UNINFORMED IDIOTS!

[HughMoran]

UNINFORMED IDIOTS!

This is an actual account of what we are up against WRT healthcare reform. Forget “not left enough” or “too centrist” or “too far right” for a minute and read what a typical non-political person from a right-leaning Northeast family is thinking…

The company President and I were discussing the impact of the Senate election on healthcare reform. We’re both for reform as it’s killing us financially & she (the president) has a pre-existing condition which means we can’t ever change insurance carriers. A young (late 20’s) purchasing person was sitting quietly while we discussed this. At one point the company president looked at the purchasing person and asked “so, what is your opinion of healthcare reform?” She said “I’m not for anything that the government is involved in”. We were dismayed & pointed out how insurance rates are 3x higher for our small business than for large businesses. She said “but the coverage is different”. I said, “No, these are both identical Blue Cross PPO plans – no difference”. This didn’t faze her at all. “Look at Canada” she said, “if you’re 60 years old they won’t let you have a heart transplant.” We both explained that this was untrue. The president asked if she saw MMs movie Sicko, and she said “I hate Michael Moore”. :eyes: We then pointed out that US medical outcomes are worse than in many other modern countries, even though we spend much more on health coverage. We told her that our healthcare system is much more expensive, but ranks down there with third-world countries. We explained that the C of C was fighting this reform even though small businesses like ours were suffering due to the current system and that the C of C was essentially anti-small business – “small business being the engine of the economy” I said. Unfazed, she says “look at the excellent coverage that Congress has”. We agreed & I mentioned a few additional points that I now forgot (I was a bit peeved at her by now) & went to lunch. During lunch I devised some questions for her to answer:

1) My 75 year old father has had multiple operations on his heart recently – what insurance do you think he has? (ans. - Medicare)
2) Who runs Medicare? (ans. - Federal Government.)
3) That fantastic coverage that Congress has – who’s in charge of administering those plans? (ans. – Federal Government)
4) Did you know that the BCBS PPO that Congress has is not much different that what this company offers, but at 1/3 the cost?
5) Do you think it’s fair that small companies pay 3x the premiums that big companies (& Congress) does?
6) Do the bills currently being considered in Congress include a government run insurance plan? (correct answer - No - so much for the Canada "they won't cover it" lie)
7) Do you think it’s fair that people are denied coverage due to pre-existing conditions and that some insurers kick people off coverage when they get sick?
8) Do you think there should be lifetime caps on coverage, after which the insurance companies simply say “you’re on your own”?
9) Should small companies be able to band together and buy insurance at low rates like Congress and big companies do (AKA exchanges)?
10) Who pays the medical bills of people who go to Emergency rooms without insurance? (ans. - we all do in our insurance rates)
11) Do you think it's right that 54 million people in the greatest country on earth can't get insurance at all?

After a typical person answers in the expected fashion, you can simply exclaim “You’re for the healthcare reform bill that Congress is about to pass!!” ... “Well, was going to pass until folks on your side gleefully voted out the one chance we had to get reform in our lifetimes!”

This isn't about left, right or center, it's about who's team is going to win the "Game" and who can best manipulate their flock of "fans", also known as "Americans". We're a nation of uninformed idiots.

[Berry Cool]

1. Ah, but you are very smart, HughMoran.

You understand that you have to start at the bottom with these people and educate them. All their lives they've been listening to and believing sound bites and currying hatreds fed to them by someone else, rather than figuring out the facts for themselves. You need to make them realize they are actually for what they think they are so vehemently against.

[county worker]

2. The federal government does not run Medicare.

It is run by companies like Palmetto GBA. Check it out.

http://www.palmettogba.com/palmetto/palmetto.nsf/DocsCat/Home


"Palmetto GBA administers Medicare health insurance for the Centers for Medicare & Medicaid Services (CMS). We have been a Medicare contractor since the inception of the program in 1966 and provide service throughout the United States and its territories. Palmetto GBA is a wholly owned subsidiary of BlueCross BlueShield of South Carolina and is based in Columbia, South Carolina."

They are called financial intermediaries. They administer Medicare.

[HughMoran]

4. Should I have said "administered"? It's obviously a government funded program

...even it the feds don't do all of the actual contract work.

[county worker]

7. I think that being funded by the government only means it's funded by us.

So many people think Medicare is similar to a single payer system. It isn't. It is insurance paid for by us through payroll deductions and employer contributions. It is mandated insurance for seniors.

[HughMoran]

14. Got it

I'm going to leave the wording as is as most people think of it as a Federally run program.

[johnaries]

66. Isn't that only for Medicar Advantage, which the bill cuts

because of outrageous overpayments? If I'm not mistaken, the government does administer Medicare except for Advantage.

[ourbluenation]

3. You are damn right and Faux News is leading the way.

The Hannity's of this world are taking the uninformed masses and leading them off a cliff, along with the rest of us who don't want to go. What can be done about this?

[HughMoran]

After this discussion, I went into the presidents office and went OFF on what I called "Nazi News"

She was loving every minute of it. We are so angry at the stupidity of our own employees who depend on us for a paycheck.

[Joanne98]

5. Fire her

[ourbluenation]

8. oh please. really?

you can't be serious.

[T Wolf]

15. Why not? If it is a small business, it is toxic to have such an idiot on the payroll.

Her statements themselves would disqualify her from any position requiring a three-digit IQ.

There are plenty of worthwhile people out there who need jobs. Give it to someone more deserving.

[Winterblues]

27. Why, you want stupid people working for you?

Anyone that stupid should work for Fox news or some similar place.

[T Wolf]

10. Agreed. Fire her reich-wing ass and tell her it is because of high medical premiums. nt

[The Doctor.]

12. You know better than that...

but I understand the impulse.

[HughMoran]

16. She's not a bad person, just an uninformed idiot from a right-wing family

I plan to "corrupt" her over time as she is still young enough to learn new things :)

[Robb]

33. Wow. How progressive. nt

[glowing]

6. Its very true.. Obama should have stuck his neck out on this one.. and they

should have gone for single-payer. Everyone understands Medicare-for-all. It works well enough and its easy to explain. Public Options and decreasing Medicare funding gets the old people's panties in a wad thinking they will get less. When Social Security increases were put on hold this year, my husband's grandmother was all a twitter... I told her at least you didn't take a pay cut which is what my husband and I got. Also, ins is now $600.00/ mo and we have a ton of co-pays. She couldn't believe how much we pd for stuff. She's 80. They've had s.s., retirement bennies, medicare, tri-care because poppa was a marine... For almost 20yrs the woman has been living off the govt and giving her a grounding in the real world shocked the hell out of her. Finally, she saw how unfair it all was. Fox news lies to her. One reason they voted for Obama was because of Bush's mis-use of service people... and Obama continues the same actions.

[ourbluenation]

13. and so then what? Give in? We all know this already, what I want to know is

what can be done about it?

[glowing]

19. No, Don't give in. Push for real reforms.. The major reason for having the White House is that

you can use it as the bully pulpit to direct the message and the country. He can speak well. Most progressives believed he'd use his calm reasoning and rhetorical gifts to move this country forward. He could have gotten single-payer medicare for all buy in for this country easily. It has full support nation wide anyways.

[The Doctor.]

9. This is the frightening truth right here;

"This isn't about left, right or center, it's about who's team is going to win the "Game" and who can best manipulate their flock of "fans", also known as "Americans". We're a nation of uninformed idiots."

The right co-opted everyone with a sport's-fan mentality to their cause. That way, they can have a mass of mindless, screaming morons preventing the rational and attentive people from bettering the nation and taking power and prosperity back from corporations.

[HughMoran]

17. Yep

I gritted my teeth when I wrote that. Arrgh! :argh:

:banghead:

[Echo In Light]

60. +1 ... yes; the macho mentality hates equality & altruism, & disavows common sense w/factoid logic

[Deep13]

11. Stupid people in large groups. nt

[Octafish]

18. Ask her if she likes the Pentagon.

Or better yet, a specific branch of the service. Say, "the Army." That's a government program.

So's fighting two wars -- both illegal, immoral and unnecessary -- is something the government is involved in.

She might even be surprised to learn it costs us more than a trillion dollars a year.

[deaniac21]

23. 944 billion between 9/11 and end of fiscal 2009

http://www.fas.org/sgp/crs/natsec/RL33110.pdf

DUers MUST get their facts straight!

