Health Care Reform - almost a done deal? DONE!

[Ivan Seeking]

It appears that the House will vote on Sunday; I think on the Reconciliation Act of 2010.
http://www.rules.house.gov/bills_details.aspx?NewsID=4606

Then it goes back to the Senate. However, as I understand this, the President can sign the bill passed by the House making it law until the Senate votes on the changes.

I still haven't figured out the ins and outs of the Deem and Pass [known dysphemistically as Demon Pass] maneuver, but it seems the Dems have a path to get this done.

[calculusrocks]

The Slaughter option (deem and pass) means that they pass a rule instead of a vote based on Yeas or Nays. It changes the rules of the house so that the House acts as though the bill passed with a vote of Yeas or Nays. This will undoubtedly draw a constitutional challenge if tried.

If they had the votes, they would have done an up/down vote by now.

ADD: http://en.wikipedia.org/wiki/Self-executing_rule

[calculusrocks]

Reconciliation is only for budget bills.

http://en.wikipedia.org/wiki/Reconciliation_%28United_States_Congress%29

That will draw a Constitutional challenge as well, because its a health coverage bill.

[Ivan Seeking]

Apparently this provides cover for Dems up for election who would not normally support the bill for fear of voter backlash.

As I understand it, aspects of the bill not relating to budget issues were deleted.

[calculusrocks]

That is the theory, that it'll provide cover for the Democrats. Barack Obama has said that this is not the case and that the American people will judge the Slaughter solution as a vote for or against health care in a recent interview (http://video.foxnews.com/v/4113350/fox-news-exclusive-president-obama/?loomia_ow=t0:s0:a16:g2:r5:c0.037577:b31982604:z6) .

[calculusrocks]

Apparently this provides cover for Dems up for election who would not normally support the bill for fear of voter backlash.

As I understand it, aspects of the bill not relating to budget issues were deleted.

Well, the democrat argument is that health coverage will save money on the budget, so it is a budget item. I see it as a rationalization in order to gain power over the insurance industry, which is about 1/6 of the total economy. I'll qualify that as an educated opinion.

[Ivan Seeking]

Imo, what is important is that this passes. Let the chips fall where they may. Most people actually support a good part of what's in the bill but they just don't know it. The Dems are betting that once people understand what was passed, more than not, the rest will be forgotten.

We have to do something about the cost and state of health care. If we don't do this now, no one will touch it again for a very long time. There is no more time to wait. Things can always be amended later.

Don't let the perfect be the enemy of the good.

[Ivan Seeking]

As far as legal challenges, I'll leave that up to the lawyers. The Republicans have used this technique 70% of the times it was used.

[turbo]

Don't let the perfect be the enemy of the good.The GOP is pulling out all the stops to kill this bill. Pass it now, with all of its warts, and fix it incrementally. The CBO has already said that the bill will reduce the deficit over time and add 32 million uninsured people to our health-care system.

[calculusrocks]

As you know, I'm on the other side of this issue. I profoundly believe in property rights, and this bill will be the first time in history where the government is allowed to force citizens to buy a product. That is flatly unconstitutional, and I see much of the problems in America as direct results of our progressive deviation of small constitutional government. There are a lot of ways to reform health care without giving up our individual liberties.

[calculusrocks]

The GOP is pulling out all the stops to kill this bill. Pass it now, with all of its warts, and fix it incrementally. The CBO has already said that the bill will reduce the deficit over time and add 32 million uninsured people to our health-care system.

The current CBO estimate is preliminary. The CBO scored it without seeing the bill yet. It's a little odd/troubling to me that the CBO comes out with the estimate on a bill that isn't even written yet.

http://www.humanevents.com/article.php?id=36091

[turbo]

As you know, I'm on the other side of this issue. I profoundly believe in property rights, and this bill will be the first time in history where the government is allowed to force citizens to buy a product. That is flatly unconstitutional, and I see much of the problems in America as direct results of our progressive deviation of small constitutional government. There are a lot of ways to reform health care without giving up our individual liberties.You want poor people to keep their individual "liberty" to have no access to preventative care, and rely on ER visits for emergent care when it is (often) too late to hope for positive outcomes, that drive up costs for all of us? Why?

[Ivan Seeking]

The current CBO estimate is preliminary. The CBO scored it without seeing the bill yet. It's a little odd/troubling to me that the CBO comes out with the estimate on a bill that isn't even written yet.

http://www.humanevents.com/article.php?id=36091

Bull
http://www.cbo.gov/

Uh, your link is dated March 1st.

[calculusrocks]

“Although CBO completed a preliminary review of legislative language prior to its release, the agency has not thoroughly examined the reconciliation proposal to verify its consistency with the previous draft. This estimate is therefore preliminary, pending a review of the language of the reconciliation proposal, as well as further review and refinement of the budgetary projections.” (CBO Director Doug Elmendorf, Letter To Rep. Nancy Pelosi, 3/18/10, P.1)

The letter is from the CBO to the Speaker of the House. You be the judge.

[calculusrocks]

The reconciliation hasn't happened yet, so it can't be officially scored. Thus its preliminary.

[calculusrocks]

Oh wait, it's been updated. They do have an official score today.

UPDATE (12:30 EDT): The Congressional Budget Office has released the official score. You can read that here (UPDATE (12:30 EDT): The Congressional Budget Office has released the official score. You can read that here.).


They did not before. It's an article that's been kept up to date.

[MotoH]

Do Illegals get health care benefits also?

Can you just walk into a hospital now and say "treat me?" Or do we get a card?

[BoomBoom]

... this bill will be the first time in history where the government is allowed to force citizens to buy a product.

My state government requires I purchase auto insurance...so maybe not the 1st time.

Besides, was it not the republicans that originally proposed the idea of an insurance mandate during the Clinton era? ...and now they are calling it unconstitutional?
http://www.npr.org/templates/story/story.php?storyId=123670612
I honestly don't see how they can keep their stories straight sometimes...talk about "Flip-Flopping". :rolleyes:

[BoomBoom]

Do Illegals get health care benefits also?

Yes, I believe people in prisons get splendid healthcare! :biggrin:

[calculusrocks]

My state government requires I purchase auto insurance...so maybe not the 1st time.

Besides, was it not the republicans that originally proposed the idea of an insurance mandate during the Clinton era? ...and now they are calling it unconstitutional?
http://www.npr.org/templates/story/story.php?storyId=123670612
I honestly don't see how they can keep their stories straight sometimes...talk about "Flip-Flopping". :rolleyes:

You are not forced to buy auto-insurance any more than you are forced to drive on public roads.

It's not republicans calling it unconstitutional. You guys have to understand that constitutional challenges originate from citizens.

[BoomBoom]

You are not forced to buy auto-insurance any more than you are forced to drive on public roads.

If I do not, then I can get a hefty fine....the same as with the health insurance mandate. So neither one is being "forced" to buy a product, just installing a penalty if you don't.

[calculusrocks]

If I do not, then I can get a hefty fine....the same as with the health insurance mandate. So neither one is being "forced" to buy a product, just installing a penalty if you don't.

Like I said before, there is no law requiring you to get auto insurance. You can simply choose not to drive. Auto insurance is required in case you injure someone else. It's a faulty analogy. Even if the analogy wasn't faulty, your conclusion is faulty. The conclusion wouldn't be that neither one forces you to buy a produce. The conclusion would be that both forces you to buy a product. But, you are not forced to buy auto insurance.

[Ivan Seeking]

To me, this is just another example of the fact that the free market is not the end-all solution to all problems. We have a free-market healthcare system now and it is clear that what we're doing isn't working. From dropped coverage upon illness, to denied coverage for pre-existing conditions, skyrocketing administrative costs in place of patient care costs, runaway patient costs, the looming costs of medicare and medicaid, and the 30 million+ people who have no coverage at all, in painfully real terms for many Americans, what we have now is barely more than a bad joke.

[calculusrocks]

We do not have a free market solution in health care right now. There are a lot of boundaries inhibiting competition. Not the least of which is the ban on buying insurance across state lines, inhibiting choice.

ADD: Choice drives down cost, because of competition.

[hamster143]

Do Illegals get health care benefits also?

Can you just walk into a hospital now and say "treat me?" Or do we get a card?

Illegals always could do that. I'm not sure how this is going to work in the new bill. I'm pretty sure that illegals can't get federal subsidies for healthcare. Therefore they are probably also exempt from the mandate.

One more thing I'm curious about is how this bill deals with older immigrants. Right now, noncitizens over 65 can't get Medicare (can't even buy it for the first 5 years in the country), and most private health insurance companies refuse to insure them. (The one insurance company I know of that does, Kaiser, charges a premium of $1000/month.) It would seem unfair to mandate those to have insurance, unless something is changed in their access to healthcare.

BTW, as of this moment, Intrade gives the health care deal a 78% chance of passing. Big improvement from January (right after the Mass elections, they saw a 20-25% chance.)

[calculusrocks]

I'll post more on that point later. I don't want to be dismissive about it.

[hamster143]

People keep conflating two very different issues. (And our president isn't helping, unfortunately.)

One issue is that the whole health care system is badly screwed up. Lots of people can't get insurance because of preexisting conditions, no one is sure that his insurance company isn't going to drop him at the first sign of trouble, any transaction involving money requires negotiating (because there's no universal schedule of fees that applies to everyone), neither doctors nor patients know a priori whether their health insurance is going to cover any given procedure ... That can be addressed partially by the existing bill, which is a big step in the right direction, but, ideally, to fix that, we need a single-payer system.

A whole different issue is cost of health care. Sure, it is driven partially by the administrative overhead in the current system, but the primary cause is the severe shortage of doctors, thanks to the AMA cartel lobby (which, as recently as 1995, was screaming about the impending surplus and demanding to limit residency spots - just as healthcare costs were taking off). The AMA cartel is fully committed to the idea of providing every medical student with a $200,000+ job by the time he or she is 35, and ensuring his salary and job security till he's 70. Why wouldn't they be? Obviously, patients have very different priorities, but no one listens to them.

http://wallstreetpit.com/wp-content/uploads/2009/06/image0270.png


Other smaller issues behind the high cost of health care are the lack of central authority that decides which tests can or cannot be made; stringent patent laws that limit availability of generic drugs; lack of nationwide medical malpractice tort limits.

All these things are completely tangential to the subject of universal mandated healthcare.

[WhoWee]

The GOP is pulling out all the stops to kill this bill. Pass it now, with all of its warts, and fix it incrementally. The CBO has already said that the bill will reduce the deficit over time and add 32 million uninsured people to our health-care system.

I believe the period of time they are looking at is 10 years.
http://www.reuters.com/article/idUSTRE61O4NV20100319

Unfortunately, it's my understanding, this 10 year period includes 10 years of taxes and only 6 years of health care - take a closer look.

[dilletante]

Dow Jones Newswires | Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House of Representatives would increase the company's health-care costs by more than $100 million in the first year alone.

In a letter Thursday to House Speaker Nancy Pelosi (D-Calif.) and House Republican Leader John Boehner of Ohio, Caterpillar urged lawmakers to vote against the plan "because of the substantial cost burdens it would place on our shareholders, employees and retirees."

Caterpillar, the world's largest construction machinery manufacturer by sales, said it's particularly opposed to provisions in the bill that would expand Medicare taxes and mandate insurance coverage. The legislation would require nearly all companies to provide health insurance for their employees or face large fines.

The Peoria-based company said these provisions would increase its insurance costs by at least 20 percent, or more than $100 million, just in the first year of the health-care overhaul program.

"We can ill-afford cost increases that place us at a disadvantage versus our global competitors," said the letter signed by Gregory Folley, vice president and chief human resources officer of Caterpillar. "We are disappointed that efforts at reform have not addressed the cost concerns we've raised throughout the year."

Business executives have long complained that the options offered for covering 32 million uninsured Americans would result in higher insurance costs for those employers that already provide coverage. Opponents have stepped up their attacks in recent days as the House moves closer toward a vote on the Senate version of the health-care legislation.

A letter Thursday to President Barack Obama and members of Congress signed by more than 130 economists predicted the legislation would discourage companies from hiring more workers and would cause reduced hours and wages for those already employed.

Caterpillar noted that the company supports efforts to increase the quality and the value of health care for patients as well as lower costs for employer-sponsored insurance coverage.

"Unfortunately, neither the current legislation in the House and Senate, nor the president's proposal, meets these goals," the letter said.

[Ivan Seeking]

Dow Jones Newswires | Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House of Representatives would increase the company's health-care costs by more than $100 million in the first year alone.

Two problems with your post: First, please do not quote the entire story as that is a copyright violation. Next, you need to provide a link.

Based on the 2008 report, Caterpillar had $51 Billion in revenues with $2.4 Billion in capital expenditures. $100 million represents a 4% increase in expenditures. It was also a record year for profit.
http://www.cat.com/cda/files/2096799/7/Caterpillar%202008%20Annual%20Report%20-%20electronic%20only.pdf

[calculusrocks]

America's health insurance market is not a free market. In fact, it is heavily regulated and controlled by gov't. The most recent bill simply expands these regulations and subsidies, and potentially create a single-payer system. Here is an article about it in Forbes (http://www.forbes.com/2009/07/28/health-care-reform-obama-opinions-columnists-shikha-dalmia.html).

[mheslep]

This is a ten year trillion dollar disaster. The mandate, and perhaps the 'deeming' non- vote are probably unconstitutional. There are far better ways on the table to reform.

[mheslep]

To me, this is just another example of the fact that the free market is not the end-all solution to all problems. We have a free-market healthcare system now Clearly not. We should actually try a free-market system.

The government already funds about 50% of every dollar spent in the US health system via Medicare, Medicaid and other programs.
If you live in Washington state, you are not free to buy perhaps cheaper medical coverage from a company in my state.
The federal employer-medical tax exemption makes only employer based coverage feasible, meaning most people are hidden from actual costs of the medical care.
US Tort law allows spurious and trivial malpractice suits.



and it is clear that what we're doing isn't working. From dropped coverage upon illness, to denied coverage for pre-existing conditions, skyrocketing administrative costs in place of patient care costs, runaway patient costs, the looming costs of medicare and medicaid, and the 30 million+ people who have no coverage at all, in painfully real terms for many Americans, what we have now is barely more than a bad joke.Yes, that doesn't mean this disaster of bill is any way close to being a workable remedy that doesn't make things worse. If one recognizes that Medicare and Medicaid government created plans are broken, it seems to me more scepticism of federally based solutions is the logical course, not of market solutions, and are surely not a recommendation for huge all-in bets on more federal health care plans.

[mheslep]

If I do not, then I can get a hefty fine....the same as with the health insurance mandate. So neither one is being "forced" to buy a product, just installing a penalty if you don't.

Like I said before, there is no law requiring you to get auto insurance. You can simply choose not to drive. Auto insurance is required in case you injure someone else. It's a faulty analogy. Even if the analogy wasn't faulty, your conclusion is faulty. The conclusion wouldn't be that neither one forces you to buy a produce. The conclusion would be that both forces you to buy a product. But, you are not forced to buy auto insurance.

The salient difference is the many states have the power to mandate insurance if they choose; the US constitution grants no such power to the federal government without some squinty eyed look at the commerce clause to interpret as meanin ... the federal government can do any dam thing it pleases, anywhere, absent conflict w/ the first five or so amendments.

[turbo]

This is a ten year trillion dollar disaster. The mandate, and perhaps the 'deeming' non- vote are probably unconstitutional. There are far better ways on the table to reform.The problem is that the GOP is adamant and unified in demanding that there be NO reform. The constant harping of "start over" is very tedious, since it is tantamount to saying "not in this generation". The GOP (apart from Sen. Snowe (R-ME)) refused to participate in the crafting of the bill, then complained that they were "shut out" of the process. The problem is that there are plenty of air-heads who watched the obstructionism unfolding, but failed to understand it and actually believe the complaints.

We need health-insurance reform ASAP. And we need to address reforms in health-care, too, though reining in systemic abuses by the insurance companies should be job #1. I am medically disabled, and I have health insurance only because my wife works for a decent company that provides comprehensive health insurance (medical, dental, and eye care) for all employees. If her company were to fail, neither of us would be able to get health insurance under the present system because both of us have pre-existing conditions. If one of us should come down with cancer, experience organ failure, or other debilitating condition, we would be ruined financially. Nobody should lose their life-savings and their homes just because they got sick. The US is the last "modern" country to allow the assets of its citizens to be stripped by catastrophic illness. Thanks, insurance companies.

BTW, in an effort to purge "ineligible" persons from coverage, Anthem required my wife's employer to audit its employees, so that I had to contact my town office and send the insurance company a copy of our marriage certificate (35+ years ago) to prove that we are married. I hope that the town clerk and the justice of the peace spelled everything just right in case Anthem has another round of recissions planned.

[ThomasT]

Clearly not. We should actually try a free-market system.I agree that the health care business isn't a free market system. But a truly free market system would leave many more people without insurance and without emergency room care.

US Tort law allows spurious and trivial malpractice suits.
Yes, it allows them to be filed, but in practice most spurious and trivial malpractice suits get dismissed.

[calculusrocks]

The problem is that the GOP is adamant and unified in demanding that there be NO reform.

Anyway, that's where I stopped reading. Do you have a source? Perhaps you should start by investigating the GOP's website for their reform plans.

[calculusrocks]

I agree that the health care business isn't a free market system. But a truly free market system would leave many more people without insurance and without emergency room care.

Yes, it allows them to be filed, but in practice most spurious and trivial malpractice suits get dismissed.

Free market capitalism always fills in the gaps. The more self-reliant the citizenry becomes, the more private charities will take it upon themselves. There is little room left for private charity from many people because taxes already take a large share of income and people figure taxes are like charity.

In my opinion, charity will make sure the money goes to the people in need. Gov't will make sure the money goes to people who will enforce more gov't.

[mheslep]

The problem is that the GOP is adamant and unified in demanding that there be NO reform. While the boogie man GOP may be out eating children, the real GOP almost unanimously states it wants medical reform. Though they should have pushed harder years ago, there are now numerous bills, actual legislation drafted:

Roadmap 2.0 for America's Future - Health, 2010 (http://www.roadmap.republicans.budget.house.gov/Issues/Issue/?IssueID=8516)
Summary of House GOP Health Care Reform Bill (PDF) - Nov 2009 (http://gopleader.gov/UploadedFiles/Summary_of_Republican_Alternative_Health_Care_plan _Updated_11-04-09.pdf)
Republicans Offer Health-Care Plan May 21 2009 (http://online.wsj.com/article/SB124286548605041517.html)
Wyden-Bennet Bill (http://en.wikipedia.org/wiki/Healthy_Americans_Act)

I'd expect anyone that had seen Maine's government run Dirigo Health care disaster (http://www.nytimes.com/2007/04/30/us/30maine.html?_r=1) up close would have pause before signing up to a national version.

[mheslep]

I agree that the health care business isn't a free market system. But a truly free market system would leave many more people without insurance and without emergency room care.Probably no more so than that many people would starve to death in a free market food supply system, but when most people say free market they don't mean pure laissez faire. They mean, or at least I do, that the mainstream economic body of the country should use a truly free market system, and the unfortunate and the chronically ill be directly funded out of a pool set up specifically for that. The 'high risk pools' are generally what is proposed now along those lines.

Yes, it allows them to be filed, but in practice most spurious and trivial malpractice suits get dismissed.No, a great many of them are settled out of court, i.e. pay-offs to avoid legal expense and the odd rogue jury. The consequence is higher medical fees and a distortion of reasonable standards on the part of heath professionals.

[turbo]

I'd expect anyone that had seen Maine's government run Dirigo Health care disaster (http://www.nytimes.com/2007/04/30/us/30maine.html?_r=1) up close would have pause before signing up to a national version.Are you aware that Maine is very poor and rural? Are you aware that we have a very large population that can only get seasonal or part-time work and has NO health insurance? Are you aware that our population is aging quite rapidly, as younger people move away to find work? Any attempt to expand health-care coverage in such a climate is bound to face significant hurdles. We need a national initiative, like all the "socialist" (according to Beck and Limbaugh) industrialized nations have adopted. Exposing poor people to poor health-care, and exposing middle-class citizens to bankruptcy in the face of catastrophic illness is the mantra of the GOP. They claim that they want "reform" as long as their patrons are untouched. That can't happen. Health-care reform is not a zero-sum game that can be balanced on the backs of our citizens.

[mheslep]

Are you aware that Maine is very poor
Maine GDP per head is ~$35k/year, better than 17 other states.

and rural?
So is most of the US with a national average of 86 people/sq mile, Maine has 42 p/sq-m, higher than ~ten other states.
Are you aware that we have a very large population that can only get seasonal or part-time work and has NO health insurance? Assume you mean the part-time worker population is large relative to the whole. What needs to be done to get them health care?

Are you aware that our population is aging quite rapidly, as younger people move away to find work? As is the US as a whole, baby boomers will continue to age the country at large for a couple more decades.

Any attempt to expand health-care coverage in such a climate is bound to face significant hurdles. We need a national initiative, like all the "socialist" (according to Beck and Limbaugh) industrialized nations have adopted. If one accepts the above rationale ("we're poor, rural", etc) for Dirigo failure, the motivation of going national can only be a desire to have other states pay your way when many of the other states are worse off than Maine.

Exposing poor people to poor health-care, citizens...If the poor in the US have bad health-care in the US, and I don't know that they necessarily do, the first place to look is with government run Medicaid set up by the government for the poor, and not elsewhere.

[russ_watters]

Imo, what is important is that this passes. Let the chips fall where they may. Most people actually support a good part of what's in the bill but they just don't know it. The Dems are betting that once people understand what was passed, more than not, the rest will be forgotten. I agree that that's what the dems hope, but I think they underestimate the populace: many people support "a good part" of it, but they also oppose "a good part of it", and they know what provisions they support and don't support. But in order to believe they can be re-elected in November, the dems up for re-election have to hope that the populace will forget why they opposed it.

This is part of why the dems are going to get slaughtered in Novemember. Things can always be amended later.

Don't let the perfect be the enemy of the good. Pass it now, with all of its warts, and fix it incrementally. This logic is absolutely apalling to me. Why can't dems (both in office and not) understand that if a bill has significant flaws that require it to be amended later, it should just be done better now? If it was done better now, republicans would support it! So why don't the dems fix those flaws in the bill?

That sort of logic makes me think dems are trying to swindle us.

[russ_watters]

You want poor people to keep their individual "liberty" to have no access to preventative care, and rely on ER visits for emergent care when it is (often) too late to hope for positive outcomes, that drive up costs for all of us? Why? Because I worked for my money and I want to keep it and reap the benefits from it that I earned. It is against the principles of freedom to force one person who has been responsible to care for another who has not.

[BoomBoom]

If it was done better now, republicans would support it!

You can't be serious, can you? The republicans have shown thus far that they are not willing to vote on anything, much less vote for anything.

Although, that said, it was encouraging to see that a handful actually voted for the jobs bill.

[WhoWee]

Based on the 2008 report, Caterpillar had $51 Billion in revenues with $2.4 Billion in capital expenditures. $100 million represents a 4% increase in expenditures. It was also a record year for profit.
http://www.cat.com/cda/files/2096799/7/Caterpillar%202008%20Annual%20Report%20-%20electronic%20only.pdf

Tell that to the shareholders - it's $100,000,000.00 in government mandated expenses!

[WhoWee]

Tell that to the shareholders - it's $100,000,000.00 in government mandated expenses!

And let's not forget about Obama's comments about helping Caterpillar - do I need to post a link to remind you?

[calculusrocks]

And let's not forget about Obama's comments about helping Caterpillar - do I need to post a link to remind you?

What you mean this (http://www.aim.org/don-irvine-blog/cat-ceo-corrects-obama-on-layoffs/)?

[calculusrocks]

Obama put words in the CEO of CAT's mouth, and the CEO had to correct the record.

8fvF2W_fa9I

ADD: This was regarding the stimulus plan.

[WhoWee]

It's time to refocus - AGAIN.
http://www.washingtonpost.com/wp-dyn/content/article/2009/10/14/AR2009101403953.html

"In a health-care debate defined by big numbers and confusing details, the prospect of losing benefits such as a free gym membership through the Silver Sneakers program is tangible, and it has spooked some seniors, who are the nation's most reliable voters and have been most skeptical about reform.

Medicare Advantage was established in the 1970s (under a different name) when private insurers convinced Congress that they could deliver care at lower costs than Medicare. The program blossomed in the late 1990s when Congress bolstered it with millions in additional federal subsidies to for-profit HMOs. It has proven popular among younger, active seniors who had managed-care plans as workers, and about a quarter of Medicare's 45 million beneficiaries are enrolled.

Many private plans require no additional monthly premiums, yet the government pays an average of $849.90 in monthly subsidies to insurance companies for a person on Medicare Advantage, according to the Kaiser Family Foundation. That is about 14 percent more than the government spends on people with standard Medicare, according to the nonpartisan Medicare Payment Advisory Commission.

"The promise of Medicare Advantage and Medicare HMOs was to save the government money, to save consumers money, all the while providing additional benefits and coordinating care," said Joseph Baker, president of the Medicare Rights Center. "That promise has been unfulfilled overall because the plans are overpaid by the federal government at this point." "

You can blame this mess on insurance companies until your head explodes. However, the TRUTH is that the Center for Medicare and Medicaid (CMS) runs this program. This is the Government run insurance program. Please note the cost PER PERSON to the Government is $849.90 per month. Then the individual pays co-pays, deductibles, some pay premiums - then we have the Part D prescription costs ($4,550 out of pocket cost to escape the Standard Coverage Gap).

The Government is the problem - not the solution.

[hamster143]

I agree that that's what the dems hope, but I think they underestimate the populace: many people support "a good part" of it, but they also oppose "a good part of it", and they know what provisions they support and don't support. But in order to believe they can be re-elected in November, the dems up for re-election have to hope that the populace will forget why they opposed it.

Of all people who oppose it, most oppose the part of it that involves giving government subsidies to the poor. Problem is, as it's been explained repeatedly by the left (e.g. by Krugman), it is a crucial part of any overhaul, in that it's impossible to provide universal healthcare without it. That is the reason no bipartisan agreement with Republicans was reached or could've been reached.

People who oppose it generally have one of three positions.

1) radical conservatives, Mitch McConnell, Rush Limbaugh, etc: "I don't care that poor people don't have health insurance. All that matters to me is that I have mine. They could die for all I care."

2) moderate conservatives: "Sure, it's sad that poor people don't have health insurance, but I refuse to spend my money to support them. Let the Congress debate (for the next 10 years, if necessary) till they find a way to lower the costs of healthcare so that everyone can afford to buy health insurance on their own. "

3) radical liberals: "This bill does not solve all problems because it does not go far enough: it is not single payer and it does not have public option."

[calculusrocks]

This might be an opportune time to wiki what a strawman (http://en.wikipedia.org/wiki/Strawman) argument is.

[Vanadium 50]

Why can't dems (both in office and not) understand that if a bill has significant flaws that require it to be amended later, it should just be done better now?

Because they are out of time.

Putting a new bill together takes 6 months, and anyone with a ruler and a pencil looking at the polls knows that there is no way a health care bill will pass in October with elections in November.

At this point, the logic goes, they are going to get slaughtered at the polls no matter what. The majority of the American people hate the bill, and they hate the imperious attitude of the democratic leadership in ramming it down their throats. (Remember, when Senator Obama was campaigning, he said that 50% plus one vote was not the way he wanted to pass healthcare. This has turned out to be exactly the strategy President Obama is adopting.) At this stage, again, as the logic goes, even a "no" vote will be used against Democrats in the election: everyone knows how well "I was for it before I was against it" plays at the voting booth.

So the Democrats are faced with two options: a serious loss in November with a health care bill, or a serious loss in November without a health care bill. Which do you think they will choose?

[calculusrocks]

So the Democrats are faced with two options: a serious loss in November with a health care bill, or a serious loss in November without a health care bill. Which do you think they will choose?

I ***deem*** this analysis spot on.

[russ_watters]

You can't be serious, can you? The republicans have shown thus far that they are not willing to vote on anything, much less vote for anything. *I* a republican and *I* would support it if it were a better bill. If it were a better bill and republican citizens supported it, then it would be republican congressmen on the hot-seat for not supporting it, not democratic congressmen on the hot-seat for supporting it.

Heck, if the democratic congressmen believed that it was a bad bill and republicans wouldn't support a good bill, they should still make it a good bill so they would have real ammo to use at election time! It is pretty weak to accuse the other side of being obstructionist for blocking bad legislation.

[turbo]

Russ, apart from Olympia Snowe, not a single Republican participated in crafting the legislation. It is painfully evident that the GOP does not want any health-care reform bill at all. If they did, they would have contributed and helped to shape it into something that they could support. They did not, and McConnell and Boehner take every second of camera-time to tell us repeatedly that the American people do NOT want health-care reform.

Why is it so important to stop meaningful reform that will lower costs, reduce the deficit, and extend basic preventive health care to tens millions of people? Could it be to deny Obama any achievement? Could it be the opportunity to line their pockets with health-insurance lobbyists' money? Maybe it's just a really patriotic resistance to the "socialism" that has gripped every other industrialized society. In any case, it is time that we stopped sacrificing our citizens' health and welfare to the corporate bottom-line.

[russ_watters]

Because they are out of time.

Putting a new bill together takes 6 months, and anyone with a ruler and a pencil looking at the polls knows that there is no way a health care bill will pass in October with elections in November. Agreed, but they put themselves in this situation, so they get no sympathy from me (not implying they would get it from you). They've known for a year what it would take to convince Republicans to suppot such a bill and have chosen not to do it.

To Ivan's point again, since they've known for a year what the flaws are and haven't fixed them, why would one believe they would be willing to fix them later? At this point, the logic goes, they are going to get slaughtered at the polls no matter what. Yeah, seems to be: you're screwed either way, so you might as well go out with a bang! It just boggles my mind that that logic has so much traction.

It is truly breathtaking how quickly they proved to be everything the public hated about the Republican controlled government and how quickly the public turned on them for it:

Corrupt back-room deals? Check.
Not listening to the people, but stuffing the bill with pork, special interest deals and lobbyist's wants? Check.
Ignoring the nations immediate problems to go after your pet crusade? Check.

What I don't understand is how some die-hard democrats seem genuinely confused about how we got here!
So the Democrats are faced with two options: a serious loss in November with a health care bill, or a serious loss in November without a health care bill. Which do you think they will choose? Well I would have expected a politician to be tenacious when it comes to their re-election bid, so it is surprising to me that they are buying into the defeatism that Obama is selling them. Are these dems even plannign to run in November or are they just going to quit?

[russ_watters]

Russ, apart from Olympia Snowe, not a single Republican participated in crafting the legislation. Right, and why is that? It's because the Democrats realized that with a 60 seat supermajority in the Senate, they could do whatever they wanted without letting the republicans have a say. It is painfully evident that the GOP does not want any health-care reform bill at all. If they did, they would have contributed and helped to shape it into something that they could support. Saying it over and over again doesn't make it any less wrong than it was the first time. You can't participate in a process you aren't allowed to participate in.
They did not, and McConnell and Boehner take every second of camera-time to tell us repeatedly that the American people do NOT want health-care reform. The American peopled do not want this healthcare reform bill. Why is it so important to stop meaningful reform that will lower costs, reduce the deficit, and extend basic preventive health care to tens millions of people? Well you seemed to acknowledge that you know it has flaws so why don't you tell me? Have you been listening to what Republicans are saying about what the flaws are?

