Thread: Health Bill

I saw an ad today against the health bill. I don't have much of an opinion on the health bill, but I noticed some logical errors in the propaghanda against it.

It was said "look at Canada and England... patients wait up to a year for vital surgeries..." implying that in Canada and England, many people die because of delays in surgery, caused by government control of health care. But do more people in these places, die because of delays, than people in non-socialized nations die because they can't afford treatment?

I'll be doing research, if anyone can please add their two cents: Try and be specific with your opinions, and provide citations for your facts.

Short answer? More people die in the US due to lack of coverage than people in England due to delayed care... by SEVERAL orders of magnitude.

I loved this program. It explores 5 different countries who all offer universal care, and they all do it somewhat differently. Well worth the 45 minutes if you've got 'em.

http://www.pbs.org/wgbh/pages/frontl...1&continuous=1

(homepage)


Also, FWIW... several of my colleagues are from England. They ALL (each and every single one of them) find their system FAR superior to the US system, and they each comment frequently about how screwed up the US is for not caring for it's people like every other advanced nation... and worse, how scared they are to get sick when they have to come here (due to the problems in our approach). They have also commented on more than one occasion that those comments about waiting are far exaggerated, and it's hardly as bad as the conservatives keep claiming.

In Canada all political parties are 100% in favour of universal health care. There may be a few differences in the details but not with the concept. If our prime minister even hinted at doing away with universal access, he'd be tossed out in a nano second by his own Conservative party.

Surveys for years have shown 95% in favour of our Health Care. Folks bitch about some aspects but not about the government (through taxpayers) picking up the tab. Canadians would have a revolution if we thought someone had to hesitate taking their child or senior parent....or themselves.. to the doctor because of what it would cost. If someone needs heart surgery, cancer care, etc. then the last issue they want to think about are dollars and cents.

Most important are wellness clinics for expectant mothers and their new borns, parental leave to take care of the little one for the first year and walk in facilities if there is any issue. I don't know how societies can break cycles of poverty and violence unless poor, minority or teenage mothers get top knotch health care and then quality education for their children.

Raptor - Can you comment at all about the wait times claim mentioned in the OP?

look at Canada and England... patients wait up to a year for vital surgeries.

Originally Posted by inow

Raptor - Can you comment at all about the wait times claim mentioned in the OP?

look at Canada and England... patients wait up to a year for vital surgeries.

Never had a problem. Four years ago I did a '360' while skiing. woke up in the hospital...they had already done a CT scan....felt a it fuzzy-headed....gave me an MRI and kept me in for 3 days....then a follow up MRI 3 weeks later...all was well. No issues. I saw 2 neurologists during that time and a cardiologist (don't know why a cardiologist) but, again all fine after tests.

Re wait times. Nothing stops anyone from paying out of pocket for procedures. 80% of Canadians live within a couple hour drive of the US border. I personally don't know folks who have had to wait any great length of time. My father-in-law was in his doctor's office one day and open heart surgery the next day. I suppose with millions of people visiting doctors every year that there are always bad experiences to cherry pick.

Having said all this, we lived in Elko, Nevada for 10 months and rec'd good coverage through our employer. Folks from there tended to go to Las Vegas for anything other than a doctor's visit and all seemed fine.

I have to admit that I would find private insurance a hindrance in life. It seemed to tie some American workers to their jobs. It's difficult for some to take a chance on relocation, going back to school, etc. One geologist in the USA we are still friends with has a wife with MS and a son with some 'issue'... He's more or less stuck in his job because of health insurance. He's had to turn down some good contracts here in Alberta because he won't be able to get coverage when he returned to the USA. In contrast our family has picked up sticks a half dozen times and never even thought about health care. The only issue is being near good medical facilities as we get older.

Precisely as I've heard from my friends and colleagues. Thanks for sharing your experience and sense of all of this with us here, raptor.

marcusclayman; Those promotions for or against US Health Care reforms are primarily based on anecdotal or extreme cases, which can be found to support either side. Further IMO, most have absolutely no understand of where these ideas have evolved from (SS Act of 1936, Johnson's Medicare/Medicaid 1965/7) where it would eventually lead to, for the US with 307M people and the current QUALITY would have to lead to...

Cost for a perceived best of anything is going to be higher, but cost in this case may not be related to the service itself, rather the 50 separate States imposing both legal rights through tort regulations or lack of, there particular mandates required to SELL insurance in a particular State or multiply other issues.

For a perspective of a British/EU Politician and Conservative, Daniel Hannan, you might google his name + US Health Care or for a brief outline of both views and qualification;

Hannan made national news headlines in August 2009 by criticizing the National Health Service on the Fox News Channel in the United States.[2] Amongst other comments, Hannan stated on US TV that he "wouldn't wish" the NHS "on anyone". The comments sparked criticism and controversy from some quarters in the UK.[3]

http://en.wikipedia.org/wiki/Daniel_Hannan

Here is a summery of one of my viewpoints on your topic...

Death Rates per 1,000/year can very greatly by Country, with the World's Average said to be about 8.6/1000/year. Most Industrialized Nations are around the 8-10/1000, with the 27 member states of the EU at 9.6 per and the US at 8.00/1000.

http://en.wikipedia.org/wiki/List_of..._by_death_rate

The latest figures on population, list the World at 6,789,300,000, the US at 307,658,000, the EU 499,794,855 and for this discussion the UK at 61,634,599.

http://en.wikipedia.org/wiki/List_of..._by_population

Most all deaths in the industrialized world are health related, failure of the Heart or respiratory system and cancer leading the list, by far. In 2006, 2,426,264 American died, on average 6648 per day and in the UK about 610,000 or 1688 per day.

http://www.cdc.gov/nchs/FASTATS/deaths.htm

Now the figure most often thrown around for uninsured deaths in the US each year is 45,000 by proponents of a UHC System for the US.

WASHINGTON (Reuters) – Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.

http://news.yahoo.com/s/nm/20090917/...lthcare_deaths

That means 1.8% of the people who died in that one year had 'NO INSURANCE' (up to 46 Million are said to have none today in the US), said another way of those nearly 2.5M others, 98.2% had insurance at the time of death or that insurance would not have played a roll in the death (suggesting preventative care, unenforceable and costly). Even the strongest and most expensive proposal TODAY, still does NOT include a percentage of folks (25M). I'll assume, life can be prolonged to some degree by immediate attention, that in the US this at worst means a few days from Family Doctor, to specialist to diagnosis and to an attempted repair of the problem, with or with out insurance. That the lack of insurance means nothing to the actual death rates (system), but where the lack of Medical Personnel and permission of a third entity (Government) and those suggested delays involve more deaths, while waiting than where little wait is involved. For the record, in both the US or any Country with UHC, no person in dire need of service is DENIED attention, in cardiac arrest, snake bites, having had an accident and so on, whether the person is from that Country or not, which in itself should defeat the argument for a US National System, one main cause for claimed for a US overhaul of the system.

Originally Posted by jackson33

For the record, in both the US or any Country with UHC, no person in dire need of service is DENIED attention, in cardiac arrest, snake bites, having had an accident and so on, whether the person is from that Country or not, which in itself should defeat the argument for a US National System, one main cause for claimed for a US overhaul of the system.

No, but often they will voluntarily forgo it in order to save money. What's worse is that people will gamble by not seeking early care in the hope that their symptoms will go away, and they'll turn out to be fine. Sometimes they end up waiting until it's too late and nothing can be done.

The key to lowering the price of health care is convincing people to focus on prevention, which simply won't happen if a person is having to pay out of pocket for their yearly checkup.

Not only do more people die of lack of treatment, in the US, than die of delays elsewhere,

but more people die of delays, in the the US. (The category "lack of treatment" includes delays, notice).

The idea that people just walk right in and get treated, in the US, is misinformed. I recall a chart showing the average delay in treatment for common complaints in the US as half again as long as in, say, France, which means the occasionally more serious diagnosis that results is also worsening for that much longer. And that's for people with insurance, in the US. (Everyone has health insurance of above average US quality, in France).

One common source of death by delay, in the US, is the overcrowded emergency rooms common in lower income neighborhoods - often crowded with people who in First World medical systems would have taken their complaints to a regular doc weeks or months earlier, or overloaded with trauma victims all brought to the one remaining open late night ER in the area (they lose money, and they are closing all over), occasionally they overlook somebody who doesn't seem that hurt, sitting in the corner quietly dying of internal bleeding or the like.

A case like that (a 90 minute delay in treating a stroke) made the news in my town just last week - made the news because the victim was white, wealthy, male, insured, had personal connections to news media, and had relatives who sued.

My only problem with socialized medicine is that different people have different paradigms and different levels of conscientiousness when it comes to their lifestyle decisions.

There is a certain culture that is interested in nutrition, but even(if not especially) they are subject to propaghanda in the media, when some studies are unduely focused on, and other studies are completely ignored.

For the most part people are guided by popular opinions, like "eat whole wheat not white bread" but why? "because whole flour is better than white flour" but why? what is missing, the germ and bran, but what is in those that you need? etc etc

People accept the simple answer, and that is ok, what makes our society so efficient is specialization; but so many refuse to accept help from experts for so many biased reasons.

Should I have to pay for those who are missing information because they care more about their stories on the telly, the rising cost of tobacco and who's partying tonight?

I suppose in some bigger scheme of things, they are helping the economy in some ways, and breeding future generations of consumers.

No, but often they will voluntarily forgo it in order to save money. What's worse is that people will gamble by not seeking early care in the hope that their symptoms will go away, and they'll turn out to be fine. Sometimes they end up waiting until it's too late and nothing can be done.

And others for many reasons, will neither seek or accept any Health Care (often for religious reason). At any rate, if saving money is the persons main goal in life and an adult (legal right) and the likely reason he/she has no insurance in the first place, in the USA (at this time) it's that person right.

Many times the systems do go away on there own and statistically what usually happens. There is another breed out there, millions of folks that will go to the Doctor for any sycosematic induced fear of illness, my neighbor got sick, I touched a raw egg and heard this or that or today, I must have Swine Flu, because I woke up feeling this morning, feeling different. I've heard many hospital emergency rooms and clinics are flooded with runny noises or mild coughing or temperatures, yet no signs of flu or even a cold.

The key to lowering the price of health care is convincing people to focus on prevention, which simply won't happen if a person is having to pay out of pocket for their yearly checkup.

I totally agree, if every person, did everything said to be healthy, they MIGHT remain healthy for an additional period. Two problems; What's been classified unhealthy far more often than should be, has later been deemed incorrect, even in some cases healthy. Both my parents in hearing salt could be bad for them, went salt free. With in a few years both contracted inner eye problems for lack of iodine (in salt), having to take very expensive pills daily for their remaining 20 years each. Second; People are going to be people and do what they wish to, regardless the consequences. Jump out of airplanes, clime mountains, eat hamburgers, milk shakes, drink soda, beer, alcohol, smoke cigars or cigarettes, chew tobacco and the thousands of things seen as unhealthy by one activist group or another. Maybe meat is unhealthy, many think it is, would you like to see a veggie-politician in the position to make meat eaters, ineligible for medical care, add a 20% sales tax on meat or just outlaw the sale of meat altogether. It may appear I am exaggerating, but with paid for health available to every person will allow people to do things they wish MORE and to eliminate that Government would have to penalize the activity in some way.

Why in the world would any healthy 18-50yo, maybe 60yo even want to get an annually physical even a general quicky. To properly prevent things 5 10 or 30 years down the road, your talking about a battery of very costly procedures. If this is available to every person each year, my guess is your talking about 500.00 per 306M people, your talking about a mostly added 153B$ expense per year and I have no idea what kind of chaos in the clinics and Doctor Offices in the US. By the way an MRI, the best diagnostic test available for current and future problems can cost from 1 to $4,000 per test.

I have to be just plain mean here, but what about genetics. If you are truly interested in creating a healthy population, don't allow certain people to mate at all or pick out their mates, see how that floats. We already have the ability to detect certain defects and future health problems while the fetus forms, would you suggest those that are born be made ineligible for health care or forced to abort that child, don't think that would fly. How about the elderly, strange as it may seem, were all going to die, once past 60-65 the odds get greater as do the cost to keep living, for many folks. Would you suggest an age limit for medical care, would it be 65-70-80 or maybe 100? Talk about riots, that would start a good one. Half the kids being born today are expected to live to 100 and it's already the fastest growing demographic (percentage wise) in the US, under age.

kojax, I understand the cost are high and I understand they are higher for those with pre-existing condition and I try to understand why every person should have access to equal care. It's just my belief, all this talk is just political rambling. There are ways to reduce cost, I mentioned a few, but if any individual really wants to reduce their personal cost, most already have the means and ability to do just that, having in many cases chose not to. As for equal care, it's just not possible, your going to get the care you can pay for, what the government or your insurance company will pay but there are just so many high quality facilities and/or medical personnel available, frankly many of them are already past 50/60 and will retire in 2013, with any additional government involvement.

You do understand, regardless of the political rhetoric, the seemingly rush to institute a program or a Congressional vote for a program in hours of release from committee are ALL for a program that will not begin until 2013, don't you??? It's not the time required to set up either, this could be started in 30 days, very much like Medicare/Medicaid. It's simple political timing and it's not going to work.

One common source of death by delay, in the US, is the overcrowded emergency rooms common in lower income neighborhoods - often crowded with people who in First World medical systems would have taken their complaints to a regular doc weeks or months earlier, or overloaded with trauma victims all brought to the one remaining open late night ER in the area (they lose money, and they are closing all over), occasionally they overlook somebody who doesn't seem that hurt, sitting in the corner quietly dying of internal bleeding or the like.

iceaura;
You are correct, but the premise may be faulty; Why are those Emergency Rooms crowded and you could include most Clinics, in the first place? Correct, in their minds it's free health care. In addition to those and the countless millions that have deductible Health Insurance (some cost), would then flood the Doctors offices for trivial ailments, creating the same problem and definitely effect waiting times for an appointments.

No doubt a few do fall through the cracks and I recall that lady that made news, dieing while waiting for attention. However the vast majority of trauma victims are attended to on arrival and the ambulance crews are generally in contact with a hospital in advance, if too busy and another available, going there.

With out picking on Countries, both France and Germany have higher death rates than the US per thousand, boiling down to .2%. (see my last post). Insignificant as it is, the US System cannot be worse than others for speedy treatment, rather slightly better.

ERs are crowded because many people don't have regular doctors -- because they can't afford them -- and an ER is the only way they know of getting help: when symptoms go beyond what they can tolerate.

I've gone to the ER multiple times for things that I could have just made an apointment for if I had a family practicioner... But I can't afford one. If I could afford one, I would much rather opt for the docter better aquainted with my peculiarities to make decisions about my health.

Also, last time I checked, ER visits are and have never been free. In America, payment is not required by law, but the hospital will still try to contact you to make a payment plan. I will pay all my debts to hospitals when I can, as would everyone who cares about their role in a quality health care system.

__________________________________________________ ______
I think that things shown to cost the socialized-medical-system, should be taxed. For example in America this would include but not be limited to meat, tobacco, alcohol, fast food, television beyond a certain limit, etc etc

1 out of every 2 bankruptcies filed in the US are the result of medical costs. That's 50% of every single bankruptcy filed... people going bankrupt just because they got sick and couldn't afford their care.

Now... that's not even the worst part. Just wait until you read this...

Out of that 50% of all bankruptcies... you know, the people who went bankrupt due to medical costs alone... 7 out of every 10 of them HAD existing healthcare coverage. 70% of people going bankrupt from medical costs actually had medical insurance, but despite that insurance they still were responsible for exorbitant fees and costs.

It's just disgusting. When you couple that with the fact that between 25 and 50 million people (depending on your source and parameters) are without insurance at all, and with the fact that those people often end up in the ER where their treatment costs are absorbed by the rest of us, and also the fact that most people with existing coverage are actually UNDER-covered (like my sister who is a lawyer and has a $3,000 deductible so can't afford to take herself or her kids to the doctor unless it's a real emergency), I find it disgusting that ANYBODY could argue that what we have is okay.

We are ranked 37th out of 191 countries in terms of healthcare outcome, yet we pay almost 4 times as much as the others... both per capita AND as a percentage of GDP.

It's embarrassing that we're in this state of affairs, and disturbing that there are people out there who think everything's fine.


Sources for the above:
http://www.nchc.org/facts/cost.shtml
http://www.who.int/whr/2000/media_ce.../en/index.html

Since no one is proposing a health system for the US that remotely resembles the Canadian or British ones the question, while interesting in itself, is actually irreleveant to the debate.

well, since the debate has nothing to do with the health care bill and in fact is about an ad against the health care bill which mentions the Canadian and English health care systems, your point, although wrong, is based on a premise that ads a lot to the discussion. Thanks

Originally Posted by jackson

Why are those Emergency Rooms crowded and you could include most Clinics, in the first place? Correct, in their minds it's free health care.

It's not free. ERs bill - and they are very expensive.

In addition to those and the countless millions that have deductible Health Insurance (some cost), would then flood the Doctors offices for trivial ailments, creating the same problem and definitely effect waiting times for an appointments.

That does not happen anywhere else.

It does not happen among people with full, no-deductible, no cap, cadillac health insurance in the US.

In France, waiting times for routine care are shorter than in the US.

Going to the doctor is not a pastime you have to strongly discourage, to keep it from becoming too popular.

Meanwhile, the current system is overloaded with serious and expensive stuff that should have been taken care of years ago when it was minor and cheaper. That's because people cannot afford to take the minor stuff, which usually takes care of itself, to the doc. Everyone I work with on the delivery trucks, for example, has a chronic ailment or injury (from dislocated collarbones to acid reflux to flat feet) that will be expensive and resource hogging in a few years, that they cannot afford to treat at the moment. The backlog of this stuff is driving prices up for everyone - what would have been a mild drug regimen and dietary advice a couple of years ago is probably going to be a medical emergency and esophageal surgery a few years from now - meanwhile, we're paying for the same thing from a few years ago.

double post deleted

Originally Posted by marcusclayman

well, since the debate has nothing to do with the health care bill and in fact is about an ad against the health care bill which mentions the Canadian and English health care systems, your point, although wrong, is based on a premise that ads a lot to the discussion. Thanks

The debate I was referring to is the health care debate. Your question is about logical errors in a propaganda ad and I was glad to be able to help out by pointing out the most fundamental logical error, which is that the ad compares apples and oranges and bananas and says if you don't like apples and oranges you're going to hate bananas.

"if you don't like apples and oranges you're going to hate bananas."

sounds logical to me

http://www.youtube.com/watch?v=aIL9IySxCkU

Michael Cannon, who debates against Government control of universal health care, raises some good points.

Does anyone think that if the government opened up free clinics, and maintained them, only for routine things and preventative medacine; and put more funding in schools to educate kids and families about health issues, especially nutrition

it would be a win for both sides of the debate?

in such a state: hospitals and insurance are still private and competitive, but routine services, like shots, antibiotics, nutritional suppliments, and education are taken care of via taxes. It could be required that clients need to volunteer, this would force them to exersize some, and socialize more, which are two major contributors to health problems; plus it would weed out those who can afford a family practicioner.

Originally Posted by jackson33

No, but often they will voluntarily forgo it in order to save money. What's worse is that people will gamble by not seeking early care in the hope that their symptoms will go away, and they'll turn out to be fine. Sometimes they end up waiting until it's too late and nothing can be done.

And others for many reasons, will neither seek or accept any Health Care (often for religious reason). At any rate, if saving money is the persons main goal in life and an adult (legal right) and the likely reason he/she has no insurance in the first place, in the USA (at this time) it's that person right.

Many times the systems do go away on there own and statistically what usually happens. There is another breed out there, millions of folks that will go to the Doctor for any sycosematic induced fear of illness, my neighbor got sick, I touched a raw egg and heard this or that or today, I must have Swine Flu, because I woke up feeling this morning, feeling different. I've heard many hospital emergency rooms and clinics are flooded with runny noises or mild coughing or temperatures, yet no signs of flu or even a cold.

Kaiser Permanente has done some studies on that, and found that, if they increased access to family doctors, the additional cost upfront from people visiting too often was fully offset by the savings elsewhere. They've actually benefited from the current recession, because they were able to keep their costs lower than their competitors. I tend to use them as a reference for a lot of things because my father works in their data department, doing cost analysis, and so I can ask him about that kind of stuff and get a pretty informed answer.

They're also a good model to look at because they handle all parts of person's health care, both insuring them, and treating them. If you look at a company that only does one or the other, then their savings might come by offloading costs to someone else, which means the process wasn't necessarily more efficient.

The key to lowering the price of health care is convincing people to focus on prevention, which simply won't happen if a person is having to pay out of pocket for their yearly checkup.

I totally agree, if every person, did everything said to be healthy, they MIGHT remain healthy for an additional period. Two problems; What's been classified unhealthy far more often than should be, has later been deemed incorrect, even in some cases healthy. Both my parents in hearing salt could be bad for them, went salt free. With in a few years both contracted inner eye problems for lack of iodine (in salt), having to take very expensive pills daily for their remaining 20 years each. Second; People are going to be people and do what they wish to, regardless the consequences. Jump out of airplanes, clime mountains, eat hamburgers, milk shakes, drink soda, beer, alcohol, smoke cigars or cigarettes, chew tobacco and the thousands of things seen as unhealthy by one activist group or another. Maybe meat is unhealthy, many think it is, would you like to see a veggie-politician in the position to make meat eaters, ineligible for medical care, add a 20% sales tax on meat or just outlaw the sale of meat altogether. It may appear I am exaggerating, but with paid for health available to every person will allow people to do things they wish MORE and to eliminate that Government would have to penalize the activity in some way.

I'm talking more about people who treat diseases when they're just beginning, so I guess using the word "prevention" is a little misleading. I'm not talking about never getting sick in the first place. What I mean is treating it while it's still in its infancy, so it never grows into a major problem.

Why in the world would any healthy 18-50yo, maybe 60yo even want to get an annually physical even a general quicky. To properly prevent things 5 10 or 30 years down the road, your talking about a battery of very costly procedures. If this is available to every person each year, my guess is your talking about 500.00 per 306M people, your talking about a mostly added 153B$ expense per year and I have no idea what kind of chaos in the clinics and Doctor Offices in the US. By the way an MRI, the best diagnostic test available for current and future problems can cost from 1 to $4,000 per test.

There is the fear of people demanding too much testing. I agree with you there. A "basic checkup" can mean different things, but in a politically controlled environment people would probably demand the full deal, the maximum possible set of tests.

One thing to consider, however, is that technology costs generally go down the more widely used a technology is. Manufacturers start to streamline their processes, and larger volumes of production lead to greater economy of scale. A lot of expensive medical equipment is only expensive because it's produced in small volumes.

kojax, I understand the cost are high and I understand they are higher for those with pre-existing condition and I try to understand why every person should have access to equal care. It's just my belief, all this talk is just political rambling.

There's also some truth to this. You can fix a lot of the problem just by changing the laws that determine how rates are set. Right now in Oregon (my home state), when quoting rates for an employee health plan, an insurance company is only allowed to ask 2 questions about the employees themselves: age and gender.

Just think how dumb that rule is. Smoking, for example, is a choice that people make, so you can give people incentives not to smoke, by allowing companies to quote different rates to smokers....... but where's the sense in adjusting prices on the basis of age and gender? What behavior does that encourage? (Euthanasia? Sex Change operations?)

Kaiser Permanente used to rate on the basis of zip code only, and it was a highly successful business setup for them. When other companies moved in and started rating on age and gender, however, they had to as well, or they'd lose all of their young customers. All it would take to restore that would be the passing of a few laws.

