[ebuddy]

Originally Posted by dcmacdaddy 

Umm, you do realise there is more than one insurance policy available to employees of the federal government? And yes, I am sure it wasn't covered by the plan I was on. I had very good coverage in other areas of medical care (flexibility of doctors to choose from, low per-visit co-pays, low emergency room co-pays, low hospitalisation co-pays) I simply had no coverage for physical therapy.

Again, that's odd. How many different plans do Federal Employees have access to? If you indulge, what's yours called/who is the underwriter? Why on earth would a basic plan cover something like physical therapy while your comprehensive plan does not?

You say time is of the essence and going to an emergency room is OK for a basic non-life-threatening accident and then you argue that you didn't have to go do an emergency room to receive medical care. So, which is it?

Your argument was a child stepping on a nail. You want to ensure your child has had a Tetanus booster in the past 5 years. If you're not sure, go to emergency. If you are sure the child has had the booster, warm pack should do the trick. Variables. For medical care, we went to a clinic and/or dentist office.

And as for options like SCHIP and Medicaid, why not combine those separate government-run programs with separate administrative costs into one single government-run program that can guarantee minimum basics of care while reducing costs? Instead of having Medicaid, Medicare, SCHIP, and various other government-funded health insurance programs at the state level why not have one single uniform program at the federal level and reduce the costs of duplicate agencies and duplicate administration fees?

Why not allow me to avoid the 50+ regulations imposed upon insurers up to and including my ability to insure my family outside my State of residence? You're asking why so many programs are needed with regard to a government entity? This is all part of the problem dc. This is what happens when the government administers any program. State representatives are accountable to their constituents. Their constituents do not want to hear that the State continues to appeal to the Federal government for their healthcare allotment only to be short-changed. (see numerous examples in Canadian healthcare of provinces getting starved of much-needed funding) Also, the more a State gets for coverage, the more it will spend regardless of need. This is evidenced throughout a wealth of government agencies. What makes you so positive that a plan administered at the Federal level will be more efficient and cost-effective than a State administered program?

Why is having a hodge-podge of service providers based on age of patient, region, or ability to pay a better way to provide health-care resources to all citizens than through a single unified nation-wide system? As big and as unwieldly as it would likely be, do you really think a single nation-wide insurance system run by the federal government--remember, we are talking about the US here--would be more expensive than running Medicaid and Medicare, SCHIP, and other programs separately?

What you're saying sounds great on paper, but in talking about the US here we simply can't ignore the historical precedent such as; 342 economic development programs, 130 programs serving the disabled, 130 programs for at-risk youth, 90 early childhood development programs, 75 programs funding international education, cultural and training exchange activities, 72 federal programs dedicated to assuring safe water, 50 homeless assistance programs, 40 separate employment and training programs, 28 rural development programs, 23 agencies providing aid to the former Soviet republics... to name a few. I mean really, we need 23 agencies providing aid to former Soviet republics?!? I'm not sure we can administer something as immense as healthcare for 304,059,724 people with "one" single system. So when you ask do I really think it'd be more expensive, my answer is yes. Exponentially more expensive.

I can tell you that the government is not even consistent in costs from program to program. Once most of the country is pulled into a nationalized system, who knows what will happen. For example;


With regard to an actual plan, no one has really provided anything to mull over.

So, which government entity guaranteed you would have access to basic preventative health- and dental-care and provided said care to you and your wife? (And I used the qualifier government for a reason. I want basic preventative health- and dental-care available to all citizens and not be something they have to scrounge around to get from other providers like say religious organizations. I don't want private non-profits to have to be in the business of providing health-care to US citizens because the government can't provide it for them.)

Medicaid. See, a lot of folks aren't aware of this because they've never been in the unfortunate circumstance of needing it. I call it the "gated community syndrome". (not directed at you) A great many are getting information from their friends over a latte at Starbuck's; talking about the suffering of those poor people in a cruel healthcare system, and walk away from the discussion woefully misinformed. Instead of donating money themselves to these "religious organizations" and "private non-profits", they're content to simply say the government should do it with no regard for the remaining 85% of the country, the quality of care, or the state of the US economy overall.

Like I said, lets deny health-care to non citizens. I have no problem with that whatsoever. And say a illegal immigrant comes to an emergency room with a life-threatening health problem, let them get the care they need and then be deported after their recovery.
Correct. What makes it a good idea is that their would exist one single government agency that guarantees citizens get access to regular basic preventative health- and dental-care and that this basic level of services is not determined by how profitable it is or is not to provide. I have not argued for the elimination of health insurance companies. I have argued for a single government agency that guarantees citizens get access to regular, basic preventative health- and dental-care regardless of their ability to pay for such services. Health insurance companies can still exist side-by-side with a government-run plan, they would simply lose out on any profit to be made from providing regular, basic preventative health- and dental-care to citizens,. There would still be plenty of other profit to be had from offering insurance on emergency services, elective surgeries, cosmetic surgeries, experimental procedures, long-term care services (dialysis, chemotherapy, insulin, etc.).

We're in general agreement here.

I asked this question regarding your claims about the circumstances in other countries where illegals get access to the health services of the country in which they life illegally and you reply with another question (below) completely un-related to the question.

Probably because I started off by asking you; While we're at it, what exactly is the expense to these other countries in terms of coverage for illegal immigrants? You answered with your question and a statement that implied some knowledge; Which countries? Canada's policies regarding health-care for illegal immigrants is different from that of the various European countries which is different from that of Japan and South Korea.

Why not simply cite the healthcare expenses for illegal immigrants in Canada, Japan, or South Korea instead of what seems nothing more than an evasive reply? The question was intended to illustrate for you the differences in scope.

