The myths of high cost healthcare

[Underhill]

well think about it dear, we have Medicaid Medicare Schip Tricare VA and intense regulation in each state while Canada has only one large bureaucracy. It figures that Cananda would be a more efficient socialism. Why on earth would our health care be so expensive compared to Cananda when everything else is the same price.

Did you think it was the Girl Scouts who controlled our health care system??????????????

Yes, but you still fail to offer a solution.

Are you suggesting everyone just pays as they go? 100% out of pocket? No regulations, a capitalistic free for all. Because I am sorry, but that is no solution. That means the poor, the sick and the elderly will all be fucked.

But cost will certainly go down. No doubt about that.

Bah... that's a dodge. We're not talking about helping the indigent. There are already safety net programs for them. If you want to beef those up, that's another discussion. Maybe we should.

So you are claiming everyone who needed insurance had it under the old system? Sorry but that just isn't true.

But 'reform' like PPACA forces all of us into into the corporate controlled "safety net" whether we need or want to be there. There's just no need to indulge those who want centralized control over everything under the sun.

Everyone needs it. The myth is that some do not.

Here is the deal. A young person who does not pay into the system still has to have some form of insurance at some point. Under the old system they could either wait until they need it, at which point it is insanely expensive or unavailable, or buy it earlier, which virtually none of them did since they didn't see the need.

Every plan, ever proposed, by either side of the aisle recognizes this problem.

I would agree Obamacare is not the answer in and of itself. It's a band aid solution. But your proposal to just leave things as they were is no solution at all.

There is a reason both Obama and McCain promised health care reform. The system was broken.

 

[dblack]

Yes, but you still fail to offer a solution.

Are you suggesting everyone just pays as they go? 100% out of pocket? No regulations, a capitalistic free for all. Because I am sorry, but that is no solution. That means the poor, the sick and the elderly will all be fucked.

But cost will certainly go down. No doubt about that.

Bah... that's a dodge. We're not talking about helping the indigent. There are already safety net programs for them. If you want to beef those up, that's another discussion. Maybe we should.

So you are claiming everyone who needed insurance had it under the old system?

Where did I say that??? Where do you come up with this stuff? Is it from previous discussions with someone else?

But 'reform' like PPACA forces all of us into into the corporate controlled "safety net" whether we need or want to be there. There's just no need to indulge those who want centralized control over everything under the sun.

Everyone needs it. The myth is that some do not.

Bullshit. PPACA is exactly one way to pay for health care (and a really shitty way under examination). There are endless other options, options that the insurance industry, and the federal government, don't want us to consider. But the main point is that we don't need to "vote" and commit to one mandated, centralized solution. What's so wrong with letting people decide for themselves?

But your proposal to just leave things as they were is no solution at all.

That's not my proposal. Are you getting me mixed up with someone else?

 

[Dragonlady]

Bullshit. PPACA is exactly one way to pay for health care (and a really shitty way under examination). There are endless other options, options that the insurance industry, and the federal government, don't want us to consider. But the main point is that we don't need to "vote" and commit to one mandated, centralized solution. What's so wrong with letting people decide for themselves?

Because things can't continue as they are. Health care is eating up way to much of the GNP and forcing people into bankruptcy. This is why every President since Truman has tried to reform health care in the US, but it had now reached a crisis point.

Yes, you do need to commit to a solution. Otherwise health care would bankrupt the nation.

 

[dblack]

Bullshit. PPACA is exactly one way to pay for health care (and a really shitty way under examination). There are endless other options, options that the insurance industry, and the federal government, don't want us to consider. But the main point is that we don't need to "vote" and commit to one mandated, centralized solution. What's so wrong with letting people decide for themselves?

Because things can't continue as they are. Health care is eating up way to much of the GNP and forcing people into bankruptcy. This is why every President since Truman has tried to reform health care in the US, but it had now reached a crisis point.

Yes, you do need to commit to a solution. Otherwise health care would bankrupt the nation.

Well, I think we've arrived at the crux of our disagreement. I simply don't see the need for mandating conformity via government, though obviously it's an appealing approach for those in power. Freedom isn't the enemy.