[Octafish]

57. I'm talking about the entire Pentagon budget.

It's coming out to more than a trillion a year. And that's from 2007, so I guess it's more now.

But, right you are, if you're just counting the wars:

'Unprecedented' Spike in Defense Spending: New Report Cites Inflated Goals, Failed Reforms and Weak Priorities as Cause.

[deaniac21]

58. bunch of bucks

The United States Department of Defense expenditures for fiscal year 2009 are $651.2 billion. This does not take into account military spending outside of the Department of Defense, which when included increases the figure to between $859 billion and $1.16 trillion.

From wikipedia

[inthenever]

20. counter

Hi all. This is my first post. I'm probably a bit of an oddity for this group, but I was forwarded a link and thought this might be an interesting place for discussion. I'm an academic (medical), independent supporting such social issues as homosexual marriage and encouraging smaller government.

I think some of the points in this healthcare argument made by the OP are arguable in other directions.

"We then pointed out that US medical outcomes are worse than in many other modern countries, even though we spend much more on health coverage. We told her that our healthcare system is much more expensive, but ranks down there with third-world countries."

There a couple of issues here. One the third world reference only applies in certain contexts. Further, environmental/cultural variables must be considered. For example, type II diabetes which can lead to/co-occur with many other high incidence conditions (stroke, heart attack) is influenced heavily by behavior (dietary content, physical activity). Socialized medical care would not fix this.

Further, part of the reason for the high cost of our healthcare system is BECAUSE of government intervention (e.g., the creation of HMOs, which transfers money from professionals to business people. The system does need reform, but I think we could go a different direction with the targeting of our educational efforts. For example, we might promote the idea of insurance as a catastrophic option (not a pay for everything option). We might talk about medical savings accounts. We might talk about expense priorities (shelter first, food second, insurance third. . . or whatever). But, a big government solution isn't the first thing that I'd lean to. While I understand the allure of a powerful central government, politicians have motivations that are independent and not always in the best interest of everyone else. Government is inefficient. Politicians often are unaware, when they construct a bill, of overarching ramifications. Consolidation of power into the hands of a few (which is what we do by ceding power to the central government to manage various aspects of our lives) is a recipe for tyranny. It doesn't matter if the original intention is benevolent, eventually, you're going to get a bad outcome with loss of freedom. It also makes no difference, in my opinion, if it is a progressive liberal ideology, a classical liberal ideology, or some bastardized neo-con movement that has the central power. So, when we look for solutions for big issues, I sympathize with the, as presented in-articulate worker who sparked the ire of the OP. Distrust of central government is healthy (forgive the double meaning).

[HughMoran]

21. Welcome to DU!

I don't have time to discredit the BS you've just posted, so I'll simply ask you this - are you in any way linked to the insurance lobby in this country? It sure sounds like it...

[inthenever]

22. Response

No, I'm a professor at a medical school.

It's not BS, in my humble opinion. There are a lot of very complicated issues in play here.

I'm also not real fond of the insurance industry (I just slammed HMOs, did I not?). But, I can tell you that medicaid, for example, is often pro bono work for medical professionals. Medicare is large enough that when it changes its rates, insurance companies follow suit. There's a lot of overhead in the system that is unnecessary. There's a lot red tape non-sense that makes doing medical jobs unnecessarily difficult. Billing code complications, denials of service, bachelors level folks from other educational disciplines making decisions on treatment and diagnostic options, etc. . .Introducing more big government into the mix seems like a recipe for worsening an already bad situation. And no, a single payor system (I'm aware that the current plan does not include this) does not fix this problem. It makes it worse. Because, then it IS an absolute monopoly.

[me b zola]

28. This is a progressive message board

Pro bono work for physicians, oh the humanity! :eyes:

Listen professor, people are literally dying in the US because of lack of health care and the attitudes and policies that you embrace.

[inthenever]

34. Response

The attitudes and policies I am embrace have not been implemented in this country. No one is dying because of them. My interest is in the greater good, this is a progressive construct, yes/


Pro bono work is great, I do a lot of it. . . but I'd prefer to do it voluntarily than by force.

[me b zola]

46. Sucks to live in a third world country

People would prefer to live without access to health care volunarily than by force.

Insurance serves nobody except the CEOs of insurance companies. It is a wholly unnecessary barrier between people and health care.

[inthenever]

51. Insurance and CEOs of insurance companies

"Inurance serves nobody except the CEOs of insurance companies. It is a wholly unnecessary barrier between people and health care. "

Not considering the enormity of the insurance industry and the jobs it provides, are you suggesting a pay for play system? Insurance is a method of limiting risk with collective input. Eliminating insurance places that burden on the individual. I do think that would lower the cost of things like primary care, but it would make more advanced treatment and assessment very burdensome. Introducing the government instead of insurance companies brings in lots of unwanted problems. . . bigger government (big brother), dictator-like qualities in a large segment of the economy. We don't need a few politicians deciding how all of healthcare will work. . . politicians mind you, who are elected because they look good, sound good, and know how to network. None of these qualities imbue politicians with any particular wisdom or practical knowledge in the management of well. . . anything. They are mostly ignorant buffoons in a number of areas. Why would we want to entrust such a monumental responsibility to them for the entire country? That seems very foolish.

[Jakes Progress]

31. I got this kind of crap from a young friend.

She is in medical school also. She is a flaming liberal in all aspects except this. She mildly dislikes the insurance and pharma companies and hates all lawyers. She is convinced that the nasty government is going to capture her and her friends and make them cure people for free. When pressed, it comes down to fear that the mystique and privilege that goes with a medical degree will be eroded if we have universal health care. She doesn't think good doctors will work for "Medicare Wages".

I think the medical schools foster this elitist line and instill fear in their charges. She's really quite bright but come up short and sputtering when you press her about health care in America.

[inthenever]

well

Btw, I am not a physician, I am a neuropsychologist (PhD clinical psych). I make far less than most physicians. Medicare just cut our reimbursement rates by 20% this year. Fortunately, I am buffered from this by the fact that most of my job is medical research. But, I feel for my very well educated colleagues that are getting shredded financially. That's 5-7 years of graduate school (average), 1 year of internship, 1-2 years of postdoc . . .and some can barely make a living. Some do quite well, but medicare and medicaid aren't helpful much of the time. Especially, when they screw us over with huge cuts a year after they grant us a professional rate (finally). Forced pro bono work, indeed.

You can understand when you consider that medical school requires 4 years of grad school and 3-4 years of residency along with 100,000+ of debt. You have to make money. Further, we see the HMO and insurance execs raking in the dollars based on our work. We see administrators in the hospital making good money dealing with insurance companies and the government. Annoying is not the word. It's not fear or elitism, it's indignation. You talk about rising costs; since I started graduate school (which was a long time ago now, I've been for a while), incomes in my field have dropped substantially. . . why? Because of monopoly, because of political lobbies allowing scope creep from uneducated paraprofessionals, etc. . . I now do clinical work because I like it, on the side. I like to help people. I'm glad it's not my primary source of income. Because, I'd be really hostile right about now. You figure, with the malpractice insurance rates as they are, the roadblocks to efficient reimbursements, the public's general aversion to paying for medical service (I don't get this), and now pressure from government, that future medical students have got to be pretty slow to consider this career.

[Jakes Progress]

56. Lots to discuss here.

First you are exchanging views with a former public school teacher. Thirty five years at the trade, eight years of college, years of learning my craft. Never broke 50K. But see, It was never about money for me. I did the job because it was what I was called to do. I tried doing something else that made double the money for half the work for a few years. Went back to the classroom. It was where I mattered and where I was needed.

So here's a solution to your worry about the college debt. How about we pay all doctors the same salary and pay for their schooling. With no college debt (not a deal I was ever offered) maybe you wouldn't mind starting at about $25K and working for thirty years with a one or two percent raise every year.

Maybe then we would get doctors whose primary interest was healing and who wouldn't turn up their noses at elderly patients because the government won't pay them enough to dirty their hands. Don't tell me it's not elitism and ego when your indignation rant never mentions the plight of those you are supposed to serve but centers only on how little you are paid. Before you get really hostile, just figure out how a family with three kids with the flu can possibly afford to have them all treated at the usual doctor's visit rate. You would understand their hostility if you ever had to live on a regular income. I hope that any future medical students who base their career decisions on just how to maximize their income would be slow to consider a career in medicine. I wonder how they get all those doctors in Canada and France and Britain and Holland and..... Well you get the idea.