So, do you have figures on illegals in foreign countries and if/how they get access to their host country's health-care services?

I already know they are a great deal less of a burden on other systems than they are on ours. It was a leading question and I get the sense from your reply that you knew it.

Absolutely, And when an illegal immigrant comes to an emergency room with a life-threatening emergency, they should get the care they need, allowed to recover, and then be deported.

Can't disagree, but then you and I aren't nearly as concerned about alienating a growing voting bloc as our policy-makers.

This is half right. We need a stronger border policy along with better enforcement and more stringent punishment for those who hire illegals* along with procedures that allow for a more rapid deportation process.
*I think there should be a tiered approach to punishing those who hire illegals. You get caught once you pay $1,000. You get caught a second time you pay $10,000. You get caught a third time you go to jail. (With "you" being the person doing the hiring. It doesn't matter whether you are someone looking for some guys to mow your lawn or looking for a crew of workers to pick your crops or work on a job site building houses.)

My intent wasn't to move the discussion into immigration policy so much as to bring them into the equation. I couldn't agree with you more on this one dc. My only change to your plan would be an increase in penalty. I've long-thought this and I regularly bring this up in discussions on illegal immigration. I think employers who hire illegal immigrants should absolutely, positively have the book thrown at them.

Correct. This is no solution because it is not a true unified, nationalised government-run plan to provide regular, basic preventative health- and dental-care to all US citizens. It is a half-assed attempt to try and cover more citizens without making it look like the whole health-care industry is being nationalised. The only workable solution is to create a new agency that replaces Medicaid, Medicare, SCHIP et al with the "FedCare" program that provides regular, basic preventative health- and dental-care to all US citizens and allows those citizens to obtain other medical services through secondary insurance plans or cash-based purchases. The solution I propose would eliminate the private insurance market for regular, basic preventative health- and dental-care and leave private insurance companies to compete among secondary medical services, long-term care services, and elective services.

So... to be clear, only preventive care?

Umm, what are you talking about--Where I have mentioned in this thread the previous Administration--and how does this relate to the topic at hand?

Are we supposed to pretend that you haven't expressed a particular distrust for government on a host of issues in which you felt they were guilty of deceit, waste, and unprecedented abuses of civil liberties? Knowing this, how could I not challenge your logic here?

Any facts or figures to support this claim?

factcheck.org
Per Census Bureau stats there are 47 million uninsured. 21% of the uninsured are both legal and illegal. However, 43.8% of non-citizens are uninsured. Of course, deriving an exact number of non-citizens from the Census Bureau is understandably difficult, but most estimates conclude that approximately 15% (about 7 of 47 million) of the uninsured are non-citizens. Most experts conclude that these figures are extremely conservative by the way.

There are already plenty of people getting something for nothing with our current system (usually with the cost for the "nothing" being borne by hospitals who provide regular medical services in emergency rooms to people not having medical emergencies and with no regular insurance). Any proposed new system will still have some people getting something for nothing.

I'm not nearly as concerned about "something for nothing" as I am "nothing for something".

I guess that's where you and I differ. I want ALL citizens to have access to regular, basic preventative health- and dental-care whether or not they "deserve" it by choosing to care for themselves in the most health-appropriate way possible.

I want world peace also, but it is not possible. You and I differ because I think your goal while noble, is lofty, unrealistic, and naive not only of Federal behavior, but of human nature.

[Big Mac]

I'd like to know where we're going to get all the extra physicians and nurses to provide all of this extra medical care. It seems clear based on the debate that we're going to get a much costlier system that provides poorer care than the majority of us previously got, along with higher taxes. How many of you believe it could work out any other way - that Obama could deliver was seems to be the impossible?

[besson3c]

How does it seem clear, Big Mac? For the umpteenth time, you are going to have to give us more than what could very well be your gut feelings.

[Big Mac]

Besson, for the umpteenth time you refuse to acknowledge it when objective support for a conservative argument is given to you. Stop trolling, please. It's getting old.

[besson3c]

Define objective? Who here is objective?

[Big Mac]

I give up. No mas.

If you really need me to define objective proof for you, besson, you need go back to elementary school.

[besson3c]

If you are going to share your feelings with us, at least be a little less inflammatory. We get it, you don't like Democrats.

At least wait until a plan is past its very early draft stages, yeessshh!

[Big Mac]

I said absolutely nothing about Democrats in any response to you.

[besson3c]

Why else would you be staunchly against the various early drafts of plans?

Please, we're not stupid. Pace yourself.

[Big Mac]

Why? Because I don't believe it's plausible that Obama can deliver on his promises based on everything I know about insurance, health care and government. I believe that much like the Stimulus, the president's promises will prove hollow and we'll be stuck with another massive, prosperity-draining Entitlement that we'll never be able to get rid of.

[Doofy]

Originally Posted by besson3c 

Who here is objective?

That would be me.

Fact: Your current health care system is better than the current UK one. Which is why Amerikans who live here always choose to go back to the US to have their babies. Saves them catching C.diff and what not.

[besson3c]

What's objective is that the accessibility of our health care is an embarrassment. I accept the debate against the life expectancy numbers available in the Wikipedia, but that our costs are nearly twice as much as Canada's seems pretty cut and dry, and this is not even taking into account all of the uninsured and the insured with only partial insurance. What we have now is garbage. It is also completely economically unsustainable.

What we are doing collectively as a nation is discussing ways to improve upon what we have so that it isn't garbage or at least less garbagey, and you're dragging your heels before we're even out of the starting blocks. We already have government provided health care, it's called Medicare. Since you think it sucks, maybe we at least ought to improve upon it? Since you're disgusted with our debt, maybe we ought to do something about that? You take the whole collapse of our economy completely out of the picture and we still have major debt problems, caused, in great part by one sixth of our economy being tied to health care.