One common source of death by delay, in the US, is the overcrowded emergency rooms common in lower income neighborhoods - often crowded with people who in First World medical systems would have taken their complaints to a regular doc weeks or months earlier, or overloaded with trauma victims all brought to the one remaining open late night ER in the area (they lose money, and they are closing all over), occasionally they overlook somebody who doesn't seem that hurt, sitting in the corner quietly dying of internal bleeding or the like.

iceaura;
You are correct, but the premise may be faulty; Why are those Emergency Rooms crowded and you could include most Clinics, in the first place? Correct, in their minds it's free health care. In addition to those and the countless millions that have deductible Health Insurance (some cost), would then flood the Doctors offices for trivial ailments, creating the same problem and definitely effect waiting times for an appointments.
.

The reason the problem hits Emergency Rooms specifically is because that's the only place where a hospital is required by law to provide service to non-paying customers.

Kojax,

I think you may be confusing the Kaiser Foundation with Kaiser Permanente. One is a research and policy group, another is a private insurer (founder of HMOs really while Nixon was in office). They are not, however, the same organization.

Can you please clarify which you meant?

EDIT: On second read, I think you have meant the insurance provider (Permanente), after all.

kojax quotes;

Kaiser Permanente has done some studies on that, and found that, if they increased access to family doctors, the additional cost upfront from people visiting too often was fully offset by the savings elsewhere. They've actually benefited from the current recession, because they were able to keep their costs lower than their competitors. I tend to use them as a reference for a lot of things because my father works in their data department, doing cost analysis, and so I can ask him about that kind of stuff and get a pretty informed answer.

They're also a good model to look at because they handle all parts of person's health care, both insuring them, and treating them. If you look at a company that only does one or the other, then their savings might come by offloading costs to someone else, which means the process wasn't necessarily more efficient.

Certainly my comments/opinions could not compete with the Permanente Group, but I would disagree. When welfare was first introduced Medicaid and frankly Medicare, all this going on today actually began, at least in my opinion. This also is when and why, Medical cost began to sky rocket, along with insurance cost and have never slowed in rising, with the many additions to eligibility or the additions of the CHIP's program. Adding 5-10-46 million, to those than can then call participating Doctors, will add to the cost, not drop it.

Since the 1960’s the federal government has tried its best to alter the health care market to increase access and drive down costs. From the chart above we can see they utterly failed in the cost category. Health care costs, as a % of GDP, have risen from 5.9% in 1965 (when Medicare and Medicaid were legislated into existence) to 16% by 2006. This is a 170% increase in costs since government initially became involved.

http://www.thefreedomfactory.us/does...th-care-costs/

I'm talking more about people who treat diseases when they're just beginning, so I guess using the word "prevention" is a little misleading. I'm not talking about never getting sick in the first place. What I mean is treating it while it's still in its infancy, so it never grows into a major problem.

Once you have heart failure, cancer or many of the major problems, preventative means very little. Catching something in its infancy is every persons desire, give them a free means to this goal and catching it will mean full physicals from the age of 21.

There is the fear of people demanding too much testing. I agree with you there. A "basic checkup" can mean different things, but in a politically controlled environment people would probably demand the full deal, the maximum possible set of tests.

And those giving/reading the test may start giving the real results. The test was 75% conclusive, 80% or 100%. A good many initial diagnostic test are inconclusive, a problem already when a person may receive two or more MRI's or other expensive test. When simple, inexpensive and non life threatening test are performed, usually they do several from the same specimen, to insure the results, blood, urine etc...

One thing to consider, however, is that technology costs generally go down the more widely used a technology is. Manufacturers start to streamline their processes, and larger volumes of production lead to greater economy of scale. A lot of expensive medical equipment is only expensive because it's produced in small volumes.

When a product is first produced, that item may be higher to recover R&D and promotion cost, but as demand and competition increases the price will come down. Where the MRI machine, now costing a million or so each, may come down, the cost of the facility, maintenance and personnel, will go up. More volume means more personnel and if enough volume an addition shift (double) the personnel, which adds cost, to saying of the administrative cost, which some claim is already over 20% of the medical cost today. Keep in mind anyway you look at it, government will be setting the price and government draws by natures is not concerned with supply and demand.

There's also some truth to this. You can fix a lot of the problem just by changing the laws that determine how rates are set. Right now in Oregon (my home state), when quoting rates for an employee health plan, an insurance company is only allowed to ask 2 questions about the employees themselves: age and gender.

That's probably why the employers in Oregon are limited to 3 or four Companies of the 1200 or so selling insurance. Every State has its own program, listing what must be covered and other required procedures, which will be the reason a good many Employers will turn to any government option, if offered.

Just think how dumb that rule is. Smoking, for example, is a choice that people make, so you can give people incentives not to smoke, by allowing companies to quote different rates to smokers....... but where's the sense in adjusting prices on the basis of age and gender? What behavior does that encourage? (Euthanasia? Sex Change operations?)

We all take Health Risk, many not even realizing it. I night out on the town, finding a stranger in your bed the next morning, taking a trip to the Amazon Jungles, climbing mountains and the rest. Americans, I suppose would lead the any list for adventuress activity.

Incentives to do or not to do, are already all around you. Have kids and get a deduction, buy solar power units for your home and get a deduction and many things from both State and Federal Government. Buy a pack of Cigarettes for $12.00 (NYC) and the cost to produce and get that pack to the vendor is less than .50, buy a beer at the local bar, cost up 7-8.00 in some towns, while costing .40 cents to produce, a couple the other way.

The reason the problem hits Emergency Rooms specifically is because that's the only place where a hospital is required by law to provide service to non-paying customers.

You might be surprised; Many folks, including this old guy, have NO doctor. In my case I haven't even seen one in 10 years, then through the Emergency Room. Come to think of it, there was no Doctor, but assume he read the X-Ray, saying I was sick and prescribed the medication. I and more than you might think, including illegals will pay for the service (I had insurance) out of pocket, which was one tenth the cost of going to a Doctor. Incidentally, the cost for my test, diagnosis and eventual cure for double lung pneumonia was 230.00. Going through the insurance program, would have cost the Government or my Insurance Company about 1500.00 and I'd would have to had paid my 500.00 deductible. Oh yes, that 230.00 included my hundred dollar medication cost to the pharmacy (6 pills). I have no idea what the shot I was given would have cost, BUT...

Originally Posted by jackson33

kojax quotes;

Kaiser Permanente has done some studies on that, and found that, if they increased access to family doctors, the additional cost upfront from people visiting too often was fully offset by the savings elsewhere. They've actually benefited from the current recession, because they were able to keep their costs lower than their competitors. I tend to use them as a reference for a lot of things because my father works in their data department, doing cost analysis, and so I can ask him about that kind of stuff and get a pretty informed answer.

They're also a good model to look at because they handle all parts of person's health care, both insuring them, and treating them. If you look at a company that only does one or the other, then their savings might come by offloading costs to someone else, which means the process wasn't necessarily more efficient.

Certainly my comments/opinions could not compete with the Permanente Group, but I would disagree. When welfare was first introduced Medicaid and frankly Medicare, all this going on today actually began, at least in my opinion. This also is when and why, Medical cost began to sky rocket, along with insurance cost and have never slowed in rising, with the many additions to eligibility or the additions of the CHIP's program. Adding 5-10-46 million, to those than can then call participating Doctors, will add to the cost, not drop it.

Part of what raises costs is, ironically enough, the discovery of new treatments. Back when all you could do was make a cancer patient comfortable, nobody expected their insurance company to pay for chemo therapy. Newer treatments quite often end up being more expensive than their predecessors, and insurance companies are expected to do "as much as it takes" to cure you.

KaiPerm also has the advantage of being a private business that doesn't want to grow its bureaucracy in order to stay competitive. Government loves to expand its bureaucracy.

Since the 1960’s the federal government has tried its best to alter the health care market to increase access and drive down costs. From the chart above we can see they utterly failed in the cost category. Health care costs, as a % of GDP, have risen from 5.9% in 1965 (when Medicare and Medicaid were legislated into existence) to 16% by 2006. This is a 170% increase in costs since government initially became involved.

http://www.thefreedomfactory.us/does...th-care-costs/

I'm talking more about people who treat diseases when they're just beginning, so I guess using the word "prevention" is a little misleading. I'm not talking about never getting sick in the first place. What I mean is treating it while it's still in its infancy, so it never grows into a major problem.

Once you have heart failure, cancer or many of the major problems, preventative means very little. Catching something in its infancy is every persons desire, give them a free means to this goal and catching it will mean full physicals from the age of 21.

I think I see where this is going. In the ideal, there would be a certain cost-benefit analysis. Statistically more likely problems (especially those for which there exists a family history) would be checked for in ways that are statistically reliable, but others not quite as much. This is probably what's happening in KaiPerm since they're a private business who's decision to increase access to checkups is genuinely driven by a desire to achieve something in their bottom line costs. A government HMO system would probably not be as reliable that way.

What my father wishes the government would do is bid everyone's risk management out to HMO's. KaiPerm would make a fortune off of that, and it would force all the other HMO's to start looking for ways to do like them, and keep costs down. Then it would become profitable for some companies to specialize too, like for example, a company might start focusing on the age 65-70 bracket, and becoming specialists at preventing and/or dealing efficiently with their most common maladies, so you'd end up changing providers when you hit age 65.

One thing to consider, however, is that technology costs generally go down the more widely used a technology is. Manufacturers start to streamline their processes, and larger volumes of production lead to greater economy of scale. A lot of expensive medical equipment is only expensive because it's produced in small volumes.

When a product is first produced, that item may be higher to recover R&D and promotion cost, but as demand and competition increases the price will come down. Where the MRI machine, now costing a million or so each, may come down, the cost of the facility, maintenance and personnel, will go up. More volume means more personnel and if enough volume an addition shift (double) the personnel, which adds cost, to saying of the administrative cost, which some claim is already over 20% of the medical cost today. Keep in mind anyway you look at it, government will be setting the price and government draws by natures is not concerned with supply and demand.

What would happen with more volume is less per capita man hours being expended on any one patient. When you've got a large volume of people using any service, it becomes cost effective to start automating portions of the process that wouldn't have been automated otherwise.

If you've only got 5 people going through your MRI per day, then you're not going to bother using assembly line tactics to deal with them. But, if you've got 500 per day, then it will probably get to be more like an assembly line. (They'll feel your company has lost the "personal touch", but you'll be paying less per person.)

The reason the problem hits Emergency Rooms specifically is because that's the only place where a hospital is required by law to provide service to non-paying customers.

You might be surprised; Many folks, including this old guy, have NO doctor. In my case I haven't even seen one in 10 years, then through the Emergency Room. Come to think of it, there was no Doctor, but assume he read the X-Ray, saying I was sick and prescribed the medication. I and more than you might think, including illegals will pay for the service (I had insurance) out of pocket, which was one tenth the cost of going to a Doctor. Incidentally, the cost for my test, diagnosis and eventual cure for double lung pneumonia was 230.00. Going through the insurance program, would have cost the Government or my Insurance Company about 1500.00 and I'd would have to had paid my 500.00 deductible. Oh yes, that 230.00 included my hundred dollar medication cost to the pharmacy (6 pills). I have no idea what the shot I was given would have cost, BUT...

This is the fundamental problem with having separate insurance companies and hospitals. A private insurance company faces most of the same problems that a government insurance company would face. There's little or no competition between hospitals for insurance business, because the insurance company doesn't want to be telling customers which provider they have to go to. Some of them have preferred providers, but it's just considered a big "no no" to restrict customers' options. Hospitals know this, and charge accordingly.

For non-insurance customers, they have to be competitive, though. The only way I can see a government system creating this kind of effect would be to bid out risk to HMO providers, instead of treatment. (Right now medicare/aid bids only treatment, making it susceptible to the overpricing problem.) This seems to me like the only way to stop all the price gouging.

What effect does "the personal touch" have in medicine?

Originally Posted by marcusclayman

What effect does "the personal touch" have in medicine?

I suspect it has none, but it greatly affects customer satisfaction. As long as you're not ignoring what they say (because a lot of symptoms can only be detected by a patient telling you about them).

marnix quotes;

Part of what raises costs is, ironically enough, the discovery of new treatments. Back when all you could do was make a cancer patient comfortable, nobody expected their insurance company to pay for chemo therapy. Newer treatments quite often end up being more expensive than their predecessors, and insurance companies are expected to do "as much as it takes" to cure you.

Obviously the cost of diagnostics, treatments and medication are going to go up, as technology and science improves. When 'consumption' (cancer) was first diagnosed you simply made plans for your funeral and the million dollar treatments of today were not spent. On the other hand, when Polio became a problem, measles and hundreds of other medical problems prevailed, those cost resulted in 'No cost' or at least greatly reduced. I'll add these were the results of the private sector, some with Federal Grants, some NOT. Since we really do ALL die, all those reasons we DO die are not treatable cheaply and in most cases are adding hours, days or maybe a few years to the life.

Most insurance companies, limit treatments to known acceptable methods and try to leave experimental treatment out. Unfortunately folks with major problems, their families and friends couldn't care less if there experimental and one major reason many are now included and our cost have gone up.

I think I see where this is going. In the ideal, there would be a certain cost-benefit analysis. Statistically more likely problems (especially those for which there exists a family history) would be checked for in ways that are statistically reliable, but others not quite as much. This is probably what's happening in KaiPerm since they're a private business who's decision to increase access to checkups is genuinely driven by a desire to achieve something in their bottom line costs. A government HMO system would probably not be as reliable that way.
What my father wishes the government would do is bid everyone's risk management out to HMO's. KaiPerm would make a fortune off of that, and it would force all the other HMO's to start looking for ways to do like them, and keep costs down. Then it would become profitable for some companies to specialize too, like for example, a company might start focusing on the age 65-70 bracket, and becoming specialists at preventing and/or dealing efficiently with their most common maladies, so you'd end up changing providers when you hit age 65.

OK, lets take you comments and add my last comment on the last paragraph. If insurance Companies cannot control cost for the sake of popular demand or sentiment, how in the world could popularly elected officials. Whether handed off to a third entity or limits set by non medical economist (cost/efficiency analysis) the government will manage the outcome by regulation. There will be few limitations for any procedure and any attempt to, will result elections being based on anecdotal, subjective opinions of the Medical Health Care System. Think about it, the young verses the old, diabetics (overweight/obese) verses the health nuts (diet and exercise). I should insert the notion, the US Government really has no authority in the Health Care system to begin with, but that always creates separate argument...

What would happen with more volume is less per capita man hours being expended on any one patient. When you've got a large volume of people using any service, it becomes cost effective to start automating portions of the process that wouldn't have been automated otherwise.

First there is no room for additional access to health care today. Most Physicians with any specialty are already over booked, over worked and IMO underpaid. They already either have a staff for handling paper work (administrative) or pay a high price for out sourcing. Most claim, that doubling the allotted time would go a long way to (one of your augments) preventative care.

If you've only got 5 people going through your MRI per day, then you're not going to bother using assembly line tactics to deal with them. But, if you've got 500 per day, then it will probably get to be more like an assembly line. (They'll feel your company has lost the "personal touch", but you'll be paying less per person.)

For starters, a general MRI full scan, not looking for a specific problem, will take about an hour, preparation, cooling, clean up. The best your going to get is MAYBE 30 or so done in a 24 Hour period. For the best results you will have either qualified technicians or medical professional observing the scan in progress (to take pictures at correct moment), which in effect are not doing something else. I have not done a cost analysis on the program, but would bet that $30,000 revenue would be break even for the total cost involved. I don't understand the 'personal touch' since unlike in the 'House' Fox Production, MRI's are generally outsourced, no personal touch. Even where I live, the two MRI's available are independently owned, but were installed on Hospital grounds, the Physician can and often does set in...

The scan itself is painless. The whole procedure can take 15-40 minutes. It may be a little uncomfortable lying still on the couch for this time. Small children may need a general anaesthetic to keep them still long enough for the pictures to be taken. In some cases an injection of a special contrast dye is given into the bloodstream via a vein on the arm. This helps to give clearer pictures of certain tissues or organs being examined.

http://www.patient.co.uk/health/MRI-Scan.htm

Now on this comparison of Health Care to Industrial production, they are not the same. Most all products are produced to a minimal cost per unit and then to the limits of demand. That is a factory will produce a particular model vehicle in the most efficient manner, so many per hour off the end of an assembly line, to the limits of there estimated sales. If two factories are seen preferable over on running two shifts (transport cost) they will go that route or add a shift to the original and so forth. This is true whether Cereal or Airplanes or whatever. Now Health Care is not predictable or for that matter controllable. Most Hospitals for instance, run at 60-70% capacity, but maintain a staff for 100%, in part many used in Emergency rooms, today. An outbreak of something, a major accident or violent weather hits, the demands of the statistical expectations for usage are shot and this can happen anyplace, any time or they can drop to 30% capacity or less on any given day.

For non-insurance customers, they have to be competitive, though. The only way I can see a government system creating this kind of effect would be to bid out risk to HMO providers, instead of treatment. (Right now Medicare/aid bids only treatment, making it susceptible to the overpricing problem.) This seems to me like the only way to stop all the price gouging.

In short, medical cost would go down, or would have never gone up for other than inflation, if every person equally contributed into the system an indeterminable amount, from birth to some kind of general fund in the area they live, transferable accounts and from birth. Since this is pure fantasy and no person goes through life with the same medical problems or the same ability to pay that, what would be trivial amount it could never happen. Digest that! What is being suggested, being done in many places and partially already exist here in the US is that very same scenario, reversed, based on those that have achieved for those for whatever reason have not or could not and the basic problem, I have with this entire issue. Think about it, under the current plans, a person would pay no fine for not buying insurance in 2013 (the year it clicks in), 100.00 in 2014 and it does go up. This for not paying the estimated 8-10k$ (Family of four, with the Federal requirements for what to cover) policy (or the cheaper Government Option when it does come into the picture) and at any time that person or member of his family does become chronically ill, can join and will be covered. That is the doctor diagnoses a problems and estimated cost are easily figured, you take on the 10k$ cost to cover you 200k problem, if cured could then drop out again and pay the cheaper fine. Said another way, it must lead to single payer, government controlled HC.

I'll try to be brief, but I have an illogical passion for this subject. First caveat, I am an unforgiving Libertarian. Therefore, I have an extreme bias for capitalism and against government infringement.

You cannot enact proper access to health insurance reform (health care is not the problem since we have the most skilled medical professionals in the world in the United States) without also addressing our broken mentality towards the role of the federal government.

The reason why a government managed health insurance system is and will always be a failed and futile experiment is because our economy is predicated on a free market system. This creates an increased level of competition, and much greater catalyst for cost reduction than any other economic system in existence. There are many reasons why health care costs have increased at a greater rate than inflation and other cost of living indicators. Fundamentally though, a large piece is due to the loss of competition. This is a fun phrase many politicians love to throw out there without an iota of understanding as to what they are talking about.

The reason why we lack competition in our health insurance industry is because of interstate commerce restrictions which the federal government regulates through an enumerated power in Article 1, Section 8, Clause 3 of the US Constitution. This allows them to restrict our access to buying insurance from other states than the one we reside in. This single act causes an artificially low competition and does not allow for a free market competition that we expect. With that in mind, the government cannot 'compete' with private markets because the government can and will be accessible across all state lines, and will do so with an unlimited money source (since they print it). For sake of illustration, they could charge $1 per year for a policy and cause all other private insurance companies out of business, then alter their rate to $25,000 per year or whatever they need to to keep their system afloat.

Originally Posted by jackson33

marnix quotes;

Part of what raises costs is, ironically enough, the discovery of new treatments. Back when all you could do was make a cancer patient comfortable, nobody expected their insurance company to pay for chemo therapy. Newer treatments quite often end up being more expensive than their predecessors, and insurance companies are expected to do "as much as it takes" to cure you.

Obviously the cost of diagnostics, treatments and medication are going to go up, as technology and science improves. When 'consumption' (cancer) was first diagnosed you simply made plans for your funeral and the million dollar treatments of today were not spent. On the other hand, when Polio became a problem, measles and hundreds of other medical problems prevailed, those cost resulted in 'No cost' or at least greatly reduced. I'll add these were the results of the private sector, some with Federal Grants, some NOT. Since we really do ALL die, all those reasons we DO die are not treatable cheaply and in most cases are adding hours, days or maybe a few years to the life.

Most insurance companies, limit treatments to known acceptable methods and try to leave experimental treatment out. Unfortunately folks with major problems, their families and friends couldn't care less if there experimental and one major reason many are now included and our cost have gone up.

I think I see where this is going. In the ideal, there would be a certain cost-benefit analysis. Statistically more likely problems (especially those for which there exists a family history) would be checked for in ways that are statistically reliable, but others not quite as much. This is probably what's happening in KaiPerm since they're a private business who's decision to increase access to checkups is genuinely driven by a desire to achieve something in their bottom line costs. A government HMO system would probably not be as reliable that way.
What my father wishes the government would do is bid everyone's risk management out to HMO's. KaiPerm would make a fortune off of that, and it would force all the other HMO's to start looking for ways to do like them, and keep costs down. Then it would become profitable for some companies to specialize too, like for example, a company might start focusing on the age 65-70 bracket, and becoming specialists at preventing and/or dealing efficiently with their most common maladies, so you'd end up changing providers when you hit age 65.

OK, lets take you comments and add my last comment on the last paragraph. If insurance Companies cannot control cost for the sake of popular demand or sentiment, how in the world could popularly elected officials. Whether handed off to a third entity or limits set by non medical economist (cost/efficiency analysis) the government will manage the outcome by regulation. There will be few limitations for any procedure and any attempt to, will result elections being based on anecdotal, subjective opinions of the Medical Health Care System. Think about it, the young verses the old, diabetics (overweight/obese) verses the health nuts (diet and exercise). I should insert the notion, the US Government really has no authority in the Health Care system to begin with, but that always creates separate argument...

What would happen with more volume is less per capita man hours being expended on any one patient. When you've got a large volume of people using any service, it becomes cost effective to start automating portions of the process that wouldn't have been automated otherwise.

First there is no room for additional access to health care today. Most Physicians with any specialty are already over booked, over worked and IMO underpaid. They already either have a staff for handling paper work (administrative) or pay a high price for out sourcing. Most claim, that doubling the allotted time would go a long way to (one of your augments) preventative care.

If you've only got 5 people going through your MRI per day, then you're not going to bother using assembly line tactics to deal with them. But, if you've got 500 per day, then it will probably get to be more like an assembly line. (They'll feel your company has lost the "personal touch", but you'll be paying less per person.)

For starters, a general MRI full scan, not looking for a specific problem, will take about an hour, preparation, cooling, clean up. The best your going to get is MAYBE 30 or so done in a 24 Hour period. For the best results you will have either qualified technicians or medical professional observing the scan in progress (to take pictures at correct moment), which in effect are not doing something else. I have not done a cost analysis on the program, but would bet that $30,000 revenue would be break even for the total cost involved. I don't understand the 'personal touch' since unlike in the 'House' Fox Production, MRI's are generally outsourced, no personal touch. Even where I live, the two MRI's available are independently owned, but were installed on Hospital grounds, the Physician can and often does set in...

The scan itself is painless. The whole procedure can take 15-40 minutes. It may be a little uncomfortable lying still on the couch for this time. Small children may need a general anaesthetic to keep them still long enough for the pictures to be taken. In some cases an injection of a special contrast dye is given into the bloodstream via a vein on the arm. This helps to give clearer pictures of certain tissues or organs being examined.

http://www.patient.co.uk/health/MRI-Scan.htm

Now on this comparison of Health Care to Industrial production, they are not the same. Most all products are produced to a minimal cost per unit and then to the limits of demand. That is a factory will produce a particular model vehicle in the most efficient manner, so many per hour off the end of an assembly line, to the limits of there estimated sales. If two factories are seen preferable over on running two shifts (transport cost) they will go that route or add a shift to the original and so forth. This is true whether Cereal or Airplanes or whatever. Now Health Care is not predictable or for that matter controllable. Most Hospitals for instance, run at 60-70% capacity, but maintain a staff for 100%, in part many used in Emergency rooms, today. An outbreak of something, a major accident or violent weather hits, the demands of the statistical expectations for usage are shot and this can happen anyplace, any time or they can drop to 30% capacity or less on any given day.

