The Will Ferell Health Care Reform video

[Reality]

http://www.youtube.com/watch?v=hcAQlRczXuo

Excellent! 

[rickortreat]

Wow, that really was great. And it points out the real aspect of the debate that isn't being discussed by the media. No, instead they're covering Tea Parties!

Let's not kid ourselves here, the health care business has a huge lobby and a lot of money that buys influence in the media and in government. Republicans are very much aligned against the President, but aren't offering any alternatives either.

The question is whether Americans can think for themselves or be influenced by Insurance companies and health care providers, or by their own legitimate need for quality care.

I don't believe health care is a right. The people who work in that business deserve compensation for the work they do, whether they are drug companies, doctors, hospital admins or pharmacists. They don't work for free and neither should they.

On the other hand, the medical profession deliberately limits the amount of doctors so they don't have to compete with each other for your business. The amount they charge for their services is outside the range of affordability for the average American out of their own pocket. Insurance companies are a major racket, renegotiation fees with the Doctors to pay them less than they want, and they make excessive profits, considering what they contribute in the way of services.

I lived in the UK, while I was a teen, and people who relied on the public doctors did not recieve the kind of quality care that Americans are/were used to. That doesn't mean Nationalized health can't work,  but it isn't a magic answer.

As it is, the entire health care system, is geared towards helping you when your sick. It was set up this way, because that is what is profitable for providers, but it is not cost-effective. A national healthy system predicated on prevention would be much less costly and improve the quality of live for all Americans, but it will also require cooperation.

Why should you pay for a crack whore's healthcare, or an alchohlics or someone who smokes? There is nothing that justifies your subsidizing someone else's poor lifestyle choices. yet under a national system that would happen unless these people were somehow segmented. Note that most of these don't have any money anyway, and cannot afford care on their own. Should they be denied care, or should they be required to pay more since they are likely to make more use of the services than those who try to live responsibly.

I think I've demonstrated why this is not an easy decision. Even someone with the best of intentions has to think long and hard about how to impliment change over the current system if we are to derive benefit from it.

[westkoast]

I sum it up like this....

Healthy Profits vs Healthy People

Good video though, I laughed pretty hard.

Why should you pay for a crack whore's healthcare, or an alchohlics or someone who smokes? There is nothing that justifies your subsidizing someone else's poor lifestyle choices. yet under a national system that would happen unless these people were somehow segmented. Note that most of these don't have any money anyway, and cannot afford care on their own. Should they be denied care, or should they be required to pay more since they are likely to make more use of the services than those who try to live responsibly.

You do eventually anyways.  If a crack whore gets the holy snot beat out of her because she was trying to steal rocks she is treated at the hospital.  An alcoholic who smokes is not going to be denied health care if he gets alcohol poisoning.  And living responsibly is part of preventive health care.  If more people have access to physicians they are more likely to be pointed in the right direction when it comes to life style changes that fall in line with them personally. You know rather than waiting until the illness is serious and it's a life or death situation in which the emergency room will step in and the state/city foots the bill. 

In the reverse of that, what about a person who lives a decent lifestyle but gets say, cancer?  The current costs to treat cancer are through the roof.  Should responsible people go bankrupt and damage their future with that on their credit because of something they cannot control?   What about the people who pay for their own insurance but are capped after a certain amount of treatment?   

I understand what you are getting at Rick but I've always wondered why money is an issue when it comes to helping people but when it comes to killing people, no one is asking similar questions.  Before the Iraq and Afghanistan wars were started I didn't hear an uproar from people on how this is wasteful government spending, 'how are we going to pay for this' questions, or anything along those lines.  Everyone is quick to jump to say 'they need to protect us from a threat'  Are diseases and illnesses not a threat to the American peoples livelihood ?

edit: Also Rick, health care professionals would not be working for free.  Nor would they work for sub par wages.  That is not what is being proposed and that is not what universal health care would do.  Clearly there is a lot of profit being made on the back of disease and illness.  You can still command a good salary and be 'non profit'

[Joe Vancil]

I can honestly say this is one of rickortreat's posts that I most strongly agree with.