What seems objective is saying that this sucks, and we can do better. What seems clear is that you would prefer keeping what we have if it meant not entertaining something that wasn't put out by the Republican or Libertarian party. How is *that* any proud demonstration of objectivity? It's a demonstration of logo recognition and knowing the difference between a D and an R, but that's about it. Or, perhaps it's cynicism in our ability to do better?

How about not caring where ideas come from and just examining them on their merits alone? How can you begin to critique any plan right now when we aren't yet focused on any one bill?

Pace your rage.

[Dakar V]

Query for besson: Do you believe life expectancy numbers are determined solely by access or cost of health care?

[besson3c]

Originally Posted by Doofy 

That would be me.

Fact: Your current health care system is better than the current UK one. Which is why Amerikans who live here always choose to go back to the US to have their babies. Saves them catching C.diff and what not.

The quality of our health care is superb. It consuming 1/6th of our economy is not, nor is the millions of Americans that are uninsured, the number of bankruptcies caused from medical problems, our lack of liberty in having comprehensive insurance tethered to employers, and the difficulty of businesses to provide for their employees.

[Big Mac]

Originally Posted by besson3c 

What's objective is that the accessibility of our health care is an embarrassment.

You have a clear agenda. I have a clear agenda. You support promoting your agenda while crying foul when others voice support for theirs. Thus, your debating skills leave much to be desired.

[besson3c]

Originally Posted by Dakar V 

Query for besson: Do you believe life expectancy numbers are determined solely by access or cost of health care?

Of course not, there are countless numbers of variables, but it is rather peculiar that the numbers are so much different than Canada given the similarities in our cultures. It's not like Canadians don't have fatal driving accidents either at a similar percentage.

However, given that there are any number of ways that those numbers can be flawed, I accept that this is not a terribly effective way to bolster an argument. The numbers may be interesting, but they don't tell us anything in a conclusive manner.

[besson3c]

Originally Posted by Big Mac 

You have a clear agenda. I have a clear agenda. You support promoting your agenda while crying foul when others voice support for theirs. Thus, your debating skills leave much to be desired.

What is my agenda, oh wise one? Is trying to get people to be reasonable and control their own emotions so that we can have an honest discussion really a nefarious agenda? Please do tell me what my agenda is, all I've ever stated is that I just want my costs reduced, and I don't see the wisdom in being closed to options. Does that qualify me as being an ideologue? Don't ideologues support something specific?

[Dakar V]

Well I'd posit that Americans work longer hours, have more stress, and have shittier diets than most other first world countries, and thats why our life expectancy sucks.

[Big Mac]

Originally Posted by besson3c 

What is my agenda, oh wise one? Is trying to get people to be reasonable and control their own emotions so that we can have an honest discussion really a nefarious agenda?

Nice use of ad hominems there.

Please do tell me what my agenda is, all I've ever stated is that I just want my costs reduced, and I don't see the wisdom in being closed to options.

Your agenda is in supporting fully Socialized medicine. You cite all of the downsides of American health care while ignoring all of the downsides of Socialized medicine. You dismiss those of us who are very wary of creating another Entitlement. You don't even acknowledge that we're arguing against government takeover based on objective fact. I'm sure you'll again claim I've provided nothing objective. You're clearly biased, and you're trolling those who hold contrary views.

[besson3c]

Originally Posted by Dakar V 

Well I'd posit that Americans work longer hours, have more stress, and have shittier diets than most other first world countries, and thats why our life expectancy sucks.

Longer and more stressful hours than the Japanese? If by stress you mean stress relating to making money and all of the usual sorts of things that we place value in, how is this set apart from a country like Canada that shares a very similar culture?

The diet thing I can accept a little easier, although I know that obesity is a growing problem in Canada too.

Again, just bringing up Canada because it's what I know, and all of this is predicated on the notion that these numbers are accurate.

[besson3c]

Originally Posted by Big Mac 

Nice use of ad hominems there.

Your agenda is in supporting fully Socialized medicine. You cite all of the downsides of American health care while ignoring all of the downsides of Socialized medicine. You dismiss those of us who are very wary of creating another Entitlement. You don't even acknowledge that we're arguing against government takeover based on objective fact. I'm sure you'll again claim I've provided nothing objective. You're clearly biased, and you're trolling those who hold contrary views.

I rarely use ad hominems, but it appears that this time it may have been appropriate.

Your placement of my agenda of being on some sort of crusade to support fully socialized medicine is your emotional response to what I have written, and that is frankly your false assumption and resulting problem, not mine. Why should we be punished because you lack the control to not work yourself up over a debate which we are not even having?

I'm glad you used the term "fully socialized" because we already have a partially socialized program in Medicare. I'm certain I have seen you bitch and moan about Medicare. Until you come up with an alternative to replace it entirely, shouldn't you logically be open to ways in which we can provide partially socialized medical programs cheaper than what we have now in Medicare? I thought you hated wasteful government programs? The major debate going on now is supplementing private health insurance with government run options, not in disbanding private insurance. One goal is reducing the costs of what is now Medicare, the other is getting more people insured.

Since you are set on coming to the predetermined conclusion that what we come up with will not be an improvement over what we have now, perhaps you should at least wait until a plan can be fully scrutinized? We can't debate your gut feelings.

[Doofy]

Originally Posted by besson3c 

The quality of our health care is superb. It consuming 1/6th of our economy is not, nor is the millions of Americans that are uninsured, the number of bankruptcies caused from medical problems, our lack of liberty in having comprehensive insurance tethered to employers, and the difficulty of businesses to provide for their employees.