That last paragraph is just blathering rhetoric, turbo-1. They aren't meangingful/useful statements you are making. A small example and I won't address the rest: line their pockets with health-insurance lobbyists' money One of the primary "changes" Obama promised was to reduce the influence of lobbyists in Washington, but this bill is a lobbyist's bonanza. Why doesn't it have tort reform in it? Because of the lawyer lobby. Why does it have freebies for unions? Because of the union lobby. Speaking in blathering generalities about lofty principles that this bill supposedly upholds is just not useful for a debate.

[Brian_C]

"Poor" people don't need subsidies for health insurance. They can already walk into the emergency room and get all the care they want.

[turbo]

The American peopled do not want this healthcare reform bill.That's pretty silly. Very few people know what's inside the bill, apart from the few talking points that politicians on either side give them. The people who demand NO reform are people who accept the GOP's fear-mongering as truth. Have you seen the tea-baggers decrying health-care reform as "socialism", yet demanding that no changes be made to their Medicare? What kind of logic is that?

At least the CBO has had time to analyze it and come out with their assessment.

As for Republicans being shut out of the legislation, they were not. They refused to participate and tried to pressure all Republicans to do the same. Snowe took all kinds of heat from her party because she participated. She wanted no public option, or failing that, performance measures that would trigger a public option years down the road if the insurance companies didn't clean up their act. The bill might have looked very different if she had not gotten concessions she demanded. What would the bill look like if other Republicans made a good-faith effort at contributing? We'll never know, because the party of "NO" held firm.

[Choronzon]

I really can not summon any emotion but contempt for this bill, for its crafters, and those who support it. They actually think the can legislate the insurance industry to do nothing less but provide unlimited health care. I'm not allowed to retroactively purchase collision insurance for my already wrecked car, so you shouldn't be able to purchase insurance to pay for your already wrecked body.

It really, truly baffles me how Americans can seriously believed that they are entitled to their fellow citizens effectively carrying them through life. People on this very board think that for a negligible monthly payment, a corporation should pay your health care in perpetuity with no annual or lifetime caps—not to mention that they have to accept you, regardless of your condition.

Seriously, people? You think you should be able to go up to someone and say "Hi! I'm going to give you say $500 a month, and in exchange you're going pay hundreds of thousands, if not millions of dollars in my medical costs. Why? Because it's my right!"

If you do think you're entitled to this, I don't know how you can live with the shame.

[Vanadium 50]

Agreed, but they put themselves in this situation

Well, they aren't going to change the past.

If the original House bill was just enough more centrist to gain the votes of the 39 democrats who defected, there would be health care today. There would also most likely be a jobs bill passed instead of the spectacle of the President holding the jobs bill hostage until a health care bill passes. People would be comparing Obama favorably to FDR rather than unfavorably to Carter.

The Democrats are doing their best to blame this on the Republicans, but the fact of the matter is that had the original bill been acceptable to every Democrat, it would be the law of the land today.

But that's not what happened, and that's why there is such a mess. As I argued in my last message, given where they are today, "ram it through" is not an irrational strategy.

If I were a Democratic Congressman about to lose an election, I wouldn't worry too much. Both parties have traditionally taken care of members who have lost elections because they voted with the party and not with their constituents. Embassies around the world are full of such people. What I would be worried about is running roughshod over the structures that exist to preserve the influence of the minority party right before the election that might very well place my party in the minority. Perhaps the recent rejection of "deem and pass" is a sign they are thinking this way.

[Brian_C]

I really can not summon any emotion but contempt for this bill, for its crafters, and those who support it. They actually think the can legislate the insurance industry to do nothing less but provide unlimited health care. I'm not allowed to retroactively purchase collision insurance for my already wrecked car, so you shouldn't be able to purchase insurance to pay for your already wrecked body.

It really, truly baffles me how Americans can seriously believed that they are entitled to their fellow citizens effectively carrying them through life. People on this very board think that for a negligible monthly payment, a corporation should pay your health care in perpetuity with no annual or lifetime caps—not to mention that they have to accept you, regardless of your condition.

Seriously, people? You think you should be able to go up to someone and say "Hi! I'm going to give you say $500 a month, and in exchange you're going pay hundreds of thousands, if not millions of dollars in my medical costs. Why? Because it's my right!"

If you do think you're entitled to this, I don't know how you can live with the shame.

Exactly. The people who think health care is a "civil right" should sail back to Europe. This country wasn't founded on Marxist ideals.

[calculusrocks]

I really can not summon any emotion but contempt for this bill, for its crafters, and those who support it. They actually think the can legislate the insurance industry to do nothing less but provide unlimited health care. I'm not allowed to retroactively purchase collision insurance for my already wrecked car, so you shouldn't be able to purchase insurance to pay for your already wrecked body.

It really, truly baffles me how Americans can seriously believed that they are entitled to their fellow citizens effectively carrying them through life. People on this very board think that for a negligible monthly payment, a corporation should pay your health care in perpetuity with no annual or lifetime caps—not to mention that they have to accept you, regardless of your condition.

Seriously, people? You think you should be able to go up to someone and say "Hi! I'm going to give you say $500 a month, and in exchange you're going pay hundreds of thousands, if not millions of dollars in my medical costs. Why? Because it's my right!"

If you do think you're entitled to this, I don't know how you can live with the shame.

Yup.

[Brian_C]

I am sick and tired of hearing Obama whine about the problems his mother had with the insurance companies. This woman didn't even live in the United States for much of her adult life and probably contributed little to the American economy. People like that don't "deserve" health coverage with no strings attached.

[Zefram]

Reconciliation is only for budget bills.

http://en.wikipedia.org/wiki/Reconciliation_%28United_States_Congress%29

That will draw a Constitutional challenge as well, because its a health coverage bill.

The reconciliation package (H.R. 4872) is not the health care bill. The health care bill is the Senate reform bill, H.R. 3590, which already passed out of the Senate (60-39 (http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00396)) and will be voted on in the House tomorrow. The reconciliation package is a series of small, budgetary tweaks to that legislation.

ADD: Choice drives down cost, because of competition.

Competition between who? Insurance companies? I take it from your across-state-lines comment that this is what you're getting at. But the reality is that this isn't necessarily true. In fact, in some circumstances greater fragmentation among payers leads to higher reimbursement rates (i.e. costs) because no payer has the bargaining power to negotiate down rates with providers. There was a paper (http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0715) in Heath Affairs recently detailing how unchecked provider clout in California is driving up costs in the state. The Massachusetts AG's office also released a report (http://www.boston.com/news/local/massachusetts/articles/2010/01/29/attorney_general_says_clout_drives_up_health_costs/?page=1) recently indicating that the same thing is happening in Massachusetts. The same force at work in very different states, one small and one with a population larger than that of Canada. And in neither would further fragmentation of the payer side of the equation address the influence of providers on reimbursement rates.

Heck, if the democratic congressmen believed that it was a bad bill and republicans wouldn't support a good bill, they should still make it a good bill so they would have real ammo to use at election time! It is pretty weak to accuse the other side of being obstructionist for blocking bad legislation.

These reform proposals are extremely similar in design to the alternative to the Clinton proposal in 1993 devised by a mix of moderate and conservative Senate Republicans (there are even some Republican co-sponsors to that bill still in the Senate: Kit Bond, Bob Bennett, Orrin Hatch, Dick Lugar, and Chuck Grassley).

Right, and why is that? It's because the Democrats realized that with a 60 seat supermajority in the Senate, they could do whatever they wanted without letting the republicans have a say. Saying it over and over again doesn't make it any less wrong than it was the first time. You can't participate in a process you aren't allowed to participate in.

Numerous ideas supported by Republicans and conservatives are contained in this bill (which, as I just said, is extremely similar to the Republican proposal last go around). I pointed these out in another thread not too long ago:

Elimination of pre-existing conditions as a pre-text for denying coverage (mentioned in Bobby Jindal's op-ed (http://www.washingtonpost.com/wp-dyn/content/article/2009/10/04/AR2009100402003_2.html?sid=ST2009101402985))
The individual mandate (Republican leaders have since reversed themselves on this). For example, the lead Republican negotiator on the Senate Finance Committee, Chuck Grassley, supported this into the summer (http://www.washingtonmonthly.com/archives/individual/2009_09/020072.php): "As recently as a month ago, Chuck Grassley, the same senator bashing the idea of a mandate yesterday, announced that the way to get universal coverage is 'through an individual mandate.' He told Nightly Business report, 'That's individual responsibility, and even Republicans believe in individual responsibility.' Earlier this year, Grassley told Fox News that there wasn't 'anything wrong' with mandates even if some may view them 'as an infringement upon individual freedom.'"
The creation of health insurance exchanges (these figured heavily into the Republican Patient's Choice Act of 2009).
Continuing the stimulus bill's support of health information exchange
Subsidies to low income buyers in the individual private insurance market. Here's the Heritage Foundation (http://www.heritage.org/Research/HealthCare/wm2448.cfm) (from before the Democratic bills were released): "Moreover, as a general principle, Congress should provide tax relief for those who purchase coverage on their own and redirect other health care spending to help low-income individuals and families purchase private health insurance coverage." This also appears in the Republican Study Committee's H.R. 3400.
An employer mandate to offer insurance. This appeared in the bipartisan "Crossing Our Lines: Working Together to Reform the U.S. Health System" proposal released by Howard Baker, Bob Dole, and Tom Daschle.
Support for comparative effectiveness research. This, too, appeared in "Crossing Our Lines: Working Together to Reform the U.S. Health System."
A tax credit aimed at encouraging small businesses to offer their employees health insurance.
The excise tax in the Senate bill.
Increased funding to fight waste, fraud, and abuse in Medicare.

Indeed, we can look just at the Republican substitute (summary (http://gopleader.gov/UploadedFiles/Summary_of_Republican_Alternative_Health_Care_plan _Updated_11-04-09.pdf)) offered this time around and find that most of the ideas Republicans want in a bill appear in some form in the Democratic legislation.

Republicans participated in all of the markups (all three in the House, both in the Senate) and had numerous amendments accepted. But they generally preferred to play games than to craft policy: watch this gem (http://www.youtube.com/watch?v=nz5AmhI9g7o) from the Senate HELP committee markup.

The reality is that this is a moderate bill that's bipartisan in content, if not support.

[WhoWee]

Does anyone know what a "health insurance exchange" looks like? Take a look at Medicare.gov and open up a few of the plans. When you are finished, please recall THESE plans cost YOU about $850 per month per person.

http://www.medicare.gov/MPPF/Include/DataSection/Questions/ListPlanByState.asp

Just for fun, look at a few $0 premium plans and a couple "Special Needs" (SNP-Dual Eligible) plans.

[Office_Shredder]

What? I went on the website and asked it to show me some plans. The most expensive premium was like 125 dollars a month. Am I missing something?

[mheslep]

[...]Competition between who? Insurance companies? I take it from your across-state-lines comment that this is what you're getting at. But the reality is that this isn't necessarily true. In fact, in some circumstances greater fragmentation among payers leads to higher reimbursement rates (i.e. costs) because no payer has the bargaining power to negotiate down rates with providers. There was a paper (http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0715) in Heath Affairs recently detailing how unchecked provider clout in California is driving up costs in the state. The Massachusetts AG's office also released a report (http://www.boston.com/news/local/massachusetts/articles/2010/01/29/attorney_general_says_clout_drives_up_health_costs/?page=1) recently indicating that the same thing is happening in Massachusetts. The same force at work in very different states, one small and one with a population larger than that of Canada. And in neither would further fragmentation of the payer side of the equation address the influence of providers on reimbursement rates.It appears to me your changing the subject in these references. The issue at hand is interstate insurance, i.e. giving payers the ability to shop out of state to get away from provincial monopolies. These references, at quick glance, talk about the concentrated power of insurance companies in states where the payers are prevented from going elsewhere.

We've discussed this theme before, and I completely disagree as before. The list below contains goals. While there may be small areas of common ground, the Republican bill differs completely from the current Senate bill in the means to achieve these goals. The bills (e.g. Ryan's and the Senate bill) are completely different in character. I address the ones the jump out at me:

[list] Elimination of pre-existing conditions as a pre-text for denying coverage (mentioned in Bobby Jindal's op-ed (http://www.washingtonpost.com/wp-dyn/content/article/2009/10/04/AR2009100402003_2.html?sid=ST2009101402985))
Differs in means. Dems intend to simply force insurance companies to cover everyone, i.e. the chronically ill, something an insurance company is ill designed to do. Ryan's bill and others would create high risk pools for them.

The individual mandate (Republican leaders have since reversed themselves on this). For example, the lead Republican negotiator on the Senate Finance Committee, Chuck Grassley, supported this into the summer (http://www.washingtonmonthly.com/archives/individual/2009_09/020072.php): "As recently as a month ago, Chuck Grassley, the same senator bashing the idea of a mandate yesterday, announced that the way to get universal coverage is 'through an individual mandate.' He told Nightly Business report, 'That's individual responsibility, and even Republicans believe in individual responsibility.' Earlier this year, Grassley told Fox News that there wasn't 'anything wrong' with mandates even if some may view them 'as an infringement upon individual freedom.'"Yes and Romney did mandates in Massachussets. So? Many people say lots of things. Some Democrats considered canning the employer - health benefits tax exemption in the Senate - a very good idea - but it's not in this bill in except in extremis. Of the dozen or so Republican drafted bills, I've seen none with a mandate to buy insurance at the federal level.

The creation of health insurance exchanges (these figured heavily into the Republican Patient's Choice Act of 2009).For the STATES! And people won't be forced on to them. C'mon.
Creates State Health Insurance Exchanges to give Americans a one‐stop marketplace to compare different health insurance policies and select the one that meets their unique needs
Continuing the stimulus bill's support of health information exchange
They might support the info exchange, but one can not reasonably claim via the stimulus bill, since no Republicans voted for the stimulus bill in the House and only 1-2 Senators.
Indeed, we can look just at the Republican substitute (summary (http://gopleader.gov/UploadedFiles/Summary_of_Republican_Alternative_Health_Care_plan _Updated_11-04-09.pdf)) offered this time around and find that most of the ideas Republicans want in a bill appear in some form in the Democratic legislation.

Republicans participated in all of the markups (all three in the House, both in the Senate) and had numerous amendments accepted. But they generally preferred to play games than to craft policy: watch this gem (http://www.youtube.com/watch?v=nz5AmhI9g7o) from the Senate HELP committee markup.

The reality is that this is a moderate bill that's bipartisan in content, if not support.This is misinformation. We know how bipartisan federal legislation is crafted in this country. For centuries the manner has been to have members of both parties sponsor the legislation. McCain-Feingold. Wyden-Bennet. Webb-Alexander. That is bipartisan legislation. Such has not happened here, and that is the responsibility solely of the Democratic party.

[WhoWee]

(Take a look at the plans in Louisiana and Florida (Miami-Dade) if you want a dose of reality)


Consider this - "health care reform" is going to insure 30 million (???) additional people and cut costs - right???

According to Obama, there will be NO pre-existing conditions, and no limit to coverage.

The specifics of that coverage mandate is VERY similar to these Medicare Advantage plans that cost YOU the taxpayer $850 per person per month to fund.

Let's see, 30,000,000 X $850.00 = $25,500,000,000 per month = $306,000,000,000 per year. Hmmm an extra $306 billion per year in Government expenditures.?

Next, let's also recall that Medicaid (State programs partially funded by Fed) will be called upon to fund the insured persons monthly share of the premiums, co-pays, and deductibles. Then, if the program mirrors Medicare, perhaps Social Security can pay for their prescriptions. Gee, I wonder how much each person's premiums, co-pays and deductibles will cost each year - especially if they are encouraged to use their benefits.

How can this plan POSSIBLY reduce the deficit? How will this strategy cut costs? Does ANYONE believe cutting payments to Doctors is a realistic option to paying for the plan?

Best of all, NOBODY making less than $250,000 per year will have their taxes raised?

[Angry Citizen]

That is bipartisan legislation. Such has not happened here, and that is the responsibility solely of the Democratic party.

The Republican party has made its platform into the "Party of No". If a Republican were attached to any major piece of Obama legislation, he would bear the stigma associated with it. The level of partisanship in this country is such that a bipartisan effort on the bill was impossible.

As was shown in the bipartisan meeting (which I watched start to finish), the Republicans repeatedly made references toward "starting over". It's a stall tactic designed to ensure that Democrats have an extraordinarily large political defeat, wasting political capital and making them look like ineffectual fools.

I'm a libertarian (no, not like Beck), so I really don't like either party very much, but an interesting trend emerges when we consider socialized medicine. Countries with socialized medicine tend to be healthier, and the expenses paid per capita are drastically lower. The Obama bill is nowhere close to socialized medicine (even the vaunted public option is removed), but it is a trend towards something that has a noticeable track record of working. I may be a libertarian, but I'm not so married to my ideology that I cannot make an exception. Perhaps you should too.

[Zefram]

It appears to me your changing the subject in these references. The issue at hand is interstate insurance, i.e. giving payers the ability to shop out of state to get away from provincial monopolies. These references, at quick glance, talk about the concentrated power of insurance companies in states where the payers are prevented from going elsewhere.

It must have been a very quick glance, as both links are about providers, not insurance companies. Regardless of where your insurance company is headquartered, you're going to deal with providers in your area. And your insurer is going to have to negotiate reimbursement rates with those providers if they're going to pay for your care. Unless your plan is also for people to travel out of state whenever they need medical care? Even so, increasing payer fragmentation doesn't inherently bring down costs when providers have the clout to keep raising them.

Of the dozen or so Republican drafted bills, I've seen none with a mandate to buy insurance at the federal level.

Really? Wyden-Bennett has a federal mandate (Republican co-sponsors: Robert Bennett, Lamar Alexander, Mike Crapo, Lindsey Graham, Judd Gregg). The Republican alternative last go around (http://thomas.loc.gov/cgi-bin/bdquery/z?d103:s.01770:) (in 1993) had both an individual and an employer mandate (as I already indicated above, the Republican sponsors still in the Senate are: Kit Bond, Bob Bennett, Orrin Hatch, Dick Lugar, and Chuck Grassley). Ryan's bill (and H.R. 3400 in a slightly different fashion) has auto-enrollment in place of a mandate.

For the STATES! And people won't be forced on to them. C'mon.

The exchanges in H.R. 3590 are state-administered. States that can achieve superior results in another way can get a waiver to do so.

They might support the info exchange, but one can not reasonably claim via the stimulus bill, since no Republicans voted for the stimulus bill in the House and only 1-2 Senators.

Shocking. The HITECH Act is one of the true keys to value-based delivery system reform in this country and we have almost no Republicans to thank for it.

[Zefram]

(Take a look at the plans in Louisiana and Florida
Let's see, 30,000,000 X $850.00 = $25,500,000,000 per month = $306,000,000,000 per year. Hmmm an extra $306 billion per year in Government expenditures.?

I can't believe CBO hasn't snatched you right up.

[calculusrocks]

I'm a libertarian (no, not like Beck), so I really don't like either party very much, but an interesting trend emerges when we consider socialized medicine. Countries with socialized medicine tend to be healthier, and the expenses paid per capita are drastically lower. The Obama bill is nowhere close to socialized medicine (even the vaunted public option is removed), but it is a trend towards something that has a noticeable track record of working. I may be a libertarian, but I'm not so married to my ideology that I cannot make an exception. Perhaps you should too.


No you are not a libertarian. You are a closet liberal, who supports big liberal gov't.

[mheslep]

As was shown in the bipartisan meeting (which I watched start to finish), the Republicans repeatedly made references toward "starting over". It's a stall tactic designed to ensure that Democrats have an extraordinarily large political defeat, wasting political capital and making them look like ineffectual fools.That's the Dem's fault. If they had started on with, e.g., a Ryan+Some Dem bill we'd have a good health care bill now. They chose to go it alone.

I'm a libertarian (no, not like Beck), so I really don't like either party very much, but an interesting trend emerges when we consider socialized medicine. Countries with socialized medicine tend to be healthier, and the expenses paid per capita are drastically lower. The Obama bill is nowhere close to socialized medicine (even the vaunted public option is removed), but it is a trend towards something that has a noticeable track record of working. I may be a libertarian, but I'm not so married to my ideology that I cannot make an exception. Perhaps you should too.So what's the logic here? What makes you think the pending legislation promising vast increases in federal involvement in the heath system will improve anything, especially when the government controls so much of it already? US health is indeed far too expensive, but why don't you take a real look at medical outcomes in other countries before casually talking about how good they are. I have, in great detail, with real personal health consequences on the line.

[WhoWee]

I can't believe CBO hasn't snatched you right up.

Just having fun.

[Angry Citizen]

No you are not a libertarian. You are a closet liberal, who supports big liberal gov't.

Argh! Here I lie, skewered by your rebuttal, the likes of which has not been seen since Voltaire himself!

I support one policy, and I'm suddenly a 'closet liberal'. Classy. Now, if I were as classy as you, I'd rebut that you are a closet conservative, who supports big conservative government. Oh, what's that? Conservatives don't support big government? Well, it sure wasn't my party that supported the Department of Homeland Security, the War On Drugs and the PATRIOT Act.

[Angry Citizen]

So what's the logic here? What makes you think the pending legislation promising vast increases in federal involvement in the heath system will improve anything, especially when the government controls so much of it already? US health is indeed far too expensive, but why don't you take a real look at medical outcomes in other countries before casually talking about how good they are. I have, in great detail, with real personal health consequences on the line.

Because a trend towards federal control historically tends to increase health standards and decrease costs. You recall, of course, that the legislation which started the major rise in health costs occurred under Ronald Reagan, yes? I am referring, of course, to the bill stipulating that a person cannot be refused emergency treatment. We the taxpayer already pay for this 'liberal' bill. If you were serious about ending government health care, you would've been against the Reagan bill from the outset.

[calculusrocks]

Argh! Here I lie, skewered by your rebuttal, the likes of which has not been seen since Voltaire himself!

I support one policy, and I'm suddenly a 'closet liberal'. Classy. Now, if I were as classy as you, I'd rebut that you are a closet conservative, who supports big conservative government. Oh, what's that? Conservatives don't support big government? Well, it sure wasn't my party that supported the Department of Homeland Security, the War On Drugs, the institution of the Federal Reserve and the PATRIOT Act.

Look, there are some libertarian who support a small government with functions for police, fire, military. They are the pragmatists. But, there are no libertarians who support health care as one of those functions. None. Libertarians are opposed to statism in all forms. You have no libertarian rationale for your support of universal health care. Instead, you drop the same talking points as the liberals. If it walks like a duck, talks like a duck, then guess what. It is a duck.

"The republicans are the party of no..."
"I'm not blinded by ideology..."

[mheslep]

Really? Wyden-Bennett has a federal mandate (Republican co-sponsors: Robert Bennett, Lamar Alexander, Mike Crapo, Lindsey Graham, Judd Gregg). The Republican alternative last go around (http://thomas.loc.gov/cgi-bin/bdquery/z?d103:s.01770:) (in 1993) had both an individual and an employer mandate (as I already indicated above, the Republican sponsors still in the Senate are: Kit Bond, Bob Bennett, Orrin Hatch, Dick Lugar, and Chuck Grassley).I missed the W-B mandate, thanks for pointing that out. Ryan's bill (and H.R. 3400 in a slightly different fashion) has auto-enrollment in place of a mandate.In place of? What's with the specious word play? The former is nothing like the latter.

The exchanges in H.R. 3590 are state-administered. States that can achieve superior results in another way can get a waiver to do so.State administered Federal rules that people are going to be forced on by the millions. Saying the 3590 Federal exchanges are a Republican idea is akin to painting strips on a horse and calling it a zebra.

Shocking. The HITECH Act is one of the true keys to value-based delivery system reform in this country and we have almost no Republicans to thank for it.I'll take that as a snarky self-correction of your earlier claim this was also a Republican supported idea.

[mheslep]

Because a trend towards federal control historically tends to increase health standards and decrease costs.
You mistake cause and effect. One might as well say the increase in the Stork population tends to increase health standards.
You recall, of course, that the legislation which started the major rise in health costs occurred under Ronald Reagan, yes? I would say that EMTALA occurred under Tip O'neil, and I know the major rise in US health costs began with WWII wage controls, creating employer provided tax exempt insurance.

[Angry Citizen]

Look, there are some libertarian who support a small government with functions for police, fire, military. They are the pragmatists. But, there are no libertarians who support health care as one of those functions. None. Libertarians are opposed to statism in all forms. You have no libertarian rationale for your support of universal health care. Instead, you drop the same talking points as the liberals. If it walks like a duck, talks like a duck, then guess what. It is a duck.

"The republicans are the party of no..."
"I'm not blinded by ideology..."

What a terrible justification for your labelling crusade. In your mind, there are no libertarians who support universal health care, because anyone who supports universal health care is not a libertarian. Like I said, there is no libertarian rationale for my support of universal health care. My beliefs coincide with libertarian philosophy in a great many cases. They do not coincide with libertarian philosophy in all cases. I think for myself based on the situation in question. Like I said, I am not blinded by my ideology. I give due credence to historical trends in all forms. If this were a debate on socialism itself, I would be attacking the leftist view based on the same historical trends, which overwhelmingly show that socialism is a very poor economic model for long term sustainability.

When you're so blinded by your party label that you become immune to the lessons of history, of logic and of compromise, you doom yourself to hateful rhetoric, relentless opposition, and staggeringly illogical standpoints -- such as your crass and brutish blanket label of anyone on the other side of the fence on one bloody issue.

Hilariously, you point to the one justification behind it: pragmatism. What the hell is so different about socialized law enforcement, socialized fire and emergency medical services, and socialized military? Maybe they should be privatized too -- just to fall in lock-step with our ideology.

[Angry Citizen]

You mistake cause and effect. One might as well say the increase in the Stork population tends to increase health standards.

Are you saying that health care and health are unrelated? Maybe cancer has nothing to do with the mortality rate of individuals 65 years and older.

[mheslep]

Well, it sure wasn't my party that supported the Department of Homeland Security, the War On Drugs and the PATRIOT Act.Yes the libertarian position would be to oppose those creations, but both parties have supported them to varying degrees and continue to do so.

[mheslep]

Are you saying that health care and health are unrelated? Maybe cancer has nothing to do with the mortality rate of individuals 65 years and older.Lets not throw strawmen around. Your statement was
Because a trend towards federal control historically tends to increase health standards and decrease costs
It is fallacy to conclude from that statement that federal control increases health standards.

[Angry Citizen]

It is fallacy to conclude from that statement that federal control increases health standards.

That is hardly fallacious. Countries with higher levels of centralized, governmental control of health care tend to have longer average lifespans and lower rates of infant mortality. I am eager to see how this correlation does not imply causation.

[WhoWee]

Thank you Angry Citizen - for once again - taking the focus off of the specifics of the debate.

If health care "reform" were a scientific problem, would ANY OF YOU look at it this way?

[calculusrocks]

..........

[calculusrocks]

What a terrible justification for your labelling crusade.

You're the one that labels yourself as a libertarian in the first place. Nonsense.
In your mind, there are no libertarians who support universal health care, because anyone who supports universal health care is not a libertarian.

Yup. It advocates the use of force and coercion.

Like I said, there is no libertarian rationale for my support of universal health care. My beliefs coincide with libertarian philosophy in a great many cases. They do not coincide with libertarian philosophy in all cases. I think for myself based on the situation in question. Like I said, I am not blinded by my ideology.

Libertarianism is rooted in ideology. Here's a YouTube for those curious. muHg86Mys7I


I give due credence to historical trends in all forms. If this were a debate on socialism itself, I would be attacking the leftist view based on the same historical trends, which overwhelmingly show that socialism is a very poor economic model for long term sustainability.

So in this paragraph you attack the socialists on economy, but yet you support the annexation of 1/6 of the US Economy. Really! I know a duck when I see a duck.

[mheslep]

What the hell is so different about socialized law enforcement, socialized fire and emergency medical services, and socialized military? These are all things that are to be avoided as much as possible as they have great carrying costs, are inefficient, and lead to abuses. However, most of them have no alternative and they are necessary. Or, per Washington,
Government is not reason, it is not eloquence, it is force; like fire, a troublesome servant and a fearful master.
Societal life requires we use the fearful master, but it should be as little as possible.

[calculusrocks]

It's time to refocus - AGAIN.
http://www.washingtonpost.com/wp-dyn/content/article/2009/10/14/AR2009101403953.html

"In a health-care debate defined by big numbers and confusing details, the prospect of losing benefits such as a free gym membership through the Silver Sneakers program is tangible, and it has spooked some seniors, who are the nation's most reliable voters and have been most skeptical about reform.

Medicare Advantage was established in the 1970s (under a different name) when private insurers convinced Congress that they could deliver care at lower costs than Medicare. The program blossomed in the late 1990s when Congress bolstered it with millions in additional federal subsidies to for-profit HMOs. It has proven popular among younger, active seniors who had managed-care plans as workers, and about a quarter of Medicare's 45 million beneficiaries are enrolled.

Many private plans require no additional monthly premiums, yet the government pays an average of $849.90 in monthly subsidies to insurance companies for a person on Medicare Advantage, according to the Kaiser Family Foundation. That is about 14 percent more than the government spends on people with standard Medicare, according to the nonpartisan Medicare Payment Advisory Commission.

"The promise of Medicare Advantage and Medicare HMOs was to save the government money, to save consumers money, all the while providing additional benefits and coordinating care," said Joseph Baker, president of the Medicare Rights Center. "That promise has been unfulfilled overall because the plans are overpaid by the federal government at this point." "

You can blame this mess on insurance companies until your head explodes. However, the TRUTH is that the Center for Medicare and Medicaid (CMS) runs this program. This is the Government run insurance program. Please note the cost PER PERSON to the Government is $849.90 per month. Then the individual pays co-pays, deductibles, some pay premiums - then we have the Part D prescription costs ($4,550 out of pocket cost to escape the Standard Coverage Gap).

The Government is the problem - not the solution.

I thought this was an excellent post.

[Zefram]

I missed the W-B mandate, thanks for pointing that out. In place of? What's with the specious word play? The former is nothing like the latter.

Yes, in place of. Auto-enrollment is in Ryan's bill for the same reason the mandate is in other bills: to achieve near-universal coverage and avoid adverse selection issues. They are two mechanisms with the same goal--getting as many people into the system as possible.

State administered Federal rules that people are going to be forced on by the millions. Saying the 3590 Federal exchanges are a Republican idea is akin to painting strips on a horse and calling it a zebra.

Ryan's exchanges:

Certified by the Feds in accordance with federal rules ("In General- The Secretary of Health and Human Services (referred to in this title as the `Secretary') shall establish a process for the review of applications submitted by States for the establishment and implementation of State-based health care Exchanges (referred to in this title as a `State Exchange') and for the certification of such Exchanges. The Secretary shall certify a State Exchange if the Secretary determines that such Exchange meets the requirements of this title.)
Participating plans required to have benefit parity with members of Congress
Autoenrollment to facilitate universal coverage
Guaranteed access ("The State Exchange shall ensure that, with respect to health insurance coverage offered through the Exchange, all eligible individuals are able to enroll in the coverage of their choice provided that such individuals agree to make applicable premium and cost sharing payments.")
HIPAA limitations on pre-existing condition exclusions are applied to nongroup plans--i.e. in the Exchange--for the first time
Risk adjustment mechanisms to provide a "limitation on exorbitant premiums" (i.e. a weak form of modified community rating)

Yes, philosophically very different from the state-based exchanges in the Democratic reform proposals. Except for the federal directives, I suppose.

I'll take that as a snarky self-correction of your earlier claim this was also a Republican supported idea.

Oh, HIE has strong bipartisan support (even the red states are gobbling up HIE Cooperative grants to build functioning HIEs in their states). But with these Republicans, that rarely translates into votes.

