Health Care Reform in the US

[Hauptman]

I give you guys credit for trying to spoon-feed the facts to BB, but he'll never believe you... he can't... his entire world view is based upon certain foundations that would crumble if he acknowledged reality.

The scary part is just how many Americans are filled with this kind of rage and vitriol. Is it just an American phenomenon? Did we truly inherit the damaged goods that couldn't survive in their countries of origin along with the oppressed and downtrodden?

[Bayou Bum]

So many foolish things, it's hard to know where to start. I'm waiting for a flight so I'll take a few minutes. Not that it will puncture your invincible ignorance.

big surprise, more insults.

Yeah, there's that democracy thing getting in the way. And their kids don't want it to go away either and have to support their parents. Get your facts straight - this is a hot button issue the Republcans are now trying to exploit.

OK, lets talk about facts. Fact: The US is not a democracy, it is a REPUBLIC. Please provide proof that kids don't want it to go away and have to support their parents, or is this just another example of something is fact just because you say it is so?

Take a look at the life expectancies when those programs started and what they are now, and advances in technology when previously you just sent somebody home to die, now you can patch 'em up and keep 'em going much longer.

My point. So why should we not expect government provided health care to have the same results. Even the CBO, which always underestimates how much a program will cost says it will cost trillions more than Obama claims. And, you never did answer the question about illegals, etc. What is the matter, Obama hasn't given you an opinion on that yet?

So, here's Bayou Bum - the one person actually calling for death panels!

You don't really read do you. Please state how I called for death panels? I am saying that the government will have no choice to limit health benefits with a government plan.

Gosh, that is so stupid. You do realize that in SS you get your own money back after having contributed to it? People like Inq have argued that it's a bad deal because because you could have invested the money on your own and done better. I don't agree for a number of reasons, but at least it's an argument that can be made by people with 3 digit IQs. SS is not the be all and end all for ending poverty, and never was. You just don't know what it means.

Name calling again, you must have doubts about your position. SS combined with medicare, medicaid, food stamps and every other wealth distribution plan was supposed to end poverty. Why hasn't it?

And for Medicare, it only kicks in if you're over 65 or have one of a small number of disabilities, so it could never have been universal healthcare.

You simply don't understand what these programs do.

Yes I do. I am just one of the majority in this country that do not want the government running healthcare like you do. But, if we were a democracy, it wouldn't be an issue. Since it is a republic and the Democrats have control of Congress and the Presidency, and a filibuster proof majority at that, what is the issue. What does your party care what "a few" greedy capitalist think. Why haven't they passed the law already? Could it be that even some liberals are admitting that it ruin the country?

That's nonsense. You don't understand what "medicare advantage" is either. Go get some proof of this, like others have said. "Medicare Advantage" was a Bush giveaway to insurance corporations that costs more than regular Medicare while reducing choice.

Then the elderly will be happy to see it go away. Oh, wait ...

Bayou Bum complaining about name calling? That's rich. You have an awfully thin skin for somebody who slanders everybody who disagrees with you. I'm just calling it the way it is - you don't understand the facts of the situation, can't back up any of your statements.

Pot ... Kettle, not much point to respond.

You claimed This is the problem with government paid health care, who decides what treatment a patient can try to obtain? when you were obviously ignorant that it's Medicare paying for the treatment patients are getting and doesn't decide it. That was total BS and I called you on it.

OK, show me where medicare will pay all health care costs. It is easy for you to say Medicare is paying for the treatment when medicare won't allow some treatments, ie: knee replacements. Please quote me the part of medicare that says that it will pay for all treatments that the doctor and patient deem medically appropriate. When I get back from Honduras in a couple of weeks, I'll provide you a detailed list of what the government won't pay for, if you agree that when I do, you will apologize and admit that you are wrong. Didn't think so. And this is usually the point where you realize you don't have an argument on the facts, call me an idiot, and say I'm on your ignore list. Go ahead, I'm ready!

[Bayou Bum]

I give you guys credit for trying to spoon-feed the facts to BB, but he'll never believe you... he can't... his entire world view is based upon certain foundations that would crumble if he acknowledged reality.

The scary part is just how many Americans are filled with this kind of rage and vitriol. Is it just an American phenomenon? Did we truly inherit the damaged goods that couldn't survive in their countries of origin along with the oppressed and downtrodden?

Actually, there aren't many facts presented in favor of government provided health care. There are lots of promises and opinions, such as it won't be like that, but no proof. Show me where in the 1000+ page document it says you can go to any doctor, get the treatment you and your doctor deem medically appropriate, and it will be paid for. Where does it say that the government or a panel won't decide that your treatment is not necessary or worth the cost? You can't because it doesn't exist. All you have is Obama saying "trust me" and he hasn't been exactly honest in the past, ie. "Not one dime in additional taxes".