So, from this I can deduce that you want:

Quality of health care (check).
Cheaper than 1/6 of your economy.
For everyone.

Let me know if you ever work out how to do that.

[besson3c]

Originally Posted by Doofy 

So, from this I can deduce that you want:

Quality of health care (check).
Cheaper than 1/6 of your economy.
For everyone.

Let me know if you ever work out how to do that.

My best theory: competition.

There are those that don't care about having the best quality money can buy and just want some basics. There are many procedures that don't warrant the best quality money can buy, we've been treating broken bones for many years, for instance. There are times when we need or want that extra edge.

So, we provide options. We get people shopping around and entities competing against each other to provide the cheapest options. Right now, we have millions of Americans that are not consumers of any kind of health care, nor are they users of Medicare. The demand is there, the (affordable) supply isn't.

The debate in Canada now is interesting, although in some ways its the exact opposite of the debate here. Their debate is where and when private insurance can supplement their public health care. In some provinces private health care is an option, but the debate is whether private health care will provide too much competition for public health. However, what seems to have happened is that private health care is often a gap filler. There will inevitably be many gaps - stuff that public health won't finance, stuff that is great enough demand that there is enough to be shared, or simply options that vary in the nature of their service (e.g. Eastern vs. Western practices, etc.) If designed properly, why can't both exist?

The key thing here is getting more people to be users of health care, to create more competition, more consumer options, lower costs, etc. I have difficulty in the wisdom of sitting around and waiting for this to happen on its own and for the insurance companies to grow tired of making lots of money. They are doing well selling group insurance packages to big employers, certainly well enough to be a profitable business. But what about the rest of us who want comprehensive insurance but don't want to pay $13,000+/year? This is not an option for many of us, but the problem is there are no other options. It's take it or leave it.

How often does creating more customers end up being a bad thing?

[besson3c]

I've also lost track of who owns who in the insurance world, all I know is that Anthem, Blue Cross, and Blue Shield are all the same. I have no idea if Anthem also owns Celtic, or whatever.

Have we gotten to a point where competing against Anthem is sort of like competing against WalMart? What incentive does Anthem have to provide these options I'm talking about and disrupting a business model which has been working very well for them?

That being said, they should continue to exist, we simply need more and better options as consumers.

[el chupacabra]

I'm excited for something new. Like I said, it's hard to imagine something worse.
[/QUOTE]

In 1 or 2 sentences could you explain whats wrong with our health care system. I'd like to get to the bottom of this logically proving why the democrat and republican solutions wont work; regardless of how "new" they are.

[besson3c]

Chupacabra: what part of what I've said isn't clear, including my most recent list I wrote to Doofy?

[Laminar]

Originally Posted by besson3c 

What is my agenda, oh wise one? Is trying to get people to be reasonable and control their own emotions so that we can have an honest discussion really a nefarious agenda? Please do tell me what my agenda is, all I've ever stated is that I just want my costs reduced, and I don't see the wisdom in being closed to options. Does that qualify me as being an ideologue? Don't ideologues support something specific?

Your left-leaning is very clear, and you're much more likely to give a "hay guyz be reazonable and logikal now!" speech in response to a right-leaning poster. Does this reflect an honest and unbiased poster?

[besson3c]

Hey, I'm not a perfect person, but I also seem to be virtually alone in my quest to make this place more reasonable and conducive for production discussion. Maybe beggers can't be choosers?

[dcmacdaddy]

Originally Posted by el chupacabra 

In 1 or 2 sentences could you explain whats wrong with our health care system. I'd like to get to the bottom of this logically proving why the democrat and republican solutions wont work; regardless of how "new" they are.

Not all citizens have insurance and as a result not all citizens have access to regular, basic preventative health- and dental-care.

The programs that cover those citizens that don't have insurance and access to regular, basic preventative health- and dental-care are a hodge-podge of plans at the federal, state, and local level that require tremendous amounts of paperwork to obtain service and don't allow for portability of patients and/or service providers (i.e.: someone who moves from one state to another usually has to fill out all the same paperwork all over again before they can obtain medical services through a different program). I would like there to be one, single government program at the federal level (for ease of portability of patients and providers across state lines) that replaces Medicaid, Medicare, SCHIP, and a variety of state-level plans. (Individuals state could still offer their own plans to supplement what was offered by the federal government but they would not be allowed to offer a plan in lieu of what was offered by the federal government.)



On a philosophical level I don't like the fact that our health-care is rationed* by ability to pay. The more money you have the more and better access you can get to medical services. I want our health-care system to change such that it is rationed by need of service and not ability to pay. In such an arrangement, doctors and other medical professionals--NOT insurance companies--would get final say over what types of procedures a patient could get and doctors would be fully empowered, and expected, to refuse services to patients if the doctors felt it was not necessary.

As one example of such a radical reorienting of how health-care is provisioned in this country, a really rich person with a major medical condition would not be able to get a life-saving procedure faster than a really poor, but much sicker, person with the same medical condition. (cf. Steve Jobs and his temporary move to Tennessee to get a liver transplant. In other words, Steve Jobs would have had to stay in California and stay on the much longer waiting list and be much more likely to die than be able to buy his way into a new liver by temporarily moving to Tennessee.)



*I am working on a fundamental assumption that all citizens can not have access to all possible medical procedures they need and/or want due to a variety of different factors: Thus, the provision of health-care in this country is rationed. If anyone cares to argue how health-care in this country (or any country for that matter) is not rationed, that would be great. I would like to hear an argument for the case that health-care services are non-finite and do not need to be rationed.

