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The Way Forward On The Health Bill

It has sunk in - the House will not pass the Stand Alone Senate bill. That is a political fact. Proponents of the Senate health bill seem to have accepted this reality - here is Ezra Klein:

Obama, who isn't particularly connected to this deal, can demand the Senate pass a reconciliation bill stripping [the Nelson deal] from the legislation. That's actually a pretty good narrative for the reconciliation rider. And the neat thing about a reconciliation bill is that Nelson can even vote against it -- as can eight of his closest Democratic friends. [. . .] The other thing that reconciliation rider will have to handle is the excise tax. [. . .] The unions might want to think about negotiating a raised limit for everybody [. . .] instead of letting themselves become the next villain in this process.

I doubt the unions are much concerned about being the GOP "villains." The excise tax itself will more likely be the "villain" anyway. The best result would be eliminating it.

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    If they can (5.00 / 1) (#1)
    by Emma on Mon Jan 25, 2010 at 12:18:17 PM EST
    strip the Nelson deal, they can strip the Nelson amendment.  Bet they won't do it.

    It still (none / 0) (#12)
    by CST on Mon Jan 25, 2010 at 12:44:08 PM EST
    has to pass the house.

    Parent
    do you think Pelosi thinks (none / 0) (#14)
    by Slado on Mon Jan 25, 2010 at 12:52:00 PM EST
    this will pass or is just going through the motions to save face?

    Parent
    Well, if you can (none / 0) (#40)
    by Emma on Mon Jan 25, 2010 at 02:44:09 PM EST
    believe the progressive caucus, it won't pass the house.

    Parent
    I mean (none / 0) (#43)
    by Emma on Mon Jan 25, 2010 at 02:51:12 PM EST
    the Nelson Amendment won't.

    Parent
    Why are dems driving off a cliff? (5.00 / 1) (#3)
    by Slado on Mon Jan 25, 2010 at 12:23:25 PM EST
    They have driven through about 10 stop signs already and a couple of barriers yet they seem convinced that the bridge isn't out.

    The public doesn't want this to be done by a wide, wide margin.

    What gives?

    That's not enitrely true. (5.00 / 1) (#9)
    by Radix on Mon Jan 25, 2010 at 12:31:52 PM EST
    There are some things the public wants and some they don't. For example, rescission, by a wide margin the public wants this done away with; pre-existing conditions are another the public wants ended. Also, closer of the Part D doughnut whole. So it's not quite cut and dry as it's made to sound.

    Parent
    You are correct (none / 0) (#16)
    by Slado on Mon Jan 25, 2010 at 01:23:22 PM EST
    Same song different verse.

    The public doesn't want all things at once at a 1 trillion dollar price tag with a budget trick that takes 10 years of tax collecting to provide 6 years of service.

    Too much, too fast, or not fast enough.

    Start over and start small.

    Parent

    No Slado (5.00 / 4) (#50)
    by cal1942 on Mon Jan 25, 2010 at 03:16:16 PM EST
    the public wants a strong government insurance offering.  In essence they want heavy government involvement.

    What they don't want is to be forced into buying private insurance they can't afford and they don't want the financing to come from a tax on employer provided health insurance.

    Parent

    Everybody wants health care insurance (2.00 / 0) (#65)
    by jimakaPPJ on Mon Jan 25, 2010 at 05:36:48 PM EST
    nobody wants to pay.

    You can't prevent insurance companies not covering pre existing conditions unless you make everyone buy insurance. Otherwise, just wait until your sick...

    Would that work on auto insurance?

    Parent

    Spot the falsehood: 'nobody wants to pay' ,,, (5.00 / 1) (#68)
    by Ellie on Mon Jan 25, 2010 at 07:18:01 PM EST
    The public already DOES pay for services we aren't receiving, whether from elected representatives invested with the responsibility of protecting the public weal, or greedy insurers multiplying their profits.

    The US pays many times over for poorer health care than other countries do for better care and coverage.

    Parent

    In case you missed it (1.00 / 0) (#71)
    by jimakaPPJ on Mon Jan 25, 2010 at 10:10:25 PM EST
    The comment was a play on the old "Everybody wants to go to heaven but nobody wants to die."

    Fits this situation perfectly. Unions want Obamacare, but don't want to pay. Nelson wants Obamacare but doesn't want Nebraska to pay. LA wants... well, I think you see my point.

    My plan remains simple. Single payer system modeled on Medicare paid for by national sales tax paid for by everyone. Even dope dealers and illegal aliens... and Congress critters of all stripes.