The current system sucks, but it's not the worst.  A new system MIGHT be better, MIGHT be worse.

The fact that money is involved is what makes it complicated, and, in addition, we're talking about BIG NUMBERS to the average person when we talk about a single doctor bill for something reasonably major.

So do we do it, or not?  Government run health-care?  Government not running it, but just paying for it?  (That's a Skander suggestion that I might be able to get on board with.)  Government staying out of it?  Government regulate the heck out of the current players in the industry?

The problem is *BAD*.  What we need to do is break the problem down into pieces.  Let's deal with one segment of the health-care problem - for example, major surgeries.  Or, if you'd prefer to approach it from the other direction, preventative care.  Confine our scope to just that segment.  Get that right, then move on.

I'm not absolutely against government health-care, but I'm not absolutely for it, either.  I'm the dreaded "swing vote."  I'm willing to listen.  Now someone needs to convince me.

[Skandery]

I'm not absolutely against government health-care, but I'm not absolutely for it, either.  I'm the dreaded "swing vote."  I'm willing to listen.  Now someone needs to convince me.

And I've solely been the one to get him even that far!!   

Let's not kid ourselves here, the health care business has a huge lobby and a lot of money that buys influence in the media and in government. Republicans are very much aligned against the President, but aren't offering any alternatives either. 

. . .

Wow Rick, I almost forget that on some things we see eye to eye!

[westkoast]

I'm not absolutely against government health-care, but I'm not absolutely for it, either.  I'm the dreaded "swing vote."  I'm willing to listen.  Now someone needs to convince me.

And I've solely been the one to get him even that far!!   

Let's not kid ourselves here, the health care business has a huge lobby and a lot of money that buys influence in the media and in government. Republicans are very much aligned against the President, but aren't offering any alternatives either. 

. . .

Wow Rick, I almost forget that on some things we see eye to eye!

Quick question...

Are you for universal single payer?  Or just a public option?

This health care debate hits home for me for a number of reasons I don't want to get into at the moment.  I follow it very closely every single day of the week.  Just curious where you fall since you are a proponent.

[bebopdeluxe]

Why the f*ck is everybody so freaking afraid of a "public option"?

News flash: there already is one.

It's called Medicare.

An existing, Government-managed health care plan with tens of millions of participants.  A pool of participants, by the way, that use health care at 1) a higher frequency and 2) for a broader range of services than the US population at large.  Haven't seen the destruction of the US health care system coming from this "Government-managed health care plan"...have you?

Any health care proposal that does not address the lack of competition and the need to control costs is a total waste of time, IMO.  Having a public option does not mean that THE GOVERNMENT IS TAKING AWAY YOUR HEALTH CARE!!!!

There is no reason why I still won't be able to keep paying my higher out-of-pocket costs for Personal Choice.  In case you don't know this, the number of available health care plans is truly staggering...just go to any website that quotes available HMO policies by Aetna, Chubb and a host of other providers.

Many corporations provide multiple options - from a premium plan like Personal Choice to your basic 80-20 HMO/PPO options...a government run plan would just be another option on that list.

So - what is the worst that can happen?

Let's see...entry-level employees and small businesses offer the Government plan - either as an option or their value-priced plan...people sign up...the plan gets critical mass...it starts using the strength of its growing membership (like Blue Cross, Aetna or other larger pools) to negotiate better deals with hospital groups, doctor/specialist groups, pharma companies and the like - except the cost savings don't go to the for-profit companies...they are used to force sharper premium pricing by the private plans...with reigns in the relentless increase in health care costs that we have seen for YEARS.