So please, save the opinions, give me some facts!

Wouldn't it be ironic if after the government health care passed, I was assigned as your primary care provider! That's a pleasant thought

[pinkelephant]

Since when were "republic" and "democracy" mutually exclusive? I live in a democratic monarchy - do you not live in a democratic republic?

[PeterGustafsson]

Hi!

I give you guys credit for trying to spoon-feed the facts to BB, but he'll never believe you... he can't... his entire world view is based upon certain foundations that would crumble if he acknowledged reality.

The scary part is just how many Americans are filled with this kind of rage and vitriol. Is it just an American phenomenon? Did we truly inherit the damaged goods that couldn't survive in their countries of origin along with the oppressed and downtrodden?

I can not speak for the other European countries with a large exodus to USA in the 19th century, but for Sweden it is instructive to note which kinds of people were over-represented among those that left.

Among those were:
1. Farmers living in areas where the natural soil was especially rocky/stony/bad, and they had perpetually bad crops. (Others living in places with nice fat soil were less likely to want to budge.) Those departurers were used to especially rotten luck, and they can to expect it as the natural state.
2. Criminals escaping the legal system. Those have no reason to trust that the state will help their personal interests.
3. People who had another religious inclination than the State church, and were particular about that issue. Those who were just vanilla-flavor religious, or not religious at all, were more likely to stay at home.
4. People with a rebellious nature in general. Their departure led to the average placidity (if that is a word!) of those staying athome to increase.
5. People who wanted to trade a safe alternative for the possibility of a large reward - and larger risk of failure - even if the expected value in thier personal cases was the same.

Where does that leave USA, providing that the imports from othe countries is similar to that from Sweden?

Well, that gives USA a population which has a segment which believes that a lot will go wrong no matter what, and that there is little that can be done about it. Witness the extremely low election participation rates in USA, compared with European countries. The criminal segment was/is a larger proportion of the population, with all attendant societal problems. Witness comparative crime rates for USA and many western European countries. It also gives USA a lot of religious people, with all their hangups and faith-based decisions. It also gave USA an unusually large proportion of habitual risk-takers. While those people provide a lot of good things, they also have to be people who think that "it will not happen to me" in regard to a lot of possible ills. Witness all the Americans who take the health-cost issue as a non-issue personally, since they seem to think that they will not personally become major-level sick within the near furture.

If one thinks about it, this mixup is perfectly chosen to create an electorate in which political issues concerning insurance-cost problems will become politically intractable. They manifold pathologies of a parliamentary system with single seats and a entrenched 2-party system add to this toxic brew, but that is a topic that I have covered before.

When a lot of those people left Sweden, politics based on a true understanding of one´s own best economic interests became the norm. Extremely few politicians over here get elected on values/morals platforms, or the v/m failings of their opponents.

Another thing is that in USA it has often been so that "Those who can, do business. Those who can not, get into regulatory bodies." My reworking of the original version - but it is an improvement, IMO. In contrast, it has often been so in Sweden that the best minds go into state bureaucracy, while private enterprise gets saddled with a lots of 2nd raters. This has given us one of the best-run state systems of the world, and that citizens generally trust it.

The downside is that our private company structure consists of a number of very large companies which were almost all founded before 1920, and quite few medium-sized companies. If a lot of those who are natural talents at organizational smarts go into state organizations, there are not enough left to make companies grow through the difficult middle size when they are not as nimble as the small ones, and do not have all the scale advantages of large companies - while at the same time having no specific upsides which belong to just their company size.


Have a nice time!

Peter Gustafsson

[jeff]

big surprise, more insults.

If you were more polite all along you would be spoken to more politely. Don't whine for for getting what you dish out.

OK, lets talk about facts. Fact: The US is not a democracy, it is a REPUBLIC. Please provide proof that kids don't want it to go away and have to support their parents, or is this just another example of something is fact just because you say it is so?

Oh, you're going to make a big deal out of that. Knock yourself out. I didn't say our government was constituted as a democracy, I said that millions of people wanting something and expressing it was an example of democracy. Which it is.

There's a lot of reported worry by people that they have to be responsible for their older relatives medical care and end of life - even with Medicare it's a real drain. You really are unaware of this?

My point. So why should we not expect government provided health care to have the same results.