    Parent

    I did skid past the quote but not the inclusion (none / 0) (#72)
    by Ellie on Mon Jan 25, 2010 at 10:48:48 PM EST
    (as I read it) of the public on owning this mess. Looks like we're on the hook for picking up the tab regardless of how sensitive my cultural antennae are tonight.

    Apart from that, the original's a good proverbial thought to see me through my late-night cocoa.

    Parent

    You beat me to it, thanks. (none / 0) (#53)
    by Radix on Mon Jan 25, 2010 at 03:37:30 PM EST
    No! (none / 0) (#46)
    by cal1942 on Mon Jan 25, 2010 at 03:05:50 PM EST
    Start over and think big. Single Payer.

    Parent
    Not going to happen (none / 0) (#58)
    by Slado on Mon Jan 25, 2010 at 04:46:16 PM EST
    Single payer that is.

    So what next?

    Parent

    The public wants more affordability (5.00 / 4) (#23)
    by esmense on Mon Jan 25, 2010 at 01:49:12 PM EST
    in both health care and insurance cost.

    The reality is; there is no way to address the affordability issue without doing something big -- radically changing the system. More little fixes around the edges willl neither solve the already huge problems presented by our insanely inefficient and illogical health care system nor prevent the eventual collapse of that system down the road. In fact, many of those little fixes, implemented outside the context of comprehensive reform, will make things worse.

    Many individual Americans (most especially that 1/3rd of the population that works in or depends upon the public sector and already has tax payer supported health care) who are happy with things the way they are simply fail to realize that they (and this is true of those with private insurance too) are living on borrowed time -- and enjoying a good fortune that is being paid for by the suffering of others. We, as a nation, can't afford things they way they are. Whether we act now or not it is all going to change. The only question is, will we wake up and work to control the process, avoid disaster, and set up a system that changes things for the better?

    Or, will we be stupid and let health care inflation continue to cripple our competitiveness, threaten the financial health and stability of individuals and families, threaten the health of the nation, and threaten to bankrupt government at just about every level?  

    Parent

    True but other (none / 0) (#27)
    by Slado on Mon Jan 25, 2010 at 01:55:44 PM EST
    nations are letting their huge social welfare programs cripple their competitiveness etc...etc....

    Be careful not to solve this problem by chosing another one that's just as bad.

    IMHO the government is too invovled.  Less government is better then more.

    Parent

    I suggest you research the competitive (5.00 / 6) (#42)
    by esmense on Mon Jan 25, 2010 at 02:49:22 PM EST
    issue in more depth. The fact is, the American industries that we have burdened with responsibility for providing health care coverage for our citizens do not agree with you.

    Here is a simple truth that you may have never heard anyone express before; you can't have a modern, effective health care system without socializing costs.

    Socialized costs and modern medicine developed hand in hand. There has never been a "free market" in health care and never will be -- because the cost of maintaining the very expensive research, plant and equipment and labor required for the practice of safe and effective modern medicine is much too high to be born by customers -- that is the sick and dying -- alone. Plus, there's the little fact that the conditions that create demand for the product -- illness and age -- are conditions that seriously undermine the customer's ability to earn and therefore to pay. A problem not faced by the producers of most consumer products in the "free market."

    Traditionally, care for the ill and dying was always seen as a social responsibility met through charity and or community support(for instance, hospitals were established and supported either by community resouces or by religious organizations and orders). The notion of "for profit hospitals" would have seemed like an oxymoron to people in the first half of the last century. There is no way for a hospital to be "for profit" unless costs are socialized through insurance and government support.

    The biggest difference between the US and other technologically advanced nations that have socialized their health care costs is that we, in an effort to pretend that we haven't  socialized costs, have done so in a pretty stupid way. A way that burdens our businesses, compromises the mobility and flexibility of our workforce, makes for profit insurance companies the gatekeepers for care, and yet must still ask taxpayers to shoulder responsibility for the sickest and most elderly patients while leaving millions of those same taxpayers without access to insurance themselves.

    If you don't think this system needs to be reformed, you're not thinking.  

    Parent

    Let me point somethng out (5.00 / 2) (#48)
    by esmense on Mon Jan 25, 2010 at 03:09:43 PM EST
    Our system socializes care very inefficiently -- but it socializes profit for certain providers and insurance companies very effectively. Which is; 1. pretty much the reverse of what other advanced nation's do, 2. the real reason it is so hard to reform the system.

    Parent
    Would disagree on the socialized profit (none / 0) (#52)
    by vicndabx on Mon Jan 25, 2010 at 03:33:38 PM EST
    for insurance co's.  Professional providers however, there is no doubt.

