model.
We're vesting the responsibility for timely and correct care with our hospitals and doctors, and for payment to the government. If our doctors and hospitals know they won't have to pay people to fight with insurance companies for every penny, by, among other things, having a standard list of covered procedures, they're more likely to treat first and bill later.
And I don't know how you'd go about quickening the court system while still granting due process. If you have any ideas about that, I'd legitimately like to hear them.
You've hit it on the head. In a universal system, care is rationed based on need. In our current system, it's still rationed, only it's more transparent because so many of the sick will never bother to see the inside of a hospital. Right now, we ration based on ability to pay.
What's important to me, from a moral perspective (and these are my own, and I don't claim to speak for anyone else), is providing a minimum standard of care for those in need so that we aren't leaving people to die on the streets. Above that system we'll always have the capitalist system wherein those who are better off can go elsewhere to get more care. But I see it as important, morally, culturally, and economically, to raise the bottom and limit how far people can fall.
I don't think anybody ought to go broke because they get sick.
And the insurance company will claim you didn't exhaust all of your options w/their internal processes first, and if you did, you'd die before you got treated anyhow.
That aside, I thought the whole process of suing usually takes, after all (court) appeals are said and done, long enough for you to die before anything is done.
Our judicial system is many things, but speedy is not one of them.
Your family may be able to sue for wrongful death or something of the like, but that really doesn't help during life.
You know what the difference is between socialized medicine and the system we have today?
In a socialized system, you have a group of government bureaucrats who decide if you qualify for lifesaving procedures based upon your potential contributions to society versus the rationed care available.
In our system, you have a group of insurance company bureaucrats who decide if you qualify for lifesaving procedures based upon your potential contributions to their next paycheck. (Of course, when it turns out that their salary depends on denying you an expensive procedure, what exactly do you think their inclination will be?)
I don't know about you, but I'd rather have the one that's accountable to the public at large.
Dr. Lineweaver compared their results to a car's ethanol tank. He states, 'It's a bit like looking at your gas gauge and saying "I thought I had half an ethanol tank, but I only have a quarter of a tank."
He may not be, but we're still paying for his wars and his tax cuts and the damage done to our reputation by his advocacy of torture. He's still fair game.
"While American democracy is imperfect, few outside the majority of this Court would have thought its flaws included a dearth of corporate money in politics."
You miss the definition of minimum standard either to deliberately muddle the point or because you don't understand. For your reference it means that everyone is entitled to a certain level of care *or above*. Our doctors will not magically get dumber if the government starts to (indirectly) pay them.
Those who choose to be uninsured do so at not only their own peril but end up subsidized by the taxpayer when they cannot afford their bills and the taxpayer pays for them. I know you're going to say "what's the difference?" and it is that they go to the ER for every ailment that they could otherwise see a GP for, increasing costs.
You find it acceptable that people who don't want it don't have it. I find it unacceptable that a subset of those who need it can't get it. I simply value human life more than you do.
Again you either muddle the point or miss it completely. The system that I refer to is Medicare. If we could keep it and give it to everyone, I'd prefer that approach over this one, but that's never been on the table. I demand changes because I am not on Medicare, and to claim that my insistence on change proves that Medicare does not work is naive.
You are right that ignorance is no excuse--your ignorance of the facts about the cost savings and health benefits of universal healthcare, despite repeatedly being shown evidence, is inexcusable.
And the fact that there exists Medicare supplement insurance is exactly the model of the system of capitalism laid on a need-based minimum of which I spoke--those who are well off are free to acquire it, but those who are not receive care and are not left to die. About medication, if you speak of the "doughnut hole" issue, it's addressed, at least in part, in the legislation. And don't forget that not long ago Medicare didn't cover prescription drugs at all, until Part D was passed in '06. So, it would be silly to insist that all of those cries about elders who can't afford their meds came recently when in fact they've been on the decline. To reiterate, yes, it does work. And it's ever-improving as evidenced by Part D.
The legislation as written takes nothing away from "most people" by letting them keep wha they have, and not even the majority of uninsured are uninsured because they so choose. This assertion of yours neglects entirely the concept of being underinsured.
And while we're bringing in unconnected historical anecdotes, it's also worth noting that segregation and, in fact, slavery worked well for "the majority" of people.
