Forbidden Donut

Very good point on how dumb that looks.

I guess I support a strong national defense not only for defense but also because it makes it easier for our country to be powerful in world affairs, which, in turn, makes it easier for us to be involved in world trade. It is kind of like an investment in infrastructure. If you build a great national highway system then you can use it to pump up the economy in the same way as if you keep the world safe for trade you can pump up your economy. It would be nice if our country could be self-sufficient (and we probably have enough natural resources to be self-sufficient but not enough political willpower to do it), but until then it is nice to be able to have a high standard of living due to world trade.

What is your opinion of Jefferson creating the Navy and sending over ships to protect merchant vessels and securing trade routes (like in the Barbary pirate wars)? I know back then we did not have a very large national budget but some huge portion of it was being paid to Barbary pirates as tribute for them not to attack merchant ships, but then we decided to create a Navy and stop paying tribute (off and on).

I think that we spend too much on the military. Not that we have too large of a military, or that we have too many toys. I feel that the money given to National Defense is mismanaged, mostly Congress' fault. We could end up with just as effective a military force and spending a lot less if the political agendas behind so many programs were eliminated. Of course, that is probably true for 100% of government spending, but being that the defense budget is the largest portion I think it has the most room for improvement.

I'm not really opposed to National Healthcare. I'm opposed to it now, both because of the plan and the timing. You don't start spending a bunch of money on a new system during a recession. (Insert snide comments about other spending programs now, most of which I agree shouldn't have been spent on).

I'm interested in seeing how many of those uninsured people deserve to receive healthcare. As far as I'm concerned, unless are a contributing member of society, or were until retirement, or are any other kind of not shitbag/drain on society you don't deserve shit. How many of those uninsured are gang bangers/Katrina runaways/career criminals/crackheads? If there was any justice in the world, those would be the 165,000 with cancer and be on the way out pretty quickly.

Out of curiosity Rob, would you support giving healthcare to a single mother working two jobs if it meant also giving healthcare to a crackhead? I find it hard to believe that 36 million American citizens living on US soil are gang bangers, Katrina runaways (what is this by the way?), career criminals, and crackheads.

I would. She's trying to contribute and be a part of society. I'm not saying all 36 are one of those, that's why I'm saying I'm curious to see what percentage of them are.

I'm pretty bummed out that more republicans didn't respond to this, but I digress. This cartoon seems surprisingly accurate:

Edited to get right to the Satire.

You are conveniently forgetting some other items. Providing for National Defense is also one of the chartered reasons for the Federal Government to exist in the first place, it is in ingrained in the articles themselves, not an amendment. That being said, concepts of health-care and health-insurance didn't really exist (in the modern sense) until just before the start of the 20th century. Further, they didn't know/understand a lot of things related to the medical field that we know today. While they had a basic understanding of trying to do quarantines, their understanding of how to handle contagions, determine vectors of spread, sanitation, and a list of other things was either very rudimentary, or non-existent.

I suspect things like the Center for Disease Control would probably have likewise found its way into the Constitution if they founding fathers knew then what we know now. How far they would have gone in regards to the governments interest in actually making sure people get medical care is anyone's guess. My own personal hunch is they would have at least put provisions in there to make sure the government was playing a significant role in at least making sure contagions were handled, or simply prevented. (part of the whole "provide for common defense, and domestic tranquility" deal)

As we don't want to deal with the economic damage that can come from things like the influenza outbreak at the end of WWI. Which puts Disease Control in a situation not much unlike the Military: If everything goes well, their mere presence will, to the common observer, seem to be largely superfluous as they never see/hear or otherwise generally enter into a situation where they need to be consciously aware of what those organizations are doing.. But when things go wrong, they're ready and able to handle what comes.

------------------

Intangibles are funny things that way. How do you put a valuation on an event that never happened?

We spend hundreds of Billions of Dollars every year to maintain a very large Military Force, whose main purpose(on paper at least) is to deter other nations from pursuing a fight with us. It also is largely effective, to the point that other nations are so satisfied with our practices they've cut back their own military spending because we're keeping them safe enough to do so. We are undoubtedly doing overkill on that, to the point that I do think that behavior is a cue for the US to potentially dial things back a bit itself, but it goes back to other intangibles at play there(reduced tensions among neighboring nations as the US presence allows both sides to mutually decrease the size of their militaries -- post WW2 Germany and the rest of Europe being a good example; or otherwise giving the US a "big stick" to use in diplomacy, if they want to do something that requires a large commitment of military resources to achieve, we're pretty much the only game in town).