 

[Dragonlady]

Well, I think we've arrived at the crux of our disagreement. I simply don't see the need for mandating conformity via government, though obviously it's an appealing approach for those in power. Freedom isn't the enemy.

You keep saying there are lots of other solutions, yet you don't provide any details as to what those might be.

You don't have "freedom" now. You have insurance companies telling doctors how to treat their patients. That's ass backwards.

 

[editec]

Get rid of the whole system and go to single payer, they now need one, maybe even none.

should we go to single payer for all industries or just health care??

I'd really like to hear an honest answer to this question. Mostly it just gets dodged. If government should be responsible for making sure everyone has health care, does this imply it should be responsible for all of life's necessities?

The health care industry is SO UNLIKE every other industry that I believe it does make sense to have one insurance pool rather than many.

I cannot think of any other industry where the consumer is not the person deciding what it is they'll be buying.

Can you?

 

[dblack]

Well, I think we've arrived at the crux of our disagreement. I simply don't see the need for mandating conformity via government, though obviously it's an appealing approach for those in power. Freedom isn't the enemy.

You keep saying there are lots of other solutions, yet you don't provide any details as to what those might be.

You don't have "freedom" now. You have insurance companies telling doctors how to treat their patients. That's ass backwards.

Exactly! The entire reason we're backed into this corner in the first place is because we've already given up so much of our freedom regarding health are. We let medical boards, boards dominated by practicing doctors with a vested interest in controlling their market, decide which doctors we're allowed to patronize. We let state regulatory agencies, agencies dominated by insurance industry lobbyists, decide what kind of insurance we can buy, and who we can buy it from. We push people into employer-provided, group health insurance with tax and labor policies.

These are the things I would change if tasked with cleaning up the health care market. The major players in the health care industry have worked hard for decades, colluding with government to create their own 'fiefdom' of sorts. To recover consumer freedom and a competitive market we need to bust up their "racket". Unfortunately, they're succeeding in pushing the opposite approach.

 

[dblack]

should we go to single payer for all industries or just health care??

I'd really like to hear an honest answer to this question. Mostly it just gets dodged. If government should be responsible for making sure everyone has health care, does this imply it should be responsible for all of life's necessities?

The health care industry is SO UNLIKE every other industry that I believe it does make sense to have one insurance pool rather than many.

I cannot think of any other industry where the consumer is not the person deciding what it is they'll be buying.

Can you?

That's the problem, in bold. And you can bet, that if we let them push this model into other industries, we'll face the same problems. And I'm betting they'll try.

 

[Underhill]

Bah... that's a dodge. We're not talking about helping the indigent. There are already safety net programs for them. If you want to beef those up, that's another discussion. Maybe we should.

So you are claiming everyone who needed insurance had it under the old system?

Where did I say that??? Where do you come up with this stuff? Is it from previous discussions with someone else?

Everyone needs it. The myth is that some do not.

Bullshit. PPACA is exactly one way to pay for health care (and a really shitty way under examination). There are endless other options, options that the insurance industry, and the federal government, don't want us to consider. But the main point is that we don't need to "vote" and commit to one mandated, centralized solution. What's so wrong with letting people decide for themselves?

But your proposal to just leave things as they were is no solution at all.

That's not my proposal. Are you getting me mixed up with someone else?

Perhaps, then give me your proposal. You allude to other ways, but fail to offer anything more substantive.

How can there be a reasonable discussion when the only response I get is always, "there's a better way"?

Lay it out there and lets here it.

 

[Underhill]

Set aside this paranoia of the government for one minute and someone please explain to me what is the problem (and skip the bullshit) with looking at what the rest of the world does and emulating them?

I look at every other system in the civilized world and most all of them offer nearly as good or better coverage and cost half as much (or less) and cover everyone. What is inherently wrong with that?

 

[dblack]

Perhaps, then give me your proposal. You allude to other ways, but fail to offer anything more substantive.

How can there be a reasonable discussion when the only response I get is always, "there's a better way"?

Lay it out there and lets here it.