[Dakar V]

Originally Posted by besson3c 

Longer and more stressful hours than the Japanese?

The Japanese are atypical. AT the very least, I believe their diet and fitness far exceeds ours.

Originally Posted by besson3c 

If by stress you mean stress relating to making money and all of the usual sorts of things that we place value in, how is this set apart from a country like Canada that shares a very similar culture?

The diet thing I can accept a little easier, although I know that obesity is a growing problem in Canada too.

Again, just bringing up Canada because it's what I know, and all of this is predicated on the notion that these numbers are accurate.

Yes, consumer culture, keeping up with the joneses, etc.

[BadKosh]

Gee, the main reasons given by our foreigner president for required health care is the NUMBER OF UNINSURED, and the COSTS associated with health care. The number of people has been inflated by adding in the illegals, so the first part of his argument is moot. The cost would less if trial lawyers and ambulance chasers were more under control. People don't want idiots in Washington controlling who gets what test, procedure, medication, as it stinks of politics, and bad government.

[besson3c]

BadKosh: are you saying that if you get rid of all illegals there is no problem with uninsured Americans? If so, you are oversimplifying the problem. However, for the sake of argument, what would you do about illegal immigration? As far as your last sentence, do you think that people on Medicare should have access to all possible treatments?

[vmarks]

You ignore the large number of people who are uninsured by choice.

Insurance is a gamble. When I get insurance, I'm betting that I'm going to need treatment that I don't want to pay for, or will not be able to afford at some time in the future.

The insurance company is betting that I won't need any treatment, and they'll get to keep taking my money without paying it out.

Insurance costs anywhere from 250/mo to 1k/mo in my personal experience, for different levels of coverage, and different numbers of dependents on a plan.

It is entirely reasonable for people to determine that they aren't at risk, or for them to accept the risks involved in being uninsured, and pocket the 3000 to 12000 a year as a contribution to their lifestyle.

[stumblinmike]

Originally Posted by vmarks 

You ignore the large number of people who are uninsured by choice.

Insurance is a gamble. When I get insurance, I'm betting that I'm going to need treatment that I don't want to pay for, or will not be able to afford at some time in the future.

The insurance company is betting that I won't need any treatment, and they'll get to keep taking my money without paying it out.

Insurance costs anywhere from 250/mo to 1k/mo in my personal experience, for different levels of coverage, and different numbers of dependents on a plan.

It is entirely reasonable for people to determine that they aren't at risk, or for them to accept the risks involved in being uninsured, and pocket the 3000 to 12000 a year as a contribution to their lifestyle.

If by reasonable you mean inexpensive, you are correct. I would love the extra pocket money!
If by reasonable you mean within reason, you are so wrong! Not having insurance (if you have an income stream) is tantamount to Russian roulette. One incident MAY cost you a lifetime of income!
Then you'd be a deadbeat. Conservatives HATE deadbeats! Is that the way America's healthcare system should be???

[ebuddy]

Originally Posted by besson3c 

However, given that there are any number of ways that those numbers can be flawed, I accept that this is not a terribly effective way to bolster an argument. The numbers may be interesting, but they don't tell us anything in a conclusive manner.

So... you bring up an argument that has nothing to do with the quality of health care in the US. I cite numbers to affirm why your logic does not compute. The numbers are flawed because you just think they're flawed. The sources for the numbers are pretty straight forward and easily verifiable yet... you just don't buy it. You seem readily willing to buy off on a "preliminary plan" that the CBO claims is going to cost over a trillion dollars and cover a third of the uninsured.

There simply has to be a sane foundation for discourse here. I give up.

[dcmacdaddy]

I think Besson's new user icon might have something to do with his lack of "sane discourse" abilities.


Having said that, I will reiterate something I said earlier, the current proposed government plan is a bust designed to try and cover more individuals without doing the politically daring, and extremely politically damaging, act of providing a true government-sponsored health-care option. We don't need more stop-gap measures. We need a new plan that replaces Medicare, Medicaid, SCHIP and a host of other programs with a single, unified, government-sponsored plan that provides basic minimum coverage to everyone. We need a plan that provides ease of portability and structured limits, determined by doctors, on what can and can not be done under the plan. I think we need a government plan that provides every citizen with the basics and allows the huge insurance industry to continue to compete for other secondary care.

You want to go to the doctor once a year for a checkup? Great. The government plans would cover that. You want to get cosmetic surgery you would have to get coverage for that from a private insurer.

You want to go to the dentist twice a year for checkups? Great. The government plans would cover that. You need major dental surgey or your kid needs braces you would have to get coverage for that from a private insurer.

[ebuddy]

Originally Posted by dcmacdaddy 

I think Besson's new user icon might have something to do with his lack of "sane discourse" abilities.

The problem here is I happen to like besson and look forward to the next thread where he'll bring up other topics he'd rather not discuss.

Having said that, I will reiterate something I said earlier, the current proposed government plan is a bust designed to try and cover more individuals without doing the politically daring, and extremely politically damaging, act of providing a true government-sponsored health-care option. We don't need more stop-gap measures. We need a new plan that replaces Medicare, Medicaid, SCHIP and a host of other programs with a single, unified, government-sponsored plan that provides basic minimum coverage to everyone. We need a plan that provides ease of portability and structured limits, determined by doctors, on what can and can not be done under the plan. I think we need a government plan that provides every citizen with the basics and allows the huge insurance industry to continue to compete for other secondary care.

I generally agree with your distaste for half-assed measures that attempt to accomplish both PR and progress, concepts that often cannot go hand in hand. I can think of some failed military strategies that went something like this and I had the same feeling about those. I also believe your intentions are more noble than partisan, but I have to take issue with some things here.