    It's clear that Medicare and all major insurers place far more relative value on fancy procedures like stents, EKGs, skin biopsies, CT scans, and bowel clean-outs than they do on actual face-to-face time with patients. Procedures, they have decreed, require more mental effort and skill than seeing actual people. The implications are obvious. Just visit any hospital: The dermatology, radiology, and cardiology centers that depend on high-volume, relatively quick procedures have gleaming new facilities, while the primary care and psychiatry clinics languish, since they earn their keep from poorly compensated face-to-face time with patients.


    Parent
    This essay (5.00 / 5) (#55)
    by Cream City on Mon Jan 25, 2010 at 04:08:52 PM EST
    may be brilliant.

    Btw, the idea of for-profit hospitals was not just something foreign in the first half of the last century.  I was born at the end of that half-century in a not-for-profit hospital, I spent a lot of time in not-for-profit hospitals (as a sickly kid), and I had my firstborn in a not-for-profit hospital not all that long ago.  

    Your writing reminds us that we have to educate generations since to the truth that the way of the world of health care today is NOT the way it always was.  It is a major reason for the fix in which we find ourselves now -- and it is a world so new that it need not be the way of the future.

    Parent

    Less government will allow the strong (5.00 / 2) (#44)
    by MKS on Mon Jan 25, 2010 at 02:53:43 PM EST
    to victimize the weak....The government acts as a buffer to help those that the free market bypasses....

    That is really a basic difference of opinion on the role of government.  I want it to do more than invade Iraq....

    Those who want less goverment generally are wealthy enough to not need it and believe that everyone else should just do as they do--forgetting that not everyone benefits from our version of a "free market" economy....

    A couple of years ago (or maybe four or five), I was stunned to learn that real median wages have not increased in this country since 1980, except for a couple of years at the end of the Clinton administration.  So all that increase in GDP has gone to the very top....

    Parent

    Humble Opinion Indeed (none / 0) (#49)
    by cal1942 on Mon Jan 25, 2010 at 03:10:08 PM EST
    And completely off the mark.  180 degrees off the mark.

    Slado, your way will send this nation tumbling.  Conservatism is death.

    Parent

    The government can help in (none / 0) (#60)
    by Slado on Mon Jan 25, 2010 at 04:55:00 PM EST
    ways other then wasteful government programs, Senate Bill being Exhibit A.

    People want choices and freedom.  Back that up with a strong government option, safety net whatever you want to call it.

    IN our perverse system they have neither.  They have heavy government regulation along with limited freedom and rising costs.  Literally the worst things from each type of system.

    One can pretend that a single payer system would be perfect but that's simply not the case.  Instead of allowing a big insurer to make your health decisions for you instead you are allowing the gov't to do it.

    For every example of wrong doing you can give for our current system I have examples of people pulling out their own teeth in socialized systems.  As pointed out earlier if you can afford a 50% tax rate accross the board we can have it all.  

    But that's not going to work in a country our size.   We have too many people and we lead to reckless a life to afford socialized medicine.

    Look at the states that have already implemented single payer.   they have all lost control of costs and that is why Mass voters rejected a fedral program layered on top of it.

    I don't have a perfect solution but I know one thing.  Single payer is not the answer.

    If conservatism is death then single payer is the path to get you to the graveyard.

    Parent

    The way the Village has been (5.00 / 3) (#7)
    by ruffian on Mon Jan 25, 2010 at 12:27:03 PM EST
    pushing the Senate bill, I think Ezra means the Unions would be painted as villains by the village Dems, not the GOP.

    Hard to tell what the GOP would rather have - the bill passed, so they can campaign on how horrible it is, or not passed, so they can say they helped defeat it. I try not to get into their heads too much.

    It's a win either way for them. (5.00 / 2) (#10)
    by Radix on Mon Jan 25, 2010 at 12:32:38 PM EST
    as usual (5.00 / 1) (#11)
    by ruffian on Mon Jan 25, 2010 at 12:39:04 PM EST
    Exactly right about the Unions (5.00 / 0) (#34)
    by Militarytracy on Mon Jan 25, 2010 at 02:27:31 PM EST
    And I'm sure they're shaking in their boots thinking about Ezra not liking them.  The Unions hardlining might actually prevent the whole country from being effed over.  What Ezra has done has not prevented anyone from getting effed over....only encouraged it.

    Parent
    My Union Shop had a laff'n a half over this threat (none / 0) (#69)
    by Ellie on Mon Jan 25, 2010 at 07:40:58 PM EST
    Ezra's warning to unions about being made 'the villains', whether by the Village Idiots aka Media or the GOP, is a lung-clearing knee-slapper.