We risk nothing by covering more people, except insurance company profits. The data which you continue to ignore is plentiful enough to be damn near conclusive: countries with universal care pay less per capita, by about half, than we do, and they live longer lives. Do you need me to link it again? They are in high demand, yes, but far from overloaded. You claim as a fact an assertion taken in a vacuum, as though it's only been tried once.
Add again while we're throwing these unrelated historical events out there, how many millions of Americans were wrong about Hitler and wanted to remain isolationist? How many, more recently, were wrong about Iraq?
The fact is that universal healthcare is now the norm for developed nations--and to debunk your irrelevant analogy all the same, the difference is that they started with systems of private insurance and moved to UHC. The analogous situation would be if we broke away from an British democracy to become a monarchy.
To discount the notion of forward progress is absurd.
Of course, never before in history have 70% of bills been subject to filibuster. The most recent social program of this magnitude was Medicare, in the 60s. The filibuster rate then? 8%. We have no bipartisan support because the Republicans want to make Obama look ineffective to better their chances in 2012 and are more concerned with party unity than the best interests of America. They want him to fail and will do anything in their power to have him seen as a failure.
I freely admit I don't know how the NY system works--however I believe in a moral obligation to universal coverage as a part of the social safety net. You can fix all the problems you want, but if it's not universal, it's not done.
I know the chances of the House passing the bill are not terribly good, however the talk is of a dual bill, which would mean passing the Senate bill and then doing the rest through reconciliation. Add in the fact that it's now all-or-nothing and it becomes a different game. There can be no more quibbling about this language or that. The Dems have already paid the political price for HCR, now they need to just go ahead and get it done. Even Stupak hasn't ruled out voting for it.
Fivethirtyeight has done some analysis of the ideal situation for swing district D representatives, and that analysis suggests (sorry I don't have a link at the moment, but this isn't too hard to swallow) that the optimal outcome for them is to pass reform without voting for it. So no matter what, you're going to see a skin-of-the-teeth vote. And at this point you won't have the liberal 'no' votes like Kucinich, and you might get the votes of the impending retirees.
It's not a terribly large majority that oppose healthcare reform per se, so much as the bill in its current incarnation. Much opposition (as much as 12% of the total people polled) oppose from the left. Even with that said, it's liable to get more popular over time, as has the MA system, and as have other social services since their inception.
Any system that leaves so many out in the cold is easily beaten by one that does not. You can fail to see it all you want, but that doesn't mean it's not there. It just means you adjust your focus a little more--that is, not only on yourself.
The House may well just pass the Senate bill, now, which is less fortunate than if they'd been able to put the bills together via conference. And just because the pundits are saying somethingdoesn't make it true. The plan certainly doesn't go far enough, as the lack of progressive enthusiasm about Coakley showed--see the exit polling I linked--but it's about damn time we started to fix this broken system we have.
Because it's better than what we have now.
And the voters in MA don't realize how much this system looks like their own, plus I've heard people say the equivalent of "Ours works--we're all set. Why bother to fix everyone else's?"
Hello? If you add 45 million people to the line of course it will get longer. Glad to see you know something about queueing--I'd have mistaken you for a Brit if we weren't talking about our healthcare mess. Either we ration based on ability to pay--like we do now--or we ration based on need first, and ability to pay second, which is to say that there will be a minimum standard of care to which everyone is entitled and around which supplemental insurance can be built. There will *always* be the capitalist system, because the rich can always go somewhere else. The poor don't have that option, so that's why we need universal care.
Despite your knowledge of how to stand in line, good sir, your assertions about wait times are common but unfounded.
The US has always been good at taking other people's good ideas and adapting them to our needs. This is why I believe that any system we have will look better than Canada, because we can make a hybrid of anybody else's systems based on the mistakes they have made provided that we ever open our eyes and take notice of this idea that everyone else has adopted.
If every other advanced country in the world is doing it, it can't be that bad of an idea.
The problem is that MY insurance company doesn't say 'no', but the government "for the people" system will be telling everyone 'no'. My costs will go up and my service will go down, which is what will happen for a majority of the people.
As it turns out, there are millions of uninsured patients--or underinsured--who are simply told "no" because they are poor. I find that unacceptable. And I don't know any elderly who are complaining about the quality of care they get with Medicare. We already have a government-run system that works. Their costs do not go up beyond the general inflation index of healthcare costs, nor their services down.
