News Assuming Affordable Care Act Is Shot Down, Should There Be a Healthcare Hospital Tax?

[CAC1001]

So I was discussing the issue of healthcare with a friend, and he pointed out something I hadn't thought of, but that I think makes sense---basically, he emphasized how Ronald Reagan signed legislation that made it where hospitals are mandated to treat a person if they are taken into the hospital, regardless of whether they have health insurance or not. And the American people would likely never support repealing such a law. Nor should it be I think. However, as Milton Friedman was fond of saying, "There is no such thing as a free lunch."

He said one of the reasons healthcare costs are increasing is because too many people without insurance use the hospital system. He said the mandate of the Affordable Care Act (Obamacare) is one of the ways the system will pay for itself. You mandate everyone has health insurance (as many of those who don't lack it due to choice), and most of the people who would then go into a hospital would have insurance. There would still be a few who did not due to legitimately not being able to afford it, but those ones the system would be able to subsidize.

Now personally, I disagree with the idea of a mandate for Constitutional reasons (I would prefer it be a tax). But if say the AFA is shot down (say by the SCOTUS), would a healthcare tax be a decent replacement policy at least? For example, create a tax to pay for the hospital system, but then make it where if you purchase health insurance, you are exempted from paying the tax?

This would not be a "universal healthcare program," but it would at least provide a way for the hospital system to be able to pay for the services it provides.

 

[ParticleGrl]

For example, create a tax to pay for the hospital system, but then make it where if you purchase health insurance, you are exempted from paying the tax?

Thats exactly how the current mandate works. You purchase insurance, or pay a tax penalty. What you are describing IS the law that was passed.

 

[Office_Shredder]

Now personally, I disagree with the idea of a mandate for Constitutional reasons (I would prefer it be a tax). But if say the AFA is shot down (say by the SCOTUS), would a healthcare tax be a decent replacement policy at least? For example, create a tax to pay for the hospital system, but then make it where if you purchase health insurance, you are exempted from paying the tax?

This would not be a "universal healthcare program," but it would at least provide a way for the hospital system to be able to pay for the services it provides.

You're describing exactly the AFA. If you don't have health insurance you have to pay a tax penalty for it.

 

[CAC1001]

The Obama administration said that it is not a tax however. If it was a tax, there'd be no Constitutional issue. They swore up and down that it is not a tax, that the Commerce Clause in the Constitution specifically allows them to mandate people purchase health insurance. That's why it is going to the Supreme Court.

While similar, mandating people purchase something and if not, pay a fine, is different than implementing a tax, and exempting those who purchase health insurance from said tax.

So I meant if the program is shot down (the mandate is found un-Constitutional), would a tax (which would be perfectly constitutional) being implemented to at least pay for the hospital system be a good idea.

Also, the mandate is just part of the AFA. The AFA also does things like place the pricing and design of health insurance under government control.

 

[Vanadium 50]

The Obama administration said that it is not a tax however. If it was a tax, there'd be no Constitutional issue. They swore up and down that it is not a tax, that the Commerce Clause in the Constitution specifically allows them to mandate people purchase health insurance. That's why it is going to the Supreme Court.

In the courts, though, they are arguing it is a tax. Yes, that's not what they said when they were trying to get it passed, but it the words of former Speaker Pelosi, "People say lots of things."

 

[CAC1001]

So I was thinking, if the SCOTUS upholds Obamacare, but says that they see it as a tax, would they in a sense be adhering to the argument the Republicans and conservatives have been giving? I mean wouldn't there be a difference between the SCOTUS saying the Commerce Clause gives the federal government the right to mandate a person purchase a product versus not saying this at all but just concluding that Obamcare doesn't do this, that it really is a tax?

Because I know some conservatives have been saying that if the SCOTUS upholds the Affordable Care Act (Obamacare), that this means that the federal government can then regulate anything, but that would be if they held that the Commerce Clause allows the government to mandate people purchase something, right? If the SCOTUS holds that the AFA "mandate" is really a tax, then wouldn't this really not change anything? Because then the original argument would seem to stand, that the Commerce Clause doesn't give the government such power, and the AFA doesn't violate it as it is a tax.

 

[WhoWee]

So I was discussing the issue of healthcare with a friend, and he pointed out something I hadn't thought of, but that I think makes sense---basically, he emphasized how Ronald Reagan signed legislation that made it where hospitals are mandated to treat a person if they are taken into the hospital, regardless of whether they have health insurance or not. And the American people would likely never support repealing such a law. Nor should it be I think. However, as Milton Friedman was fond of saying, "There is no such thing as a free lunch."

He said one of the reasons healthcare costs are increasing is because too many people without insurance use the hospital system. He said the mandate of the Affordable Care Act (Obamacare) is one of the ways the system will pay for itself. You mandate everyone has health insurance (as many of those who don't lack it due to choice), and most of the people who would then go into a hospital would have insurance. There would still be a few who did not due to legitimately not being able to afford it, but those ones the system would be able to subsidize.