There are 50 States. No matter what single, unified plan you devise will have to be facilitated at the State level where the recipients are more in touch with the need. You will have some States that abuse the funding to secure future funding and there are numerous examples of this phenomena. You will have other States that are starved of funding not unlike the provinces in Canada in continuous appeal to Parliament for additional funding, losing precious personnel and closing clinics. This will lead to healthcare rationing which will cause the very problems systems using this model are trying to move away from by reintroducing privatization. You would think a system like Canada's would finally answer some of the tough questions around accessibility and yet, 80% of Canadians want serious healthcare reform with just under half wanting a market-oriented solution that facilitates accountability and competition. Of course, it remains a political football. Canada's system is a $100 billion system and in terms of population is 11% the size of our undertaking.

- Make no mistake, healthcare will be rationed with doctors not being the determinant factor of coverage.
- You will lose more healthcare professionals.
- 22 months for an MRI
- unequal doctor pay in higher-need regions will leave you starved in other regions.
- they will underestimate the cost and the cost will explode yearly. Once the plan is enacted, there is absolutely no way to put the Genie back in the bottle.
- It will become the single most important political football and an additional boon to those who want honest representation from elected officials.
- black-market clinics will become the order of the day, providing the basic coverages you can't get from a public plan; accepting cash under the counter.
- If we move to nationalized healthcare, those who currently enjoy it will no longer be able to come to the US for necessary care.

... to name a few...

[Big Mac]

Another important point that many people don't acknowledge concerning the working poor who don't have insurance is that a large amount of them are eligible for Medicaid but don't get it. The same applies to SCHIP. I think I know one reason why. There's a stigma attached to Medicaid/SCHIP in some quarters - that its very poor coverage that only the very poor have. I imagine that many Americans who don't have much money don't want to acknowledge or label themselves as poor, so they forgo the options for the poor. I know there was a stigma attached to Medicaid in my family growing up, due at least in part to my grandfather being a doctor who would not accept the very poor reimbursements given by Medicaid.

It's a complex problem. Obama talks a good game but his talk doesn't guarantee fact. His predictions about the Surge and the Stimulus package were completely wrong. Now he makes lofty predictions about a health care reform package he's not even actively crafting. As I said, his talking points on the issue sound great. I'm strongly in favor of addressing the preexisting condition catch that allows insurers to turn many people away from getting affordable plans, although premiums are the highest in the states where guaranteed issue plans are mandated. I don't see why only some Republicans and zero Democrats that I know of are discussing the HSA route that I favor, but hey you don't always get what you want.

I'm sure he'll get a very positive polling response from his days long infomercial on ABC. Yet, all of the experiences we've had with government intrusion into health care show that costs, inefficiencies and corruption go up across the board, and the taxpayer is left footing the bill (either now in the form of higher taxes or through the delayed effects of gigantic deficits). Medicare was originally projected by Congress to cost far less than it actually has. Why should Americans trust that Obama knows what he's talking about on this issue? As I've said, I can very easily envision him downplaying his failed predictions about health reform three years down the line just as he has downplayed his failure to at all accurately predict the effects of the Surge or Stimulus. And at that point we'll be stuck with another massive, budget destroying Entitlement that brings us that much closer to national bankruptcy. I surely hope I'm wrong, but experience tells me I'm most likely right.

[dcmacdaddy]

Originally Posted by ebuddy 

The problem here is I happen to like besson and look forward to the next thread where he'll bring up other topics he'd rather not discuss.


I generally agree with your distaste for half-assed measures that attempt to accomplish both PR and progress, concepts that often cannot go hand in hand. I can think of some failed military strategies that went something like this and I had the same feeling about those. I also believe your intentions are more noble than partisan, but I have to take issue with some things here.

There are 50 States. No matter what single, unified plan you devise will have to be facilitated at the State level where the recipients are more in touch with the need. You will have some States that abuse the funding to secure future funding and there are numerous examples of this phenomena. You will have other States that are starved of funding not unlike the provinces in Canada in continuous appeal to Parliament for additional funding, losing precious personnel and closing clinics. This will lead to healthcare rationing which will cause the very problems systems using this model are trying to move away from by reintroducing privatization. You would think a system like Canada's would finally answer some of the tough questions around accessibility and yet, 80% of Canadians want serious healthcare reform with just under half wanting a market-oriented solution that facilitates accountability and competition. Of course, it remains a political football. Canada's system is a $100 billion system and in terms of population is 11% the size of our undertaking.

- Make no mistake, healthcare will be rationed with doctors not being the determinant factor of coverage.
- You will lose more healthcare professionals.
- 22 months for an MRI
- unequal doctor pay in higher-need regions will leave you starved in other regions.
- they will underestimate the cost and the cost will explode yearly. Once the plan is enacted, there is absolutely no way to put the Genie back in the bottle.
- It will become the single most important political football and an additional boon to those who want honest representation from elected officials.
- black-market clinics will become the order of the day, providing the basic coverages you can't get from a public plan; accepting cash under the counter.
- If we move to nationalized healthcare, those who currently enjoy it will no longer be able to come to the US for necessary care.

... to name a few...

Why oh why do you constantly assume that the system we adopt will be based on the Canadian model? Every time you bring up a specific complaint about "socialised medicine" you refer to the shortcomings of the Canadian model as if that is the only type of model in the whole world for government-run health-care. Why? You do realise there are other models for how this works and the other models have varying degrees of success, some quite successful in fact. So, why the constant assumption we will adopt the Canadian model? (I don't want to say it out of respect but in your replies to me you really have been arguing against a strawman as I have NEVER advocated for adopting anything remotely like the Canadian model of full-coverage, fully-government-funded provision of health-care services. So, what gives? Why reply to me arguing against Canada when I have never mentioned Canada as a model?)