[Angry Citizen]

So in this paragraph you attack the socialists on economy, but yet you support the annexation of 1/6 of the US Economy. Really! I know a duck when I see a duck.

Of course. Socialist policies are not socialism. Socialism and social democracies are two very different things. 1/6 of the US economy has already been annexed. If legislation to pay for it and ensure it is universal are such terrifying concepts, then so be it. I'd rather have good health care than ascribe to an inflexible ideology. If you're against universal health care just because it's the evil guvmnt, then you're against it for all the wrong reasons. If there were an historical trend towards lower health standards and greater costs inherent in socialized medicine, naturally I would be against it. Unfortunately, the trend is against you here. You are, essentially, supporting the same thing the socialists support: a system that is proven to be ineffective and inefficient.

[mheslep]

That is hardly fallacious. Yes it is unless one shows the connection between the two, as you are now attempting to do here:
Countries with higher levels of centralized, governmental control of health care tend to have longer average lifespans and lower rates of infant mortality. I am eager to see how this correlation does not imply causation.That's a Wikipedia level look at the topic. For instance, lifespans are obviously impacted by many things other than health care. If you want to know about quality health care, take a detailed look as I suggested above, at survival rates for cancer, heart disease, i.e. what happens to you if you actually get sick and see a doctor. You'll find most often the best place to be is in the US. If you want to know about lifespan causes start with McDonalds and car wrecks.

[Angry Citizen]

If you want to know about quality health care, take a detailed look as I suggested above, at survival rates for cancer, heart disease, i.e. what happens to you if you actually get sick and see a doctor. You'll find most often the best place to be is in the US.

These statistics ignore the fact that the United States is known to have more specialists in these kinds of fields. If the United States' health care was so good, its average life span would be at or near the top spot, right? It's not.

Sure, other things could be affecting the statistic. But what? Average life span is a pretty huge indicator of public health, because it is a broad view of health that ignores focused studies on certain diseases. If the summary of American health care is, "We can treat your really bad diseases pretty darn well, but you're still not likely to outlive a Japanese or Norwegian", then American health care needs to change regardless.

[mheslep]

Yes, in place of. Auto-enrollment is in Ryan's bill for the same reason the mandate is in other bills: to achieve near-universal coverage and avoid adverse selection issues. They are two mechanisms with the same goal--getting as many people into the system as possible.
So? It is nonsensical to cite Ryan's auto-enrolment as an example of a Republican idea in the current Democratic bill. One might as well say the Republicans and Democrats both want 'good' things and that therefore all their particular methods for getting there are pretty much the same.

[calculusrocks]

Apparently this Canadian socialist was not so rooted in ideology (http://www.google.com/hostednews/canadianpress/article/ALeqM5h0QC7bditrEb3wYz_6_b-gsGGDxA) as to get his heart surgery in the Canadian socialist system. If the US switches from mixed economy (gov't built HMOs in the 1970s) to total socialization the health care, where are Canadian politicians going to go for their health care?

[mheslep]

These statistics ignore the fact that the United States is known to have more specialists in these kinds of fields. If the United States' health care was so good, its average life span would be at or near the top spot, right? It's not.

Sure, other things could be affecting the statistic. But what?
Diet. Crime. Average driving distance. Gene pool. If one controls life span for these causes of death, the US is close to or at the the top. For infant mortality, the US difference is about 0.6 deaths out of a 1000 from the top, if you believe the infant death rates are measured the same way everywhere.

If the summary of American health care is, "We can treat your really bad diseases pretty darn well, but you're still not likely to outlive a Japanese or Norwegian", then American health care needs to change regardless.The US health care system does need to change, but I advocate that along the way we not screw up the fact that we do indeed treat 'diseases pretty darn well'

[mheslep]

Oh, HIE has strong bipartisan support (even the red states are gobbling up HIE Cooperative grants to build functioning HIEs in their states). But with these Republicans, that rarely translates into votes.I find this line so tiresome. Some $850 billion (the stimulus bill) of our money is taken by force and spent. But since we may have vociferously opposed its authorization, it is somehow not appropriate to get in line and take our own money back. Or if we do, that demonstrates we really supported the idea all along and were just acting out of politics. Please.

[hamster143]

Diet. Crime. Average driving distance. Gene pool. If one controls life span for these causes of death, the US is close to or at the the top. For infant mortality, the US is about 0.6 deaths out of a 1000 from the top, if you believe the death rates are measured the same.

Yes, there was that famous article that claimed that crime and accidents accounted for most of the difference in life expectancies between the US and OECD ... unfortunately, it turned out to be fake. As you can easily calculate by yourself, crime effectively reduces the US life expectancy by something like 0.4 years compared to virtually crime-less countries like Japan. If you also account for traffic accidents, you can probably explain away some more. The US is 1 year behind UK/Germany, 2 years behind New Zealand & Italy, 4 years behind Iceland and Japan.

I find it doubtful that the US has the worst dietary habits of all major countries. New Zealand has worse gene pool than the US (as recently as 100 years ago, it was basically populated by cannibal natives and convicts). Iceland has a horrible climate, but people manage to live quite long over there.

Smoking is an important contributor to premature death, but it turns out that Americans smoke substantially less than, say, Japanese or Greeks.

The US infant mortality is twice that of Iceland or Japan, 25% higher than in New Zealand or Italy.

[calculusrocks]

hamster, do you have any sources at all? If so, what is your point?

[hamster143]

hamster, do you have any sources at all? If so, what is your point?

My source is Wikipedia. My point is that the claim that "If one controls life span for these causes of death, the US is close to or at the the top" is inaccurate. In fact, the US does have one of the lowest life expectancies and highest infant mortalities in the developed world. So, we do NOT treat 'diseases pretty darn well', and the worry that we might somehow "break" our treasured healthcare system by trying to set up universal healthcare may be overblown.

[calculusrocks]

My source is Wikipedia. My point is that the claim that "If one controls life span for these causes of death, the US is close to or at the the top" is inaccurate. In fact, the US does have one of the lowest life expectancies and highest infant mortalities in the developed world. So, we do NOT treat 'diseases pretty darn well', and the worry that we might somehow "break" our treasured healthcare system by trying to set up universal healthcare may be overblown.

Great, then you can provide a link to it.

Well, when democrat politicians start going to Iceland, or wherever to get their critical treatments, then I'll see your point.

[hamster143]

Great, then you can provide a link to it.

Well, when democrat politicians start going to Iceland, or wherever to get their critical treatments, then I'll see your point.

Link to which part?

Would it be adequate if I provided links that showed that Sarah Palin's family went to Canada to get medical treatment?

Look, I have no doubt that the system we have here in the country is ideal for the wealthiest 1% (including most democrat and republican politicians). If your money is, for all intents and purposes, unlimited, you can get very good healthcare and you don't need to go to Canada or anywhere else.

Unfortunately, I'm not in the top 1% and probably neither are you, or most Americans on this forum.

[WhoWee]

Link to which part?

Would it be adequate if I provided links that showed that Sarah Palin's family went to Canada to get medical treatment?


Please do - and don't forget to explain the circumstances.

[calculusrocks]

Please do - and don't forget to explain the circumstances.

Didn't know it'd take more than a couple hours to use wikipedia.

[Office_Shredder]

http://www.huffingtonpost.com/2010/03/08/palin-crossed-border-for_n_490080.html

Referring to when she was a child:

Former Alaska Gov. Sarah Palin -- who has gone to great lengths to hype the supposed dangers of a big government takeover of American health care -- admitted over the weekend that she used to get her treatment in Canada's single-payer system.

"We used to hustle over the border for health care we received in Canada," Palin said in her first Canadian appearance since stepping down as governor of Alaska. "And I think now, isn't that ironic?"

[calculusrocks]

http://www.huffingtonpost.com/2010/03/08/palin-crossed-border-for_n_490080.html

Referring to when she was a child:

Huff. Post huh? Gee, I'm a little skeptical.

[calculusrocks]

So even taking it at face value, did she go to Canada for critical treatments such as heart surgery? Like my original question asked?

[Office_Shredder]

Huff. Post huh? Gee, I'm a little skeptical.

Seriously. Then why don't you look on google and find out yourself? This isn't hard. Just search for 'sarah palin went to canada for healthcare'

http://www.cbsnews.com/8301-503544_162-20000152-503544.html
http://latimesblogs.latimes.com/washington/2010/03/sarah-palin-canadian-health-care.html
http://www.telegraph.co.uk/news/worldnews/northamerica/usa/sarah-palin/7409555/Sarah-Palins-family-sought-health-care-in-Canada.html
http://voices.washingtonpost.com/44/2010/03/palin-says-she-used-canadian-h.html
http://politicalwire.com/archives/2010/03/08/palin_went_to_canada_for_health_care.html


So even taking it at face value, did she go to Canada for critical treatments such as heart surgery? Like my original question asked?

When she was a kid, the nearest city was a Canadian city, so when they had health issues they went there for health care. She specifically cites when her brother burned his ankle and they had to rush him onto a train that was going to Canada.

This is an example of how a more average American family had better access to health care from the Canadian system than the American system

[Argentum Vulpes]

....
When she was a kid, the nearest city was a Canadian city, so when they had health issues they went there for health care. She specifically cites when her brother burned his ankle and they had to rush him onto a train that was going to Canada.

This is an example of how a more average American family had better access to health care from the Canadian system than the American system

How about the fact that more then 10 min with out oxygen brain damage is very likely and irreversible [218]. Also that if her brother was 5 or younger, or the burn was a critical/moderate burn the risk of Shock is incredibly high [715-718]. Given these two facts the decision to transport across the border to the nearest hospital facilities was the best idea and most logical. Also even ALS services are not as good as getting someone to an ER. Paramedics are trained in stabilization, not in treatment [4-5]. Finlay when the option arises to drive X or Y amounts and X is much greater than Y you goto Y, even if it is across the Canadian border.

Information came from:
Emergency Care and treatment of the sick and injured. Ninth edition. Series Editor, Andrew N. Pollak, MD, FAAOS. Copyright 2005.

[Al68]

The Republican party has made its platform into the "Party of No".Too little too late. They should have been shouting no to these kinds of attacks on liberty much louder, and much more consistently.

Republicans are the ones I blame for this. Blaming Democrats is like blaming a wolf for eating a sheep instead of blaming the shepherd for sleeping on the job.I may be a libertarian, but I'm not so married to my ideology that I cannot make an exception.Your position on this issue is anti-libertarian, as you know. Your positions on other issues are irrelevant to this thread.

As far the implication that anyone should be ashamed of being "married" to libertarianism, that's just silly. Libertarianism is more like a best friend with benefits. :!!)

[Al68]

That is hardly fallacious. Countries with higher levels of centralized, governmental control of health care tend to have longer average lifespans and lower rates of infant mortality. I am eager to see how this correlation does not imply causation.Google "logical fallacies". This is one of the most famous ones in history, that a correlation like this implies a causal relationship.Socialist policies are not socialism.LOL. Yep, that's why you called them socialist policies. Because they're nothing like socialism. Gotcha. :rofl:

[calculusrocks]

Too little too late. They should have been shouting no to these kinds of attacks on liberty much louder, and much more consistently.

Republicans are the ones I blame for this. Blaming Democrats is like blaming a wolf for eating a sheep instead of blaming the shepherd for sleeping on the job.Your position on this issue is anti-libertarian, as you know. Your positions on other issues are irrelevant to this thread.

As far the implication that anyone should be ashamed of being "married" to libertarianism, that's just silly. Libertarianism is more like a best friend with benefits. :!!)

Republicans hasn't exactly done very much for the liberty conscious. I'm shocked they were even able to mount a filibuster. That being said, I don't know why republicans are what come up in this debate. The democrats own congress. They own the presidency. They had 60 senators, filibuster proof majority, and yet they still blame republicans for not helping democrats trample over individual liberty.

[WhoWee]

This is an example of how a more average American family had better access to health care from the Canadian system than the American system

Actually, this is an example of how a system can be abused by illegals.

[Ivan Seeking]

I won't be able to tune in today so the anticipation will be killing me, but it looks like the Dems have the votes. YAY!!!!

Responding to Russ's comments earlier regaring amendments, as I told him in person, no doubt we will be tweeking this for decades; and we would be no matter what passes. What matters most is that after 70 years of trying, we finally get over the hump.

This is truly an historic day.

[Ivan Seeking]

Regarding popular opposition, when people discover that they no longer have lifetime caps; when their insurance can't be cancelled because they got sick or pregnant; when they can't be refused insurance due to a preexisting condition, just as was true with the prescription drug plan, all of the Republican-created furor will fade away. Americans want what is in this bill.

I was struck by objections that while this may reduce the deficit, the overall cost of health care will increase. Given that 30 million people who have no insurance will now have coverage, of course it will cost more. The complaint seems to be that 30 million people should have no coverage if they can't afford it; that we have a $trillion to fight wars but not to protect American citizens from a corrupt, greedy, and inhumane insurance system. And perhaps that is what sours me on the Republicans more than anything: We always seem to have the money for wars but not for Americans.

Btw, college students, you will now be able to stay on your parent's policy until you are 26 years of age.

[WhoWee]

Regarding popular opposition, when people discover that they no longer have lifetime caps; when their insurance can't be cancelled because they got sick or pregnant; when they can't be refused insurance due to a preexisting condition, just as was true with the prescription drug plan, all of the Republican-created furor will fade away. Americans want what is in this bill.

I was struck by objections that while this may reduce the deficit, the overall cost of health care will increase. Given that 30 million people who have no insurance will now have coverage, of course it will cost more. The complaint seems to be that 30 million people should have no coverage if they can't afford it; that we have a $trillion to fight wars but not to protect American citizens from a corrupt, greedy, and inhumane insurance system. And perhaps that is what sours me on the Republicans more than anything: We always seem to have the money for wars but not for Americans.

Btw, college students, you will now be able to stay on your parent's policy until you are 26 years of age.

How much are YOU willing to pay per year to house, feed, educate, nurture and care for others from cradle to grave Ivan? How about in YOUR lifetime - how much do you feel YOU OWE to your fellow citizen?

I assume that you (like everyone else on the PF) intend to work and contribute their "fair share" - and not sit at home and collect.

Also, how do you feel about giving more power to the IRS to enforce these mandates - and the student loan program aspects that are being included?

[Zefram]

How much are YOU willing to pay per year to house, feed, educate, nurture and care for others from cradle to grave Ivan? How about in YOUR lifetime - how much do you feel YOU OWE to your fellow citizen?

The current (limitless) subsidy for employer-sponsored health insurance costs about $250 billion per year. The proposed (means-tested, capped) subsidy to buyers in the individual market will cost less than that every year. These new subsidies will be paid for partially by capping the tax exclusion for employer-sponsored plans (I'm referring, of course, is the excise tax). The result: a greater degree of parity between the individual and group markets.

[Alfi]

how much do you feel YOU OWE to your fellow citizen?

Everything?
Individuals are an evolutionary dead end in this collective society age.

[mheslep]

My source is Wikipedia. My point is that the claim that "If one controls life span for these causes of death, the US is close to or at the the top" is inaccurate. Edit: A couple of references if you are interested:

http://repository.upenn.edu/cgi/viewcontent.cgi?article=1012&context=psc_working_papers

See especially Table 1-3 for causes of death other than health care related, and Table 1-5 for corrected numbers.
http://www.aei.org/docLib/20061017_OhsfeldtSchneiderPresentation.pdf

Table 1-5 again, same researchers in html online
http://politicalcalculations.blogspot.com/2007/09/natural-life-expectancy-in-united.html

[calculusrocks]

Btw, college students, you will now be able to stay on your parent's policy until you are 26 years of age.


That is suppose to make me feel better? That my elected officials have turned me into a thief, moocher, and a child for life?

[calculusrocks]

Barack Obama is the Commander in Chief Lollypop Distributor in Chief.

p8sZcmQr6KY

[spacemanspiff]

I guess I don't understand why people who don't have health insurance can't get it? It took me all of 30 seconds to hop on ehealthinsurance.com and find dozens of plans for under $100/m. What is the problem???? The pre-existing illness is a problem and maybe we can try to cut pill costs, but we need a 2400 page new bill for that?

[MotoH]

Has the middle class been charged 40% more for insurance yet, or are the votes still coming in?

[Count Iblis]

The Third World health insurance system will finally be changed to a First World one.

[MotoH]

The Third World health insurance system will finally be changed to a First World one.

I didn't know first world nations turned middle class citizens into poor people.

[turbo]

I didn't know first world nations turned middle class citizens into poor people.The US system turns middle-class citizens into poor citizens with every catastrophic illness. The insurance companies dump you when you get sick, and you lose everything to bankruptcy when you can't pay for care or you die. When you are older and more experienced you will gain an appreciation for this. I hope you never develop a debilitating disease, but if you do, you will gain an appreciation for this health-care bill. My wife and I both have some chronic pre-existing conditions, and if she loses her job (and her health insurance), we will never be able to buy health insurance again, at least a rates that won't bankrupt us AND with ruinous caps. So many opponents of health-care reform wave the flag and talk about how the bill is socialism. Funny, it's only socialism if it benefits somebody else.

European countries manage to provide almost universal health-care coverage at about 1/2 the cost per capita of what we spend. If the US cannot do the same, our system deserves to fail.

[WhoWee]

Someone just explained to me that Obama needed to include student loan reform in the health care Bill because he's going to need to train a lot of new doctors (that will work for a lot less).:uhh:

[MotoH]

I never said the insurance system should stay they way it is. There are problems with it, and that can be fixed. But now I am paying not only for every low life piece of ****s food stamps and welfare, but their health insurance too! Where is the justice in that?

Yeah you know what, it is me first. And that is how the game of life is played. I've got enough bills to pay for already, and when I need to pay 40% more for someone who sits on their *** all day, gets a cough and goes to the doctor, it brings ME into the hole.

[turbo]

Someone just explained to me that Obama needed to include student loan reform in the health care Bill because he's going to need to train a lot of new doctors (that will work for a lot less).:uhh:As long as the AMA keeps throttling the graduation/residency rate, we will have shortages of doctors. Maine has a particular problem in this regard. We need general practitioners and family doctors in rural areas. Canada has similar problems, which results in Canadians in rural provinces traveling to the US for specialized care, which the Canadian health care system pays for.

[WhoWee]

The US system turns middle-class citizens into poor citizens with every catastrophic illness. The insurance companies dump you when you get sick, and you lose everything to bankruptcy when you can't pay for care or you die. When you are older and more experienced you will gain an appreciation for this. I hope you never develop a debilitating disease, but if you do, you will gain an appreciation for this health-care bill. My wife and I both have some chronic pre-existing conditions, and if she loses her job (and her health insurance), we will never be able to buy health insurance again, at least a rates that won't bankrupt us AND with ruinous caps. So many opponents of health-care reform wave the flag and talk about how the bill is socialism. Funny, it's only socialism if it benefits somebody else.

European countries manage to provide almost universal health-care coverage at about 1/2 the cost per capita of what we spend. If the US cannot do the same, our system deserves to fail.

I'm afraid this Bill is not going to live up to your expectations My Friend. IMO, this Bill will double the cost of health care to working people who don't qualify for public assistance.

Again, the cost per person (to the Government) for Medicare is $850 per month. Also, the Bill does not say that pre-existing conditions can't be rated. What are YOU going to do if you HAVE to purchase a Government plan and they tell you the cost is $2,500/month - or the IRS will come to visit YOU?

I am very concerned this evening.

[MotoH]

I'm afraid this Bill is not going to live up to your expectations My Friend. IMO, this Bill will double the cost of health care to working people who don't qualify for public assistance.

Again, the cost per person (to the Government) for Medicare is $850 per month. Also, the Bill does not say that pre-existing conditions can't be rated. What are YOU going to do if you HAVE to purchase a Government plan and they tell you the cost is $2,500/month - or the IRS will come to visit YOU?

I am very concerned this evening.


From what I have heard from my state, if the health care bill passes, for the current plan we have the rates will double, forcing us to move to a cheaper plan which covers less.

[WhoWee]

As long as the AMA keeps throttling the graduation/residency rate, we will have shortages of doctors. Maine has a particular problem in this regard. We need general practitioners and family doctors in rural areas. Canada has similar problems, which results in Canadians in rural provinces traveling to the US for specialized care, which the Canadian health care system pays for.

I spoke with someone last week that needs to find a new doctor.

She is on Medicare and her doctor is tired of fighting to get paid. He joined a group of "VIP Providers" who will now require their patients to pay a "VIP Fee" of $1,500 per year to join - or they will no longer be treated.

She's been with the doctor for about 12 years.

[MotoH]

Well I guess I should start saving up now to be able to pay for this when I graduate from college.

[Office_Shredder]

intrade.com says that the healthcare bill will be passed

http://www.electoral-vote.com/evp2010/Senate/Maps/Mar21-s.html#1

[WhoWee]

It's over - close the thread and turn off the lights (please).

[MotoH]

Tough luck. There will be immediate benefits, but as soon as 2016 (not sure if right year) rolls around, we will be paying through the nose for this.

[WhoWee]

Tough luck. There will be immediate benefits, but as soon as 2016 (not sure if right year) rolls around, we will be paying through the nose for this.

What "immediate benefits" do you think will be forthcoming - other than tax increases for the next 4 years? Are you referring to the tens of thousands of jobs due to Government expansion?

[MotoH]

What "immediate benefits" do you think will be forthcoming - other than tax increases for the next 4 years? Are you referring to the tens of thousands of jobs due to Government expansion?

I was in such a fluster, I put them in the wrong way :/ All sorts of lovely taxes and the like.

[Nebula815]

The Democrats just permanently destroyed the country financially. They also just brought the IRS into our lives in a new way, unless the SCOTUS can maybe overturn the mandate (I don't know). But otherwise, the debt is going to explode. IMO, the American people made a terrible mistake in their election of President Obama.

[MotoH]

cp069Y_P-9M

Sheep will always follow.

[mheslep]

The US system turns middle-class citizens into poor citizens with every catastrophic illness. The insurance companies dump you when you get sick, and you lose everything to bankruptcy when you can't pay for care or you die. When you are older and more experienced you will gain an appreciation for this. I hope you never develop a debilitating disease, but if you do, you will gain an appreciation for this health-care bill. My wife and I both have some chronic pre-existing conditions, and if she loses her job (and her health insurance), we will never be able to buy health insurance again, at least a rates that won't bankrupt us AND with ruinous caps. So many opponents of health-care reform wave the flag and talk about how the bill is socialism. Funny, it's only socialism if it benefits somebody else.

European countries manage to provide almost universal health-care coverage at about 1/2 the cost per capita of what we spend. If the US cannot do the same, our system deserves to fail.
Why not spend some effort to see what would happen to you with exactly those chronic conditions under a European system. Step 1: rough out your lifetime income up until you became disabled and jack up the tax rates on both you and your wife's income over that time. Add a big VAT tax on any major items - house,farm,car. Then add in some downtime for perennial 10% unemployment over your career (http://www.indexmundi.com/g/g.aspx?c=fr&v=74) That period where you were self-employed, acted as your own contractor - 50/50 chance it never happens. Step 2: Pick a country and check out exactly what happens for your illness. Wait-times, etc.

[MotoH]

Oh by the way, How do you PhD students plan on paying for health care once you get past 26?

[Office_Shredder]

mheslep, have you actually been to Europe? You're making it sound like the average lifestyle there is third world compared to the glorious bounty we have in America. That's simply false. Also, your random 10% unemployment stat is ridiculous: it's not true for many European nations with universal healthcare (UK, Norway, Finland, Sweden, Denmark, Switzerland, just to name a few from browsing that website)

MotoH, my school already provides insurance for its grad students. If you're poor enough to not be able to afford health insurance the government is supposed to help cover it under the new bill

[zomgwtf]

I never said the insurance system should stay they way it is. There are problems with it, and that can be fixed. But now I am paying not only for every low life piece of ****s food stamps and welfare, but their health insurance too! Where is the justice in that?

Yeah you know what, it is me first. And that is how the game of life is played. I've got enough bills to pay for already, and when I need to pay 40% more for someone who sits on their *** all day, gets a cough and goes to the doctor, it brings ME into the hole.

I live in Canada, and because I pay for health care I certainly am not in any sort of hole. In fact I don't think my life is any different from an Americans life... unless I am understanding the system wrong?

[MotoH]

We will be paying way more than what you are zomg.

[Office_Shredder]

Why do you say that?

[spacemanspiff]

It seems backwards that the CBO estimates the fees from people not buying coverage would raise $17 billion over 10 years. So they are expecting a bunch of money from the people they are supposed to be helping? wtf!

They are also demanding small business to provide coverage for their employees? Isn't this what got us into trouble in the first place? When people rely on companies then they feel entitled and if they get fired then they are screwed. If we get people into their own plans then they don't have to worry when they are fired. This will also free up companies with tons of extra cash.

[rootX]

We will be paying way more than what you are zomg.

Why do you say that?

Canada health costs are far below American (in terms of GDP %) IIRC. American Healthcare is entirely different from Canadian and cannot be addressed similarly.

[rootX]

Also, your random 10% unemployment stat is ridiculous: it's not true for many European nations with universal healthcare (UK, Norway, Finland, Sweden, Denmark, Switzerland, just to name a few from browsing that website)


What you mean by random? It's unemployment is always close to 10% which is worse than US. It has many regulations and unions.

[Office_Shredder]

But the entire idea behind the bill is to lower the average cost of healthcare. The system is inefficient (compared to other countries in % GDP) so the whole point is the change the system to drop the costs

root, that was for France. There are countries other than France. Go back to the website that you posted, and look up the countries that I mentioned. Their unemployment rate is no worse than the US, and in some cases far better over the period they graph

[calculusrocks]

But the entire idea behind the bill is to lower the average cost of healthcare. The system is inefficient (compared to other countries in % GDP) so the whole point is the change the system to drop the costs

root, that was for France. There are countries other than France. Go back to the website that you posted, and look up the countries that I mentioned. Their unemployment rate is no worse than the US, and in some cases far better over the period they graph

And the whole idea of social security was to take care of a just few years of retirement for the elderly. And the whole idea of the DMV is to process motor related forms efficiently. And the whole idea of the Post Office is... well you get the point.

[Office_Shredder]

Does social security NOT help pay for retirees anymore? Has the post office stopped delivering mail?

DMVs are run by state governments (which is what currently regulate health insurance), so you're hurting your point by criticizing them.

[calculusrocks]

The point was that government doesn't run anything efficiently by the standards of a free market. Social Security started out as a modest government program and has balooned well beyond its stated charted, and now is facing bankruptcy within a decade or two.

The post office is so badly run that it simply encourages us to use email.

The DMV is so badly run that I had to wait 4 hours in line to get license plates.

After all of the government failures, what makes people think that government control of health care is remotely a good idea?

[Nebula815]

I do not understand those who say to those of us who oppose this bill, "Why are you against helping people? Why are you against health reform?"

That, IMO, would be like saying to an Iraq War protestor, back when the invasion was occurring, "Why are you against helping those people? Why are you against keeping America safe?"

Obviously, their answer would be, "We are NOT against helping the people or against keeping America safe, but there are huge COSTS involved in invading a country like this, the administration we do not think has thought through properly what they are doing, and we think there are far more effective ways to keep America safe."

Well it is the same regarding this healthcare bill.

People opposed to it are not against healthcare reform. And we are not against helping people. But again, there's that bit about costs, and also much better alternatives to fix the system

Those of you who like to point out the foreign systems, well a couple of things:

It is of course debatable whether or not the foreign systems actually provide better-quality healthcare or not than you can get in America, but let's pretend they do.

Okay fine. But there's one big problem: Everytime we in America then try to copy these Euro-systems, we have an EPIC fail as the youth like to term it. Seriously.

Medicaid - bankrupt
Medicare - bankrupt
Social Security - headed to bankruptcy as this recession blew a hole into the projections (and when it had a surplus, the government robbed it)

Even non-healthcare government programs, like Postal Service - bankrupt

Fannie Mae and Freddie Mac - bankrupt (and almost brought down the global financial system in the process)

Massachussettes universal healthcare system - bankrupting the state and premiums there higher than in any other state.

http://www.boston.com/news/health/articles/2009/08/22/bay_state_health_insurance_premiums_highest_in_cou ntry/

Tennessee also had to kick a good deal of people off its experiment with expanded government healthcare because the costs ballooned out of control and almost bankrupted the state:

http://online.wsj.com/article/SB125046457087135327.html

And of course, within California they wanted to enact a universal care program, except it was determined it would flat-out destroy the state financially, so it was voted down.

So what the above show is that for whatever reason, assuming (and there is a big assumption there as some of the Euro states are heading towards bankruptcy it seems) the Euro "universal" healthcare systems work out financially, we Americans seem to have an inability to design a functioning, cost-effective universal healthcare system. So even if we want such a system, we don't try creating one nationally until we are sure we can do it.

Now in this great United States, we have a major benefit over other, smaller nations, in that we have fifty policy laboratories in our states. Each state is a microcosm of the nation, with its own legislative, executive, judicial, economy, tax systems, laws, Constitution, etc...so we have the benefit of being able to try stuff on the state level and if it works out, great. We can then try it on the national level.

If it fails on the state level, then we know not to try it out on the national level. Massachusettes's program was meant to be a model for other states to copy, and possibly for a national program. It is obviously an "epic fail" financially.

The UTTER INSANITY of this current bill is it flies in the face of all the above evidence (Massachusettes, Tennessee, Medicare, Medicaid, California, etc...) with the idea that, "Oh, don't worry, those are states, we can pull this off on the national level, because we're the Federal Government and we know best."

The other big thing is that, while the Democrats want to copy the British single-payer heathcare system, they ignore that the British system has heavy regulations regarding junk lawsuits. That would mean some heavy tort reform in America, which the Democrats will NEVER do because it would mean going against one of their primary constituents, the trial lawyers.

So in other words, they want to implement the British system without the British cost controls.

And then of course is the aircraft analogy I used before. This is a 2,000+ page bill. History shows government programs, and in particular government healthcare programs, do not work out the way they are intended.

And this bill is like the policy equivalent of engineering a brand-new jetliner, and without building a prototype and testing it extensively, they just decide to go by the skill of the engineers and let's say an engineering CBO equivalent that says it will ("should") fly, and then put it into production.

Obviously such a way of building an aircraft would be insane. It has a million different parts. You can have the most brilliant engineers in the world and the best equipment, but you still won't know exactly how the plane will work until you actually build a version of the thing and put it into the air.

YET, we are doing the policy equivalent of exactly this. We are like a company with a history of engineering smaller planes that just cannot fly well, and eventually even crash, so now we have just gone and engineered a full-on jetliner, and without bothering to test it at all, just put it right into production.

The Democrats tout the CBO numbers, saying it will "reduce the deficit," yeah right, I'll believe that when I see it. History, both of healthcare programs from the government, and of government programs overall, says otherwise. Plus the CBO had to rely on a number of tricks and assumptions in its calculations.

[Nebula815]

After all of the government failures, what makes people think that government control of health care is remotely a good idea?

It is a religion to the Left. When you are dealing with religious zealots, logic does not come into play. IMO, these Democrats are like the hardcore Marxist who sees the Soviet Union, then walks through an American mall and a supermarket, then comes out and proclaims the gloriousness of the Soviet Empire.

[Office_Shredder]

The point was that government doesn't run anything efficiently by the standards of a free market. Social Security started out as a modest government program and has balooned well beyond its stated charted, and now is facing bankruptcy within a decade or two.

The post office is so badly run that it simply encourages us to use email.

The DMV is so badly run that I had to wait 4 hours in line to get license plates.