For example, our Navy is essentially the defacto ruler of the open seas, which allows our corporations, and our allies, to move very large amounts of commerce across the open seas with minimal concern about the safety of their cargo from other human parties/nations.

But then, I guess my particular background dealing in Combat Identification plays into a significant appreciation for "the intangible" side of things. It isn't "omg WOW" technology at play, or something most people are going to drool over like the weapons themselves or the platforms they ride upon. If everything works right, you never hear about those things, and most people won't even give it a second thought about them. Nobody keeps a running tally of "things that would have been blown up, but didn't get blown up because it was properly identified" but the moment something does, the people working that side of things are among the first to brought in on the carpet, from R&D down to the guy(s) who last serviced the equipment involved.



In a bit of Google searching, closest thing I could find was this when it came to cancer treatment costs on an individual level, and it is only a partial picture as it only reports medicare payments made:

http://www.msnbc.msn.com/id/23783216/

Ovarian Cancer in the first year ran $36,600/person in Medicare payments in 2004.
Leukemia in the first year ran $18,000/person in Medicare payments in 2004.

Just pulling arbitrary numbers from the one you provided already. An estimated 1.4 million patients with cancer, we'll go with the Average person undergoing treatment for 3 years, so we'll take only a third of those 1.4 million people. That gives us 466 thousand patients in their first year, we'll go with the cheap option, and saying they're averaging $18,000/person in cost per year, that gives us a cost of $8.388 Billion dollars. Not too terribly bad, and being the federal government, $8.3 Billion is almost pocket change.

Of course, as that article reports, you get other fun things, how about a pancreatic cancer treatment drug for $4,000/month ($48K/year) that may only increase patient life expectancy by only a few weeks?

Or two different drugs that can be used to treat metastatic colon cancer, but one costs $60,000 less over the course of treatment than the other. (they don't give a price tag for the other option, or any indicator on what the duration of treatment is)

-------------------

As was generally already run around in another thread much earlier this month, I do think there is a definite compelling "general welfare" national interest in providing health care at a national level sufficient to mitigate the risks of a contagion type event. Which means doctor visits(and treatment) for things like bronchitis, pneumonia, the common cold, influenza, etc should be things that get covered.

I also feel there is a generally less compelling argument to made for a "general welfare" interest existing where "productivity type" medical issues come into play. Broken bones, sprains, and other such instances, a person who has full function of their body is likely to be (able to be) more productive than someone who doesn't have full function.

I somewhat like "social justice" items, which is why I also generally felt minors shouldn't be penalized for the economic status of their parents where health care is concerned. This plays loosely into the "general welfare" interest as well, as getting children to adulthood in good health is in their best interest, and assuming they pursue a productive adult life, worthwhile to the taxpaying public as well.

------------

However, my "social justice" interests start to cease to exist when it comes to people who have attained adulthood, and I'm more than willing to leave them in the realm of sink or swim at that point. If they're productive members of society, they should be put in a position to be able to take care of their own needs without someone doing it for them(no choices being made on their part). If they prove they are incapable of making choices in their own self-interest, they should be allowed to suffer accordingly.

Health care reform is needed in a lot of respects(to get it to the point where people can take care of their own (advanced) medical needs), but single payer(government) isn't one I'm overly fond of.

Otherwise you seem very conflicted.

Somewhat, yes. Nobody wants to be the "bad guy" who has to tell people they screwed up, and have earned themselves a horrible and painful death as a result(untreated cancer for example).

However, on the flip side, I do not see a compelling "general welfare" interest in treating cancer patients. Cancer is not communicable directly(though some forms can be caused as a result of communicable diseases), so there are no "contagion" concerns about leaving people to suffer through it and wander about the streets without government assistance.

Which is not the same thing that could be said about someone walking around with Ebola, Smallpox, Polio, Measals(sp?), and a number of other communicable diseases that are very harmful if not lethal for many people who contract them. There is a very compelling general welfare interest in getting those people off the streets to reduce risk of the disease spreading, and in the cases where it can be prevented(vaccination) making sure that people get access to those vaccines.