The numbers in particular that I speak of are here and they are from the OECD.
You're oblivious to the actual data that shows that countries with universal care spend less per-capita on healthcare and have longer lifespans. It's one of the links I've already posted, but your post is full of so much wrong that I don't know if I feel like refuting you point by point.
You're talking about how increasing the risk pool would somehow increase the cost of care when the majority of uninsured are in the just-graduated-college age bracket and think they're bulletproof.
And comparing true universal care to "only for people under 17" care is apples to oranges. If the parents have to have policies themselves, of course they're not going to cover their kids on them. That's redundant. However, if mom and dad are covered by the state too, they're paying their premiums to the state instead, whose boards making decisions have no financial dependence on denial of care. And more of their money goes to actual healthcare than it would through a private company--just look up the administrative cost differences between Medicare and private insurance.
And when I said 'best' I very clearly indicated that I meant most cost-effective. When you have no incentive to go with the lowest common denominator (or no treatment at all, where possible) and instead have incentive to spend money on those things which provide the best balance of cost and result--which is what happens when you remove the profit motive from health insurance--everyone benefits.
And if you're going to compare to a UHC system, compare to the best, not the worst. How about France?
And for that matter have you ever had to make an appointment with a specialist here in the US? It takes 3 months to get in, life-threatening or not. In a UHC system patients are prioritized based on need, or to put it another way, threat of imminent death or permanent injury. Heart surgeries come before hip transplants.
On top of all that you're missing the fact that for a health insurance company, the profit motive points in the wrong direction. Can you debate the point that an insurance company makes more money if they take in more premiums and provide less care? How does that work in anyone's interest but theirs? By putting the government there instead, whose sole interest is that of the people, to whom they are accountable and by whom they are paid, the people will get better and more equitable care. The numbers don't lie.
First, I've no interest in trampling anything, but religion is a poor excuse, and if your right to practice Scientology with all ten other Scientologists denies 45 million people healthcare, I'm all for healthcare. There's something to be said for *scale* here.
Second, we make cars safer all the time, and yet highway deaths increase because we drive more. Deaths per mile, however, decrease, whereas the number of uninsured and deaths among them is *increasing*. The problem is that we're already addressing highway deaths (though we need better driver ed) and nothing's being done about healthcare. Third, everywhere I've been it's been mandated that you have car insurance. It's effectively federal. Would you have a problem with a state mandating health insurance? As far as citizenship goes--you can leave. It's optional, though you're not going to find another similarly developed country that doesn't offer universal healthcare, so I think you're SOL on that one. But you can still go to Zimbabwe or something.
Fourth, Candidate Obama was wrong on that, and we all knew it at the time.
Fifth, about half of the legislation's $900b is going to states for Medicaid, so this isn't entirely unfunded either. And this theory that none of the cuts will stick has been debunked, as it turns out that most similar cuts in the past have stuck.
And finally, making you buy health insurance minimizes risk. This enables you to be *free* to live without the worry of someday getting hit by a car driven by an uninsured motorist and to live the rest of your life in suffocating debt. To me, that sense of safety makes me *more* free--free to leave my job, for example, and find another because I know I won't be denied coverage. Furthermore, unionization of a fraction of the population does benefit the collective. Just look at the income disparity numbers from the golden age of unions in the 50s and 60s. And with higher unionization, as union wages go, so go the wages of nonunionized workers. This is less true nowadays, but were we still more unionized, it would mean that when they renegotiate cheaper healthcare plans the higher salaries they'd exchange them for would be seen by nearly everyone.
For the record, I work for big pharma. And in the US, drugs comprise something like 10% of all healthcare spending. But that's another discussion for another day.
Actually, the people of the Bay State already *have* this system. And they like it. I should know--I am one. Massachusetts liberal to the core. And I know that this proposed system, like the one in MA, is broken. But it's far less broken than what we have, wherein we let people die.
No, I am aware that there will be minimum standards for insurance plans, however I don't buy the argument that they will no longer protect you from catastrophe. Since everyone will have them, they will still be protected, however the insurance company saves money in the long run, as it turns out, by making you buy coverage for preventative care as well, thereby making catastrophe less likely. This is not to mention the assertion I made above that even long-term recurring costs (e.g., medication) can be catastrophic, and I'm assuming that under a catastrophic-only plan those would not be covered.