After all of the government failures, what makes people think that government control of health care is remotely a good idea?

Government programs growing larger than they originally intended? How is that a sign of failure?

Your information on social security is wrong. It's actually taking in more money than it spends as we speak. Current predictions on the aging trend of the US predict it starts hitting a negative cash flow around 2020 and then runs out of its 2 trillion dollar reserve sometime around 2040 or 2050. And that's assuming that nothing is changed, for example the cap on social security taxes.

I don't understand where the hate on the post office is coming from. My letters get where they need to go for a pretty good price

And again, the car stuff is run state by state. Considering health care is currently regulated by state governments, saying the states can't run something efficiently is a reason to hand it over to the national government. And your argument for the DMV is lame and anecdotal

To summarize: You're listing government programs and saying they're failures. Please discuss how much better off we would be without the post office.

[calculusrocks]

Don't get me started on incompetant regulators. The crook Bernie Madoff was investigated by the SEC 8 times!!! Bernie Madoff then showed the results of these investigations to his investors as proof of his legitimacy! Of course, the left will never look at that. Nothing to see here. Just move along, sir.

http://www.theaustralian.com.au/business/news/madoff-chasers-dug-for-years/story-e6frg90x-1111118484476

In my opinion as well this is Marxism. They want us to adopt socialism by selling it to us as medicine.

[Nebula815]

Government programs growing larger than they originally intended? How is that a sign of failure?

When the costs to them balloon way out of control.

Your information on social security is wrong. It's actually taking in more money than it spends as we speak.

Right now, but that won't last.

Current predictions on the aging trend of the US predict it starts hitting a negative cash flow around 2020 and then runs out of its 2 trillion dollar reserve sometime around 2040 or 2050. And that's assuming that nothing is changed, for example the cap on social security taxes.

That projection just had a huge hole blown into it because of the recession; as for the SS cap, if that is raised, it gets turned into a de-facto welfare program.

I don't understand where the hate on the post office is coming from. My letters get where they need to go for a pretty good price

The point is simply about the inefficiency with which government does things. No one is saying a service like the post office is bad.

SS and Medicare are good programs as well, but the way they are designed is unsustainable and very bad.

And again, the car stuff is run state by state. Considering health care is currently regulated by state governments, saying the states can't run something efficiently is a reason to hand it over to the national government. And your argument for the DMV is lame and anecdotal

If the states cannot run something efficiently, that's a primary reason NOT to hand it over to the national government.

To summarize: You're listing government programs and saying they're failures. Please discuss how much better off we would be without the post office.

You need to realize that this argument is moot if you can't pay for the service in the first place. If you can't pay for it, you'll end up without a Postal Service anyway.

[Nebula815]

In my opinion as well this is Marxism. They want us to adopt socialism by selling it to us as medicine.

I'm not saying the Democrats are Marxists, I'm just saying that their fervent belief in government-run healthcare in the face of all the evidence showing it's a bad idea at the moment, is like the fervent belief in socialism a Marxist will have, and the utter denial they will show upon seeing a free-market in action.

[calculusrocks]

Your information on social security is wrong. It's actually taking in more money than it spends as we speak. Current predictions on the aging trend of the US predict it starts hitting a negative cash flow around 2020 and then runs out of its 2 trillion dollar reserve sometime around 2040 or 2050. And that's assuming that nothing is changed, for example the cap on social security taxes.

Huh? So you're saying its fiscally sound and at the same time it's going to run out of its reserves by 2040, and 2050, and you're saying that's not a path to insolvency?

[calculusrocks]

If the economy is under performing, then not as much is paid into social security in terms of wages and employment thus skewing the numbers.

http://www.americanthinker.com/2009/08/why_social_security_will_go_ba.html

[calculusrocks]

I'm not saying the Democrats are Marxists, I'm just saying that their fervent belief in government-run healthcare in the face of all the evidence showing it's a bad idea at the moment, is like the fervent belief in socialism a Marxist will have, and the utter denial they will show upon seeing a free-market in action.

Glad you clarified, I'm not saying democrats are Marxist either. In fact, some I've met are disenchanted conservatives.

[Char. Limit]

I think the best thing about health care would be for people to quit using buzzwords...

"death panels", "Marxism", "government takeover"...

Oddly enough, most of the buzzwords are utilized by conservatives.

Where are the liberal buzzwords?

[Vanadium 50]

Where are the liberal buzzwords?

"Ram it through".

[calculusrocks]

I think the best thing about health care would be for people to quit using buzzwords...

"death panels", "Marxism", "government takeover"...

Oddly enough, most of the buzzwords are utilized by conservatives.

Where are the liberal buzzwords?

This just illustrates the superficial understanding you have of the entire situation.

[Ivan Seeking]

I'm not saying the Democrats are Marxists, I'm just saying that their fervent belief in government-run healthcare in the face of all the evidence showing it's a bad idea at the moment, is like the fervent belief in socialism a Marxist will have, and the utter denial they will show upon seeing a free-market in action.

The first thing to understand is that this is not "government-run healthcare". It doesn't even include a single-payer system, much less government-run hospitals. Using such language only shows that you don't understand the bill or the healthcare system.

[Ivan Seeking]

This just illustrates the superficial understanding you have of the entire situation.

Not true. It is precisely the sort of language used to terrorize the public.

[Char. Limit]

This just illustrates the superficial understanding you have of the entire situation.

Excellent work. A vague insult with no explanation!

Keep it up.

[calculusrocks]

terrorize sounds like a "buzzword". I can name many, but why? Isn't it sad that all you choose levy are petty linguistic critics?

[Office_Shredder]

For all our bickering, I don't think anyone bothered to mention that health care reform is now a done deal. In unrelated news, Moody's has dropped the US federal government's credit rating to "junk"

[Ivan Seeking]

For all our bickering, I don't think anyone bothered to mention that health care reform is now a done deal

YES!!! I couldn't wait to get to a TV and check the news.

[calculusrocks]

For all our bickering, I don't think anyone bothered to mention that health care reform is now a done deal

Well, there are some hurdles left concerning the Constitution... and the Senate isn't a done deal yet. That being said the major hurdle is cleared and looks like its going through, although it doesn't start for 4 years because that was the only way the democrats could make it look near budget neutral over a 10 year period.

[Ivan Seeking]

sounds like a "buzzword".

Consider the "Pull the plug on Grandma" claim. That came from Senator Grassley and is absolute drivel. In fact, the end-of-life counsiling that he objected to is already in place and was a bill written by a Republican!

Yes, telling people that Democrats want to kill your grandmother [or you if you are a grandmother] does terrorize them.

Terrorize
To coerce by intimidation or fear.
http://education.yahoo.com/reference/dictionary/entry/terrorize

It is a form of terrorism. The difference is that this claim is true, while Senator Grassley's claim was false and was intended to induce fear. I would add that to the best of my knowledge, I am the only one to properly name the technique used by Republicans. IT is not a Democratic buzzword; it is my observation. Also, I'm an Independent, not a Democrat.

[calculusrocks]

Consider the "Pull the plug on Grandma" claim. That came from Senator Grassley and is absolute drivel. In fact, the end-of-life counsiling that he objected to is already in place and was a bill written by a Republican!

Yes, telling people that Democrats want to kill your grandmother does terrorize them.

Pffff. People are just going to wait to get sick to get health care. Then the insurance company will have to cover the illness because of the new health care legislation. After the insurance companies lose money, they will have to cut back on care. Rationing. Rationing is unavoidable, and granny may or may not get treatment in the years to come. Sure, it's not a single-payer, but it might as well be a death sentence to the insurance companies leading to a single-payer.

[calculusrocks]

Time will tell on grandma.

[Office_Shredder]

Pffff. People are just going to wait to get sick to get health care. Then the insurance company will have to cover the illness because of the new health care legislation. After the insurance companies lose money, they will have to cut back on care. Rationing. Rationing is unavoidable, and granny may or may not get treatment in the years to come. Sure, it's not a single-payer, but it might as well be a death sentence to the insurance companies leading to a single-payer.

Do you even know what the bill is? It requires everyone to have health insurance. This is the major sticking point that makes people call it socialism. Do you even know why you're criticizing the bill?

[Topher925]

The first thing to understand is that this is not "government-run healthcare". It doesn't even include a single-payer system, much less government-run hospitals. Using such language only shows that you don't understand the bill or the healthcare system.

This seems to be the general inclination with the American public. People seem to think that this bill is going to give our health care system a complete overhaul when its really just providing a very basic public option and mandating coverage for almost every citizen. Yet, people seem the think they are getting their "freedomz" taken away from them and we are on our way to a socialist government (but to arrogant to realize we haven't been capitalist for a long time).

I've recently had many conversations with peers about this subject and they all call me an ignorant liar when I tell them Hawaii has had a system much like this for years and just call me stupid when I tell them it actually works!
But perhaps the most intriguing lesson from Hawaii has to do with costs. This is a state where regular milk sells for $8 a gallon, gasoline costs $3.60 a gallon and the median price of a home in 2008 was $624,000 — the second-highest in the nation. Despite this, Hawaii’s health insurance premiums are nearly tied with North Dakota for the lowest in the country, and Medicare costs per beneficiary are the nation’s lowest.
http://www.nytimes.com/2009/10/17/health/policy/17hawaii.html

I find the amount (and inanity) of the negative responses towards this health care bill is just more evidence of the "idiocracy" in this country and ultimately an omen that the prowess of the US will soon fall.

[Char. Limit]

My AP European History teacher (a wise man) tells us that the favorite part of government for conservatives, the military, is possibly the most socialist part of government.

Irony!!

So, yeah, we're already socialist. How much could a little more hurt?

[calculusrocks]

Do you even know what the bill is? It requires everyone to have health insurance. This is the major sticking point that makes people call it socialism. Do you even know why you're criticizing the bill?

The point that you ignored is that someone can simply wait until he gets sick to get insurance. They can pay the fines, and just wait until they get sick.

[Char. Limit]

Why would you bother paying the fines, when you can just get health insurance and probably pay less money, as I believe that the fines get bigger over time?

Your argument isn't making as much sense as you think it is...

Wait, are ad argumentem attacks allowed?

[calculusrocks]

This seems to be the general inclination with the American public. People seem to think that this bill is going to give our health care system a complete overhaul when its really just providing a very basic public option and mandating coverage for almost every citizen. Yet, people seem the think they are getting their "freedomz" taken away from them and we are on our way to a socialist government (but to arrogant to realize we haven't been capitalist for a long time).

I've recently had many conversations with peers about this subject and they all call me an ignorant liar when I tell them Hawaii has had a system much like this for years and just call me stupid when I tell them it actually works!

http://www.nytimes.com/2009/10/17/health/policy/17hawaii.html

I find the amount (and inanity) of the negative responses towards this health care bill is just more evidence of the "idiocracy" in this country and ultimately an omen that the prowess of the US will soon fall.

It only shows that you haven't read what I've been saying at all. Gov't has been running HMOs since the 1970s. We haven't had capitalism in a long, long time. Yet somehow capitalism is the boogieman. Don't say the "idiots" didn't warn you, okay?

[Nebula815]

The first thing to understand is that this is not "government-run healthcare". It doesn't even include a single-payer system, much less government-run hospitals. Using such language only shows that you don't understand the bill or the healthcare system.

It is government-run healthcare. It is single-payer by proxy. It gives the government far more control over the health insurance companies, turning them into utilities, appendages of the government, in exchange for guaranteed profits (mandating everyone buy their product). It also makes the inroads for introduction of a public option later on and then moving to full-on single-payer.

[Nebula815]

This seems to be the general inclination with the American public. People seem to think that this bill is going to give our health care system a complete overhaul when its really just providing a very basic public option and mandating coverage for almost every citizen. Yet, people seem the think they are getting their "freedomz" taken away from them and we are on our way to a socialist government (but to arrogant to realize we haven't been capitalist for a long time).

What do you call it if the government mandates you purchase a company's product?

The car insurance argument doesn't hold, because no one is forced to purchase a car. And the argument that everyone purchasing health insurance would be better is a separate argument from whether or not you should force people to purchase health insurance.

I've recently had many conversations with peers about this subject and they all call me an ignorant liar when I tell them Hawaii has had a system much like this for years and just call me stupid when I tell them it actually works!

Hawaii is very tiny, and from my understanding, their system has been a horrendous failure. Furthermore, even if it works, one tiny example is not enough. It failed in Tennessee and it failed in Massachussettes, and it has failed in the forms of Medicare and Medicaid.

Like I said, the British system, which the Democrats want to copy, has regulations regarding junk lawsuits. Democrats will not enact tort reform to copy that here. Enacting such massive legislation on the national level is the height of irresponsibility, arrogance, and ideology.

I find the amount (and inanity) of the negative responses towards this health care bill is just more evidence of the "idiocracy" in this country and ultimately an omen that the prowess of the US will soon fall.

So you're okay with a bill that will most likely bankrupt the nation, mandates people purchase a product (sorry we aren't Europe, mandating people purchase something just because "it's better for the society" is not the American way), and gives the government control over 1/6 of the economy?

It also will make the way for single-payer, that is the goal.

What I find amazing is Democrats had to ram the bill through because they flat-out lost the debate on it. President Obama himself was lost completely in terms of how to defend it. All we've been seeing and hearing is this man talk, talk, talk for the last two or three years, with zero substance on healthcare, and when it came down to it, he just rammed it through.

[Nebula815]

My AP European History teacher (a wise man) tells us that the favorite part of government for conservatives, the military, is possibly the most socialist part of government.

Irony!!

So, yeah, we're already socialist. How much could a little more hurt?

Healthcare is 17% of GDP.

The military is 5%.

And defense spending can be curtailed rather easily when you need it to. But trying getting rid of a government agency that was created by your predecessor. GOOD LUCK!

[WhoWee]

Government programs growing larger than they originally intended? How is that a sign of failure?

Your information on social security is wrong. It's actually taking in more money than it spends as we speak. Current predictions on the aging trend of the US predict it starts hitting a negative cash flow around 2020 and then runs out of its 2 trillion dollar reserve sometime around 2040 or 2050. And that's assuming that nothing is changed, for example the cap on social security taxes.

You need to support the claims you've made in your post with links to current sources.

You do realize that Government workers don't actually contribute to the tax base (because they are paid FROM taxes). You also realize the size, scope and power of the IRS is going to be increased by this Bill?

[WhoWee]

It's been deemed "Obamacare", and the "IRS Expansion Act of 2010"
http://camp.house.gov/News/DocumentSingle.aspx?DocumentID=177007

Mandating coverage and fining people (enforcement by an expanded IRS) who don't have coverage indicates the end of a free society.

If you plan to have a successful career - you should be very concerned.

[whybother]

Mandating coverage and fining people (enforcement by an expanded IRS) who don't have coverage indicates the end of a free society.

If you plan to have a successful career - you should be very concerned.

Yeah, because helping everyone have the means to take care of themselves is pretty much the end of society. /sarcasm

[Office_Shredder]

You need to support the claims you've made in your post with links to current sources.

http://www.ssa.gov/OACT/STATS/table4a3.html

Assets at end of year, 2009: 2.5 trillion dollars

You do realize that Government workers don't actually contribute to the tax base (because they are paid FROM taxes). You also realize the size, scope and power of the IRS is going to be increased by this Bill?

How is this relevant to the discussion at hand?

[MotoH]

This seems to be the general inclination with the American public. People seem to think that this bill is going to give our health care system a complete overhaul when its really just providing a very basic public option and mandating coverage for almost every citizen. Yet, people seem the think they are getting their "freedomz" taken away from them and we are on our way to a socialist government (but to arrogant to realize we haven't been capitalist for a long time).

I've recently had many conversations with peers about this subject and they all call me an ignorant liar when I tell them Hawaii has had a system much like this for years and just call me stupid when I tell them it actually works!

http://www.nytimes.com/2009/10/17/health/policy/17hawaii.html

I find the amount (and inanity) of the negative responses towards this health care bill is just more evidence of the "idiocracy" in this country and ultimately an omen that the prowess of the US will soon fall.



The high food prices just aren't related to them being in BFE. They have to pay for "low" health care some how, and that comes out of taxes.

[MotoH]

Also. As I said before,

You are a PhD student, 27 years old. You are no longer on your parents health care plan, and you aren't making ends meat. (as I have heard from many-a-PhD student) Not only can you not afford to get health care, but you will get fined because you don't have health care!

[WhoWee]

http://www.ssa.gov/OACT/STATS/table4a3.html

Assets at end of year, 2009: 2.5 trillion dollars

Are you serious?
http://www.washingtonpost.com/wp-dyn/content/article/2009/03/30/AR2009033003291.html

"The Treasury Department has for decades borrowed money from the Social Security trust fund to finance government operations. If it is no longer able to do so, it could be forced to borrow an additional $700 billion over the next decade from China, Japan and other investors. And at some point, perhaps as early as 2017, according to the CBO, the Treasury would have to start repaying the billions it has borrowed from the trust fund over the past 25 years, driving the nation further into debt or forcing Congress to raise taxes.

The new forecast is fueling calls for reform of the Social Security system from conservative analysts, who say it underscores the financial fragility of a system that provides a primary source of income for millions of Americans.

"It suggests we better get working on Social Security and stop burying our heads in the sand," said Sen. Judd Gregg (N.H.), the senior Republican on the Senate Budget Committee. "The Social Security trust fund, though technically in balance, is going to put huge pressures on taxpayers very soon."

Many liberal analysts reject the notion that Social Security needs fixing, arguing that the system is projected to fully support payments to beneficiaries through 2041 -- so long as the Treasury repays its debts. But they agree that the news is not good for the federal budget.

"This is not a problem for Social Security, it's a problem for fiscal responsibility," said Christian Waller, a public policy professor at the University of Massachusetts at Boston and a senior fellow at the Center for American Progress. He said the new estimates would force President Obama and his budget director, Peter Orszag, "to stay on track in what they have set out to do, and that is rein in deficits."

The CBO, Congress's nonpartisan budget scorekeeper, released its most recent estimates for the Social Security trust fund last week as part of its final budget projections for the fiscal year that begins in October.

The trust fund has long taken in more in revenue from payroll taxes and other sources than it pays out in benefits. Last August, the CBO predicted that surplus would exceed $80 billion this year and next, then rise to around $90 billion before slowly evaporating by 2020. But the rapidly deteriorating economy -- particularly the loss of more than 4 million jobs -- has driven those numbers much lower much faster, with the surplus expected to hit $16 billion this year and only $3 billion next year, then vanish entirely by 2017.

CBO is not the official arbiter of the trust fund's health; that task falls to the Social Security trustees, a panel of Cabinet secretaries and others who are expected to issue a new report later this spring. In his budget, Obama predicted that the trust fund surplus would hit $30 billion this year, according to Mark Lassiter, a spokesman for the Social Security Administration.

But that number, too, is far less than the $80 billion the trustees had forecast for 2009. In addition to declining revenues, Lassiter said the system is likely to incur higher expenses due to big jumps in new retirement and disability claims. Both are expected to rise by at least 12 percent this year compared with 2008.

"There are some people who are, in fact, delaying retirement" because the plunging stock market took a huge bite out of their retirement accounts, Lassiter said. "But the stronger trend is that people who are losing a job are looking for other sources of income. And if you're of retirement age, you're going to go ahead and file for Social Security benefits."

Though Obama has pledged to address the precarious financial situation of Social Security, the administration currently has no plans to do so. Under pressure from congressional Democrats who argued that Social Security should not be at the top of the new administration's agenda, the White House last month dropped a proposal to name a task force to reexamine the program.

During the campaign, Obama proposed applying payroll taxes to annual earnings over $250,000 help fund Social Security after the surplus vanishes. With the new numbers, some analysts said, the president might be forced to step up the timetable.

"Over the past 25 years, the government has gotten used to the fact that Social Security is providing free money to make the rest of the deficit look smaller," said Andrew Biggs, a resident scholar at the American Enterprise Institute. "Now they've essentially got to pay their own way, at least a little more fully.

"Instead of Social Security subsidizing the rest of the budget," he said, "the rest of the budget will have to subsidize Social Security." "

[spacemanspiff]

As a small business owner I must take issue with any policy that requires me to either pay health insurance premiums for my employees, pay a penalty for not providing the insurance, or decrease the number of employees to the lowest possible level in order to survive in an already struggling economy. Hummmmm! Which one should I choose??? - Dwayne Strickland

This bill will create temp job loss?

Insurers will no longer be able to set rates or exclude coverage based on pre-existing conditions, and can vary premiums only by geographic location, age, and tobacco use. - CNN

Do you think an insurer will look at an app. See a person with cancer and 65 years old. Then tell them to pay $1000 a month.... because they are 65 years old. Also I wonder how many of the 32 million uninsured are in high risk locations, are old and smoke. What if it is half? They aren't helped at all. What a waste.

[mheslep]

mheslep, have you actually been to Europe? Many times and for extended periods.
You're making it sound like the average lifestyle there is third world compared to the glorious bounty we have in America. Lets not throw strawmen around. I made no such generalization.

Also, your random 10% unemployment stat is ridiculous: it's not true for many European nations with universal healthcare (UK, Norway, Finland, Sweden, Denmark, Switzerland, just to name a few from browsing that website)That stat is for France, a good place to start if you want to compare large countries. Norway, has less population than some American cities and is oil rich, so I don't think it makes sense to compare w/ the 300 million in the US, do you?

[mheslep]

The first thing to understand is that this is not "government-run healthcare". It doesn't even include a single-payer system, much less government-run hospitals. Using such language only shows that you don't understand the bill or the healthcare system.The contrary is true for the first and last sentences. The government will now run the insurances companies as utilities, and thus the providers. Even if the government is not the payer, just as for utilities they will be told who to service and what they can charge. Eventually all of the health plans will be specified by the government on the exchanges.

[Topher925]

Even if the government is not the payer, just as for utilities they will be told who to service and what they can charge.

What part of the bill says this? From what I have read, the bill only states that insurance companies can not deny people for pre-existing conditions, they have to come up with some other excuse. The bill also includes no cost regulation for insurance companies either, it only states that insurance companies can only determine costs for age, location, and activities that have negative health effects such as smoking.

[Astronuc]

I can't get excited about this.

I received an email from 'Organizing for America', which is purportely a 'Thank you' note from Mr. Obama. It states "Because of you, every American will finally be guaranteed high quality, affordable health care coverage".

Well - firstly - it didn't happen because of me.

And -secondly - that statement is nonsens. Millions of Americans get left behind. There is not such guarantee of 'high quality' health care, even if one could afford it.

This is so mind bogglingly disingenous - if just not downright dishonest!

[MotoH]

Health Care Reform Bill Summary: A Look At What's in the Bill

By CBS News Capitol Hill Producers Jill Jackson and John Nolen
Cost:

* $940 billion over ten years.



Deficit:

* Would reduce the deficit by $143 billion over the first ten years. That is an updated CBO estimate. Their first preliminary estimate said it would reduce the deficit by $130 billion over ten years. Would reduce the deficit by $1.2 billion dollars in the second ten years.



Coverage:

* Would expand coverage to 32 million Americans who are currently uninsured.


Health Insurance Exchanges:

* The uninsured and self-employed would be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level.
* Separate exchanges would be created for small businesses to purchase coverage -- effective 2014.
* Funding available to states to establish exchanges within one year of enactment and until January 1, 2015.


Subsidies:

* Individuals and families who make between 100 percent - 400 percent of the Federal Poverty Level (FPL) and want to purchase their own health insurance on an exchange are eligible for subsidies. They cannot be eligible for Medicare, Medicaid and cannot be covered by an employer. Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale.


Federal Poverty Level for family of four is $22,050

Paying for the Plan:

* Medicare Payroll tax on investment income -- Starting in 2012, the Medicare Payroll Tax will be expanded to include unearned income. That will be a 3.8 percent tax on investment income for families making more than $250,000 per year ($200,000 for individuals).
* Excise Tax -- Beginning in 2018, insurance companies will pay a 40 percent excise tax on so-called "Cadillac" high-end insurance plans worth over $27,500 for families ($10,200 for individuals). Dental and vision plans are exempt and will not be counted in the total cost of a family's plan.
* Tanning Tax -- 10 percent excise tax on indoor tanning services.


Medicare:

* Closes the Medicare prescription drug "donut hole" by 2020. Seniors who hit the donut hole by 2010 will receive a $250 rebate.
* Beginning in 2011, seniors in the gap will receive a 50 percent discount on brand name drugs. The bill also includes $500 billion in Medicare cuts over the next decade.


Medicaid:

* Expands Medicaid to include 133 percent of federal poverty level which is $29,327 for a family of four.
* Requires states to expand Medicaid to include childless adults starting in 2014.
* Federal Government pays 100 percent of costs for covering newly eligible individuals through 2016.
* Illegal immigrants are not eligible for Medicaid.


Insurance Reforms:

* Six months after enactment, insurance companies could no longer denying children coverage based on a preexisting condition.
* Starting in 2014, insurance companies cannot deny coverage to anyone with preexisting conditions.
* Insurance companies must allow children to stay on their parent's insurance plans through age 26.


Abortion:

* The bill segregates private insurance premium funds from taxpayer funds. Individuals would have to pay for abortion coverage by making two separate payments, private funds would have to be kept in a separate account from federal and taxpayer funds.
* No health care plan would be required to offer abortion coverage. States could pass legislation choosing to opt out of offering abortion coverage through the exchange.


**Separately, anti-abortion Democrats worked out language with the White House on an executive order that would state that no federal funds can be used to pay for abortions except in the case of rape, incest or health of the mother. (Read more here)


Individual Mandate:

* In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people.


Employer Mandate:

* Technically, there is no employer mandate. Employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any worker receives federal subsidies to purchase health insurance. Fines applied to entire number of employees minus some allowances.



Contd. (http://www.cbsnews.com/8301-503544_1...46-503544.html)

There you go, this is the jist of what the bill is.

[Dembadon]

Don't get me started on incompetant regulators. The crook Bernie Madoff was investigated by the SEC 8 times!!! Bernie Madoff then showed the results of these investigations to his investors as proof of his legitimacy! Of course, the left will never look at that. Nothing to see here. Just move along, sir.

http://www.theaustralian.com.au/business/news/madoff-chasers-dug-for-years/story-e6frg90x-1111118484476

In my opinion as well this is Marxism. They want us to adopt socialism by selling it to us as medicine.

You've been paying for social security and medicare for years! Why complain about socialism now?

What about the fire department, the police force, the military, veteran care programs, public school systems, et cetera? Where is the uproar regarding these socialistic concepts?

I'm not saying I agree with the recent reform to health care, but it's silly to reject something just because it is congruent with socialistic concepts. Do people honestly think that this nation is fully capitalistic?

[MotoH]

You've been paying for social security and medicare for years! Why complain about socialism now?

What about the fire department, the police force, the military, veteran care programs, public school systems, et cetera? Where is the uproar regarding these socialistic concepts?

I'm not saying I agree with the recent reform to health care, but it's silly to reject something just because it is congruent with socialistic concepts. Do people honestly think that this nation is fully capitalistic?


Voluntary in most parts of the United States.

[spacemanspiff]

* In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people.


I am willing to bet that the majority of the 32 million uninsured are low income people. uh oh


I'm not saying I agree with the recent reform to health care, but it's silly to reject something just because it is congruent with socialistic concepts. Do people honestly think that this nation is fully capitalistic?

I think the vast majority are for universal healthcare or atleast some kind of reform. They are just against this problem filled bill.

[turbo]

Voluntary in most parts of the United States.Paying for SS, Medicare, fire protection, police departments is not voluntary anywhere in the US. I have no children, yet over 50% of my town property taxes paid for education. Nothing voluntary in that.

[mheslep]

What part of the bill says this? From what I have read, the bill only states that insurance companies can not deny people for pre-existing conditions, they have to come up with some other excuse.

Well I'm not sure how to respond to this:
The bill also includes no cost regulation for insurance companies either, it only states that insurance companies can only determine costs for age, location, and activities that have negative health effects such as smoking.
as I read the first and second clauses as contradictory. Anyway:


Information about Insurance Plan Expenditures, and a Rebate to Assure Value
o Each year, insurers will report the percentage of Americans’ premiums they spend on items other than health care costs, such as bureaucracy, marketing, or executive compensation.
o Americans will receive a rebate if their health insurer’s non-medical costs exceed 15 percent of premium costs in the group market or 20 percent in the small group and individual market. Using cost data from this year, rebates will begin in 2011 and the policy applies to all insurance plans.
[...]
Protection from Exorbitant Out-of-Pocket Costs
o Insurance companies will abide by yearly caps on what they may charge beneficiaries for out-of-pocket expenses, like co-payments or co-insurance charges. This will ensure that Americans are not forced to file bankruptcy due to high health care costs.
 Notification and Justification of Premium Increases
o Insurers will be required to publicly disclose the amount of any premium increase prior to the increase taking effect, and to provide a justification for the increase. This will limit the industry’s current practice of hiking up insurance rates in order to push less healthy individuals and small businesses off their rolls.
http://dpc.senate.gov/healthreformbill/healthbill54.pdf
http://dpc.senate.gov/healthreformbill/healthbill55.pdf

In addition to the above, you are correct that insurers are only allowed to consider age, family composition, geography, and tobacco use in adjusting their premiums, period; that they can not deny pre-existing conditions; that they can not have any lifetime caps on payments ($1million, $1billion, $1trillion, doesn't matter they have to pay).

Now recall my statement was the law makes the insurance companies into utilities, which the above confirms. They're by and large no longer in the business of assessing risk, though they'll make plenty of money just as utilities do and make big donations to politicians just as utilities do.

[mheslep]

Paying for SS, Medicare, fire protection, police departments is not voluntary anywhere in the US. ...Fire protection is in many places.

[NeoDevin]

Fire protection is in many places.

Source? Given the potential damage to other buildings from an uncontrolled fire, I'm having a hard time believing this. (I could be mistaken though)

[turbo]

Source? Given the potential damage to other buildings from an uncontrolled fire, I'm having a hard time believing this. (I could be mistaken though)Some high-end estates and large business may contract for private fire-protection, but the large businesses that I have worked with have mutual-aid agreements with public fire departments, as well. I haven't yet lived anywhere where your property taxes didn't pay for public fire departments.

[NeoDevin]

Some high-end estates and large business may contract for private fire-protection, but the large businesses that I have worked with have mutual-aid agreements with public fire departments, as well. I haven't yet lived anywhere where your property taxes didn't pay for public fire departments.

That's what I was thinking. There may be some options as far as getting private protection, but I don't expect there is anywhere you can opt out of it completely.

[MotoH]

For a long while, there was no rural fire dept. where I live, and you could opt to pay for the city fire dept to come out and save surrounding houses

[Galteeth]

[QUOTE=Dembadon;2635945]

What about the fire department, the police force, the military, veteran care programs, public school systems, et cetera? Where is the uproar regarding these socialistic concepts?

QUOTE]

There is uproar over these things.

[Office_Shredder]

Are you serious?
http://www.washingtonpost.com/wp-dyn/content/article/2009/03/30/AR2009033003291.html

Ok, let's review:

I said: The social security trust fund has a 2.5 trillion dollar reserve.

You respond by pointing out that they had a net loss in profit for this year

Do you see how those statements are completely unrelated?

[MotoH]

2.5 trillion will go awfully quick once the government realizes they don't have enough money for health care. They have always dipped into social security.

[Ivan Seeking]

A letter from the late Ted Kennedy, to President Obama.

Text of a letter Sen. Ted Kennedy, D-Mass., wrote before his death to send President Barack Obama, as provided by the White House.