Now I admire many physicians. My own family doctor is a gem. He does a nice little practice and does three days a week at free clinics. My ophthalmologist gives three months a year working for free in South America. Then there is the clown who blinded my friend's mother. He was supposed to correct a problem he did in operating the first time, but this time he cut open the wrong eye. Then he sent her, blind, home. He blamed her and said she made him operate on the wrong eye. Then when she tried to get compensation to pay for the help she now has to have to just live, he changed his records as did the hospital. They basically got together with their insurance friends and decided a set of lies to tell. Doctors in the town won't see the 88 year old woman because she had the audacity to expect for the "Doctor" to pay for the damages he caused. The whole medical "community" gathered round the clown and offered their integrity to protect him from paying for what he did. She wasn't suing for millions or a fortune. She just wanted the money she will now be out for help and services because she is now blind, which she wasn't before she went to him.

If you don't view your profession as a privileged class, maybe you will begin to see that colluding with the insurance industry and supporting pharma doesn't exactly make people feel sorry for your "plight".

[inthenever]

64. Reply to public school teacher

"First you are exchanging views with a former public school teacher. Thirty five years at the trade, eight years of college, years of learning my craft. Never broke 50K. But see, It was never about money for me. I did the job because it was what I was called to do. I tried doing something else that made double the money for half the work for a few years. Went back to the classroom. It was where I mattered and where I was needed. "

I'm an academic. I make more than 50k. But, then again, with my background I could have gone to an Ivy law school. I understand making decisions because of the work and not the money.

"So here's a solution to your worry about the college debt. How about we pay all doctors the same salary and pay for their schooling. With no college debt (not a deal I was ever offered) maybe you wouldn't mind starting at about $25K and working for thirty years with a one or two percent raise every year. "

Maybe so, but that's not what's currently on the table. Further, why not do that to other fields as well? E.g., lawyers. They are essentially agents that interface with out government, shaping the law of the land. Why not take away the commission based law we currently have and pay them all the same. I'm not a physician. I have a PhD, not an MD. I don't have any college debt. . . scholarships to undergrad and grad school. Even so, I wouldn't take that deal. .. starting at 25K and working for thirty years with a one or two percent raise every year. Figure, the average teacher starts when they're 21. They've attended college for four years in an easy major. To get an MD or do what I do requires a lot more training, talent, hours, effort, and opportunity cost than does becoming a primary or secondary school teacher. Though I enjoy my job, I got my first reasonably paying position when I was 30.

"Maybe then we would get doctors whose primary interest was healing and who wouldn't turn up their noses at elderly patients because the government won't pay them enough to dirty their hands."

Maybe. . . and maybe you'd get doctors who aren't very good, or very bright. Physicians and other health professional do a lot to serve our communities. I can't work for what medicaid would pay me. . . if I were doing 100% clinical work. I'd make less than a Walmart greeter (accounting for overhead, etc. . .). Sorry, but that's a raw deal. Further, the skill/talent level required to be a physician merits reward. If in a free market, they would get it, so the supply and demand issues support that as well. Given that these are talented people, if you made them work on the cheap, you will have massive brain drain. I've thought of getting out many times. What I do is stressful and I could, quite frankly, make a lot more money with a lot less effort expenditure doing something else. And I wouldn't get sanctimonious grief for wanting to be paid.

"Don't tell me it's not elitism and ego when your indignation rant never mentions the plight of those you are supposed to serve but centers only on how little you are paid."

Elitism and ego? Sure. But, I have compassion for my patients and those on whom I conduct research to understand their conditions. Why else would I do it? I want our system to serve the needs of as many people as it can, at as high a quality level as we can, while still advancing our knowledge. Many solutions proposed. . . more midlevels, lowering compensation, I think may have some short term benefits in getting more people seen, but would be harmful in the long term in stunting development of health technology (including intellectual resources) and in the promotion of a lower standard of education and hence lower standard of student as the modal health care provider. Compassion great; skill is greater.


"Before you get really hostile, just figure out how a family with three kids with the flu can possibly afford to have them all treated at the usual doctor's visit rate."

Why did a poor family have three kids? I don't have any and I'm 35. Why don't I have any? Because, I haven't accumulated enough resources yet to feel comfortable raising them. Personal responsibility must extend to reproduction decisions.

"You would understand their hostility if you ever had to live on a regular income. "

I live on a fairly "regular" income. . . ish. Well, ok, no. But, I have lived on a regular income. And yes, I'd feel very stressed out making $17,000 a year like I did on internship (after 9 years of post high-school education) if I had three children. But, whose fault would that be?

"I wonder how they get all those doctors in Canada and France and Britain and Holland and..... Well you get the idea. "

Many of them try to come here. But, in Britain, doctors make quite a bit of money. Their educational systems are different.


"My own family doctor is a gem. He does a nice little practice and does three days a week at free clinics. My ophthalmologist gives three months a year working for free in South America."

And those are not uncommon stories. The department chair at my last university goes to Alaska every year to help them set up infrastructure so that hospital services are available and emergency services are available in rural areas.

"If you don't view your profession as a privileged class, maybe you will begin to see that colluding with the insurance industry and supporting pharma doesn't exactly make people feel sorry for your "plight". "

Privilege is an interesting word. I view Paris Hilton as a priviledged class. Me, I have to work. . . a lot. Sometimes I envy the secretaries, carpenters, and electricians that I encounter in my daily walks through the hospital. It must feel nice to turn it off when you go home. But, like many in creative fields (again, I'm a scientist), I'm a tormented soul. It never turns off. I wake up in the middle of the night and run statistics. I lay in bed and think about theories and I can't sleep because I need to solve... whatever. But, that's me. That's what I do. I like my job. I like helping others, but it's not an easy thing to be. I also don't collude with insurance or big pharma. Nor does anyone I work with.

[TheWatcher]

36. You don't have time, or you can't?

Guess which one I'm guessing?

You have time to toss in a cheap insult though.

Very typical.

[HughMoran]

40. Still at work - I can't spend too much time on deciphering a somewhat long post right now

Thanks for assuming the worst though - I bet you unrecced this thread too since you don't seem to like me.

:hi:

[HughMoran]

45. What is your response?

Did you search through this thread just to find a post to attack me on, then run away like the coward that you clearly are?

[TheWatcher]

62. Another insult. What a surprise.

I hate to burst your ever-growing bubble of self-importance, Hugh, but what you posted wasn't important enough to respond to.

But if you are so hard up for a response, I guess it would be thus.....

"Still at work - I can't spend too much time on deciphering a somewhat long post right now"

Ahhhh, nice cop out and deflection.

And yet nearly 48 hours later you still don't have a response to the poster's thoughts.

Which just reinforces my stance that you CAN'T.

The coward is you, my friend.

You can't refute, you can only insult.

As for going out of my way to attack you, again, you are too full of self-importance to realize you hardly matter that much, or carry that much relevance.

All I did was ask you a question, and made an observation based on your weak-cop out, thinly veiled accusation pathetically disguised as a question, and the unnecessary insult, and your fake little welcome.

That poster did not attack anyone, it was his first post, and whether you agreed with him or not, he made a genuine attempt at making points and attempting to have a discussion.

And instead of engaging him, You responded in a childish, insulting manner. And 48 hours later, you still have made no attempt to engage his points. (Of course, at this point, even if you did, it would probably be in the form of some kind of yes-bot spin or propaganda, so maybe it's better.)

Now, don't make the mistake of thinking I endorse what he posted, because I don't necessarily share his point of view either.

HOWEVER.

He attempted to engage in discussion. You needlessly attacked him. Pretty simple.

And it's true Hugh, I don't like you, and it's pretty clear you don't like me. I know this may come as a disappointment to you, but I am pretty unaffected by it. :)

It's pretty funny actually. For someone who claims to religiously have me on ignore, you go out of your way to respond to my posts which you are ignoring.

Why, if I didn't know better, I would think I get under your skin, just a little.

Thick head, Thin skin.

That's my Moran!

