I’m sure it’s too late for my opinion to matter on the topic but I’ll lay it out here anyway.
1) I think the Democrats have gone about this all crabbed. Health insurance reform should be approached from a consumer protection angle, not an “everybody has a right” angle. If you want to sell a product called “health insurance” then you need to meet certain federal guidelines on what you do and do not cover. Health insurance coverage shouldn’t be any harder to understand than when you motor up to a gas pump and decide what octane rating you want the gasoline in your car to be.
2) Not having a “public option” is bullshit. I can’t believe the package we’re getting doesn’t include one. When you’re running a small business with 5-20 employees it’s a bitch to track down a policy that’ll actually cover you at a reasonable cost. We really should let the feds gobble up a giant pool of policies that meet their criteria (see point 1) and then resell them at cost to small business owners. Insurance companies get a giant customer pool with a single payer out of it and small businesses would have a nice “default” to go to if they don’t want to invest man hours in shopping around for something better.
3) Go ahead and regulate the profit margins while you’re at it. Health insurance is nothing more than pushing money from party A to party B and taking a bit of profit for your trouble along the way. It’s not much different than lending really and we’ve all accepted that the government can regulate interest rates to some extent. Let the government set the actuary tables on the health policies and hold the insurance companies to that. You want more profit or market share? Do it through better customer service and gathering more customers. Seems to work for the Swiss.
4) Just get rid of Medicaid and drop those people into the public option plan. Either pay for it out of the general fund or weight the premiums paid by those on the public option so that they’re covering folks that cannot afford it.
What’s wrong with that?
Not a damned thing. But, umm, aren’t you a Republican, Justin? What you suggest is heresy as far as the GOP goes. The Teabaggers will not be pleased.
Wow. Never thought I’d see some of this from you, of all people.
1) Here you’re advocating for more Federal level administration, and regulation of an industry that is already a mess due to said regulation and involvement of Bureaucracy. In regards to your ‘ease of understanding’ arguement, I still don’t get this one, and you’re not the first person I’ve heard toss it out there. I use private health coverage, and I didn’t have any trouble reading and understanding what I’m covered for, and what I’m not based on the information provided to me. Of course, it wasn’t as easy as just looking for the correct octane on a gas pump, I had to read a few pages and ask a few questions .. but if there was a market for the sort of thing you’re looking for, the market would be offering it.
2) No, spending Tax Payer money on any form of “public option” is bullshit. Show me one sentence in the Constitution that says such a thing is the Government’s responsibility. You’re actually complaining about the fact that when you’re shopping for a product, there are options? Sweet Jesus …
3) Selling plants is nothing more than pushing money from party A to party B, and taking a bit of the profit for your trouble along the way. It’s not much different than lending, really, and we’ve all accepted that the Government can regulate interest rates to some extent. So, I suppose you’re folks are now limited to a set margin each year … which would be good, because the excess can be used to support that Greenhouse down the street that no one goes to because they’re prices are so high. Of course, really, Programmers are kind of the same … so now the guy that sleeps at his desk gets the same wage as you, but you still have to work. You know how this ends up.
4)Wait .. I finally agree with something you said! “Get rid of Medicaid.” Huzzah!
I’m hoping this was in jest, because if not … who are you and what did you do with Justin. At the very least, if this is your new line of thinking, I’d really love to sit down over a beer and discuss it with you.
-Abject_Disappointment
The problem with dropping Medicaid is that Medicaid is *much* cheaper than private health insurance. We currently spend less than HALF as much per-patient with Medicaid as the average private health insurance premium. This is part of why the Massachusetts experiment resulted in exploding health care costs there — most Medicaid funding got diverted into health insurance subsidies there, and the result was a huge increase in costs compared to simply giving hospitals uncompensated care Medicaid funding for caring for the uninsured. I thought Republicans were about fiscal prudence? Oh wait, Ronald Reagan and George W. Bush. Never mind ;).
Regarding Abject’s question of “is it Constitutional”, the Constitution mentions “the general welfare” *twice*, in the pre-amble and in the section describing the powers given to Congress (the power to pass laws to improve the general welfare — as vs. the welfare of specific individuals — being one of them). The Supremes already danced on this with Medicare and Medicaid. It’s a non-starter — there is no (zero) Constitutional barrier to setting up a mandatory health insurance program (like Medicare) or provide health care subsidies for the poor (Medicaid).