Now personally, I disagree with the idea of a mandate for Constitutional reasons (I would prefer it be a tax). But if say the AFA is shot down (say by the SCOTUS), would a healthcare tax be a decent replacement policy at least? For example, create a tax to pay for the hospital system, but then make it where if you purchase health insurance, you are exempted from paying the tax?

This would not be a "universal healthcare program," but it would at least provide a way for the hospital system to be able to pay for the services it provides.

IMO - Reagan's crystal ball didn't predict the unintended consequences of allowing everyone to use the Emergency Room with or without insurance.

 

[turbo]

One of the consequences of NOT having universal health-care coverage is that providers can (and must, if they want to stay profitable) charge on a sliding scale for services. There is all kinds of hospital consolidation underway in this area. We don't need that. We need affordable services that people can afford. Unfortunately, the big insurance companies are pricing regular people out of the market.

Right-wingers like to crow about how great the US is. I would like to ask all of them to explain how Canada, England, Germany, France, and all other advanced western countries can offer universal health-care coverage to their citizens, while the "great" US cannot. Bribery is the most obvious reason, but there may be some morons in our government who actually believe that keeping health-insurance companies fat is good for our economy. Are there some adult willing to talk about this?

 

[WhoWee]

One of the consequences of NOT having universal health-care coverage is that providers can (and must, if they want to stay profitable) charge on a sliding scale for services. There is all kinds of hospital consolidation underway in this area. We don't need that. We need affordable services that people can afford. Unfortunately, the big insurance companies are pricing regular people out of the market.

Right-wingers like to crow about how great the US is. I would like to ask all of them to explain how Canada, England, Germany, France, and all other advanced western countries can offer universal health-care coverage to their citizens, while the "great" US cannot. Bribery is the most obvious reason, but there may be some morons in our government who actually believe that keeping health-insurance companies fat is good for our economy. Are there some adult willing to talk about this?

my bold - The US is "great" - isn't it?

 

[turbo]

my bold - The US is "great" - isn't it?

The US isn't great about protecting its citizens, providing preventative health care, providing care for people with catastrophic diseases without driving the survivors into ruin, or providing good end-of-life care. Canada and European countries can somehow manage to do these things. Why cannot this "great" country not do so? The simple answer is bribery and corruption at the highest levels of our government, aided by expensive ad campaigns against "socialist medicine", but it goes even deeper than that.

 

[WhoWee]

The US isn't great about protecting its citizens, providing preventative health care, providing care for people with catastrophic diseases without driving the survivors into ruin, or providing good end-of-life care. Canada and European countries can somehow manage to do these things. Why cannot this "great" country not do so? The simple answer is bribery and corruption at the highest levels of our government, aided by expensive ad campaigns against "socialist medicine", but it goes even deeper than that.

Do you have any proof of this "bribery and corruption at the highest levels of our government"? I suggest you call the FBI immediately.

 

[russ_watters]

Right-wingers like to crow about how great the US is. I would like to ask all of them to explain how Canada, England, Germany, France, and all other advanced western countries can offer universal health-care coverage to their citizens, while the "great" US cannot.

Because we choose not to.

Bribery is the most obvious reason, but there may be some morons in our government who actually believe that keeping health-insurance companies fat is good for our economy. Are there some adult willing to talk about this?

I'm not really sure...

 

[CAC1001]

Right-wingers like to crow about how great the US is. I would like to ask all of them to explain how Canada, England, Germany, France, and all other advanced western countries can offer universal health-care coverage to their citizens, while the "great" US cannot.

Well for one, probably because they spend pennies on national defense, as the United States has subsidized their security for decades. It's easy to pour money into social services that would go into defense when the U.S. is protecting you. Quite a few of those European nations also fail to provide the forces to NATO that they are supposed to. The United Kingdom is really the only exception to this in having a military that can actually project power, but even they today would have a problem pulling off something like the Falklands again.

Second is that they have higher taxes, via a VAT tax, fuel tax, automobile taxes, and healthcare mandates. The Left love to crow about how Republicans want to cut taxes for the rich on the backs of the middle-income and poor, what they do not bother pointing out is that the very policies they like to advocate (healthcare for everyone, college for everyone, etc...) require high taxes on the poor and middle-income, not the rich, to finance them.

Third is that they don't all necessarilly provide healthcare to everyone. Remember, universal coverage is not the same as universal care. Canada has seen private clinics popping up in recent years, because of the wait times that have been occurring in the Canadian system due to rationing. The English also have problems with wait times, and have among the worst breast-cancer survival rates due to rationing. Their systems are good in that they provide universal coverage, but not necessarilly care when you need it. However, the British and Canadian systems are both single-payer.