Now, there is your response Hugh. I hope you enjoyed it. Now you can return to your fantasy world where I am hiding under my bed, considering suicide as a preferable option over having to live in fear of you.

::Kiss Kiss:: :rofl:

(And one more thing. If I fail to respond to your follow-up, which your ego will dictate that you make, please don't engage in the misunderstanding that I am hiding from you. The most likely reason will be one of two options: 1. I have something much more important to do (Like watching paint dry) 2. I could not give less of a shit what you think.) :)

[jtuck004]

26. Exploring some of these ideas

You do make some cogent points - and thank you for posting. This is a good place to talk about ideas, (well, most times, till the keyboard experts go nuts), and I am exposed to information I may never get otherwise. I also appreciate the fact that you are an academic, so please forgive some of my incorrect punctuation and capitalization. They have nothing to do with the content of the ideas ;) It's just that I am multi-tasking...

I am a big proponent of the government stepping into the insurance business. I think a public option is the only way we can guarantee at least a minimal level of coverage, and I think it will serve as a curb to higher prices. But perhaps there are other ways to think about this...

I agree with you that distrust of central government is healthy, which would lead to an idea that an individual is better off on their own. On the other hand, the most amazing things we have ever done have been done collectively. So we have a constitution and a bill of rights to insure that the "tyranny" can be broken down.

You are correct, changing the medical provider is not going to influence behavior. Though there are other diseases, do you happen to know how the rates of type II diabetes differ in countries where they do have a centralized or socialized health care? I was wondering if perhaps people go to doctors more when they are well, and can then be alerted to the need to change their behavior, instead of here where 15% (or more) of our neighbors, those with no insurance, don't find out until they have damage, and may not find treatment even then.

I am hoping you have seen the site "sick for profit" and are at least somewhat familiar with Sicko. You in fact did talk about the evil HMO's, so at least we have some common ground. While I agree that perhaps the government should possibly not be the "first" provider we should look to, what other choice makes any sense?

1) If insurance becomes more of a "catastrophic option", would that not lead to a gradual deterioration of health in the population, because people likely will not get care until their diseases are much more advanced? With 46 million people unable to get insurance, (I attribute this to lack of income, since with enough money most anyone can have coverage, or at least pay for their care). That would seem to leave us in the same boat we are in.

2) Medical savings accounts only helps people with jobs, seems dependent on how long you have worked, does nothing to control costs, etc. It also seems to move away from the standard insurance concept of a lot of individuals paying into a pool and spreading the risk.

3)While politician may not always have our best interests at heart, the health insurance companies make the politicians almost seem like Mother Teresa, could you agree? And the last I heard, we are the government. That was proved last night in Massachusetts - so much for tyranny. On the other hand, the power we have given to insurance companies has no control except for the policies set by the government (us), and those are heavily influenced by the profits the insurance companies use to influence politicians instead of providing health care. What freedom do most people have with the present system? They have no control over these companies at all...unlike the government.

My optimal solution would be a public option that simply covers everyone with some basic health care. Those who are fortunate enough to opt out for more money would be free to do so, as long as they are required to pay back any money they cost the system if, and when their insurance company dumps them or cuts off their benefit, perhaps along the lines of Canada. Our only other alternative is the freedom to start our own insurance company and see if we can get better deals at lower prices...

I know this is a little scattered. But although we agree on some things, it sounds like we look at this from far different perspectives. What is it that I don't know that you have had the advantage of learning?

[inthenever]

32. response

"I also appreciate the fact that you are an academic, so please forgive some of my incorrect punctuation and capitalization. They have nothing to do with the content of the ideas ;) It's just that I am multi-tasking..." No worries, same here. . . and I make my share of errors as well. Hell, on of the best academics I know is dyslexic. . . terrible grammar.

"I am a big proponent of the government stepping into the insurance business. I think a public option is the only way we can guarantee at least a minimal level of coverage, and I think it will serve as a curb to higher prices. But perhaps there are other ways to think about this..."

Without diving into an issue, my natural inclination to "We should have the government step into. . ." is no. When we start thinking about healthcare, percent of GDP, and centralized government, I start to get really nervous. Now, many of you would consider me to be a right wing lunatic as would many of my friends consider me to be a left wing lunatic. I tend to fall in line most consistently with libertarian minded folks and classical liberalism. I think, though, that the goal is the same. The right to pursue health and happiness that serves the needs best of the as many people in our population as possible. These goals are best served with an initial focus on economic power. Historically, strong central government intervention in business results in a loss of economic power. I think we are on a teeter totter. My fear is that we are fighting two forms of aristocracy, government and corporate. For example, the way "free" trade has evolved (with more and more outsourcing of jobs. . . beyond manufacturing) attacks our middle class. It also creates a business class that is independent of country and, in my opinion, promotes greater consolidation of wealth in the hands of the few as companies move their base of operation from 3rd world economy to 3rd world economy to 3rd world economy. In any case, in my opinion, and I am no expert (I'm a neuroscientist, not a political scientist or economist), the government would do well to butt out of health care. I think the majority of our citizenry would benefit from this. Because, I think the economics of healthcare would change. I think where the government could intervene would be in situations like illegal immigration. This has significantly affected the economy of healthcare, particularly in border states with flooding of emergency rooms. I think we have a form of exploitation going on there that is problematic. A few businesses benefit from the presence of illegal workers, but they are putting off the costs of doing business onto the American public and onto hospitals/medical professionals. Further, they are driving down the value of labor, but I digress. The government could introduce criminal penalties for hiring illegals and dry up some of the carrots drawing these people into the country. This might alleviate some of the current burden on the healthcare system.

Much of the elevating costs of healthcare are within the red tape, not the practice of medicine. Much of that red tape has to do with the government and their rules. It ends up requiring we hire multiple billing people, administrators to deal with specific agencies, panels, and so on. This drives up costs of doing business. Further, we have advancing technologies that are more expensive. One of the issues brought up in the healthcare debate has been rationing. Obviously, we ration healthcare currently. I do find it somewhat of a hypocracy that congress has a serious cadillac insurance plan and yet, they want to offer something less to the American public. By the way, someone else in this thread mentioned they had communist healthcare (based on military service. . . sorry, but no you don't, you earned your healthcare). In any case, if we would find a way to cut the red tape it would go a long way to lowering costs of healthcare. We could probably even pay physicians and other health providers more, which would be great as it would influence better talent to come into the field. Instead, we have a push towards more midlevels performing in roles they aren't trained for (social workers taking over psychologist roles, nurses taking over physician roles, etc. . .), which lowers overall talent/performance providing medical services in the country.

"I agree with you that distrust of central government is healthy, which would lead to an idea that an individual is better off on their own. On the other hand, the most amazing things we have ever done have been done collectively. So we have a constitution and a bill of rights to insure that the "tyranny" can be broken down."

Our constitution and bill of rights are flimsy shields against the potential tyranny in the interpretation of a "living" document.

"Though there are other diseases, do you happen to know how the rates of type II diabetes differ in countries where they do have a centralized or socialized health care? I was wondering if perhaps people go to doctors more when they are well, and can then be alerted to the need to change their behavior, instead of here where 15% (or more) of our neighbors, those with no insurance, don't find out until they have damage, and may not find treatment even then."

I don't know. But, I do know that medical professionals often give up on their overweight patients and don't even try to counsel them to exercise or eat better, instead electing to prescribe medication. Why? Because behavioral change, at that stage, is seriously challenging. What we need is a cultural shift. In other countries, for example, Italy, the rate is a bit lower than the US. The people are also slimmer, on average.


"While I agree that perhaps the government should possibly not be the "first" provider we should look to, what other choice makes any sense?"

Education on health hygeine. . . treat exercise like brushing one's teeth, focus on personal responsibility in regards to both carrying insurance and being a personal medical advocate.


"If insurance becomes more of a "catastrophic option", would that not lead to a gradual deterioration of health in the population, because people likely will not get care until their diseases are much more advanced?"

I don't know. I think it depends on your definition of catastrophic. For example, primary care isn't necessarily all that expensive, especially compared to other household expenses. .. getting a physical once a year, paying for allergy medication or antacids (other common meds) are not cost prohibitive on an individual level. Cancer, on the otherhand, is catastrophic, regardless of the level of cancer. You have to treat it. That should be an insurance cost. Treating a cold, not so much. We need to emphasize preventative medicine, but it needs to be done in a more patient proactive way.