    Broadcast personnel belong to some form of union or guild that sets minimums for their exorbitant contracts. That includes clowns like Glenn Beck, Rush Limbaugh, and the 'liberal' bobbleheads that Master Klein confidently assumes will rain their invective down on unions.

    The GOP? Bring. It. On.

    Sincerely,
    Ellie
    Proud Member of the Loyal Order of Sports Bookmakers, Rotten Poets and Rickshaw Ferriers
    "We shan't spread, lest the meter is ON!'


    Parent

    Paul Begala (Huff Post) agrees. (5.00 / 2) (#19)
    by oculus on Mon Jan 25, 2010 at 01:34:44 PM EST


    Never fear - Obama's here (5.00 / 5) (#21)
    by MO Blue on Mon Jan 25, 2010 at 01:46:10 PM EST
    In an interview with the Arkansas Democrat-Gazette, Rep. Marion Berry (D-AR) claims the White House is ignoring the parallels between today's political environment and when Democrats lost control of the House in 1994.

    Said Berry: "They just don't seem to give it any credibility at all. They just kept telling us how good it was going to be. The president himself, when that was brought up in one group, said, 'Well, the big difference here and in '94 was you've got me.' We're going to see how much difference that makes now." link

    Evidently Berry is not convinced. He has chosen to retire.

    That pisses me off. (5.00 / 3) (#22)
    by oculus on Mon Jan 25, 2010 at 01:48:45 PM EST
    I'm just amazed (none / 0) (#26)
    by Slado on Mon Jan 25, 2010 at 01:54:03 PM EST
    that he might have actually said that.

    He can't be that big an ego maniac can he?

    Parent

    Yes, he can! (5.00 / 1) (#57)
    by Cream City on Mon Jan 25, 2010 at 04:12:51 PM EST
    Have you really not seen that before, in the campaign (which candidate ever takes a vacation at a crucial point in the campaign?) and at the convention (styrofoam pillars, enough said)?

    All pols have to have major egos to make it, sure.  But to claim to be transformational, imagine how major the ego must have to be.

    Parent

    We must wait for the next dishy book. (none / 0) (#28)
    by oculus on Mon Jan 25, 2010 at 01:56:19 PM EST
    "Dreams of my Ego"? (5.00 / 3) (#29)
    by jbindc on Mon Jan 25, 2010 at 02:01:18 PM EST
    The Audacity of My Ego; (5.00 / 4) (#35)
    by Anne on Mon Jan 25, 2010 at 02:28:52 PM EST
    From My Dreams To Your Reality.

    Parent
    Ha. I was thinking of "Game Change," (none / 0) (#31)
    by oculus on Mon Jan 25, 2010 at 02:09:43 PM EST
    the sequel.

    Parent
    How about "Game's Up" (5.00 / 2) (#56)
    by Cream City on Mon Jan 25, 2010 at 04:10:47 PM EST
    subtitled "The Voters Got on to Me."

    Parent
    If only Obama were the Republican (5.00 / 1) (#32)
    by observed on Mon Jan 25, 2010 at 02:23:34 PM EST
    President, so he could be working his electoral magic on THEIR party instead of mine.
    sigh

    Parent
    Oh God (5.00 / 1) (#37)
    by Militarytracy on Mon Jan 25, 2010 at 02:31:32 PM EST
    He believes his own propaganda now.  John Edwards isn't the only one who was working on a messiah complex.  I guess reality is going to have to get a lot more rude for THE ONE, and the stars are completely lined up for nothing other than that to happen.  So be it.  Nobody can make him do anything he doesn't want to do.  He drank his own kool-aid though.

    Parent
    Whatever Ezra's smoking (5.00 / 1) (#33)
    by Militarytracy on Mon Jan 25, 2010 at 02:24:23 PM EST
    lay off it buddy.  In this economy the only people seeing Unions as villians are villagers such as yourself.  Good luck trying to paint the Unions as villians with this excise tax Ezra (nobody is buying your schpiel on this but you), best of luck with that cuz you will need a ton of it to even start that narrative up hoping that it'll catch on with real people at the kitchen tables of America right now.

    Agree 100% (5.00 / 2) (#47)
    by Andy08 on Mon Jan 25, 2010 at 03:07:22 PM EST
    I doubt the unions are much concerned about being the GOP "villains." The excise tax itself will more likely be the "villain" anyway. The best result would be eliminating it.


    Stupak takes 10 dems on any deal (5.00 / 1) (#66)
    by pluege on Mon Jan 25, 2010 at 05:52:31 PM EST
    that doesn't have the stupak amendment, which I would think at this point is completely dead. Striping nelson's pork and his abortion BS would be a step in the right direction. Eliminate the excise tax altogether, tax the filthy rich and put a real public option in and presto change-o, dems are back in command. Anything else and its another generation of republican plundering the average tax payers to enrich the filthy rich.