As for all the theoretical mumbo-jumbo Abject brings up, look. We have a practical problem here: A huge number of uninsured, and a huge number of insured people who are not getting the care they’re paying insurers for due to recissions, lifetime limits, and simple refusals to pay. “Let them eat cake” is *not* a viable policy for government in a democracy. It simply isn’t. The majority (those who are being told to eat cake) will *not* tolerate it for a long time. Either they will overthrow any government which tells them that the solution to their health care problems is “eating cake” via voting it out of office, or if that doesn’t work, they will overthrow it violently, but they *will* overthrow it. This is America. We may be sheeple most of the time (just stand in line at the airport “security” checkpoints to see that), but we’re also a violent, vicious people who do *not* take well to being subjects rather than a free people. The overwhelming majority of Americans, in all polls, even Fox News polls, say that health care is a right that government must guarantee. As in, 70% to 80% of Americans in *ALL* polls say this.
In a democracy, no government can ignore this except at its own mortal peril. What that means is that however this plays out (and I’m as disappointed with the current bills in the House and Senate here as anybody is), government is going to *have* to do something to guarantee health care for all Americans, regardless of any theoretical quibbles, or end up on the street — or under the graveyard after Madam Guillotine Time happens (just ask Marie Antoinette about *that* consequence of “let them eat cake” ignoring the will of the majority, oh wait, you can’t, the majority chopped her head off). I realize that many conservatives hate democracy (they sneer at it as “the tyranny of the majority”), but what’s your alternative? The only alternative I’ve seen is a tyranny where jackboots enforce the will of a minority upon the majority. That never turns out well.
In response to “Badtux”…
Your snipe about Republicans is quite correct. Their rhetoric does not match their actions. Which is precisely why I argue this is not a left/right issue. In fact, step out of the left/right paradigm and start determining what is actually going on by reviewing the facts, instead of listening to the talking heads.
Medicaid is a racket, as a simple search on your favorite search engine, and a bit of research will tell you. The manner in which rates are determined, paid out, and exemptions determined is a bureaucratic nightmare that is never included within the costs. Representative Ron Paul, amongst others, has referenced the appropriate documentation of this multiple times.
The Constitution does indeed mention “… the general welfare.” By twisting the meaning of that line to include mandated publically paid for health coverage, you’re opening the door to force the Federal Government to control almost every aspect of your life. Does that include trash pick up? What about the kind of soap available at the store? The list could go on for ever. Specially, this issue has been referenced in Baily v. Drexel Furniture, which has never been overturned. In this case, the court held that Congress could not use taxing power to regulate behavior that would otherwise lie beyond the scope of the Federal Government’s other enumerated powers. Hence, your constitutional argument and reference of the Supreme Court’s upheld definition there-of is void, based on this simple ruling.
The ‘practical problem’ you reference here, is indeed an issue. Large numbers of uninsured people. So, why are they uninsured? You can do a quick search of the phone book, or the internet, and get up to 2 Million dollars of coverage for less than $50 a month. Yes, Insurance Companies are not fun to deal with. Yes, they have created a bureaucratic nightmare that is worse than the DMV. None of these are factors that require the Federal Government to step in and solve the problem. That being said, I completely agree with the lower half of your paragraph where you reference my points as ‘mumbo-jumbo’ in such a kind fashion.
Regarding your conclusion first let me correct you on facts. We are a Republic, not a Democracy. Now, you are correct … no Government of the people, by the people, and for the people can ignore the situation they’ve created by their regulation, and involvement within the industry since the 60’s. Remove the barriers, created by Federal legislation that have made our medical system so stagnant and let people do their jobs. If there wasn’t so many administrative positions for ever doctor, costs wouldn’t be as high. If there wasn’t so much paperwork, and regulation to go through, costs would drop. Health Care is a very sensitive issue, for a great number of people, but the reflex action of kicking it to Washington for a solution is not the answer, just as it is not the answer for any other problem in life.