The Left have an infatuation with single-payer here in America, but single-payer is not the only means to create a universal healthcare system. Germany and France both have universal healthcare, but neither have single-payer systems. Germany's is a multipayer system that utilizes multiple non-profit health insurance providers. People are mandated to purchase health insurance from one of them (the "tax"), and for-profit private care is also available. The French, for living in a literal quasi-socialist country, want nothing to do with a single-payer system. Theirs is again a complex combination of public-private.

The Affordable Care Act, or "Obamacare," also has to utilize a tax or something similar (mandate) to finance itself.

Bribery is the most obvious reason, but there may be some morons in our government who actually believe that keeping health-insurance companies fat is good for our economy. Are there some adult willing to talk about this?

According to this link, the health insurance companies supported the Affordable Care Act (http://covertrationingblog.com/weird-fact-about-insurance-companies/how-the-health-insurance-industry-saved-obamacare ). They needed it to survive and went out of their way to appear as evil as possible so as to turn public opinion against them to revive public support for the passage of the AFA.

Remember when that health insurance company in California hiked its rates big-time right on the eve of the legislation possibly passing? If you are a major company in an industry that is about to possibly come under heavy legislation you do not want, you go out of your way to appear as good as possible. You do not go out of your way to appear evil. Bill O'Reilly was talking about them hiking their prices on his show, along with other news outlets, exactly as they probably wanted. The AFA guarantees the health insurance industry's profits. It also brings a lot of new customers to Big Pharma, who also supported the legislation.

The formal public option, where you have a separate government-run health insurance company competing against the private health insurers, the health insurance industry did not want, because this threatened their business. It could have possibly driven them out of business entirely. On the other hand, if you do the public option through the private health insurance companies, basically have the government enact a lot more regulation and control over them, but also mandate people purchase their product (health insurance), well that they were all for, as it secures their business. Big corporations are notorious for not minding heavy regulation at all as long as it guarantees their security and cuts out competitors.

The US isn't great about protecting its citizens, providing preventative health care, providing care for people with catastrophic diseases without driving the survivors into ruin, or providing good end-of-life care. Canada and European countries can somehow manage to do these things. Why cannot this "great" country not do so? The simple answer is bribery and corruption at the highest levels of our government, aided by expensive ad campaigns against "socialist medicine", but it goes even deeper than that.

In theory, the government shouldn't need much of anything to do with healthcare, just as it doesn't provide people with "universal housing" or "universal food" or "universal automobile insurance," and so forth. So it would be thought healthcare and health insurance should be handled solely by the private sector and free-market. The problem however is that the analogy of homes-cars-food doesn't necessarilly carry over to healthcare.

If your car gets a broken tail light or something breaks in it, and you take it to the mechanic but lack the money to pay for the repair or lack auto insurance, the mechanic is free to say they aren't fixing your car. But if you're a human and you break something, well you can't really have a system where you slip and crack your skull, go into the hospital, and the hospital says, "Sorry, we can't treat you because you lack health insurance." So it is now law that regardless of whether a person has insurance or not, the hospital system must treat them.

But this means that the system must pay for itself somehow as well. As Milton Friedman said, "There is no such thing as a free lunch." I think health care and health insurance can mostly still be private-sector and free-market, but that the government has a larger role to play in the healthcare industry then what it does in food, automobiles, and housing.

Another reason is that if you buy an old house, well you are in general choosing to. You can generally move out of an old house, you can generally get rid of an old car. You can also upgrade the parts of an old house too (re-do the plumbing and electrical wiring for example). A human body, however, you are stuck with. You can't trade your aging body in for a brand-new one, and you can't upgrade the parts either. So while an insurance company can get away with not even offering say collision insurance coverage for a very old vehicle, a very old person is a living human, so the situation is different.

That said, I do not like the idea of a single-payer system (I'd prefer a multi-payer system) and I do not like the idea of turning the health insurance companies into utilities. That said, I also don't know what the full solution is. I was talking with a friend who said that John McCain's plan actually was right in wanting to remove the tax incentive for employer-provided health insurance, but the problem is that the individual health insurance industry is a mess. He said that we thus need to repair the individual market first (hopefully the AFA will do this as he sees it, partially by mandating or taxing all those who choose not to purchase health insurance), and then we could reform the system further by removing the tax incentive on employer-provided health insurance.

But then you have the example of Romneycare, which Obamacare is supposedly very similar to, and yet Romneycare is plagued with its own set of problems.

 

[Al68]

One of the consequences of NOT having universal health-care coverage is that providers can (and must, if they want to stay profitable) charge on a sliding scale for services. There is all kinds of hospital consolidation underway in this area. We don't need that. We need affordable services that people can afford. Unfortunately, the big insurance companies are pricing regular people out of the market.

Right-wingers like to crow about how great the US is. I would like to ask all of them to explain how Canada, England, Germany, France, and all other advanced western countries can offer universal health-care coverage to their citizens, while the "great" US cannot. Bribery is the most obvious reason, but there may be some morons in our government who actually believe that keeping health-insurance companies fat is good for our economy. Are there some adult willing to talk about this?