___

May 12, 2009

Dear Mr. President,

I wanted to write a few final words to you to express my gratitude for your repeated personal kindnesses to me – and one last time, to salute your leadership in giving our country back its future and its truth.

On a personal level, you and Michelle reached out to Vicki, to our family and me in so many different ways. You helped to make these difficult months a happy time in my life.

You also made it a time of hope for me and for our country.

When I thought of all the years, all the battles, and all the memories of my long public life, I felt confident in these closing days that while I will not be there when it happens, you will be the president who at long last signs into law the health care reform that is the great unfinished business of our society. For me, this cause stretched across decades; it has been disappointed, but never finally defeated. It was the cause of my life. And in the past year, the prospect of victory sustained me – and the work of achieving it summoned my energy and determination.

There will be struggles – there always have been – and they are already under way again. But as we moved forward in these months, I learned that you will not yield to calls to retreat – that you will stay with the cause until it is won. I saw your conviction that the time is now and witnessed your unwavering commitment and understanding that health care is a decisive issue for our future prosperity. But you have also reminded all of us that it concerns more than material things; that what we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.

And so because of your vision and resolve, I came to believe that soon, very soon, affordable health coverage will be available to all, in an America where the state of a family's health will never again depend on the amount of a family's wealth. And while I will not see the victory, I was able to look forward and know that we will – yes, we will – fulfill the promise of health care in America as a right and not a privilege.

In closing, let me say again how proud I was to be part of your campaign – and proud as well to play a part in the early months of a new era of high purpose and achievement. I entered public life with a young president who inspired a generation and the world. It gives me great hope that as I leave, another young president inspires another generation and once more on America's behalf inspires the entire world.

So, I wrote this to thank you one last time as a friend – and to stand with you one last time for change and the America we can become.

At the Denver Convention where you were nominated, I said the dream lives on.

And I finished this letter with unshakable faith that the dream will be fulfilled for this generation, and preserved and enlarged for generations to come.

With deep respect and abiding affection,

(Ted)
http://www.huffingtonpost.com/2009/09/11/kennedy-letter-to-obama-v_n_283338.html

[Dembadon]

What about the fire department, the police force, the military, veteran care programs, public school systems, et cetera? Where is the uproar regarding these socialistic concepts?
There is uproar over these things.

Can you please provide some examples?

[turbo]

Thanks for quoting the letter, Ivan. While I have not always been a great fan of Ted, his dedication to this cause is his legacy (IMO). I wish he could have been here.

I wish some Republicans had been willing to cross the aisle, along with Olympia Snowe. The GOP could have gotten some impressive concessions. Instead, they demanded to win all the marbles, and lost all the marbles.

[Nebula815]

You've been paying for social security and medicare for years! Why complain about socialism now?

Social Security and Medicare are FAILING and they were passed with bipartisan support and had wide popular support. They are fine programs in what they do but awful in terms of HOW they try to do it.

But a society has to take care of its elderly, its mentally and physically-handicapped, etc...however this healthcare bill is a whole different story.

What about the fire department, the police force, the military, veteran care programs, public school systems, et cetera? Where is the uproar regarding these socialistic concepts?

There is a lot of outrage over aspects of the public school system.

HOWEVER

Most of these programs are at most local and state level. We do not have a national police force. We do not have a national firefighting service. We do not have a national public education system, it is still mostly at the local and state level.

The military is not a socialist program. You try to dismantle a government agency. Good luck. Now see how easy it is to cut military spending. As long as there isn't some massive threat, it can be curtailed fairly easily.

I'm not saying I agree with the recent reform to health care, but it's silly to reject something just because it is congruent with socialistic concepts. Do people honestly think that this nation is fully capitalistic?

Healthcare is not a public service that should provided by government IMO, however if one does believe this, then at most, it should be provided at the local and state level.

[Nebula815]

The GOP could have gotten some impressive concessions. Instead, they demanded to win all the marbles, and lost all the marbles.

If someone serves you a plate of crap, and promises to put some whipped cream on it, maybe a few cherries, well it's still a pile of crap :wink:

Now you may disagree with the Republicans that it is a pile of crap, but as far as the GOP is concerned, it's a pile of crap, and you cannot really have "compromise" on something you view as a pile of crap.

It would be like the GOP seeking to ban abortion, and trying to give "concessions" to the Democrats. It doesn't matter what concessions they offer, the Democrat would never agree to that. There is no compromise there.

You applaud Ted Kennedy for standing by his principles, well in this case so did the GOP.

[turbo]

If someone serves you a plate of crap, and promises to put some whipped cream on it, maybe a few cherries, well it's still a pile of crap :wink:

Now you may disagree with the Republicans that it is a pile of crap, but as far as the GOP is concerned, it's a pile of crap, and you cannot really have "compromise" on something you view as a pile of crap.

It would be like the GOP seeking to ban abortion, and trying to give "concessions" to the Democrats. It doesn't matter what concessions they offer, the Democrat would never agree to that. There is no compromise there.

You applaud Ted Kennedy for standing by his principles, well in this case so did the GOP.You miss the point entirely. The Republicans could have have had a bill that they could be proud of. Instead, they refused to participate for the last 14 months, lost (in the sense of having the Dem's bill passed) and have abandoned their constituents in the process. There are no real conservatives left in the GOP - only cynical neo-cons bought with lobby-money. It is very difficult for Democrats to agree on anything because some of them at least try to vote on principle. No such problem in the GOP. Just say NO, never compromise or negotiate, and then claim that you were "shut out" of the process.

[Dembadon]

Social Security and Medicare are FAILING and they were passed with bipartisan support and had wide popular support. They are fine programs in what they do but awful in terms of HOW they try to do it.

But a society has to take care of its elderly, its mentally and physically-handicapped, etc...however this healthcare bill is a whole different story.



There is a lot of outrage over aspects of the public school system.

HOWEVER

Most of these programs are at most local and state level. We do not have a national police force. We do not have a national firefighting service. We do not have a national public education system, it is still mostly at the local and state level.

The military is not a socialist program. You try to dismantle a government agency. Good luck. Now see how easy it is to cut military spending. As long as there isn't some massive threat, it can be curtailed fairly easily.



Healthcare is not a public service that should provided by government IMO, however if one does believe this, then at most, it should be provided at the local and state level.

Whether or not they are regulated at the state level is irrelevant; they are still socialistic.

Also, I asked for examples of outrage regarding these programs due to them being socialistic, not because there are implementation issues.

[turbo]

Whether or not they are regulated at the state level is irrelevant; they are still socialistic.

Also, I asked for examples of outrage regarding these programs due to them being socialistic, not because there are implementation issues.Really. Nobody complains that Maine is Communist or Marxist (tea-bagger complaints) because >50% of our property tax bills go to support public education. Last time I looked, law-enforcement, fire-protection, and other "socialist" enterprises were pretty widely supported, too. Where is the "outrage" and the refusal to pay for the services, and the refusal of delivery of services? Even the biggest apocalyptic nut-case the at I know would not demand that the local fire department not try to save his house if it was on fire.

[WhoWee]

Ok, let's review:

I said: The social security trust fund has a 2.5 trillion dollar reserve.

You respond by pointing out that they had a net loss in profit for this year

Do you see how those statements are completely unrelated?

Actually, what they have is an IOU - read my post.

[WhoWee]

You miss the point entirely. The Republicans could have have had a bill that they could be proud of. Instead, they refused to participate for the last 14 months, lost (in the sense of having the Dem's bill passed) and have abandoned their constituents in the process. There are no real conservatives left in the GOP - only cynical neo-cons bought with lobby-money. It is very difficult for Democrats to agree on anything because some of them at least try to vote on principle. No such problem in the GOP. Just say NO, never compromise or negotiate, and then claim that you were "shut out" of the process.

And now the Liberals own it - let the chips fall...

[turbo]

And now the Liberals own it - let the chips fall...Not just liberals. Independents who feel that corporations are a bit too free with denials and recissions. If your property insurance carrier got an alert that your house was on fire, and called you and cancelled your coverage, only agreeing to pay part of the claim that might have been due before the whole place was destroyed, you would be outraged and demanding heads on pikes. Health insurance companies do this every day. Come down with a cancer that might be expensive to treat? You are dropped like a hot potato, and you are so financially disadvantaged that you have no way to fight them.

Get a clue. If your house catches on fire, and your insurance company gets wind of it and abruptly cancels their contract with you, you would be livid. The same thing happens every single day when people get sick. That fastest way to make money is to refuse to pay claims. Pure profit.

[Char. Limit]

Of course the military is socialist!
Socialism isn't about inability to tear down a government agency or the military... That's not what defines a socialist agency.

[MotoH]

Recall the Red Army. They were pretty BA. Communists too!

[lisab]

David Frum has a very thoughtful blog that is ostensibly about the health care bill, but ends up diagnosing a big problem the Republicans have:

When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished. For the cause they purport to represent, it’s Waterloo all right: ours.

It's worth a read. (http://www.frumforum.com/waterloo)

[WhoWee]

Not just liberals. Independents who feel that corporations are a bit too free with denials and recissions. If your property insurance carrier got an alert that your house was on fire, and called you and cancelled your coverage, only agreeing to pay part of the claim that might have been due before the whole place was destroyed, you would be outraged and demanding heads on pikes. Health insurance companies do this every day. Come down with a cancer that might be expensive to treat? You are dropped like a hot potato, and you are so financially disadvantaged that you have no way to fight them.

Get a clue. If your house catches on fire, and your insurance company gets wind of it and abruptly cancels their contract with you, you would be livid. The same thing happens every single day when people get sick. That fastest way to make money is to refuse to pay claims. Pure profit.

The Liberals own the legislation.

[turbo]

David Frum has a very thoughtful blog that is ostensibly about the health care bill, but ends up diagnosing a big problem the Republicans have:



It's worth a read. (http://www.frumforum.com/waterloo)Picked it up earlier, Lisa. He's spot-on. I hope enough idiots get purged in the next few election cycles so that actual conservatives might work up into the party. I'd like to have a rational choice at election day. I was so damned Republican for Goldwater and Reagan (1st time) that my father wanted to disown me. After Reagan's first term (during, actually) I swore off both of the major parties. They will get nothing from me. Even if I was really fired up about a national candidate, whatever I could afford to contribute would be an election-campaign non-event.

[Nebula815]

Whether or not they are regulated at the state level is irrelevant; they are still socialistic.

Also, I asked for examples of outrage regarding these programs due to them being socialistic, not because there are implementation issues.

No one is saying EVERY service must be private-sector. But MOST should be. We should NOT have a 50/50 split.

And being local and state government is a lot different from the national level. With national, it gives the national government a lot more power, the power becomes far more centralized.

You like your local and state police, don't you? Now how would you respond if the government decided to create a United States National Police Force? No more local police, no more state police. Now all police officers are under the federal government. Sounds rather dictator-like to me.

Services that are better provided by government, we keep them decentralized and local and state level for a reason. Only ones that absolutely must be centralized, like the military, do we let the national government control (and even that has its own state-level National Guard units for defense of the homeland).

[Nebula815]

...teabaggers...

turbo-1, it is fine to disagree and have opinions, but please (BTW this is meant politely, not any command) stop referring to tea party people as teabaggers, that is like calling Iraq War protesters anti-American.

During the Bush years, dissent was the highest form of patriotism. You were a redneck blinded idiot if you just blindly supported Bush. Yet now with Obama, it's like we're all just supposed to hold hands and if anyone DARES organize protests against his big leftwing agenda, they are nothing but racist, redneck teabaggers.

Also how are you a fan of Goldwater but support Obama:confused::confused::confused::confused: (talk about two opposities!!)

[Char. Limit]

turbo-1, it is fine to disagree and have opinions, but please stop referring to tea party people as teabaggers, that is like calling Iraq War protesters anti-American.

During the Bush years, dissent was the highest form of patriotism. You were a redneck blinded idiot if you just blindly supported Bush. Yet now with Obama, it's like we're all just supposed to hold hands and if anyone DARES organize protests against his big leftwing agenda, they are nothing but racist, redneck teabaggers.

Also how are you a fan of Goldwater but support Obama:confused::confused::confused::confused: (talk about two opposities!!)

This is how the left-wing thought... and they were right... from their perspective. To the right-wing perspective, the patriots are the ones organizing protests against Obama, and the traitors were the ones organizing protests against Bush.

And since both terms are subjective, both sides are right... from their perspective.

I sound like a complete idiot, don't I?

[Nebula815]

This is how the left-wing thought... and they were right... from their perspective. To the right-wing perspective, the patriots are the ones organizing protests against Obama, and the traitors were the ones organizing protests against Bush.

Intelligent right-wingers may have disagreed with protestors, but in no way regarded them as traitors. Yes you will have a few whackjobs in every group, there were some truly anti-American nutjobs among some of those war protesters as well, did not make all the war protestors anti-American or anything.

I would think the Obama-supporting Left would more have the attitude of, "We respect they're right to organize and protest, but we disagree with their claims for XXX reasons."

Instead, they have been called everything from teabaggers to Nazis by Democrats.

I sound like a complete idiot, don't I?

Nope.

[Brian_C]

Obama forgot to tell the ignorant masses that his "reforms" will result in higher premiums for middle class Americans as insurance companies absorb the costs of covering millions of previously uninsured people. There is a reason that insurance companies drop people with pre-existing conditions. This stuff is enormously expensive, and that expense will be passed along to everyone else. There is no such thing as a free lunch.

[Brian_C]

The liberal "FDL Action" website has written a pretty damning indictment of the health care bill. They note that this legislation will not prevent medical bankruptcies, and will impose major costs on families making as little as $66,000/year.

http://fdlaction.firedoglake.com/2010/03/19/fact-sheet-the-truth-about-the-health-care-bill/

This stuff isn't right-wing propaganda. There are very serious problems with ObamaCare.

[Gokul43201]

Obama forgot to tell the ignorant masses that his "reforms" will result in higher premiums for middle class Americans as insurance companies absorb the costs of covering millions of previously uninsured people. Do you have a reliable independent study supporting that assertion (and how many "middle class Americans" are you talking about: 100 or 100 million)? The last CBO analysis on premiums, from Nov 30, says that most people will see a decrease in costs. I don't believe they've redone that analysis more recently.

http://www.politifact.com/truth-o-meter/statements/2010/jan/28/nancy-pfotenhauer/health-care-reform-does-not-increase-premiums-and-/

www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf

[WhoWee]

Do you have a reliable independent study supporting that assertion (and how many "middle class Americans" are you talking about: 100 or 100 million)? The last CBO analysis on premiums, from Nov 30, says that most people will see a decrease in costs. I don't believe they've redone that analysis more recently.

http://www.politifact.com/truth-o-meter/statements/2010/jan/28/nancy-pfotenhauer/health-care-reform-does-not-increase-premiums-and-/

www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf

If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS.

[MotoH]

Gokul, where do you think this money will come from? Us middle class citizens will get raped through the nose in the coming years.

4-6 years of taxes before we see any benefits? Just another way for the government to try and make money under the guise of health care.

[drankin]

So, now that 30 million more people have insurance, does this mean there will be more patients or just that their medical bills will be paid by everyone else?

If both, aren't we going to need another 500,000-1,000,000 more doctors and supporting staff?

[Ivan Seeking]

Interesting bit of information about the popularity of this bill. While 59% of those surveyed last weekend opposed the bill, 13% said it is because the bill isn't liberal enough. Those people will mostly fall in line, which means that over 50% of the country supports the bill in principle, with 13% saying it should have gone farther.
http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf

In fact, if we assume that all liberals who wanted more will ultimately support the progress made, that puts the approval of the bill at 52%, which is about the same number that Obama saw in the 2008 election - 53%. 5% are undecided. It is likely that they will also support this with time as the truth begins to sink in.

The popularity of this will continue to rise for many months as the gloom and doom predictions prove to be nonsense. Obama should also take a good bump in the polls. Former President Clinton predicts that he will see a 10 point rise in his approval rating.

[MotoH]

Wow Ivan. You really twisted those poll results to try and strengthen your point.

Oppose: 59%

Oppose because it is too liberal: 43%

[Ivan Seeking]

Note also that the Dow went up yesterday. No doom and gloom.

[Ivan Seeking]

Wow Ivan. You really twisted those poll results to try and strengthen your point.

Oppose: 59%

Oppose because it is too liberal: 43%

No, 39% support the bill, while 13% thought it didn't go far enough. That makes 52%.

[humanino]

Wow Ivan. You really twisted those poll results to try and strengthen your point.

Oppose: 59%

Oppose because it is too liberal: 43%There was no twist. The number is displayed on the same page, sic :
Oppose, not liberal enough 13%

[turbo]

Also, once people realize that the sky hasn't fallen, and they see some of the more immediate benefits of the legislation, approval will rise.

There are a lot of healthy people with no insurance that would like insurance. Their entry into the market will reduce the experience rates for their pools, which should decrease costs, as long as the insurance companies don't gouge. Getting them early preventative care will reduce the chances for non-covered care for more serious conditions, too, further reducing costs. Hospitals don't provide "free" care to uninsured individuals. They raise the costs of all care so that people with insurance pay for the "free" care.

[Ivan Seeking]

Senator McConnell [R] stood before the chamber and declared that most Americans are dumbfounded today by the passage of this bill.

Clearly that is a lie.

[zomgwtf]

Just wondering... why exactly does the American healthcare system work the way it does (or did I guess)???

Is it just so that the doctors and insurance companies can be free to make as much money as they want and so the goverment doesn't have to step on anyones money making toes???

[Topher925]

So, now that 30 million more people have insurance, does this mean there will be more patients or just that their medical bills will be paid by everyone else?

If both, aren't we going to need another 500,000-1,000,000 more doctors and supporting staff?

No, the amount of patients will remain the same. And we already pay all those 32 million people's bills.

There will always be a shortage of medical professionals so long as the AMA caps the amount of doctors that can graduate per year.

[Ivan Seeking]

This is a big f*cking deal
- Vice President Joe Biden
http://www.wgme.com/template/inews_wire/wires.national/3e9d2d30-www.wgme.com.shtml

Too funny!!! :rofl:

[edward]

If the health care reform works Limbaugh says he will leave the country. That alone is a good enough reason to hope that it is successful.

http://www.youtube.com/watch?v=CLpyO8tC-L0

[MotoH]

I've re-read your information and it is correct. Jumbled, but correct.

Why don't I have benefits now? Why can't I go to the doctors office and get some free care for this soar throat I have?

Oh wait we have to pay taxes until the government has enough money to provide everyone with care.

[WhoWee]

Interesting bit of information about the popularity of this bill. While 59% of those surveyed last weekend opposed the bill, 13% said it is because the bill isn't liberal enough. Those people will mostly fall in line, which means that over 50% of the country supports the bill in principle, with 13% saying it should have gone farther.
http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf

In fact, if we assume that all liberals who wanted more will ultimately support the progress made, that puts the approval of the bill at 52%, which is about the same number that Obama saw in the 2008 election - 53%. 5% are undecided. It is likely that they will also support this with time as the truth begins to sink in.

The popularity of this will continue to rise for many months as the gloom and doom predictions prove to be nonsense. Obama should also take a good bump in the polls. Former President Clinton predicts that he will see a 10 point rise in his approval rating.

If you ask the same people if they would like the Govt to pay their utilities - what do you think they would say?

[Gokul43201]

If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS.

Gokul, where do you think this money will come from? Us middle class citizens will get raped through the nose in the coming years.

4-6 years of taxes before we see any benefits? Just another way for the government to try and make money under the guise of health care.
So neither of you knows of a reputable study that calculates the extent of the middle class raping that is to ensue?

[MotoH]

I've posted an article earlier in the thread.

Read.

[Nebula815]

Hope you all are right who say the bill will greatly improve healthcare, it will be wonderful if in the future it really has made things better, but with the history of government programs and in particular government healthcare programs, I will believe it when I see it.

[Ivan Seeking]

So, in fact, most Americans support health care reform, while 13% think this should have gone father. What do our conservative news sources have to report?

Dobbs
...but this "victory for the American people" is anything but. If that was the case, why would poll after poll show an overwhelming majority of Americans against the legislation?...
http://loudobbs.com/

CS Monitor
In a sign of President Obama’s failed attempt at convincing Americans his healthcare reform bill will help them, a new Gallup poll shows the majority of the US believes the bill in Congress will benefit just the poor and uninsured.
http://www.csmonitor.com/USA/Politics/2010/0319/Why-Americans-oppose-the-healthcare-reform-bill

Rasmussen
Yet while in Congress there has been months of posturing and shifting of political tactics, voter attitudes have remained constant: A majority oppose the plan being considered by the legislators...
http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform

LifeNews
Polls Find Majority Oppose Barack Obama, Pro-Abortion Health Care Bill
http://www.lifenews.com/nat6179.html

Fox
Fox News Poll: 55% Oppose Health Care Reform
http://www.foxnews.com/politics/2010/03/18/fox-news-poll-oppose-health-care-reform/

[Topher925]

Hope you all are right who say the bill will greatly improve healthcare, it will be wonderful if in the future it really has made things better, but with the history of government programs and in particular government healthcare programs, I will believe it when I see it.

One important thing to note, is that lot of this "government run healthcare" will actually be managed at the state level. So if your state screws it up, just move to another one. :smile:

[MotoH]

That's weird, I didn't know 39% was more than 59%

[Nebula815]

Note also that the Dow went up yesterday. No doom and gloom.

Not surprising since the bill mandates 300M customers for health insurance with 30M new members and Big Pharma is promised exclusive distribution in the US with a ban on imported pharmaceuticals. The health insurance companies, big pharmaceutical companies, hospitals, etc...all are guaranteed big profits thanks to this bill.

[cristo]

Also, your random 10% unemployment stat is ridiculous: it's not true for many European nations with universal healthcare (UK, Norway, Finland, Sweden, Denmark, Switzerland, just to name a few from browsing that website)
What you mean by random? It's unemployment is always close to 10% which is worse than US. It has many regulations and unions.

Do you guys across the pond actually look at statistics, or do you just prefer to conjure things up yourselves? If you would, you'd see this:

Unemployment rates (from wiki (http://en.wikipedia.org/wiki/List_of_countries_by_unemployment_rate), but see sources)

UK 7.8%; Switzerland 3.6%; Denmark 4.2%; Norway 3.3%; Sweden 8%; Finland 8.5%

USA 9.7%.

[CRGreathouse]

Do you guys across the pond actually look at statistics, or do you just prefer to conjure things up yourselves?

The original quote to which RootX referred was about the unemployment rate in France, and included a link showing its unemployment rate over the last 10 years or so. So your ad hominem attack is baseless.

Now there's an argument for cherry-picking: maybe France is a bad example, or maybe the Scandinavian countries are. You could compare other European countries (Spain, Germany, Portugal, Italy, Poland, Greece, etc.), or perhaps just the overall EU rate. At least this way you'd be discussing the facts rather than attacking each other.

[cristo]

The original quote to which RootX referred was about the unemployment rate in France, and included a link showing its unemployment rate over the last 10 years or so.

Even if that was the comment he was replying to, had he looked at statistics comparing the two countries, he would see that a claim such as "It's unemployment is always close to 10% which is worse than US" was incorrect. For example, from table 1 here (http://www.bls.gov/fls/intl_unemployment_rates_monthly.htm) one can see that the unemployment rate in the USA for much of 2009 was worse than that in France.

[CRGreathouse]

Even if that was the comment he was replying to

I did trace the quotes backward (that's what the 'right arrow' buttons do*). That was the quote responded to.

* Not to be condescending -- actually I only noticed this myself a few months ago.

he would see that a claim such as "It's unemployment is always close to 10% which is worse than US" was incorrect. For example, from table 1 here (http://www.bls.gov/fls/intl_unemployment_rates_monthly.htm) one can see that the unemployment rate in the USA for much of 2009 was worse than that in France.

That claim was about long-term rates for both countries (as I mentioned in my post, the source was a long-range plot). That the US rate was at some point worse doesn't seem to weaken the point at all. (That France may not be a good example *does* weaken the point.)

Now if the claim had been "Its unemployment is close to 10% which is always worse than US", the criticism would be valid. But it wasn't.

[Nebula815]

Europe, on average, has a higher unemployment rate than the U.S. The UK isn't really Europe and Switzerland is more free-market than the U.S., so I wouldn't use them as an example.

Stand by for a VAT tax when it becomes clear how large a hole in the budget this healthcare legislation blows.

[Office_Shredder]

Europe, on average, has a higher unemployment rate than the U.S. The UK isn't really Europe and Switzerland is more free-market than the U.S., so I wouldn't use them as an example.

Stand by for a VAT tax when it becomes clear how large a hole in the budget this healthcare legislation blows.

Switzerland requires everyone to get health insurance, and the UK has universal health care, and a fairly high VAT. Considering that we're supposed to be talking about how the march to socialism brought on by the health care bill will sink us like Europe, I think they're very relevant examples.

[Nebula815]

Switzerland requires everyone to get health insurance, and the UK has universal health care, and a fairly high VAT. Considering that we're supposed to be talking about how the march to socialism brought on by the health care bill will sink us like Europe, I think they're very relevant examples.

Switzerland is a very tiny country and is not an entitlement utopia though. The central government there has very little power. They have a large private sector health insurance system combined with a public aspect.

As for the UK, they are in dire straits economically and fiscally right now and headed towards going over a cliff again. They almost did in the late 1970s, the only thing that saved them was Margaret Thatcher and the Conservative party. After the Conservate party started becoming too corrupt (and also raising some taxes), they lost to Labour party, which had re-branded itself as "New Labour," and thus has gone on to spend money like crazy and raise taxes. I would not hold them as an example for us to copy.

They're universal healthcare system has been a contentious issue ever since it was created, and they have various problems with rationing in it to this day. There were actually fewer hospitals in the UK by the 1970s then there had been in the early twentieth century due to the NHS.

They also have heavy regulations over junk lawsuits, which would mean the equivalent of heavy tort reform in the U.S. I am sure that to pay for health reform here, the Democrats will push for a VAT tax, but mention tort reform and they will never do that.

Also, as I said in an earlier post, even if we decide to copy the Euro systems, assuming they work well, we have a very poor record of creating such systems within our own nation. Again, it may sound like a broken record, but it's the truth:

Medicare - trillions in deficit
Medicaid - trillions in deficit

(these two programs alone are both causes of the increasing costs of American healthcare and also are responsible for a large portion of the future deficit projections our nation faces)

Massachusettes healthcare program - premiums among highest and costs very high (http://www.boston.com/news/health/articles/2009/08/22/bay_state_health_insurance_premiums_highest_in_cou ntry/)

Tennessee - tried an expansion of Medicaid which ballooned out of control in costs (http://online.wsj.com/article/SB125046457087135327.html)

So IMO we should work to make sure this stuff works on the small level before trying it on the national level.

[Galteeth]

If you ask the same people if they would like the Govt to pay their utilities - what do you think they would say?

I, for one, would like for the government to give me a pizza.

[turbo]

I, for one, would like for the government to give me a pizza.
I'd prefer and oil and filter change.

[WhoWee]

So neither of you knows of a reputable study that calculates the extent of the middle class raping that is to ensue?

I commented:

"If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS."

As for a reputable study on the subject - I have to laugh (or maybe cry). That is the problem - they didn't do an honest study of the consequences of this legislation.

I posted with regards o how the insurance industry operates. Risk is measured and a premium is quoted ->>> more risk = greater premium.

[Galteeth]

I commented:

"If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS."

As for a reputable study on the subject - I have to laugh (or maybe cry). That is the problem - they didn't do an honest study of the consequences of this legislation.

I posted with regards o how the insurance industry operates. Risk is measured and a premium is quoted ->>> more risk = greater premium.

Theoretically, this might be offset by the massive influx of new customers. Of course, it sort of stifles competition, and this "increased competition" aspect of the bill doesn't take effect till 2014, and by my understanding still does not allow for competition over state lines.

[cristo]

Europe, on average, has a higher unemployment rate than the U.S.

Really? Because the link I gave above, averaged over the last year or so, says otherwise.


The UK isn't really Europe and Switzerland is more free-market than the U.S., so I wouldn't use them as an example.


You can't just redefine "Europe" to suit your argument.

[Nebula815]

Really? Because the link I gave above, averaged over the last year or so, says otherwise.

Europe, on average, as a continent, has a chronically high unemployment rate and more stagnant economic growth rates during good times. They also have higher levels of national debt to GDP on average. The United States, on average, maintains full employment, with unemployment only going higher during recessions. This current recession was the equivalent of a torpedo (real-estate bust) hitting the ship (economy), which has thus driven unemployment to its highest in approximately three decades (the last time being the Volcker Recession of 1981-1982).

The U.S. also has fairly decent growth during good times and a lower debt-GDP ratio (although it's getting up there).

You can't just redefine "Europe" to suit your argument.

"Technically" the UK may be considered part of Europe but from my understanding, they have never regarded themselves as "European" in the conventional sense. But regardless, the UK does not have the same degree of mixed economy as other nations in the EU. The UK is able to still put the same amount of money proportionally into its national defense as the United States.

Switzerland is not part of the European Union. Switzerland does not follow the same policies as most EU countries (high taxes, massive social welfare systems), although they have aligned certain policies to match the EU recently. They have a modern market economy with low taxes, low unemployment, decent GDP growth, and one of the highest GDP per capitas in the world.

One thing to also think about is the national defense. A big danger for the United States of becoming a European-style social democracy is the cut required in the defense. In addition to more of the budget going to social expenditures, the probable higher level of debt will increase the interest that must be paid, gutting the defense more.

Remember, if the European nations had had to fend for themselves after WWII, there is no way they would have been able to pour the amount of money into social systems that they do. They were able to do this because the U.S. to a great degree has subsidized their security for many years.

But if the U.S. goes the same route, who will replace us?

The paranoid fear about a New World Order forming, but I think in the future we risk just the opposite, a world with truly no order.

[mheslep]

Source? Given the potential damage to other buildings from an uncontrolled fire, I'm having a hard time believing this. (I could be mistaken though)

Some high-end estates and large business may contract for private fire-protection, but the large businesses that I have worked with have mutual-aid agreements with public fire departments, as well. I haven't yet lived anywhere where your property taxes didn't pay for public fire departments.

Surely you guys have heard of Volunteer Fire Departments (http://en.wikipedia.org/wiki/Volunteer_fire_department)? Often the VFD's mix in with the regular pro's, but in some small towns it is all VFD, at least there are in my state. Edit: The first VFD in the US was Franklin's idea, set up in Philadelphia in 1736. They followed with private fire insurance in 1751 which led to rapidly improvement in Philly's fire prevention measures. Maybe that's why Philly never had one of those total city-destroying fires ala Chicago, SF, NYC.
http://www.ushistory.org/tour/tour_contrib.htm

[Ivan Seeking]

I commented:

"If anyone pays less, it will be because YOUR taxes subsidized them. Premiums will increae otherwise due to mandated coverage of (high risk) pre-existing conditions and removal of maximum lifetime payouts. The costs to the insurance companies WILL INCREASE - SO WILL PREMIUMS."

As for a reputable study on the subject - I have to laugh (or maybe cry). That is the problem - they didn't do an honest study of the consequences of this legislation.

I posted with regards o how the insurance industry operates. Risk is measured and a premium is quoted ->>> more risk = greater premium.

So you keep insisting on your point but have nothing to back it up but personal opinion. Got it.