To your point about best versus cheapest care: in Medicare, the government, by its taxpayer-funded nature, does not care about making a profit, versus insurance companies who clearly do. The hospitals and doctors providing care certainly do, but they're not deciding how much care that my insurer will approve. There exist decision-making bodies for such purposes and they lie within the entity insuring the patient. And in a government system, as the board of decision-makers do not have their salaries dependent upon denying my care, what they are left with is "what's the most we can get for the money?" i.e. the most cost-effective care.
I can tell you that I searched out the data used to make that plot, and found that it's from this OECD spreadsheet. Within the spreadsheet there's a link to the online database from which the data is extracted, and within which you can find the precise details about which metrics are what, and how they are measured.
To do a bit of adventurous guessing re: how we'd keep these costs in check, I'd suggest that we look at how these other countries run their healthcare systems. On the whole it appears as though they all have universal healthcare. We're certainly an outlier, and this seems to be the most noticeable difference, so why don't we try that and see if it works? If not, well, we'll have saved some lives in the process.
The league of crazies I speak of are the birthers, etc., who despite being shown all valid evidence to the contrary continue to propagate myths about death panels and "pulling the plug on grandma" and so forth;
No, the league of crazies that you spoke of were those who think that the current Health Care bill is unconstitutional. Your previous comment said nothing about birthers.
However, if you were to say that it was unconstitutional, you would be advocating the birther position on the matter, and they are easily the majority of people I've seen expressing that opinion. Generalization, yes. Unfounded? No.
Do you believe in free association? If so, how do you justify a mandate that people do business with health insurance companies?
I do, but I believe more in the right of a human being to healthcare regardless of income. In any other civilized nation (G8, G20, etc.), it is just that: a right. It doesn't much matter who you associate with if you've been allowed to die.
Do you believe in freedom of religion? If so, what about people whom have a religious objection to doing business with health insurance companies? If I raise a religious or moral objection is the Government going to accept my word or get into the business of determining whether or not my faith is genuine?
I believe that religion is a net negative force in the world, and that as a practice, religious-belief exceptions have a lot of grief to answer for. If your religious belief forbids such a system from coming into being, why is my belief that everyone ought to be granted the right to healthcare not equally as enforceable? I understand that you're talking about individual versus collective here, but when concern for the individual's beliefs preclude the collective from benefiting itself, something has to give. And I believe that the qualms of a few are not justification for the death of 18,000 people a year. And I also believe that the most common (Judeo-Christian) religions, at least, advocate giving of yourself to help your neighbor--so pay into the pool.
Do you believe that you have the right to be secure in your papers and effects? If so, how is it Uncle Sam's business whether or not I have health insurance?
How is it his business that you have car insurance? Whereas car insurance protects other people from your potential inability to pay should you injure them, health insurance in addition to protecting you, as above, protects the hospital and the doctors from your inability to pay.
but it's in line with the mandate to insurance companies that they have to cover you.
That could be imposed without an individual mandate. If the Democrats had sought to end the pre-existing condition practice without attaching it to the rest of this "reform" they could have passed it months ago with supermajorities in both houses of Congress. There's bipartisan support for reining in the most egregious practices of the insurance industry.
There *is* wide popular support, but did you not read what I first wrote about this? There MUST be a mandate that everyone is covered, or else people game the system and only buy insurance when they get sick. This means that the risk pool turns sour and premiums skyrocket until you're paying full hospital prices at the time of service. The mandate has to be there to prevent this, whether it's individual or employer-based. It happened that the least preferable of the two came out of the debate, but it's better than nothing and it's scarcely a price to pay for getting rid of the PEC abuses. Either have a mandate and no more PECs, or neither. That's how the economics of it work out.
You might also consider the costs that the states are going to in
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I agree, sort of. Although current healthcare reform is very simply the *minimum* we can do... keeps private markets, eliminates PEC clauses. But avoids the death spiral that elimination of PEC clauses would cause by mandating everyone have insurance. Keeps it rational by subsidizing for those who can't afford it. It's a very centrist policy, practically written by Romney. And it's got this ridiculous, uninformed aura of spin on it as though it's single-payer.
:-/
The problem in this case isn't the policy... it's all of the lying about the policy. Death panels? C'mon...
I see no reason they'd switch from MS products if they work properly. Having used both MS Office and OpenOffice, I'd rather pay for MS Office than use OpenOffice, I'm pretty sure most desk jockeys would feel the same way.