For non-insurance customers, they have to be competitive, though. The only way I can see a government system creating this kind of effect would be to bid out risk to HMO providers, instead of treatment. (Right now Medicare/aid bids only treatment, making it susceptible to the overpricing problem.) This seems to me like the only way to stop all the price gouging.

In short, medical cost would go down, or would have never gone up for other than inflation, if every person equally contributed into the system an indeterminable amount, from birth to some kind of general fund in the area they live, transferable accounts and from birth. Since this is pure fantasy and no person goes through life with the same medical problems or the same ability to pay that, what would be trivial amount it could never happen. Digest that! What is being suggested, being done in many places and partially already exist here in the US is that very same scenario, reversed, based on those that have achieved for those for whatever reason have not or could not and the basic problem, I have with this entire issue. Think about it, under the current plans, a person would pay no fine for not buying insurance in 2013 (the year it clicks in), 100.00 in 2014 and it does go up. This for not paying the estimated 8-10k$ (Family of four, with the Federal requirements for what to cover) policy (or the cheaper Government Option when it does come into the picture) and at any time that person or member of his family does become chronically ill, can join and will be covered. That is the doctor diagnoses a problems and estimated cost are easily figured, you take on the 10k$ cost to cover you 200k problem, if cured could then drop out again and pay the cheaper fine. Said another way, it must lead to single payer, government controlled HC.

I have a feeling you and I would be doing alot of 'uh huh uh huh' 'yep I agree' with each other. Its unfortunate that since we have the majority opinion, that our 'elected' officials aren't interested in listening to us. So unbelievable how snobby and arrogant they are to us 'average' people.

I should insert the notion, the US Government really has no authority in the Health Care system to begin with, but that always creates separate argument...

Good idea, since that would open you up to the counter argument that perhaps health care is as basic of a service as police or fire fighters.

What would happen with more volume is less per capita man hours being expended on any one patient. When you've got a large volume of people using any service, it becomes cost effective to start automating portions of the process that wouldn't have been automated otherwise.

First there is no room for additional access to health care today. Most Physicians with any specialty are already over booked, over worked and IMO underpaid. They already either have a staff for handling paper work (administrative) or pay a high price for out sourcing. Most claim, that doubling the allotted time would go a long way to (one of your augments) preventative care.

One advantage of automating or refining a process is that you can use people with less education to carry it out. That is, at least so long as popular sentiment doesn't continually oppose the idea of being seen by a nurse instead of a doctor. My sister tells me that she prefers seeing a nurse, because they're less egotistical, so maybe that trend needs to catch on.

For non-insurance customers, they have to be competitive, though. The only way I can see a government system creating this kind of effect would be to bid out risk to HMO providers, instead of treatment. (Right now Medicare/aid bids only treatment, making it susceptible to the overpricing problem.) This seems to me like the only way to stop all the price gouging.

In short, medical cost would go down, or would have never gone up for other than inflation, if every person equally contributed into the system an indeterminable amount, from birth to some kind of general fund in the area they live, transferable accounts and from birth. Since this is pure fantasy and no person goes through life with the same medical problems or the same ability to pay that, what would be trivial amount it could never happen. Digest that! What is being suggested, being done in many places and partially already exist here in the US is that very same scenario, reversed, based on those that have achieved for those for whatever reason have not or could not and the basic problem, I have with this entire issue. Think about it, under the current plans, a person would pay no fine for not buying insurance in 2013 (the year it clicks in), 100.00 in 2014 and it does go up. This for not paying the estimated 8-10k$ (Family of four, with the Federal requirements for what to cover) policy (or the cheaper Government Option when it does come into the picture) and at any time that person or member of his family does become chronically ill, can join and will be covered. That is the doctor diagnoses a problems and estimated cost are easily figured, you take on the 10k$ cost to cover you 200k problem, if cured could then drop out again and pay the cheaper fine. Said another way, it must lead to single payer, government controlled HC.

This isn't the problem I was talking about. During the brief interval of time when medicare was bidding out risk instead of treatment, Kaiperm started doing all kinds of data analysis on chronic problems like how to deal more efficiently with dialysis patients, or determining what was causing patients to return again after being treated for curable problems.

For dialysis patients they determined it would actually be cheaper to buy the patient a dialysis machine of their own, and send it home with them, rather than have them visit the clinic for dialysis all the time. For a lot of the returning patients, it was determine that a statistically large number of them were forgetting to take their meds, so they hired phone people to call them and remind them. - These are just two examples of what I mean.

My father explained all this to me with a cynical smile, then pointed out that the whole program was shut down immediately when the government changed its mind and started bidding only treatment instead of risk. Why spend data resources trying to get them better if you can bill for the return visits? You'd have to be a sado-masochist to deliberately cut yourself out of additional business.

I should insert the notion, the US Government really has no authority in the Health Care system to begin with, but that always creates separate argument...

Good idea, since that would open you up to the counter argument that perhaps health care is as basic of a service as police or fire fighters.

I would further counter then that the government does provide health care through hospitals to cover any and all imminent threats to life or normal function. However, since health care is not "providing for the common defense" or "maintaining the peace", the Federal government has no constitutional authority over health insurance, any more than they do running automobile businesses (however since they did the latter, then they believe they can do the former).

However, I would only state these things if we were having that discussion which we most certainly are not :wink:

So, you're against medicare, too, eh?

As per your constitutional authority argument, you may want to refresh yourself on the 9th amendment. In sum, just because the framers don't explicitly state something in the constitution does not mean they intended for it to be unconstitutional. It works both for the enumeration of rights for the people as well as the enumeration of powers for the government.

Originally Posted by inow

So, you're against medicare, too, eh?

As per your constitutional authority argument, you may want to refresh yourself on the 9th amendment. In sum, just because the framers don't explicitly state something in the constitution does not mean they intended for it to be unconstitutional. It works both for the enumeration of rights for the people as well as the enumeration of powers for the government.

Hm. I just checked the ninth amendment. You have an odd interpretation. I think it rather limits the power of the government. How can you stretch this to say it gives the government powers not enumerated in the constitution?

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

Originally Posted by Harold14370

Hm. I just checked the ninth amendment. You have an odd interpretation.

Well, odd as you may think it is, my interpretation of the Enumeration Clause is informed by the interpretation of our Supreme Court... the body set in place to provide said interpretations.

As I mentioned in my previous post, it is interpreted to mean that... just because the framers did not explicitly guarantee a right in the constitution does not mean they intended for the people not to have that right. The same amendment has been used to show that... just because the framers did not explicitly state that the government had a particular power does not mean they do not (unless, it is specifically prohibited).

This is all rather moot, anyway. These same criticisms about the constitutionality of government involvement with healthcare were raised when medicare was enacted. They did not apply then, and they don't apply now. We have government involvement in health care, and it's not unconstitutional.

I've found that many conservatives have a rather narrow view of constitutionality, suggesting that the governments only role is security of the people. The funny thing is, even with that view, healthcare can easily be demonstrated to be an issue of security... So they fail on multiple fronts with these types of attacks. I won't even bother flanking you from yet another angle by showing how economics and financial impact on our businesses (as well as innovation and freedom to pursue the careers they desire) are greatly improved by such government programs which shift the focus from job lock on to job mobility and enhance opportunities for our advancement as a people (and as individuals).

Originally Posted by Harold14370

Originally Posted by inow

So, you're against medicare, too, eh?

As per your constitutional authority argument, you may want to refresh yourself on the 9th amendment. In sum, just because the framers don't explicitly state something in the constitution does not mean they intended for it to be unconstitutional. It works both for the enumeration of rights for the people as well as the enumeration of powers for the government.

Hm. I just checked the ninth amendment. You have an odd interpretation. I think it rather limits the power of the government. How can you stretch this to say it gives the government powers not enumerated in the constitution?

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

I agree with you harold. The 9th amendment was enacted as a means to keep in check the federal powers from infringing on the individual liberties of the people. Therefore, the federal government has no right to interfere with private enterprise in selling a service for which people are willing to buy and for which it does not violate state or federal laws. This is easily extended to say that the government has no right to 'bail' out an individual enterprise which cannot develop a successful business model to continue to operate. Also, you could argue that the federal government violated its rights in enacted regulations on those same enterprises forcing them to in fact not succede. You can successfully argue that most regulations force private enterprise to fail and give the public the perception that 'only' the government can successfully opearate something normally left to the private market.

http://papers.ssrn.com/sol3/papers.c...ract_id=789384

Originally Posted by inow

Well, odd as you may think it is, my interpretation of the Enumeration Clause is informed by the interpretation of our Supreme Court... the body set in place to provide said interpretations.

As I mentioned in my previous post, it is interpreted to mean that... just because the framers did not explicitly guarantee a right in the constitution does not mean they intended for the people not to have that right. The same amendment has been used to show that... just because the framers did not explicitly state that the government had a particular power does not mean they do not (unless, it is specifically prohibited).

That is an apppeal to authority fallacy. The Constitution is there for all to read and we do not need a judge to tell us it says something that is clearly the opposite of what it plainly says in the eighth amendment.

I wonder if you think the Constitution limits the powers of the federal government in any way, and if it does not, then what function does it serve? Are food, clothing and shelter also national security issues? How about cable hookup and internet access, aren't they important, too?

(post moved)

http://www.thescienceforum.com/Nutri...hip-20834t.php

(post moved)

http://www.thescienceforum.com/viewt...bfdcc25#214449

"Not only do more people die of lack of treatment, in the US, than die of delays elsewhere,

but more people die of delays, in the the US." -iceaura

Nonetheless, more people/capita/year die in the UK than the US; according to the figures jackson provided on page 1 of this discussion.
1/126 US, 1/101 UK


"1 out of every 2 bankruptcies filed in the US are the result of medical costs....70% of people going bankrupt from medical costs actually had medical insurance" -inow

Taken from the site you cited

"A recent study found that 62 percent of all bankruptcies filed in 2007 were linked to medical expenses. Of those who filed for bankruptcy, nearly 80 percent had health insurance.9 "

Not only are your figures inacurate -- however, to your benefit -- but you claim causation when your source only claims correlation. Why?


"(health care is not the problem since we have the most skilled medical professionals in the world in the United States)" -zubs

Do you have a source for this? If so, please share it. I'm curious to see how skill was measured, because last time I heard: the percentage of deaths due to malpractice is pretty much the same throughout the developed world.

Originally Posted by jackson33

Obviously the cost of diagnostics, treatments and medication are going to go up, as technology and science improves. When 'consumption' (cancer) was first diagnosed you simply made plans for your funeral and the million dollar treatments of today were not spent. On the other hand, when Polio became a problem, measles and hundreds of other medical problems prevailed, those cost resulted in 'No cost' or at least greatly reduced. I'll add these were the results of the private sector, some with Federal Grants, some NOT. Since we really do ALL die, all those reasons we DO die are not treatable cheaply and in most cases are adding hours, days or maybe a few years to the life.

The polio vaccine was developed by Dr. Salk with funding from the National Foundation for Infantile Paralysis society which was a non-profit originally set up by Roosevelt, in 1938. Most of the rest of the major vaccines, and the current polio vaccine, were developed by Dr. Hilleman at Merck though

Vaccines are an interesting case for private medical development. Unfortunately, private sectors focus on strains that are present in the major drug markets: NA, Europe, and Japan. A good example of this is Wyeth's pneumococcus vaccine, it is only 40% effective in Africa, but 80-85% in the target markets. Pneumonococcus kills very few babies in the developed world, but many in Africa.

Anyway, the reason vaccines are cheap, is they have historically been much cheaper to develop than medications. Also, the company has a good incentive if they can guarantee a mandatory vaccination campaign.

The Rota virus vaccine only cost 1 million dollars to develop, this is nothing compared to the 800 million that went into the latest cholesterol pill. Research into diseases that effect 3rd world countries are almost exclusively undertaken in Universities.

Medical treatment cost haven't simply risen for cancer treatment though. The annual drug treatment for a patient suffering from MS can cost around 20-30k a year, and you're uninsurable. HIV drug treatments are another pricey life long expense. The only cheap drugs are the ones that have been around since the 60s and 70s, which would be most of our antibiotics. Otherwise, the prices of everything has risen.

Ah my education as a microbiologist has given me all these conflicting feelings about pharmaceutical companies, I love the work they do, but I think their profits are sometimes outrageous. Nonetheless, I think it is a necessary evil. Drugs simply cost a fortune to develop, and without major profits no one would put in the investments of several hundreds of millions of dollars to get nothing.

Originally Posted by marcusclayman

(post moved)

http://www.thescienceforum.com/Nutri...hip-20834t.php

Can you provide a link to the new thread? I'm having difficutly locating it.

Thanks.

kojax quotes;

Good idea, since that would open you up to the counter argument that perhaps health care is as basic of a service as police or fire fighters.

OK, here goes, but I warned you this can bring out the worst in people....

We're talking the Federal Government. Where ever you live in the US, short of a Military or Government Installation, you are or will pay local/county/state taxes that cover all cost covering services. That is your fire department, law enforcement (plus a long list of services, including your local School District) are locally paid for through your own local tax structure. Even health care, is basically a State Issue today with the programs being proposed in Congress, using the States as the enforcer of Congressional decision. Said in real life terms, States could be responsible, take responsibility for decisions made at the Federal Level.

One advantage of automating or refining a process is that you can use people with less education to carry it out. That is, at least so long as popular sentiment doesn't continually oppose the idea of being seen by a nurse instead of a doctor. My sister tells me that she prefers seeing a nurse, because they're less egotistical, so maybe that trend needs to catch on.

IMO, 'people with less education' adding experience has already been accomplished, or at least we peaked years ago. You just can't expect the truly bright people in an affluent society to go through what it takes to become a Medical Doctor for a weighted average 180k$ wage, generally on duty 24/7/365. The US and most of the industrialized World, has been educating and certifying a large number of foreign born folks for years, not that they are not qualified, but are motivated by the standards they came from...

I don't doubt there are corrupt people in any field, including medicine. Frankly I think all Auto Repair Shops are corrupt, but I do feel, when a life is the issue or a correctly done treatment, it should be done by those with the experience and the knowledge of what is a valid conclusion/result, and at least some idea what to do when and if something goes wrong. Most all home testing, is subject to error, can result in reassuring, while a problem becomes worse.

subz1 quote;

I have a feeling you and I would be doing alot of 'uh huh uh huh' 'yep I agree' with each other. Its unfortunate that since we have the majority opinion, that our 'elected' officials aren't interested in listening to us. So unbelievable how snobby and arrogant they are to us 'average' people.

No doubt, you have heard the term 'Silent Majority', which exist in the US today and in my opinion are being wakened. The problem has been apathy of that same group, when things appear to be flowing along just fine, especially for themselves.

As for this current Administration or in part the last one, I really think there actions were or are being based on a PERSONAL viewpoint, felt confirmed by the society that elected them, not necessarily today for the good of the Country or a majority. In each State those newly elected in 06 and 08, (a bunch) had no idea how Congress works. While being elected at the State or District level, Congress operates as a collective for the good of future party policy, IMO.

Harold quote;

Hm. I just checked the ninth amendment. You have an odd interpretation. I think it rather limits the power of the government. How can you stretch this to say it gives the government powers not enumerated in the constitution?

All those first 10 A's, today called 'Bill of Rights', were intended protection to the State Rights for there people, generally agreed on to get some States ratification of the Constitution, passed/ratified in the first days of the first session of Congress (1791). My understanding, but keep in mind the President of the US, a Harvard Constitutional Law Graduate, would disagree.

The Bill of Rights (Amendments 1 through 10)

As noted on the Constitutional Convention Topic Page, several delegates to the convention refused to sign the newly drafted constitution because it did not include a bill of rights. Bills of rights were typically parts of the constitutions of the several states of the day (and today), placed there to ensure that certain rights were recognized by the government. Most of the delegates did not feel such a bill was necessary, and other may have been on the fence but were weary from the months of negotiations.

http://www.usconstitution.net/constamnotes.html#BOR

inow; As I read the this;

In the United States, the Ninth Amendment to the U.S. Constitution protects against federal infringement of unenumerated rights. The text reads:
The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

Unenumerated rights are sometimes defined as legal rights inferred from other legal rights that are officiated in a retrievable form codified by law institutions, such as in written constitutions, but are not themselves expressly coded or "enumerated" among the extant writ of the law

In part another SC decision limiting Federal Infringement and my reading..

''The language and history of the Ninth Amendment reveal that the Framers of the Constitution believed that there are additional fundamental rights, protected from governmental infringement, which exist alongside those fundamental rights specifically mentioned in the first eight constitutional amendments. . .

http://caselaw.lp.findlaw.com/data/c...n/amendment09/

As for Medicare, the several revisions and the CHIP's program, that should be a matter for the States. All it's accomplished is an equalization of cost (Federal Mandates and regulation) a primary complaint today as the majority of recipients live in high cost areas and very low numbers live in low cost areas. County taxes alone and today from Louisiana to several NE counties vary from a few hundred dollars to 8 to $10,000/household/year as I recall.

IFTired; I did say 'In part', but do understand FDR's roll in the Polio vaccine. In fact one result of the program which was called ATCH (what ever that is) probably allowed me to be whatever I was in life. In 1947 I was diagnosed with Polio, my Dad told I may never walk again, suggested that experimental ATCH treatment and WALKED out of that hospital a week later.

However the point of my comments was the Private Sectors roll in modern medicine, whether the incentives were, monetary, professional or both. Since your in the business, I'm sure you know there are hundreds, maybe thousands over the years of small Companies that have gone bankrupt, failed in part and sold or are struggling today, just to maintain government requirements and regulations in areas they logically have no idea whats going on. I'd like to see that same Government stay out of all Medical decision!!!

Originally Posted by marcusclayman

"(health care is not the problem since we have the most skilled medical professionals in the world in the United States)" -zubs

Do you have a source for this? If so, please share it. I'm curious to see how skill was measured, because last time I heard: the percentage of deaths due to malpractice is pretty much the same throughout the developed world.

I don't have a source readily available, but this was based on the fact that the United States receives more foreign medical students to be trained here (and many remain) than anywhere else in the world. We also have more clinical studies that happen here than elsewhere. Of the 202 total Nobel Laureates in Medicine/Physiology since 1901, 92 have been from the United States.

http://en.wikipedia.org/wiki/List_of...gy_or_Medicine

I wasn't intending on making claims to malpractice deaths.



*Edited for grammar*

Originally Posted by zubs1

I should insert the notion, the US Government really has no authority in the Health Care system to begin with, but that always creates separate argument...

Good idea, since that would open you up to the counter argument that perhaps health care is as basic of a service as police or fire fighters.

I would further counter then that the government does provide health care through hospitals to cover any and all imminent threats to life or normal function. However, since health care is not "providing for the common defense" or "maintaining the peace", the Federal government has no constitutional authority over health insurance, any more than they do running automobile businesses (however since they did the latter, then they believe they can do the former).

However, I would only state these things if we were having that discussion which we most certainly are not :wink:

I would place it under "maintaining the peace" as any crime a person commits in defense of their own life, or the life of one of their children, can be considered to have been committed under duress.

Even a ridiculous movie like "Spider Man 3" can articulate this point pretty well. You've got the "Sand Man" character committing burgleries in order to pay for an expensive operation for his child. Would even the guarantee of a life sentence be sufficient to deter that kind of behavior?

If you knowingly create a set of conditions that cannot lead anywhere but one place, then it's pretty hypocritical to turn around say that arriving at that one place isn't part of the intended result. Of course it is.

Originally Posted by jackson33

kojax quotes;

Good idea, since that would open you up to the counter argument that perhaps health care is as basic of a service as police or fire fighters.

OK, here goes, but I warned you this can bring out the worst in people....

We're talking the Federal Government. Where ever you live in the US, short of a Military or Government Installation, you are or will pay local/county/state taxes that cover all cost covering services. That is your fire department, law enforcement (plus a long list of services, including your local School District) are locally paid for through your own local tax structure. Even health care, is basically a State Issue today with the programs being proposed in Congress, using the States as the enforcer of Congressional decision. Said in real life terms, States could be responsible, take responsibility for decisions made at the Federal Level.

There's also the FBI, which handles interstate crime.

As for insurance companies, they work best if they are very large, because analyzing their customer base provides more statistically valid results if they've got a lot of customers, than if they've only got a few customers.

Originally Posted by Harold14370

Originally Posted by inow

Well, odd as you may think it is, my interpretation of the Enumeration Clause is informed by the interpretation of our Supreme Court... the body set in place to provide said interpretations.

As I mentioned in my previous post, it is interpreted to mean that... just because the framers did not explicitly guarantee a right in the constitution does not mean they intended for the people not to have that right. The same amendment has been used to show that... just because the framers did not explicitly state that the government had a particular power does not mean they do not (unless, it is specifically prohibited).

That is an apppeal to authority fallacy. The Constitution is there for all to read and we do not need a judge to tell us it says something that is clearly the opposite of what it plainly says in the eighth amendment.

No, actually... It's not an appeal to authority (despite your assertion to the contrary). It's how our constitutional republic is designed. The judicial branch is in place to ensure all legislation is inline with our constitution. As part of this effort, they are forced to interpret the constitution with every case brought before them. Their rulings have a very real impact on how those laws are executed and carried out, and whether legislation is allowed to exist at all.

I am not appealing to authority. I am reminding you that the SCOTUS has the express mandate and authority to rule on issues of constitutionality. Following this point, for someone to come here and suggest that a public option is unconstitutional shows a profound ignorance of our system and its setup.

Now, you might have a valid argument against me that the 9th amendment has nothing to do with this (yes, it's the 9th amendment I cited, not the 8th - which prevents the government from engaging in cruel and unusual punishments... surely, Harold... It was not your intent to suggest that a government providing healthcare for its people is "cruel and unusual." )

Kidding aside, I will stipulate that the 9th amendment is a weak (and potentially irrelevant) argument so we can move forward.

People are suggesting that a public option is unconstitutional. That's plainly stupid, and shows a lack of understanding of Article 1, which lays out that Congress has the power to “lay and collect taxes, duties, imposts and excises” and to “provide for….the general welfare of the United States.” As was my central point when I cited the Enumeration Clause previously, rather than itemizing specific subject matters, such as health care, which Congress is allowed to spend money on, the framers chose instead to give Congress a broad mandate to spend money in ways that promote the “general welfare.”

For the argument that a "public option is unconstitutional" to hold water, we'd also have to allow for Medicare, Social Security, federal education funding, Medicaid, and veterans benefits such as the VA health system and the GI Bill to also be "unconstitutional," which they very certainly ARE NOT.

My suggestion is that people who make the argument that "a public option is unconstitutional" have a very myopic and inaccurate understanding of our constitution (and our republic), are completely ignoring the countless other ways the government spends money to promote the general welfare, and that they should better educate/inform themselves before repeating such painfully stupid arguments.

Originally Posted by Harold14370

I wonder if you think the Constitution limits the powers of the federal government in any way

Absolutely it does, just not in the way you and zubbs1 are suggesting it is limited regarding a public option, as I've elucidated plainly above.

Originally Posted by Harold14370

Are food, clothing and shelter also national security issues? How about cable hookup and internet access, aren't they important, too?

Since you seem so keen on logical fallacies, you should really try to avoid the appeal to ridicule, especially since the central premise of your own position has been so completely obliterated above.

Originally Posted by kojax

If you knowingly create a set of conditions that cannot lead anywhere but one place, then it's pretty hypocritical to turn around say that arriving at that one place isn't part of the intended result. Of course it is.

Then congress/white house cannot be surprised that we are at the result we are.

