Report your fellow citizens' remarks about health care!

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athelas
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Re: Report your fellow citizens' remarks about health care!

Postby athelas » Fri Aug 07, 2009 6:17 pm UTC

It is likely that a public plan will become a first step towards single-payer healthcare, for two reasons:

1. If the government plan is not subsidized, then it has no competitive advantage over private insurers. If you think it can cover more people at less cost, why aren't you starting your own company doing the same thing, and making a killing? On the other hand if its bureaucrats are instructed to increase coverage, then that will by definition cost more money as you add more high-risk people into the pool. A subsidy would then be needed and it's hard to see politicians having as much incentive to save taxpayers' money as they do to increase coverage. Subsidies will therefore increase without a countervailing force

2. Most of the people supporting this change would prefer a single-payer system.

So "the plan" increases the probability of a socialized healthcare system down the road, yet administration supporters seem to, to put it lightly, have difficulty recognizing this as an argument.

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Re: Report your fellow citizens' remarks about health care!

Postby Spacemilk » Fri Aug 07, 2009 6:23 pm UTC

athelas wrote:It is likely that a public plan will become a first step towards single-payer healthcare, for two reasons:

1. If the government plan is not subsidized, then it has no competitive advantage over private insurers. If you think it can cover more people at less cost, why aren't you starting your own company doing the same thing, and making a killing? On the other hand if its bureaucrats are instructed to increase coverage, then that will by definition cost more money as you add more high-risk people into the pool. A subsidy would then be needed and it's hard to see politicians having as much incentive to save taxpayers' money as they do to increase coverage. Subsidies will therefore increase without a countervailing force

2. Most of the people supporting this change would prefer a single-payer system.

So "the plan" increases the probability of a socialized healthcare system down the road, yet administration supporters seem to, to put it lightly, have difficulty recognizing this as an argument.


Ok, I get it. I also see that this program is similar to Medicare, except Medicare is obviously for the old and disabled - people who would find it very hard to get insurance normally. Except this program is going to extend coverage to everyone, right? Ok so here are my questions:

-What tenets of this plan make it more likely to fail than Medicare? Is it because you have such a range of at-risk patients? Er, I think I see the answer to this one but I want to make sure.
-Why do so many older people think that this new program will hurt them, if they already have Medicare?
-What do we gain from this program if we already have Medicaid and Medicare? Wouldn't it make more sense just to revamp those two programs? And then instead of adding a public option, just regulate the health insurance industry some more, since it sounds like that industry is pretty messed up. What's the problem with doing that?

Thanks so much for all the answers, guys!
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Re: Report your fellow citizens' remarks about health care!

Postby Heisenberg » Fri Aug 07, 2009 6:46 pm UTC

netcrusher88 wrote:Apparently you haven't seen the footage.
I've seen the same footage you have, along with the misleading deomocratic propaganda surrounding the protests. We're just seeing it differently, apparently.
netcrusher88 wrote:misleading (read: pundit-style) questions
God forbid our elected officials answer questions from their constituents. They could be difficult questions! Those must come from the evil lips of Michael Steele!

Also, you're right, apparently some right-wing nutjob talk-show hosts misrepresented end-of-life care somewhat, but none to the ridiculous level that you and Maddow purport. Politico also accuses Boehner of doing so, but doesn't offer any proof. And yes, Obama's plan socializes health insurance, not yet the entire health care industry. But government control of business is socialism, whether it is in the financial, auto, or insurance industry.

In the case of disinformation, it is the responsibility of the citizenry and the Congress to make sure that the people's interests are being represented. A White House witch hunt is not an appropriate solution.

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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Fri Aug 07, 2009 6:52 pm UTC

Medicare is actually a bad example. You want a good one? The VA. Even as enrollment has increased, they've managed to keep the price per patient relatively stable, with a real dollar price growth rate of 1.7 percent from 1999 to 2005 when controlled for the fact that the new enrollees of late are largely younger, less disabled, and requiring less expensive care. If you don't account for that, the cost per patient decreased by 5.6% each year. Compare that to 29.3% increase that Medicare suffered along the same timeline, which is more or less similar to the growth rate among private insurers. And while it's been expanding its customer base and decreasing its costs? It's seen a precipitous increase in patient satisfaction. There isn't a health plan in this country that insures as many people as the VA that has a higher patient satisfaction.