Now broken bones, stitches, and other forms of basic care play into other things. There is a decent argument to made in the interest of "national productivity" to make sure that everyone is able to perform to the best of their physical ability and that nobody become crippled when it could be otherwise prevented. However, there I am not entirely sure I want to deal with a National Government that is extensively invested in maximizing "citizen productivity."

The other more ghastly side of things is there also are public health concerns about people wandering about with improperly treated cuts/sores/etc oozing pus and whatever else at various times.. Putting us back at trying to prevent contagions. However, even with how broken health care currently is in the United States, that isn't a particularly common problem(to the point where it is virtually unheard of, particularly of it being bad enough for it to be an actual problem for the population at large), so I don't see a compelling case for radical change being necessary.

----------------

That being said, I have seen the numbers on a number of other things, and I do generally agree with the conclusions that people are acting on when it comes to pushing a lot of this stuff. A healthy work force is a more productive workforce, a more productive workforce is likely to result in improved quality of life(better pay/benefits) and more revenues for their employer, and by even further extension, more tax revenues for the government itself.

It is one giant freaking grey area on where you want to draw your personal lines on a lot of this stuff, and a lot of it centers around what you want to believe the Government's role in a lot of it should be. It is because we are talking about a "grey subject" that I come across as slightly confused on it, because it isn't simply black and white. There are a lot of pros and cons for going either way on it. I also tend to favor less government involvement on things whenever possible over more government involvement.

I know and understand that there are some things that are best handled by a governmental entity over a private one because the typical motive for private sector involvement tends to revolve around self-sustainability(co-ops) and/or profitability(commercial), and that there are "public interest" situations that do exist where neither a co-op or a commercial entity would be able to normally provide services to people without someone/something subsidizing their costs for them(governmental assistance and/or charitable donations) or providing another incentive(public relations) to do so, but those avenues tend to have limits on how much they'll fund.

In the case of health care, those "problematic people" would chiefly be the unemployed, the homeless, and the very poor, as they couldn't pay premiums even if they wanted to(obvious loss of money to provide them with coverage).

Other examples would be rural phone service and power, where the rate of return on investment is so slow(and low) that the only way some areas/people can get service is to pay the provider a substantial amount of money to run wire out to them(direct subsidy from the customer themselves), or for some level of government(subsidy from government -- cost diffused across the tax base) to provide some incentive for them to do so.

-------------

It still ultimately runs back to which side of the line you expect a government run health care system to fall on.
Will it turn out like the first ~30 years of Welfare?
The first ~50 years of HUD and "the projects?"

Or will it turn out like the Tennessee Valley Authority, Bonneville Power Administration, the Transcontinental Railroad, or the Interstate Highway System?

Do keep in mind however that the Transcontinental Railroad was privately owned and operated, even if the construction was financed in large part by Federal land grants. TVA, from my understanding generates power and provides some transmission services, but delivery to the end-user is private sector. I know BPA works that way as I live under its collective umbrella. The Interstate Highway System has federal standards for what is generally expected(lane width, signage, road grades, etc), and is largely financed federally, but construction and maintenance still falls to the state/local level.

I'm willing to concede that something like a single payer system, with government being heavily involved in health care could possibly reap huge rewards for the nation as a whole. However, I'm suspecting they're simply treating the symptoms, not the underlying problems(as I don't think anyone in a decision making position honestly has a clue what the actual problems are), and what we would get under the current plans would turn into a disaster like Welfare has largely been, and like the housing projects of the 1940's and 50's undeniably did become.

Jesus Christ, Mark. tl;dr.

-dan

Wall of text crits you for 628394710 characters, you fall to ground and burst into tears.

More like, "Wall of text attacks. Dan dodges. Dan goes to play HoN instead."

-dan

Daemon, here's your homework:
Read John Rawls. All of everything he has written. Then get back to me on the "general welfare" value of treating cancer.

Also it's worth noting that we're not even talking about government run health care in America.

The discussion is about whether we get a public option or not. Then there's an entire sub discussion about whether adding a government run option drives private options out of business. Which is what happened to UPS and FedEx, if you remember when they went bankrupt.