[mheslep]

I wish some Republicans had been willing to cross the aisle, along with Olympia Snowe. Snowe as you may know voted to forward the Senate bill out of here Finance Committee with some reservations. After that the bill went behind closed doors it came out completely differently; she and every other R. voted against that. Today she went on the floor and attacked the final bill in detail, describing how it went completely off the rails after committee. Meanwhile, here's the written statement she released couple days ago, as I can't find today's floor speech yet.

http://snowe.senate.gov/public/index.cfm?FuseAction=PressRoom.PressReleases&ContentRecord_id=881403bd-802a-23ad-4641-266a1f517857

“As one who has been intimately involved in the multiple facets of health care reform for well over a year and the only Republican to vote for the Finance Committee's reform bill, and at this time when Americans are facing the enormous challenges of access to affordable coverage, it is disappointing to consider what might have been if the process had focused on addressing fundamental problems with the bill to develop a more balanced, effective, and credible approach that would be embraced broadly by the American people. Instead, energy and ingenuity that could have been applied to making key adjustments on the critical issues of the affordability of plans and the negative effect of the bill on small businesses and job growth was directed toward executing an arcane process that ultimately denied Congress the opportunity to pass the best possible package. Today was regrettably the manifestation of legislative and political expediency trumping responsible policy.

“Representing the State of Maine which has been bludgeoned by premium costs representing a 349 percent increase over the last decade alone, it is inherently clear that the status quo is unacceptable. At the same time, I believe that process dictates substance, and the bill that the Senate voted on last December was the result of a defective process that could not produce the kind of legislation that would garner widespread support and credibility.

“Now, here we are today – with the majority leadership doing an ‘end run’ around the regular order of legislative procedures with a ‘reconciliation’ process that severely curtails the scope of potential amendments that could improve the underlying bill, which I find profoundly troubling as one who has said throughout this debate that I would work to improve the legislation regardless of whether I could ultimately support it. The fact is, reconciliation was designed to address budget deficits, not to enact the reordering of more than $33 trillion on health care expenditures over the next ten years and one-sixth of our economy. Given this legislation would essentially not take effect until 2014, Congress could have taken the opportunity to address the underlying concerns with the bill rather than resort to legislative machinations.

“Indeed, at this precarious time when we must reestablish our economy, this is precisely the wrong moment to be increasing penalties in the bill from $750 to $2,000 for employers, with more than 50 workers, who do not offer health insurance. Moreover, retaining the Medicare tax increases from the Senate version of the bill will disproportionally affect our nation’s small businesses which will hinder, rather than help, small business job growth. The House also failed to remove the Class Act, a new entitlement which has been criticized by the non-partisan Medicare Actuary, who pointed out that it has serious problems with adverse risk selection that would make it ‘unsustainable.’ And I am troubled that the House also cut more deeply into Medicare, which moves us further in the wrong direction.

“While the House reconciliation bill would increase subsidies for low-income and middle-class individuals, I remain concerned the bill does not ensure affordable premium options for all Americans. That is why I wrote to the Congressional Budget Office on December 3 to request a state-specific analysis of the impact on premiums, however I did not receive an answer to that question before the Senate vote in December and as of today we still don’t have that critical information.

“This was not Congress’s finest hour -- we could have produced bipartisan legislation supported by a strong majority of Americans but the process by which we considered this enormous task failed to allow for that outcome, to the detriment of the American people."

The floor speech today has much more detail.

[mheslep]

David Frum has a very thoughtful blog that is ostensibly about the health care bill, but ends up diagnosing a big problem the Republicans have:

It's worth a read. (http://www.frumforum.com/waterloo)
I agree with Frum here:
So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry.For me its an empiric point: if I look objectively at the current public policy and conclude its going very wrongly, I conclude that the mouths doing most of the talking center stage are not effective, even destructive. They need to shut up and get off the stage. Limbaugh from what little I can tell is not much of a Burkean (http://74.125.93.132/search?q=cache:sZDS09qaVUAJ:en.wikipedia.org/wiki/Edmund_Burke+edmund+burke&cd=1&hl=en&ct=clnk&gl=us) conservative in the political sense. He is a 'leave everything as it is' conservative in the first dictionary sense, and the two are often completely different.

[mheslep]

Do you have a reliable independent study supporting that assertion (and how many "middle class Americans" are you talking about: 100 or 100 million)? The last CBO analysis on premiums, from Nov 30, says that most people will see a decrease in costs. I don't believe they've redone that analysis more recently.

http://www.politifact.com/truth-o-meter/statements/2010/jan/28/nancy-pfotenhauer/health-care-reform-does-not-increase-premiums-and-/

www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf
I'm inclined to look to the 2006 Massachusetts reforms as the best guides for what is to come, as they're similar. Mass has by far the highest premiums in the country and the longest wait times to see a GP. They had high premiums before reform too, but they've continued to increase since 2006, the WSJ op ed says 30%/year for individuals.
http://online.wsj.com/article/SB10001424052748703444804575071294139286892.html?m g=com-wsj
Boston.com says, about 10%/year for the overall market.
http://www.boston.com/business/healthcare/articles/2009/09/16/health_insurers_plan_10_rise_in_rates/
Meanwhile the state's spending on health has increased dramatically, with Gov Patrick recently threatening price controls.

http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/03/02/mass_healthcare_reform_is_failing_us/

[Gokul43201]

Yeah, it's possible this may end up similarly, but I'm not sufficiently aware of the details to comment. Nevertheless, I find it odd that a plan that is supposedly so similar to the one implemented by the Republican front-runner for the next Presidential election is being heckled so savagely by the Republican Party.

On a somewhat related note, I'd never heard of the position and role of Senate Parliamentarian until today.

http://en.wikipedia.org/wiki/Parliamentarian_of_the_United_States_Senate

[Gokul43201]

Snowe as you may know voted to forward the Senate bill out of here Finance Committee with some reservations. After that the bill went behind closed doors it came out completely differently; she and every other R. voted against that. Today she went on the floor and attacked the final bill in detail, describing how it went completely off the rails after committee. There was an op-ed in the Times a couple weeks ago, written by Snowe's Health Policy adviser.

Here it is: http://www.nytimes.com/2010/03/16/opinion/16pewen.html

Some interesting snippets:
...Republicans rightly note that their role was minimized in four of the five Congressional committees charged with drafting the legislation. Yet many Republicans had decided even before Inauguration Day to block reform, including policies that their party had previously supported. In 2003, for example, Republicans enacted legislation that financed end-of-life counseling — yet in town halls last August they claimed a similar measure would create “death panels.”

Republican cries for fiscal responsibility also ring hollow when you consider the party’s record of establishing higher-cost private Medicare plans and enacting a drug benefit that wasn’t paid for. The fact is that under the Republicans’ watch, critical problems of escalating health costs and access to affordable coverage were largely ignored.

Yet Democratic leadership worsened the erosion of bipartisanship.
...
Democrats later merged legislation from the two Senate committees into a single bill.

In that merging, the focus shifted to a one-sided political calculus, and away from critical questions like just how much it would cost Americans to carry the minimum amount of insurance coverage required under the emerging bill. Rather than address such concerns, the Democratic leadership, in the interest of political expediency, expanded the scope of the legislation, adding more regulation, spending and taxes. Soon health care reform, which had been achievable, became endangered.
...
No less embarrassing was the way the majority leadership killed a bipartisan amendment to establish an F.D.A.-regulated system for importing prescription drugs. Safe importation would have produced nearly $100 billion in savings, $19.4 billion of which would have been realized by the federal government. But the amendment conflicted with the deal Democrats had made with the pharmaceutical industry.
...

[mheslep]

Yeah, it's possible this may end up similarly, but I'm not sufficiently aware of the details to comment. Nevertheless, I find it odd that a plan that is supposedly so similar to the one implemented by the Republican front-runner for the next Presidential election is being heckled so savagely by the Republican Party.Two reasons, as Romney and others have often responded when asked that question:
1. Mass/Romney care admittedly didn't attempt to address cost head on. The main idea was simply to get people covered. Romney now admits the beast doesn't work for costs. Then, the Mass legislature, in an all too predictable hand-out-the-bacon move for politicians, piled on a heap of benefits and requirements into the state plans that Romney didn't want.
2. Mass/Romney care is a _state_ based solution. At the state level, the plan is customized for Mass needs, the politicians have a higher degree of accountability for the problems, as do the local bureaucratic implementers, and fixes are far easier to make than it ever will be for a federal plan.

On a somewhat related note, I'd never heard of the position and role of Senate Parliamentarian until today.

http://en.wikipedia.org/wiki/Parliamentarian_of_the_United_States_SenateNeither had I.

[Nebula815]

Yeah, it's possible this may end up similarly, but I'm not sufficiently aware of the details to comment. Nevertheless, I find it odd that a plan that is supposedly so similar to the one implemented by the Republican front-runner for the next Presidential election is being heckled so savagely by the Republican Party.

Well just because Mitt Romney enacted the program doesn't mean that conservatives were in agreement with it.

One thing to keep in mind on Romney as well is most conservatives have always been suspicious of him, but are willing to go along with his current policy choices, not vote for him based on his past, in which he was first a Democrat, then became a pro-choice Republican who created Romneycare in Massachusettes, then changed to being pro-life and against government-mandated healthcare.

On a somewhat related note, I'd never heard of the position and role of Senate Parliamentarian until today.

http://en.wikipedia.org/wiki/Parliamentarian_of_the_United_States_Senate

A lot of people hadn't heard of reconciliation until this bill either. Or deem-and-pass.

[MotoH]

At birth, Houston Tracy let out a single loud cry before his father cut the cord and handed him to a nurse.

Instantly, Doug Tracy knew something was wrong with his son.

"He wasn't turning pink fast enough," Tracy said. "When they listened to his chest, they realized he had an issue."

That turned out to be d-transposition of the great arteries, a defect in which the two major vessels that carry blood away from the heart are reversed. The condition causes babies to turn blue.

Read more: here (http://www.star-telegram.com/2010/03/25/2068267/crowley-newborn-with-heart-defect.html#tvg#ixzz0jaHceHC8)



I can't believe it. It's a baby! How could a health insurer deny coverage for something like this.

[NeoDevin]

How could a health insurer deny coverage for something like this.

Same reason they deny coverage for anything else they think they can get away with: Profit.

[Char. Limit]

Can't we all just get along?

Wait... looking at the way things are in this country, that's never gonna happen.

Obviously, considering that the no pre-existing conditions clause doesn't take effect until september, we should boycott health insurance companies until september. Of course, this plan has many fundamental flaws, but then, so did the Bay of Pigs, the Iraq War, and Oprah, and we did that, right?

[edpell]

A technical point. People are using the word risk but this is only valid when talking about one person. When we talk about a pool of 1 million people it is no longer risk it is a highly predictable amount of money we will spend each year for medical care (i.e cost). Just as talking about one gas molecule is a different subject then talking about a volume of gas with 10^23 molecules.

So a pool of 1 million healthy people has an annual cost of X dollars for medical care and a pool of unhealthy people has an annual cost of Y dollars for care and a pool of mixed healthy and unhealthy has a cost of Z dollars per year. It is safe to say

X<<Y
X<Z
Z<Y

[mheslep]

I can't believe it. It's a baby! How could a health insurer deny coverage for something like this.
http://www.star-telegram.com/2010/03/25/2068267/crowley-newborn-with-heart-defect.html#tvg#ixzz0jaHceHC8
I think this is a case of the uninsured, not denial. To have a denial, there had to be an insurance policy in place. There was no insurance as I read the story, nothing to deny. I wonder what happened to Medicaid, if the problem here was affordability.

[Ivan Seeking]

Obama signed the Reconciliation Act this morning. The biggest piece of legislation to pass in 40 years, is now the law.

Who knew it was still possible to get something big done in Washington?

Congratulations to President Obama, VP Biden, SOH Pelosi, and SML Reid, who dared to tackle America's unfinished business, and won! And it only took 100 years. The first President to attempt this was Teddy Roosevelt.

http://blog.beliefnet.com/progressiverevival/imgs/Teddy%20Roosevelt.jpg

Bully Bully!

[turbo]

Obama signed the Reconciliation Act this morning. The biggest piece of legislation to pass in 40 years, is now the law.

Who knew it was still possible to get something big done in Washington?

Congratulations to President Obama, VP Biden, SOH Pelosi, and SML Reid, who dared to tackle America's unfinished business, and won! And it only took 100 years. The first President to attempt this was Teddy Roosevelt.Pretty impressive achievement, since there was NO bipartisanship, even on such an important issue. Rounding up Democratic votes in Congress is like herding cats, so Pelosi and Reid deserve extra credit.

[edpell]

Obama signed the Reconciliation Act this morning. The biggest piece of legislation to pass in 40 years, is now the law.


Ivan, I still have virtually no idea what IT is.

I of course have read lots of commentary those who like it say it is the best thing since sliced bread and those who do not like it say the sky is falling. I have not and will not read 2000 pages of legal speak myself.

I take it you are on the like it side. What are some of the things it does?

[rootX]

So Dems will start implementing the new reform. It will take few years before the reform will start showing some benefits. However, the Reps will come into office for the next term (which I am confident about unless it's Sarah Palin again :P) and change all what Dems started?

[Ivan Seeking]

Ivan, I still have virtually no idea what IT is.

I of course have read lots of commentary those who like it say it is the best thing since sliced bread and those who do not like it say the sky is falling. I have not and will not read 2000 pages of legal speak myself.

I take it you are on the like it side. What are some of the things it does?

That's why, imo, it is so important to find reliable and balanced pundits, like David Gergen, and stick with them. They are paid to be experts and have the experience to provide the proper perspective. As with most any subject, one cannot become an expert by reading a document.

A few highlights, general expectations, and achievements:
Insures 30 million people who currently have no insurance, through a low-cost insurance pool
Eliminates lifetime limits on insurance plans
Eliminates "prexisting conditions" as a basis to refuse insurance to an applicant
Penalizes those who could afford insurance but have none.
Mandates that insurance companies disperse 80% of funds collected, for claims.
50% tax credit [credit, not a deduction] for small business medical insurance costs
Reduces deficit by $1.2 trillion over the next twenty years

There are many cost-saving features, the impact of which cannot be accurately estimated, so the CBO assumes a zero benefit. In fact we should see significant reductions in medical costs.

Philosophically, we have defined that health care is now a right, not a privilege.

David Gergen: an American political consultant and presidential advisor during the administrations of Nixon, Ford, Reagan, and Clinton. He is currently Director of the Center for Public Leadership and a professor of public service at Harvard Kennedy School.[1] Gergen is the Editor-at-large for U.S. News and World Report and the Senior Political Analyst for CNN.[2]
http://en.wikipedia.org/wiki/David_Gergen

[Char. Limit]

That's why, imo, it is so important to find reliable and balanced pundits, like David Gergen, and stick with them. They are paid to be experts and have the experience to provide the proper perspective. As with most any subject, one cannot become an expert by reading a document.

A few highlights, general expectations, and achievements:
Insures 30 million people who currently have no insurance, through a low-cost insurance pool
Eliminates lifetime limits on insurance plans
Eliminates "prexisting conditions" as a basis to refuse insurance to an applicant
Penalizes those who could afford insurance but have none.
Mandates that insurance companies disperse 80% of funds collected, for claims.
50% tax credit [credit, not a deduction] for small business medical insurance costs
Reduces deficit by $1.2 trillion over the next twenty years

There are many cost-saving features, the impact of which cannot be accurately estimated, so the CBO assumes a zero benefit. In fact we should see significant reductions in medical costs.

Never talk about the future as fact before it's happened.

We don't KNOW that, whatever the CBO says. After all, the CBO is part of government, and government is made up of people, and people are often wrong. What I'm trying to say is that the CBO might be wrong.

[Ivan Seeking]

Never talk about the future as fact before it's happened.

We don't KNOW that, whatever the CBO says. After all, the CBO is part of government, and government is made up of people, and people are often wrong. What I'm trying to say is that the CBO might be wrong.

There are never guarantees in Washington, but the CBO is highly respected by both parties and is considered the judge and jury. The fact is that the CBO tends to be very conservative in its estimates. That is why, for example, none of the cost reducing features were given any consideration. If they can't be quantified in concrete terms, then then don't get counted at all.

To argue that we can't look to analysis for guidance is to make us like blind men in a mine field. What I would not pay ANY attention to are people like Limbaugh or Beck, who have no basis for an opinion. The one certainty here is that the CBO is infinitely more qualified to comment that most anyone on television or the radio; or anyone else, for that matter.

[Char. Limit]

There are never guarantees in Washington, but the CBO is highly respected by both parties and is considered the judge and jury. The fact is that the CBO tends to be very conservative in its estimates. That is why, for example, none of the cost reducing features were given any consideration. If they can't be quantified in concrete terms, then then don't get counted at all.

To argue that we can't look to analysis for guidance is to make us like blind men in a mine field. What I would not pay ANY attention to are people like Limbaugh or Beck, who have no basis for an opinion. The one certainty here is that the CBO is infinitely more qualified to comment that most anyone on television or the radio; or anyone else, for that matter.

Now I wasn't suggesting not listening to the CBO at all. I was trying to imply that we shouldn't take the fact that you posited as, well, fact.

And please... I know better than to listen to people like Limbaugh and Beck... didn't you see my earlier post? Actually, FOX News is my favorite comedy channel.

[mheslep]

David Gergen: an American political consultant and presidential advisor during the administrations of Nixon, Ford, Reagan, and Clinton. He is currently Director of the Center for Public Leadership and a professor of public service at Harvard Kennedy School.[1] Gergen is the Editor-at-large for U.S. News and World Report and the Senior Political Analyst for CNN.[2]
http://en.wikipedia.org/wiki/David_GergenEh? Are you saying Gergen is your reference for all the above? If so is that your synopsis of one of his broadcasts or is there a link?

[mheslep]

Reduces deficit by $1.2 trillion over the next twenty years

Never talk about the future as fact before it's happened.

We don't KNOW that, whatever the CBO says. The CBO didn't say that. The actual text:

[...]
Effects of the Legislation Beyond the First 10 Years
Although CBO does not generally provide cost estimates beyond the 10-year budget projection period, certain Congressional rules require some information about the budgetary impact of legislation in subsequent decades, and many Members have requested CBO’s analyses of the long-term budgetary impact of broad changes in the nation’s health care and health insurance systems. Therefore, CBO has developed a rough outlook for the decade following the 2010-2019 period by grouping the elements of the legislation into broad categories and (together with the staff of the Joint Committee on Taxation) assessing the rate at which the budgetary impact of each of those broad categories is likely to increase over time. Our analysis indicates that H.R. 3590, as passed by the Senate, would reduce federal budget deficits over the ensuing decade relative to those projected under current law—with a total effect during that decade that is in a broad range between one-quarter percent and one-half percent of gross domestic product (GDP).3 The imprecision of that calculation reflects the even greater degree of uncertainty that attends to it, compared with CBO’s 10-year budget estimates.In today's terms, that's $35 to $70B per year of deficit reduction, given their assumptions (see below).
That's it for the letter. There is no 2029 tabulated dollar figure hiding somewhere in an appendix.
http://www.cbo.gov/ftpdocs/113xx/doc11355/hr4872.pdf

In his blog (http://cboblog.cbo.gov/), CBO director Elmendorf has some caveats about that long term estimate:
[the second ten years] calculation reflects an assumption that the provisions of the legislation are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation. For example, the sustainable growth rate mechanism governing Medicare’s payments to physicians has frequently been modified to avoid reductions in those payments, and legislation to do so again is currently under consideration by the Congress. The current legislation would maintain and put into effect a number of policies that might be difficult to sustain over a long period of time.

[edpell]

Mandates that insurance companies disperse 80% of funds collected, for claims.


Ivan, thanks for the insight. This is the first time I have heard about the above 80%. I like it.

[mheslep]

Ah, here's an example of why the health law's deficit estimates from CBO are likely bogus through no fault of their own, as exactly warned about by the CBO.

From the CBO director again:
[the second ten years] calculation reflects an assumption that the provisions of the legislation are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation. For example, the sustainable growth rate mechanism governing Medicare’s payments to physicians has frequently been modified to avoid reductions in those payments, and legislation to do so again is currently under consideration by the Congress. The current legislation would maintain and put into effect a number of policies that might be difficult to sustain over a long period of time.
The point being that CBO is obligated to estimate from what's written down on the books, not how Congress perennially behaves. In this case the (SGR) law (http://www.cms.hhs.gov/SustainableGRatesConFact/01_Overview.asp#TopOfPage) says Medicare doc payments will be cut. CBO estimated accordingly. Later, either Congress or the executive calls an audible, as they have done for years.

Doctors Get Reprieve From 21% Medicare Payment Cut (Update1) (http://www.businessweek.com/news/2010-03-29/doctors-get-reprieve-from-21-decline-in-payments-from-medicare.html)

March 29 (Bloomberg) -- Doctors slated to have their Medicare reimbursements cut 21 percent on April 1 got a reprieve from the Centers for Medicare and Medicaid Services, which is delaying lowered payments until after Congress reconvenes.We'll see what happens when Congress gets back on the 12th.

[Sea Cow]

So Dems will start implementing the new reform. It will take few years before the reform will start showing some benefits. However, the Reps will come into office for the next term (which I am confident about unless it's Sarah Palin again :P) and change all what Dems started?
Not if (when) it proves popular, they won't.

As an observer looking in from a country with universal health care provided free at the point of need, I find the US debate rather mystifying, I must admit. I would hope and expect many of those who opposed the legislation to come to rather like the idea of healthcare as a universal right. It's quite a modest reform, really, but it's a start.

[Char. Limit]

The only problem with America is that even when a party has a supermajority, this is all they can get done. Two thngs that I would have liked to see included:

1. Public Option. Seriously Dems, biggest mistake you've made this term is taking that off.
2. Sell insurance across state lines. I'm not sure why this is a Republican idea (I thought the Republicans were FOR monopolies, not against them), but there's no reason not to put it in. Shame, congress, shame.

[mheslep]

Not if (when) it proves popular, they won't.

As an observer looking in from a country with universal health care provided free at the point of need, Is it? Is it universally slow? Should it be called universal at all if the government decides that some tests or treatments won't be done, that, say, an MRI really isn't needed?

[mheslep]

The only problem with America is that even when a party has a supermajority, this is all they can get done. Two thngs that I would have liked to see included:

1. Public Option. Seriously Dems, biggest mistake you've made this term is taking that off.You understand that the public option would never have passed?

[Char. Limit]

You understand that the public option would never have passed?

We don't know that. If Democrats were loyal to party (a bad trait normally, but here it's a good thing), it could have passed. Plus, if the FOX News Disinformation Machine (trademark) hadn't done so much, I think it would have passed...

[mheslep]

We don't know that.Yes we do. People went on record saying they would not vote for it. Lieberman comes to mind - said he would join a filibuster against the original Senate bill.

If Democrats were loyal to party (a bad trait normally, but here it's a good thing), it could have passed. Plus, if the FOX News Disinformation Machine (trademark) hadn't done so much, I think it would have passed...What do these hypotheticals have do with your original assertion?

[Char. Limit]

Yes we do. People went on record saying they would not vote for it. Lieberman comes to mind - said he would join a filibuster against the original Senate bill.

Lieberman might as well be a Republican, and I count him firmly in that camp. I also count him in the same camp as Arlen Specter... if you know which camp that is, as, being an intelligent person, I'm sure you do.

What do these hypotheticals have do with your original assertion?

You're right... my original assertion is that the public option should have been in the bill, and when you challenged that by saying it wouldn't have passed, I created the hypotheticals. Nevertheless, I believe that FOX News was the reason the public option didn't pass despite majority support for it.

Washington Post Poll (http://www.washingtonpost.com/wp-dyn/content/article/2009/10/19/AR2009101902451.html)
Talking Points Memo Poll (http://tpmdc.talkingpointsmemo.com/2009/06/poll-overwhelming-majority-of-americans-support-public-insurance-option.php)
ABC News Poll (http://blogs.abcnews.com/theworldnewser/2009/09/majority-of-americans-support-a-public-option-in-health-reform.html)
The American Poll (http://blog.american.com/?p=4754)
Wall Street Journal Poll (http://blogs.wsj.com/washwire/2009/10/08/quinnipiac-most-americans-support-public-option/tab/article/)

[Sea Cow]

Is it? Is it universally slow? Should it be called universal at all if the government decides that some tests or treatments won't be done, that, say, an MRI really isn't needed?
In the US, it is not 'the government' but private insurance companies that make that decision. So yes, heath care is rationed here in the UK and there in the US. Here in the UK, the decision how to ration care is taken by a board of health care professionals (not 'the government' – there is a difference) according to clinical criteria. There in the US, the decision is taken by profit-making companies according to the financial situation of the individual concerned.

I know which situation I prefer. I don't have to worry about health care. If I'm ill, I go to a doctor – and I'm seen, for free, that same day. There may then be a waiting period as I'm referred to a specialist for free – the system in the UK is by no means perfect, although waiting times have come right down in the last decade – it used to be much worse. But life expectancy in the UK is higher than the US. They're doing something right.

ETA: A lot of lies were told about the UK system in the run up to these reforms in the US. All I can say is, come here, stand in the street and ask people whether they favour the system we have or some kind of private insurance scheme. You'll be hard-pushed to find anyone, rich or poor, who does not favour our system. Every political party falls over itself to appear the most keen on the National Health Service. Even Thatcher did. Universal health care provided free at the point of need is great. Really. You'd like it.

You're not banned from going private, btw, if you so wish. But if you do go private, you still have to pay for the NHS for the rest of us through your taxes. In just the same way, you in the US are free to send your children to private schools, but still have to pay for the state schools that everyone else uses through your taxes. Certain provisions, such as health and education, can and should be considered a universal right and responsibility of citizenship. It's called society.

[CRGreathouse]

In the US, it is not 'the government' but private insurance companies that make that decision. So yes, heath care is rationed here in the UK and there in the US.

Absolutely. Further, health care will be rationed in any system. It's literally not possible to do otherwise.

I know which situation I prefer. I don't have to worry about health care. If I'm ill, I go to a doctor – and I'm seen, for free, that same day. There may then be a waiting period as I'm referred to a specialist for free – the system in the UK is by no means perfect, although waiting times have come right down in the last decade – it used to be much worse.

I'll admit, my bad experiences in the UK were about two decades ago, when waiting time for a specialist was typically over 1 year (at least where I was). They've surely improved since!

[Sea Cow]

I'll admit, my bad experiences in the UK were about two decades ago, when waiting time for a specialist was typically over 1 year (at least where I was). They've surely improved since!
It has improved, and yes waiting times were pretty awful. A lot more money has gone into health care in the last decade – it was underfunded for ages.

[mheslep]

In the US, it is not 'the government' but private insurance companies that make that decision. [...]

Absolutely. Further, health care will be rationed in any system. It's literally not possible to do otherwise.I disagree with these characterizations, though I know it is often stated that way. Yes of course the insurance company uses my premiums to pay the medical provider, but I selected the insurer after some fairly careful background checking. My firm provided a number of insurer options. The benefits were clearly stated and I get exactly what I chose to pay for, including the care for a critically sick family member. Along the way nothing was denied. There are five-star quality hospital rooms out there which we didn't use and would not have been covered, but again we got what we asked for. I could have chosen a lame-insurer, there was one on the list as I recall, and no doubt I would have had problems.

The point being that if anyone did any rationing in my case (really a misuse of the term), I did it myself.

[mheslep]

[..]Here in the UK, the decision how to ration care is taken by a board of health care professionals (not 'the government' – there is a difference) according to clinical criteria. [...]The staff of NICE was created by the government, is employed by the government, and answers to the UK Secretary of State (http://www.opsi.gov.uk/si/si1999/uksi_19990220_en.pdf). How is NICE not the government?

[Sea Cow]

The staff of NICE was created by the government, is employed by the government, and answers to the UK Secretary of State (http://www.opsi.gov.uk/si/si1999/uksi_19990220_en.pdf). How is NICE not the government?
It is odd how you object to there being some democratic accountability for services run in the communal good.

[mheslep]

[...]I'll admit, my bad experiences in the UK were about two decades ago, when waiting time for a specialist was typically over 1 year (at least where I was). They've surely improved since!Yep, agrees with what I've read and heard second hand - both the way it used to be and that the NHS has improved now. Still, NHS was called 'universal' back as now and in my opinion there is nothing 'universal' about a program that would make one wait a year for a specialist.

[mheslep]

It is odd how you object to there being some democratic accountability for services run in the communal good.C'mon, I said no such thing above. Enough with the subject changing strawmen; it simply degrades the conversation. You stated the "decision how to ration care is taken by a board of health care professionals (not 'the government' – there is a difference)". Is the board (NICE) employed and answerable by the government or not?

[mheslep]

ETA: A lot of lies were told about the UK system in the run up to these reforms in the US. All I can say is, come here, stand in the street and ask people whether they favour the system we have or some kind of private insurance scheme. You'll be hard-pushed to find anyone, rich or poor, who does not favour our system. Every political party falls over itself to appear the most keen on the National Health Service. Even Thatcher did. Universal health care provided free at the point of need is great. Really. You'd like it.
Ok, fine, I get you like it and NHS does well by you.

But I'm not so hard pushed to find those who disagree who have had first hand experience. I have several friends from the UK who won't touch the NHS. One of them, just back from serving with the UK forces in Afghanistan, visited me here last week. For a more public example, see the UK's MEP Daniel Hannan here:
http://www.youtube.com/watch?v=OAbaMS12aDY&feature=related

[CRGreathouse]

The point being that if anyone did any rationing in my case (really a misuse of the term), I did it myself.

I agree. There is rationing -- not everyone could afford to go the the world's best X surgeon for their X problems. I don't think this is bad or inappropriate, and I (as a capitalist) prefer systems that let individuals decide how to ration. For example, I have little money and prefer to severely limit the amount I spend on healthcare. Another person with my income might decide to spend less on housing and more on healthcare than I do. I'm glad to have that choice -- although because I have employer-subsidized health insurance, I still spend more than I would prefer on healthcare.

[Sea Cow]

Ok, fine, I get you like it and NHS does well by you.

But I'm not so hard pushed to find those who disagree who have had first hand experience. I have several friends from the UK who won't touch the NHS. One of them, just back from serving with the UK forces in Afghanistan, visited me here last week. For a more public example, see the UK's MEP Daniel Hannan here:
http://www.youtube.com/watch?v=OAbaMS12aDY&feature=related
Yes, Daniel Hannan's appearances on US TV were well covered here. He is considered an extremist right-winger even in his own right-wing political party, the Conservatives – whose leader, David Cameron, disowned him because of his comments. It is electoral suicide here to suggest getting rid of the NHS. I can't watch that clip at the moment as I'm sneaking a view of this at work, but I know the kinds of things he's been saying. Suffice to say that I think, having listened to this idiot, you'd be pleasantly surprised if you then stepped into a British doctor's surgery/hospital. What he does is take examples of isolated incidents and imply that these are the norm. They are not. He also takes examples of things that happened several years ago, problems that have since been solved.

That said, the UK system would be unworkable in the US. The physical buildings are owned by the state and doctors are employed directly by the state. Realistically, you couldn't go from what you have now to this. If I were American, I'd be pressing for a system like they have in France. Hospitals and doctors are not owned/employed directly by the state there. Instead, they have a system of universal national insurance, and they pay fixed amounts for particular treatments. You can then choose to go to a hospital that charges this standard rate or use the contribution as part-payment at a more expensive place, but the hospitals themselves are not run directly by the state. French healthcare is generally very good, although you do often have to pay money up front and go through the hassle of claiming it back.