    Krugman says the excise tax (none / 0) (#2)
    by observed on Mon Jan 25, 2010 at 12:22:35 PM EST
    is an essential piece of a three-legged stool, with its cost containment effect.
    Supposing he's right, then how else can a bill "bend the curve"?

    Tell Krugman to tell the unions (5.00 / 3) (#5)
    by Big Tent Democrat on Mon Jan 25, 2010 at 12:25:36 PM EST
    to suck it up.

    Since he can't, his ponderings are pretty pointless.

    Parent

    His cost analysis is probably right, (none / 0) (#8)
    by observed on Mon Jan 25, 2010 at 12:27:30 PM EST
    even if he isn't getting the politics.

    Parent
    Hmm ... three-legged stools ... (5.00 / 1) (#18)
    by Robot Porter on Mon Jan 25, 2010 at 01:28:54 PM EST
    well, this guy looks pretty comfortable and his chair has no legs.  He's even playing a video game.

    Maybe Krugman should think "outside the stool".

    (Scatological meaning included.)

    Parent

    There is no solid evidence (5.00 / 3) (#38)
    by Militarytracy on Mon Jan 25, 2010 at 02:36:10 PM EST
    that the excise tax will bring about cost containment.  Even Gruber has now caveated his own study on it.  Now Krugmans been drinking kool-aid.  Why hasn't anyone even begun to address how deals like Humana has with Tricare and Tricare providers are driving up prices for everyone else.  When Tricare only pony's up $3,000 on a $21,000 bill, where is that screwing over going to be made up for?  Can doctors and healthcare facilities really stay in business with those kind of payments?  Of course we don't want to mess with that profit ratio because it could upset Humana.

    Parent
    Good question (none / 0) (#4)
    by Slado on Mon Jan 25, 2010 at 12:24:32 PM EST
    Another good question is how is massive government intervention going to bend the cost curve?

    That's the question the average voter is asking and answering and why the average voter wants nothing to do with Obamacare.

    Parent

    Oh, I"m not asking your question. (none / 0) (#6)
    by observed on Mon Jan 25, 2010 at 12:26:10 PM EST
    It's quite clear that government single payer would drastically reduce costs, for example.


    Parent
    You are correct (none / 0) (#13)
    by Slado on Mon Jan 25, 2010 at 12:50:23 PM EST
    It would restrict access to helath care and reduce costs.

    Whether that is good or bad is pretty irrelevant because single payer isn't going to happen.

    So if the idea is to reform the current system (which already has massive gov't intervention) with more government intervention you can imagine how the average American is a little worried.

    Simple economics state that 30million new people with unfiltered access to the current health system will not decrease the cost curve.  It's simply impossible.

    The only real argument is in the long term it'll reduce costs by reducing the amount of care we provide through smarter more efficient care.

    The problem is I and many Americans don't trust the government to execute.  Call us crazy but we simply don't think the government (no matter who is in power) has the ability to make something complicated (and it doesn't get more complicated then our health system) more efficient and cost less.

    That is the major pushback against Obamacare that liberals/progressive and especially Obama and co. can't understand.

    The country as a whole doesn't trust them to execute what they're selling.   They want change, they want a better system but they've been listening and watching this process play out for more then a year and have responded forcefully.

    We simply don't believe they will deliver on their promises and worry the fix will create a bigger mess then we already have.

    Time to start over.

    Parent

    There's so much wrong with (5.00 / 6) (#25)
    by Anne on Mon Jan 25, 2010 at 01:52:40 PM EST
    your comment, I almost don't know where to begin.

    It would restrict access to helath care and reduce costs.

    While it definitely would reduce costs, it doesn't do that through restricting access to care.  On the other hand, this monstrosity of a reform bill does not significantly reduce costs and is likely to restrict access to care by making it financially difficult or impossible for people to afford the care they need after they pay premiums for mandated insurance and the higher co-pays and deductibles.

    Whether that is good or bad is pretty irrelevant because single payer isn't going to happen.
     
    The only reason it isn't going to happen is because the people with the power to make it happen have other interests more compelling: making sure the money keeps flowing into campaign coffers so they can keep their jobs.
    So if the idea is to reform the current system (which already has massive gov't intervention) with more government intervention you can imagine how the average American is a little worried.