Desk jockey, here. And just to be clear... have you ever used Office 2007? That's what made me switch to OOo.
The plural of anecdote is not data, but in any case, I'm sure if everyone realized they could get a free MS-compatible software suite, fewer would spend the money. The wallet is a powerful motivator.
And just wait until Microsoft extends the open standard in proprietary ways... remember IE6? This is why people want to motivate others to move away from Microsoft's software.
The one objection I have is the idea that we can't fix overprescription of drugs and procedures. We can most certainly fix this, but there are several facets to the problem:
As it turns out, this problem goes away with true single-payer, but there may be a way to incorporate these regulations into the system we have, given that Mayo works so well on the same model.
We're vesting the responsibility for timely and correct care with our hospitals and doctors, and for payment to the government. If our doctors and hospitals know they won't have to pay people to fight with insurance companies for every penny, by, among other things, having a standard list of covered procedures, they're more likely to treat first and bill later.
And I don't know how you'd go about quickening the court system while still granting due process. If you have any ideas about that, I'd legitimately like to hear them.
You've hit it on the head. In a universal system, care is rationed based on need. In our current system, it's still rationed, only it's more transparent because so many of the sick will never bother to see the inside of a hospital. Right now, we ration based on ability to pay.
What's important to me, from a moral perspective (and these are my own, and I don't claim to speak for anyone else), is providing a minimum standard of care for those in need so that we aren't leaving people to die on the streets. Above that system we'll always have the capitalist system wherein those who are better off can go elsewhere to get more care. But I see it as important, morally, culturally, and economically, to raise the bottom and limit how far people can fall.
I don't think anybody ought to go broke because they get sick.
And the insurance company will claim you didn't exhaust all of your options w/their internal processes first, and if you did, you'd die before you got treated anyhow.
That aside, I thought the whole process of suing usually takes, after all (court) appeals are said and done, long enough for you to die before anything is done.
Our judicial system is many things, but speedy is not one of them.
Your family may be able to sue for wrongful death or something of the like, but that really doesn't help during life.
Alternatively, in a non-monopoly situation, they're both valid mechanisms.
You know what the difference is between socialized medicine and the system we have today?
In a socialized system, you have a group of government bureaucrats who decide if you qualify for lifesaving procedures based upon your potential contributions to society versus the rationed care available.
In our system, you have a group of insurance company bureaucrats who decide if you qualify for lifesaving procedures based upon your potential contributions to their next paycheck. (Of course, when it turns out that their salary depends on denying you an expensive procedure, what exactly do you think their inclination will be?)
I don't know about you, but I'd rather have the one that's accountable to the public at large.
By what?
Elections?
Useful as it sounds, I think DIY bioweapons could be a *small* concern. Especially if they come with instructions better than Ikea's.
What boggles my mind is that somebody has come up with a prototype for an all-composite crew! Can we just plug in the module and go?
Dr. Lineweaver compared their results to a car's ethanol tank. He states, 'It's a bit like looking at your gas gauge and saying "I thought I had half an ethanol tank, but I only have a quarter of a tank."
He may not be, but we're still paying for his wars and his tax cuts and the damage done to our reputation by his advocacy of torture. He's still fair game.
"While American democracy is imperfect, few outside the majority of this Court would have thought its flaws included a dearth of corporate money in politics."
IAWTC.
You miss the definition of minimum standard either to deliberately muddle the point or because you don't understand. For your reference it means that everyone is entitled to a certain level of care *or above*. Our doctors will not magically get dumber if the government starts to (indirectly) pay them.
Those who choose to be uninsured do so at not only their own peril but end up subsidized by the taxpayer when they cannot afford their bills and the taxpayer pays for them. I know you're going to say "what's the difference?" and it is that they go to the ER for every ailment that they could otherwise see a GP for, increasing costs.
You find it acceptable that people who don't want it don't have it. I find it unacceptable that a subset of those who need it can't get it. I simply value human life more than you do.
Again you either muddle the point or miss it completely. The system that I refer to is Medicare. If we could keep it and give it to everyone, I'd prefer that approach over this one, but that's never been on the table. I demand changes because I am not on Medicare, and to claim that my insistence on change proves that Medicare does not work is naive.
