If at the time we were given Social Security, and later Medicare, lawmakers could have been given a glimpse into the present day, who believes they would have passed it?
If you took into consideration all the good intentions and best laid plans, could you have voted for it if you had known how much in debt it would turn out to be in?
Does anyone believe for a hot second that our government will get it right with health care reform?
No other fact in the debate is as glaring as this one....... We can`t afford to insure everyone. Is that a compassionate statement? No. Is it a true statement? Yes
I'm assuming when you say that the government will get it right with health care, you mean will the govt be competent, effective, and efficient, then the answer is no. The govt is not designed that way. Those on the left that want health care reform believe health care is a right. It gets down to a basic philosophical difference on the role of the government in our lives.
Entitlements consume 65% of our federal budget. Irrespective of the sound bytes, new taxes and proposed cuts will not cover the proposal to cover 31M, or whatever the number is. That 65% number will continue to rise. And if you ask Medicare and SSN recipients, whether they are liberal or conservative, their response "hands off my entitlements". Entitlements are part of our lives and will continue to expand.
They will grow until we either become Greece or wake up because of it.
Are you against Social Security & Medicare ? & How are the rising costs of Health Insurance to be addressed ? Are Insurance comapnies going to unilaterally lower their rates ? Do you think that tort reform & allowing customers to buy their insurance across state lines will get the costs down enough ? A major factor for insurance/medical costs going up are the millions of uinsured being treated in emergency rooms/hospitals . Who's going to deal with that ?
What about the cost of the uinsured adding billions to the deficit ?
Obama's mistake on Healthcare was that he should have dealt with the economy 1st, before healthcare. Still, it's an issue that has to be EVENTUALLY addressed. I'm self employed & have Health insurance,but the costs went up 17% this year. If rate increases keep going this way over the years, I won't be able to afford Health insurance. However, I'm one of the lucky ones--how about People in Ca on Blue Cross/anthem whose
pemiums have gone up 39% ?----What about them.? We currently have 40 million uninsured---if reforms aren't implemented,that number will double in several years. Do you realize what that will do to the deficit ?
Healthcare reform has to be inevitably enacted----trouble is, I"m unsure ( as with many others ), that Obama is going about it the right way.
Do you honestly believe that insuring the currently uninsured, at tax payer expense, will have the slightest effect of lowering the cost of health care in this country?
My opinion on the subject is that it will simply shift the burden of paying for said health care to the backs of the taxpayers who are already struggling to pay for their own health care needs.
Still,how do healthcare costs get lowered ? What about abuses on the "pre-existing" conditions clauses ? American Healthcare is ranked # 37 worldwide. Is keeping the status quo an option ?
Something HAS to be done, but fuck if I can figure out how to do it.
but rushing into a socialized heath care plan, not only is a bad idea, but it sets the stage for an even larger Government than we already have, and that can't be good for the average taxpaying citizen.
Was cramming the Patriot Act down our throats before anyone even had a chance to read it a good idea? How can this multi trillion dollar boondoggle be any better?
but some level of government involvement in health care requires an adoption of the private sector mentality, and that is profit. Without it there is no incentive to control costs.
Ask a liberal if they want Universal Health Care, or at a minimum, some degree of a public option, and they will say yes. Then ask them, if the public option does not meet agreed to operational and financial metrics, would they agree that this new govt department/agency be dismantled after an agreed to period of time. They either can't or won't answer the question. You have to have the threat of bankruptcy or dismantling a department in order to change behavior, just like you have in the private sector. Otherwise costs will continue to rise.
What is being proposed still to certain degree excludes the cost driver issues, including administration, quality vs quantity of care, and most important consumer involvement. Name me another product or service where the customer is totally excluded from the process as it relates to cost.
It's so easy to blame the insurers. They are the current whipping boys just as banks, oil and pharma companies were the whipping boys last week, last month or last year. Look at their net income as a percent of total revenues, and you are talking about 3 to 6% on average. Actually, somebody needed to slap the shit out of Angela Braley (Wellpoint and Anthem CEO) for putting forth that 39% premium increase right in the middle of this fight. She could have gotten away with a 10% increase. Granted they are losing healthy customers, and at 3-6% net income profit, they are not in the business of subsidizing customers. But give it to the government, and costs will no longer be an issue, because it's irrelevant to how govt operates.
You asked quite a few questions there. I`ll try to answer what I can but you have to understand that I already know my reply isn`t going to be popular or in many peoples minds even fair.
You actually hit the nail on the head with the SS/Medicare question. The fact is I don`t believe in it as it exists and my point was that any self respecting lawmaker wouldn`t have believed in it under the condition it turned out to be in either. How could anyone possibly believe in something so obviously flawed in it`s funding. Like I said, the intentions were noble but it`s a fantasy to believe they`re a success. They are in fact quite the opposite.
Okay, here`s the unfair, lack of compassion part of my reply. Insurance companies are businesses, not charities. They are not obliged to serve anyone they think will be a detriment to their bottom line and the government has no business in either forcing rate ceilings on them, or mandating that you or I purchase their product for that matter. The fact that the business they`re in is life and death does not change that. It makes them an easier mark for criticism but it doesn`t change it. They offer what they offer at a price they determine maximizes their investment after taking market conditions into consideration. Do you do otherwise with your investments?