While it's easy to argue against a viewpoint that no one else is arguing for, like "keeping health-insurance companies fat is good for our economy", why not instead argue against a viewpoint someone else is actually expressing?

Step one in honest debate is to acknowledge your opponent's actual viewpoint, which you consistently refuse to do, instead stating an absurd and fraudulent strawman argument to argue against. You are the one refusing to engage in honest debate.

 

[WhoWee]

While it's easy to argue against a viewpoint that no one else is arguing for, like "keeping health-insurance companies fat is good for our economy", why not instead argue against a viewpoint someone else is actually expressing?

Step one in honest debate is to acknowledge your opponent's actual viewpoint, which you consistently refuse to do, instead stating an absurd and fraudulent strawman argument to argue against. You are the one refusing to engage in honest debate.

Let's address this entire post - IMO.

We've addressed these issues in multiple other threads. It seems a waste of time to debunk these same comments once again. However, yes - there are adjustments that can be made to lower costs and expand coverage. The Government is very good at financing large capital projects. I pointed out in an earlier thread the US Postal Service is closing (perhaps a 1,000 - can't recall the number) locations. Perhaps these could be re-fitted into free clinics - to relieve the pressure and expense at emergency rooms. Perhaps doctors could be paid with tax credits to work in these clinics and medical students allowed to gain credit for hands-on training in these clinics.

Next is the insurance aspect. Insurance is the transfer of risk. How can you mandate that an insurance company accept any risk that presents? The Government (again) is very good at raising capital - if the Government creates a high risk pool that pays after insurance claims reach a maximum (transfer the risk to the pool - a re-insurance) - call it the "Government Umbrella Plan" - it might be doable. Last, there are far too many state regulations governing health insurance. We need a single standardized set of regulations for the industry (start the discussion with the overall highest standards) and allow all of the insurance companies (and agents) to offer products anywhere in the country.

 

[Al68]

According to this link, the health insurance companies supported the Affordable Care Act (http://covertrationingblog.com/weir...the-health-insurance-industry-saved-obamacare). They needed it to survive and went out of their way to appear as evil as possible so as to turn public opinion against them to revive public support for the passage of the AFA.

This has been known and verifiable the whole time, but reality is irrelevant in politics.

And not only are Americans penalized for not buying their product, it has to be a "comprehensive" expensive version of it that most people have never bought in their lives, and never would. And it outlaws any plan that isn't so expensive.

This law simultaneously outlaws every kind of insurance policy I would ever consider buying and penalizes me for not buying insurance.

 

[Al68]

The US isn't great about protecting its citizens, providing preventative health care, providing care for people with catastrophic diseases without driving the survivors into ruin, or providing good end-of-life care. Canada and European countries can somehow manage to do these things. Why cannot this "great" country not do so? The simple answer is bribery and corruption at the highest levels of our government, aided by expensive ad campaigns against "socialist medicine", but it goes even deeper than that.

So it couldn't possibly be a desire for peaceful co-existence? It couldn't possibly be opposition to using force against peaceful citizens to make them do "what they ought to do anyway", rationalizing the use of force the same way as a rapist does?

But this is characteristic of all of the economic agenda of the left: their solutions completely preclude peaceful co-existence. And they never, ever, acknowledge this. They insist on using force against peaceful citizens, yet act like they are civil, decent people. Like a rapist pretending it was consensual and expecting his victim to do the same.

It's time to face the facts: the left has no interest in peaceful co-existence, they demand to be our economic "shepherds".

As long as the left uses every line in the book to avoid discussing individual liberty in the context of their agenda, there can be no honest debate.

The only path to peaceful co-existence is to defeat the left. They will never be persuaded to "live and let live".

(Yes, I felt like ranting today. )

 

[CAC1001]

This has been known and verifiable the whole time, but reality is irrelevant in politics.

And not only are Americans penalized for not buying their product, it has to be a "comprehensive" expensive version of it that most people have never bought in their lives, and never would. And it outlaws any plan that isn't so expensive.

This law simultaneously outlaws every kind of insurance policy I would ever consider buying and penalizes me for not buying insurance.

Could they reform it to make it where cheaper, less expensive plans are available?

 

[turbo]

Could they reform it to make it where cheaper, less expensive plans are available?

That is quite possible. The US government can provide Medicare with only about 3% overhead. If you allow younger healthier people to opt-in, the total experience rate would decrease and average costs per patient would decrease simply because the pool is that much larger.

There are some things that governments can do more efficiently than smaller entities. Providing for common defense, public education, roads, rails, etc. Economies of scale factor in.

 

[Al68]

Could they reform it to make it where cheaper, less expensive plans are available?

Sure, they have always been available. I've always bought the kind that only covers major unexpected expenses, that's what actual insurance was designed for. The only reason they aren't available under Obamacare is because they are outlawed.