The Market that FedEx and UPS works in is different from what the Health Care market is.

Also keep in mind that there have been many decades of strong congressional pressure to make sure the USPS does not get subsidies from the US Government, it is to be self-sustaining, self-sufficient, and subject to providing a range of employment (namely -- retirement) benefits by virtue of being a US Government Agency that FedEx and UPS don't have to contend with. Postal Workers get government retirement benefits(paid for by the USPS), Postal Workers with military experience have military service count towards retirement.. UPS and FedEx employees? They get a 401K if they're lucky.

Further:

I doubt you will find successful congressional efforts to require any "government (aka public) option" in health care to do the same. Reason being that not many people want to be the bad guy, and most people in congress don't want to be viewed as that guy. Once a public option for health care is made available, it will receive whatever funding it needs, by whatever means it needs, in order to be sustained. Because no politician wants to have fingers pointed at them for why somebody's grandparent, parent, child, significant other, or other close associate died because (s)he approved of budget cuts to that particular program.

There is no credible reason to believe self-sufficiency will be a requirement for the "public option."

Also given who they're targeting the "public option" for, I doubt it stands a chance of ever being solvent in the first place, unless you get virtually everyone in the United States enrolled in it... Something you can't do unless it is the defacto standard.

The is no credible reason to believe that a "public option" health plan that doesn't have to be concerned about self-sufficiency(solvency) will not displace private health insurance for anyone who is not in the top 5% of income earners in the United States (that is a household income of $177K/year as of 2007 according to the US Census).

There are few private sector entities that can be found anywhere that has been able to compete successfully against someone who is not concerned about profitability(Microsoft provides examples of this happening in the private sector, see "Browser Wars and Internet Explorer" and "XBox" -- pre-360, though it should be noted that I understand Microsoft is still very heavily subsidizing the 360). There are some, but they're the exception, not the rule, and they generally only found success by offering a vastly superior product, the competition dropping the ball, or getting the Government to step in with anti-trust actions against the offending party.

Considering in this case the new competitor would be the Government itself, I'm going to have to wish the private sector much luck in pursuing anti-trust actions against anything the Government does that they can't compete against.

Also keep in mind that the insurance industry does have a requirement for maintaining equity reserves in case of certain contingencies. I think we can safely say that the public option can go "N/A" on that, as it would be the Government, they're backed by the full faith and credit of the United States Taxpayer, which incidentally includes the majority of those insurance companies operating in the United States.

It's politics, a lot of what goes on there doesn't make sense because it isn't supposed to. Smoke and mirrors and all that jazz.

There is a rather significant difference between denying the granting of additional privileges/entitlements to the population at large, and trying to remove a privilege/entitlement once granted. It's why politicians are deathly afraid of touching Social Security even though it has been known to be in desperate need of fixing since the early 1980's.

It's why the only real changes made to Medicare and Medicaid over the years has been to expand those programs, even when the Republicans had control of Congress.

It's the difference between dealing with "some people" and "most/all people" politically speaking, where entitlements are concerned, the only ones that are likely to see cuts or reforms are the ones that majority, or at least the largest plurality, of people can safely view as being the "other." (Tyranny of the Majority at its finest)

Which is how/why the Republicans managed to play the bad guy in the 1990's when they rammed Welfare Reform through Congress and across Clinton's desk. Those reforms had no direct impact on the Republican constituency, or even most Democrats, as none of them intended to ever use it/become dependent on it. It was the "other guy" that would pay the price of those reforms, and the benefit to their constituents is they experienced a lesser tax burden in exchange.

Single Payer healthcare makes everyone who falls under the umbrella of the Government's program dependent upon it. It becomes a vested interest item to them once they start using it(until then its simply an abstract, and can be generally treated as an "other" construct by the very people who stand to benefit from it). Once it goes into effect, handling it will be like trying to reform Medicare, Medicaid, and Social Security. It simply isn't likely to happen in anything outside of a geologic time scale.



If by "do it so right" you mean "operate in such an anti-competitive manner that nobody is able to compete against it" then you'd be right.