More people are covered.  Costs can actually be REDUCED for small/medium sized businesses, mom-and-pop-type outfits and individuals.  The government already has experience in running a HUGE health care operation (i.e. Medicare), so it's not exactly re-inventing the wheel for them.  For those who want a premium priced plan (like my Personal Choice plan), I will likely have to pay more in premiums at first, but if the Government-run plan is successful in attracting a large subscriber base, eventually the hospitals and doctor groups who have until now been opting to not be part of these pools will have no choice but to opt back in.

And the silly think is that the "Public option" is only one component of this.  How about Tort Reform?  There's another 3rd rail that nobody has the cojones to touch....

Obama blew it.  He allowed the Republicans to "Swift Boat" him here...instead of proactively framing the issues and taking it DIRECTLY to the people...HARD.  These right-wing nutjobs at these Town Halls would have looked absolutely Palin-esque had Obama done a better job of selling this from the jump...and as a result, he blue a BOATLOAD of political capital...he won't get this through Congress (or worse, they'll pass a piece of dreck that does SQUAT to either meaningfully increase coverage or control costs)...and the Republicans will have a great 2010 election cycle in Congress.

Nice job, Barack.

[Joe Vancil]

People are "afraid" of a public option for several reasons:

1.  Pretty much anything the government does - including Medicare - costs more than it needs to, and underperforms.
2.  Corruption seems to go hand-in-hand with every government program.
3.  Republicans don't like the ways Democrats spend their tax dollars, the same way Democrats don't like the ways Republicans spend their tax dollars.
4.  We've got an $11 TRILLION dollar National Debt, and a budget that is adding on to that.  Many folks don't want the country paying for *ANYTHING* more.
5.  A lot of folks are still upset about the ridiculous amounts of money spent on the bailouts - many were against the very idea of a bailout.
6.  Many folks don't trust their employers to keep offering more pricey plans if a "cheaper" government option is available.
7.  Some believe less government, less programs, less involvement in our day-to-day lives is something to strive for.
8.  Some believe that constitutionally, health care responsibility should fall to the state or local governments due to the 10th Amendment.

I personally have a hard time believing that the incompetents from both parties in Washington, DC can get *ANYTHING* right.  Considering the first two choices are to do the two things that are most likely to kill the whole deal (no public option for the left, no publicly-funded abortion prohibition for the right) - am I wrong?  Wouldn't the REASONABLE compromise have been to leave the public option in, and prohibit the funds from being used for abortion?


I'm simply waiting for the next act in the carnival of errors that has been our federal government for at least the last 18 years.  (I'm reasonably convinced that it's to have Iran host the Olympics at their new nuclear plant, given the two things Obama seems to be focusing on right now.)

[Lurker]

I have some questions on a public option that no one seems to answer clearly.  Maybe some of you could.  I am openminded to a public option but don't feel the current offerings are workable.

How will the public option offer lower premiums?

Without price fixing which will drive providers away (see medicaid and drs refusing to accept)?

Without govt subsidies which makes it not deficit neutral?

Will a public option supported solely by premiums have to pay the same fees that are targeted to private companies (no unfair business practices)?

Why do the health care packages being discussed set up training programs for the medical personnel with the SEIU?  Do we really need heavily unionized medicine?

In short, if the govt option will compete on equal footing with the private companies then I would consider it.  However there are several other steps that IMO could be tried that are not getting any discussion by the Congressional leaders.

1. Interstate competition - every other type of insurance can be purchased from multiple companies across state lines; even over the internet.  Why not health insurance?

2. Tort reform - states that have installed tort reform have seen reductions in malpractice premiums and an increase in the number of physicians entering practice.

3. Eliminate employer based plans - YOU are not the insurance company's customer.  Your employer is; and that is who the insurance industry is responsive to.  Immediately convert all employer based policies to individual/family policies.  Make them guaranteed renewable.  Allow insurance companies to develop and market plans that people want to buy.  Let people choose deductibles and co-pays.  Allow different annual and lifetime caps.  Adjust premiums to reward healthy people who utilize health care sparingly; penalize those who abuse the system and/or their health.  Life insurance is more expensive for smokers; health insurance should be also.