I've been very clear about what I would change:

You keep saying there are lots of other solutions, yet you don't provide any details as to what those might be.

You don't have "freedom" now. You have insurance companies telling doctors how to treat their patients. That's ass backwards.

Exactly! The entire reason we're backed into this corner in the first place is because we've already given up so much of our freedom regarding health are. We let medical boards, boards dominated by practicing doctors with a vested interest in controlling their market, decide which doctors we're allowed to patronize. We let state regulatory agencies, agencies dominated by insurance industry lobbyists, decide what kind of insurance we can buy, and who we can buy it from. We push people into employer-provided, group health insurance with tax and labor policies.

These are the things I would change if tasked with cleaning up the health care market. The major players in the health care industry have worked hard for decades, colluding with government to create their own 'fiefdom' of sorts. To recover consumer freedom and a competitive market we need to bust up their "racket". Unfortunately, they're succeeding in pushing the opposite approach.

In short, I propose removing the legal barriers currently inhibiting our freedom to seek out health care solutions that suit our individual circumstances.

 

[dblack]

Set aside this paranoia of the government for one minute and someone please explain to me what is the problem (and skip the bullshit) with looking at what the rest of the world does and emulating them?

I look at every other system in the civilized world and most all of them offer nearly as good or better coverage and cost half as much (or less) and cover everyone. What is inherently wrong with that?

It's inherently wrong because it vests too much power with centralized authority. For the same reasons we don't want government in charge of our religious beliefs (or telling us how to raise our children, or who to marry, etc, etc.... ), we don't want them in charge of our health care. This isn't based on paranoia, but history. The rest of the world is wrong on this, and I suspect we'll some really ugly shit go down this century as a result.

 

[Underhill]

Perhaps, then give me your proposal. You allude to other ways, but fail to offer anything more substantive.

How can there be a reasonable discussion when the only response I get is always, "there's a better way"?

Lay it out there and lets here it.

I've been very clear about what I would change:

You keep saying there are lots of other solutions, yet you don't provide any details as to what those might be.

You don't have "freedom" now. You have insurance companies telling doctors how to treat their patients. That's ass backwards.

Exactly! The entire reason we're backed into this corner in the first place is because we've already given up so much of our freedom regarding health are. We let medical boards, boards dominated by practicing doctors with a vested interest in controlling their market, decide which doctors we're allowed to patronize. We let state regulatory agencies, agencies dominated by insurance industry lobbyists, decide what kind of insurance we can buy, and who we can buy it from. We push people into employer-provided, group health insurance with tax and labor policies.

These are the things I would change if tasked with cleaning up the health care market. The major players in the health care industry have worked hard for decades, colluding with government to create their own 'fiefdom' of sorts. To recover consumer freedom and a competitive market we need to bust up their "racket". Unfortunately, they're succeeding in pushing the opposite approach.

In short, I propose removing the legal barriers currently inhibiting our freedom to seek out health care solutions that suit our individual circumstances.

So back to what we had in the 70's. Got it.

 

[dblack]

Perhaps, then give me your proposal. You allude to other ways, but fail to offer anything more substantive.

How can there be a reasonable discussion when the only response I get is always, "there's a better way"?

Lay it out there and lets here it.

I've been very clear about what I would change:

Exactly! The entire reason we're backed into this corner in the first place is because we've already given up so much of our freedom regarding health are. We let medical boards, boards dominated by practicing doctors with a vested interest in controlling their market, decide which doctors we're allowed to patronize. We let state regulatory agencies, agencies dominated by insurance industry lobbyists, decide what kind of insurance we can buy, and who we can buy it from. We push people into employer-provided, group health insurance with tax and labor policies.

These are the things I would change if tasked with cleaning up the health care market. The major players in the health care industry have worked hard for decades, colluding with government to create their own 'fiefdom' of sorts. To recover consumer freedom and a competitive market we need to bust up their "racket". Unfortunately, they're succeeding in pushing the opposite approach.

In short, I propose removing the legal barriers currently inhibiting our freedom to seek out health care solutions that suit our individual circumstances.

So back to what we had in the 70's. Got it.