As for the California companies steep rate increases..... One reason they give is that the high unemployment rate in the state means less people in the pool which in turn means higher premiums for those who remain insured by them. It`s not greed, It`s maintaining a healthy bottom line and right now that means rate hikes. That brings up this false charge that insurance companies are fighting this reform. If I own stock in an insurance company I`m going to be pretty happy when I get 30 million new people on the rolls. If I`m a taxpayer subsidizing it I probably feel much different. Of course, if Obamas real goal of Medicare for all, government run health care ever comes to pass the last thing I`ll want to own will be a soon to be out of business heath insurer.
There is no easy answer to the problem of getting relief to people in pain or worse, facing death. There are a few things we can do from the cost cutting end as opposed to the just paying for it for everyone end though. You mentioned a couple of them with tort and buying across state lines. Another that`s getting some play right now is paying bases on results, not services. As one legislator said, if you pay for services you get services. If you pay for results you get results. I`m not naive, I know there are problems there too but it`s worth exploring.
I've heard the argument that Obama made a mistake when he decided to address health care instead of focusing on the economy. I couldn't disagree more. Both are linked and the cost of health is serious impediment to economic growth.
The employer based model is drowning businesses. It's preventing businesses, particularly small businesses, from expanding and hiring new employees. The cost of a US made automobile is approximately $1500-$2000 higher than our competitors because most, if not all have some sort of nationalized medicine. Average premiums for a family cast approx $13K and businesses picks up most of that cost. If you are a micro business, a business with less than 50 employees, you have little recourse dealing with insurance companies given they way they compute cost of premiums. It doesn't matter how healthy your workforce may or may not be. My company premiums have increase 38% over that past two years and I expect another double-digit increase next year.
Insurance premium increases causes employers to lower salaries and cut costs in other areas. In fact, this is a major contributor as to the decline middle class salaries in real term of the past decade.
Insurance companies have near monopolies is several states and have no reason to change their way of doing business. One way to impose change would to have a nationalized health care system. This could potentially lower costs associated with Medicare/Medicaid, as the gov't could do more to influence pricing through reimbursement rate. The current system has no incentive to change, the insurance companies are making ot like bandits.
Until we get a handle on cost of health care, the US will continue to be at a economic disadvantage and middle class wealth will continue to decline.
Remember the theme of this post when we start talking about cap and trade as it pertains to hindering economic growth.
There's no problem with Social Security that minor adjustments in the retirement age and/or increasing the maximum income taxed won;t solve, even in the long term. Even if nothing is done, 75% of benefits can be paid to the Boomer generation.
As for Medicare, it already operates more efficiently than private insurers. That's why Medicare Advantage has to get a supplement from the government to do the same thing that Medicare does for a lower cost. 4% overhead for Medicare versus more than 20$ for private insurers.
Bringing younger and healthier people into the Medicare insurance pool will lower premiums since they consume less medical care. Bringing more people into a system with 4% overhead will lower premiums. Giving Medicare the authority to bargain with health care providers will help contain costs.
We currently spend almost twice as much as France for health care and we get inferior care. Sometimes, more socialism IS the answer.
We can easily afford to insure everyone if we reduce "defense" expenditures so that we only spend as much as the next 5 nations combined instead of the next 15. Defense has become nothing but corporate welfare for defense contractors and oil companies.
http://www.ncpa.org/pub/ba662
I wouldn`t call 107 trillion in the hole successful.
-- Modified on 3/8/2010 3:49:37 AM
unless government bonds are actually worthless and, if that's the case, then our government will collapse and none of this matters.
Remember when SS was supposed to go bust as soon as the Boomers started to retire? That was the projection during the Reagan years- SS was supposed to run out of money in the early 21st century. Now the people who hate social programs are saying 2040 or so. In 2040, they'll be screaming about 2080.
http://krugman.blogs.nytimes.com/2008/03/28/about-the-social-security-trust-fund/
http://www.armageddononline.org/baby-boomers-social-security.html
Medicare is a different story because health care costs have increased so much faster than economic growth. The key there is to do two things- bring more healthy people into the system to keep premiums form rising too fast and contain costs by giving Medicare the authority to bargain with health care providers.
The 107 trillion in the hole is an accounting phantom. Kotlikoff bases his estimates on no action being taken to solve the problems and we can easily see from past experience that Congress has acted to solve problems when they've needed to.
Want to talk unfunded liabilities? How about the 1trillion we've spent in Iraq or the trillion or so we've spent bailing out the assholes who undermined our entire economy. That is money being spent NOW, not in 2042 or 2075. THAT is an unfunded liability. The 'crisis' in SS is just a red herring to keep you occupied while greedy con men pick your pockets right now.
I disagree with most of your post but I`ll keep this reply focused on one part of it.
"bring more healthy people into the system to keep premiums form rising too fast"
Here`s a news flash. Healthy people don`t want to spend money on something they don`t feel they need and the government can`t mandate that they do.