"With 46 million people unable to get insurance, (I attribute this to lack of income, since with enough money most anyone can have coverage, or at least pay for their care). That would seem to leave us in the same boat we are in."

That number is disputable. Further, when we look at average household incomes, etc. . ., we see that many can in fact afford insurance, especially in the younger age groups (where it is substantially cheaper and where the rate of uninsured is quite high, comparatively).

"Medical savings accounts only helps people with jobs"

True. The current unemployment rate in the US is around 10%; that's really high rate historically in this country. 10% of the population is what 28-30 million people these days? Further, most of that 10% is not chronically unemployed. That rate is much lower.

"seems dependent on how long you have worked, does nothing to control costs, etc. It also seems to move away from the standard insurance concept of a lot of individuals paying into a pool and spreading the risk."

Collective risk applies to catastrophic things. . . like car insurance. If your car insurance bill is less than $500, many people just pay that out of pocket. . . why? Because their insurance might go up. Some of the health insurance adjustments people have discussed would be akin to running your car into ground, crashing into a bunch of stuff, never changing the oil, and then going to Geico, signing up for insurance and submitting a claim to get everything fixed. Now, that's a fantastic return on your dollar, but if you weren't paying into the system, that's not collective risk.

"While politician may not always have our best interests at heart, the health insurance companies make the politicians almost seem like Mother Teresa, could you agree?"

No, I don't. Politicians are pretty much on par with personal injury attorneys in my book. The motivations of insurance companies are clear. . . politicians, not so much.

"And the last I heard, we are the government."

I don't agree. We, the people, are sheeple. .. pawns to be moved around by the government aristocracy. We maintain a degree of power over that, but even then, we, the people, are gullible and easily influenced by marketing campaigns of the rich. Further, the more we turnover to the federal government, the more we lose with respect to our ability to affect change in a way meaningful to our existence.

"the power we have given to insurance companies has no control except for the policies set by the government (us)"

If there were more insurance companies, free market principles would have an effect. If the government didn't have a rate setter (e.g., medicare/medicaid), free market principles might produce some surprising results.

"What freedom do most people have with the present system? They have no control over these companies at all...unlike the government."

The government is not an ally.

"What is it that I don't know that you have had the advantage of learning?"

I think there is no obvious right answer. I haven't learned it. I have an opinion based on my general world view and my observations of the healthcare system. I am a student of history and philosophy (my hobbies) and I like to think I make informed and rational judgments. But, I think there are far too many variables in play for anyone to be 100% confident in a result.

[jtuck004]

61. Finally an answer

Sorry about the delay in responding to your post, I had a customer with some computer problems to fix...my own focus on economics.

Interesting answer. The post names you an "academic neuroscientist", implying that you have at least 18 to 20 years of education in schools which primarily exist because of government funding, yet states that "the government is not an ally". Perhaps you did it by correspondence, but I would guess not. Even private universities that do big research exist on millions of dollars of government money, or private money taken as profits from others, and also use the same infrastructure we all use. In any event it would seem, despite the post, like you had an ally in someone's government.

The post says the figure of 46 million people without insurance is "disputable. that seems reasonable. The U.S. Census bureau published those figures as 45.7 in 2007 and 46.3 in 2008, other places say it is higher. Take out the illegal immigrants that the post calls out as a burden. For now, we will leave the fact that we built one of the most powerful and creative countries on the planet with the cooperation of immigrants from all over the world (as well as exploitation and murder of Native people, but that's another post). Remove the potential potential over count of people on medicare as well. We are still left with about 35 million of our neighbors who have no care. I hope that's better, but it doesn't feel any better. Oh, and it is double that number for those who are without health care for a part of the year. And when they go back to renew might they hear "pre-existing condition"?

The post infers they should just pay for primary care out of pocket, save insurance for something else. That's not an unreasonable expectation if you are looking at the average per capita income in households, around 40K-50K a year. But that same Census report says there were about 39.8 million people living in poverty in 2008. There are 48 levels (talk about red tape) but you can figure that means people who are living on, roughly, $11,000 ish dollars per year. Food and a not so great rental place and that paycheck is gone. Clothes for the kids? A trip to a museum? Insurance? Are you kidding? (well, not you personally). But to make it easier, let's take 9.89 million off that number as a sop to the "disputable" nature of such numbers. I'm easy.

That leaves us with tens of millions of people who may go year after year without even minimal comfort, much less any care short of an emergency room. Maybe not even that. It is quite likely they will not have food every day for them or their kids, relying on school lunch programs or perhaps meals on wheels. Food stamps, sure. Nothing says self-esteem like food stamps. The post mentions a $500 expense on a car as a very casual thing. For many of these people a car is just a dream. The post says that the 10% figure for unemployment is not chronic. There are a lot of people for whom a couple years of unemployment sure feels like chronic. Is this the libertarian part of the philosophy? If so, I now know why it has nothing for me.

The post states that the goals of health and happiness are best served with an initial focus on economic power. (and maybe that qualifier "initial" is getting at what I am about to say). Those with the most economic power benefit far more than others, and tens of millions are simply left behind. This pursuit of profit, especially as it has become less regulated, has ruined a lot of people in this country over the past several years. Government is the only hope of controlling the excesses of capitalism. I will grant that there is an enormous amount of red tape in medicine, especially that introduced by insurance and medicaid funding requirements. But I am certain that we would be better off spending the hundreds of millions in profits garnered the pharmaceutical and insurance companies on actual health care. (United Health just announced a 30% increase in profits in the 4th quarter. How does that help anyone without insurance? How does it help the CEO who made $3 million dollars last year with $744 million in un-exercised stock options? Oh yeah, his stock options increased).

The post seems to insinuate that these people, our neighbors, should depend on businesses to float their boat. Given that the aim of business is profit, what would the motivation to help possibly be? They don't need these people, except perhaps as cheap labor, for which the immigrants mentioned in the post serve as an example. The virtues of "free trade" which business extols, (some of the dangers of which the post highlights), makes other markets possible. As noted, business routinely avoids costs - the air they pollute and the water they poison paid for by the people in the nearby communities they ruin stand as prime examples. If a worker can't afford a decent running car, if they are old, or if they are anything other than something that produces a profit for the business, they are outside the walls. However, the costs the post attributes to illegal immigrants flooding our emergency rooms are more a result of our policies than a desire by them to wait until they are miserably sick to go sit in an ER for a half a day waiting for an overpriced injection. (And how dare they look at our success and desire the same for themselves and their families? Doggone it, what gives them the right to cut into the front of that huge line of people waiting to ruin their backs in picking fields, tire shops, slipping in the blood on the floor of the packing plant, working for people whose first concern when people get hurt is whether they messed up the machine? And why is it that when they leave there is no line behind them, except for other illegal immigrants?).

We would probably agree that the government is destined to fail when trying to create jobs. On the other hand, government policies can help business create such jobs. But when the business climate is such that such jobs cannot be created, the government - sans profit - can provide work, which people desperately need for the benefits work provides: order, structure, dignity, and opportunity for growth (thank you Rich Benjamin), until the climate is conducive for business to create those jobs. There is real value in that, and sometimes a new public park or bridge.

While I understand that their choices play a part in some situations, external influences can put people in such situations with appalling regularity. And the pursuit of profit by business does this with a terrible efficiency. After being beaten down enough such a person simply cannot muster the personal responsibility that some philosophies insist is necessary. We can't depend on business to address this - there is no profit. On a small scale individuals can effect some change, and some businesses moderate their pursuit of profit with an eye toward social justice. We started a nonprofit to bring spay/neuter for the pets of people living in areas of low income. We hire veterinarians (great people) and bring supplies and equipment, and invite (gently) the people to work with us to address the issue of pet overpopulation in their own neighborhood (we won't just do it for them), and in doing this we try to provide a hand up, if they can grab hold. But when talking about health care for tens of millions of people with little hope of monetary profit, government may well be the only hope.