Not what I said. At all. Can you read?

 

[Underhill]

Set aside this paranoia of the government for one minute and someone please explain to me what is the problem (and skip the bullshit) with looking at what the rest of the world does and emulating them?

I look at every other system in the civilized world and most all of them offer nearly as good or better coverage and cost half as much (or less) and cover everyone. What is inherently wrong with that?

It's inherently wrong because it vests too much power with centralized authority. For the same reasons we don't want government in charge of our religious beliefs (or telling us how to raise our children, or who to marry, etc, etc.... ), we don't want them in charge of our health care. This isn't based on paranoia, but history. The rest of the world is wrong on this, and I suspect we'll some really ugly shit go down this century as a result.

Okay but on that list most are nonsense comparisons.

Health care is not the same at all. Health care is something everyone will need. This notion that healthcare choices are a fundamental freedom seems silly.

Ask anyone if they would rather have it or not, and the answer is clear. Everyone will need it and it isn't (for 99.9% of the world) something people are against. The only real choice is how much money you want to spend.

And even that is nonsense. Because nobody knows when they will need it. Nobody knows how much money they need set aside. So leaving it up to personal choice is absurd. Nobody would buy it until they need it, at which point nobody could afford it.

The only way any form of insurance (government or otherwise) can be affordable is if those who need it pool with those who don't. It's really that simple. Either make everyone have it and it is affordable, or allow them to opt out and nobody who needs it can afford it. This is the inherent problem with any system that's goal is to take care of people.

People who don't need it will always avoid paying for it right up until the point they do need it. Then they will complain that it is too expensive.

 

[Underhill]

I've been very clear about what I would change:


In short, I propose removing the legal barriers currently inhibiting our freedom to seek out health care solutions that suit our individual circumstances.

So back to what we had in the 70's. Got it.

Not what I said. At all. Can you read?

What you said is fairly close to what we had in the 70's. There were some regulations, but no where near as many. But if that is still too much, pick an earlier date.

The point is, whatever time you choose, it was never a panacea for those needing health care. These regulations were put in place to deal with real problems people had.

 

[dblack]

Set aside this paranoia of the government for one minute and someone please explain to me what is the problem (and skip the bullshit) with looking at what the rest of the world does and emulating them?

I look at every other system in the civilized world and most all of them offer nearly as good or better coverage and cost half as much (or less) and cover everyone. What is inherently wrong with that?

It's inherently wrong because it vests too much power with centralized authority. For the same reasons we don't want government in charge of our religious beliefs (or telling us how to raise our children, or who to marry, etc, etc.... ), we don't want them in charge of our health care. This isn't based on paranoia, but history. The rest of the world is wrong on this, and I suspect we'll some really ugly shit go down this century as a result.

Okay but on that list most are nonsense comparisons.

Health care is not the same at all. Health care is something everyone will need. This notion that healthcare choices are a fundamental freedom seems silly.

Then we have fundamentally different views on individual rights. What could be more fundamental than your health? Are you sure you don't want to take that back? If not, what rights DO you consider fundamental?

Ask anyone if they would rather have it or not, and the answer is clear. Everyone will need it and it isn't (for 99.9% of the world) something people are against. The only real choice is how much money you want to spend.

And even that is nonsense. Because nobody knows when they will need it. Nobody knows how much money they need set aside. So leaving it up to personal choice is absurd. Nobody would buy it until they need it, at which point nobody could afford it.

The only way any form of insurance (government or otherwise) can be affordable is if those who need it pool with those who don't. It's really that simple. Either make everyone have it and it is affordable, or allow them to opt out and nobody can afford it. This is the inherent problem with any system that's goal is to take care of people.

People who don't need it will always avoid paying for it right up until the point they do need it. Then they will complain that it is too expensive.

That last sentence is really where it all breaks down. Insurance isn't something you buy after you are sick (or after your house burns down, or after you wreck your car) and then cash in. Insisting that that be a legal requirement is changing "insurance" into something else altogether. It's essentially government outsourcing its socialism - to be run by private, for-profit companies. It's the worst of both worlds.