    The "more government intervention" is coming in the form of subsidies to insurance companies, not to the administration of health care.  The private companies will still be loading people up with forms and procedures and denials and all the other stuff that eats up such a high percentage of premium dollars.  
    Simple economics state that 30million new people with unfiltered access to the current health system will not decrease the cost curve.  It's simply impossible.

    "Unfiltered access?"  As long as you still have private insurance companies acting as gatekeepers to care, there will be no such thing as unfiltered access; it's the filters, after all, that keep the profits up.
    The only real argument is in the long term it'll reduce costs by reducing the amount of care we provide through smarter more efficient care.

    Um, no.  Care will definitely be reduced, but it won't be because the care will be smarter and more efficient, it will be because people still won't be able to afford it.  
    The problem is I and many Americans don't trust the government to execute.  Call us crazy but we simply don't think the government (no matter who is in power) has the ability to make something complicated (and it doesn't get more complicated then our health system) more efficient and cost less.

    The government took the health care needs of arguably the oldest and sickest segment of the population out of the complicated private market, has them all paying the same premium and all claims processed via the same forms, with a fraction of the cost; you seem to be attributing to the government the failings of private industry.
    That is the major pushback against Obamacare that liberals/progressive and especially Obama and co. can't understand.

    If people think that Obama favors government-run health care, it is only because Obama's message changed almost daily for a long time, and the media and other politicians - Republicans, mostly - framed it that way.
    The country as a whole doesn't trust them to execute what they're selling.   They want change, they want a better system but they've been listening and watching this process play out for more then a year and have responded forcefully.

    The country doesn't trust the politicians to execute and deliver on what they're selling, but they are not selling government-run health care.  In fact, they have tied themselves in knots to avoid that and keep the private companies in the driver's seat.  What they're selling is more of the same private insurance control that has brought us to this crisis, and the people are smart enough to know that the industry that failed us is not going to succeed if given more money and more mandated customers and more guarantees of subsidies.
     
    We simply don't believe they will deliver on their promises and worry the fix will create a bigger mess then we already have.

    The fix will create a bigger mess, but it won't be a government-run mess, it will be a private-industry mess aided and abetted by government dollars.
    Time to start over.

    The only thing we agree on.


    Parent
    Wonder if "it will happen" when (none / 0) (#70)
    by BackFromOhio on Mon Jan 25, 2010 at 08:30:29 PM EST
    The only reason it isn't going to happen is because the people with the power to make it happen have other interests more compelling: making sure the money keeps flowing into campaign coffers so they can keep their jobs.

    the flowing money fails to get Dems elected?

    Parent

    The anti-government one-note tuba gets old. (5.00 / 2) (#45)
    by cenobite on Mon Jan 25, 2010 at 02:53:54 PM EST
    Simple economics state that 30million new people with unfiltered access to the current health system will not decrease the cost curve.  It's simply impossible.

    This is simply economically incorrect. You assume those 30 million people's health care currently costs nothing. That's not true. Right now they're using the most expensive, inefficient health care possible: emergency rooms. So, yes. It would cost less if they could walk into community health clinics on the government's dime and get preventative care.

    The problem is I and many Americans don't trust the government to execute.  Call us crazy but we simply don't think the government (no matter who is in power) has the ability to make something complicated (and it doesn't get more complicated then our health system) more efficient and cost less.

    Gooper, please.

    The government created the Manhattan Project, the Apollo Program and the interstate highway system. It has a proven track record of running enormous complicated projects. And yes, the Manhattan Project was in fact more complicated than Medicare.


    Parent

    What is being proposed (none / 0) (#63)
    by jimakaPPJ on Mon Jan 25, 2010 at 05:25:24 PM EST
    is not health care.

    And comparing health care to Apollo or the Manhattan project is a false argument. They are not the same, not even close.

    Parent

    Funny Slado (5.00 / 1) (#51)
    by cal1942 on Mon Jan 25, 2010 at 03:29:08 PM EST
    that you've missed the outstanding efficacy of the government's premier single-payer system; Medicare.

    Parent
    Really? (none / 0) (#61)
    by Slado on Mon Jan 25, 2010 at 05:03:49 PM EST
    Medicare is insolvent.

    Please find a better example.

    Parent

    Restrict access to health care? (none / 0) (#15)
    by gyrfalcon on Mon Jan 25, 2010 at 12:53:50 PM EST
    On which planet?

    Parent
    See England and Canada (none / 0) (#17)
    by Slado on Mon Jan 25, 2010 at 01:25:04 PM EST
    Single payer systems restrict access through government control rather then as our system does through insurance and price controls.

    Neither are pleasurable and both are realities.

    Pretending it isn't so is a waste of time.

    The promise all along is democrats have promised the impossible and the public doesn't believe them.