[mheslep]

...If I were American, I'd be pressing for a system like they have in France. Hospitals and doctors are not owned/employed directly by the state there. Instead, they have a system of universal national insurance, and they pay fixed amounts for particular treatments. You can then choose to go to a hospital that charges this standard rate or use the contribution as part-payment at a more expensive place, but the hospitals themselves are not run directly by the state.
I'm aware of the French approach and I'll pass. People keep forgetting the US has effectively had the government paid by and controlled by (if not employed by) system for years for the poor and the elderly via Medicaid and Medicare; the results are that either the care is poor or the costs explode or both. The Netherlands approach (http://healthcare-economist.com/2007/09/07/wsj-on-the-dutch-health-care-system/) interests me though.
French healthcare is generally very good, ...No doubt they're good, but my reading shows actual medical outcomes are generally better in the US. The real problem here is cost and access, not quality.

[mheslep]

...He also takes examples of things that happened several years ago, problems that have since been solved. Solved? Perhaps better funded for the moment. I understand that NHS quality has improved quite a bit in recent years, coincident with a doubling (http://www.channel4.com/news/articles/society/health/factcheck+is+the+nhs+in+the+worst+financial+health +ever/306547) of the NHS budget from £33bn in 1996-97 to £75bn ten years later. My observation is that government agencies run ok for awhile after being fed by simply growing larger but never really gaining in efficiency, and then they either collapse quality again or explode costs again or both, ending with a problem much more intractable in the end. That's certainly the trend with agencies like the the US postal service.

[mheslep]

Yes, Daniel Hannan's appearances on US TV were well covered here. He is considered an extremist right-winger even in his own right-wing political party, the Conservatives – whose leader, David Cameron, disowned him because of his comments. Hmm, in the Cameron interview I heard, Cameron opposed Hannan's NHS views, but didn't disown him.

[Sea Cow]

Solved? Perhaps better funded for the moment. I understand that NHS quality has improved quite a bit in recent years, coincident with a doubling (http://www.channel4.com/news/articles/society/health/factcheck+is+the+nhs+in+the+worst+financial+health +ever/306547) of the NHS budget from £33bn in 1996-97 to £75bn ten years later. My observation is that government agencies run ok for awhile after being fed by simply growing larger but never really gaining in efficiency, and then they either collapse quality again or explode costs again or both, ending with a problem much more intractable in the end. That's certainly the trend with agencies like the the US postal service.
Hmmm. Unlike the bloated, extraordinarily bureaucratic, expensive and wasteful US health insurance system, you mean?

It appears that you have fallen for the rather crude propaganda of Fox News when they drag out people like Hannan to tell blatant lies. Look at health care spending in the US. The UK's NHS budget is not that much more than the US's Medicaid programme – about £200billion in 2008 compared to £75billion (US population about 5 times greater than the UK's, so Medicaid is in fact a little cheaper than the NHS, but not much). Yet the UK's NHS provides comprehensive coverage for every single person and Medicaid covers just basic treatment for the poor. You think you're getting a good deal there?

[WhoWee]

Hmmm. Unlike the bloated, extraordinarily bureaucratic, expensive and wasteful US health insurance system, you mean?

It appears that you have fallen for the rather crude propaganda of Fox News when they drag out people like Hannan to tell blatant lies. Look at health care spending in the US. The UK's NHS budget is not that much more than the US's Medicaid programme – about £200billion in 2008 compared to £75billion (US population about 5 times greater than the UK's, so Medicaid is in fact a little cheaper than the NHS, but not much). Yet the UK's NHS provides comprehensive coverage for every single person and Medicaid covers just basic treatment for the poor. You think you're getting a good deal there?

It is time to request support for your comments. First, your description of "the bloated, extraordinarily bureaucratic, expensive and wasteful US health insurance system" is misleading. The insurance companies are highly regulated and must maintain a compliance office with each individual state (because their products can't be sold across state lines). Next, the Medicare products differ not only by state, but by COUNTY. Insurance companies - unlike Government - operate with as few departments and employees as possible. The goal of private industry is to control costs - not become a bloated bureaucracy.

As for Medicaid, how much of the budget total is allocated to services such as transportation costs, health club memberships, eyewear, hearing aids, and meals per year (again Medicare related)?

If you want to engage in rhetoric, start first with an analysis of the Center for Medicare and Medicaid (CMS) - not the insurance industry that it oversees and burdens with mandates.

[mheslep]

...It appears that you have fallen for the rather crude propaganda of Fox News when they drag out people like Hannan to tell blatant lies.Look at my last couple posts. Which lie do you contend I'm repeating? Cost?

Look at health care spending in the US. The UK's NHS budget is not that much more than the US's Medicaid programme – about £200billion in 2008 compared to £75billion (US population about 5 times greater than the UK's, so Medicaid is in fact a little cheaper than the NHS, but not much). Yet the UK's NHS provides comprehensive coverage for every single person and Medicaid covers just basic treatment for the poor. You think you're getting a good deal there?I already stated in #316 (http://www.physicsforums.com/showpost.php?p=2659094&postcount=316) that I'm critical of the US Medicaid program.

And I don't agree that government run systems provide 'comprehensive coverage' for every single person, rather they provide the service the government decides you'll receive, good, bad, or indifferent, for every single person.

[Sea Cow]

http://ucatlas.ucsc.edu/spend.php

This link provides some sobering stats regarding value for money in the US system.

Ironic that their relative life expectancies should place the US and Cuba side-by-side in the second graph down.

I find the casual disregard for inequality that some on here show quite mystifying really. I don't judge US health care by the best care available. I judge it by the worst care given to the poorest. By that judgement, it is very poor indeed. That some appear not to feel any responsibility towards the health needs of their neighbours is simply shameful.

[mheslep]

http://ucatlas.ucsc.edu/spend.php

This link provides some sobering stats regarding value for money in the US system.

Ironic that their relative life expectancies should place the US and Cuba side-by-side in the second graph down.You are simply looking around for what you want to see. Those comparisons have little to do with medical care.

[Ivan Seeking]

You are simply looking around for what you want to see. Those comparisons have little to do with medical care.

How are the cost of health care and life expectancy not related to health care?

[drankin]

How are the cost of health care and life expectancy not related to health care?

If your lifestyle is not "healthy" then it doesn't matter what your health care is. I do not believe life expectancy is related as much as culture and lifestyle.

[turbo]

If you lifestyle is not "healthy" then it doesn't matter what your health care is. I do not believe life expectancy is related as much as culture and lifestyle.Lifestyle may have a role in depressing the life expectancy of Americans WRT the very high costs we pay, but there's another factor that needs to be taken into account. Many people (especially in poor rural areas and in blighted cities) have no access to regular preventive care, and conditions that might have been detected earlier go untreated until they become serious enough to require emergency care, which is VERY expensive. There may be a rigorous analysis out there somewhere that addresses this situation, but I have yet to find it.

Here is a nation-to-nation comparison of "amenable mortality" - rates of deaths due to untreated or undertreated preventable conditions. I don't have access to the journal Heath Affairs, so I don't know how rigorous the study was, but this summary is a bit discouraging.

http://blogs.consumerreports.org/health/2009/08/amenable-mortality-us-health-care-system-versus-other-countries-.html

[Ivan Seeking]

If your lifestyle is not "healthy" then it doesn't matter what your health care is.

Really? I'd like to see you backup that one. My dad just had quintuple bypass surgery and a pacemaker implanted, that saved his life. He was in a perpetual state of heart failure. How is the surgery irrelevant? What IS irrelevant at this point is how he got so bad that he needed the bypass.

I do not believe life expectancy is related as much as culture and lifestyle.

Beliefs are a dime a dozen.

[drankin]

Really? I'd like to see you backup that one. My dad just had quintuple bypass surgery and a pacemaker implanted, that saved his life. He was in a perpetual state of heart failure. How is the surgery irrelevant? What IS irrelevant at this point is how he got so bad that he needed the bypass.



Beliefs are a dime a dozen.

Figured you would call me on this. So let's do a little logic exercise:

Group A and Group B have the same excellent health care available. Group A does not have a healthy diet. Group B has a healthy diet and works 20% less than Group A. Which group has a longer life expectancy?

[Ivan Seeking]

Figured you would call me on this. So let's do a little logic exercise:

Group A and Group B have the same excellent health care available. Group A does not have a healthy diet. Group B has a healthy diet and works 20% less than Group A. Which group has a longer life expectancy?

But not all groups have the same excellent health care, so your point is moot. Try this one. One critical heart patient has socialized medical care through the Veteran's administration [dad], and another has no insurance or VA benefits, and lives in Watts, California. Who is more likely to survive?

Query: Why are only vets entitled to socialized medicine?

[Ivan Seeking]

Actually, since it came up, wrt to the VA, let me put it this way: If government run health care is so terrrible, then why do we impose this on our Vets? Don't they deserve the same care as everyone else? We don't have government run health care under the Obama reforms, but the position of the right is very perplexing in this respect.

Has one opponent of universal health care ever called for the VA medical system to be deconstructed? It almost begs the question: What does the right have against our vets? Or is the problem that their position is completely inconsistent?

[WhoWee]

Actually, since it came up, wrt to the VA, let me put it this way: If government run health care is so terrrible, then why do we impose this on our Vets? Don't they deserve the same care as everyone else? We don't have government run health care under the Obama reforms, but the position of the right is very perplexing in this respect.

Has one opponent of universal health care ever called for the VA medical system to be deconstructed? It almost begs the question: What does the right have against our vets? Or is the problem that their position is completely inconsistent?

I like your logic - let's impose VA on ALL Government workers and retirees (including politicians) and abolish TRICARE as well - who needs it when they can have VA.

By the way, how many VA eligible people are on Medicare? I'll look for a link.

[turbo]

My father is a WWII vet and gets VA care, as well as Medicare to help with medications, etc. Getting decent care was tough, as the nearest VA hospital is quite distant. Within the last year or so, though, the VA has been offering care in small field offices in rural towns on a rotating basis. That way, he gets to see the same nurses and doctors routinely, when he needs care. Lots of our veterans are getting quite old, and it is a burden on them to have to drive 2-3 hours or more to get the health care they were promised, so this is a welcome change.

Transfer all government officials, elected or appointed, over to VA care, and watch how fast that system would improve. It would get LOTS better very quickly once our cherished bureaucrats had to rely on it for their primary health care.

[mheslep]

How are the cost of health care and life expectancy not related to health care?Of course they're related. The complication is that longevity is related to many things. Thus, a comparison based on a couple years of difference in unqualified life expectancy as a metric for the medical system is invalid. Many things having zero to do with the medical system impact life expectancy, including homicides, car wrecks, gene pools. If one corrects for those factors, the US comes out at or near the top of a longevity ranking.

[mheslep]

Actually, since it came up, wrt to the VA, let me put it this way: If government run health care is so terrrible, then why do we impose this on our Vets? Probably we should not:

Soldiers Face Neglect, Frustration At Army's Top Medical Facility (http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html)

Currently they're given no (economic) choice. In the US, the government has set up the system so that one can only get medical benefits economically through an employer. For VA patients, their employer is the US military, and it says you will use the VA.

[mheslep]

Massachusetts Care (now Patrick Care) is often compared to Obama care. In response to state price controls, in the last few days health insurance companies decided to stop selling any more new heath policies. In my view this was all too predictable.

Earlier this week, the state’s six largest health insurers sued Massachusetts after nearly all of their requests to raise rates were denied. For several days they stopped offering policies to individuals and small businesses as the dispute intensified.
http://blogs.marketwatch.com/election/2010/04/08/massachusetts-a-harbinger-of-health-law-problems/

The state's insurance commissioner blocked 235 of 274 increases ranging from 8 to 32 percent on policies for small businesses and individuals. Those hikes would have taken effect April.

The insurers say increased costs of care are the problem and lay the blame for the hikes on higher charges by hospitals and doctors. They want a state judge to quash the insurance commissioner's actions.

In reaction to the commissioner's decisions, most of them said earlier this week they would stop offering new policies at the old rates, as the Boston Globe reported.
http://www.npr.org/blogs/health/2010/04/by_scott_hensley_massachusetts.html

[Choronzon]

Query: Why are only vets entitled to socialized medicine?


Are you kidding?

Let me give you a very simple answer to your query— because they earned it. You would like to just give away for free what your father earned. What your father and myself and people like us earned by risking our lives.

But of course we were stupid to do so, because we should have just stood in line with all of the useless people who are so vehemently opposed to making their own way through the world. Are you going to ask now why only vets are entitled to the G.I. Bill?

[turbo]

Are you kidding?

Let me give you a very simple answer to your query— because they earned it. You would like to just give away for free what your father earned. What your father and myself and people like us earned by risking our lives.

But of course we were stupid to do so, because we should have just stood in line with all of the useless people who are so vehemently opposed to making their own way through the world. Are you going to ask now why only vets are entitled to the G.I. Bill?My father is a WWII vet who quit HS, lied about his age and joined Airborne. His compatriots are dying daily. He deserves VA care and he deserves Medicare assistance to help pay for prescription drugs. He left his family to live with a store-owner and his family when he was in his early teens, so he could work every night, have regular meals, a roof over his head, and money to send to his mother every week. When he joined the Airborne, he designated that all his checks be sent to his mother. Until very recently, VA care in this state was horribly deficient, and elderly veterans had to drive hours one-way to get to a VA center to get any treatment. Why should any veteran be subjected to that?

Why should any citizen be subjected to that? If you have a good answer to that, you can get the 2012 presidential nomination because that will be the GOP's hot-button.

[Choronzon]

My father is a WWII vet who quit HS, lied about his age and joined Airborne. His compatriots are dying daily. He deserves VA care and he deserves Medicare assistance to help pay for prescription drugs. He left his family to live with a store-owner and his family when he was in his early teens, so he could work every night, have regular meals, a roof over his head, and money to send to his mother every week. When he joined the Airborne, he designated that all his checks be sent to his mother. Until very recently, VA care in this state was horribly deficient, and elderly veterans had to drive hours one-way to get to a VA center to get any treatment. Why should any veteran be subjected to that?

Why should any citizen be subjected to that? If you have a good answer to that, you can get the 2012 presidential nomination because that will be the GOP's hot-button.

Hey, you won't find me defending the quality of VA health care. It should definitely be improved—but it should in no way be used as some model to describe what every person is entitled to. Vet's earned the money society spends on them, which is not something that can be said about everybody else clamoring for hand-outs.

[turbo]

Vet's earned the money society spends on them, which is not something that can be said about everybody else clamoring for hand-outs.People in the US are not exactly clamoring for hand-outs. They would like for their coverage not to be cancelled if they get sick. They would like for their children's coverage not to be dropped because the insurance company deems the kids' sickness a "pre-existing condition" and other types of abuse. Insurance is supposed to be a shared-risk/shared-cost pool, but it has been perverted into a situation in which the insurance companies can drop people on any pretense, and no individual has the financial means to prevail against them in court. How would you feel if you bought fire insurance, and your insurance company dropped your insurance as soon as they got word that your house was on fire? Health insurance companies do this every day, all day long. I spent years in the health-care industry as an IT specialist, and I have never seen a more predatory bunch than health insurance companies.

[Choronzon]

People in the US are not exactly clamoring for hand-outs. They would like for their coverage not to be cancelled if they get sick. They would like for their children's coverage not to be dropped because the insurance company deems the kids' sickness a "pre-existing condition" and other types of abuse. Insurance is supposed to be a shared-risk/shared-cost pool, but it has been perverted into a situation in which the insurance companies can drop people on any pretense, and no individual has the financial means to prevail against them in court. How would you feel if you bought fire insurance, and your insurance company dropped your insurance as soon as they got word that your house was on fire? Health insurance companies do this every day, all day long. I spent years in the health-care industry as an IT specialist, and I have never seen a more predatory bunch than health insurance companies.

That's not what I've seen throughout this health care debate. Those are just the talking points that the left has used to get reasonable people to support the bill, and in the end they're going to get none of those. They're going to get a massive bill to provide welfare in the form of health care subsidies. Insurance company abuses can be handled with nothing more than strong consumer protection laws. This massive farce of a bill is basically legerdemain designed to create more subsidies for useless people who then become voters desperate to keep democrats in office so that their monthly portion of their neighbors labor arrives via the USPS.

[Ivan Seeking]

This massive farce of a bill is basically legerdemain designed to create more subsidies for useless people who then become voters desperate to keep democrats in office so that their monthly portion of their neighbors labor arrives via the USPS.

What people in particular are you referring to, and what subsidies? People on the bottom end wouldn't be affected by this. People on Medicare would actually lose some benefits, such as hearing and vision benefits, IIRC.

Moving up one notch on the economic ladder: The last time I checked, one the biggest complaints is that this penalizes people who don't have insurance and who refuse to purchase insurance through the low-cost insurance pool. How does this support your premise?

[Galteeth]

My father is a WWII vet who quit HS, lied about his age and joined Airborne. His compatriots are dying daily. He deserves VA care and he deserves Medicare assistance to help pay for prescription drugs. He left his family to live with a store-owner and his family when he was in his early teens, so he could work every night, have regular meals, a roof over his head, and money to send to his mother every week. When he joined the Airborne, he designated that all his checks be sent to his mother. Until very recently, VA care in this state was horribly deficient, and elderly veterans had to drive hours one-way to get to a VA center to get any treatment. Why should any veteran be subjected to that?

Why should any citizen be subjected to that? If you have a good answer to that, you can get the 2012 presidential nomination because that will be the GOP's hot-button.

You realize this is an argument AGAINST socialized medicine, right?

[Sea Cow]

Many things having zero to do with the medical system impact life expectancy, including homicides, car wrecks, gene pools. If one corrects for those factors, the US comes out at or near the top of a longevity ranking.
Rubbish.

Diet, exercise, primary health care provision – these are the single most important factors, in fact, to raise life expectancy. The levels of obesity in the US certainly show that the first two of these factors are at a bad level for many people there, and primary health care is precisely the area that the poor and uninsured do not receive. These are linked, of course – improve primary care and diet and levels of fitness will also improve.

The factors you mention are ridiculous. Homicides will have a fairly negligible bearing. 17,000 murders in the US in 2006 – about 3–5 times the rate of most industrialised countries. So, let us call that 12,000 extra deaths due to murder. Compare that to this study (http://prescriptions.blogs.nytimes.com/2009/09/17/harvard-medical-study-links-lack-of-insurance-to-45000-us-deaths-a-year/), which estimates that 45,000 deaths per year can be directly attributed to lack of health insurance.

As for car crashes, you haven't been to Cuba, have you? I have been to both the US and Cuba, and I can assure you that US roads are much safer. Cuba's life expectancy would probably jump ahead of the US 'correcting' for this factor. Road deaths in the US are high – 40,000 per year, a rate that's three times higher than the UK (which has a very good record), and about twice as high as Japan (which has one of the highest life expectancies, and is about average for road deaths). So, again, even comparing the US with countries with good records, you're talking about an extra 20,000 deaths. This also begs the question: How many of these deaths could have been prevented if the victims had all had good health insurance?! Is the UK's low death rate on the roads in part attributable to the fact that we all have equal access to all A&E departments? I would suspect that it is – you are taken to the nearest hospital, not the nearest hospital that your insurance will cover.

And your final factor, gene pools... I'd like to see some evidence, please. The US is largely a country of descendants of recent immigrants – there's a pretty wide gene pool in the US population. At the very least, you would need to provide some evidence for this assertion. I suspect that it is, to put it in the British vernacular, utter bollocks. In fact, it would be pretty easy to show that this is bollocks. Life expectancy among black Americans is significantly lower than the overall average. Is this because of their genes? No. How do we know that? Because we can compare the life expectancy of poor black Americans and rich/middle class black Americans and see that the difference can be fully explained by their relative positions in society.

ETA: Just to put these figures into perspective – 12,000 extra deaths due to murder, 20,000 due to car crashes – 2.5 million people die in the US each year. Even if you could show that none of these extra deaths could have been prevented with a more equitable health care system (there are strong reasons to doubt this), these are not the reasons for the US's relatively poor performance wrt life expectancy.

Please don't make stupid, unjustified assertions like "If one corrects for those factors, the US comes out at or near the top of a longevity ranking." It simply isn't true and it debases the discussion.

[hypatia]

How many of these deaths could have been prevented if the victims had all had good health insurance?! Is the UK's low death rate on the roads in part attributable to the fact that we all have equal access to all A&E departments? I would suspect that it is – you are taken to the nearest hospital, not the nearest hospital that your insurance will cover.

All general hospitals in the USA must take emergency cases, you can not be turned away. Once the person has become stable{non critical}, they can then be transfered to another hospital for recovery.

[Sea Cow]

All general hospitals in the USA must take emergency cases, you can not be turned away. Once the person has become stable{non critical}, they can then be transfered to another hospital for recovery.
Glad to hear it. My argument doesn't stand on this point, however. The reason for the US's relatively low life expectancy (for a rich country) is its health care system. Why flounder around searching for alternative explanations when the truth is so obvious, and easily demonstrable. If you're rich in the US, you have a very good life expectancy. If you're poor, you have the life expectancy of a poor country, not a rich one. This is due mostly to your relative access to health care, in particular primary health care. Nobody who has seriously studied the matter disagrees with this. If you do, you're probably one of those with access to the good care, and are simply in denial about the situation of others.

It's a common psychological defence strategy for the relatively rich to blame the poor for their poverty. It makes them feel less guilty about the fact that they have drawn the lucky cards in the lottery of life.

[Sea Cow]

More stats, this time infant mortality (http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate).

Try explaining the ranking of the US (33rd or 46th, depending on which table you use) without reference to the health care system.

[Zefram]

Massachusetts Care (now Patrick Care) is often compared to Obama care. In response to state price controls, in the last few days health insurance companies decided to stop selling any more new heath policies. In my view this was all too predictable.

This isn't a feature unique to the Massachusetts system. Roughly 30 states require premium increases to be approved by state insurance regulators. Recent (i.e. in the last few years) raises have been rejected or challenged in a number of states--Maine, Connecticut, and Washington come to mind immediately and I'm sure some of you have heard about the recent challenge (and subsequent delay) to premium increases in the individual market in California.

[Choronzon]

What people in particular are you referring to, and what subsidies? People on the bottom end wouldn't be affected by this. People on Medicare would actually lose some benefits, such as hearing and vision benefits, IIRC.

Here's from Whitehouse.gov Link:http://www.whitehouse.gov/health-care-meeting/proposal/whatsnew/affordability


Health reform also improves the cost sharing assistance for individuals and families relative to the Senate bill. Families with income below $55,000 will get extra assistance; the additional funding to insurers will cover between 73 and 94% of their health care costs. It provides the same cost-sharing assistance as the Senate bill for higher-income families and the same assistance as the House bill for families with income from $77,000 to $88,000.

That sounds an awful lot to me like the government has been feeling like it doesn't send our enough checks in the mail to voters. I'm so glad that people with income under $55,000 feel that 73-94% of their health care is other people's problem.




Moving up one notch on the economic ladder: The last time I checked, one the biggest complaints is that this penalizes people who don't have insurance and who refuse to purchase insurance through the low-cost insurance pool. How does this support your premise?

That complaint, at least in my own opinion, falls squarely on constitutional grounds. The government is telling me that I have to give another private entity some of my labor, whether I desire their product or not—that's basically the definition of enslavement. It's part of the legerdemain I was talking about earlier—mere slight of hand to take money from people who want nothing to do with this stupidity and give it to potential voters for the Democrats.

What people like you fail to grasp is you have effectively delivered the provision of health care into the hands of the government. You think that's okay now, because all the talk about Quality Life Years and all that jazz doesn't bother you, but you have a big surprise coming. Wait until religious conservatives are back in power, and all of a sudden there is a clamor to save money by denying care to homosexuals and infected with AIDS, or perhaps people who have harmed themselves through the use of recreational drugs. You'll see the monstrosity of this bill quite clearly then, and you'll finally reap what you've sown.

[Galteeth]

Why flounder around searching for alternative explanations when the truth is so obvious, and easily demonstrable.

By this logic, comparative placebo studies are just a big waste of time.

[Ivan Seeking]

Here's from Whitehouse.gov Link:http://www.whitehouse.gov/health-care-meeting/proposal/whatsnew/affordability



That sounds an awful lot to me like the government has been feeling like it doesn't send our enough checks in the mail to voters. I'm so glad that people with income under $55,000 feel that 73-94% of their health care is other people's problem.

I believe the purpose of that is to ensure that the cost of health care premiums do not exceed the insured's ability to pay; which was one of the main goals of reform. What you would need to demonstrate is that this exceeds what would be considered reasonable. It is a limit based on a percentage of one's income, which is how one would deteremine the limit on costs that can be managed. What is not clear at all is how many people would be entitled to assistance under this section.

That the CBO projects deficit reductions means that cost alone is not a sufficient objection. There is give and take throughout the system. Obama argued that the strings must all be pulled at once in order to make this work. Note also that the assistance is for the premiums. The cost of health care itself is still paid by insurance companies.

That complaint, at least in my own opinion, falls squarely on constitutional grounds.

This thread addresses your concern.
http://www.physicsforums.com/showthread.php?t=389899

What people like you fail to grasp is you have effectively delivered the provision of health care into the hands of the government. You think that's okay now, because all the talk about Quality Life Years and all that jazz doesn't bother you, but you have a big surprise coming. Wait until religious conservatives are back in power, and all of a sudden there is a clamor to save money by denying care to homosexuals and infected with AIDS, or perhaps people who have harmed themselves through the use of recreational drugs. You'll see the monstrosity of this bill quite clearly then, and you'll finally reap what you've sown.

Imo, that is just silly Fox-like fearmongering. Also, first and foremost, it was the current cost of health care that drove this issue. To assume that doing nothing was an option, is fallcious. The cost of health care was going to bankrupt the country if not addressed soon, and aggressively. That you failed to recognize this shows that you lack even a basic understanding of the need for reform.

[Ivan Seeking]

Okay, if I understand this correctly - after thinking about it for a bit - the assistance for premiums based on income is already in the tax code. The new plan apparently sets lower ceilings in order to be eligible, and for tax credits, not just a deduction. But the cost of medical expenses has long been deductible once it exceeds a certain percentage of one's income.

[Greg Bernhardt]

It's interesting that the Amish (250k pop) will be exempt, but Muslims will have to buy.
http://www.wnd.com/index.php?fa=PAGE.view&pageId=137221

[turbo]

It's interesting that the Amish (250k pop) will be exempt, but Muslims will have to buy.
http://www.wnd.com/index.php?fa=PAGE.view&pageId=137221Interesting distinctions in that argument. Thanks. I didn't know about this.

[mheslep]

Rubbish.
...
Please don't make stupid, unjustified assertions like "If one corrects for those factors, the US comes out at or near the top of a longevity ranking." It simply isn't true and it debases the discussion.
Run the numbers yourself instead talking about what you suspect. If one assumes the average age of the homicides and car wrecks is 25, by itself that moves the longevity of the entire US population down by nearly year, and we only talking about a couple years of difference.
http://www.aei.org/docLib/20061017_OhsfeldtSchneiderPresentation.pdf, table 1-5

[CRGreathouse]

I would be interested in seeing more numbers on this, if either side would care to contribute.

[Al68]

The last time I checked, one the biggest complaints is that this penalizes people who don't have insurance and who refuse to purchase insurance through the low-cost insurance pool.Just pointing out that it penalizes people who decide not to participate in the new system, regardless of the fact they it is this law that will prevent them from keeping/obtaining the insurance (private non-system) that they want to buy.

This includes many, like me, who have good insurance now, and want to keep it, but will be prohibited from doing so.

[Al68]

It's interesting that the Amish (250k pop) will be exempt, but Muslims will have to buy.
http://www.wnd.com/index.php?fa=PAGE.view&pageId=137221The Amish are exempt from many things due to their religious beliefs. This law exempts anyone who is a member of a recognized group with religious beliefs that prohibit their participation. Muslims are not a recognized group for this purpose.

One more constitutional strike against this law, it discriminates based on religious beliefs.

[CRGreathouse]

One more constitutional strike against this law, it discriminates based on religious beliefs.

How is that unconstitutional? It's not a law "respecting an establishment of religion, or prohibiting the free exercise thereof". Unless of course you meant that the right to so discriminate is "reserved to the States respectively, or to the people"?

[TheStatutoryApe]

How is that unconstitutional? It's not a law "respecting an establishment of religion, or prohibiting the free exercise thereof". Unless of course you meant that the right to so discriminate is "reserved to the States respectively, or to the people"?

Amendment 14 Section 1. "All persons born or naturalized in the United States ..... nor deny to any person within its jurisdiction the equal protection of the laws."

Commonly the "Equal Protection Clause". Its arguable but the supreme court is unlikely to accept it as a violation.

Edit: and the "Establishment Clause" is commonly interpreted as prohibiting any law which gives preference to any religious group or institution.

[mheslep]

This isn't a feature unique to the Massachusetts system. Roughly 30 states require premium increases to be approved by state insurance regulators. Recent (i.e. in the last few years) raises have been rejected or challenged in a number of states--Maine, Connecticut, and Washington come to mind immediately and I'm sure some of you have heard about the recent challenge (and subsequent delay) to premium increases in the individual market in California.Well the insurance regulators denied the initial rate incrrease requests but they were eventually granted (http://online.wsj.com/article/SB10001424052748703315004575073013721784050.html) to some degree:
After initial rejections from local insurance regulators, Mr. Fluegel said WellPoint wound up with a 17.5% increase in Connecticut and a 10.5% increase in Maine.

As far as I know the refusal of health insurers to offer any new policies is indeed unique to Massachusetts, as the highest in the nation premiums brought on by the state rules are causing people to game the system and jump in and out insurance policies, or put another way Mass. rules have blown apart the risk pool and taken all the slack out of the system.

[CRGreathouse]

Amendment 14 Section 1. "All persons born or naturalized in the United States ..... nor deny to any person within its jurisdiction the equal protection of the laws."

Commonly the "Equal Protection Clause". Its arguable but the supreme court is unlikely to accept it as a violation.

I agree that the Supreme Court is unlikely to consider that a violation.

Edit: and the "Establishment Clause" is commonly interpreted as prohibiting any law which gives preference to any religious group or institution.

That's a clear misreading of the Constitution. It seems to be quite common, though; I'm not sure why. Aside from the elastic clause, it seems to be the most heavily reinterpreted clause of the whole document. (I shouldn't complain too loudly, though; I consider the dormant commerce clause an important facet of law, but it's really just another stretch/interpretation/misreading...)

[mheslep]

I would be interested in seeing more numbers on this, if either side would care to contribute.
Here are some more relevant figures.

Percentages of the male population with a BMI (http://en.wikipedia.org/wiki/Body_mass_ind) of 30 or more (female obesity rates are similar) of 6 OECD countries (http://gregmankiw.blogspot.com/2007/11/where-would-you-rather-be-sick.html):

Japan 2.8 (Japan is at the top of the life expectancy rankings)
France 9.8
Germany 14.4
Canada 17.0
U.K. 22.7
U.S. 31.1

My larger point is that it is very difficult to cleanly separate out all of the non-medical care related life expectancy causes, and given we can directly to medical care numbers why try? We have readily available numbers for the treatment of various diseases - cancer, heart disease - which are directly and almost solely dependent on medical care quality, it becomes a waste of time to try and make something of a 5% difference in life expectancy. A similar argument (unrelated causes) applies to a difference of two or three deaths per thousand in infant mortality.

[CRGreathouse]

That's percentage overweight, not the BMI itself, of course.

Becker and Posner have discussed this several times; some links for those interested:
http://uchicagolaw.typepad.com/beckerposner/2010/02/on-consumer-competence-becker.html
http://www.becker-posner-blog.com/2009/05/a_tax_on_sodas.html
http://www.becker-posner-blog.com/archives/2007/08/social_obesityp.html

[mheslep]

That's percentage overweight, not the BMI itself, of course.Oops, yes, corrected.