I’m truly hoping that Justin isn’t being honest with his statements, but I understand that people change. Thus the reason I offered to sit down over a beer and hear him out on why he feels this way, if indeed he does actually mean what he has stated herein, and it is not in jest.
John Wayne for President ! :)
Abject, I cannot get 2 million dollars of health care coverage for $50 per month, because I’m not 18 years old in perfect health. Indeed, as a 50+ year old man with pre-existing conditions, I’m basically uninsurable outside of the employment-based health insurance marketplace. This is true for most baby boomers, who are a *huge* demographic. You are either a liar or sadly ignorant of the reality of today’s health insurance marketplace. If it was not for the government regulation (ERISA) of employer-provided health insurance that you so hate, the majority of Americans over age 50 would have no (zero) health insurance — just as in 1964, before the passage of the Medicare Act, where 60% of people above age 65 had no health insurance.
Regarding your statement on Medicaid costs, once again you are either lying or woefully ignorant. I’ve examined two different states (California and Louisiana) in detail. In both states, Medicaid expenditures are much lower on a per-recipient basis than individual or family health insurance rates — and in Louisiana you can’t even blame cost-shifting to privately insured patients, because in Louisiana the majority of Medicaid funds go to their extensive charity hospital system, which is state-owned and state-run and provides hospital care to Louisianians for roughly 2/3rds the cost of private hospitals. You may wish to go over to the Kaiser Family Foundation web site to get current information on this subject, the Kaiser Family Foundation has done a good job of collecting all this data for your perusal and is non-partisan (naturally they tend to support HMO’s as the solution to all our health care problems — duh — but I have not noticed that this greatly affects the data they collect).
The difference between a Republic and a Democracy is irrelevant for our purposes. You do not address my point that the only way to enforce the will of the minority upon the majority is via jackboots — brute force tyranny. We are Americans, not subjects. You do not address the practical problem that the only way to not have a government-guaranteed right to health care when the majority want a government-guaranteed right to health care is to impose the rule of the minority upon the majority. We have a name for that system of government, it is called TYRANNY, sir, and I will have nothing to do with it. I find it offensive and disgusting that you seem to have no problem at all with the notion of tyranny, as long as it fits your ideology. Bolshevik, Bushevik, it appears the only difference is the ideology, not the methods they advocate, which is all about imposing their ideology upon the majority at gunpoint. I believe in freedom and democracy, sir. Have a nice day.
In response to ‘Badtux” yet again …
A Maximum payout of two million dollars, for a charge of $50 per month, with a maximum out of pocket expense that varies from $500 to $5000 for one calendar year for a 30-40 year old male, with prior conditions, who is a smoker, and at high risk due to family history is available. I current have such a policy. A Maximum payout of two million dollars, for a charge of $50 per month, with a maximum out of pocket expense of $10,000 for a male, age 46, life -long smoker, with existing heart condition and a prior surgery of a quadruple bypass is available. Both of these are real examples, and both were found after only several days of research, and questions. Now, do both of these policies require constant vigilance with preemptive care? Yes. Do both require the individual to attend smoking cessation courses? Yes. Do both have a hefty out of pocket fee for not following these rules, and constraints on what is covered (i.e. – Dental, Optical, and prescription is not covered)? Yes. Are each of these items available for anywhere from $15-$50 a month for each of these cases from supplementary insurance policies? Yes.
Granted, these are only two examples. But the argument that you are uninsurable is nonsense. Open up a phone book, and I’ll find you a life insurance agent that will sell a whole life insurance policy for a 104 year old man with a tremendous payout. Will the rates be high? Yep, but he is insurable. In a society where a $600 telephone bill, $150 dollars of which are taxes(1), is acceptable … why is it unacceptable to expect to pay for insurance?
This is also the second time you have personally attacked me. I am not a liar. I am not sadly ignorant of the reality of today’s health insurance marketplace. I’ve been fighting insurance companies for the vast majority of my life, and gladly admit to the frustration they cause, and general apathy they express towards their customers. I also argue, that in my experience with almost every other service oriented industry, I have experienced much worse examples. I should not have to explain myself, as I’ve clearly indicated where I’ve expressed opinion, and where I’ve expressed fact. The fact you disagree with me on my opinions does not give you liscene to degrade my character. You will also notice, I have not once attacked you personally. As I said before, this is an issue with strong feelings on both sides. I understand your passion, appreciate discourse on the topic, but see no need for you to hurl such attacks.