1. Enroll the most destitute and needy people in the Government option at affordable prices.
2. Discover the affordable prices for the end users is not a sustainable price point for solvency of the program.
3. Subsidize the Government option with Taxpayer money obtained by various other means that is not tied to enrollment in the Government option.
4. Watch the consumer market start shifting over to the Government option as it's cheaper and provides comparable/better levels coverage on the financial side(quality of customer service isn't going to be that much of a factor for most of the population, as long as their medical bills get paid)
5. Watch commercial insurance entities either go bankrupt trying to match what the Government is offering, or simply exit that market altogether.
6. Attain governmental near-monopoly status as the Health Coverage Provider for all but a very small percentage of the US Population(the people able to pay for "premium levels" of health care).

It isn't going to be an overnight process. It may take upwards of a Decade to play out, but that is what would happen. 10 or so years down the line when they have 90% or more of the population enrolled in it. It may be able to be reasonably self-sustaining. But it won't be because the government option was better, it will be because the United States Government spent the competition out of the business, using taxpayer dollars to do so.



How are health insurance providers going to credibly offer you a superior product at a barely breaking even funding point?

Keep in mind, for the general population, they are going to be paying for you to receive medical care from exactly the same care providers the US Government is offering to pay for, at generally the same level of care.

Remember, the private company has to be concerned about breaking even, while a government subsidized effort doesn't.

Which leaves us with what?

Paying higher premiums to the insurance companies to "stick it to the man" where the Government is concerned?

Paying higher premiums to have a better customer service experience when dealing with the insurance company?

Paying (significantly) higher premiums to get access to (experimental) treatment options that the Government isn't likely/willing to pay for? (which goes back to who do you think is going to be able to afford those premiums)



See the previous point I just made. What could a private insurer offer to the average American that would make their insurance plan preferable to the one offered by the Government, when the private insurer must remain profitable(and compliant with government laws), while the Government doesn't need to be concerned about operating their competing program completely in the red?

It's like saying you see no problems for a locally owned general store trying to compete against a general store owned and operated by the Railroad in the late 1800's, while the Railroad was charging the local stores exorbitant fees for transporting merchandise to them. There is a reason why anti-trust laws exist, and the Government Option if it ever sees the light of day, will be a 21st century example of it on a national scale, only instead of "Robber Barons" being the ones behind it, it'll be the United States Congress.

Seriously, fuck all your words after this. THIS is the point.

You don't have answers, only questions. This is the problem with the opposition to health care reform right now. It's all what if's based on cherry picked historical information.

Meanwhile, let's stop pretending that insurance companies are on the brink of bankruptcy here. It's disingenuous.

And pretending you know everything about how this will shake out, despite admitting that politics doesn't really make a whole lot of sense, doesn't add much to the debate.

How about we don't make another agency or program.

Let's call it the medicare/medicaid reform and expansion bill of 2009, and be done with it. Open medicare up to all ages, expand coverage, and call it a day.

But then we'd have a single payer system... LIKE CANADA!

At the same time, do you know how this will shake out if your choice pans out? Just keeping things in perspective, everyone likes to assume they know what's going to happen -- but no one ever does,

I think the point is, you never know exactly what is going to happen, so you try to do what is right and hope for the best. Democrats aren't saying that the pubic option will end bankruptcy, cure all disease, and make everyone live to 90. However, Republicans are saying that any form of health care reform proposed by the democrats is going to cause the destruction of American values and this country as a whole based on pretty crazy assumptions about what would happen with such a system.

I'm not even willing to call them crazy! But they are definitely assumptions, and basing your entire argument off of not just one, but dozens of assumptions isn't going to fly with me.

Also, I support the pubic option.

Also, bear in mind, I'm pretty tightly focused on the "public option."

Which is health insurance premiums paid to the US Government in exchange for the government making payments to cover that person's medical expenses.

-----------

I have repeatedly agreed that the health care system in the US is badly broken and needs to be fixed, and reforms are a good place to start. There are some basic things that the government itself can do which will probably help immensely.

However, I do not think that displacing Private Health Insurance Companies with a newly created Government Agency or Program is a workable solution to this problem. All that does is accomplish a gigantic shell game that changes who is picking up the tab and the hands the money passes through.

Objection! You are assuming facts not in evidence.