You are right that ignorance is no excuse--your ignorance of the facts about the cost savings and health benefits of universal healthcare, despite repeatedly being shown evidence, is inexcusable.
And the fact that there exists Medicare supplement insurance is exactly the model of the system of capitalism laid on a need-based minimum of which I spoke--those who are well off are free to acquire it, but those who are not receive care and are not left to die. About medication, if you speak of the "doughnut hole" issue, it's addressed, at least in part, in the legislation. And don't forget that not long ago Medicare didn't cover prescription drugs at all, until Part D was passed in '06. So, it would be silly to insist that all of those cries about elders who can't afford their meds came recently when in fact they've been on the decline. To reiterate, yes, it does work. And it's ever-improving as evidenced by Part D.
The legislation as written takes nothing away from "most people" by letting them keep wha they have, and not even the majority of uninsured are uninsured because they so choose. This assertion of yours neglects entirely the concept of being underinsured.
And while we're bringing in unconnected historical anecdotes, it's also worth noting that segregation and, in fact, slavery worked well for "the majority" of people.
We risk nothing by covering more people, except insurance company profits. The data which you continue to ignore is plentiful enough to be damn near conclusive: countries with universal care pay less per capita, by about half, than we do, and they live longer lives. Do you need me to link it again? They are in high demand, yes, but far from overloaded. You claim as a fact an assertion taken in a vacuum, as though it's only been tried once.
Add again while we're throwing these unrelated historical events out there, how many millions of Americans were wrong about Hitler and wanted to remain isolationist? How many, more recently, were wrong about Iraq?
The fact is that universal healthcare is now the norm for developed nations--and to debunk your irrelevant analogy all the same, the difference is that they started with systems of private insurance and moved to UHC. The analogous situation would be if we broke away from an British democracy to become a monarchy.
To discount the notion of forward progress is absurd.
Of course, never before in history have 70% of bills been subject to filibuster. The most recent social program of this magnitude was Medicare, in the 60s. The filibuster rate then? 8%. We have no bipartisan support because the Republicans want to make Obama look ineffective to better their chances in 2012 and are more concerned with party unity than the best interests of America. They want him to fail and will do anything in their power to have him seen as a failure.
I freely admit I don't know how the NY system works--however I believe in a moral obligation to universal coverage as a part of the social safety net. You can fix all the problems you want, but if it's not universal, it's not done.
I know the chances of the House passing the bill are not terribly good, however the talk is of a dual bill, which would mean passing the Senate bill and then doing the rest through reconciliation. Add in the fact that it's now all-or-nothing and it becomes a different game. There can be no more quibbling about this language or that. The Dems have already paid the political price for HCR, now they need to just go ahead and get it done. Even Stupak hasn't ruled out voting for it.
Fivethirtyeight has done some analysis of the ideal situation for swing district D representatives, and that analysis suggests (sorry I don't have a link at the moment, but this isn't too hard to swallow) that the optimal outcome for them is to pass reform without voting for it. So no matter what, you're going to see a skin-of-the-teeth vote. And at this point you won't have the liberal 'no' votes like Kucinich, and you might get the votes of the impending retirees.
It's not a terribly large majority that oppose healthcare reform per se, so much as the bill in its current incarnation. Much opposition (as much as 12% of the total people polled) oppose from the left. Even with that said, it's liable to get more popular over time, as has the MA system, and as have other social services since their inception.
Any system that leaves so many out in the cold is easily beaten by one that does not. You can fail to see it all you want, but that doesn't mean it's not there. It just means you adjust your focus a little more--that is, not only on yourself.
The House may well just pass the Senate bill, now, which is less fortunate than if they'd been able to put the bills together via conference. And just because the pundits are saying something doesn't make it true. The plan certainly doesn't go far enough, as the lack of progressive enthusiasm about Coakley showed--see the exit polling I linked--but it's about damn time we started to fix this broken system we have.
Because it's better than what we have now. And the voters in MA don't realize how much this system looks like their own, plus I've heard people say the equivalent of "Ours works--we're all set. Why bother to fix everyone else's?"
Despite your knowledge of how to stand in line, good sir, your assertions about wait times are common but unfounded.
The US has always been good at taking other people's good ideas and adapting them to our needs. This is why I believe that any system we have will look better than Canada, because we can make a hybrid of anybody else's systems based on the mistakes they have made provided that we ever open our eyes and take notice of this idea that everyone else has adopted.