That's what many refuse to discuss: the new law doesn't just mandate medical insurance, it mandates a comprehensive health care plan. The former costs a fraction of the latter.

And they still fraudulently claim that anyone who declines to participate in the new system is "refusing to buy insurance". The law makes it illegal to just buy medical insurance without the rest of the plan that many don't want or need.

 

[WhoWee]

That is quite possible. The US government can provide Medicare with only about 3% overhead. If you allow younger healthier people to opt-in, the total experience rate would decrease and average costs per patient would decrease simply because the pool is that much larger.

There are some things that governments can do more efficiently than smaller entities. Providing for common defense, public education, roads, rails, etc. Economies of scale factor in.

my bold - Support please. Please factor in all of the capital costs of office space,executive salaries, marketing, HHR, CMS, and all of the new departments that have been created.

 

[turbo]

my bold - Support please. Please factor in all of the capital costs of office space,executive salaries, marketing, HHR, CMS, and all of the new departments that have been created.

From Physicians for a National Health Program.

The United States has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc. Because the U.S. does not have a unified system that serves everyone, and instead has thousands of different insurance plans, each with its own marketing, paperwork, enrollment, premiums, and rules and regulations, our insurance system is both extremely complex and fragmented.

The Medicare program operates with just 3% overhead, compared to 15% to 25% overhead at a typical HMO. Provincial single-payer plans in Canada have an overhead of about 1%.

It is not necessary to have a huge bureaucracy to decide who gets care and who doesn’t when everyone is covered and has the same comprehensive benefits. With a universal health care system we would be able to cut our bureaucratic burden in half and save over $300 billion annually.

http://www.pnhp.org/facts/single-payer-faq

 

[WhoWee]

From Physicians for a National Health Program.

http://www.pnhp.org/facts/single-payer-faq

How about a source like the CBO? Here's a "fun" read from them:

http://medicareupdate.typepad.com/medicare_update/2010/01/cbomedicarespending2020.html

"Under current law, the CBO also reports that Medicare and Medicaid spending (combined) is expected to grow faster than the economy, reaching 6.6 percent of GDP by 2020 and potentially reaching 10 percent by 2035.

In fact, the CBO states in part the following:

"The single greatest threat to budget stability is the growth of federal spending on health care - pushed up both by increases in the number of beneficiaries of Medicare and Medicaid (because of an aging population) and by growth in spending per beneficiary that outstrips growth in per capita GDP. For the nation's fiscal situation to be sustainable in future decades, growth in such spending will have to be reduced relative to its historical trend and to CBO's projected path." "

 

[Ryumast3r]

How about a source like the CBO? Here's a "fun" read from them:

http://medicareupdate.typepad.com/medicare_update/2010/01/cbomedicarespending2020.html

"Under current law, the CBO also reports that Medicare and Medicaid spending (combined) is expected to grow faster than the economy, reaching 6.6 percent of GDP by 2020 and potentially reaching 10 percent by 2035.

In fact, the CBO states in part the following:

"The single greatest threat to budget stability is the growth of federal spending on health care - pushed up both by increases in the number of beneficiaries of Medicare and Medicaid (because of an aging population) and by growth in spending per beneficiary that outstrips growth in per capita GDP. For the nation's fiscal situation to be sustainable in future decades, growth in such spending will have to be reduced relative to its historical trend and to CBO's projected path." "

Doesn't say anything about the overhead costs of medicare though, simply mentions, as you said, that healthcare is the fastest growing part of our budget... with good reason... and thus why it is (arguably, some say it helped, others say not) a good thing we passed some healthcare reform and a good reason to continue reforming our healthcare system as opposed to keeping the "status quo."

 

[Al68]

From Physicians for a National Health Program.

What? You mean a health care monopoly lobby claims that a health care monopoly is the greatest thing since sliced bread? More efficient since they don't have to trouble themselves with competing with anyone else for customers? Plus the added bonus of lawmaking power to force people to be customers?

Yep, we all know how great monopolies are, especially a monopoly with lawmaking power over its customers. Oh, what a wonderful world! And not even remotely an Orwellian nightmare.

 

[turbo]

How about a source like the CBO? Here's a "fun" read from them:

http://medicareupdate.typepad.com/medicare_update/2010/01/cbomedicarespending2020.html

"Under current law, the CBO also reports that Medicare and Medicaid spending (combined) is expected to grow faster than the economy, reaching 6.6 percent of GDP by 2020 and potentially reaching 10 percent by 2035.

In fact, the CBO states in part the following:

"The single greatest threat to budget stability is the growth of federal spending on health care - pushed up both by increases in the number of beneficiaries of Medicare and Medicaid (because of an aging population) and by growth in spending per beneficiary that outstrips growth in per capita GDP. For the nation's fiscal situation to be sustainable in future decades, growth in such spending will have to be reduced relative to its historical trend and to CBO's projected path." "

That's a great bunch of misdirection which does nothing to support your argument that Medicare is not an efficient program. Surely you can do better.