I like history too, and nearly everything I have read says that when large populations are in trouble, in great need, or could be helped by big infrastructure that cannot or is not being addressed by business, a democratic government, (or maybe sometimes a benevolent dictatorship) is terribly handy to have. The post states "the government is not an ally". Despite the fact that government can be misused (Iraq) , I suspect there are a lot of people in Haiti today thankful that the resources of this government have been brought to bear on that tragedy. The post mentions that there are a lot of variables. Certainly. Ours is the same country that gave money and arms to the French to beat back (unsuccessfully) a slave revolt in Haiti around 1790, lest they inflame the slaves in captivity here (did it anyway). So I don't think government is predestined to evil. While the post states that "Our constitution and bill of rights are flimsy shields against the potential tyranny in the interpretation of a "living" document", this is a government "by the people and for the people" (thank you Abe) and those documents appeared quite sturdy in Massachusetts a couple nights ago (whether one agrees with the outcome or not).

This is getting way too long-winded (one of my real liabilities), but the post used terms such as aristocracy, tyranny, and "sheeple" (cute). While I do see some elements of an aristocracy, the fact that most people would rather watch television than a political debate may have more to do with our educational system than anything endemic to government. "We want one class of persons to have a liberal education, and we want another class of persons, a very much larger of necessity in every society, to forgo the privilege of a liberal education and fit themselves to perform specific difficult manual tasks" (thank you, sort of, Woodrow Wilson). And we really haven't moved much beyond that. We could teach reading with a Tom Paine pamphlet as easily as we do the milk toast curriculum we use, exposing people to the responsibilities of freedom. Want to scatter administrators like cockroaches from under a cabinet? Introduce a student to the essay on the school\student relationship at: http://ry4an.org/readings/short/student/. Subversive and educational. We focus on schedules and dates instead of introducing students to the bloody and messy history which would cause some serious cognitive dissonance and keep them fascinated. We gripe that people watch tv and don't go to citizen's meetings, and then put television sets in the classroom. Why we should expect more I have no idea, and this lays directly at the feet of those who control our local school boards. The lack of vision in our national educational policy is breathtaking. And they/we are the government, at a very fundamental level.

"Tyranny" seems a little strong. Tyrants are often killed, and don't typically have a popular election held every few years to see whether they can keep their position. I find it ironic, a little humorous, and even a bit whiney that people gather in this country to speak and act like thugs, brandishing firearms and teabags, and then have to put all that up so they can muster up the strength to pull a voting lever, which is their real power. Personally I think they ought to charter a plane to stand in Tienanmen Square while criticizing the government of China. Those that survive would be screaming for our form of government as their bloody bodies were being dragged off to a not-so-nice prison cell. Now that would be an education.

Thank you for posting. Though I think we disagree on some points, I appreciate your opening your beliefs up for study, and I hope I was respectful of them even when I disagreed. Maybe it's a good thing that "there is no obvious right answer" - it keeps us busy striving for it. And if you see anything factually incorrect I would appreciate knowing.

[inthenever]

63. Hi. . . reply.

"The post names you an "academic neuroscientist", implying that you have at least 18 to 20 years of education in schools which primarily exist because of government funding, yet states that "the government is not an ally". Perhaps you did it by correspondence, but I would guess not. Even private universities that do big research exist on millions of dollars of government money, or private money taken as profits from others, and also use the same infrastructure we all use. In any event it would seem, despite the post, like you had an ally in someone's government."

Yes, I have a Ph.D. No, I never paid anything for my education. . . full academic scholarships to undergrad and graduate school. Yes, some of that money was public funds. I currently hold a few government grants, along with some private foundation work. But, the government needs things. It needs to invest in science and technology. Because, these things are part of the life blood of a nation. We have contractors for defense (Boeing, Lockeed Martin, among myriad others). I see my role as similar. I perform a service for the government and in exchange for that, they pay me. I see the value in government programs. But, we must keep in mind purpose and psychology. For example, the GI bill was a very successful government program. Welfare. . . not so much. Social security is a pyramid scam. Al Gore talked about a "lock box" for social security. Barack Obama claims he is fundamentally opposed to privitizing social security. But, there is no lock box. Because all those trillions of dollars that have been collected in social security are spent as soon as they come in the door by the government in their general budget. A true lock box would actually reflect a physical holding, like those statements we get in the mail imply every year. So, when I say the government is not an ally, what I mean is that there are many forces in play in government, some positive and some negative. A big and powerful central government is a danger to its people.


"For now, we will leave the fact that we built one of the most powerful and creative countries on the planet with the cooperation of immigrants from all over the world (as well as exploitation and murder of Native people, but that's another post)."

Sure, what the US did to the native Indians was wrong. But, we exist. We are a nation. It is in our best interests to promote the development of this nation in a positive direction. There is an emotional complexity to this situation. Allowing the rapid expansion/illegal immigration in the Hispanic community has fundamentally changed the demographics of this nation, for better or for worse. But, that's a debate for another time. The reality, to me, is that we should be attacking the carrot that brings the illegals here. We have an immigration system. It is our right to control the flow of immigration, to say who comes to our country and who does not. Those that ignore that, harm us.


"That leaves us with tens of millions of people who may go year after year without even minimal comfort, much less any care short of an emergency room."

Yes, tens of millions in a country of 300,000,000. Greater good. How is it best served? Do we scrap a system that most Americans are happy with and implement something radically different to deal with the poor? What effect will this have on the economy? It's not something that we can just jump into, in my opinion. I think reform needs to happen in the healthcare industry. We need tort reform. We need to get rid of commission based law in the health care litigation arena. We need to get rid of HMOs. We need to de-complicate the current billing system in interfacing with the government programs that are out there (medicaid/medicare).

"The post says that the 10% figure for unemployment is not chronic. There are a lot of people for whom a couple years of unemployment sure feels like chronic. Is this the libertarian part of the philosophy? If so, I now know why it has nothing for me."

I see the government, economy, and the people as a system. It is a complex system. To make an analogy to the human body, if we over-compensate for a small problem (e.g., treating allergies with large doses of Benadryl, we may jeapordize other parts of the system (benadryl is an anticholinergic and can have a negative impact on memory performance). It is such a complex system, that I have little confidence in those who may be elected (politicians look and sound good. . . beyond that, well. . .they aren't people I'd hang out with or respect. . . C students, drug users, sexual scandals, corruption, frat guys, beauty queens. . .this isn't the stuff of great analytical skill). Because of this complexity, I tend to support ideas that take power away from central government, keep it distributed and weak, so that smaller systems, that are not as complex are able to be effective.

"Those with the most economic power benefit far more than others, and tens of millions are simply left behind. "

The standard of living for our nation's poor far outstrips that of most of the world's population. This is because of our economic power.

"This pursuit of profit, especially as it has become less regulated, has ruined a lot of people in this country over the past several years."

Less regulated? Hmm . . . You may be referring to the housing issue. The Fannies, Lehman Brothers. . . at the heart of the collapse were government created entities with poorly thought out government mandated policies that were anathema to business practices in the banking industry, melding poorly with existing short term incentive structures. They guaranteed to buy loans. This spurred a relaxation in credit determinations, fueling record housing purchases that the government trumpeted as signs of the attainability of the American Dream. This isn't deregulation. It's government stupidity. . . reflecting again, my opinion that our relatively incapable public servants have little positive to contribute to anything.

"Government is the only hope of controlling the excesses of capitalism. "

It is a balance. Looking at our government's budget, we are tilting far to the left.


"But I am certain that we would be better off spending the hundreds of millions in profits garnered the pharmaceutical and insurance companies on actual health care."

Pharmaceuticals push research and development in medicine. The government is not qualified to distribute or make decisions about where those dollars go. Nor should they be allowed to interfere. Insurance companies, in their current incarnations, are heavily tied to government policy. . . reporting methods, medicare rate adjustments all are tied together.

"(United Health just announced a 30% increase in profits in the 4th quarter. How does that help anyone without insurance? How does it help the CEO who made $3 million dollars last year with $744 million in un-exercised stock options? Oh yeah, his stock options increased)."

Hey, I'm not a big fan of CEO excess. I think they, in general, get far more credit than they deserve for the success or failure of a company. Further, I think their skillsets aren't that unique that they merit the level of compensation they receive. However, I don't want government dipping their hand into that world. I would prefer an internal correction.

"The post seems to insinuate that these people, our neighbors, should depend on businesses to float their boat. "

Barring disability, they can create their own businesses. They can work for someone. Yes, business provides flow in the economy which allows are country to function, including the government. Business is not our enemy.