If every other advanced country in the world is doing it, it can't be that bad of an idea.
The problem is that MY insurance company doesn't say 'no', but the government "for the people" system will be telling everyone 'no'. My costs will go up and my service will go down, which is what will happen for a majority of the people.
As it turns out, there are millions of uninsured patients--or underinsured--who are simply told "no" because they are poor. I find that unacceptable. And I don't know any elderly who are complaining about the quality of care they get with Medicare. We already have a government-run system that works. Their costs do not go up beyond the general inflation index of healthcare costs, nor their services down.
The numbers in particular that I speak of are here and they are from the OECD.
You're oblivious to the actual data that shows that countries with universal care spend less per-capita on healthcare and have longer lifespans. It's one of the links I've already posted, but your post is full of so much wrong that I don't know if I feel like refuting you point by point.
You're talking about how increasing the risk pool would somehow increase the cost of care when the majority of uninsured are in the just-graduated-college age bracket and think they're bulletproof.
And comparing true universal care to "only for people under 17" care is apples to oranges. If the parents have to have policies themselves, of course they're not going to cover their kids on them. That's redundant. However, if mom and dad are covered by the state too, they're paying their premiums to the state instead, whose boards making decisions have no financial dependence on denial of care. And more of their money goes to actual healthcare than it would through a private company--just look up the administrative cost differences between Medicare and private insurance.
And when I said 'best' I very clearly indicated that I meant most cost-effective. When you have no incentive to go with the lowest common denominator (or no treatment at all, where possible) and instead have incentive to spend money on those things which provide the best balance of cost and result--which is what happens when you remove the profit motive from health insurance--everyone benefits.
And if you're going to compare to a UHC system, compare to the best, not the worst. How about France?
And for that matter have you ever had to make an appointment with a specialist here in the US? It takes 3 months to get in, life-threatening or not. In a UHC system patients are prioritized based on need, or to put it another way, threat of imminent death or permanent injury. Heart surgeries come before hip transplants.
On top of all that you're missing the fact that for a health insurance company, the profit motive points in the wrong direction. Can you debate the point that an insurance company makes more money if they take in more premiums and provide less care? How does that work in anyone's interest but theirs? By putting the government there instead, whose sole interest is that of the people, to whom they are accountable and by whom they are paid, the people will get better and more equitable care. The numbers don't lie.
Whoops. Missed a line break in there...
First, I've no interest in trampling anything, but religion is a poor excuse, and if your right to practice Scientology with all ten other Scientologists denies 45 million people healthcare, I'm all for healthcare. There's something to be said for *scale* here.
Second, we make cars safer all the time, and yet highway deaths increase because we drive more. Deaths per mile, however, decrease, whereas the number of uninsured and deaths among them is *increasing*. The problem is that we're already addressing highway deaths (though we need better driver ed) and nothing's being done about healthcare. Third, everywhere I've been it's been mandated that you have car insurance. It's effectively federal. Would you have a problem with a state mandating health insurance? As far as citizenship goes--you can leave. It's optional, though you're not going to find another similarly developed country that doesn't offer universal healthcare, so I think you're SOL on that one. But you can still go to Zimbabwe or something.
Fourth, Candidate Obama was wrong on that, and we all knew it at the time.
Fifth, about half of the legislation's $900b is going to states for Medicaid, so this isn't entirely unfunded either. And this theory that none of the cuts will stick has been debunked, as it turns out that most similar cuts in the past have stuck.
And finally, making you buy health insurance minimizes risk. This enables you to be *free* to live without the worry of someday getting hit by a car driven by an uninsured motorist and to live the rest of your life in suffocating debt. To me, that sense of safety makes me *more* free--free to leave my job, for example, and find another because I know I won't be denied coverage. Furthermore, unionization of a fraction of the population does benefit the collective. Just look at the income disparity numbers from the golden age of unions in the 50s and 60s. And with higher unionization, as union wages go, so go the wages of nonunionized workers. This is less true nowadays, but were we still more unionized, it would mean that when they renegotiate cheaper healthcare plans the higher salaries they'd exchange them for would be seen by nearly everyone.
For the record, I work for big pharma. And in the US, drugs comprise something like 10% of all healthcare spending. But that's another discussion for another day.