Certainly, medical costs are a great threat to our nation's wealth, but that's because the system drives up costs. We could establish a system similar to Canada's in which everybody is covered, and bring costs under control, to improve our country's finances and protect personal wealth in the face of catastrophic illnesses.

 

[Al68]

We could establish a system similar to Canada's in which everybody is covered, and bring costs under control, to improve our country's finances and protect personal wealth in the face of catastrophic illnesses.

But then where would Canadians go to get good timely health care?

 

[WhoWee]

Doesn't say anything about the overhead costs of medicare though, simply mentions, as you said, that healthcare is the fastest growing part of our budget... with good reason... and thus why it is (arguably, some say it helped, others say not) a good thing we passed some healthcare reform and a good reason to continue reforming our healthcare system as opposed to keeping the "status quo."

Turbo is the one who made the claim - but hasn't supported properly.

 

[WhoWee]

That's a great bunch of misdirection which does nothing to support your argument that Medicare is not an efficient program. Surely you can do better.

Certainly, medical costs are a great threat to our nation's wealth, but that's because the system drives up costs. We could establish a system similar to Canada's in which everybody is covered, and bring costs under control, to improve our country's finances and protect personal wealth in the face of catastrophic illnesses.

YOU Sir made the claim - it's YOUR job to support your claim.

 

[turbo]

YOU Sir made the claim - it's YOUR job to support your claim.

I did so. It's not my fault that you have an idealogical resistance to the support.

 

[WhoWee]

I did so. It's not my fault that you have an idealogical resistance to the support.

You quoted from a website labeled (PNHP) "Physicians for a National Health Program" and I "have an idealogical resistance"?

Please support their "facts" - I don't see their source anywhere - do you?

 

[russ_watters]

Here's a rebuttal of turbo-1's myth (these are easy to find): http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf

The cost of collecting the insurance "premiums" (taxes) isn't included in that 3%. The real overhead fraction is much higher, but very difficult to calculate because government accounting isn't transparent, whereas private insurance company accounting is (ironic).

It also, of course, doesn't speak to the effect of competition on the cost of the care itself. Overhead fraction is misleading if the cost of care isn't identical.

 

[WhoWee]

Here's a rebuttal of turbo-1's myth (these are easy to find): http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf

The cost of collecting the insurance "premiums" (taxes) isn't included in that 3%. The real overhead fraction is much higher, but very difficult to calculate because government accounting isn't transparent, whereas private insurance company accounting is (ironic).

Great find Russ! Again, the same failed arguments seem to be made every time one of these healthcare threads begins - nothing new.

 

[russ_watters]

There are some things that governments can do more efficiently than smaller entities. Providing for common defense, public education, roads, rails, etc. Economies of scale factor in. [emphasis added]

As a conservative and a believer in freedom and it's mirror personal responsibility, I believe that the government should provide only those services that the public can't provide for themselves.

 

[turbo]

Great find Russ! Again, the same failed arguments seem to be made every time one of these healthcare threads begins - nothing new.

Think that Russ' source is honest and unbiased?

http://www.sourcewatch.org/index.php?title=Council_for_Affordable_Health_Insurance

 

[Antiphon]

Russ, good point but let's sharpen the definition so the leftists can't pull a fast one.

It should provide only those services that the public can't, even in principle, provide for themselves.

No individual can, even in principle, build the interstate highway system.

The leftists will try to twist your words into the following pretzel: "Well, there are lots of poor who can't afford health insurance. They can't provide it for themselves, so everyone else should be forced to do it for them."

 

[WhoWee]

Think that Russ' source is honest and unbiased?

http://www.sourcewatch.org/index.php?title=Council_for_Affordable_Health_Insurance

Have you found support for YOUR post yet?

 

[Gokul43201]

Russ, good point but let's sharpen the definition so the leftists can't pull a fast one.

It should provide only those services that the public can't, even in principle, provide for themselves.

No individual can, even in principle, build the interstate highway system.

But individuals can certainly travel without it (and did).

Try this: no individual can, even in principle, create a government healthcare system.

 

[ParticleGrl]

As a conservative and a believer in freedom and it's mirror personal responsibility, I believe that the government should provide only those services that the public can't provide for themselves.

You need to define can't in this context. Certainly anything that the government provides, a private sector COULD provide.

The question is more desirability. Is it desirable to have large, private armies on American soil? Probably not so much. Hence, a public army.

Could private companies provide police and jail services? Yes, but its the potential for abuse is pretty high (not that the current system is perfect). Hence, public police,courts, jails.

So how do you draw the line on what's desirable? If it could be shown that the government could provide the same (or better) health care at a lower price, should we go with a government health care problem? Or should our ideology direct us to spend more money?

 

[Vanadium 50]

It also, of course, doesn't speak to the effect of competition on the cost of the care itself. Overhead fraction is misleading if the cost of care isn't identical.