The VA is, quite simply, the real fucking deal. The best healthcare system in the fucking world, short of the team of doctors who follow the President, Vice President, and their families wherever they travel, just outside the kill zone of a hypothetical rocket attack on their limousines. Even Bill Kristol admitted it when Jon Stewart put his feet to the fire. Of course, he admitted it not knowing that the VA also has a lower cost per patient than private insurance, which is astounding, given that they also have a higher per capita rate of a number of extremely nasty and expensive ailments among the patients they cover.

If you don't believe me, gorge yourself on some deliciously boring CBO white paper.

If you're a member of Congress involved in the healthcare debate, you've seen that report. Or you should have. Which means that any elected official who still says that the government can't run a world-class health care system is either a fucking liar or a douchetruck who can't be arsed to do their god damned job. I can't pretend that I know why they oppose reform (though the rather large numbers on the checks they recieve from health insurance lobbyists is a clue), but there isn't a chance that facts have anything to do with it.
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Re: Report your fellow citizens' remarks about health care!

Postby Crius » Fri Aug 07, 2009 6:58 pm UTC

Spacemilk wrote:Ok, I get it. I also see that this program is similar to Medicare, except Medicare is obviously for the old and disabled - people who would find it very hard to get insurance normally. Except this program is going to extend coverage to everyone, right? Ok so here are my questions:

-What tenets of this plan make it more likely to fail than Medicare? Is it because you have such a range of at-risk patients? Er, I think I see the answer to this one but I want to make sure.
-Why do so many older people think that this new program will hurt them, if they already have Medicare?
-What do we gain from this program if we already have Medicaid and Medicare? Wouldn't it make more sense just to revamp those two programs? And then instead of adding a public option, just regulate the health insurance industry some more, since it sounds like that industry is pretty messed up. What's the problem with doing that?

Thanks so much for all the answers, guys!


- The public option would try to extend monopsony pricing much more broadly than medicare, which is likely to impact quality of care without impacting the growth of costs (it will likely reduce the costs in the short term, though). Also, the costs of the Medicare program are much greater than originally projected, and some people fear that may become true for this bill as well (especially considering it's already priced at $1.6 trillion). Don't forget that Medicare fraud cost is estimated at $60 billion.
- The older population is probably most afraid of healthcare rationing. See this thread for more about rationing.
- The public option would likely reduce costs in the short term. The rest of the reform is mainly insurance regulation.

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Re: Report your fellow citizens' remarks about health care!

Postby Lumpy » Fri Aug 07, 2009 7:01 pm UTC

misleading (read: pundit-style) questions
God forbid our elected officials answer questions from their constituents. They could be difficult questions! Those must come from the evil lips of Michael Steele!


I think he means more like rhetorical questions. "Do you people in Washington you know many people died in the Iraq War?!" "Why would we let the government run our healthcare system when they're going to give 44 million illegal immigrants access?" "Do you think we are going to stand with this? NO!"

Those are more like protester questions you would expect to be asked by someone holding a picket sign. If they don't really expect any answer from the politicians at the town hall meeting, then they're just as effective toward the actual purpose of the town hall meeting when they're outside as when they're inside, for anything beyond mere visibility.

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Re: Report your fellow citizens' remarks about health care!

Postby Heisenberg » Fri Aug 07, 2009 7:08 pm UTC

EsotericWombat wrote:they also have a higher per capita rate of a number of extremely nasty and expensive ailments among the patients they cover.

They also are a group of individuals who have been in top physical condition for a significant portion of their lives. Not that this disproves your claim, but it's important to consider the sample. For instance, the average American is probably more likely to seek medical attention for a minor condition than someone who has been trained to keep running after multiple gunshot wounds. Also, I'd imagine those with the civic responsibility to serve would be less likely to attempt to defraud the government.

But yeah, the VA is a much better example than Medicare, which a lot of people like, and a lot of people hate. There are still those who want to see improvement in the VA system, but on the whole it's a much tighter ship.