Originally Posted by inow

I am not appealing to authority. I am reminding you that the SCOTUS has the express mandate and authority to rule on issues of constitutionality. Following this point, for someone to come here and suggest that a public option is unconstitutional shows a profound ignorance of our system and its setup.

I understand about the supreme court, but if we discuss the constitution we should be able to discuss it on its merits. Simply citing the Supreme Court decisions does not do that; it simply tends to quash any further discussion. And I will remind you that the Supreme Court was also responsible for the Dred Scott decision.

Now, you might have a valid argument against me that the 9th amendment has nothing to do with this (yes, it's the 9th amendment I cited, not the 8th - which prevents the government from engaging in cruel and unusual punishments... surely, Harold... It was not your intent to suggest that a government providing healthcare for its people is "cruel and unusual." )

Well, you got me there. I was thinking of the tenth.

Kidding aside, I will stipulate that the 9th amendment is a weak (and potentially irrelevant) argument so we can move forward.

People are suggesting that a public option is unconstitutional. That's plainly stupid, and shows a lack of understanding of Article 1, which lays out that Congress has the power to “lay and collect taxes, duties, imposts and excises” and to “provide for….the general welfare of the United States.” As was my central point when I cited the Enumeration Clause previously, rather than itemizing specific subject matters, such as health care, which Congress is allowed to spend money on, the framers chose instead to give Congress a broad mandate to spend money in ways that promote the “general welfare.”

For the argument that a "public option is unconstitutional" to hold water, we'd also have to allow for Medicare, Social Security, federal education funding, Medicaid, and veterans benefits such as the VA health system and the GI Bill to also be "unconstitutional," which they very certainly ARE NOT.

My suggestion is that people who make the argument that "a public option is unconstitutional" have a very myopic and inaccurate understanding of our constitution (and our republic), are completely ignoring the countless other ways the government spends money to promote the general welfare, and that they should better educate/inform themselves before repeating such painfully stupid arguments.

Originally Posted by Harold14370

I wonder if you think the Constitution limits the powers of the federal government in any way

Absolutely it does, just not in the way you and zubbs1 are suggesting it is limited regarding a public option, as I've elucidated plainly above.

Originally Posted by Harold14370

Are food, clothing and shelter also national security issues? How about cable hookup and internet access, aren't they important, too?

Since you seem so keen on logical fallacies, you should really try to avoid the appeal to ridicule, especially since the central premise of your own position has been so completely obliterated above.

It wasn't an appeal to ridicule. I was asking an honest question, because I think your interpretation would lead to an untenable conclusion; i.e., that the 10th amendment has no meaning. I wanted to see how you would counter that. Exactly what if anything in the Constitution would prevent Congress from passing a law providing a free television to each citizen, on basis that an informed citizenry is good for the public welfare? Or what law that is good for the public welfare, and by definition all laws are good or they would not be passed, would violate the tenth?

Originally Posted by Harold14370

It wasn't an appeal to ridicule. I was asking an honest question, because I think your interpretation would lead to an untenable conclusion; i.e., that the 10th amendment has no meaning. I wanted to see how you would counter that. Exactly what if anything in the Constitution would prevent Congress from passing a law providing a free television to each citizen, on basis that an informed citizenry is good for the public welfare? Or what law that is good for the public welfare, and by definition all laws are good or they would not be passed, would violate the tenth?

Buying everyone a TV is not an exercise of power. Giving everyone health insurance isn't either. Mandating insurance might be, however.

However: one of the powers specifically granted to congress, in Section 8 (the Powers of Congress) is the power to regulate interstate commerce.

To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;

The possibility that an uninsured human being, living in a state that does not mandate health insurance might get sick, and then decide to move into a state that does mandate health insurance for everyone, to get access to the free insurance, might be reason enough to invoke the interstate commerce clause. What else would stop one state's uninsured sick people from overwhelming their neighbors' health insurance system?

Originally Posted by kojax

Buying everyone a TV is not an exercise of power. Giving everyone health insurance isn't either.

I think it is, because the government would transfer money from taxpayers to other citizens, which the taxpayers might not necessarily agree to, if not for a federal law to that effect. So that would be an exercise of federal power. Aside from that, are you saying a law buying everyone a TV is constitutional or not?

The possibility that an uninsured human being, living in a state that does not mandate health insurance might get sick, and then decide to move into a state that does mandate health insurance for everyone, to get access to the free insurance, might be reason enough to invoke the interstate commerce clause. What else would stop one state's uninsured sick people from overwhelming their neighbors' health insurance system?

It's not really interstate commerce per se, and the state could have residency requirements.

Originally Posted by kojax

However: one of the powers specifically granted to congress, in Section 8 (the Powers of Congress) is the power to regulate interstate commerce.

To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;

The possibility that an uninsured human being, living in a state that does not mandate health insurance might get sick, and then decide to move into a state that does mandate health insurance for everyone, to get access to the free insurance, might be reason enough to invoke the interstate commerce clause. What else would stop one state's uninsured sick people from overwhelming their neighbors' health insurance system?

Originally Posted by kojax

Mandating insurance might be, however.

Are you arguing that mandating insurance might be beyond the limit of the federal or state government?
You also state that states would have the authority to mandate health insurance for everyone. Under no proposed system, that I am aware of, is the insurance 'free'. I assume if you moved somewhere to gain access to health insurance it would still have a price tag, but it might be more manageable due to a lack of state income tax burdening the budget of that individual.

Lastly, the commerce clause I think should be very narrowly interpreted and applied. It is quite easy to bs an argument for the commerce clause to allow access for some ridiculous legislation. In other words, I feel it has become a pick and choose. If you really have an agenda then you could stretch the meaning to apply to your off the wall ideology/legislation.

Originally Posted by inow

People are suggesting that a public option is unconstitutional. That's plainly stupid, and shows a lack of understanding of Article 1, which lays out that Congress has the power to “lay and collect taxes, duties, imposts and excises” and to “provide for….the general welfare of the United States.” As was my central point when I cited the Enumeration Clause previously, rather than itemizing specific subject matters, such as health care, which Congress is allowed to spend money on, the framers chose instead to give Congress a broad mandate to spend money in ways that promote the “general welfare.”

For the argument that a "public option is unconstitutional" to hold water, we'd also have to allow for Medicare, Social Security, federal education funding, Medicaid, and veterans benefits such as the VA health system and the GI Bill to also be "unconstitutional," which they very certainly ARE NOT.

My suggestion is that people who make the argument that "a public option is unconstitutional" have a very myopic and inaccurate understanding of our constitution (and our republic), are completely ignoring the countless other ways the government spends money to promote the general welfare, and that they should better educate/inform themselves before repeating such painfully stupid arguments.

First, the issue I have is the notion that the federal government has overstepped its limits in stipulating regulations to supercede states regulations. In regards to health insurance, the HIPAA was one way in which the fed did this. I understand that the intention was to prevent insurance being dropped for preexisting conditions (I generally feel the government always acts with beneficial intentions). However, this fundamentally violates a core belief of mine that the individual is repsonsible for protecting their financial liability.




The root of the problem catalyzing the desire to reform, as I believe it to be, is not the lack of access to health insurance. We have 46 major insurance companies providing health insurance coverage plans. The issue remains the cost of the premiums to the individual. Our argument of wether or not the federal government has the authority to establisha governement run health insurance company is not the real issue I have with the debate. If the cost of premiums are the 'danger' to the american person for which the federal government government is using to hold up their authority to enact a public option, then why are they not addressing this issue?

They want to increase competition to reduce costs. How specifically does the government compete with private markets especially with health insurance? In all other industries, the federal government cannot compete with the private market (the USPS uses FEDEX to deliver mail for them, and has for years: http://www.postalproject.com/documents.asp?d_ID=2487)
It seems the government believes it can rewrite the rules of capitalism. If the government can print money to reinvest in their 'insurance company' (as they have for decades for the postal service, medicare etc.), and private companies have a finite capital to invest and operate their business, then they cannot compete with each other. Further, if the government sets reimbursement rates lower than private insurance can (which they have stated they would since they want to keep the same reimbursement as medicare) then this will happen even faster. Also if the governement makes it less penalizing to shift workers to the government insurance than paying their portion of their employee's premium, then over time the government option will be the monopoly. They have then created an environment where they are exerting dominant authority over the state's rights to provide free market access to health insurance.

In simple terms, why does the government believe that it can run a health insurance to be more cost effective than the post office, medicare, medicaid, social security etc. Also, how do they think they can run implementation of socialized medicine any better than they do to VA hospitals?


I realize my arguments are not purely of a constitutional matter, but more of a projection (based on common sense), so forgive me that. I am not a legal scholar, and only try (poorly) to summarize things I have heard (mostly in interviews) from authroitative figures who are experts in constitutional law.

Originally Posted by inow

For the argument that a "public option is unconstitutional" to hold water, we'd also have to allow for Medicare, Social Security, federal education funding, Medicaid, and veterans benefits such as the VA health system and the GI Bill to also be "unconstitutional," which they very certainly ARE NOT.

From a constitutional standpoint, do you have objection to the federal government establishing the regulatory standards alone, and allowing the states to use free markets to enforce the substance of the regulation: i.e. the FDA states what the limits are for x,y, and z toxins. Then a private market lab in one state does the testing on the samples to keep food and drug manufacturers in line.

There are many questions above. I'm going to summarize my response thusly:

Healthcare is not subject to normal free market principles. Unlike buying a television or a car, we cannot choose when or if we'll need health care services, nor can we choose where those services are provided in cases of emergency. Further, we don't have a problem if someone can't afford a car or tv, but none of us would stand for it (not for one second) if someone wasn't provided health care because they can't afford it.

There are laws in place requiring care at ERs, but that care is supremely expensive and results in higher premiums for the rest of us as the insurance companies must absorb those costs. It makes more sense to allow coverage up front, treat the issues early for lower costs (preventative), instead of forcing people to wait until catastrophic (much more expensive) care can no longer wait.

Insurance is required, because people who are sick through no fault of their own should not be forced to go bankrupt (I'm a type 1 diabetic, and I'm tired of hearing the ridiculous argument that people should care for their own health and pay for it out of pocket... essentially subjugating me and my family to a life of poverty because of uncontrollable circumstance, instead of agreeing that the smart move is to provide care and allow me to continue contributing to the economy and society).

Individual mandates are the only way to ensure there is enough money in the risk pool and that people don't game the system. Just like everyone has to ante up in poker to be allowed to take home any cash at the end, so too must everyone ante up in insurance to be allowed to get help with payments when they are needed.

Doing this at the state level decreases purchasing power too significantly to be taken seriously. Much like how large corporations can offer much higher quality care for much lower premiums to their employees than can small businesses (due to the vast differences in the number of people making premium payments... small companies have fewer people in the risk pool and hence pay more and get less than large companies), the federal level plan gives us the most leverage toward cost reduction (which is crucial in making this work).

The higher the number of participants in the risk pool, the lower the individual payments to each of us, the higher the level of care, and the more people who can be covered. Medicare is a federal level program, and so too should any public option (let's call it "Medicare for Everyone").

From both an economic standpoint and a moral one (25-50 million people without coverage is not acceptable in an advanced civilization such as ours), the federal level public option simply makes the most sense right now (I'm actually for single payer, but that's off the table, so is moot in this discussion).

This is done very successfully in lots of other nations. There is NO reason we cannot do the same here, and it's absolutely not unconstitutional.

This 50 minute program is well worth the watch. It provides insight into how universal coverage is achieved in five other nations, and each of them do it slightly differently (and for half the cost... or less... of what we're doing now in the US both per capita and as a percentage of GDP).

http://www.pbs.org/wgbh/pages/frontl...1&continuous=1
(Homepage)

Originally Posted by inow

There are many questions above. I'm going to summarize my response thusly:

Healthcare is not subject to normal free market principles. Unlike buying a television or a car, we cannot choose when or if we'll need health care services, nor can we choose where those services are provided in cases of emergency. Further, we don't have a problem if someone can't afford a car or tv, but none of us would stand for it (not for one second) if someone wasn't provided health care because they can't afford it.

There are laws in place requiring care at ERs, but that care is supremely expensive and results in higher premiums for the rest of us as the insurance companies must absorb those costs. It makes more sense to allow coverage up front, treat the issues early for lower costs (preventative), instead of forcing people to wait until catastrophic (much more expensive) care can no longer wait.

I'm not sure you are correct that our health insurance would be increased when a non-insured individual seeks care at a hospital and cannot afford to pay their bill. Although it is an interesting question as to what is the exact process that a hospital goes through to recover the losses for uncollectable bills (i.e. is there tax payer subsidies that the federal government gives to the hospital).

Originally Posted by inow

Insurance is required, because people who are sick through no fault of their own should not be forced to go bankrupt (I'm a type 1 diabetic, and I'm tired of hearing the ridiculous argument that people should care for their own health and pay for it out of pocket... essentially subjugating me and my family to a life of poverty because of uncontrollable circumstance, instead of agreeing that the smart move is to provide care and allow me to continue contributing to the economy and society).

First, I'm very sorry that you suffer from diabetes. It is a terrible disease especially type I. For what its worth, there is some great research being done on it and other autoimmune disorders.
Second I have not, nor will I ever say that we should favor a system that allows people to not have access to buy health insurance. We agree that everyone should carry health insurance. However, I as a libertarian don't feel its the governments role to force anyone to carry health insurance. I think we all sink or swim because we learn to make informed choices for ourselves and those who depend on us.

Originally Posted by inow

Individual mandates are the only way to ensure there is enough money in the risk pool and that people don't game the system. Just like everyone has to ante up in poker to be allowed to take home any cash at the end, so too must everyone ante up in insurance to be allowed to get help with payments when they are needed.

If by mandate you mean give them a positive incentive versus a punitive fine then I'm ok with that. If we qualify for a tax write off/tax credit for carrying a verifiable minimum quality health insurance then I would be more apt to agree with that approach to getting everyone covered.

Originally Posted by inow

Doing this at the state level decreases purchasing power too significantly to be taken seriously. Much like how large corporations can offer much higher quality care for much lower premiums to their employees than can small businesses (due to the vast differences in the number of people making premium payments... small companies have fewer people in the risk pool and hence pay more and get less than large companies), the federal level plan gives us the most leverage toward cost reduction (which is crucial in making this work).

So would allowing small businesses to pool together their employee 'risk pools'. It could also be done for a fraction of the cost of a government option.

Originally Posted by zubbs1

I'm not sure you are correct that our health insurance would be increased when a non-insured individual seeks care at a hospital and cannot afford to pay their bill.

Well, I am sure. That is PRECISELY what happens. Hospitals, to cover the loss, increase their fees on everything else, which increases costs to the insurers, which gets passed on to us through higher premiums.

http://wonkroom.thinkprogress.org/wp...cost_shift.pdf
http://www.familiesusa.org/resources...a-premium.html
http://www.nchc.org/facts/coverage.shtml

Originally Posted by zubbs1

Originally Posted by inow

Doing this at the state level decreases purchasing power too significantly to be taken seriously. Much like how large corporations can offer much higher quality care for much lower premiums to their employees than can small businesses (due to the vast differences in the number of people making premium payments... small companies have fewer people in the risk pool and hence pay more and get less than large companies), the federal level plan gives us the most leverage toward cost reduction (which is crucial in making this work).

So would allowing small businesses to pool together their employee 'risk pools'. It could also be done for a fraction of the cost of a government option.

A fraction of the cost? Let's see some numbers and some citations.

Also, just on it's face the logic you propose fails. You suggest that smaller groups of people can spread the risk pool in the same fashion as significantly larger groups of people. That's false. In essence, the co-ops you suggest are really nothing more than a weaker/watered down public option, and by weakening like this you also lose the benefits gained by the larger pool.

There is nothing preventing those small coops from being big coops, is there?

Originally Posted by inow

Originally Posted by zubbs1

I'm not sure you are correct that our health insurance would be increased when a non-insured individual seeks care at a hospital and cannot afford to pay their bill.

Well, I am sure. That is PRECISELY what happens. Hospitals, to cover the loss, increase their fees on everything else, which increases costs to the insurers, which gets passed on to us through higher premiums.

http://www.familiesusa.org/resources...a-premium.html
hthttp://wonkroom.thinkprogress.org/wp-content/uploads/2009/03/cost_shift.pdf
tp://www.nchc.org/facts/coverage.shtml

Originally Posted by http://www.familiesusa.org/resources/publications/reports/paying-a-premium.html

Through this study, we found that the remaining $43 billion is primarily paid by two sources: Roughly one-third is reimbursed by a number of government programs, and two-thirds is paid through higher premiums for people with health insurance.

So technically we were both right Thank you though for the links. I am still a little confused simply because insurance negotiates (or rather tells) medical providers the reimbursement rates (so I suppose this figure represents that value?).

However, we both are vying for 'coverage' and 'access to coverage' for everyone (which are essentially the same idea even with slightly different approaches).

Originally Posted by inow

Originally Posted by zubbs1

Originally Posted by inow

Doing this at the state level decreases purchasing power too significantly to be taken seriously. Much like how large corporations can offer much higher quality care for much lower premiums to their employees than can small businesses (due to the vast differences in the number of people making premium payments... small companies have fewer people in the risk pool and hence pay more and get less than large companies), the federal level plan gives us the most leverage toward cost reduction (which is crucial in making this work).

So would allowing small businesses to pool together their employee 'risk pools'. It could also be done for a fraction of the cost of a government option.

A fraction of the cost? Let's see some numbers and some citations.

Also, just on it's face the logic you propose fails. You suggest that smaller groups of people can spread the risk pool in the same fashion as significantly larger groups of people. That's false. In essence, the co-ops you suggest are really nothing more than a weaker/watered down public option, and by weakening like this you also lose the benefits gained by the larger pool.

As marcusclayman points out there is no reason why you cannot 'merge' the risk pools of numerous small business (perhaps group by services they provide, i.e. all financial planning services small businesses etc.)
Therefore the logic is sound, and its not a public option, because these pools would still have the ability to comparatively shop for the best rates in a competitive market, not be forced to choose the government insurance due to artificially low rates due to imballanced competititon rules (as I've stated earlier).

Further, I can search for sources, but it follows simple logic that modifying existing regulations to allow company a, b, and c to pool together rather than shop individually while also utilizing the existing market resources and tools already available are going to be much cheaper than enacting new legislation to create new, or expand an existing bureaucracy. How can you argue with that?

Originally Posted by zubbs1

Further, I can search for sources, but it follows simple logic that modifying existing regulations to allow company a, b, and c to pool together rather than shop individually while also utilizing the existing market resources and tools already available are going to be much cheaper than enacting new legislation to create new, or expand an existing bureaucracy. How can you argue with that?

Because, I think you are taking too narrow a view of cost. You appear to be measuring only the cost to the consumer (which, I agree, can be reduced through use of co-ops of a few small businesses, but not nearly as significantly as it will be reduced if you spread the risk pool across the entire nation). Also, my sense is that you are ignoring the other sources of costs... for example, your proposal seems to ignore the required pressures on the system itself which allow for controls and negotiations... controls and negotiations which are strengthened with a larger risk pool and/or government option. That... and the fact that you've not supported your assertions despite my request for citations.

So... in addition to the above, I can "argue with that" because all you have done is repeat your assertion that "new legislation will cost more than a co-op approach" without ever A) defining which costs you are evaluating and including in your conclusion, B) giving an order of magnitude estimate/relative comparison of the cost differences, or C) supplying anything other than your own gut feelings as evidence of your claims.

Logic is nifty, but evidence trumps it. I've shared evidence in support of my position. Now, where's yours?

food stamps can be used to buy vitamin water, but not vitamin supplements

Originally Posted by inow

Originally Posted by zubbs1

Further, I can search for sources, but it follows simple logic that modifying existing regulations to allow company a, b, and c to pool together rather than shop individually while also utilizing the existing market resources and tools already available are going to be much cheaper than enacting new legislation to create new, or expand an existing bureaucracy. How can you argue with that?

Because, I think you are taking too narrow a view of cost. You appear to be measuring only the cost to the consumer (which, I agree, can be reduced through use of co-ops of a few small businesses, but not nearly as significantly as it will be reduced if you spread the risk pool across the entire nation). Also, my sense is that you are ignoring the other sources of costs... for example, your proposal seems to ignore the required pressures on the system itself which allow for controls and negotiations... controls and negotiations which are strengthened with a larger risk pool and/or government option. That... and the fact that you've not supported your assertions despite my request for citations.



Logic is nifty, but evidence trumps it. I've shared evidence in support of my position. Now, where's yours?

AIG buys insurance as 1 entity insuring say 10000 people. My proposed coop of 100 businesses each with 100 employees buys their insurance as 1 entity (if given the authority). They have the same purchasing power across the whole nation (which I assued was evident and Im sorry if you didn't make the same assumption therefore clouding my reasoning).

Originally Posted by inow

for example, your proposal seems to ignore the required pressures on the system itself which allow for controls and negotiations

I assume my above answer addresses this, but could you clarify this in case I'm mistaken on your intended meaning by 'required pressure'.

Originally Posted by inow

So... in addition to the above, I can "argue with that" because all you have done is repeat your assertion that "new legislation will cost more than a co-op approach" without ever A) defining which costs you are evaluating and including in your conclusion, B) giving an order of magnitude estimate/relative comparison of the cost differences, or C) supplying anything other than your own gut feelings as evidence of your claims.

Im not trying to turn this into a pissing match, Im only arguing a premise based on a logical foundation. If it helps I'll retract my definitive and replace it with "I feel absolutely without a doubt 100% certain that a small business coop would be cheaper than a government insurance 'company'"
I'm arguing based on a few premises which, in my opinion give creedence to my assertion.

1 The federal government has an established track record of running defecit systems that go bankrupt without further infusion of cash

Originally Posted by source

http://www.federaltimes.com/index.php?S=3821780

2 It is quite often the case that the federal government underestimates their costs when projecting a budget for legislation (especially as it relates to healthcare).

Originally Posted by Senate Joint Economic Committee

Medicare (hospital insurance). In 1965, as Congress considered legislation to establish a national Medicare program, the House Ways and Means Committee estimated that the hospital insurance portion of the program, Part A, would cost about $9 billion annually by 1990.v Actual Part A spending in 1990 was $67 billion. The actuary who provided the original cost estimates acknowledged in 1994 that, even after conservatively discounting for the unexpectedly high inflation rates of the early ‘70s and other factors, “the actual [Part A] experience was 165% higher than the estimate.”

Medicare (entire program). In 1967, the House Ways and Means Committee predicted that the new Medicare program, launched the previous year, would cost about $12 billion in 1990. Actual Medicare spending in 1990 was $110 billion—off by nearly a factor of 10.

Medicaid DSH program. In 1987, Congress estimated that Medicaid’s disproportionate share hospital (DSH) payments—which states use to provide relief to hospitals that serve especially large numbers of Medicaid and uninsured patients—would cost less than $1 billion in 1992. The actual cost that year was a staggering $17 billion. Among other things, federal lawmakers had failed to detect loopholes in the legislation that enabled states to draw significantly more money from the federal treasury than they would otherwise have been entitled to claim under the program’s traditional 50-50 funding scheme.

Medicare home care benefit. When Congress debated changes to Medicare’s home care benefit in 1988, the projected 1993 cost of the benefit was $4 billion. The actual 1993 cost was more than twice that amount, $10 billion.

Medicare catastrophic coverage benefit. In 1988, Congress added a catastrophic coverage benefit to Medicare, to take effect in 1990. In July 1989, the Congressional Budget Office (CBO) doubled its cost estimate for the program, for the four-year period 1990-1993, from $5.7 billion to $11.8 billion. CBO explained that it had received newer data showing it had significantly under-estimated prescription drug cost growth, and it warned Congress that even this revised estimate might be too low. This was a principal reason Congress repealed the program before it could take effect.