When SS first came out, life expectancy beyond 65 was very low. Or to 65 for that matter. Now that more people live longer past retirement (not as long as in those countries with "socialized medicine" that so much frightens you) do you find it a surprise that original actuarial estimates are off? That's a mark of success, not failure.

Here's another data point: just heard of today. Spain has much longevity than we do, and spends a lot less, just like France and Germany. They have a fully nationalized health care system (payer and providers all are government), not the private system of providers we have even in the health care proposals, with a mix of private and public payers (again, what we have today and tomorrow no matter what). They don't ration healthcare. They had a doctor interviewed saying that the average lifespan has gone up dramatically and now they have these 80 and 90 year olds coming in and getting hip replacements. So, if they can do it, why can't we?

Even the CBO, which always underestimates how much a program will cost says it will cost trillions more than Obama claims. And, you never did answer the question about illegals, etc. What is the matter, Obama hasn't given you an opinion on that yet?

I don't get my opinions from anyone but myself - oh, I see, that was an insult. Okay. But, pay attention: he's already said it doesn't cover illegals.

You don't really read do you. Please state how I called for death panels? I am saying that the government will have no choice to limit health benefits with a government plan.

And what I'm saying is that since MEDICARE IS ALREADY A GOVERNMENT PLAN, GOING TO A PUBLIC OPTION DOESN'T CHANGE ANYTHING SO BLAMING IT ON OBAMA IS FALSE. Sorry to yell, but nothing else seems to work.

In today's Wall Street Journal, an ex-advisor to Reagan said this could be fixed in his opinion very easily by added co-pays in Medicare. Is that okay or do you want to say that they're commie pinkos too.

Name calling again, you must have doubts about your position. SS combined with medicare, medicaid, food stamps and every other wealth distribution plan was supposed to end poverty. Why hasn't it?

Well, some people hoped it would, but seriously: how do you expect a health program that kicks in at age 65 to be universal healthcare. Even with Medicaid, which most doctors don't accept. So, nice try, and a big improvenment that reduced poverty to a great deal, and reduced the consequences by a great deal. But eliminate? Nope.

Jesus said "the poor will always be with us" which makes him the most accurate economist. But being poor doesn't have to mean that somebody has nothing to eat and has to die miserably when they get sick.

Yes I do. I am just one of the majority in this country that do not want the government running healthcare like you do. But, if we were a democracy, it wouldn't be an issue. Since it is a republic and the Democrats have control of Congress and the Presidency, and a filibuster proof majority at that what is the issue. What does your party care what "a few" greedy capitalist think. Why haven't they passed the law already? Could it be that even some liberals are admitting that it ruin the country?

I'll give you a straight answer. What you have is a Democratic party that doesn't stay on message like the Republicans did. They have different factions: those that insist on the public option, and those that that oppose it. Also, they are trying to be bipartisan, in a way that Republicans never did in the previous Administration (the item that Sarah Palin lied about was from a Republican, remember). This tends to delay and dilute things. and create compromises. There are days when I wish they would just stick to their guns instead of rolling whenever the Republicans are obstructionist. But, they're trying to run the country in a way that satisfies more people - a goal that their opposition lacks.

Then the elderly will be happy to see it go away. Oh, wait ...

Get rid of "Medicare Advantage", while retaining Medicare? Sure, without a doubt. That would help everyone. It costs more than traditional Medicare and locks you in to specific doctors. It was an expensive giveaway to the insurers - a gold mine. You understand the difference between the two, don't you?

Pot ... Kettle, not much point to respond.

You've slandered and insulted everyone who disagrees with you, and cast smears on their patriotism and intelligence. Don't act shirty when you get a tiny fraction of that back.

OK, show me where medicare will pay all health care costs. It is easy for you to say Medicare is paying for the treatment when medicare won't allow some treatments, ie: knee replacements.

It doesn't. It takes no longer than to Google "medicare knee replacements" to get a list of hits, including:
http://www.stjohn.org/HipAndKneeCent...placementFAQs/
and
http://www.kneereplacement.com/DePuy...knee_FAQs.html

So, once again you have a hazy connection with the facts. That's not an insult - that's a simple observation of the difference between what you say, and what the facts are.

Please quote me the part of medicare that says that it will pay for all treatments that the doctor and patient deem medically appropriate. When I get back from Honduras in a couple of weeks, I'll provide you a detailed list of what the government won't pay for, if you agree that when I do, you will apologize and admit that you are wrong. Didn't think so. And this is usually the point where you realize you don't have an argument on the facts, call me an idiot, and say I'm on your ignore list. Go ahead, I'm ready!