There can be a govt backstop for catastophic illnesses.  Also the current Medicare/Medicaid programs can be used to subsidize the premiums of the non-rich elderly (incomes less than $250K) and poor.

4. Mandate health providers to post prices - this works for the dental industry.  You pick your dentist and generally agree on the cost of procedures.  Dental insurance then pays for routine work and co-pays, based on the policy terms, for high cost procedures (orthodontics, root canals, crowns, etc).  This would increase competition among medical providers which would help control costs.  It also helps explain why "boutique" doctors are gaining popularity.

Just these 4 reforms would do more to control costs and insure more people (everyone already has health care) without costing close to a trillion $.



rick, as far as republican alternatives; they have proposed several.  Unfortunately the party in power controls the docket.  If you use google you will find these alternatives.  The problem is that they don't move towards a govt controlled system; I am not saying any of them are necessarily better than what is being debated.  But the Dems aren't about to let them actually get to even committee for discussion.

And if you want to look at various "universal" care programs check out Mass, Mo (or Mich I can't recall), Tenn and Indiana.  All have some form of state wide plans and each has different levels of success.  I will say that if you truly investigate the other systems in the world you will find that as horrible as we all feel our system is; it is still light years ahead of the others in patient satisfaction, timeliness of major surgeries and technological advances.  The WHO report that is held up as the standard dropped America for its lack of universal insurance.  But there is no one in America (including illegals) who is lacking in care.  Otherwise the "ERs are overrun" argument is a misrepresentation at best.

[bebopdeluxe]

Joe:

I'm not going to get into a point-by-point discussion with you...it is obvious that you and I will never see eye-to-eye on this issue.  From your point about "corruption" (Enron, AIG, etc...) to the money spent on "bailouts" to complaints about the national debt (which EXPLODED under Reagan and became a freaking DISASTER long before Obama had to come in and try to clean up "W"'s mess), I find way, WAY more fault with corporate greed and a criminal lack of oversight by a Republican Congress and White House who - after their "Contract with America" - became the biggest hypocrites of all time.

Over the past three years, I have averaged paying approximately $700,000 a year in Federal income taxes alone...and if I have to choose between what the Republicans have spent the money on and what Obama is proposing spending the money on, that is a freaking no-brainer to me.  While the Feds have done a terrible job of managing my money, I would rather see a health care plan that expands coverage, keeps working class people from declaring bankruptcy (and losing their dignity), and helps small and midsize businesses (who are the entreprenurial lifeblood of our country) stay in business...rather than the nightmare that W, the Republicans and their corporate friends (Exxon, Haliburton, Enron and all the rest) have shoved up our collective azz for the past 10 years.

Lurker:

Good post, bro.  I agree with all of your suggestions.  Interstate health insurance competition - ANY kind of competition, for that matter - is a good thing.  Tort reform is simply HUGE - my next door neighbor is a clinical raidiologist for a major hospital group in the metro area where we live...and according to her, the fear of lawsuits is probably the number one reason why so many tests and proceedures are done...VERY high cost tests...simply to protect the doctors from getting sued.  While I like the theory of an employer using their "perceived" buying power to keep premium costs under control, having an exponential increase of customers for the insurance companies to try to get could lead to even MORE competition between insurers to get customers.

Unfortunately, there is no rational debate anymore in this country.  Everything is controlled by the extremes on both sides of the issue.  It is why politicians who occupied the rational center of these debates (Warren Rudman, Tim Penny, Vin Weber and others) have left politics...replaced by the Maxine Waters' on the left and the Michele Bachmann's on the right....

And THEY control the debate.

It makes me sick.

[westkoast]

I can honestly say this is one of rickortreat's posts that I most strongly agree with.

The current system sucks, but it's not the worst.  A new system MIGHT be better, MIGHT be worse.