SCHIP. In 1997, Congress established the State Children’s Health Insurance Program as a capped grant program to states, and appropriated $40 billion to be doled out to states over 10 years at a rate of roughly $5 billion per year, once implemented. In each year, some states exceeded their allotments, requiring shifts of funds from other states that had not done so. By 2006, unspent reserves from prior years were nearly exhausted. To avert mass disenrollments, Congress decided to appropriate an additional $283 million in FY 2006 and an additional $650 million in FY 2007.

3 In matters of a competitive nature, the fed has not been able to cost effectively compete with the private market. (see prior links to the use of fedex by usps)

Conclusion
Given that, if the government establishes their insurance company, then this is the projected enrollment trend and the denied claims we will see:

According to AMA’s National Health Insurance Report Card, Medicare denies 6.85 percent of its claims, higher than any private insurer (Aetna was second, denying 6.80 percent of its claims), and more than double any private insurer’s average.

Originally Posted by source

http://blog.heritage.org/2009/10/06/medicare-largest-denier-of-health-care-claims/

Originally Posted by zubbs1

Lastly, the commerce clause I think should be very narrowly interpreted and applied. It is quite easy to bs an argument for the commerce clause to allow access for some ridiculous legislation. In other words, I feel it has become a pick and choose. If you really have an agenda then you could stretch the meaning to apply to your off the wall ideology/legislation.

The massive gutting that the commerce clause suffered under Roosevelt basically weakened it to the point where you don't need a very strong argument anymore. Maybe that should change, but if invoking it to support federally mandated insurance is an abuse , then would be a very tame abuse compared to lots of other stuff that's already happening and nobody complains.

Originally Posted by zubbs1

The root of the problem catalyzing the desire to reform, as I believe it to be, is not the lack of access to health insurance. We have 46 major insurance companies providing health insurance coverage plans. The issue remains the cost of the premiums to the individual. Our argument of wether or not the federal government has the authority to establisha governement run health insurance company is not the real issue I have with the debate. If the cost of premiums are the 'danger' to the american person for which the federal government government is using to hold up their authority to enact a public option, then why are they not addressing this issue?

They want to increase competition to reduce costs. How specifically does the government compete with private markets especially with health insurance? In all other industries, the federal government cannot compete with the private market (the USPS uses FEDEX to deliver mail for them, and has for years: http://www.postalproject.com/documents.asp?d_ID=2487)
It seems the government believes it can rewrite the rules of capitalism. If the government can print money to reinvest in their 'insurance company' (as they have for decades for the postal service, medicare etc.), and private companies have a finite capital to invest and operate their business, then they cannot compete with each other. Further, if the government sets reimbursement rates lower than private insurance can (which they have stated they would since they want to keep the same reimbursement as medicare) then this will happen even faster. Also if the governement makes it less penalizing to shift workers to the government insurance than paying their portion of their employee's premium, then over time the government option will be the monopoly. They have then created an environment where they are exerting dominant authority over the state's rights to provide free market access to health insurance.

Has the post office ever driven delivery prices down to the point where FedEx and UPS can't compete? Why do you think a government health plan would do that to private insurance companies?

A lot of people think that privately owned == competition. It's not always true in the health care industry. As long as your insurance company doesn't put serious restrictions on what hospitals you can visit, there will be zero price competition between those hospitals. You're making the decision, but someone else is paying for it, so you have no reason to care what the price is.

It's also really hard to compare rates in the health insurance industry. I was assigned the task of trying to get rate quotes from competitors once when I worked in the Underwriting (rate setting) department of KaiPerm. It was quite an operation. I had to totally pretend I was a customer, and string their customer service reps along, and pretend I was a legitimate businessman to get anything out of them, then decline when it was time to close the deal. It was seriously a headache.

Originally Posted by zubbs1

AIG buys insurance as 1 entity insuring say 10000 people.

The risk pool for AIG is still smaller than the risk pool of a nation. Even if you co-op several small businesses to have the same purchasing power as AIG, you'll still have less purchasing power than a public option. That's the point.

Originally Posted by zubbs1

Im not trying to turn this into a pissing match, Im only arguing a premise based on a logical foundation.

My apologies for being curt last night. You lost a lot of credibility with me when you suggested that a government option would be unconstitutional, so that really primed me to react the way did. Also, I had been sipping on some scotch, and simultaneously having an argument with a creationist at another site last night. My mood was foul, and I should have checked that before responding to you here. Either way, though, I too am arguing with a logical foundation, and I think I've done a more than adequate job showing your premises to be flawed.

Originally Posted by zubbs1

If it helps I'll retract my definitive and replace it with "I feel absolutely without a doubt 100% certain that a small business coop would be cheaper than a government insurance 'company'"

Fair enough. You just "feel" that the government option will cost more, but have no numbers to back up the assertion. I guess that's the point which rubbed me the wrong way. I really don't find "feelings" to be a very robust argument.

Most of your examples are about past behaviors of the government. That's a legitimate point. Established histories should not be ignored. However, I think the larger point is that we need to focus on one bill at a time. Look at what is being put forth and debated right now... Look at the actual wording... and see if the protections are strong enough. Pointing to past failures is no guarantee that a specific proposal in the future will fail (it provides a higher probability, but you are using that as the basis of your entire argument... it is a weak and speculative premise with no certainty or specificity... you are building castles in the sand, and then charging forward with slippery slope fallacies with that as your foundation).

Originally Posted by zubbs1

3 In matters of a competitive nature, the fed has not been able to cost effectively compete with the private market. (see prior links to the use of fedex by usps)

Originally Posted by kojax

Has the post office ever driven delivery prices down to the point where FedEx and UPS can't compete? Why do you think a government health plan would do that to private insurance companies?

The post office is a false comparison, anyway. The post office isn't supported by taxes, so it's inappropriate to use that as the basis of an argument (I know you were responding to someone else who brought it up, but I felt it was time to correct it since it's been repeated now more than a few times).

The only money the postal service receives from government is payments for things like free mail for the blind, for overseas voting, and also for free mail from congressmen (franking). Essentially, the government is a customer of the postal service.

The post office hasn't received operating appropriations for quite some time (1971, I think), when they stopped being a government department.

Originally Posted by kojax

Originally Posted by zubbs1

Lastly, the commerce clause I think should be very narrowly interpreted and applied. It is quite easy to bs an argument for the commerce clause to allow access for some ridiculous legislation. In other words, I feel it has become a pick and choose. If you really have an agenda then you could stretch the meaning to apply to your off the wall ideology/legislation.

The massive gutting that the commerce clause suffered under Roosevelt basically weakened it to the point where you don't need a very strong argument anymore. Maybe that should change, but if invoking it to support federally mandated insurance is an abuse , then would be a very tame abuse compared to lots of other stuff that's already happening and nobody complains.

Well I'm not on here singing praise I complain, alot! I'm a libertarian and think the government is TOO big and has become so using the argument of commerce clause to justify themselves.

Originally Posted by kojax

Originally Posted by zubbs1

The root of the problem catalyzing the desire to reform, as I believe it to be, is not the lack of access to health insurance. We have 46 major insurance companies providing health insurance coverage plans. The issue remains the cost of the premiums to the individual. Our argument of wether or not the federal government has the authority to establisha governement run health insurance company is not the real issue I have with the debate. If the cost of premiums are the 'danger' to the american person for which the federal government government is using to hold up their authority to enact a public option, then why are they not addressing this issue?

They want to increase competition to reduce costs. How specifically does the government compete with private markets especially with health insurance? In all other industries, the federal government cannot compete with the private market (the USPS uses FEDEX to deliver mail for them, and has for years: http://www.postalproject.com/documents.asp?d_ID=2487)
It seems the government believes it can rewrite the rules of capitalism. If the government can print money to reinvest in their 'insurance company' (as they have for decades for the postal service, medicare etc.), and private companies have a finite capital to invest and operate their business, then they cannot compete with each other. Further, if the government sets reimbursement rates lower than private insurance can (which they have stated they would since they want to keep the same reimbursement as medicare) then this will happen even faster. Also if the governement makes it less penalizing to shift workers to the government insurance than paying their portion of their employee's premium, then over time the government option will be the monopoly. They have then created an environment where they are exerting dominant authority over the state's rights to provide free market access to health insurance.

Has the post office ever driven delivery prices down to the point where FedEx and UPS can't compete? Why do you think a government health plan would do that to private insurance companies?

See my post previous to this. There is a graphical depiction of the portion of insured currently on a public plan, and the number estimated in 2019. Competition is not 'set blatant disregard towards amount of deficit losses in my business and print mone to make up the difference, but rather 'produce a superior product/service and price it more affordable than my competitors'.

Originally Posted by kojax

A lot of people think that privately owned == competition. It's not always true in the health care industry. As long as your insurance company doesn't put serious restrictions on what hospitals you can visit, there will be zero price competition between those hospitals. You're making the decision, but someone else is paying for it, so you have no reason to care what the price is.
It's also really hard to compare rates in the health insurance industry. I was assigned the task of trying to get rate quotes from competitors once when I worked in the Underwriting (rate setting) department of KaiPerm. It was quite an operation. I had to totally pretend I was a customer, and string their customer service reps along, and pretend I was a legitimate businessman to get anything out of them, then decline when it was time to close the deal. It was seriously a headache.

I agree there needs to be transparency in cost.

As F. A. von Hayek said, "the price system [is]… a mechanism for communicating information." When you lack price information and price compe*tition, you also impede one of the critical signals in an efficient market for communicating information about quality and efficiency. As a result, we as con*sumers have no way other than word of mouth and referrals to gauge the quality of health care that we receive and to choose providers—and any statisti*cian will tell you how poor measures anecdotes are. Providers don’t even have the ability to see how their care measures up against competitors in terms of quality.

Originally Posted by inow

Originally Posted by zubbs1

AIG buys insurance as 1 entity insuring say 10000 people.

The risk pool for AIG is still smaller than the risk pool of a nation. Even if you co-op several small businesses to have the same purchasing power as AIG, you'll still have less purchasing power than a public option. That's the point.

I'm not sure that the potential savings for 300 million people in one risk pool would offset the increased hidden fees (in higher taxes to fund it). Also this assumes a premise that the government is the only provider of insurance, thus eliminating all free market health insurance providers.
On principle I obviously feel that the coop is a step forward in providing improvements. However, a state run market exchange where employers don't sponsor coverage, they simply administer the acquisition once purchased. This allows portability to any employmer who belongs to an exchange (which would be most if not all small businesses whom employ >60% of american workers). The federal government has mentioned using a market exchange, I just disagree that they should administer it rather than states. Again becauase I think the power for such should be at the state level and not the federal level.

Originally Posted by inow

Originally Posted by zubbs1

Im not trying to turn this into a pissing match, Im only arguing a premise based on a logical foundation.

My apologies for being curt last night. You lost a lot of credibility with me when you suggested that a government option would be unconstitutional, so that really primed me to react the way did. Also, I had been sipping on some scotch, and simultaneously having an argument with a creationist at another site last night. My mood was foul, and I should have checked that before responding to you here. Either way, though, I too am arguing with a logical foundation, and I think I've done a more than adequate job showing your premises to be flawed.

Originally Posted by zubbs1

If it helps I'll retract my definitive and replace it with "I feel absolutely without a doubt 100% certain that a small business coop would be cheaper than a government insurance 'company'"

Fair enough. You just "feel" that the government option will cost more, but have no numbers to back up the assertion. I guess that's the point which rubbed me the wrong way. I really don't find "feelings" to be a very robust argument.

Most of your examples are about past behaviors of the government. That's a legitimate point. Established histories should not be ignored. However, I think the larger point is that we need to focus on one bill at a time. Look at what is being put forth and debated right now... Look at the actual wording... and see if the protections are strong enough. Pointing to past failures is no guarantee that a specific proposal in the future will fail (it provides a higher probability, but you are using that as the basis of your entire argument... it is a weak and speculative premise with no certainty or specificity... you are building castles in the sand, and then charging forward with slippery slope fallacies with that as your foundation).

Only if the history is showing a pattern of improvement would your argument be valid. If nothing else it is a well agreed upon notion that federal government, by nature of their bureaucracy, does not operate with efficiency because 'greed' for profit while vilanized by so many is the best way to improve efficiency.

Originally Posted by Albert Einstein

Insanity - Doing the same thing over and over and expecting a different outcome

Originally Posted by inow

Originally Posted by zubbs1

3 In matters of a competitive nature, the fed has not been able to cost effectively compete with the private market. (see prior links to the use of fedex by usps)

Originally Posted by kojax

Has the post office ever driven delivery prices down to the point where FedEx and UPS can't compete? Why do you think a government health plan would do that to private insurance companies?

The post office is a false comparison, anyway. The post office isn't supported by taxes, so it's inappropriate to use that as the basis of an argument (I know you were responding to someone else who brought it up, but I felt it was time to correct it since it's been repeated now more than a few times).

The only money the postal service receives from government is payments for things like free mail for the blind, for overseas voting, and also for free mail from congressmen (franking). Essentially, the government is a customer of the postal service.

The post office hasn't received operating appropriations for quite some time (1971, I think), when they stopped being a government department.

Government agency maybe not but surely they are at least a quasi-government agency.

http://www.politico.com/news/stories/0909/27513.html

They did receive funding though to freeze payments to their pension plans. While you could argue this is in the form of a loan to be repaid in 2017, the post office has no record of generating profits (especially when paying the postmaster general an $800k/year salary)


Does nobody on this board besides Inow, Kojax, and I have feelings about this issue????

Originally Posted by zubbs1

the post office has no record of generating profits (especially when paying the postmaster general an $800k/year salary)

Sigh.
Yet another empty assertion, and one that is plainly false. Here... more evidence in support of my challenge:


http://usgovinfo.about.com/b/2008/02...ofit-in-q1.htm

Despite a downturn in mail volume, the perennially cash-strapped U.S. Postal Service managed to post a net profit of $672 million on gross revenue of $20.4 billion during the first quarter of 2008.

The USPS' total revenue of $20.4 billion represented a 3.5 percent increase over the same period last year.

<...>

USPS also reduced its operating expenses for the first quarter to $19.7 billion, down from $22.7 billion for the same period last year.

I apologize, but you continue to trend downward with the credibility of your claims as this thread continues.

inow quotes; However a general post to many comments.

Healthcare is not subject to normal free market principles. Unlike buying a television or a car, we cannot choose when or if we'll need health care services, nor can we choose where those services are provided in cases of emergency. Further, we don't have a problem if someone can't afford a car or tv, but none of us would stand for it (not for one second) if someone wasn't provided health care because they can't afford it.

Nobody I am aware of believes the US system is 100% perfect, or that there may be many things that could be done to decrease cost, allowing service to more, yet maintaining the quality you and millions must be receiving. Simply, it's these ideas or possible remedies to individual problems that are being argued.

Free Market, Capitalism for this issue is the risk taker for something possibly being wrong with an idea. Those that believe in the idea are going to voluntarily invest in the program, while those that do not, will not. Government is the people, in this case forcing that investment and taking the risk is unimaginable to any economist, based on the Governments performance of not only health related issues, but many services where privatizing has been achieved, trash collection to commuter services.

There are laws in place requiring care at ERs, but that care is supremely expensive and results in higher premiums for the rest of us as the insurance companies must absorb those costs. It makes more sense to allow coverage up front, treat the issues early for lower costs (preventative), instead of forcing people to wait until catastrophic (much more expensive) care can no longer wait.

I would argue adding cost to insurance, suggesting the lack of administrative cost, need for unwarranted testing for legal reason and the use of stand by staff, that make up most ER services. ER service is the most efficient and least costly of anything available. I don't believe there are any regularly scheduled Federal grants to 'For Profit' Hospitals or Clinics, but many States do offer some assistance. Non profits or religious Hospitals, may receive some grants through the Federal 'Faith Based Programs' or through Congressional Appropriations Action (attachments) but many Hospitals or Clinics have filed chapter 7 or 11, over the years, illegal aliens usually getting the blame.

Insurance is required, because people who are sick through no fault of their own should not be forced to go bankrupt.

Everybody dies, most for no fault of their own. Being elderly to being born with heart defects, AID's, or the health problems many of the young, most of the elderly, or all that can happen during a lifetime, regardless of ignorance, neglect or stubbornness are not necessarily that persons fault. They are the cards dealt. Think about all those folks in Africa, all their Health Problems, a life expectancy of 38-40-45 years, the malnutrition or other problems from poor hygiene. I'll take any Americans hand over those folks and am grateful for it.

(I'm a type 1 diabetic, and I'm tired of hearing the ridiculous argument that people should care for their own health and pay for it out of pocket... essentially subjugating me and my family to a life of poverty because of uncontrollable circumstance, instead of agreeing that the smart move is to provide care and allow me to continue contributing to the economy and society).

This argument disturbs me for three basic reasons; 1- You are basing your arguments on a very important issue, FROM a subjective, personal viewpoint, with out regards to the other 307 Million Folks running around this country. 2- It sets a very poor example for the millions of folks, with your condition or many more millions looking life long ailments, many of which are worse and more expensive than your own, to say nothing of what those 50-60 or 70 year olds that may be going through some problem, especially in this economic climate, yet continuing to try to both survive and succeed at something. The only drawback for you to achieve absolutely anything (fame, wealth, even efforts to cure you own medical problem), for yourself and/or your family is YOURSELF and getting rid of that attitude would be good start. Since this is a Science oriented Forum, I feel sure you have heard the name Stephen Hawking and his accomplishments under incredible odds...

And it was then that he was first stricken with amyotrophic lateral sclerosis (Lou Gehrig's disease), a debilitating neuromotor disease that eventually led to his total confinement to a wheelchair and to a virtual loss of his speech functions. At Cambridge his talents were recognized by his major professor, the cosmologist Dennis W. Sciama, and he was encouraged to carry on his studies despite his growing physical disabilities. His marriage in 1965 to Jane Wilde was an important step in his emotional life. Marriage gave him, he recalled, the determination to live and make professional progress in the world of science. Hawking received his doctorate degree in 1966 and began his life-long research and teaching association with Cambridge University.

http://www.answers.com/topic/stephen-hawking

3- And this my pivotal argument; People (all) in life are going to make unwise decisions, that WILL to some degree generate future Health Problem, not indicating your particular case. For at least the past 50 years (probably longer), many of these choices have been made with full knowledge of the potential consequences. Whether from a choice in a profession or job, to peer pressure/acceptance or the many reasons we just knowingly continue some activity until the health problem develops. An analogy, would be the simple current purchase of Auto Insurance, which in order to drive legally, a responsible driver may received a lower rate, verses the high risk drivers will pay the most, according to their personal history. What's setting up is the reverse, where the irresponsible are granted the privilege of good health, literally at the expense of the responsible.

Individual mandates are the only way to ensure there is enough money in the risk pool and that people don't game the system.

Individual mandates, to begin with are not legal, constitutional or the will of the American people, I suspect including yourself, would accept. Would you accept any mandate, that no other person was required, for any reason. Regardless of how implemented (don't think would ever pass Congress), fines to requiring insurance or the denial of anything others receive would never pass a SC test.

Doing this at the state level decreases purchasing power too significantly to be taken seriously. Much like how large corporations can offer much higher quality care for much lower premiums to their employees than can small businesses (due to the vast differences in the number of people making premium payments... small companies have fewer people in the risk pool and hence pay more and get less than large companies), the federal level plan gives us the most leverage toward cost reduction (which is crucial in making this work).

I disagree and would go further down the list from State Level, so long as we're not talking about or have a 'Government Option". There are 12-1300 Insurance Companies today and if you opened to incentive and opportunity for growth, probably a few hundred more would join in, with new ideas. The purchasing power would come from those that survive any bidding system offered. Take this opportunity to localized areas (I've liked Congressional Districts) a bidder in an rural area where cost may be relatively inexpensive or health problems less intrusive and already accepted would be a competitor in an urban area where cost would offset, but leave room for potential profits.

Since this word 'profit' may upset some, keep in mind to a great extent those profits are a backbone (pool) to any company and the private investor of that company. With government control, that pool is the general public through taxation, confiscation or whatever process deemed necessary by the controlling members of that government.

The higher the number of participants in the risk pool, the lower the individual payments to each of us, the higher the level of care, and the more people who can be covered. Medicare is a federal level program, and so too should any public option (let's call it "Medicare for Everyone").

Why not just call it Medicaid (welfare) for everybody, it's no different, at least for the half with greater medical expenses than the other half (fact of life).

From both an economic standpoint and a moral one (25-50 million people without coverage is not acceptable in an advanced civilization such as ours), the federal level public option simply makes the most sense right now (I'm actually for single payer, but that's off the table, so is moot in this discussion)

No it's not "moot" and the intended goal as stated by Obama, Dodd, Franks, many in the current administration. Whatever passes, will be revised, added to, amended or wording re-evaluated to mean things never thought of. In 1300 pages of mumble jumble, any two bit lawyer can twist wording to justify anything wished to advance the intended agenda...

Advanced society, does not relate to Government involvement, in fact it should be the reverse, personal responsibility. Cuba, N Korea, most all Monarchy forms of Government would be the economical giants and moral ones (?).

With out the private sector, which no other Country is like the US in this respect, would likely have 200 million w/o insurance. The US is too large and too diversified and far to complex to even suggest a Universal System, that would give equal medical care to each person....IMO.




kojax quote;

Has the post office ever driven delivery prices down to the point where FedEx and UPS can't compete? Why do you think a government health plan would do that to private insurance companies?

Good Obama example; The USPS, is expected to lose 7B$ by the end of this year and has lost money annually for some time. That's about $24 per person in the US.

http://voices.washingtonpost.com/federal-
eye/2009/08/24_billion_quarterly_loss_for.html

Rather than break down the differences, of the Private Sector verses Government, for both working and the retired, often the retired outnumbering the working, I'll offer the following site. Keep in mind FedEx, has not cost any tax payer one cent, that each community involved, each City/County/State and the Federal Government have been paid billions in Taxes, yet the taxpayer has paid for every dollar of cost (to operate or as a loss) for the operation of the USPS.

http://www.publicpurpose.com/apcxv.htm

Average US Postal Service compensation per employee was nearly $45,000 in 1991 (3) --- 40 percent more than the average private employee. Yet, it would be expected that Postal employees would be paid less private employees, since the Postal Service has a lower percentage of supervisory, technical or professional employees than the private sector. (4)

An interesting side note on FedEx; Fred Smith the founder and current CEO, was at one point a USPS employee. He suggested the single point distribution system, to the Postal Service, who simple dismissed. In turn he started what has become the single largest package delivery system in the world and in fact IS USED BY THE USPS, today.


zubbs1; With over 1300 views in a short period, there appears to be a great deal of interest. For starters you and inow are new here and making good arguments on a political issue, which is a reasonably new catigory on this forum.

Jackson - Stephen Hawking can contribute back to society PRECISELY because hle lives in England where he has access to universal government run healthcare, so that was a rather poor example to use.

Your concerns about me using personal experience to reinforce my points are irrelevant. My sharing of that information was not the basis of my position. It simply shows how this "pull yourself up by the bootstraps" argument is deeply flawed... the idea that people should pay out of pocket and "live better" to be healthy. I live quite well, but there is no cure for juvenile diabetes. If you know of one, please share it. Until then, my arguments stand. I should not be forced to go bankrupt and divert all of my earnings toward survival when a simple change to the system could cover my care and allow me to invest my earnings elsewhere in the economy... You know, just like they do it in any other advanced civilization.

Further, you seem to suffer from the same poor logic as most others who argue against healthcare reform. On the one hand, you claim that the government can't do anything right... that they fail at everything they do. Then, in the very next breath, you claim that they are going to force the private insurers out of business, that everybody will flock toward government coverage, and this will put insurers out of business. That makes zero sense. Either the government cannot handle healthcare and private insurers will be fine, or they will do a wonderful job and the need for private insurers will decrease in parallel. Pick one. You can't play it both ways.