Nope. I'm taking a homework assignment from you. I already did enough right above this to show where you're wrong in a specific case you brought up. They cover that and just about all the care received by people over 65. You tell me what you think they don't cover - and let's see if you can get it right that time.

[Bayou Bum]

It doesn't. It takes no longer than to Google "medicare knee replacements" to get a list of hits, including:
http://www.stjohn.org/HipAndKneeCent...placementFAQs/
and
http://www.kneereplacement.com/DePuy...knee_FAQs.html

So, once again you have a hazy connection with the facts. That's not an insult - that's a simple observation of the difference between what you say, and what the facts are.

Sure, medicare will pay for it if MEDICARE approves it. I can name several cases where medicare deemed certain surgeries were not medically necessary based on the patients age or condition. While this is also true of some private insurance plans, under a single payer system you don't have the option of paying for it yourself.

Of course, you still haven't answered my question. I know what Obama wants, he wants to make all illegal immigrants citizens. But, since they are not legal citizens, what do YOU think; should illegal immigrants should be covered? And since they are not covered, isn't it a lie that Obama wants all "47 million" covered?

[Purple Fencer]

I know what Obama wants, he wants to make all illegal immigrants citizens.

Show your proof...

[Gav]

Why are you guys interacting with a blatant troll?

[Bayou Bum]

Why are you guys interacting with a blatant troll?

Cool, I reached the status of a Troll. Anyone who disagrees with you is a troll. The only debate allowed here is how much wealth to redistribute, not whether it is right to do so or not. Actually, I think you are mistaking the word TROLL with TRUTH. It should say "Why are you guys interacting with a blatant truth?

[Gav]

Cool, I reached the status of a Troll. Anyone who disagrees with you is a troll. The only debate allowed here is how much wealth to redistribute, not whether it is right to do so or not. Actually, I think you are mistaking the word TROLL with TRUTH. It should say "Why are you guys interacting with a blatant truth?

Gather round everyone...

This is a clear example of trollish behaviour. Note the facile exhortations. The random capitalisation. The belligerent wording. The refusal to recognise reality. Classic. I might file this one in my gallery of favoured trolls.

Bless, he's so cute.

[jeff]

Yes, Balrog Breath is sooo cute a troll. When he gets caught in a howler that shows he made stuff up, he just changes the topic - or goes away, like last week when he tried to say that all medical advances came from greed, or that "Flemming" wouldn't have found penicillin if it wasn't for his rifle time. That's really the only reason to respond to him: hope that he gets caught and has to shut up for a while instead of brazen it out.

I'll just respond to his last silly question: Medicare only pays for approved procedures - and this is somehow different from the HMOs like CIGNA, Aetna, the Blues, UHC, etc? So, there's no difference, and it's factually incorrect to say in a single payer system you can't pay for it yourself: just look at the UK, where you sure as heck can pay for it yourself if you want. Gav already pointed that out.

But, it is a good idea to ignore BB. He adds nothing to any conversation.

[Bayou Bum]

Yes, Balrog Breath is sooo cute a troll. When he gets caught in a howler that shows he made stuff up, he just changes the topic - or goes away, like last week when he tried to say that all medical advances came from greed, or that "Flemming" wouldn't have found penicillin if it wasn't for his rifle time. That's really the only reason to respond to him: hope that he gets caught and has to shut up for a while instead of brazen it out.

Once again you don't pay attention. It is fact that Fleming went into research to remain on the rifle team at St. Marys. And I didn't say that ALL medical advances come from greed. I said I don't necessarily agree that Fleming had no profit incentive in his research. After all, everyone, except those living off of the greedy rich, needs to earn an income.

I'll just respond to his last silly question: Medicare only pays for approved procedures - and this is somehow different from the HMOs like CIGNA, Aetna, the Blues, UHC, etc? So, there's no difference, and it's factually incorrect to say in a single payer system you can't pay for it yourself: just look at the UK, where you sure as heck can pay for it yourself if you want. Gav already pointed that out.

But, it is a good idea to ignore BB. He adds nothing to any conversation.

Yep, there's the predicted ignore. The next time I'm in Phoenix, we'll have to have lunch, me paying of course.

[jeff]

Unlikely. I'm a little pickier about who I break bread with, and I certainly don't need you to pay for my meals.

Be polite here on the conference, and more respectful of other people, then maybe things can be different. I'm willing to be friendly with anyone who is friendly in turn. It's okay to differ in political views but you don't have to be obnoxious. But as it stands I wouldn't voluntarily spend time in your company.

[Hauptman]

Hi!