    Parent

    Nowhere near to the extent (5.00 / 1) (#59)
    by gyrfalcon on Mon Jan 25, 2010 at 04:50:01 PM EST
    that the private insurance system does.  Give me a break.  If somebody's going to "ration" my access to health care services, I'd 1,000 times rather have it be the government than the flesh-eating zombies of the insurance industry.

    And then there are the millions and millions of people who have no access to health care other than emergency services, and too bad if you have a chronic illness.  That's where that figure about the number of people who die because they don't have insurance comes from.

    And lastly, the huge number of bankruptcies from medical bills for people who have insurance.

    There's none of that cr*p-- zero-- in the rest of the civilized world.  It does not exist.

    Parent

    Unfortunately, the reality is Medicare denies more (none / 0) (#67)
    by vicndabx on Mon Jan 25, 2010 at 06:24:05 PM EST
    claims than just about anyone:

    Medicare: 6.85%
    Aetna: 6.80%
    Anthem BCBS (WellPoint): 4.62%
    Cigna: 3.44%
    United Healthcare: 2.68%

    Others are lower.

    Draw your own conclusions.  See metric #12.

    Additional metrics can be found here.

    Parent

    That's a completely meaningless (none / 0) (#73)
    by gyrfalcon on Mon Jan 25, 2010 at 11:05:54 PM EST
    statistic without the info about what kind of claims and why they're denied.

    Did you know, for instance, Medicare won't pay for a wheelchair so you can get a housebound elderly person to the doctor, dentist, etc., but only if they need it to get around indoors?

    Most people don't know that and a lot who make the claim get rejected.  That's not good, but it's relatively trivial.

    Not precisely the same as someone denied expensive life-saving treatment because of a suddenly discovered preexisting condition or because the ins. co. deems it "experimental."

    Give. Me. A. Break.

    Parent

    There's a difference (none / 0) (#74)
    by BrassTacks on Tue Jan 26, 2010 at 01:15:42 AM EST
    My insurance company does say that I cannot have a certain procedure, it says they won't pay for it.  I still have the option of paying for it.   If the government is in charge, as in Canada or England, they say if I cannot have a certain procedure, then I cannot have it.  It doesn't matter if I want to pay for it.  I cannot have it.  How do I know?  Because that's exactly what happened to my sister in Canada.  She could not GET a PET scan to check for cancer spread.  Her province did not allow such scans. Period.  She had to come to the US and pay for it herself.  She had no other option.  Her government said NO and that was that.  She was lucky, she could afford to come stay with me and pay for the scan.  I'd rather not have the government deciding what procedures I can have and which ones I can't have.  That's not to say that I don't support HCR, I just don't want the government making those decisions for me.  I want the options of either health insurance paying for me, or paying for it myself.  But I must say, after two bouts with cancer, I never had a problem with my insurance paying for what I needed, including scans that were not available in Canada.  As a cancer patient, I was thankful to live in the US.  I know the problems that women have in other countries with delays, not enough specialists, no scan machines or not enough of them, crowded hospital wards, just lots of bad stuff that I hear about from women in other countries on the cancer forums.  It about broke my heart when treatment delays killed my dear friend in England.  Poor thing couldn't afford to come to the US and pay for treatment.  It was one awful delay after another, a nightmare from the beginning.  Now she's gone, leaving behind a grieving husband and 3 kids.  It kills me because I know how different my experience was with the same cancer, same stage and grade.  She deserved better treatment.  

    Sorry for getting all personal.  Lots of emotion still.  

    Parent

    My sympathies (none / 0) (#76)
    by gyrfalcon on Tue Jan 26, 2010 at 01:23:01 AM EST
    But having it available if you can pay for it means not having it available for most people.

    I also know a birder in Scotland with a heart condition who doesn't dare come to the U.S. on a birding trip because he would be bankrupt if he got sick.  He goes happily to Cuba, though, every year.

    Fact remains there are far fewer people in Canada (or the U.K. or even Cuba) who die because treatment is denied either for ability to pay or an insurance company bureaucat versus a government one.

    I'd still eagerly take my chance with a goverment one over the other options.

    Parent

    And in Australia (none / 0) (#20)
    by Cream City on Mon Jan 25, 2010 at 01:43:15 PM EST
    as I'm learning, health care is covered, and that's great.

    But you have to take out a policy on your own to cover ambulance transportation and other add-ons.

    And even the great health care coverage comes at a cost.  My Australian newcomer to this country was asking about doing taxes soon -- and was astonished at how low a percentage of our pay that we pay in taxes.