As for the free market drum you keep beating, that's precisely what's led to the current sorry state with the skyrocketing premiums we're all facing... premiums which keep doubling every 10 years. Yes, they make profits, and you know how they do this? They do it like any other company... by increasing revenues and decreasing costs. Do you know what that means?

Higher premiums = higher revenues.
Denial/Rescission of coverage = lower costs.
They also waste 20-30% of every dollar they earn on administrative overhead... as a general rule, by paying people to find ways to deny more claims.

That's all a recipe for failure with healthcare. We're not talking about selling ice cream or prada shoes here. We're talking about caring for our populace in the manner which makes the most sense. We pay twice as much as any other nation (both per capita and as a percentage of GDP), and we don't even offer universal care. How you can argue in a manner which would continue that trend really boggles the mind.


Finally, you really need to read the whole thread before commenting. You've merely repeated the same tired arguments (such as with the post office) which have already been debunked. More rebuttals to the post office argument here:

http://usgovinfo.about.com/od/consum.../uspsabout.htm

Until adoption of the Postal Reorganization Act of 1970, the U.S. Postal Service functioned as a regular, tax-supported, agency of the federal government.

According to the laws under which it now operates, the U.S. Postal Service is a semi-independent federal agency, mandated to be revenue-neutral. That is, it is supposed to break even, not make a profit.

In 1982, U.S. postage stamps became "postal products," rather than a form of taxation. Since then, The bulk of the cost of operating the postal system has been paid for by customers through the sale of "postal products" and services rather than taxes.

<...>

The US Postal Service has averaged a profit of over $1 billion per year in each of the last five years.

Same with this "unconstitutional" canard of yours which keeps rearing its nonsensical head:

Originally Posted by jackson33

Individual mandates are the only way to ensure there is enough money in the risk pool and that people don't game the system.

Individual mandates, to begin with are not legal, constitutional or the will of the American people, I suspect including yourself, would accept.

I will say this again. You guys REALLY need to familiarize yourself with Article 1 of our constitution and stop repeating these stupid and false arguments you hear on Fox news. I'm just so damned tired of hearing arguments which are so obviously fallacious, grounded in false premises, and have no basis in reality. Oddly, they seem to keep coming primarily from those who oppose reform.

"Does nobody on this board besides Inow, Kojax, and I have feelings about this issue????"

I do! I have some thoughts as well, but I've already shared them, and don't know enough about things to participate in you guys' discussion.


The only thing I am very passionate about is how many people I know who live such unhealthy lives, eating piles of BS for food and doing S for physical activity. Why should I have to pay for that?

Originally Posted by inow

Originally Posted by zubbs1

the post office has no record of generating profits (especially when paying the postmaster general an $800k/year salary)

Sigh.
Yet another empty assertion, and one that is plainly false. Here... more evidence in support of my challenge:


http://usgovinfo.about.com/b/2008/02...ofit-in-q1.htm

Despite a downturn in mail volume, the perennially cash-strapped U.S. Postal Service managed to post a net profit of $672 million on gross revenue of $20.4 billion during the first quarter of 2008.

The USPS' total revenue of $20.4 billion represented a 3.5 percent increase over the same period last year.

<...>

USPS also reduced its operating expenses for the first quarter to $19.7 billion, down from $22.7 billion for the same period last year.

I apologize, but you continue to trend downward with the credibility of your claims as this thread continues.

I have no accounting degree or any formal business education, and even I can see that if you cannot pay for your pension plans, then you have NOT made a profit. I stand by my claim, and insist that you are trying to belittle my point with false logic. A profit is not a profit if you choose to disregard all expenses.

Further a quasi-governmental agency business is not successful if it needs the federal government to 'bail' it out by loaning it money for which it would not be able to secure any form of loan in the private market. Basically their 'credit score' would be in the 400s (for sake of argument, don't claim I didn't support that with a citation) and insufficient to get a standard business loan.

PAGE 9-10

We have reported that the Service faces growing challenges from competition, notably from private delivery companies and electronic communications
alternatives such as the Internet. The Service projects that such competition will lead to substantial declines in the Service’s First-Class Mail volume in the next decade. We have also reported that should this occur, the Service will likely face unprecedented challenges as it seeks to fulfill its primary mission of providing universal postal service at reasonable rates while remaining self supporting from postal revenues.

My claims are credible, I just apparently am to blame for 'thinking for myself with the facts available' instead of relying on someone else to print the same conclusions I come to. I'm not saying you do this, I'm just arguing that reasoning can occur based on the same knowledge base between myself or a so called 'expert'.

Originally Posted by marcusclayman

The only thing I am very passionate about is how many people I know who live such unhealthy lives, eating piles of BS for food and doing S for physical activity. Why should I have to pay for that?

Well, you might be able to receive incentives and breaks for maintaining a healthy lifestyle. In short, instead of paying for them to be unhealthy, you could ultimately pay less than they do because you yourself take steps to remain healthy.

Here's a story on exactly that point from the day before yesterday:

http://www.msnbc.msn.com/id/33336289...ashington_post

Originally Posted by zubbs1

I have no accounting degree or any formal business education, and even I can see that if you cannot pay for your pension plans, then you have NOT made a profit. I stand by my claim, and insist that you are trying to belittle my point with false logic. A profit is not a profit if you choose to disregard all expenses.

Evidence of this claim please? As cited in my response to Jackson33, the USPS has averaged a profit of over $1 billion per year in each of the last five years.

Actually... you know... never mind. My whole point was to show that the USPS is not a valid comparison to a government option in healthcare since the USPS hasn't been funded by tax payer dollars since the early 1970s. I think we should just consider our respective points made and move on.

Originally Posted by zubbs1

My claims are credible

Not the ones I've shown to be false (eg. public option is unconstitutional, USPS is funded by tax dollars, public option will cost more than small co-ops, smaller risk pools net the same savings as nation-wide risk pools, USPS has never turned a profit, etc.).

Originally Posted by zubbs1

I just apparently am to blame for 'thinking for myself with the facts available' instead of relying on someone else to print the same conclusions I come to.

Listen. You made some assertions with were flawed and/or false. I corrected you on the ones I was educated enough to understand. This has nothing to do with thinking for ourselves, and EVERYTHING to do with ensuring our arguments are aligned with reality.

Does nobody on this board besides Inow, Kojax, and I have feelings about this issue????

Oh yes, but iNow is doing such a splendid job there's no need to butt in. Good work iNow.

A coop CAN be cheaper than a government thing, but this is not the same as saying a coop will be cheaper than a government run program.

Originally Posted by inow

Further, you seem to suffer from the same poor logic as most others who argue against healthcare reform. On the one hand, you claim that the government can't do anything right... that they fail at everything they do. Then, in the very next breath, you claim that they are going to force the private insurers out of business, that everybody will flock toward government coverage, and this will put insurers out of business. That makes zero sense. Either the government cannot handle healthcare and private insurers will be fine, or they will do a wonderful job and the need for private insurers will decrease in parallel. Pick one. You can't play it both ways.

It really comes down to a simple question: If the government can print money and keep themselves operating on a deficit (as I've pointed out many government initiatives do) and a private organization has a finite level of capital, then are they really competing with one another? If you think they are, then I'm sorry but you just don't understand capitalism. Further, every deficit requires a greater burden on the taxpayer and future taxpayers. Therefore, would you potentially not be doing more harm over the long term than the harm you intend to mitigate?

Originally Posted by inow

As for the free market drum you keep beating, that's precisely what's led to the current sorry state with the skyrocketing premiums we're all facing... premiums which keep doubling every 10 years. Yes, they make profits, and you know how they do this? They do it like any other company... by increasing revenues and decreasing costs. Do you know what that means?

Higher premiums = higher revenues.
Denial/Rescission of coverage = lower costs.
They also waste 20-30% of every dollar they earn on administrative overhead... as a general rule, by paying people to find ways to deny more claims.

Actually it was the federal government under FDR that caused health insurance premiums to skyrocket by instituting a system that would only favor the disconnect we now see from the provider of insurance (the employer) and the user of the benefits (the employee) such that dollars used on health treatment are not seen by policy holder; basically the cost transparency argument.

http://voices.washingtonpost.com/ezr...inners_th.html

1)Sever tax exemption for 'health insurance benefits' freeing up capital for businesses to grow business and increase wages for employees.
2)Allow individual access to purchase insurance from market exchange that is portable to any job they work at the belongs to the exchange.
3)Maximize tax protection for Health Savings Accounts so that you eliminate copayment type low deductable insurance (meaning you will use your money to pay for routine non 'break the bank' type care and have health insurance for the truly wallet busting things (heart attacks, ICU visits, cancer treatment etc.)

Originally Posted by inow

That's all a recipe for failure with healthcare. We're not talking about selling ice cream or prada shoes here. We're talking about caring for our populace in the manner which makes the most sense. We pay twice as much as any other nation (both per capita and as a percentage of GDP), and we don't even offer universal care. How you can argue in a manner which would continue that trend really boggles the mind.

We pay more not because we don't have universal coverage, but because we allowed the fed to dictate bad rules for how health insurance companies could gain access to the purchasers of policies. All we anti government run insurance are saying is if we can show an established record for why the government getting involved in things mucks them up, then why should anyone believe they can do better now (when a similar type system in medicare has not done well)? Would you give a crack addict $400 dollars because he says he will do better with that money than he has with other money under his care?

Frankly pleading to humanitarian sides is getting old. We ALL want the same thing. We ALL feel terrible that people suffer and that people get sick. We ALL want people to have confidence that they will be cared for if something horrible happens to them. We are simply wishing for whatever comes out of reform to make sense; meaning getting the most bang for our tax dollar and help the greatest amount of people while also inflicting the least amount of harm to others. There is simply a fundamental schism in the logic for how the liberal and conservative thinks this goal can be achieved. I'm a former liberal that changed once I simply started examining the logic of the argument and not letting my emotion guide my opinion. I'm not pointing fingers, simply sharing how I came to the discovery.

Originally Posted by inow

Originally Posted by zubbs1

I have no accounting degree or any formal business education, and even I can see that if you cannot pay for your pension plans, then you have NOT made a profit. I stand by my claim, and insist that you are trying to belittle my point with false logic. A profit is not a profit if you choose to disregard all expenses.

Evidence of this claim please? As cited in my response to Jackson33, the USPS has averaged a profit of over $1 billion per year in each of the last five years.

Actually... you know... never mind. My whole point was to show that the USPS is not a valid comparison to a government option in healthcare since the USPS hasn't been funded by tax payer dollars since the early 1970s. I think we should just consider our respective points made and move on.

1) If you hide the fact that you have to pay billions of dollars to prepay your pensions from your accountants and they claim a profit was made then that is not really a profit (I DID provide a source that discussed the post office being bailed out by a loan from TAXPAYER funds passed by congress recently)
2)I cannot move on when you fail to acknowledge my actual point, which was that the government CANNOT actually compete with private markets because they have DIFFERENT rules. If you want to drop the issue of weather tax dollars have been spent on the post office, then fine, but at least concede that they were not operating a profit, neutral spending or whatever since they had to use the loan to keep solvent this year.

Originally Posted by inow

Originally Posted by zubbs1

My claims are credible

Not the ones I've shown to be false (eg. public option is unconstitutional[1], USPS is funded by tax dollars[2], public option will cost more than small co-ops[3], smaller risk pools net the same savings as nation-wide risk pools[4], USPS has never turned a profit, etc.).

1)Technically we haven't finished visiting the Article 1 discussion since it progressed towards other issues
2)The USPS is ongoing(yes they stop being funded directly by tax dollars in 1971, going for a quasi business model where the stamp represented a mailing currency and not a direct tax payment which ultimately created an unsustainable agency of the Federal Government that DOES require tax payer funding)
3)You conceded that the government DOES underestimate costs, and that costs go overboard due to bureaucracy and that they cannot run things well yet you did not acknowledge that this would have any bearing on them running a health insurance plan (I'm pretty sure that is not you showing me to be false) You basically are saying 'yes it has always s*cked, but this time will be better, and why should anyone feel the same way?
4)I stated in a private market that a coop of small businesses could achieve the same risk pool size as a large coorporation such as AIG. I also indicated that the coops WOULD be nation wide. You are the one who equated nation wide to be exclusive to government public option.
5) Yes I technically said profit, and made the terrible error in debate of stating an absolute. Shame on me. I would rather we had focused on the substance of the debate and not the nitpicking of an 'absolute statement' (although I too would probably have gone after that one had I reread it or seen an absolute made by another).
Perhaps you interpret it as showing me to be false, but I contest 1-4 above (but not 5).

Originally Posted by inow

Originally Posted by zubbs1

I just apparently am to blame for 'thinking for myself with the facts available' instead of relying on someone else to print the same conclusions I come to.

Listen. You made some assertions with were flawed and/or false. I corrected you on the ones I was educated enough to understand. This has nothing to do with thinking for ourselves, and EVERYTHING to do with ensuring our arguments are aligned with reality.

See above. I stand by 1-4. Especially with regard to number 3. Since I feel I have made my case based at least on deductive reasoning, an you've have at least implied me to be false, then what evidence do you have that a public option would be cheaper than allowing coops to create purchasing pools?

Originally Posted by Bunbury

Does nobody on this board besides Inow, Kojax, and I have feelings about this issue????

Oh yes, but iNow is doing such a splendid job there's no need to butt in. Good work iNow.

Ok, I'm just use to forum debates encompassing more than one on one. (In my best Garth typed voice) Game on man

Originally Posted by Bunbury

Good work iNow.

Thanks for the kind words, Bunbury. It's appreciated.

Zubbs1,

The free market can't cure healthcare. I'm sorry. This is a fundamental obstacle in our finding common ground with one another (you think it can, I know better, and a good handful of the nations top economists definitely seem to agree with me).


Why markets can't cure healthcare

A significant number of Americans believe that the answer to our health care problems — indeed, the only answer — is to rely on the free market. Quite a few seem to believe that this view reflects the lessons of economic theory.

Not so. One of the most influential economic papers of the postwar era was Kenneth Arrow’s Uncertainty and the welfare economics of health care, which demonstrated — decisively, I and many others believe — that health care can’t be marketed like bread or TVs. Let me offer my own version of Arrow’s argument.

There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.

This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.

This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.

The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.

You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.

Between those two factors, health care just doesn’t work as a standard market story.

All of this doesn’t necessarily mean that socialized medicine, or even single-payer, is the only way to go. There are a number of successful health-care systems, at least as measured by pretty good care much cheaper than here, and they are quite different from each other. There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence.

(emphasis mine)

Here's another interesting take.


A Free-Market Case for the Public Option

Free-market conservatives and libertarians have made the case that sweeping health care reform, especially the inclusion of a government-run health insurance option, would undermine the free-market for health insurance. They rightly say that, without a free market, there are little or no incentives for promoting innovation or efficiency. The great thing about our system is that the more companies compete for our business, the more they must produce a better product at lower cost, and so on. But this is a fallacy because the health insurance industry is not a free market right now.

Something like televisions exist in a free market because consumers, if they don't like any of the new TVs on the market, can simply keep their old one. If they really don't like the market, they can even forgo owning one altogether; it will make you unpopular on game day, but it won't risk your life. Insurance is different. Anyone with a sense of basic self-preservation has no choice but to buy health insurance every single month. You cannot opt out, there are few options to choose from, and it's difficult to know how to price your future risk of injury. So health insurance companies have distorted incentives to innovate or provide a more cost-effective product.

A public option would, crazy as it might sound, make health insurance a free market. If there exists a government-run plan, which by all accounts would be basic and geared towards affordability, consumers will have the ability to opt out of the private insurance market. Private providers would finally have real incentives to provide a better product and innovate by building an insurance plan stronger than public insurance. Fears that a public option might decree certain treatments "not cost-effective," which are not as outlandish as some liberals think, should delight free-market conservatives because it would be an opportunity for private insurers to step in. Worried you might develop a condition requiring $60,000 medication that no public option would ever include? Buy a blinged-out private plan that, for an increased premium, will.

And here, too:

http://www.guardian.co.uk/commentisf...re-republicans

Back in the good old days, the conservatives were the folks who favoured individual choice. Not any more. In the current healthcare debate, the top priority of the so-called conservatives is to deny people choice. They want to make sure that Americans do not have the option to buy into a Medicare-type public healthcare plan. These alleged conservatives have come up with a variety of arguments against allowing people the Medicare-type option, but the only one that makes sense is that they work for the insurance industry.

The argument against a Medicare-type option always begins with the assertion that the government can't do anything. This is a peculiar claim given the popularity of Medicare, but it also makes no sense as an argument against giving people a buy-in option. Suppose the government gives people the option to buy into its really bad plan. Everyone would just stick with the good private plans we have now, right?

The so-called conservatives then tell us that people will end up buying into the bad Medicare-type plan instead of the good private insurance options because the government will subsidise the Medicare-type plan. A little bit of arithmetic is sufficient to dismiss this argument.

How much money would be needed to get people to choose a bad healthcare plan rather than a good one? This would have to involve some serious subsidies. People are not going to sacrifice their health and the health of their families for another cup of coffee at Starbucks.

Suppose it took a subsidy of $1,000 a year to get people to choose the bad Medicare-type plan over the good private sector plans. With a non-Medicare population of more than 250 million, this would imply government subsidies of more than $250bn a year, if the Medicare-type plan was to fully replace private sector plans, as the so-called conservatives warn.

Is it really plausible that Congress will approve $250bn a year in subsidies ($2.5tn over a 10-year budget window) for a Medicare-type plan that everyone thinks is awful? Is there another altogether wasteful programmes that gets public subsidies even one-tenth of this size?

This one just doesn't pass the laugh test. If conservative politicians don't think they can prevent such an enormous waste of taxpayer dollars being perpetuated year after year for the indefinite future, they should probably consider another line of work.

In short, there is no genuine conservative argument against allowing people the option of buying into a Medicare-type plan. If the plan proves to be inferior to private insurance plans, as is often argued, then the consequences will be relatively minor. Some number of people who choose to sign up with this plan will find that they don't like it, and then will switch to a better alternative. In time, a bad public plan will soon flounder, since few people will buy into it. There may be some effort to provide subsidies to even a bad public plan, but it is not plausible that the subsidies could be large enough to displace private plans.

Originally Posted by zubbs1

Originally Posted by kojax

Has the post office ever driven delivery prices down to the point where FedEx and UPS can't compete? Why do you think a government health plan would do that to private insurance companies?

See my post previous to this. There is a graphical depiction of the portion of insured currently on a public plan, and the number estimated in 2019. Competition is not 'set blatant disregard towards amount of deficit losses in my business and print mone to make up the difference, but rather 'produce a superior product/service and price it more affordable than my competitors'.

This is true, but sometimes even unfair competition serves the purpose of forcing everyone else to do better.

Originally Posted by kojax

A lot of people think that privately owned == competition. It's not always true in the health care industry. As long as your insurance company doesn't put serious restrictions on what hospitals you can visit, there will be zero price competition between those hospitals. You're making the decision, but someone else is paying for it, so you have no reason to care what the price is.
It's also really hard to compare rates in the health insurance industry. I was assigned the task of trying to get rate quotes from competitors once when I worked in the Underwriting (rate setting) department of KaiPerm. It was quite an operation. I had to totally pretend I was a customer, and string their customer service reps along, and pretend I was a legitimate businessman to get anything out of them, then decline when it was time to close the deal. It was seriously a headache.

I agree there needs to be transparency in cost.

As F. A. von Hayek said, "the price system [is]… a mechanism for communicating information." When you lack price information and price compe*tition, you also impede one of the critical signals in an efficient market for communicating information about quality and efficiency. As a result, we as con*sumers have no way other than word of mouth and referrals to gauge the quality of health care that we receive and to choose providers—and any statisti*cian will tell you how poor measures anecdotes are. Providers don’t even have the ability to see how their care measures up against competitors in terms of quality.

Transparency in cost would be really nice. A lot of things would be nice. What's frustrating to me on this thread is that people keep comparing the current health care bill against ideal alternatives, which are unlikely to be brought before congress any time soon.

If, instead of measuring it against our pie in the sky dreams, we compare the bill against the current healthcare system we have right now, this very second, it would be a step up. In the current system, there is no transparency, but if the government decided to subcontract insurance services to private companies, it would probably do so by bidding out different risk groups. They would, for example, go around to different companies and ask: "What price can you offer us to cover the male, age 55-60 group, with (such and such list of) coverage options?" Whoever bid the lowest would get the contract.

That's the way it would most likely play out. I highly doubt the government is going to try and reinvent the wheel, or set up its own massive infrastructure, rather than just utilize what's there already.

Originally Posted by jackson33

Insurance is required, because people who are sick through no fault of their own should not be forced to go bankrupt.

Everybody dies, most for no fault of their own. Being elderly to being born with heart defects, AID's, or the health problems many of the young, most of the elderly, or all that can happen during a lifetime, regardless of ignorance, neglect or stubbornness are not necessarily that persons fault. They are the cards dealt. Think about all those folks in Africa, all their Health Problems, a life expectancy of 38-40-45 years, the malnutrition or other problems from poor hygiene. I'll take any Americans hand over those folks and am grateful for it.

It's not a question of people dying. It's a question of them living in slavery. A healthcare issue is just a like a gun to your head. You either solve it, or you die.

The free market falls apart when people have no choice but to buy something. They stop acting like ideal consumers.

3- And this my pivotal argument; People (all) in life are going to make unwise decisions, that WILL to some degree generate future Health Problem, not indicating your particular case. For at least the past 50 years (probably longer), many of these choices have been made with full knowledge of the potential consequences. Whether from a choice in a profession or job, to peer pressure/acceptance or the many reasons we just knowingly continue some activity until the health problem develops. An analogy, would be the simple current purchase of Auto Insurance, which in order to drive legally, a responsible driver may received a lower rate, verses the high risk drivers will pay the most, according to their personal history. What's setting up is the reverse, where the irresponsible are granted the privilege of good health, literally at the expense of the responsible.

Again, if we're comparing the health care bill against the current state of health care, instead of an imaginary ideal state, this argument fails. At least in my home state, the only information an employer submits about their employees is their age and gender. Is that supposed to create an incentive to never get old?

In health care matters, behavior is usually too subjective to measure, and there's often no way to prevent a person from lying. For example: you could give them a discount for keeping a gym membership, but you can't confirm whether they're using it. And, no insurance company anywhere is going to pour over your grocery shopping receipts to see if you're buying healthy food. It's not like auto insurance, where the state keeps a driving record.

Any time you don't have access to information, competition is a fallacy. That's why the free market will never be able to create a good health care system. The conditions for that to occur are impossible to meet.

kojax quote;

Has the post office ever driven delivery prices down to the point where FedEx and UPS can't compete? Why do you think a government health plan would do that to private insurance companies?

Good Obama example; The USPS, is expected to lose 7B$ by the end of this year and has lost money annually for some time. That's about $24 per person in the US.

http://voices.washingtonpost.com/federal-
eye/2009/08/24_billion_quarterly_loss_for.html

I wasn't suggesting that the Post Office runs at a profit, not at all. I was merely pointing out that it is not a danger to its private competitors. UPS and FedEx are not worried they are going to get driven out of business.

Why do you think a government health plan would drive private companies out of business then?

An interesting side note on FedEx; Fred Smith the founder and current CEO, was at one point a USPS employee. He suggested the single point distribution system, to the Postal Service, who simple dismissed. In turn he started what has become the single largest package delivery system in the world and in fact IS USED BY THE USPS, today.

And you don't think this is how government health care would play out? As I mentioned above, the gov is usually willing to subcontract to anybody who can do their job better than they can.

Call it what you will, but I must bow out of this debate. I feel overwhelmed being the only one vying the anti big government hoopla. It really does come down to core principles. Either you beleive in the free market, or you don't. If you don't feel the current system is a free market (which I agree it has strayed from but I would argue it has done so at the whim of governement regulations as I pointed out with the post WWII FDR regulations on not taxing benefits while capping salaries) then the solution as I believe is to strengthen it towards that end. If people know where their dollars go to cover their health care costs, then they become stronger at demanding quality and affordability, and less likely to 'waste' money on unnecessary medical costs due to only seeing it as spending $20 for a copay.