As to your points, the US federal government reimbursing the states would ONLY occur if we adopt wholesale the Canadian model. And why do you assume that a "single, unified plan you devise will have to be facilitated at the State level"? The whole point of what I am proposing is that it removes multiple layers of government bureaucracy from the system of provisioning health care. Everything I have proposed has revolved around a federal-level program that provides basic, preventative health- and dental-care. It doesn't matter what state you live in as your state of residency would have no say in the administration and/or management of the plan. You live in Texas and want to go to for an annual physical then you would make the appointment, go to the appointment, hand over your "FedCare" insurance card which covers the visit, and walk out the door afterwards not having paid a thing. At what point would the local state have to get involved in any of this?

[Big Mac]

No one in DC is proposing what you're asking for, dc. Obama wants reform of the whole system coupled with a public insurance option that competes with private insurance on an equal playing field. This isn't just preventive care. Many of us are concerned that his public option would destroy private insurance and turn into Medicare-for-all.

If you want an indication of the corruption that's already intrinsic to this reform process, just look at the fact that Senator Bacus is considering taxing employer provided benefits for everyone except for union employees. That's a clear violation Equal Protection, yet it's seriously being considered by one of the most influential voices in the debate.

[dcmacdaddy]

Originally Posted by Big Mac 

No one in DC is proposing what you're asking for, dc.

I know. That's why I have said several times already that the proposal offered by the Obama Administration is a "bust" and a "failure". (If you keep me off of ignore you might have known this.) And that is why I have proffered a suggested alternative plan.

Originally Posted by Big Mac 

Obama wants reform of the whole system coupled with a public insurance option that competes with private insurance on an equal playing field. This isn't just preventive care. Many of us are concerned that his public option would destroy private insurance and turn into Medicare-for-all.

Except, Obama *doesn't* want reform of the whole system. His proposal is a stop-gap measure designed to look like it is doing something important without actually doing the hard work of completely reforming the existing federal programs that provide medical care to citizens. As for competing with insurance companies, so what? Competition is a good thing, right? Why can't nationwide insurance companies go head-to-head with a nationwide insurance plan provided by the federal government? How is that level of competition in any way bad? Those insurance companies that can compete against the federal government will do well and make lots of money. And those insurance companies that cannot compete against the federal government will do poorly and be driven out of business. As to your argument that Obama's proposals would leave to the complete elimination of private medical insurance, please show me where someone, anyone has suggested this is a goal of the Obama plan.


NOTE: I have never argued in favor of the idea that the federal government should completely replace the private insurance industry. I am simply replying to your arguments with my own arguments that seem logically meaningful as rebuttals to your points. In other words, I am arguing against your points with my own arguments while not believing my own arguments have any merit as a viable solution. (In a logical argument you don't have to believe the points you make have merit as long as they have logic.)

Originally Posted by Big Mac 

If [you] want an indication of the corruption that's already intrinsic to this reform process, just look at the fact that Senator Bacus is considering taxing employer provided benefits for everyone except for union employees. That's a clear violation Equal Protection, yet it's seriously being considered by one of the most influential voices in the debate.

Again, let me reiterate my opposition to the plan proposed by the Obama Administration.

[Big Mac]

Okay, I apologize for misunderstanding your position. I think I should take you off ignore.

Let me ask you as a follow-up, what types of reform of insurance for medical needs that are outside of preventative care are you advocating?

[dcmacdaddy]

Originally Posted by Big Mac 

Okay, I apologize for misunderstanding your position. I think I should take you off ignore.

Let me ask you as a follow-up, what types of reform of insurance for medical needs that are outside of preventative care are you advocating?

Just wanted to let you know that I have started a reply to this request--an reply that will outline the specifics of what I have been proposing--but have yet to find the time to finish it. I will get to it soon, though.

[CRASH HARDDRIVE]

Why can't nationwide insurance companies go head-to-head with a nationwide insurance plan provided by the federal government? How is that level of competition in any way bad?

1. because it's not really a legitimate role of the federal government to be in competition with private sector insurance companies in the first place.

2. Because one entity can write/rewrite/change/influence/tilt/slant/regulate the rules in its own favor and against others (with special interests lobbyists paying them gazillions to do so) and other entities they're supposedly in 'competition' with, can't. Real competition is fair.

3. Because the private sector generally has to operate in the REAL WORLD- IE: compete in reality, make ACTUAL money, operate with an ACTUAL budget that works, cater to consumer's ACTUAL wants and needs, and turn an ACTUAL profit.

4. Because the public sector NEVER has to operate in the real world, has every incentive to have nothing but 'use it or lose it' budgeting, can burn everything at both ends, can cook its own books at will (while having the power to go over everyone else's books with a fine tooth comb and impose penalties) can run a supposed 'business' completely into the red, and can then just enslave the taxpayer for endless bailouts to pay for the resulting deficits. And the consumer can get stuffed if they don't like it- there's no recourse.


The last step by the way, will in no time have the effect of leaving the taxpayer unable to willingly pay for the product of the competition. It'd be like Ford having the power to extract money out of your paycheck in ever-increasing amounts -even when you DIDN'T buy a car from them- as they bloat themselves, and then expecting people of average means to on top of floating Ford, also go and buy a Mercedes.

[BadKosh]

Do the Dems have ANY solution that isn't raising taxes, and controlling private industries? Where are the 'smart' Libs and efficient cost effective solutions? They haven't displayed ANY innovations, but more taxes. I guess politicians aren't the smart or ethical types.