The fact that money is involved is what makes it complicated, and, in addition, we're talking about BIG NUMBERS to the average person when we talk about a single doctor bill for something reasonably major.

So do we do it, or not?  Government run health-care?  Government not running it, but just paying for it?  (That's a Skander suggestion that I might be able to get on board with.)  Government staying out of it?  Government regulate the heck out of the current players in the industry?

The problem is *BAD*.  What we need to do is break the problem down into pieces.  Let's deal with one segment of the health-care problem - for example, major surgeries.  Or, if you'd prefer to approach it from the other direction, preventative care.  Confine our scope to just that segment.  Get that right, then move on.

I'm not absolutely against government health-care, but I'm not absolutely for it, either.  I'm the dreaded "swing vote."  I'm willing to listen.  Now someone needs to convince me.

Joe, if you are looking for some more information and have some free time check out this link

edit: Lurker you should check it out as well.  While it doesn't answer all your questions head on, it is worth listening to, to get a small glimpse how the rest of the world handles their health care.  I have a lot of pride as an American but at the same time I feel like we are arrogant in thinking that OUR way is always the best way no matter what. 

http://airamerica.com/ronreagan/blog/2009/sep/30/around-world-health-care-audio

T.R. Reid took a trip around the world to get health care for a bad shoulder, and, more important, to compare systems in other countries. So what happened? Which health care system was the best? And does this speak to the possibility of a public option in the United States?

[Lurker]

koast, I'll listen to that one tonight.  But also think about this...every country that has "socialized" or "universal" or "govt run" health care also have some of the highest income and consumption taxes in the world.  They also spend much, much less on national defense, roads, etc.

Are you willing to pay income taxes at a 25-35% higher rate than you do currently?  And look in the Wall Street Journal for an article yesterday (or Tues) about a left wing think tank calling on Obama for a Value Added Tax and think about the impact on prices and consumer spending.  And most of the plans also shift more Medicare funding to the states...many ogf which are already financially strapped.  This entire discussion goes far beyond just providing health coverage for every American.

I wholeheartedly agree that our current system needs to be fixed.  I am NOT advocating the staus quo.  Just want to make that clear.  I just don't believe the current proposals address the problems with our system but instead just compound those problems.  Adding another insurance provider (public option) does not address the runaway costs of health care.

And speaking of taxes, effective 1/1/2011 Bush's tax cuts and the right to work credit (stimulus plan) will expire.  A single person earning approx $50,000 will pay over $1,000 more in taxes than they will under the current laws.  Are you ready for a 2-3% decrease in your take home pay?

[Lurker]

I'm not going to get into a point-by-point discussion with you...it is obvious that you and I will never see eye-to-eye on this issue.  From your point about "corruption" (Enron, AIG, etc...) to the money spent on "bailouts" to complaints about the national debt (which EXPLODED under Reagan and became a freaking DISASTER long before Obama had to come in and try to clean up "W"'s mess), I find way, WAY more fault with corporate greed and a criminal lack of oversight by a Republican Congress and White House who - after their "Contract with America" - became the biggest hypocrites of all time.

 

Sorry, bebop...but Obama with one bill; the stimulus; created more deficit spending in 1 month than Bush did in any ONE year of his presidency.  And that pork laden garbage has really done NOTHING to stimulate the economy.  Bush's highest deficits occurred in the final 2 years (and in fy 2001/02 after 9/11 dampened the economy and tax revenues) when Democrats controlled Congress which is where ALL spending bills originate.  Bush was a spineless East Coast liberal wrapped in a down home cowboy wrapper that compromised on spending to push his other initiatives.

Otherwise I agree BOTH parties are hypocritical.  And IMO anyone who votes for the party instead of the person has been indoctrinated and is no better than any other fanatic in the world.  And for the record I am from Texas and hated Bush when he was governor.  He was always a compromiser that stood for very little.  But I must say he could at least make a decision (albeit mostly wrong); a trait I find strangely missing in our current executive.