Regarding your specific reference of the ‘ERISA’ regulations passed by the Federal Government, I will direct you to the testimony of Professor Rand E. Rosenblatt, http://www.harp.org/rblatt.htm. It was set to the record on February 24th, of 1999. Within his testimony, Professor Rosenblatt cited that…
”Second, far from fostering stable and/or expanding health insurance coverage, ERISA preemption has contributed to the steady erosion of health insurance coverage from the 1980s to the present. Indeed, as interpreted and implemented in the 1980s and 1990s, ERISA preemption has undermined basic principles of insurance, de-stabilized coverage and decisions about coverage, permitted reckless interference with quality of care, violated fundamental principles of accountability in American law, created larger numbers of uninsured (in part by hobbling state-level reforms), and undermined responsible competition itself. The coverage mandates and regulatory and liability provisions under consideration in this Congress, and so vociferously opposed by employers and health insurers, are responses to these problems and an attempt to create more defensible conditions of competition in health insurance and health care delivery.”
I do believe that sums up my previous statements, and responds to your own, quite succinctly.
With regards to Medicaid costs, I cite the following analysis from the Cato Institute: http://www.cato.org/pub_display.php?pub_id=4049. This analysis from 2005 illustrates how the Medicaid system is woefully broken, and how reforms, or downright abolishment of the system, would create an eventual improvement to the situation.
Regarding your indifference to the issue of a Republic or a Democracy being relevant for the purposes of the discussion you have promoted, I, not surprisingly, argue the contrary. Continually in your points, you make reference to the ‘will of the minority upon the majority.’ In a Democracy, it is quite true, such an issue would not be a point at all. The majority would vote, and all would have to step in line with their decision. Fortunately, we live in a Constitutional Republic. A system where, despite the majorities opinion, African Americans were allowed to vote and integration took place during the 1960’s. A system where, despite the fact only males were allowed to vote, women also attained that right. A system, where despite deeply held views of the religious nature held by the majority at the time, a woman can make decisions regarding her own body.
Tyranny, as defined, is as follows:
1. Arbitrary or unrestrained exercise of power; despotic abuse of authority
2. The government or rule of a tyrant or absolute ruler.
3. A state ruled by a tyrant or absolute ruler.
4. Oppressive or unjustly severe government on the part of any ruler.
5. Undue severity or harshness.
6. A tyrannical act or proceeding.
I, as Justin himself will tell you gladly, do have quite the issue with Tyranny. In fact, my entire opposition to any form of the Public Option is expressly because of this. To take any of the wealth I accrue, earn, or manufacture, and to use it for the purposes of someone elses benefit without my consent … to force unto me the obligation to do so … is Tyranny. So yes, again we find something we agree on. I will have no part of that either. I find such a system offensive and disgusting as well. I believe in G-d the almighty creator, Liberty, the Constitution of the United States, my Family, those I Love with all my heart, and Jelly Beans. I do believe I will have a nice day, thank you very much, and to you as well.
-Abject_Disappointment
Dear Justin,
My name is Barbara O’ Brien and my blogging at The Mahablog, Crooks and Liars, AlterNet, and elsewhere on the progressive political and health blogophere has earned me the notoriety of being a panelist at the Yearly Kos Convention and a featured guest blogger at the Take Back America Conference in Washington, DC.
I’m contacting you because I found your site in a prominent political and health reform blog search and want to tell you about my newest blogging platform —the public concern of health care and its reform. Our shared concerns include health reform, public health, safe workplaces, and asbestos contamination.
To increase awareness on these important issues, my goal is to get a resource link on your site or even allow me to provide a guest posting. Please contact me back, I hope to hear from you soon. Drop by our site in the meantime—www.maacenter.org/blog.
Sincerely,
Barbara O’ Brien
barbaraobrien@maacenter.org
Whoa, Justin. I agree with you. Weird.
I have concerns about the Proposed Healthcare Plan. Can it create costly effects to my mothers well being? How do the advances counterbalance the bad aspects?