It's happened before in other industries prior to anti-trust laws, and has been attempted in spite of those same laws later on. There is no reason to believe it will play out any differently in this case, particularly since this particular "trust" would be backed by the United States Congress... Which is fully capable of amending those anti-trust laws to make what they're doing legal.

Particularly given every reason to believe active use of anti-competitive practices is likely to be going on at the same time.

Something you have acknowledged yourself when you agreed that it is unlikely that the government option will be required to self-sufficient.

You're saying that private industry isn't trustworthy until there's government intervention.

There you go... assuming again. And then presenting it as fact.

Please stop that. Seriously.

I say no healthcare for anyone, ever.

Let it happen naturally.

Private Industry isn't trustworthy until there is a government to intervene on some items, mostly to enforce societal norms.

Much like people(individually and collectively) are not completely trustworthy until there is some kind of governmental organization put in place to enforce some semblance of societal norms.

It isn't too surprising really, considering that Private industry is run by people.

Of course, there is another part of that as well.

Governments aren't trustworthy until the people and the organizations it rules over are able to hold that government fully accountable for its actions. Because governments are also run by people, amazingly enough.

And in case you haven't noticed the United States Government is a very large entity in its own right now, and it is a pretty daunting task to hold much of it accountable for anything anymore due to the many layers of bureaucracy it has built up over the years. Adding more to it shouldn't be high on anyone's priority list, if there are other options that can still be pursued.

And if you're so confident that I'm wrong, care to make a bet on it. (not that we're likely to care/remember/know how to find each other at that point)

But I'd be very comfortable with saying that if a Health Care Reform package goes through with a Government Option being present in it:
1) Within 10 years time of that law taking effect(and assuming it remains in force), there will be no insurance packages competing directly with it.

2) If there are health insurance packages being offered by private industry at that point(10 years later), they will be supplemental insurance packages that ride on top of the Government Option, to cover things that Congress decides it doesn't want to pay for. (Abortions/Birth Control being the two big ones I can think of as likely first targets for non-coverage)

This is a much better candor to take.

You don't know, but you're willing to bet. I'll respond to this more reasonably later, I'm leaving work now.

4:20 and heading home? Lucky f*ck.

I think this is much more likely than the scenario you were laying out before. I also think this would be an out-fucking-standing outcome if it happened.

But I think what WILL happen, is precisely bupkiss. The opposition won pretty much immediately. I knew as soon as I heard the phrase "death panel" come up in an inquisitive way on MSNBC that we're not getting anything meaningful. Maybe an expansion of chip, or something. Probably not.

And then rather than relish the victory, pundits will spend the next 3 years talking about Obama's complete failure to bring change to America.

*book it*
*done*

$5?

I'll just leave this here:

"Pseudoconservativism is among other things a disorder in relation to authority, characterized by an inability to find other modes for human relationship than those of more or less complete domination or submission ... The pseudo-conservative is a man who, in the name of upholding traditional American values and institutions and defending them against more or less fictitious dangers, consciously or unconsciously aims at their abolition ... [He] sees his own country as being so weak that it is constantly about to fall victim to subversion; and yet he feels that it is so all-powerful that any failure it may experience in getting its way in the world ... cannot possibly be due to its limitations but must be attributed to its having been betrayed."
- Richard Hofstadter, The Paranoid Style in American Politics and Other Essays, 1965.

...and most of those "supplemental policies" would be expensive enough that most people would be unable to afford them, leaving them stuck with what the Government offers them only. (back to only the top ~5% of incomer earners having it)

Likewise, there is a world of difference between a supplemental insurance policy, and a full fledged insurance policy. They are not the same thing, and it would destroy the existing insurance industry. In the scenario of single payer coming to pass, many of them may have survived to become medical supplement service providers, most of them would not.

And while cases could be made for the bargaining power the Government would then have to essentially put price controls(oh wait, I meant "increased bargaining power") in place to control growing health care costs, as they're then the only game in town. The problem with that is that price controls, when tried in other things, have a tendency to turn into disasters when carried out for a prolonged period of time. (Rent control, anyone?)

Yes, medical care is godawful expensive. No, giving someone a giant sledgehammer they can use to force pharmaceutical companies, medical suppliers, hospitals, and doctors from charging exorbitant rates/fees is not going to fix it.