Actually, the people of the Bay State already *have* this system. And they like it. I should know--I am one. Massachusetts liberal to the core. And I know that this proposed system, like the one in MA, is broken. But it's far less broken than what we have, wherein we let people die.
No, I am aware that there will be minimum standards for insurance plans, however I don't buy the argument that they will no longer protect you from catastrophe. Since everyone will have them, they will still be protected, however the insurance company saves money in the long run, as it turns out, by making you buy coverage for preventative care as well, thereby making catastrophe less likely. This is not to mention the assertion I made above that even long-term recurring costs (e.g., medication) can be catastrophic, and I'm assuming that under a catastrophic-only plan those would not be covered.
To your point about best versus cheapest care: in Medicare, the government, by its taxpayer-funded nature, does not care about making a profit, versus insurance companies who clearly do. The hospitals and doctors providing care certainly do, but they're not deciding how much care that my insurer will approve. There exist decision-making bodies for such purposes and they lie within the entity insuring the patient. And in a government system, as the board of decision-makers do not have their salaries dependent upon denying my care, what they are left with is "what's the most we can get for the money?" i.e. the most cost-effective care.
I can tell you that I searched out the data used to make that plot, and found that it's from this OECD spreadsheet. Within the spreadsheet there's a link to the online database from which the data is extracted, and within which you can find the precise details about which metrics are what, and how they are measured.
To do a bit of adventurous guessing re: how we'd keep these costs in check, I'd suggest that we look at how these other countries run their healthcare systems. On the whole it appears as though they all have universal healthcare. We're certainly an outlier, and this seems to be the most noticeable difference, so why don't we try that and see if it works? If not, well, we'll have saved some lives in the process.
The league of crazies I speak of are the birthers, etc., who despite being shown all valid evidence to the contrary continue to propagate myths about death panels and "pulling the plug on grandma" and so forth;
No, the league of crazies that you spoke of were those who think that the current Health Care bill is unconstitutional. Your previous comment said nothing about birthers.
However, if you were to say that it was unconstitutional, you would be advocating the birther position on the matter, and they are easily the majority of people I've seen expressing that opinion. Generalization, yes. Unfounded? No.
Do you believe in free association? If so, how do you justify a mandate that people do business with health insurance companies?
I do, but I believe more in the right of a human being to healthcare regardless of income. In any other civilized nation (G8, G20, etc.), it is just that: a right. It doesn't much matter who you associate with if you've been allowed to die.
Do you believe in freedom of religion? If so, what about people whom have a religious objection to doing business with health insurance companies? If I raise a religious or moral objection is the Government going to accept my word or get into the business of determining whether or not my faith is genuine?
I believe that religion is a net negative force in the world, and that as a practice, religious-belief exceptions have a lot of grief to answer for. If your religious belief forbids such a system from coming into being, why is my belief that everyone ought to be granted the right to healthcare not equally as enforceable? I understand that you're talking about individual versus collective here, but when concern for the individual's beliefs preclude the collective from benefiting itself, something has to give. And I believe that the qualms of a few are not justification for the death of 18,000 people a year. And I also believe that the most common (Judeo-Christian) religions, at least, advocate giving of yourself to help your neighbor--so pay into the pool.
Do you believe that you have the right to be secure in your papers and effects? If so, how is it Uncle Sam's business whether or not I have health insurance?
How is it his business that you have car insurance? Whereas car insurance protects other people from your potential inability to pay should you injure them, health insurance in addition to protecting you, as above, protects the hospital and the doctors from your inability to pay.
but it's in line with the mandate to insurance companies that they have to cover you.
That could be imposed without an individual mandate. If the Democrats had sought to end the pre-existing condition practice without attaching it to the rest of this "reform" they could have passed it months ago with supermajorities in both houses of Congress. There's bipartisan support for reining in the most egregious practices of the insurance industry.
There *is* wide popular support, but did you not read what I first wrote about this? There MUST be a mandate that everyone is covered, or else people game the system and only buy insurance when they get sick. This means that the risk pool turns sour and premiums skyrocket until you're paying full hospital prices at the time of service. The mandate has to be there to prevent this, whether it's individual or employer-based. It happened that the least preferable of the two came out of the debate, but it's better than nothing and it's scarcely a price to pay for getting rid of the PEC abuses. Either have a mandate and no more PECs, or neither. That's how the economics of it work out.
You might also consider the costs that the states are going to in