If what we want is socialized medicine, or even just socialized health insurance, we should do it through our elected representatives. I didn't vote for anyone sitting on the board of Aetna.

As far as I can tell, most advocates of PPACA actually want, eventually, socialized health care, or single-payer or something that makes government the primary funding source for our health care. They see the current clusterfuck as a "path" to that (still haven't figure out what they'd dreaming of there). But for now, we have to sell ourselves out to the insurance industry, essentially giving them the power to tax us. Brilliant. Only temporary. Got it.

 

[dblack]

So back to what we had in the 70's. Got it.

Not what I said. At all. Can you read?

What you said is fairly close to what we had in the 70's. There were some regulations, but no where near as many. But if that is still too much, pick an earlier date.

The point is, whatever time you choose, it was never a panacea for those needing health care. These regulations were put in place to deal with real problems people had.

What is the fixation with "going back"? I'm certainly not suggesting any such thing. Unless fixing bad regulations and correcting ill-conceived policies is "going back" in your book.

This is why I don't rail much about "small government" or calling for blanket "deregulation". Just removing existing legislation wily nilly is no more likely to improve things then blindly passing unneeded regulation. In either case, we want laws and regulations necessary for government to do its job. The important question, that all these debates hover around and we rarely dicuss in depth, is "what is the 'job' of government?" i.e. which problems should we be allowed to turn to government to solve, and which must we deal with on our own?

 

[Underhill]

Then we have fundamentally different views on individual rights. What could be more fundamental than your health? Are you sure you don't want to take that back? If not, what rights DO you consider fundamental?

If you want to get into fundamental rights as they relate to importance, I would agree that their should be a fundamental right to health care. But a right to not enroll? Sorry but I don't buy that.

That last sentence is really where it all breaks down. Insurance isn't something you buy after you are sick (or after your house burns down, or after you wreck your car) and then cash in. Insisting that that be a legal requirement is changing "insurance" into something else altogether. It's essentially government outsourcing its socialism - to be run by private, for-profit companies. It's the worst of both worlds.

If what we want is socialized medicine, or even just socialized health insurance, we should do it through our elected representatives. I didn't vote for anyone sitting on the board of Aetna.

As far as I can tell, most advocates of PPACA actually want, eventually, socialized health care, or single-payer or something that makes government the primary funding source for our health care. They see the current clusterfuck as a "path" to that (still haven't figure out what they'd dreaming of there). But for now, we have to sell ourselves out to the insurance industry, essentially giving them the power to tax us. Brilliant. Only temporary. Got it.

I agree a lot of what you say. I am extremely disappointed that PPACA is what it is. I wanted single payer. What we got is a republican plan from the 90's.

On the other hand I think he recognized that if he had gone with full on single payer it would be another historical relic that never went anywhere, much like the Clinton's attempt in the 90's.

I do see this as a stepping stone, because like you, I don't see this plan working as well as it should. But I think for single payer to have a hope of happening, our private system will have to become nightmarish and I think our system is heading in that direction with this plan or without it.

Too many people (perhaps yourself included?) seem hung up on the whole socialist issue. They love to ignore the successes we have had with programs like Social Security or Medicare and focus on the current problems with both as an example of failure. Of course this isn't realistic. Both programs have worked very well for decades and simply need a minor adjustment to continue to be successful for another half century. What seems absurd to me is the fact we didn't make this adjustment decades ago. It's not like the baby boom is a recent observation.

We've been talking about this problem for as long as I can remember.

 

[Dragonlady]

Nobody inside the health care industry wants single payer because they won't be able to charge whatever they want. Doctors and hospitals will have to join the AMA or some other union like association to negotiate with the state on reimbursement rates. They do that now with insurance companies, but here there would be only one negotiation with the government. The medical establishment knows that if the government is negotiating, their rates will have to come down and they don't want that.

For-profit medicine has been free to charge whatever they want. A lot of doctors and hospitals refuse to deal with Medicare or Medicaid patients because the rate of reimbursement is too low. In countries with single payer, there is only one rate of reimbursement and that's what they fear. An end to the highest doctor and hospital fees in the world.