That is, in fact, the larger effect. Administrative dollars per patient are slightly larger in dollars per person (an average of around 20%, but with large year-to-year fluctuations - nevertheless, private insurance is uniformly cheaper) for Medicare than for private insurance. But costs for direct patient care are ~3x larger for Medicare, so as a fraction of total expenditures, this number is smaller.

My personal view is that neither the Right nor the Left is using the proper number - and they both just happen to pick a number that makes their case look best. You have two kinds of costs - costs that (on average) scale per patient, and costs that (again, on average) scale per procedure. You need to model that before making any comparisons between programs with such widely different patient cohorts.

There is also the additional complication of the overhead that is involved in monitoring fraud. In 1995 (the latest number I have found) private companies investigated 42,950 cases. This year, the equivalent number for Medicare is 867. Reducing fraud reduces the amount paid out, and increases the overhead (because you have to pay someone to find it), and thus makes the outfit attempting to reduce fraud appear less efficient in the ratio.

 

[WhoWee]

That is, in fact, the larger effect. Administrative dollars per patient are slightly larger in dollars per person (an average of around 20%, but with large year-to-year fluctuations - nevertheless, private insurance is uniformly cheaper) for Medicare than for private insurance. But costs for direct patient care are ~3x larger for Medicare, so as a fraction of total expenditures, this number is smaller.

My personal view is that neither the Right nor the Left is using the proper number - and they both just happen to pick a number that makes their case look best. You have two kinds of costs - costs that (on average) scale per patient, and costs that (again, on average) scale per procedure. You need to model that before making any comparisons between programs with such widely different patient cohorts.

There is also the additional complication of the overhead that is involved in monitoring fraud. In 1995 (the latest number I have found) private companies investigated 42,950 cases. This year, the equivalent number for Medicare is 867. Reducing fraud reduces the amount paid out, and increases the overhead (because you have to pay someone to find it), and thus makes the outfit attempting to reduce fraud appear less efficient in the ratio.

Part of the problem is the administrative, regulative, and compliance burden placed onto (and in some cases transferred to) the insurance industry by CMS.

 

[russ_watters]

Think that Russ' source is honest and unbiased?

http://www.sourcewatch.org/index.php?title=Council_for_Affordable_Health_Insurance

Oh dear lord, turbo! Even your link criticising the bias of my link has an adjenda:

The Center for Media and Democracy (CMD) publishes SourceWatch, this collaborative, specialized encyclopedia of the people, organizations, and issues shaping the public agenda. SourceWatch profiles the activities of front groups, PR spinners, industry-friendly experts, industry-funded organizations, and think tanks trying to manipulate public opinion on behalf of corporations or government.

They don't even list your special interest group.

So please, cut the crap and attempted burden-of-proof shifting. Both your link and my link include facts that are easy to understand and judge. There is no need to read the opinions of either much less attack either. The facts are the facts and the context behind them is clear.

 

[russ_watters]

But individuals can certainly travel without it (and did).

Yes, and...?

Try this: no individual can, even in principle, create a government healthcare system.

That's a pointless tautology.

 

[russ_watters]

You need to define can't in this context. Certainly anything that the government provides, a private sector COULD provide.

That's not really true. Roads and a military are a good example of things that simply can't be done privately. Recently, we've seen examples of failure of communities offering private fire departments. We're getting down to real basics here: this is essentially the whole point of government! We've recently lost touch with that with the emergence of the idea of the welfare state.

Some of the reasons:
1. Funding. If you make things like a fire department private, people won't fund it. We saw this recently with the case where a fire department sat by and watched a guys's house burn down because he wasn't paying the monthly fee.
2. Roads provide a host of problems: standardization/consistency, eminent domain. There is just no way that large-scale private roads could be made and actually be functional.
3. Control and effectiveness. Who runs all the private militaries and how could they possibly provide protection for a single state?

The question is more desirability. Is it desirable to have large, private armies on American soil? Probably not so much. Hence, a public army.

No. That's just plain not accurate. Private armies on a national scale would not be able to function. They must be under the control of the federal government or the federal government ceases to be the federal government!

Could private companies provide police and jail services? Yes, but its the potential for abuse is pretty high (not that the current system is perfect). Hence, public police,courts, jails.

...um...so in other words, they would be pretty much non-functional?

So how do you draw the line on what's desirable? If it could be shown that the government could provide the same (or better) health care at a lower price, should we go with a government health care problem? Or should our ideology direct us to spend more money?

Since there is an ocean of difference between 'could government provide the same or better' and the other examples which would be vastly worse to the point of being non-functional, it isn't a fair comparison. Again, with the inception of the welfare state in the 20th century, many people have become comfortable with the idea that government provivde everything for them, even if it could be done privately (or worse, provided by themselves!).

Believing that if the government can, it should, is forgetting history.