"However, the costs the post attributes to illegal immigrants flooding our emergency rooms are more a result of our policies than a desire by them to wait until they are miserably sick to go sit in an ER for a half a day waiting for an overpriced injection."

I agree, our policy of not enforcing immigration laws and not cracking down on businesses that use illegal labor is a serious problem.

"(And how dare they look at our success and desire the same for themselves and their families? Doggone it, what gives them the right to cut into the front of that huge line of people waiting to ruin their backs in picking fields, tire shops, slipping in the blood on the floor of the packing plant, working for people whose first concern when people get hurt is whether they messed up the machine? And why is it that when they leave there is no line behind them, except for other illegal immigrants?)."

I'm not hostile to illegal immigrants. I understand their motivation. But I don't think our country nor our culture can absorb all of them. And, if given amnesty, like we did in 1986, it will encourage even more. It's becoming a not so silent invasion, supplanting our culture. . . e.g., Miami, where I grew up. I couldn't go home, because I don't speak Spanish. . . couldn't get a job there. I'm sure I could now, but when I was fresh out of undergrad, no way.


" the government - sans profit - can provide work, which people desperately need for the benefits work provides: order, structure, dignity, and opportunity for growth (thank you Rich Benjamin), until the climate is conducive for business to create those jobs. There is real value in that, and sometimes a new public park or bridge."

I agree.


"We started a nonprofit to bring spay/neuter for the pets of people living in areas of low income. We hire veterinarians (great people) and bring supplies and equipment, and invite (gently) the people to work with us to address the issue of pet overpopulation in their own neighborhood (we won't just do it for them), and in doing this we try to provide a hand up, if they can grab hold. But when talking about health care for tens of millions of people with little hope of monetary profit, government may well be the only hope."

That's awesome!

"I like history too, and nearly everything I have read says that when large populations are in trouble, in great need, or could be helped by big infrastructure that cannot or is not being addressed by business, a democratic government, (or maybe sometimes a benevolent dictatorship) is terribly handy to have."

But, a big all-powerful one is dangerous. . . see Weimar Republic. Our government thru Republican and Democratic administrations has increased spending like drunken sailors picking up hookers. We have huge debt, huge. We can't print money and expect it to hold its value. It's irresponsible. With the government taking on more and more responsibilities (e.g., universal healthcare ideas, retirment of the baby boomers and hit from social security

"Despite the fact that government can be misused (Iraq) , I suspect there are a lot of people in Haiti today thankful that the resources of this government have been brought to bear on that tragedy."

Surely. But, that doesn't change the fundamental nature of government. Democracies fail for a few reasons. George Bernard Shaw has a great quote or two, "Lack of money is the root of all evil," and " government that robs Peter to pay Paul can always depend on the support of Paul."

"So I don't think government is predestined to evil."

With enough power, I think that is an inevitable occurrence. With enough power, that evil is bigger than it would otherwise be.


"The lack of vision in our national educational policy is breathtaking. And they/we are the government, at a very fundamental level. "

I agree is some ways. But, the problems in our educational system are as much symptoms of our diversity, rapid influx of immigrants (that don't speak our language), and a culture that in general does not value the kind of education about which you write. I was talking to an old professor one day. Famous chap. We were driving to a conference. He was thrilled to discuss his old high school; he visited it recently. It's in Brooklyn. This professor, quite progressive in his ideology, was very happy that 147 different countries and nearly as many languages were represented at his old stomping grounds. I thought about it. And, this spoke volumes to me with respect to why we have problems in our schools. I love diversity. I have friends from all over the world. It's part of my job. Science is international. Therefore, I've been all over the world. However, the rapid and uncontrolled influx into our schools is hurting education. How can you discuss abstract concepts, the beauty of science and math, the awe of history. .. when half the students are struggling to understand the teacher. This also compounds the poverty issues and the influence of that in the school system.

"'Tyranny' seems a little strong. Tyrants are often killed, and don't typically have a popular election held every few years to see whether they can keep their position. "

Oh, we're not there yet. But, we'll get there if we keep voting for big brother to bail us out.


"Thank you for posting. Though I think we disagree on some points, I appreciate your opening your beliefs up for study, and I hope I was respectful of them even when I disagreed. Maybe it's a good thing that "there is no obvious right answer" - it keeps us busy striving for it. And if you see anything factually incorrect I would appreciate knowing."

Politics are a blast to debate. I didn't notice anything factually inaccurate (though, the insurance numbers are still debatable).

[HughMoran]

47. Making excuses for our inefficient system

Do you deny the fact that many uninsured don't seek medical care until they are 'stage 2' or worse and likely to cost the system a LOT more in the long run?

HMOs? I haven't been part of an HMO in 20 years! That system, though it exists today is hardly a point I'd spend a lot of time focusing on.

We priced out catastrophic coverage at our last job - the cost for just catastrophic coverage was still excessive considering that NONE of our routine doctor visits etc. were covered, it was actually WORSE that full coverage.

Medical savings accounts? We have those now and I hate them. I'm just not that organized to play that game.

Expense priorities? You mean just "don't worry about it and it'll go away"? You'll have to explain that further as it seems like a psychological game.

Medicare is claimed to have a much better cost/benefit ratio compared to private insurance as the government doesn't need to spend millions in ads and lobbying AGAINST government reforms. Government is inefficient? You better prove that fucking statement - only right-wingers say stupid shit like that.

One thing is for sure, politicians may not always be aware of the overarching ramifications of a bill, BUT THE INSURANCE COMPANIES ARE WELL AWARE OF THEIRS - THEY KILL PEOPLE.

Tyranny? Medicare is tyranny? Funny, my parents seem to like it just fine.

Bad outcome and a loss of freedom? That's the most right-wing thing you've said to date. We're talking healthcare here, not the military industrial complex - where do you come up with this crap?

"It also makes no difference, in my opinion, if it is a progressive liberal ideology, a classical liberal ideology, or some bastardized neo-con movement that has the central power. So, when we look for solutions for big issues, I sympathize with the, as presented in-articulate worker who sparked the ire of the OP. Distrust of central government is healthy (forgive the double meaning)."

Wow, so you don't care if neocons are in charge and you sympathize with a mindless right-winger who's facts were 100% wrong? You don't belong here.

[inthenever]

48. Goals are similar

"Do you deny the fact that many uninsured don't seek medical care until they are 'stage 2' or worse and likely to cost the system a LOT more in the long run?"

That sounds like behavior to me. Behavior is modifiable.

"HMOs? I haven't been part of an HMO in 20 years! That system, though it exists today is hardly a point I'd spend a lot of time focusing on. "

That you aren't part of it doesn't make them less of a problem.

"We priced out catastrophic coverage at our last job - the cost for just catastrophic coverage was still excessive considering that NONE of our routine doctor visits etc. were covered, it was actually WORSE that full coverage."

I find that unlikely given the alternative of paying, for example, for a lung transplant out of pocket.

"Medical savings accounts? We have those now and I hate them. I'm just not that organized to play that game."

Hey, I acknowledge there are individual differences in tolerances for such things, even comprehension. I think they offer a potentially nice vehicle for some people. Obviously, that's not a global solution. But, global solutions tend to be blunt instruments. We need variety to account for the diversity in our population.

"Expense priorities? You mean just "don't worry about it and it'll go away"? You'll have to explain that further as it seems like a psychological game."

No, I mean people need prioritize their health. Before they spend their money on other things, they need to make sure they deal with health. Before they spend time doing other things, they need to make sure they deal with their health.

"Medicare is claimed to have a much better cost/benefit ratio compared to private insurance as the government doesn't need to spend millions in ads and lobbying AGAINST government reforms."

Cost/benefit ratio for what and for whom? Certainly, that the government is the actor is an advantage in some respects, but it's also an awful lot of power to give to the government. Also, medicare is far less friendly than it was years and years ago. Meaning, there is a lot of strain on the system.

"Government is inefficient? You better prove that fucking statement - only right-wingers say stupid shit like that. "

Government is bureaucracy. Dealing with it is a chore. For example, remember the cash for clunkers program. Car companies began opting out of that amid complaints that they couldn't deal with the paperwork. I've worked for government. I still work for government in some capacities. The paperwork is overwhelming as is the apparatus (manpower) in place to deal with it. There is nothing efficient about government. Remember also, that right-wing is a wide net to cast. I understand where you're coming from in casting it, but right wing can be just as big government as left (just a bit different in form). I don't support either.