    Parent

    I wish some reputable research firm (5.00 / 1) (#54)
    by MO Blue on Mon Jan 25, 2010 at 03:40:24 PM EST
    would put together an analysis of the total we pay in taxes (payroll, Medicare tax, state and local taxes that go towards medical services) combined with insurance premiums and total out of pocket expenses for deductibles, copays and prescription drugs and compare that amount to what other countries in taxes for related services.

    Parent
    Great point (none / 0) (#24)
    by Slado on Mon Jan 25, 2010 at 01:52:19 PM EST
    I'm not arguing that either system is better.

    What everyone needs to agree on is we can't have it all.  We can't all have the best and most expensive care.  

    We either pay with our own money or through taxes but in the end the promise of more care for less money is fantasy.  

    Thats the problem with Obamacare.  It promises the impossible.

    Parent

    Agreed -- and I'm not arguing (5.00 / 3) (#30)
    by Cream City on Mon Jan 25, 2010 at 02:04:13 PM EST
    that one is better than another, either -- because I don't know.  That is the problem.  We are not being given clear information on costs.  And when I go to a store that won't give me a price, or keeps changing it, I walk away -- as I have done with Obamacare, scratch that, Corporatecare.

    From what I hear from family and friends in Australia, Canada, et al., I am for what they have got, even though it apparently means more income tax.  But their systems are not what we would get.  So I'm walking away . . . and so are a lot of us.


    Parent

    Depends on WHERE in Canada (none / 0) (#75)
    by BrassTacks on Tue Jan 26, 2010 at 01:17:40 AM EST
    Some areas are good, some not so good.  Some have PET scan machines that patients can use, some don't.  

    I agree, there is no free lunch.  I want options, and I want everyone else to have them too.  

    Parent

    What about France? (none / 0) (#39)
    by MKS on Mon Jan 25, 2010 at 02:42:14 PM EST
    Its system delivers high quality medical care, and is a combination of government and private health insurance--much what our system might look like with a viable public option.

    England is not single payer--but rather true socialized medicine with the government in charge of providing health care, or, in other words, what conservatives accuse Democrats of proposing even no one has actually come close to proposing anything of the kind....Canada is from what I understand a true single payer system.

    Doing nothing of course benefits most those who have adequate health care and can afford the increasing premiums--basically the wealthy.....If you are poor, uninsured, or not able to keep up with costs, then you are in trouble....But let those folks eat cake...

    Parent

    New people with health care as taking (none / 0) (#36)
    by MKS on Mon Jan 25, 2010 at 02:30:43 PM EST
    from those who already have it....I heard that view from a Republican recently.  If we let everybody have health care, then I will have to wait longer.....Me first....typcial Republican stuff.

    But that would not be the case if everyone has to pay for health insurance via a mandate and government subsidies....You will have more money to buy more health care.  As to insurance costs, by increasing the pool of insureds to include the young and healthy, you spread the risk (which is the entire premise behind insurance) and premiums should go down or at least stabilize....

    Parent

    Mandates? (none / 0) (#62)
    by Slado on Mon Jan 25, 2010 at 05:08:32 PM EST
    Why should I be forced to buy health insurance I don't need?

    It is nothing more then a tax on the young and healthy and really un-american.  

    This is a center right country.  You will have a hard time selling mandates and it's a chief reason this whole effort is so close to death.

    Parent

    Un-American? (5.00 / 1) (#64)
    by Radix on Mon Jan 25, 2010 at 05:32:06 PM EST
    Why should I be forced to buy health insurance I don't need?

    Because we aren't omniscient. We don't know who, among the healthy, are going to get sick or hurt. When those people do, they will end up in emergency care, costing taxpayers and the insured, through higher premiums money. So we spread the risk, just like taxes for police or fire services; I've never been robbed nor had anything burn down, yet I pay.

    It is nothing more then a tax on the young and healthy and really un-american.  

    There are quite a few things I don't like my taxes going for, this is a Democracy, therefore we make concessions to get some of what we want in exchange for the other guy getting some of what they want. Hardly un-american, just the opposite in fact.

    Parent

    BTD, you don't have the power to frame the question and the answer so that it is a matter of the Unions ONLY being the GOP villain!

    I think that many Democrats and certainly many many Independents that don't belong to Unions or at least Unions with special sweetheart Cadillac plans will resent the UAW as well as corporate workers/management having those Cadillac deals, especially if that is one of the major reasons or the only reason for not getting a general Health Care Plan.

    You keep trying to frame the question as one of the UAW and like being heroes or at least victims.  That isn't how a lot of folks are going to see it.  It can also be seen that the UAW and other Cadillac plan holders are greedy "spoilers" for the rest of the people.