I don't know that the argument we are having matters, since it seems pretty evident that Nancy Pelosi and Harry Reid are going to do what they think they know to be right for everyone despite the objections from the majority of the public. The threat of the nuclear option (being pushing the bill through with a simple majority and not a 60% vote) scares the begeezes out of me, but there is little that can be done. The normal pressures that keep our politicians in check are not sufficient now sense they don't seem to care for their reelection.

Call it pragmatism or whatever you want, but in a crippled economy with >10% (I tend to count those who gave up on searching and those who took part time work as 'unemployed') unemployment with deficits of many trillions of dollars projected for the next decade, spending a guaranteed (underbudgeted) >1 Trillion on a health care reform seems like at least bad judgment and neglectful if not outright criminal. That alone seems reason enough to take simple direct steps to curbing costs that don't cost an increase in taxes on the majority of people. I can only cross my fingers and hope that common sense wins out and we don't go through with such a huge expenditure. On the other hand there is a part of me that says to go forward with whatever big government big spending they want so that we 'hit rock bottom' so to speak and a real reform of our federal government happens (i.e. term limits, reformed tax code, long term shrinkage of federal spending and size etc.) However these are all issues, I suppose for another argument.

As is the case with many forum debates, nobody changes anyone's views, as most of the debates are not fact searching, but dogmatic. Inow - I hear your views, and I shared many of them even 4 years ago. I just cannot believe that bigger government is the answer. I am compelled to continue to feel that individuals without unnecessary limitations can make well informed decisions for themselves and their dependents. If there were a proven option that doesn't cost a ridiculously large financial burden on the public, while still keeping innovation and quality high then I'd be willing to investigate it. However that isn't found with any of the other models out there. The facts are still that medical research, techniques, device technology, and skill are best represented in the American medical field, and not in a UK, France, Germany, Canada, or any other socialized health care system. We continue to have the highest survivability of cancers in the US, and I don't feel that we could maintain these if penalties are placed on the very companies that generate the innovation. Again, this is perhaps a core difference in how we view the free market and the governments role in providing some level of oversight.

You can respond if you'd like, but I cannot guarantee I'll be able to counter. I've found my obsession with this topic to be distracting me from my more important goals of getting into a program in Anesthesiology so that I can go be involved more directly in our broken medical system.

Sorry the volleys could not go on for longer.

"It really does come down to core principles. Either you beleive in the free market, or you don't."

There are many advocates of the free market who relly on evidence, not beliefs. In fact most libertarians I've ever met were more intelligent in their debates than other conservatives. Principles are one thing, but lack of support is another. There is evidence to support your agument if you took a minute to look for it, not only would you be able to debate it better, but you will have a better understanding of why your principles have been developed by intelligent scholars of the past.

kojax;

I wasn't suggesting that the Post Office runs at a profit, not at all. I was merely pointing out that it is not a danger to its private competitors. UPS and FedEx are not worried they are going to get driven out of business.

Why do you think a government health plan would drive private companies out of business then?

If the US Government, decided to run the entire package/delivery service in the US for some material reason, THEY COULD take control overnight. Offering everything either UPS or FedEx at half the price. Frankly, this would be as acceptable as the Medical System to probably more of the people. Health Care, unlike Postal (could imply packages) service was not authorized in the Constitution, implied or intended by the founders or more important the Capitalist system, this country has perfected, generational acceptance so to speak.

Since I don't want to see 'Article One' mentioned again, the Constitution allows for the promoting of the general welfare which most certainly did not mean PROVIDING, which was the message in "PROVIDE" for the common defense".

Article One, Section 8 - Powers of Congress
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

Welfare Defined
welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD
Welfare in today's context also means organized efforts on the part of public or private organizations to benefit the poor, or simply public assistance. This is not the meaning of the word as used in the Constitution.

http://www.usconstitution.net/const.html
http://www.usconstitution.net/glossary.html#WELFARE

Once again, my concerns are for both quality and quantity of all that's involved for servicing 307 million people, not the 32M in Canada, 50M in the UK or 21M in Australia. Aside from the authority (which is being totally ignored) or the intent of those behind this movement, the past and no doubt future movement (Government Controlled Single Payer) the idea that a Federal Government can do more, be more efficient or that they can or will cut cost are IMO all pure, unadulterated nonsense. Basically if left to the private sector (competitive forces), including all current Federal Programs the TRUE future problem, those 50 States and all the various elements of Health Care would work thing out. There would be problems, some of the components will fail, but unlike when the last resort for success is the Federal Government, others will pick up the slack, make things work, all during the time prices w/o that Federal component will come down and those same competitive prices will encourage the entire basic system that got the US to the point it is today.

And you don't think this is how government health care would play out? As I mentioned above, the gov is usually willing to subcontract to anybody who can do their job better than they can.

That was not the purpose in mentioning Mr. Smith case, but yes it is a good example of how the mind of an entrepreneur works. He was working in the system, understood it and had a good idea, which was rejected. I could have mention Sam Walton, founder of Wal Mart, who was working for a Dime Store, think Kresge's, advised his bosses that he felt that the Dime Store would work in small towns as well, they refused to even listen to a proposal saying "only in Big Towns". He just quit and you know the rest. There are solutions out there to most any problem, but limiting the usable ideas or the actual decisions to a hand full of political elected folks, is not going to achieve results.

zubbs1 quote;

As is the case with many forum debates, nobody changes anyone's views, as most of the debates are not fact searching, but dogmatic. Inow - I hear your views, and I shared many of them even 4 years ago. I just cannot believe that bigger government is the answer. I am compelled to continue to feel that individuals without unnecessary limitations can make well informed decisions for themselves and their dependents. If there were a proven option that doesn't cost a ridiculously large financial burden on the public, while still keeping innovation and quality high then I'd be willing to investigate it.

No person taking the time or making the effort to post a view or opinion, is going to have his/her mind changed. What's digested may in time be instrumental in a change of mind, apparently as you have had, but the people that read the post, some never registering and truly looking for answers may be convinced. Your just getting started in you life, what going on will mean a great deal to you many years from now and your family. The "ridiculously large financial burden", if correct (I believe it is) could go well beyond even living in a Country, you have seen some of, studied or been told of, by your elders. As I just relayed to kojax, much nearer your age than mine and as impotent to him is IMO teetering on the edge of understanding of the consequences to him, if he is wrong and is promoting the wrong program.

marcusclayman; Sincerely, I hope you are correct, that it involves core principles, or not core wishes/desires based on greed, politics or the individual. One example of what I'm saying is the ideological divide on most any issue. That is other than the issue is the driving force behind backing, voting or discussing an issue.

Either you believe in the free market, or you don't.

Since most people are reasonably happy, with the status quo, would you say that whatever actually got this country to the point it is, is at least worthy of discussion of maintaining?

Originally Posted by zubbs1

I don't know that the argument we are having matters, since it seems pretty evident that Nancy Pelosi and Harry Reid are going to do what they think they know to be right for everyone despite the objections from the majority of the public.

Sorry. Wrong yet again.

http://www.surveyusa.com/client/Poll...8-62b9d1ba8693

That study by SurveyUSA puts support for a public option at a robust 77 percent, one percentage point higher than where it stood in June.

Or here, it shows 55% still supporting a public option: http://www.washingtonpost.com/wp-dyn...091302962.html


And, according to this poll from just last week, 61% support the public option: http://www.quinnipiac.edu/x1284.xml?...ea=;&strTime=0

No matter how you slice it, there is no "majority" objecting to the public option.

Originally Posted by zubbs1

Call it pragmatism or whatever you want, but in a crippled economy with >10% (I tend to count those who gave up on searching and those who took part time work as 'unemployed') unemployment with deficits of many trillions of dollars projected for the next decade, spending a guaranteed (underbudgeted) >1 Trillion on a health care reform seems like at least bad judgment and neglectful if not outright criminal. That alone seems reason enough to take simple direct steps to curbing costs that don't cost an increase in taxes on the majority of people.

You can call it pragmatic. I call it demonstrative of a deep misunderstanding of economics, and a deep disconnect from the reality of the situation.


http://blog.newsweek.com/blogs/thega...re-reform.aspx

The CBO estimates that Baucus’s bill will actually reduce the deficit by $81 billion over 10 years, and will cost about $829 billion over that period.

<...>

According to CBO analysts, the insurance co-ops—Baucus’s much-ballyhooed alternative to a public plan—will have a negligible impact. The letter to Baucus states that they “seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments.”

Originally Posted by zubbs1

Inow - I hear your views, and I shared many of them even 4 years ago. I just cannot believe that bigger government is the answer. I am compelled to continue to feel that individuals without unnecessary limitations can make well informed decisions for themselves and their dependents.

The primary challenge I have with your focus on the free market approach, zubbs, is this. Normal free market principles and assumptions simply don’t work in the field of healthcare, nor in the selection of coverage. Those assumptions which fail are these:

• Assuming consumers know what products and services they’ll need
• Assuming consumers know anything about the products and services they buy
• Assuming that consumers have a choice
• Assuming that private insurers have a motivation to provide good services
• Assuming that lowering costs will result in higher consumption
• Assuming that parties have bargaining power

There is simply no way, given the arguments I've put forth in this thread, that anyone can realistically argue that the solution to healthcare access, cost and quality problems is to put healthcare in the hands of the free market. It's just silly on its face, and it's important that people... despite preconceptions or ideology... have enough integrity to admit this. There are just way too many ways which the inherent nature of healthcare guarantees that normal market principles and assumptions don’t work.

When you take that in combination with all of the other false/flawed premises on which the "OMG! Big government is always bad... always!" crowd keep using, the conclusion is clear. Not only should we offer a public option for both economic and moral reasons,, but we should ultimately go even farther and move toward universal care for the whole nation.

Originally Posted by jackson33

Since I don't want to see 'Article One' mentioned again, the Constitution allows for the promoting of the general welfare which most certainly did not mean PROVIDING, which was the message in "PROVIDE" for the common defense".

Article One, Section 8 - Powers of Congress
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

Welfare Defined
welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD
Welfare in today's context also means organized efforts on the part of public or private organizations to benefit the poor, or simply public assistance. This is not the meaning of the word as used in the Constitution.

http://www.usconstitution.net/const.html
http://www.usconstitution.net/glossary.html#WELFARE

For your argument to be consistent, you would have to think that Medicare, Social Security, federal education funding, Medicaid, and veterans benefits such as the VA health system and the GI Bill are ALSO unconstitutional. However, they are not.

You know... at least not according to the Supreme Court of the United States, whose express mandate it is to rule on constitutionality of laws and programs. Here are two quick examples:


http://en.wikipedia.org/wiki/Helvering_v._Davis

Helvering v. Davis, 301 U.S. 619 (1937), was a decision by the United States Supreme Court, which held that Social Security was not a contributory insurance program. The Court defended the constitutionality of the Social Security Act of 1935, requiring only that welfare spending be for the common benefit as distinguished from some mere local purpose. It affirmed a District Court decree that held that the tax upon employees was not properly at issue, and that the tax upon employers was constitutional.

http://en.wikipedia.org/wiki/Flemming_v._Nestor

Flemming v. Nestor, 363 U.S. 603 (1960), is a Supreme Court Case in which the Court upheld the Constitutionality of Section 1104 of the 1935 Social Security Act. In this Section, Congress reserved to itself the power to amend and revise the schedule of benefits.
<...>
Under Due Process Clause analysis, government action is valid unless it is patently arbitrary and utterly lacking in rational justification.

Originally Posted by jackson33

Since most people are reasonably happy, with the status quo, would you say that whatever actually got this country to the point it is, is at least worthy of discussion of maintaining?

This assertion is flatly contrary to the actual data. Again, can we at least ensure our arguments are aligned with reality? People are NOT happy with the status quo. It's difficult to take you seriously when you continue to present such blatant untruths.



http://www.pbs.org/nbr/blog/2009/10/...tatus_quo.html

The opposition claims Americans are happy with the health care system, and since it "ain't broke" it needn't be fixed. For them, the status quo is the only way to go. Frankly I think many of these opponents are really just against government in general, this government in particular or, more commonly, in favor of government when it bails out big business but opposed when it seeks to provide a safety net for the working class.

Be that as it may, I think their premise is fundamentally flawed.

<...>

The big tracking polls conducted by organizations without a stake in the outcome does not say Americans are happy with the health care system, it says they are happy with their doctors, which is quite different. In fact, we are not happy with the cost of our insurance, we are not happy with the co-pays, deductibles and other costs of medical services, we are not happy with the cost of the drugs we buy. And, if we have insurance, we also have horror stories about the bureaucratic mess we face every time we deal with our insurance company.

<...>

The problem with the status quo is that there really is no such thing. We can elect not to change our health care system, but the status quo will change anyway. According to the Kaiser Family Foundation's most recent report, "Spending on health care, which is a projected to be 17.6% of the U.S. gross domestic product (GDP) in 2009, has consistently grown faster than the economy overall since the 1960s." I urge you to read this short brief, it is frightening.

With the House of Representatives insisting on a public alternative to private insurance and the Senate just as adamantly headed toward a bill without that option, if it can pass anything at all, the prospects do not seem encouraging. Up to this point the naysayers have been making most of the noise. It's way past time for the people in favor of reform to sound off for their side.

Originally Posted by jackson33

kojax;

I wasn't suggesting that the Post Office runs at a profit, not at all. I was merely pointing out that it is not a danger to its private competitors. UPS and FedEx are not worried they are going to get driven out of business.

Why do you think a government health plan would drive private companies out of business then?

If the US Government, decided to run the entire package/delivery service in the US for some material reason, THEY COULD take control overnight. Offering everything either UPS or FedEx at half the price. Frankly, this would be as acceptable as the Medical System to probably more of the people. Health Care, unlike Postal (could imply packages) service was not authorized in the Constitution, implied or intended by the founders or more important the Capitalist system, this country has perfected, generational acceptance so to speak.

But, you understand my point, right? Historically the government driving private businesses under is not what has happened in the past, so there's no solid basis to believe it's what will happen in the future.

It *could* happen, but it probably won't.

zubbs1 quote;

As is the case with many forum debates, nobody changes anyone's views, as most of the debates are not fact searching, but dogmatic. Inow - I hear your views, and I shared many of them even 4 years ago. I just cannot believe that bigger government is the answer. I am compelled to continue to feel that individuals without unnecessary limitations can make well informed decisions for themselves and their dependents. If there were a proven option that doesn't cost a ridiculously large financial burden on the public, while still keeping innovation and quality high then I'd be willing to investigate it.

No person taking the time or making the effort to post a view or opinion, is going to have his/her mind changed. What's digested may in time be instrumental in a change of mind, apparently as you have had, but the people that read the post, some never registering and truly looking for answers may be convinced. Your just getting started in you life, what going on will mean a great deal to you many years from now and your family. The "ridiculously large financial burden", if correct (I believe it is) could go well beyond even living in a Country, you have seen some of, studied or been told of, by your elders. As I just relayed to kojax, much nearer your age than mine and as impotent to him is IMO teetering on the edge of understanding of the consequences to him, if he is wrong and is promoting the wrong program.

You usually don't get people to do a 180 on their views, but you still influence them. I've changed my mind about a lot of things on this forum, but most of the time I just refine my views from what people say.

I hope other people have the same experience.

Originally Posted by zubbs1

I don't know that the argument we are having matters, since it seems pretty evident that Nancy Pelosi and Harry Reid are going to do what they think they know to be right for everyone despite the objections from the majority of the public. The threat of the nuclear option (being pushing the bill through with a simple majority and not a 60% vote) scares the begeezes out of me, but there is little that can be done. The normal pressures that keep our politicians in check are not sufficient now sense they don't seem to care for their reelection.

The core of the matter is that this is a bad economy, and people are scared. Nobody wants to lose their good credit score to medical bills they simply can't pay. It's the one financial problem that nobody can plan for. The only workable plan is "be a millionaire", or have plenty of insurance, but a lot insurance companies these days won't say in the fine print whether this or that medical condition is going to exceed your coverage.

And... when people can't plan their finances, capitalism fails. I believe that other areas of our economy will perform better if this one area is modified to make it a little bit less uncertain for people, and that's really what motivates me. I'm not committed to any one economic ideology except "do whatever makes us prosper".

Originally Posted by Harold14370

Originally Posted by kojax

The possibility that an uninsured human being, living in a state that does not mandate health insurance might get sick, and then decide to move into a state that does mandate health insurance for everyone, to get access to the free insurance, might be reason enough to invoke the interstate commerce clause. What else would stop one state's uninsured sick people from overwhelming their neighbors' health insurance system?

It's not really interstate commerce per se, and the state could have residency requirements.

I was reexamining this, and actually a more airtight argument for the commerce clause is the possibility that, if a patient has a condition that none of the in-state specialists are able to solve efficiently, that a specialist from out of state might be brought in, or the patient might be shipped to the specialist's facility. Either way, we would be dealing with business arrangements that cross state lines.

So, if the bill uses the commerce clause as it's justification, then an insurance company could claim exemption by rigorously keeping all of its health care services in state. But, then what happens if you're insured with this company, and you get injured while you're traveling in another state? Would they still pay for your hospitalization?

kojax quotes;

But, you understand my point, right?

Yes, I understood your assumptions. I used the package analogy to simplify the discussion. If I used the USPS, it would get complicated with facts and figures that are simply not available. As an off budget entity and under Executive Control (with Congressional oversight) most Federal expenditures are via other departments, through Congressional appropriations for the operation of the Executive Branch, with some Congressional Subsidy, not to mention the minor obligation of retired workers from the USPS, which falls under 'Federal Employee' rules, including and fully subsidized by the Congress. If that sounds convoluted, both SS and Medicare (payroll taxes) are off budget items, the incomes from employee/employers (near 20% of wages to different point), goes into the the General Funds. These figures then being used for formulating budgets. Here any figures you might see for future cost are based on assumptions of both incomes and expenses, which are likely indeterminable.

Historically the government driving private businesses under is not what has happened in the past, so there's no solid basis to believe it's what will happen in the future.

Lets reverse this and say Government can't compete with the private sector and the real point of many today. Government is already obligated (meaning people have paid the requested dues taxes) SS/Medicare for 74 and 44 years, with the original ideas and added benefits guaranteed through the years for trillions of dollars, some suggesting up to Trillion$ (that's nearly twice the world's annual GDP last year) for those living under the programs today or working under and have the required 40 quarters (10 years) for eligibility. In fairness these obligation include, unemployment/disability payment (also funded through employers) and partially paid for by States.

Based on your comment; I am not going to take the idea of pure socialism as the end agenda. However many Governments have driven private business under, taken over or driven from their country. You have no idea how many products, you buy today that are manufactured outside the US or those produced in the US are for Companies (private or publicly owned) that are based and owned outside the US.

You usually don't get people to do a 180 on their views, but you still influence them. I've changed my mind about a lot of things on this forum, but most of the time I just refine my views from what people say.

Many poster, including myself, have a personal agenda in bothering to post. On science issues, even at my age it remains searching for answers, exploring my own ideas or some means of keeping up with new theory etc... In Law, History, it's more the teacher in me trying to help others understand whatever it is I think is correct and in politics it really is the desire to influence as many as I can to the traditional conservative values, I feel gave my parents, their parents and myself the life I was allowed. A recent dismissal of 'picking yourself up and moving on', is one such example. All my grandparents, living through WWI, the Great Depression and many through WWII, picked themselves up so many times, I doubt I could have ever had lived up to their examples, but did so to lessor degrees and personally I believe every person in this Country, has the opportunity to do no less and hope that environment can be maintained.

inow quote;

For your argument to be consistent, you would have to think that Medicare, Social Security, federal education funding, Medicaid, and veterans benefits such as the VA health system and the GI Bill are ALSO unconstitutional. However, they are not.

Briefly; SS/Medicare were funded by those that receive/received the benefits and the most the benefits your mentioning are rewards for serving their grateful country.

Medicare, War on Poverty or welfare in general, in my mind is are STATE issues, not Federal responsibilities. To emphasize what I think of National anything or when a definitive figure is mandated to all States or localities; I am on SS and come very close to living comfortably on my 1200.00 per month today, but having traveled 49 States many times, done business in most and lived in many, I know the folks in most places can't even afford decent housing for 1200.00 per month. I have not, but my neighbors can visit a doctor, get diagnosed, medication and advice for about 50-75.00, where in many places you can't take a cab to the doctors office for that.

On the 1937 judgment; The taxing and equal distribution to those involved, under the meaning of welfare in 1788, would have been the same. Welfare as known today, that taxing (however derived) and redistribution to benefit one portion of the society would not be constitutional, IMO in 1937 or 1788.

In the 1960 judgment "Under Due Process Clause analysis, government action is valid unless it is patently arbitrary and utterly lacking in rational justification", says the same as I just said on the 1937 case. Said another way, the attachments to FDR's 1935/7 programs in 1965-7 and the arbitrary programs for eligibility qualification were unconstitutional for lacking rational justification, FOR THE FEDERAL GOVERNMENT.

This assertion is flatly contrary to the actual data. Again, can we at least ensure our arguments are aligned with reality? People are NOT happy with the status quo. It's difficult to take you seriously when you continue to present such blatant untruths.

As I have said, maybe 100 times, NO BODY believes the US Health Care System is 100% perfect in all ways, which I could say the same for any people of any Country with UHC. While many have differing ideas on just what's wrong or needs to be fixed, they are currently satisfied to the point of keeping the Federal Government out of it.

Having said that, you have again taken a comment out of context. "Either you believe in the free market, or you don't" made by 'marcusclayman' was the context of my remark and I believe correct. We all have some issues we don't agree with or dislike, but for the most part are satisfied with Free Market Princilples....I'd say Wal Mart, with the most competitors of any retailer, yet the overwhelming choice of the people for shopping, yet growing in sales in todays down economy, is a very good example.

The primary challenge I have with your focus on the free market approach, zubbs, is this. Normal free market principles and assumptions simply don’t work in the field of healthcare, nor in the selection of coverage. Those assumptions which fail are these:

In defense of zubbs, while he is out checking out schooling; Free market principles worked just fine (he believes until FDR's programs set in) IMO until Johnson's deep intrusion into the Medical system with Medicare/Medicaid, later CHIP's and all the revisions/additions by Congress since. In depicting American's as a bunch of dummies, stumbling around not understanding health care or having the ability to dialog with a doctor, I'll suggest some politician, setting in Washington or the State Capital has a whole lot LESS understanding.

Please think of what you said;

There is simply no way, given the arguments I've put forth in this thread, that anyone can realistically argue that the solution to healthcare access, cost and quality problems is to put healthcare in the hands of the free market.

You are saying is to put these issues in the hands of a Federal Government, over the Free Market, knowing the track records of both. Government has extracted trillions of dollars from a Free Market society, is 100% dependent on that system for it's very survival, has no means or ever could to be self sufficient.

It's just silly on its face, and it's important that people... despite preconceptions or ideology... have enough integrity to admit this. There are just way too many ways which the inherent nature of healthcare guarantees that normal market principles and assumptions don’t work.

Continuing from my last paragraph; The people control the free market, they are free to buy any product anyplace available and at any price they wish to pay. Any portion of the HC system, is subject to that approval by and of the people is it primary concern. You might think or even believe it's greed driven, but factually with out results and/or the payment of service under their contract, THEY COULD NOT EXIST. On the other hand, each Federal Government (each 2 years), makes all kind of promises, enacts all kind of legislation, actually does very little during their tenure, is sooner or later voted out, taking their retirement package and moves on.