 

[Gokul43201]

Yes, and...?
That's a pointless tautology.

As is the one I was responding to. And ... that was the point of my response.

 

[russ_watters]

As is the one I was responding to. And ... that was the point of my response.

Well I'm glad we're in agreement about what you said, but what I (and Antiphoton) said was most certainly neither a tautology, nor pointless.

You're trying to obfuscate a concept that is both real and clear.

Heck, Gokul, you (and particlegirl) are basically arguing that anarchy would work fine, therefore we should have government provide us with everything. It's not just wrong, it's nonsensical.

 

[russ_watters]

Russ, good point but let's sharpen the definition so the leftists can't pull a fast one.

It should provide only those services that the public can't, even in principle, provide for themselves.

No individual can, even in principle, build the interstate highway system.

The leftists will try to twist your words into the following pretzel: "Well, there are lots of poor who can't afford health insurance. They can't provide it for themselves, so everyone else should be forced to do it for them."

I didn't at first see the difference between what you said and what I said, but I do now...

Yes, you are correct that the "even in principle" part is critical. This should be obvious given the two-sided coin I mentioned before of personal freedom and personal responsibility (which is why I overlooked it), but people just aren't thinking that way anymore. We've gone so far beyond "even in principle" though, with now 47% of tax filers paying no federal income tax and thus not contributing to the cost of the associated federally provided services. People don't even have to fail or choose not to provide for themselves - we're not even asking them to anymore.

 

[Gokul43201]

It is as much a tautology that a public individual can not build The Interstate System as it is a tautology that a public individual can not exert governmental control over healthcare.

My argument is farther to the right than yours - I'm saying that private roadways are not, in principle, impossible.

 

[russ_watters]

It is as much a tautology that a public individual can not build The Interstate System as it is a tautology that a public individual can not exert governmental control over healthcare.

It most certainly is not. Yours was a tautology because you included the word "government" in it. You made yours logically impossible - you made it self-contradictory by its very wording. A privately-run state road/interstate system is functionally impossible. Meaning that people could try it, but it wouldn't work.

This isn't a word-game, Gokul.

My argument is farther to the right than yours - I'm saying that private roadways are not, in principle, impossible.

You haven't made any arguments yet! This is the first I've seen of a point from you! So: why do you believe that private roadways are possible? And please, don't make this about small-scale communities. I live in such a community and my 1/4 mile road is privately-owned and works fine. This isn't about that.

Governments need to build and maintain roads because private companies wouldn't build roads where/how they are needed, they'd build them where/how they could make the most money. So people in rural areas would suffer, maintenance and quality would suffer, etc. The need for government control of roads is exactly the same as the need for government control of the power grid. Even as private companies own the wires, they are essentially just government contractors at that. People in rural areas would still not have electricity today if the government didn't require it.

 

[Gokul43201]

It most certainly is not. Yours was a tautology because you included the word "government" in it. You made yours logically impossible - you made it self-contradictory by its very wording.

Antiphon made his logically impossible by his choice of words: The Interstate System. The existing interstate system could not, even in principle, be operated privately (it goes through government owned and protected lands, etc).

A privately-run state road/interstate system is functionally impossible. Meaning that people could try it, but it wouldn't work.

That's your contention, and might very well be true. But it's also a slightly different choice of words than antiphon used.

This isn't a word-game, Gokul.

It's not a word game - maybe a nitpick, if you wish.

You haven't made any arguments yet!

I didn't wish to. Pointing out an error in an existing argument is not against forum rules.

This is the first I've seen of a point from you! So: why do you believe that private roadways are possible?

I didn't think the clarification was necessary to understand what I was saying. And at that point I had no intention of going further - didn't have the time for it either, but I've burned that bridge now.

To answer your question: In many parts of Asia (probably in the US too), plenty of roadways are born privately, and operated privately until they recoup construction costs and then the government takes over ownership. Italy has thousands of miles of private highways. There are probably many more such countries that I'm unaware of. I suspect you will find better arguments in the wiki page on "free market roads" than you will from anything I write here.

And please, don't make this about small-scale communities. I live in such a community and my 1/4 mile road is privately-owned and works fine. This isn't about that.

It's not.

Governments need to build and maintain roads because private companies wouldn't build roads where/how they are needed, they'd build them where/how they could make the most money. So people in rural areas would suffer, maintenance and quality would suffer, etc. The need for government control of roads is exactly the same as the need for government control of the power grid. Even as private companies own the wires, they are essentially just government contractors at that. People in rural areas would still not have electricity today if the government didn't require it.

I don't object to the government providing a road system in areas where private industry will not (were that to become necessary). But the present interstate system clearly does a lot more than just that. I'm also not in opposition to a government system to provide for heath assistance in situations where private industry will not. Clearly, I think, a system of Universal Healthcare does a lot more than just that.

This is about all the time I have today. I hope I've made my arguments abundantly clear. You may disagree with them, but that would be an improvement.