[Stegabot]

As a health professional , health reform will not succeed unless everybody understands two basic facts , health care is not a right and two , the private sector and the consumers should take the lead in reforming health care and the government's role should be limited to two things , 1) Are the reforms legal 2) Is it safe for the consumers . Now , what makes health care very costly . Lawyers and politicians . Politicians because they pander to anyone who will help them stay in office and ambulance chasers because they are willing to sue the pants off against any health care provider , pharmaceutical firm and medical equipment maker for millions of dollars even if the suit has no merit .

[Big Mac]

Originally Posted by dcmacdaddy 

Just wanted to let you know that I have started a reply to this request--an reply that will outline the specifics of what I have been proposing--but have yet to find the time to finish it. I will get to it soon, though.

Thank you for the update.

Originally Posted by Stegabot 

As a health professional , health reform will not succeed unless everybody understands two basic facts , health care is not a right and two , the private sector and the consumers should take the lead in reforming health care and the government's role should be limited to two things , 1) Are the reforms legal 2) Is it safe for the consumers . Now , what makes health care very costly . Lawyers and politicians . Politicians because they pander to anyone who will help them stay in office and ambulance chasers because they are willing to sue the pants off against any health care provider , pharmaceutical firm and medical equipment maker for millions of dollars even if the suit has no merit .

Well said, Stegabot (although what's up with the spaces after punctuation marks?), but unfortunately the country's going in the exact opposite direction.

[ebuddy]

Originally Posted by dcmacdaddy 

Why oh why do you constantly assume that the system we adopt will be based on the Canadian model? Every time you bring up a specific complaint about "socialised medicine" you refer to the shortcomings of the Canadian model as if that is the only type of model in the whole world for government-run health-care. Why? You do realise there are other models for how this works and the other models have varying degrees of success, some quite successful in fact. So, why the constant assumption we will adopt the Canadian model? (I don't want to say it out of respect but in your replies to me you really have been arguing against a strawman as I have NEVER advocated for adopting anything remotely like the Canadian model of full-coverage, fully-government-funded provision of health-care services. So, what gives? Why reply to me arguing against Canada when I have never mentioned Canada as a model?)

Frankly, I had to bring up something to have a basic idea of what exactly it is you're talking about. I've asked you questions in an attempt to narrow it down and you've not been forthcoming. Is it for preventive care only for example? You pop in to mention that at some point you're going to unveil some plan and in the meantime you're suggesting reform is in order. You've mentioned some things that sound an awful lot like the primary tenets of the Canadian model such as universal access, portability, public management, and coverage of all medically necessary (or in your words the more ambiguous; basic) services. I'm sorry the Canadian model was so offensive to you. Do you suppose there's a possibility that a US plan would look a lot like the Canadian model if your goals are exactly the same?

I mean it doesn't make a whole lot of sense to remain vague enough to have basically outlined what at the surface sounds an awful lot like the Canadian model, then tell me how far off the mark I am by bringing up the Canadian model.

As to your points, the US federal government reimbursing the states would ONLY occur if we adopt wholesale the Canadian model. And why do you assume that a "single, unified plan you devise will have to be facilitated at the State level"? The whole point of what I am proposing is that it removes multiple layers of government bureaucracy from the system of provisioning health care. Everything I have proposed has revolved around a federal-level program that provides basic, preventative health- and dental-care. It doesn't matter what state you live in as your state of residency would have no say in the administration and/or management of the plan. You live in Texas and want to go to for an annual physical then you would make the appointment, go to the appointment, hand over your "FedCare" insurance card which covers the visit, and walk out the door afterwards not having paid a thing. At what point would the local state have to get involved in any of this?

I'm guessing risks will still be pooled to some degree as there are stark differences in need from state to state. I don't know that a Federal operation would function effectively if it did not have more intimate operations inside the local governments who manage all the hundreds of thousands of clinics throughout the country. The hundreds of thousands of clinics who would then be bill-bombing the Federal entity. Now what you're suggesting is a complete upheaval of our current situation including the transfer of management of the hundreds of thousands of facilities from local factions to the Feds. Now, the $1.6 trillion the CBO budgeted for Obama-care has just increased exponentially.

Again, it's clear you've not really worked out any details of your plan.

To those of you who still wish to talk about something related to this thread and would like to discuss this with dc, you'll have to invoke strawmen because dc hasn't worked out his plan yet.

[Doofy]

Originally Posted by BadKosh 

Do the Dems have ANY solution that isn't raising taxes, and controlling private industries? Where are the 'smart' Libs?

In the Republican Party.

[BadKosh]

Senate Dems say health bill covers 97%
By Jeffrey Young
Posted: 07/02/09 12:53 PM [ET]

Senate Democrats on Thursday unveiled their plans to create a government-run public health insurance option and require most employers to provide healthcare benefits to their workers, partially filling in the blanks on two of the biggest unsettled questions in the effort to reform the healthcare system.

According to Democrats on the Senate Health, Education, Labor and Pensions (HELP) Committee, their legislation would extend health insurance coverage to 21 million uninsured people over 10 years at a net cost of $611.4 billion. Combined with separate legislation being developed by the Senate Finance Committee, senators said their healthcare reform plan would bring the total number of newly insured people to 41 million by 2019, or 97 percent of the projected U.S. population, excluding illegal immigrants.

Sen. Chris Dodd (D-Conn.), who is overseeing the HELP Committee in the absence of ailing Chairman Edward Kennedy (D-Mass.), said he anticipates the Finance Committee bill would extend coverage to 20 million people via an expansion of the Medicaid program.