Hundreds of millions of people buy auto insurance because it's mandated by government. Would we be better off if it were left to the individual to decide whether to buy auto insurance or not?
Medicare has become a giant boondoggle that is equally unsustainable.
The current health care bill(s) do absolutely nothing to contain costs, only to shift the burden of payment. Several million people will supposedly get a free ride (at the expense of a ruined economy) so naturally there will be support for it from the socialist leaning electorate.
For those of you that don't like the term socialist, I will remind you that government taking money from one person to give to another, is socialism. There is no other, accurate way of putting it.
since a basic function of any government is to tax and spend, by definition governments all take some money from some people and give it to others.
Of course, your definition of socialism is wrong. But being wrong has never bothered you.
How about that 'ruined' socialist economy in Canada, eh? No failed banks, recession much smaller and shorter than ours, almost all indicators of social welfare higher than ours.
In the US, we have socialism for the rich and capitalism for everyone else. The problem isn't too much socialism, it's too little.
Whenever I see Canada mentioned as an example I feel obligated to post this.
http://www.google.com/hostednews/canadianpress/article/ALeqM5h0QC7bditrEb3wYz_6_b-gsGGDxA
called the fallacy of composition which is a significant problem with capitalism in general.
People who use this fallacy assume that a behavior which is better for an individual, usually themselves, is also better for everyone. The obvious problem with this is the old 'fire in a crowded theater' example. Each individual may think it's better for them to run as fast as they can toward the exits and trample people in their way. That's the worst thing for the group, however. To save the largest number of people, and orderly exit is necessary.
It's stupid to base public policy on anecdotal data, anyway. Do you really think it's a good idea to make policy affecting millions when you have a data sample of exactly 1?
If Canada's health care system is so much worse than ours, why do they spend so much less with results which are significantly better?
"If Canada's health care system is so much worse than ours, why do they spend so much less with results which are significantly better?"
Do you really believe that it's better? 4-6 months wait for an MRI is better? There are more MRI facilities in New Jersey than in the whole of Canada. If you're over 55, and need a heart transplant, you can get it here. In Canada, ain't gonna happen. You're 62 and need knee replacement surgery, you can get it here. In Canada, again, ain't gonna happen. Maybe that's a few of the reasons they spend less in Canada. I live 20 miles from the #1 Heart and Lung hospital in the USA. If you have health insurance, they'll accept you. If you don't have health insurance, they'll still accept you, and it's FREE. They have patients go there from world wide countries. Ever hear of Deborah Hospital?
Our health care system here certainly has problems that need to be rectified, but Obama's plan is not the one to fix it. I laugh every time I hear him, or Pelosi, or Reid talk about, "quality, affordable, health care". What a fucking joke that is. If you think private insurance is expensive now, wait until they are forced to insure those with pre-existing conditions.
Canada spends approximately 50% less on health care than we do in the US.
All measures of public health indicate that the Canadian system achieves better results than the US system.
You already pay for people with pre-existing conditions. When they seek treatment now but can't pay, that cost is added to YOUR hospital bill. And, they often wait until they are in crisis and go to the emergency room which adds to the cost that YOU pay.
The long waits are for ELECTIVE or MINOR treatments and that makes perfect sense.
Answer this honestly. Do you really believe that health care will be more affordable, and of better quality when the Obama plan is signed into legislation?
As for being deficit neutral, that is not true. There will be 10 years of taxes and fees to cover 6 years of health care in the first decade. After that, what happens? Simply put, 10 years of taxes and fees WILL NOT pay for 10 years of care. Something's gotta give, or the deficit goes up another trillion $$. Also, even Reid/Pelosi have stated that 96% of people will be covered after the bill is passed. What happened to the other 4%? Guess they're screwed again.
Yes, I believe health care will be more affordable and the results of the public health system will be better.
EVERY developed nation on teh planet manages to provide their citizens with more affordable health care than the US does. In addition, EVERY developed nation on the planet has better results from their system of health care than the US does. The one thing that all of those nations have in common is a dynamic public health care component from almost completely nationalized systems such as Japan's to hybrid systems such as Germany's and France's.
Obama's plan is too weak in terms of a public health component, but it's several steps in the right direction.
I'm really tired of the right wingers crying about the deficit, too. Where were you guys when Reagan and the two Bushes racked up the ten trillion dollar debt we owed when Obama took office? Were you railing against the Bush tax cuts because they weren't paid for? Were you yelling about the structural deficit created by the combination of those tax cuts and the huge increases in defense expenditures?
No, you weren't. So why the big concern now? IS it because the borrowed money will be spent to actually help people instead of kill them?
Guess you didn't hear Dick Durbin's, speech in the Senate, in which he stated flatly that the cost of health care under their plan will increase?
Where'd you get that 10 trillion dollar deficit number. The deficit Obama inherited from GWB's last budget was something like $450 billion. One reason Reagan spent like he did was the restructuring of the US military after it was decimated by Carter. Shit, if we had gone to war with El Salvador, we probably would have lost. Carter left the military in a sad way.