Where does that leave USA, providing that the imports from othe countries is similar to that from Sweden?

Well, that gives USA a population which has a segment which believes that a lot will go wrong no matter what, and that there is little that can be done about it. Witness the extremely low election participation rates in USA, compared with European countries. The criminal segment was/is a larger proportion of the population, with all attendant societal problems. Witness comparative crime rates for USA and many western European countries. It also gives USA a lot of religious people, with all their hangups and faith-based decisions. It also gave USA an unusually large proportion of habitual risk-takers. While those people provide a lot of good things, they also have to be people who think that "it will not happen to me" in regard to a lot of possible ills. Witness all the Americans who take the health-cost issue as a non-issue personally, since they seem to think that they will not personally become major-level sick within the near furture.


Have a nice time!

Peter Gustafsson

Along these lines, if you're familiar with ADHD (Attention Deficit Hyperactivity Disorder), we see very high rates of diagnosis of it in this country. Now while there may be many reasons for this (including over-diagnosis), there is an interesting theory that it is because ADHD symptomology fits very nicely with some of the characteristics implicit in an immigrant population.

If you think about the restlessness, impulsivity, risk-taking behavior, negative social interaction (and response).... it all fits with what might motivate someone to immigrate.

So being a counrty of immigrants might truly give us a different mindset here in the U.S. and it might even have genetic origins. I find that a fascinating possibility.

[Hauptman]

Since when were "republic" and "democracy" mutually exclusive? I live in a democratic monarchy - do you not live in a democratic republic?

I always laugh at that assertion as well. A republic, as even our founding fathers said, IS a democracy. Usually a representative democracy, but clearly a democracy none the less.

But when you can't win the argument at hand then feel free to pick a fight about something else.

[Hauptman]

These cries about the horrors of gov't rationing of healthcare are just utter crap. The health insurance companies ration health care every day!! Hello?!?! Anyone out there?

And then there are the cries about how expensive gov't healthcare will be and all the taxes they will force on the middleclass. But what about the fact that private healthcare costs have more than doubled in the last 10 years and are expected to double again in the next ten years!! All the while employers are dropping plans left and right. Hello?!? Anyone out there?

So yeah, we don't need no stinking healthcare reform!! Things are just fine the way they are. I'll have some of that koolaid now... :P

[I_luv_saber]

Most people feel tort reform is the best first move... mostly because even if the government IS paying, I don't want to be paying a huge excess of dollars because our system is screwed up.

Clarifying my position stated earlier... let's do this in small steps. It can be very easy to overcompensate in this situation. Try tort reform... try some regulation. Let's try things that are comparatively easy (and lower cost) before we go gallivanting into programs that will cost us billions of more dollars in debt. A little caution in proceeding, shall we?

In short: I am against high direct government involvement now. If we try some... less extreme fixes first and it proves ineffective, then I'd be more willing to consider a government option... I don't rule it out completely as never, ever, ever. I'm just saying maybe that much just ain't necessary yet.

[Hauptman]

Most people feel tort reform is the best first move... mostly because even if the government IS paying, I don't want to be paying a huge excess of dollars because our system is screwed up.

Clarifying my position stated earlier... let's do this in small steps. It can be very easy to overcompensate in this situation. Try tort reform... try some regulation. Let's try things that are comparatively easy (and lower cost) before we go gallivanting into programs that will cost us billions of more dollars in debt. A little caution in proceeding, shall we?

In short: I am against high direct government involvement now. If we try some... less extreme fixes first and it proves ineffective, then I'd be more willing to consider a government option... I don't rule it out completely as never, ever, ever. I'm just saying maybe that much just ain't necessary yet.

Does anybody have any numbers on how much tort reform will save us? I acknowledge that it would be a good thing and save money, but I would like to know how much litigation truly adds to our healthcare costs.

I'm reminded of the pharmaceutical companies crying about patent reform because of the supposed high cost of R&D, but then they turned around and spent far more for TV commercials than they do for that R&D. And let's not forget that the price of single-source innovator drugs went up by outrageous amounts when the drug companies realized that they had a captive audience and could essentially charge whatever they liked.

[Philistine]

Does anybody have any numbers on how much tort reform will save us? I acknowledge that it would be a good thing and save money, but I would like to know how much litigation truly adds to our healthcare costs.
{snip}

According to this 2004 CBO Issue Brief, medical malpractice costs were less than 2% of total health care spending. Their estimate was that commonly called-for reforms could reduce premiums by 25-30% (making a concomittent .4% to .5% reduction in health care costs).

It estimated costs due to "defensive medicine" as "very small."

--Philistine