[Ivan Seeking]

... In Obama's Deal, veteran FRONTLINE producer Michael Kirk (Bush's War, Dreams of Obama) takes viewers behind the headlines to reveal the political maneuvering behind Barack Obama's effort to remake the American health system and transform the way Washington works. Through interviews with administration officials, senators and Washington lobbyists, Obama's Deal reveals the dramatic details of how an idealistic president pursued the health care fight -- despite the warnings of many of his closest advisers -- and how he ended up making deals with many of the powerful special interests he had campaigned against...

Watch online:
http://www.pbs.org/wgbh/pages/frontline/obamasdeal/view/?utm_campaign=viewpage&utm_medium=toparea&utm_source=toparea

[Al68]

How is that unconstitutional? It's not a law "respecting an establishment of religion, or prohibiting the free exercise thereof". Unless of course you meant that the right to so discriminate is "reserved to the States respectively, or to the people"?I think the tax penalty qualifies as "prohibiting the free exercise thereof", since there will be a federal penalty imposed on some but not others based on their religious beliefs.

Does the penalty have to be death or prison to qualify?

[Sea Cow]

Run the numbers yourself instead talking about what you suspect. If one assumes the average age of the homicides and car wrecks is 25, by itself that moves the longevity of the entire US population down by nearly year, and we only talking about a couple years of difference.
http://www.aei.org/docLib/20061017_OhsfeldtSchneiderPresentation.pdf, table 1-5
The fact that the US is an extremely violent place in which large numbers of people appear to drive like maniacs does indeed reduce the life expectancy. In comparison to most of the countries in the report you link to, the difference is worth, as you say, the best part of a year – up to 0.8 assuming 40,000 extra deaths per year and average age of death in murder/car crash of 25.

However, that is not what table 1-5 says. It makes the swing in difference due to fatal injuries between Japan and the US 4.3 years. Now, perhaps unsurprisingly, they don't show their workings in that report. Could that be because they've made their figures up?

It would mean not 40,000 extra deaths per year, but 220,000. Given that about 60,000 people are murdered/die in car crashes each year in the US, this must mean that 160,000 (adjusted for size of population) are resurrected in such incidents in Japan each year. I haven't checked Japan's latest figures, but I doubt this is correct.

BTW I'm assuming you've abandoned your third criterion, genetics? This is a science forum after all. I'm also not quite sure how the murder/road death rate affects infant mortality, in which the US performs very poorly. Are mothers going into labour on the road, perhaps? I can see how the distraction of childbirth might cause them to crash.


Facetiousness aside, beware internet 'reports' of dubious provenance. They are likely to be full of crap.

[Sea Cow]

My larger point is that it is very difficult to cleanly separate out all of the non-medical care related life expectancy causes, and given we can directly to medical care numbers why try? We have readily available numbers for the treatment of various diseases - cancer, heart disease - which are directly and almost solely dependent on medical care quality, it becomes a waste of time to try and make something of a 5% difference in life expectancy. A similar argument (unrelated causes) applies to a difference of two or three deaths per thousand in infant mortality.

You are ignoring the single most important factor in life expectancy – primary health care.

This is where the US, in particular, falls down. Left to our own devices, we will tend to scrimp on health care until we fall seriously ill, at which point we plough everything we have into trying to prolong our lives. This is one reason why health care ought to be provided communally. We're very bad, in the most part, as individuals at judging risk and making rational assessments of how we should spend today to save tomorrow. Sometimes it is good for us all to take such decisions together. This doesn't mean a loss of freedom. In fact, it is quite the reverse.

[mheslep]

? This is a science forum after all.Yes it is. In that vein, you might lay off the polemics and make some posts based on referenced information on actual medical outcome statistics. I am not at all interested in what you may or may not find personally dubious.

[Sea Cow]

Yes it is. In that vein, you might lay off the polemics and make some posts based on referenced information on actual medical outcome statistics. I am not at all interested in what you may or may not find personally dubious.
The report you linked to is wrong. Address that point.

Can you explain the 4.3-year swing between the US and Japan in the table you directed the thread to?

[mheslep]

The report you linked to is wrong. Address that point.
I am not interested in what you may or may not hand waive away as wrong without argument or reference.

[Sea Cow]

I am not interested in what you may or may not hand waive away as wrong without argument or reference.
Did you read my post? I took the trouble to read the link you provided and I have pointed out what is wrong in it and how it is wrong. That is not hand waving. It's fairly simple arithmetic.

Yes, I was sarcastic. I probably shouldn't do that. It is in fact quite a serious problem that such reports are out there and that people are believing them.

[Al68]

You are ignoring the single most important factor in life expectancy – primary health care.

This is where the US, in particular, falls down. Left to our own devices, we will tend to scrimp on health care until we fall seriously ill, at which point we plough everything we have into trying to prolong our lives. This is one reason why health care ought to be provided communally. We're very bad, in the most part, as individuals at judging risk and making rational assessments of how we should spend today to save tomorrow. Sometimes it is good for us all to take such decisions together. This doesn't mean a loss of freedom. In fact, it is quite the reverse.An individual having his decisions made by the community instead of himself isn't a loss of freedom?

I can only assume that's some kind of weird joke. :confused:

As for the point, a claim that an individual is likely to make bad decisions for himself doesn't justify using force to deny his liberty, despite the fact that such claims have been used by oppressors many times historically.

[TheStatutoryApe]

I think the tax penalty qualifies as "prohibiting the free exercise thereof", since there will be a federal penalty imposed on some but not others based on their religious beliefs.

Does the penalty have to be death or prison to qualify?

This would hinge more rightly on the Establishment Clause I believe. I think that the USSC would likely discern a difference here between religious preference and exemption based on nonparticipation. If the law specifies the Amish without exemption for any other members of a group with some form conscientious nonparticipation the court would likely simply state that the law may not discriminate and any persons seeking nonparticipation in the general health care system should be granted exemption status.

Edit: I mentioned the Equal Protection Clause. I think that this would be where the strongest argument would be (my opinion). One could argue that allowing the right of privilege to exemption for some perforce denies that right to others and further does so based on religion in violation of the Establishment Clause. In my opinion though the court would likely say that it must weigh the protected rights of the Amish (and others of a similar mind) against the alleged denial of rights to the population at large and would weigh in favour of the protected rights.

[mheslep]

An individual having his decisions made by the community instead of himself isn't a loss of freedom?

I can only assume that's some kind of weird joke. :confused:

As for the point, a claim that an individual is likely to make bad decisions for himself doesn't justify using force to deny his liberty, despite the fact that such claims have been used by oppressors many times historically.
Or, from a similar conversation:
"Why do you resist? We only wish to raise quality of life, for all species."
"I like my 'species' the way it is!"
"A narrow vision."

- Locutus of Borg to Lt Worf

[Sea Cow]

An individual having his decisions made by the community instead of himself isn't a loss of freedom?


The individual makes the decision as part of the community, rather than individually.

You appear to have a weird idea of freedom that includes the freedom not to be helped by others, the freedom to drown on your own, the freedom to be exploited by those that make ownership claims to resources you need, the freedom to carry the biggest stick you can find.

As for your point about force, all I can say is: eh? You are already forced to pay taxes. If communal provision is paid for out of taxation, the only 'force' is a change in that level. In terms of health care, the US currently has the most expensive system in the world, which provides not very good outcomes overall. Many on this thread seem not to care about the US's overall poor outcomes because the outcomes for the richest in the US are good, they themselves consider themselves well insured, and, well, basically, stuff everyone else. That's your freedom for you.

Remember that we are not all born free. We are all born helpless, and some of us are born into better environments than others in the lottery of life. This is basic stuff, really. If you wish to advocate freedom, you need to do better than this simplistic nonsense. You only seem interested in 'freedom to act'. You seem to ignore 'freedom not to be acted upon'.

To go back to the point, if everyone else is taking poor decisions and pouring too much of their health care money into the crisis at the end of their lives, under your system, that leaves me, the individual, in a worse position. The primary care infrastructure that I may want will not be there. The poor decisions of others acting individually have impinged upon my freedom to not to be acted upon.

Services such as health care are, necessarily, provided communally. Everyone doesn't have their own hospital with staff they've trained themselves, handing out drugs they've come up with in their garden shed. It's a massive collective enterprise. You think you have an effective voice in how that massive collective enterprise is run under your system? Really? You tell the insurance companies how to run things? Where's the accountability? A real, effective say in a communal decision is greater freedom than no say at all.

[Sea Cow]

Or, from a similar conversation:
"Why do you resist? We only wish to raise quality of life, for all species."
"I like my 'species' the way it is!"
"A narrow vision."

- Locutus of Borg to Lt Worf

Your quote begs the question: Do you consider those unable to afford decent health care insurance to be part of your species?



Can you explain the 4.3-year swing between the US and Japan in the table you directed the thread to?

Well?

[mheslep]

You are ignoring the single most important factor in life expectancy – primary health care.

This is where the US, in particular, falls down. ...Nicely visualized here:
http://www.youtube.com/watch?v=v8wE6D98m1c

I'd respond further but at the moment I have go drive like a 'maniac' spewing 'rubbish' out the window while running down the lesser of my species.

[Al68]

This is basic stuff, really. If you wish to advocate freedom, you need to do better than this simplistic nonsense. You only seem interested in 'freedom to act'. You seem to ignore 'freedom not to be acted upon'.This is basic stuff. You are the one ignoring 'freedom not to be acted upon'. You are insisting on 'acting on me' while I have no interest in 'acting on you'. To go back to the point, if everyone else is taking poor decisions and pouring too much of their health care money into the crisis at the end of their lives, under your system, that leaves me, the individual, in a worse position. The primary care infrastructure that I may want will not be there. The poor decisions of others acting individually have impinged upon my freedom to not to be acted upon.Failure to meet your needs isn't 'acting on' you.Services such as health care are, necessarily, provided communally.Obviously false. Too obvious to debate. Everyone doesn't have their own hospital with staff they've trained themselves, handing out drugs they've come up with in their garden shed. It's a massive collective enterprise.No, it's not. In the U.S., it's thousands of different enterprises. Do you really not know this? You think you have an effective voice in how that massive collective enterprise is run under your system? Really? You tell the insurance companies how to run things? Where's the accountability? A real, effective say in a communal decision is greater freedom than no say at all.You are the one advocating a "massive collective enterprise", not me. I don't want any kind of "system" at all. I want individual private insurance companies to compete for my business.

[Sea Cow]

I don't want any kind of "system" at all. I want individual private insurance companies to compete for my business.
That is a system.

[Sea Cow]

Failure to meet your needs isn't 'acting on' you.
It is if your needs are not met because someone else has taken a giant share of limited resources. Your concept of freedom requires infinite resource availability.

[Al68]

That is a system.It's not a system in the sense relevant to this discussion. The individual enterprises involved are operated independently, not under common management or control.It is if your needs are not met because someone else has taken a giant share of limited resources. Your concept of freedom requires infinite resource availability.This makes no sense. What limited resource are you talking about? What health care resource is running out that can't be produced any more?

What relevant natural resource isn't "infinitely available" as a practical matter for these purposes?

As far as "my" concept of freedom, here I'm using it as a synonym of "liberty". I didn't make it up.

[Char. Limit]

I don't want any kind of "system" at all. I want individual private insurance companies to compete for my business.

The problem is, they don't compete for your business. They put prices as high as they want, because they know that eventually, you'll come to them.

It's the underlying principle of most human activities... greed. Can't escape it.

[CRGreathouse]

The problem is, they don't compete for your business. They put prices as high as they want, because they know that eventually, you'll come to them.

I'm reluctant to post, but I see this reasoning often and felt the need to address it.

*****

This is clearly not the case, and it shows a lack of understanding of even basic microeconomics. If companies *can* charge any price they want (they can), and they would make more money by doing so, why wouldn't they be charging more *right now*? After all, they are driven by greed, as you say. Why would they charge $800 per month when they could charge $8000 per month?

The reasoning is flawed on two levels. First, even if they were the only company in the business, there are limits on what they'd charge. There's some point at which so many people would be priced out of the market that they would prefer to charge a lower rate (to more people) than a higher. This is what's called the monopoly price. Now if there were many firms competing, so many that no individual firm had pricing power*, then they would charge a lower rate; this is the competitive price. At present, rates are between the two: oligopoly pricing. This happens when there are enough firms to keep the prices well below monopoly rates, but not so many that firms lose their pricing power altogether.

But the real problem, IMO, is not the number of companies or their market power. It's the power the companies have (collectively) over the government itself: regulatory capture, government failure, etc.

Personally I hate health insurance companies, and I dislike buying insurance. (It's worth the price after the employer subsidy so I do buy it... but I don't think it's a good deal at face value, or even half of face value.) But if we're to find a reasonable alternative, we should look at the current system fairly.

* Suppose the going price for wheat was $4.90 per bushel and someone offered to sell you wheat at $5.00 per bushel. You'd decline, obviously -- you could get wheat from anyone else at $4.90. That seller has no market power. On the other hand, a drug company supplying patented medicine has absolute pricing power. They charge monopoly prices (not infinite prices!) because they are able to do so.

[NeoDevin]

The reasoning is flawed on two levels. First, even if they were the only company in the business, there are limits on what they'd charge. There's some point at which so many people would be priced out of the market that they would prefer to charge a lower rate (to more people) than a higher. This is what's called the monopoly price. Now if there were many firms competing, so many that no individual firm had pricing power*, then they would charge a lower rate; this is the competitive price. At present, rates are between the two: oligopoly pricing. This happens when there are enough firms to keep the prices well below monopoly rates, but not so many that firms lose their pricing power altogether.

The problem with this reasoning is that major hospitals, emergency response crews, and many of the highly specialized fields of medicine have an effective monopoly at the "point of sale". When someone is dying of a disease/injury, they (often) don't have the option of saying "No thanks, I'll take the next ambulance, they offer better rates." or "Drive me to the hospital 2 counties over, it's cheaper." Furthermore, the "monopoly price" is not determined by what individuals can afford, but rather what the insurance companies/medicare can afford.

[mheslep]

[...]
The popularity of this will continue to rise for many months as the gloom and doom predictions prove to be nonsense. Obama should also take a good bump in the polls. Former President Clinton predicts that he will see a 10 point rise in his approval rating.Tomorrow will be one month after Sunday March 21st passage. When did Clinton say that bump would kick in?
http://www.realclearpolitics.com/epolls/other/president_obama_job_approval-1044.html

[mheslep]

As it has done for the past seven years, Congress voted on April 15 (http://www.bizjournals.com/houston/stories/2010/04/12/daily65.html) to stop the doctor's Medicare pay cut as scheduled by existing law, and in so doing ended any reasonable debate as to whether or not the recent Health Reform law will reduce the deficit when matched with reality: it will not, as was specifically warned about in the last CBO report before passage.

This issue is commonly referred to as the 'doctor fix' in the media, and it refers to Medicare payments to doctors. As mentioned in an earlier post, the US Social Security Act as modified in the Balanced Budget Act of 1997 requires (http://www.cms.gov/SustainableGRatesConFact/01_Overview.asp#TopOfPage) the Secretary of HHS to provide and act on a 'Sustainable Growth Rate' (SGR) calculation for Medicare, every year, which includes what HHS figures it can pay doctors and keep Medicare solvent. Obviously Medicare is not solvent, and so prior to April 15th the law required HHS to cut Medicare doctor payments 21% (http://www.businessweek.com/news/2010-03-29/doctors-get-reprieve-from-21-decline-in-payments-from-medicare.html). As these cuts would have doctors dumping Medicare in mass, Congress has at the last minute stopped or delayed those cuts for the last seven years, without ever changing what the law required for the following year.

Yet CBO, which reported a ten year deficit reduction of $143 billion to Sen Reid, was obligated to score based on the existing SGR law, i.e. Medicare doctor spending should drop 21% (this year). CBO specifically warned about this dependency in the first of its 'Key Considerations' (http://www.cbo.gov/ftpdocs/113xx/doc11379/Manager%27sAmendmenttoReconciliationProposal.pdf), page 13:

Key Considerations. Those longer-term calculations reflect an assumption that the provisions of the reconciliation proposal and H.R. 3590 are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation. For example, the sustainable growth rate mechanism governing Medicare’s payments to physicians has frequently been modified (either through legislation or administrative action) to avoid reductions in those payments, and legislation to do so again is currently under consideration by the Congress.[...]
Many in the opposition had been vocal about this gimick; Rep Ryan spoke specifically to the President about it in the Health Care Summit on Feb. 25th (http://www.washingtonpost.com/wp-dyn/content/article/2010/02/25/AR2010022504074.html) (scroll to 'doc fix').

Well Congress acted on April 15th to revoke these cuts, as everyone knew all along that it would, so the CBO dependency is gone and with it any deficit reduction. CBO forecasts that the doc fix alone will cost $208 billion (http://www.cbo.gov/ftpdocs/113xx/doc11376/RyanLtrhr4872.pdf) over the first ten years, meaning the deficit will increase.
CBO estimates that enacting H.R. 3961 [permanent elimination of the doctor pay cuts], by itself, would cost about $208 billion over the 2010–2019 period.

There are several other serious gimicks in the Health Reform law that also forced CBO to play silly games, but this one as of last Thursday was brought into clear view. So much for I have also pledged that health insurance reform will not add to our deficit over the next decade, and I mean it.

[CRGreathouse]

The problem with this reasoning is that major hospitals, emergency response crews, and many of the highly specialized fields of medicine have an effective monopoly at the "point of sale". When someone is dying of a disease/injury, they (often) don't have the option of saying "No thanks, I'll take the next ambulance, they offer better rates." or "Drive me to the hospital 2 counties over, it's cheaper."

I'm talking about insurance companies, not hospitals. The points about pricing do carry over for hospitals but are much more complicated, since the number of buyers is small (it's an oligopsony).

Furthermore, the "monopoly price" is not determined by what individuals can afford, but rather what the insurance companies/medicare can afford.

Again, I'm talking about insurers not hospitals. But if you think that they (or any other company) could increase their profits by charging, say, 10 times more, why wouldn't they?

[NeoDevin]

Again, I'm talking about insurers not hospitals. But if you think that they (or any other company) could increase their profits by charging, say, 10 times more, why wouldn't they?

They did, that's why (almost) no individual can afford a major medical procedure without insurance.

[CRGreathouse]

They did

Citation, please.

But even if that were true, why not raise them ten-fold again? Or a trillionfold? It just doesn't hold up logically.

[CRGreathouse]

(almost) no individual can afford a major medical procedure without insurance.

Are you suggesting the insurance companies are giving out more benefits than they charge their customers? :confused:

[NeoDevin]

But even if that were true, why not raise them ten-fold again? Or a trillionfold? It just doesn't hold up logically.

Because even with an effective monopoly, there are limits, as you pointed out earlier.

[NeoDevin]

Are you suggesting the insurance companies are giving out more benefits than they charge their customers? :confused:

No, I'm suggesting exactly what I said.

[mheslep]

They did, that's why (almost) no individual can afford a major medical procedure without insurance.I expect most could afford one every 5-10 years. Certainly insurance is required to cover the most expensive of them, but many major medical procedures are about the cost of nice new car - $35k (http://www.costhelper.com/cost/health/knee-replacement.html), against a US median income of about $50k (http://en.wikipedia.org/wiki/Household_income_in_the_United_States).

[turbo]

I expect most could afford one every 5-10 years. Certainly insurance is required to cover the most expensive of them, but many major medical procedures are about the cost of nice new car - $35k (http://www.costhelper.com/cost/health/knee-replacement.html), against a US median income of about $50k (http://en.wikipedia.org/wiki/Household_income_in_the_United_States).Need a bone marrow transplant? Probably $50-250K. Need a liver transplant? Probably >$300K plus ongoing anti-rejection treatments that can run $1500-2500/month or more. Few people could afford that without insurance.

There are some types of cancer that are very expensive to treat, and dialysis for kidney failure is costly and the cost never goes away without a transplant. Treatment and follow-up for bladder cancer could easily run $100K+

[mheslep]

Need a bone marrow transplant? Probably $50-250K. [...]Along with the common course of treatment that eventually ends with a bone marrow transplant, it's closer $1 million total. As I said: Certainly insurance is required to cover the most expensive of them

[CRGreathouse]

No, I'm suggesting exactly what I said.

What you said was this (bracketed text mine):
[Insurance companies] did [charge 10 times more], that's why (almost) no individual can afford a major medical procedure without insurance.

So because insurance companies charge 10 times more, almost no individual can afford a major medical procedure without insurance.

That seems indefensible. If people can afford insurance now (a large majority of Americans are insured), and insurance companies have increased their rates tenfold, then you're saying that
1. People can afford 10 times the old cost of insurance
2. People can't afford the medical procedures provided by insurance

So for #1 and #2 to hold, insurance companies must be providing more benefits than costs (and more than 10 times the old cost in benefits).

[CRGreathouse]

Because even with an effective monopoly, there are limits, as you pointed out earlier.

Ah, so we agree that this is false:

The problem is, they don't compete for your business. They put prices as high as they want, because they know that eventually, you'll come to them.

No problem then.

[mheslep]

Medicare's chief actuary released a memorandum that confirms the increased deficits due to health care reform law (PPACA). The actuary forecasts "Federal expenditures would increase by a net total of $251 billion [2010-2019] as a result of the selected PPACA provisions"
Summary page 2:
http://www.politico.com/static/PPM130_oact_memorandum_on_financial_impact_of_ppac a_as_enacted.html

I predict the actual costs will be worse yet when they come in years ahead. None of this is affordable. What a waste.

[CRGreathouse]

I predict the actual costs will be worse yet when they come in years ahead. None of this is affordable. What a waste.

I agree that costs are probably understated even now. But what, specifically, do you mean when you say, "What a waste"?

[mheslep]

I agree that costs are probably understated even now. But what, specifically, do you mean when you say, "What a waste"?We had some good market oriented reforms on the table. The plan from McCain's advisor Douglas Holtz-Eakin that Obama-Biden demagogued to death during the campaign, and even better was Rep Ryan's plan (http://www.roadmap.republicans.budget.house.gov/plan/#Healthsecurity).

[mheslep]

On the topic of "keeping the coverage you have", I see in the same actuaries report (page 7):
We estimate that such actions [employers dropping coverage despite penalties] would collectively reduce the number of people with employer-sponsored health coverage by 14 millionbrackets mine

[Char. Limit]

Ah, so we agree that this is false:



No problem then.

Are you calling me wrong? Listen, just because I have absolutely no experience with either health care, or insurance, or even economics, doesn't mean that my opinions are not always right!

(LOL, parody)

[CRGreathouse]

Are you calling me wrong?

Well, technically, in that post I was merely seeing if NeoDevin was calling you wrong. :tongue:

[NeoDevin]

What you said was this (bracketed text mine):


So because insurance companies charge 10 times more, almost no individual can afford a major medical procedure without insurance.

That seems indefensible. If people can afford insurance now (a large majority of Americans are insured), and insurance companies have increased their rates tenfold, then you're saying that
1. People can afford 10 times the old cost of insurance
2. People can't afford the medical procedures provided by insurance

So for #1 and #2 to hold, insurance companies must be providing more benefits than costs (and more than 10 times the old cost in benefits).

I thought we were still talking about hospitals, not insurance. Sorry for the confusion.

[CRGreathouse]

I thought we were still talking about hospitals, not insurance. Sorry for the confusion.

Oh. Yeah, sorry `bout that.

[mheslep]

CBO just bumped the cost of the health care bill another $115B over ten years, that is in addition to the doc fix increases; total cost now ~$1 trillion.
http://www.politico.com/news/stories/0510/37081.html

[Zefram]

CBO just bumped the cost of the health care bill another $115B over ten years, that is in addition to the doc fix increases; total cost now ~$1 trillion.
http://www.politico.com/news/stories/0510/37081.html

This is misleading at best. According to the CBO letter (http://www.cbo.gov/ftpdocs/114xx/doc11493/Additional_Information_PPACA_Discretionary.pdf) on the subject:

The potential discretionary costs identified in both CBO’s earlier analysis and the letters provided on May 11 include many items whose funding would be a continuation of recent funding levels for health-related programs or that were previously authorized and that PPACA would authorize for future years. Some of those items include:

Section 3129 – Extension of Medicare rural hospital flexibility program ($0.1 billion over the 2010–2019 period)
Section 5207 – Funding for the National Health Service Corp ($9.1 billion over the 2010–2019 period)
Section 5312 – Funding for Parts B-D of Title VIII of the Public Health Service Act (relating to nursing workforce development) ($2.7 billion over the 2010–2019 period)
Section 5401 – Centers of Excellence ($0.5 billion over the 2010–2019 period)
Section 5402 – Scholarships, loans and educational assistance relating to students from disadvantaged backgrounds ($0.6 billion over the 2010–2019 period)
Section 5601 – Federally qualified health center grants ($33.6 billion over the 2010–2019 period)
Section 5603 – Wakefield emergency medical services program ($0.1 billion over the 2010–2019 period)
Section 10221 – Indian health improvement act ($39.2 billion over the 2010–2019 period)
Section 10412 -- Automated defibrillation ($0.25 billion over the 2010–2019 period)

CBO estimates that the amounts authorized for these items exceed $86 billion over the 10-year period (out of the roughly $105 billion total shown in the table that was provided along with the May 11 letter). Thus, CBO’s discretionary baseline, which assumes that 2010 appropriations are extended with adjustments for anticipated inflation, already accounts for much of the potential discretionary spending under PPACA.

In addition, there are a number of other items that could overlap some or even by a considerable amount with current law activities assumed in CBO’s baseline. Title V of PPACA includes many of those items. For example, section 5210 and sections 5301-5303 of PPACA replace provisions of prior law with new provisions offering a great deal more detail. The May 11 letter addresses these potential sources of overlap. The last paragraph on page 3 of that letter states: “Although Tables 1 and 2 provide more information about the discretionary costs associated with PPACA, they do not represent all of the potential budgetary implications of changes to existing discretionary programs—including both potential increases and decreases relative to recent appropriations…”

The vast majority of the discretionary spending in that estimate would be occurring in the absence of a reform bill and is not a consequence of reform (to review very briefly, reform consists primarily of: 1) instituting a new regulatory framework on insurance markets, 2) extending subsidization of health insurance to the individual market instead of keeping it confined to the group market, and 3) simplifying and expanding Medicaid eligibility thresholds).

In the same way, updating the SGR formula (which isn't even a provision in the reform bill) is something that will eventually have to be done and exists as an issue independently of any reform plan. If you want to tack that on as a cost of reform, you might as well throw in the additional expenses to the VHA associated with injuries sustained by soldiers in the wars in Iraq and Afghanistan. Those costs must somehow be attributable to reform, since we still have to pay for them after the law is implemented, right?

On the topic of "keeping the coverage you have", I see in the same actuaries report (page 7):
We estimate that such actions [employers dropping coverage despite penalties] would collectively reduce the number of people with employer-sponsored health coverage by 14 million

It might be a little more intellectually honest to quote the entire relevant paragraph, which paints a substantially different picture than you imply it does:

Employer-sponsored health insurance has traditionally been the largest source of coverage in the U.S., and we anticipate that it would continue to be so under the PPACA. By 2019, an estimated 13 million workers and family members would become newly covered as a result of additional employers offering health coverage, a greater proportion of workers enrolling in employer plans, and an extension of dependent coverage up to age 26. However, a number of workers who currently have employer coverage would likely become enrolled in the expanded Medicaid program or receive subsidized coverage through the Exchanges. For example, some smaller employers would be inclined to terminate their existing coverage, and companies with low average salaries would find it to their--and their employees'--advantage to end their plans, thereby allowing their workers to qualify for heavily subsidized coverage through the Exchanges. Somewhat similarly, many part-time workers could obtain coverage more inexpensively through the Exchanges or by enrolling in the expanded Medicaid program. Finally, as mentioned previously, the per-worker penalties assessed on nonparticipating employers are relatively low compared to prevailing health insurance costs. As a result, the penalties would not be a substantial deterrent to dropping or forgoing coverage. We estimate that such actions would collectively reduce the number of people with employer-sponsored health coverage by about 14 million, or slightly more than the number newly covered through existing and new employer plans under the PPACA. As indicated in table 2, the total number of persons with employer coverage in 2019 is estimated to be 1 million lower under the reform legislation than under the prior law.

The first thing to note is that a significant fraction of those "losing" employer-sponsored coverage are doing so voluntarily because they're getting a better deal somewhere else. The second thing to note is that the difference between projected employer-sponsored coverage under current law and under reform is 1 million, not 14 million. The CMS Actuary projects that 165.9 million people would have it under current law but under reform "only" 164.5 million will (by comparison, Census data (http://www.census.gov/hhes/www/hlthins/historic/index.html) tells us that two years ago more than 176 million people had employer-sponsored coverage). Put another way, the bit you selectively quoted might be amended to say reform will "reduce the number of people with employer-sponsored health coverage by 14 million, while current law will reduce the number of people with employer-sponsored health coverage by 13 million" if you wanted to give an accurate picture of the projections.

It's also worth considering what "if you like your coverage, you can keep it" means (http://blogs.abcnews.com/politicalpunch/2009/06/what-does-the-presidents-promise-youll-be-able-to-keep-your-health-care-plan-period-really-mean.html):

“When I say if you have your plan and you like it,…or you have a doctor and you like your doctor, that you don't have to change plans, what I'm saying is the government is not going to make you change plans under health reform,” the President said.

Now that's confusing, because I thought that phrase meant that if I like my doctor and he's set to retire, the government will step in and forbid him from retiring so that I can keep going to him. Ditto for employers voluntarily altering coverage offerings. I mean, that just makes sense, right? Now I find out this law doesn't strip doctors and employers of free will. What other surprises are lurking in there?!

Medicare's chief actuary released a memorandum that confirms the increased deficits due to health care reform law (PPACA). The actuary forecasts "Federal expenditures would increase by a net total of $251 billion [2010-2019] as a result of the selected PPACA provisions"

This is false. What does the report actually say?

The Medicare, Medicaid, growth-trend, CLASS, and immediate reform provisions are estimated to result in net savings of $577 billion, leaving a net overall cost for this period of $251 billion before consideration of additional Federal administrative expenses and the increase in Federal revenues that would result from the excise tax on high-cost employer-sponsored health insurance coverage and other revenue provisions. [...] The Congressional Budget Office and the Joint Committee on Taxation have estimated that the total net amount of Medicare savings and additional tax and other revenues would somewhat more than offset the cost of the national coverage provisions, resulting in an overall reduction in the Federal deficit through 2019.

So, yes, the CMS Actuary foresees a net $251 billion increase in federal expenditures. But that doesn't "confirm increased deficits" because there are revenue streams in the bill, which the Actuary reminds us JCT has forecast will bring in enough money to pay for that additional spending.

[Char. Limit]

Are people still on about this whole bill? Wow.

[Al68]

Are people still on about this whole bill? Wow.Apparently. Someone even resurrected a dead, year old thread about it.

[Char. Limit]

Apparently. Someone even resurrected a dead, year old thread about it.

Something gives me the feeling you're mocking me. And right now, in the mood I'm in, I'm not going to tolerate any mocking of me.

[mugaliens]

I thought it was done, dead, and gone when a Federal judge declared it unconstitutional...

[Ivan Seeking]

I thought it was done, dead, and gone when a Federal judge declared it unconstitutional...

Really? You thought one Fed judge has the final say? That isn't how the law works.

There have now been three district court rulings upholding all of the health-care reform law, and two striking down the individual mandate as unconstitutional.
http://nymag.com/daily/intel/2011/02/another_judge_rules_health-car.html

[CAC1001]

The issue will be "done" when the SCOTUS lays down their ruling.