Do you just not read what others write? You've just brought up like ten concepts that have already been debunked (for instance, which assumptions are required for a free market to operate yet which are not satisfied with healthcare). Power in the states? Look to the commerce clause. This satisfies it, both before and after FDR. People DO want government involved. I even cited references.

Your entire argument (besides just being false premises and flawed logic) is "government equals bad." Sure, there are examples to support such a notion, but it's hardly some absolute truth.

If you want to convince others of your position, try using consistent logic, valid premises, and keep it all based in reality. Right now, you are arguing ideals which simply don't apply. You may as well be arguing that we fix healthcare by punching leprechauns.

My comment about you guys not dealing with reality is simple. We are NOT a free market. We are a mixed market... a hybrid economy... and, for good reason. History has repeatedly shown us that either free market or socialism on their own lead to failures. However, when properly synthesized into a hybrid of both, we maximize benefit and everybody does better overall. Our world is rather gray, not black and white.

I have laid out in numerous ways WHY free markets won't work in this situation, and have cited multiple references which all have a confluence on this point. I have laid out WHY larger risk pools with national healthcare reduce costs more than smaller plans or co-ops, including providing estimates from the CBO in support of my points. I have laid out WHY these programs are constitutional and how this is supported by the fact the the programs remain despite consistent challenges at the supreme court level. In sum, I've argued my points on the merits, and using facts and logic which is actually connected with reality.

All you've done is repeat the same thing over and over, despite the fact that the assertions you are making have been debunked. Repetition of an invalid point does not suddenly make it valid. Not only are we not a free market economy, but the assumptions for a free market to operate are not satisfied in healthcare systems (you know, that and you are wrong about the public feelings on the matter about being happy with what they've got, and your narrow/selective reading of the constitution which makes you think this stuff is unconstitutional despite multiple SCOTUS rulings to the contrary).

You were wrong when you argued at another site that the founding fathers intended for this to be a christian nation based on christian values.
You were wrong when you argued that global warming was a big conspiracy.
You were wrong when you argued that homosexuals should not be allowed to marry.
You were wrong when you argued that Obama was a secret marxist communist socialist nazi muslim, and you're now wrong about the healthcare debate.

I think we're done here.

All you've done is repeat the same thing over and over, despite the fact that the assertions you are making have been debunked. Repetition of an invalid point does not suddenly make it valid. Not only are we not a free market economy, but the assumptions for a free market to operate are not satisfied in healthcare systems (you know, that and you are wrong about the public feelings on the matter about being happy with what they've got, and your narrow/selective reading of the constitution which makes you think this stuff is unconstitutional despite multiple SCOTUS rulings to the contrary).

inow; The majority of my post are in response to others. If your going to repeat the same opinions, over and over and I choose to respond, of course it going to be repetitious. Since even your current post seems to be a repeat from paragraph to paragraph, telling us how you have debunked all opposing viewpoints, I'll respond to the last two...

As a society we operate under the Capitalist, Free Market System as do the laws of all States and the Federal Government. The Health Care System practiced in near total until 1965, IS a product of those principles, based on supply/demand, the public acceptance of needs and used as a tool for employers to gain or maintain the best workers for there purpose. Repeating, SS was not always mandatory and we have three Texas Counties that went Private Sector in the 1981.

A specific example of smaller local units of government choosing to opt out of Social Security to design their own pension plans occurred in 1981, when Congress still allowed government units to make that choice. The three Texas gulf coast counties of Brazoria, Galveston, and Matagorda selected a private investment firm to manage their employees’ retirement plans with a guaranteed annual return of 6.5 percent.

By 1996 the results were in, and county employees’ retirement benefits were triple what would have been paid by Social Security for a worker who earned $20,000 per year and over five times the Social Security benefits for a worker whose pay was $50,000 (see Chart 4, next page). Congress closed the local government opt-out window in 1983 with major Social Security reform legislation that raised taxes and effectively reduced benefits by raising the eligible retirement age after 2015. (See Chart 4.)

http://www.mackinac.org/article.aspx?ID=1487

A later article; http://www.ncpa.org/pub/ba514

Your argument has been in large numbers, mine in small numbers even below the States. Under the above tested example, in 1998 recipients received $2740 to $6843 per month opposed to the $775 to $1302 per month by SS. I believe if allowed the same would work for HC. There are many example today on Health Insurance, where the private sector working with business or States, have been successful. In Florida today, according to Jebb Bush, where some insurance can be had for 24.00 per month ranging on up to the person or family desired level of coverage. Each program proposed would eliminate those and many other programs, under minimum coverage.

Now for your sobering methods for debate/discussing;

You were wrong when you argued at another site that the founding fathers intended for this to be a Christian nation based on christian values.

No sir, on many forums, I have argued the Founders/Framers and the society of the day WERE primarily Christan, forming the secular Constitution, to INSURE government could not mandate the practice of any one religion.

You were wrong when you argued that global warming was a big conspiracy.

Yes, just as I argued Global Cooling, Over Population, Peak Oil, in the 1950's to the 70's. There always seems to be nut cases out there, searching for grant money, trying to establish personal creditability, play to human emotions or just come up for a reason to get elected, HOWEVER my arguments have generally been along a line of exaggerations, over emphasizing minor problems.

You were wrong when you argued that homosexuals should not be allowed to marry.

In the most recent case, NO; I do not believe a reasonably minority of society, Gay/Lesbians/Transvestite or Crossdressers wishing to achieve equal STATUS, to the religious folks who IMO own the word 'Marriage'. I do not oppose anything, any two people, or for that matter 3-4-10 wish to call their preferred lifestyle or where the limits of State LAW should be placed. Keep the Federal out of this...

You were wrong when you argued that Obama was a secret marxist communist socialist nazi muslim,

Sorry, but any way you address this, that's a lie, or you have mixed my comments with some one else, but for the most part I have never heard these things on any public forum. I do have very serious problems with Obama, his Administration, there apparent objectives/agenda (UHC One) and I do believe he is a rambling empty suite, if you consider his policy, with his Constitutional Law Degree and the History prerequisite. Now, if you want to discuss his personal associations over the years, members of the administration or some of those so called czars, I could get pretty nasty...

On Obama himself, I have a rather long track record here;

US 2008 Election (111 post, 11,800 views, if your ever read this zubbs1)

http://www.thescienceforum.com/viewt...=123579#123579

You are welcome at any point to back up your accusations, by posting quotes, from other forums (think I've posted on 15 over 6 years). Think this permission fits with this forums rules. As in my first post, since returning and directed toward you, I noted the larger membership here, not from the US, however toward the week end, I'll introduce a thread or two on your above subject matter.

"As a society we operate under the Capitalist, Free Market System as do the laws of all States and the Federal Government." -Jackson

Yeah, those other, non capitalist, non free market system, societies, with their social security, federal subsidies and bailouts... oh wait a second

:?

Originally Posted by jackson33

kojax quotes;

Lets reverse this and say Government can't compete with the private sector and the real point of many today. Government is already obligated (meaning people have paid the requested dues taxes) SS/Medicare for 74 and 44 years, with the original ideas and added benefits guaranteed through the years for trillions of dollars, some suggesting up to Trillion$ (that's nearly twice the world's annual GDP last year) for those living under the programs today or working under and have the required 40 quarters (10 years) for eligibility. In fairness these obligation include, unemployment/disability payment (also funded through employers) and partially paid for by States.

Based on your comment; I am not going to take the idea of pure socialism as the end agenda. However many Governments have driven private business under, taken over or driven from their country. You have no idea how many products, you buy today that are manufactured outside the US or those produced in the US are for Companies (private or publicly owned) that are based and owned outside the US.

Actually, I've been talking with my father some more about this, and he's pointed out a way that the government could/may very easily drive private insurance under. With Medicare, the government mandates prices on care that are often lower than cost for the majority of hospitals. The way they manage to stay afloat is by price gouging everyone else (non-medicare insurance companies) for the same services.

A government health insurance plan might be tempted to do this as well, and then they would kill all the others off, and in the end, they'd end having to raise prices back up to the normal level in order to keep hospitals from going out of business and/or medical students from choosing not to become doctors and/or both, but the whole private sector will have been decimated.

It's sad that this would happen, because there are so many ways government could run the show better than its being run, but they probably won't run it any of those better ways.

Originally Posted by inow

For your argument to be consistent, you would have to think that Medicare, Social Security, federal education funding, Medicaid, and veterans benefits such as the VA health system and the GI Bill are ALSO unconstitutional. However, they are not.

Briefly; SS/Medicare were funded by those that receive/received the benefits and the most the benefits your mentioning are rewards for serving their grateful country.

GI bill/VA Health.. etc can be excluded from this because it's a job related benefit. No health insurance company in their right mind would insure a soldier, so they kind of have to get that benefit from their job.

Medicare, War on Poverty or welfare in general, in my mind is are STATE issues, not Federal responsibilities. To emphasize what I think of National anything or when a definitive figure is mandated to all States or localities; I am on SS and come very close to living comfortably on my 1200.00 per month today, but having traveled 49 States many times, done business in most and lived in many, I know the folks in most places can't even afford decent housing for 1200.00 per month. I have not, but my neighbors can visit a doctor, get diagnosed, medication and advice for about 50-75.00, where in many places you can't take a cab to the doctors office for that.

Yeah, but think of the havoc if you lose your job half way through the process and then have to move to another state to find employment. It's very uncommon that you would ever change countries for a job. (Not impossible, but certainly uncommon).

As I have said, maybe 100 times, NO BODY believes the US Health Care System is 100% perfect in all ways, which I could say the same for any people of any Country with UHC. While many have differing ideas on just what's wrong or needs to be fixed, they are currently satisfied to the point of keeping the Federal Government out of it.

And... Nobody believes that socialized/government health care would be 100% perfect in all ways.

Probably a lot of people are getting unsatisfied right now because they're not sure the insurance they're getting through their job is going to be there tomorrow. Indeed, they're not even sure the job will be there. Worrying about your childrens' health is a horrible state of affairs. Maybe people are just tired of leaving that up to chance.

In this economy, you cannot assume that everyone who doesn't have a job is lazy. That would be both unfair, and totally inaccurate.

kojax quotes;

Actually, I've been talking with my father some more about this, and he's pointed out a way that the government could/may very easily drive private insurance under. With Medicare, the government mandates prices on care that are often lower than cost for the majority of hospitals. The way they manage to stay afloat is by price gouging everyone else (non-Medicare insurance companies) for the same services.

One of the points in my discussing this issue, is the complexity of the proposed 'Bill' or 'Bills', working there way through Congress. In just the 1300 pages (some are saying we will have 3,000 pages of pure double talk) there is NOTHING that the could somehow be said part of or not part of the intent. We do know that the main players, want a single payer, government controlled system in all respects. When and if, whatever is being discussed takes effect in 2013, it will likely not look anything like what we're being told today.

Your Dad of course is correct, in that today Government sets prices, which IMO are higher than than the Hospitals would ask of insurance companies or the 'for pay' patients, however with these established limits, every one normally will be charged the higher price. Insurance Companies then in order to compete are already influenced (hurt) by having to add cost to their policy holders. Since the agenda is the Government Option, somehow forcing as many into accepting, prices will not come down anytime soon, possibly increasing (costing tax payer in some way) while more and more turn to the Government Option, which has no incentive to decrease overall cost or keep their premiums in line with cost.

A government health insurance plan might be tempted to do this as well, and then they would kill all the others off, and in the end, they'd end having to raise prices back up to the normal level in order to keep hospitals from going out of business and/or medical students from choosing not to become doctors and/or both, but the whole private sector will have been decimated.

Government is not interested in the single policy holder, rather adding Labor Unions or business under 'Group Policy', which would automatically turn to the Government Option and already include mostly insured workers. Those individuals not insured and healthy for years will pay whatever fine (unconstitutional) or along with the current folks with pre-existing problems will join when problems do come up. I can't guess what the end results may be, other than total failure in the Medical System. Think you know a couple State Plans failed (Hawaii the most notable) thrown in the towel, causing all kinds of problems, but if the Federal did this, having destroyed the private sectors involvment, the results could be castistophic.........IMO.

It's sad that this would happen, because there are so many ways government could run the show better than its being run, but they probably won't run it any of those better ways.

kojax, in what way can any entity, that changes every two years run anything better than where lives are spent trying to run any private sector project? Remember my belief lies in the States or even smaller segments of society with in the State. If something takes hold, other segments or States will follow. Two movements that have been successful and do lower cost, does increase availability of personnel are the 'Tort Reforms being adopted by more and more States and State involvement with insurance Companies to increase those covered.

Four years after Texas voters approved a constitutional amendment limiting awards in medical malpractice lawsuits, doctors are responding as supporters predicted, arriving from all parts of the country to swell the ranks of specialists at Texas hospitals and bring professional health care to some long-underserved rural areas.

http://www.tortreform.com/node/433/print

I don't think people understand how much Medical Cost is built into the system to protect ALL the medical folks from suits. The over bloated trial decisions awarding extremely large awards for mistakes, is only part of the problem. This includes Hospitals, Clinics down to even a receptionist who might say something he/she shouldn't have...

Originally Posted by jackson33

While many have differing ideas on just what's wrong or needs to be fixed, they are currently satisfied to the point of keeping the Federal Government out of it.

Nope. Yet another baseless assertion contradicted by reality. In case you missed my previous response, here it is again:

Originally Posted by inow

Originally Posted by zubbs1

I don't know that the argument we are having matters, since it seems pretty evident that Nancy Pelosi and Harry Reid are going to do what they think they know to be right for everyone despite the objections from the majority of the public.

Sorry. Wrong yet again.

http://www.surveyusa.com/client/Poll...8-62b9d1ba8693

That study by SurveyUSA puts support for a public option at a robust 77 percent, one percentage point higher than where it stood in June.

Or here, it shows 55% still supporting a public option: http://www.washingtonpost.com/wp-dyn...091302962.html


And, according to this poll from just last week, 61% support the public option: http://www.quinnipiac.edu/x1284.xml?...ea=;&strTime=0

No matter how you slice it, there is no "majority" objecting to the public option.

Also, here's more recent data from just three days ago. 60% favor the public option while only 33% oppose.
http://www.dailykos.com/statepoll/2009/10/22/US/404

Here's another from last week showing support at 62% and opposition at 31%.
http://www.cbsnews.com/blogs/2009/10...y5401123.shtml


Or, hey look... Yet another one from just last week which ALSO shows a high 57% support for the public option, and less than 40% opposition.
http://www.washingtonpost.com/wp-dyn...902451_pf.html


I say again... Can we all at the very least try to ensure our arguments and premises are accurate and reality-based?

Your quote which I shared above, Jackson33, is DIRECTLY and REPEATEDLY contradicted by the facts, and from practically EVERY source. You do know, right, that merely repeating a lie over and over again won't suddenly make it true?

jackson33 wrote:

While many have differing ideas on just what's wrong or needs to be fixed, they are currently satisfied to the point of keeping the Federal Government out of it.

inow reply;

Nope. Yet another baseless assertion contradicted by reality. In case you missed my previous response, here it is again:

There is nothing baseless in my comment, nor is it an assertion. On your suggested sites, here are a few to counter. As it would seem, my entire life has been spent trying to explain, confirmation of personal opinions are easy to find.

Gallup has unintentionally revealed how they, and other polling organizations, have been pushing the public to accept Obamacare.

The revelation came in a report late last month which revealed that a significant majority of Americans believes that individuals themselves, and not the government, should be responsible for ensuring they have health insurance. According to Gallup, 61% of folks they surveyed believe that health insurance should be left to the individual, not the nanny state. Unsurprisingly, 89% of Republicans held that view, but so did 64% of independents. Only Democrats, at 62%, wanted Big Brother to shoulder the responsibility.

http://www.americanthinker.com/2009/..._to_accep.html

Poll after poll shows that a huge majority of Americans don’t want the government messing with their health care. Sure, few of us are totally satisfied, but we still don’t want government screwing up a system that works, no matter how imperfectly.

http://www.delmarvadealings.com/2009...-on-obamacare/

PRINCETON, NJ -- Americans are broadly satisfied with the quality of their own medical care and healthcare costs, but of the two, satisfaction with costs lags. Overall, 80% are satisfied with the quality of medical care available to them, including 39% who are very satisfied. Sixty-one percent are satisfied with the cost of their medical care, including 20% who are very satisfied.

http://www.gallup.com/poll/123149/co...americans.aspx

Your quote which I shared above, Jackson33, is DIRECTLY and REPEATEDLY contradicted by the facts, and from practically EVERY source. You do know, right, that merely repeating a lie over and over again won't suddenly make it true?

inow; You really should ask that question, of yourself. As for repeating, I'm not aware of mentioning the American Attitudes at all or offering poll results. My concerns for Health Care in the US, fall along cost, quality and availability to those that WANT insurance to obtain, which I FEEL are already being limited by Federal Government intrusion into State Rights or the apparent push to destroy the private sector. IMO, the Federal can not possibly create a HC System, for 50 separate States, with totally different needs, incomes and wishes/desire, to each other.

Analogy, though used before; On SS, I receive 1200.00 per month. Where I live, I can sustain a pretty good life style on that figure alone, if needed to. However in Austin Texas, NYC, or LA, that would not cover a home or rent expenses. You can't equalize/socialize a Society of 307 Million people, with out destroying it. It you could the European Union, with 500 million and 27 States would have the best HC system on the planet, rather than 27 different plans, many of which are failing.

I took issue with your assertion that the majority of citizens in the US want to keep government out of healthcare. That claim is contradicted by reality. I really don't know how much more clear I can be on this point.

Originally Posted by inow

I took issue with your assertion that the majority of citizens in the US want to keep government out of healthcare. That claim is contradicted by reality. I really don't know how much more clear I can be on this point.

From what I can tell, it's mostly the older people on medicare who want the government not to go granting free health care to the young people. That would be consistent with the republicans' constituency.

Originally Posted by jackson33

Your Dad of course is correct, in that today Government sets prices, which IMO are higher than than the Hospitals would ask of insurance companies or the 'for pay' patients, however with these established limits, every one normally will be charged the higher price. Insurance Companies then in order to compete are already influenced (hurt) by having to add cost to their policy holders. Since the agenda is the Government Option, somehow forcing as many into accepting, prices will not come down anytime soon, possibly increasing (costing tax payer in some way) while more and more turn to the Government Option, which has no incentive to decrease overall cost or keep their premiums in line with cost.

I don't disagree, but I think you're getting this backward. Medicare mandates a low cost. The hospital is forced by law to bill medicare for a smaller amount than their actual costs. Then they turn around and bill private customers for the same services, at a higher rate, in order to make up for it.

In other words: Medicare causes the same effect as non-paying clients cause. The hospital has to make up its losses by gouging all the rest of us. It's possible that a nationwide health care plan might do the same thing in order to save taxpayer money, but it will end up costing all the private customers more, and eventually kill them off. (Their insurance companies, anyway.)

inow; If your generalizing, people are satisfied with their current healthcare, in the US. Whether it be Medicare/Medicaid, private sector insurance either employer based or individual, the figures are around 60% on most all polls. If your asking cost, coverage, choice, service or any specific item, those figures are going to get distorted with subjective opinions, ranging the gamet in both lows and highs.

Pre-existing conditions a very good example; Everyone wants HC service available to every person, until it becomes an additional cost to themselves. Everyone wants the elderly in their family to get the same medical service the very wealthiest in America can get, but when it comes to another's family and the cost is shared by them, they won't accept. No one wants the poor, helpless or any child to go without any medical attention, but will not agree to pay those additional cost. NO ONE WANTS forced euthanasia, but if it comes to added cost for themselves, might support the idea.

For these reasons and a hundred more, are the problems I have with any Politically driven Healthcare System, to say nothing of the authority/jurisdiction for US Federal involvement, to begin with. Try to understand this, with 307 million Americans, we cannot in any way control anything from a central point and yet maintain freedom of choice. If you really want a list of what may be harmful to your health, occupation that would have to vanish, hobby's, interest, risky ventures for pleasure or not, that could be taxed out of sight or simply outlawed, just ask...I'll start those already taxed, vanished or in some manner deemed unsafe by some nanny group, in the past 20/40 years...

Originally Posted by jackson33

inow; If your generalizing, people are satisfied with their current healthcare, in the US. Whether it be Medicare/Medicaid, private sector insurance either employer based or individual, the figures are around 60% on most all polls.

Again. Sorry. No.
I have already debunked that particular assertion. Repeating an invalid assertion and providing no new information or evidence doesn't suddenly make it valid. You can repeat yourself until you are blue in the face and red in the fingers, you are still incorrect when making the assertion above.

Originally Posted by inow

Originally Posted by jackson33

Since most people are reasonably happy, with the status quo, would you say that whatever actually got this country to the point it is, is at least worthy of discussion of maintaining?

This assertion is flatly contrary to the actual data. Again, can we at least ensure our arguments are aligned with reality? People are NOT happy with the status quo. It's difficult to take you seriously when you continue to present such blatant untruths.



http://www.pbs.org/nbr/blog/2009/10/...tatus_quo.html

The opposition claims Americans are happy with the health care system, and since it "ain't broke" it needn't be fixed. For them, the status quo is the only way to go. Frankly I think many of these opponents are really just against government in general, this government in particular or, more commonly, in favor of government when it bails out big business but opposed when it seeks to provide a safety net for the working class.

Be that as it may, I think their premise is fundamentally flawed.

<...>

The big tracking polls conducted by organizations without a stake in the outcome does not say Americans are happy with the health care system, it says they are happy with their doctors, which is quite different. In fact, we are not happy with the cost of our insurance, we are not happy with the co-pays, deductibles and other costs of medical services, we are not happy with the cost of the drugs we buy. And, if we have insurance, we also have horror stories about the bureaucratic mess we face every time we deal with our insurance company.

<...>

The problem with the status quo is that there really is no such thing. We can elect not to change our health care system, but the status quo will change anyway. According to the Kaiser Family Foundation's most recent report, "Spending on health care, which is a projected to be 17.6% of the U.S. gross domestic product (GDP) in 2009, has consistently grown faster than the economy overall since the 1960s." I urge you to read this short brief, it is frightening.

With the House of Representatives insisting on a public alternative to private insurance and the Senate just as adamantly headed toward a bill without that option, if it can pass anything at all, the prospects do not seem encouraging. Up to this point the naysayers have been making most of the noise. It's way past time for the people in favor of reform to sound off for their side.

Originally Posted by jackson33

For these reasons and a hundred more, are the problems I have with any Politically driven Healthcare System, to say nothing of the authority/jurisdiction for US Federal involvement, to begin with. Try to understand this, with 307 million Americans, we cannot in any way control anything from a central point and yet maintain freedom of choice.

Again, I have already shown how healthcare and health insurance fail to meet the basic assumptions which are required for a free market to operate.

Originally Posted by inow

Why markets can't cure healthcare

Originally Posted by inow

Here's another interesting take.

A Free-Market Case for the Public Option

<...>

And here, too:

http://www.guardian.co.uk/commentisf...re-republicans

Originally Posted by inow

Normal free market principles and assumptions simply don’t work in the field of healthcare, nor in the selection of coverage. Those assumptions which fail are these:

• Assuming consumers know what products and services they’ll need
• Assuming consumers know anything about the products and services they buy
• Assuming that consumers have a choice
• Assuming that private insurers have a motivation to provide good services
• Assuming that lowering costs will result in higher consumption
• Assuming that parties have bargaining power

There is simply no way, given the arguments I've put forth in this thread, that anyone can realistically argue that the solution to healthcare access, cost and quality problems is to put healthcare in the hands of the free market. It's just silly on its face, and it's important that people... despite preconceptions or ideology... have enough integrity to admit this. There are just way too many ways which the inherent nature of healthcare guarantees that normal market principles and assumptions don’t work.

Now, you either demonstrate where my rebuttal is flawed, offer valid data in support of your own position, or concede that you are unable. Simply repeating yourself without bringing anything new to the table has grown quite tiresome.