"One thing is for sure, politicians may not always be aware of the overarching ramifications of a bill, BUT THE INSURANCE COMPANIES ARE WELL AWARE OF THEIRS - THEY KILL PEOPLE. "

Insurance companies are not in the business of killing people. People die. It is inevitable. Further, resources are finite. This is realilty. If the government is in charge, rationing will occur. It will likely be more aggressive than the current situation for more people in our country than the current situation.

"Tyranny? Medicare is tyranny? Funny, my parents seem to like it just fine. "

No, tyranny is what we enable by the promotion of big government.

"Bad outcome and a loss of freedom? That's the most right-wing thing you've said to date. We're talking healthcare here, not the military industrial complex - where do you come up with this crap?"

Military, healthcare, social programs. These are all things that have the potential for abuse of power within government. We must strive to maintain balance. We must be mindful of how and where we yield power of our lives. That is not right wing per se; it is more of a classical liberal idea.

"Wow, so you don't care if neocons are in charge and you sympathize with a mindless right-winger who's facts were 100% wrong? You don't belong here."

I'm not a fan of the neocons. They are the opposite of my political philosophy with their push of big government and religion. My point was that, at a certain point, ideology no longer matter to the common man, meaning the experience is the same. It can be a religious zealot neo-con, or a Stalin-esque leftist commi. It doesn't matter; life still sucks because the power of the people has been ursurped as they are led as if by nose ring in a cow.

[HughMoran]

52. You sound like a libertarian

Even though I sometimes call myself a libertarian liberal, my issue is I don't want the government in my bedroom, on my property or otherwise messing with my civil liberties. What I DO wan the government to do is to make sure that (among other things) we have good healthcare coverage for ALL Americans. The summation I draw from your posts is that you are more for 'personal responsibility' - a very Republican theme.

[inthenever]

54. Libertarian? Sure, I identify with some of that.

"Even though I sometimes call myself a libertarian liberal, my issue is I don't want the government in my bedroom, on my property or otherwise messing with my civil liberties. "

I agree, but I don't see that as separable from. . .

"What I DO wan the government to do is to make sure that (among other things) we have good healthcare coverage for ALL Americans. "

I think we can get good to excellent healthcare coverage for most Americans, just like we can have good jobs for most Americans, and a high standard living relative to the rest of the world for most Americans. We can do this by focusing on balance and maintaining a strong economy.


"The summation I draw from your posts is that you are more for 'personal responsibility' - a very Republican theme.
"

I think personal responsiblity is the key to success, but I acknowledge environmental/system blame arguments. Hell, I think, given enough data that it can be a philosophically valid argument that there is no such thing as free will. Be that as it may, the environment, the psychological environment, must be geared towards personal responsibilty. . . for the greater good. Because resources are finite, I liken many of these debates to the situation of trying to rescue someone that is drowning. It's a very risky action, one that must be carefully planned but swiftly implemented. No one wants the drowning man to die. But, if we are hasty and we go "all in" so to speak, we could end pulled under. I fear that is the game we play with shifts to big government. We yield too much power and all of those personal freedoms will go away.

[HughMoran]

55. C'mon

"I think we can get good to excellent healthcare coverage for most Americans, just like we can have good jobs for most Americans, and a high standard living relative to the rest of the world for most Americans. We can do this by focusing on balance and maintaining a strong economy."

Is that your plan? Focus, balance, maintain? Kinda lean on the details. Based on how conservative you sound, I'd say that we'd have all Americans covered in, say, 100 years maybe?

"I think personal responsiblity is the key to success, but I acknowledge environmental/system blame arguments. Hell, I think, given enough data that it can be a philosophically valid argument that there is no such thing as free will. Be that as it may, the environment, the psychological environment, must be geared towards personal responsibility. . . for the greater good. Because resources are finite, I liken many of these debates to the situation of trying to rescue someone that is drowning. It's a very risky action, one that must be carefully planned but swiftly implemented. No one wants the drowning man to die. But, if we are hasty and we go "all in" so to speak, we could end pulled under. I fear that is the game we play with shifts to big government. We yield too much power and all of those personal freedoms will go away."

You make commentators like David Brooks look like a flaming liberal. I seriously wonder if other posters here will be a patient as I am being with you.

[jpak]

24. Are you series? - You sound like a hugh moran

get some brains

:D

:hi:

[HughMoran]

25. Uggh, the president says they're all like this up here

:puke:

[ShortnFiery]

37. "Medical Savings Accounts!?!" Now being healthy is something you have to EARN.

If we are born into the wrong caste, NO, NO HEALTH FOR YOU.

Heath care is a privilege, just like they have made a decent college education.

Welcome to full blown FASCISM! :thumbsdown:

[inthenever]

50. MSAs do not equal fascism

Really? Fascism? Please.

[GOPBasher]

29. This is typical. You pointed out facts, and she just stuck to rhetoric. n/t

[HughMoran]

30. What pissed me off is that she just dug deeper for more arguments planted by her idiot family

She had no idea what we were talking about when we slammed her comments to the mat. As far as I can tell, she doesn't even realize how uninformed she looked as she was unable to accept our input. I'm going to make her pay for this - every day I'm going to rub her face in it.

[ShortnFiery]

39. "Idiot family" ? We have to make these people smart. eom

[Glenda]

42. She doesn't know who she's up against!

I bet on you, Hugh!

She doesn't stand a chance now that she has been outed ;)

:toast:

[ShortnFiery]

35. Jingoism much? "greatest country on earth ..."

I love my country and even served four years active duty in the Army, but I see her AS SHE IS.

Our political system is both corrupt and broken.

[ThatsMyBarack]

38. Now back to American Idol.

:eyes:

[ShortnFiery]

41. Now back to the insurance cartel and big pharma charging people to stay healthy.

That's just plain VILE, to be making PROFITS off of "life and death."

[HughMoran]

43. Teh stupid

it burns.

[Angry Dragon]

44. If Rush or Glenn did not say it

it can not be true

[HughMoran]

49. I later said pretty much the same thing to my boss

She laughed and agreed.

[TCJ70]

53. The only way to improve your Q&A session...

...would be if it ended in suggesting expansion of Medicare with a buy-in system. Other than that, spot on. When all these tea baggers turn 65 they'll be grateful for Medicare...assuming they allow it to last that long.

[-wulf-]

59. BCBS Sucks BTW and so does government run care.

We dropped BCBS because more and more doctors are not taking BCBS because of non-payment and other issues. They don't pay enough for services and are late making the payments that they do make (just like medicare.) To top things off, they raised their rates again!

Also, saying that your company can't change providers due to "pre-existing" conditions is not true. So long as a person is continuously insured, they can change providers all they want. I have pre-existing conditions, as do my children and we've had three different providers over the last four years.

As for thinking existing government run health care plans being the greatest thing since sliced bread, that is a fantasy.

I don't know of any government plan that would allow me to call any specialist I wanted and make an appointment for whatever "specialist" services (i.e. MRI, CAT scan, physical therapist, etc) without having any prior approval or referral from my primary care physician (or any other doctor or insurance rep) and have no co-pay at all.

The government plants that I've been under in the past are all operating at a loss, much less offer this kind of easy access to care.

And yes, I've had TRi-Care as a below-poverty-earning enlisted troop, and Medicaid after I separated. I am legal guardian for my father-in-law, so I'm familiar with Medicare. He has to see all kinds of specialist and I have to first take him to his primary doctor and get a referral that the insurance then has to pre-approve just to get him an MRI.

My wife had to have an MRI last week, and thanks to our non-government care I was able to just make the appointment directly with the lab and walk in, get the MRI, pay no co-pay and walk out with her own MRI images on a CD to take to whatever doctor she wants for further treatment or evaluation.

For years, the government run plans that we were under wouldn't refer her for an MRI because her back pain was deemed to be due to stress and she was told by TRI-Care and Medicaid to relax and stretch. Turns out she has degenerative disk disease and it is advanced to the point that she may need surgery to prevent the bone from cutting off the blood flow to her nerves in her back, which would cause paralysis if un-treated.

Thank God I got out from under the government's thumb where were just a number and into a situation where we had the freedom to just get an MRI because we wanted it.

[Greyhound]

65. At last, we agree! n/t