[bebopdeluxe]

Lurker:

As somebody who pays more than his fair share of taxes (and with the full understanding that I will pay more in all likelihood going forward), I have no problem with that - as long as it is going to places that I believe are productive.  To expect ANY government to be as efficient with spending as you or I may be in our household is a pipe dream...and it has been that way since the founding of the republic.

Our tax burden is low relative to our European counterparts - but they have better health care, better public transit, better infrastructure, better enviormental policies, a better social safety net...and a mindset where they care more about society as a whole than what each individual keeps for themselves.  While I certainly appreciate the American apporach to individualism and do not support structures that take away the value of hard work and putting capital at risk, I also believe that our society would be WAY, WAY better off if we thought more about the collective good and took the lofty ideals that we preach (read: ram down the throats of other cultures around the world in the name of "democracy") and put them to practive right here in America.  Is is an EMBARASSMENT that the richest nation in the world also has such relatively poor infant mortality rates...such middle-of-the-road secondary-level academic achievement...such abject poverty...and tens of millions of people without basic health care (including untold millions of children).

The amount of lip service that we give to the lofty ideals that we wrap ourselves around is a joke.

But that's OK.  We'll just continue to underinvest in health care, education, the environment, our infrastructure (in the name of SMALLER GOVERNMENT and LOW TAXES), and our kids and grandkids will reap the "benefits" of our self-centered and selfish ways...and the society that comes from that.

Yay.

[Lurker]

Lurker:

As somebody who pays more than his fair share of taxes (and with the full understanding that I will pay more in all likelihood going forward), I have no problem with that - as long as it is going to places that I believe are productive.  To expect ANY government to be as efficient with spending as you or I may be in our household is a pipe dream...and it has been that way since the founding of the republic.

Our tax burden is low relative to our European counterparts - but they have better health care, better public transit, better infrastructure, better enviormental policies, a better social safety net...and a mindset where they care more about society as a whole than what each individual keeps for themselves.  While I certainly appreciate the American apporach to individualism and do not support structures that take away the value of hard work and putting capital at risk, I also believe that our society would be WAY, WAY better off if we thought more about the collective good and took the lofty ideals that we preach (read: ram down the throats of other cultures around the world in the name of "democracy") and put them to practive right here in America.  Is is an EMBARASSMENT that the richest nation in the world also has such relatively poor infant mortality rates...such middle-of-the-road secondary-level academic achievement...such abject poverty...and tens of millions of people without basic health care (including untold millions of children).

The amount of lip service that we give to the lofty ideals that we wrap ourselves around is a joke.

But that's OK.  We'll just continue to underinvest in health care, education, the environment, our infrastructure (in the name of SMALLER GOVERNMENT and LOW TAXES), and our kids and grandkids will reap the "benefits" of our self-centered and selfish ways...and the society that comes from that.

Yay.

Obviously this is an area where we will have to seriously disagree.  If you believe that the European nations are better in all of those regards then there is little I can do to dissuade you. 

But then I guess when you are worried about a much smaller population base and geographical area as well as count on your big Uncle for defense; it is easier to try to appease the masses.  Just don't look for hospitals in the French countryside as they are being closed.  And infrastructure for major transportation spots may be better but to get to more rural areas then the infrastructure drops below the quality in the majority of America's rural areas.  Environment is a joke around the world...European nations are no farther advanced in this than parts of America.  And if you don't think the US govt plays a major role in our attitude just count the number of car commercials; after the bailouts; for large trucks, SUVs, "muscle" cars and compare to the commercials for small fuel efficient cars and hybrids.  Where is that change I was promised?

Education is the one area I will give kudos too.  Our education system has been entirely ruined by two major factors IMO: the unionization of teachers and the goal of teaching our children to regurgitate as opposed to thinking (no child left behind).

And as far as your claims of paying "your fair share of taxes" - stop crowing about your multi-million dollar income.  It means jack to this conversation.