Getting everyone under the same umbrella does help with eliminating the deadbeat issue(care provided to a person who does not/cannot pay for it), but the deadbeats are not the only major factor on the cost of care.

We have wildly escalating medical(and other) education costs, we have a medical system that rewards greatly better pay to specialists than to general practitioners(this goes for nurses as well), which is causing shortages of general practitioners/nursing staff in other fields.

We have a litigation system that makes medical personnel very paranoid about the medical calls they do make, which helps further drive the demand for specialists in anything and everything and other high tech diagnostic tools that may not actually be necessary.

We(as well as numerous other first world nations -- including Canada) have a excessively "Tech-centric" view on medical care, from the latest and greatest diagnostic devices to the newest designer drugs for treating things. In the case of Canada, that continued interest in Tech, paired with tightly controlled reimbursement rates(price controls) on health care services has lead to facility neglect and decline in a lot of other areas. While their health care situation isn't nearly as bad as some people try to make it out to be, almost 40 years of their single payer system is starting to take its toll on a fair bit of the underlying medical infrastructure.

The solution put forward was incomplete, it was a bandaid, and it was one that was going to be highly destructive to existing industry in exchange for producing only minimal improvement(in the short run) over current conditions for the average person in the United States. It is possible that the supplemental insurance sector could possibly still cough up enough money to cover a number of short-comings of the "single payer" system for a lengthy period of time, but I'd be somewhat skeptical of that.

Once they start talking about meaningful healthcare reforms that are not bandaids, we'll see what happens, but that time doesn't appear to be upon us just yet.



Yup, death panels probably killed in large part, which is somewhat sad, as they didn't exactly exist in the first place.

And considering what happened with Clinton, you're probably right about the pundits for the next 3 years.

I personally wouldn't mind an expansion of CHIP, if you paid much attention to the comments I made in the other thread.

I mostly agree with what you say. It's just when you go off into predicting an impossible future that I lose you.

In my idiotic analysis of things, I would suggest that if Private Insurance were forced to re-align their business to deal in supplemental insurance, then this frees up their money from regular ass insurance. Like drugs, doctors visits, etc.

I see no reason for them not to realize these savings and convert them in to an alternate insurance strategy. And I'm fairly certain if you poke around the world you can see this sort of system somewhere that probably won't meet your rigorous standards for acceptable analogs.

You on the other hand seem convinced that no matter what, Private Insurance would completely collapse.

Also, regarding all those symptoms of a broken health care system. I'd posit that they are really just symptoms of a nation held hostage by private insurance. Not us Americans overusing our hospitals.

Lastly, please support your claim that a public option in Canada "has lead to facility neglect and decline in a lot of other areas." You must have gotten this info somewhere, and I'm curious, since I've never heard this particular criticism.

Not quite the specific article I'm looking for, but it'll do for a start.

http://www.google.com/hostednews/canadianp...D335rGu_Z3KXoQw

How about the Canadian Press reporting on an interview with the incoming President of the Canadian Medical Association, as well as some comments from the outgoing one as well?

Let's not stop short here. The VERY NEXT paragraph reads:
His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

So do you trust the guy, or not?

Him, I'm somewhat inclined to believe.

The Democratic National Committee, as well as the Grand Ol' Party, and their memberships at the national level, not so much.

If either side can find a way to fuck it up(with the best of stated intentions, no less), they will.

Right. But then again, I don't trust private insurance companies with the health of the country either.

But this guy wasn't saying that the public option is destroying healthcare in Canada, but rather that inexplicably high healthcare costs are destroying healthcare in Canada. And his solution isn't to absolve the government of this burden, but to instead restructure it's involvement in the process. Tie hospital reimbursement to treatment given, rather than lump sum budgeting.

This article seems to have quite a bit to say on the pitfalls of providing care to an entire country, be it through government or private means. But "40 years of their single payer system is starting to take its toll on a fair bit of the underlying medical infrastructure" is not in there.

Hence the commentary on it not quite being the article I'm looking for, I'll have to get creative with Google search terms to see if I bring it up again. But other priorities atm.

Fair enough.

I think in reality, our opinions on what SHOULD be done are similar enough to agree to disagree on the finer points. But I'm intrigued enough by the conversation to continue it.