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Re: Report your fellow citizens' remarks about health care!

Postby The Reaper » Fri Aug 07, 2009 7:17 pm UTC

The VA system definitely needs some improvements. It's nice getting perscriptions for crazy cheap, but holy god the wait times suck. It's also packed EVERY TIME i walk in. Like many cases, you're better off going to the emergency room if you need it to get dealt with anytime within the next week/month.

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Re: Report your fellow citizens' remarks about health care!

Postby Crius » Fri Aug 07, 2009 7:22 pm UTC

The VA is an interesting example because it covers how care is provided, not just how it's paid. There's other good examples in private industry - such as Cleveland Clinic, Geisinger, and Kaiser Permanente. Kaiser in particular is interesting because it acts as both the insurer and provider.

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Re: Report your fellow citizens' remarks about health care!

Postby SummerGlauFan » Fri Aug 07, 2009 7:22 pm UTC

Heisenberg wrote:
EsotericWombat wrote:they also have a higher per capita rate of a number of extremely nasty and expensive ailments among the patients they cover.

They also are a group of individuals who have been in top physical condition for a significant portion of their lives. Not that this disproves your claim, but it's important to consider the sample. For instance, the average American is probably more likely to seek medical attention for a minor condition than someone who has been trained to keep running after multiple gunshot wounds. Also, I'd imagine those with the civic responsibility to serve would be less likely to attempt to defraud the government.

But yeah, the VA is a much better example than Medicare, which a lot of people like, and a lot of people hate. There are still those who want to see improvement in the VA system, but on the whole it's a much tighter ship.


However, consider that the VA probably has a higher percentage of severely, chronically disabled people it cares for, too. However, you are right that it is the best example of US government-run healthcare.

I'm just concerned that, by rushing healthcare legislation, congress is going to botch up. I'm all for a total revamp of our health system, but for frak's sake, do it carefully!
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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Fri Aug 07, 2009 7:46 pm UTC

Also, any effort to upgrade our healthcare system should include an effort to upgrade the general health of the populace. Basically, we need to stop being fatasses.

SummerGlauFan wrote:I'm just concerned that, by rushing healthcare legislation, congress is going to botch up. I'm all for a total revamp of our health system, but for frak's sake, do it carefully!


We've been trying to do this for 60 years. This isn't rushing. And when the people who seek to kill healthcare reform indefinitely say openly that the first step to killing reform is to delay it, that's a pretty clear-cut clue that we can't afford to be Ents about this.
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Re: Report your fellow citizens' remarks about health care!

Postby Spacemilk » Fri Aug 07, 2009 7:50 pm UTC

EsotericWombat wrote:Also, any effort to upgrade our healthcare system should include an effort to upgrade the general health of the populace. Basically, we need to stop being fatasses.

SummerGlauFan wrote:I'm just concerned that, by rushing healthcare legislation, congress is going to botch up. I'm all for a total revamp of our health system, but for frak's sake, do it carefully!


We've been trying to do this for 60 years. This isn't rushing. And when the people who seek to kill healthcare reform indefinitely say openly that the first step to killing reform is to delay it, that's a pretty clear-cut clue that we can't afford to be Ents about this.


So if we rush, and mess it up, isn't that going to prove the reform-killers right when they tell us that we shouldn't have done it in the first place? :? That sounds rather stupid to me.

I'm with Summer on this one. Let the detractors delay. They can sit there smugly thinking they've won and when we come back with a sensible, well-thought out plan, it'll be that much easier to steamroll past their efforts to delay it. By rushing it, we're only making it easy for people to oppose it.*

Also, re: 60 years comment: Sure, people have been saying "hey we need reform" for a while, but this is the first time anyone has sat down and written out a plan. (at least, anyone in Congress) Just because we've been saying it doesn't mean we actually know what the hell needs to be done. It doesn't seem like very many people in the general public have thought really deeply about what needs to be done, so it's going to take some thinking before we really know and agree with what needs to be done.

*I still haven't decided how much I like the idea of a comprehensive health care plan yet. :?
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Re: Report your fellow citizens' remarks about health care!

Postby Heisenberg » Fri Aug 07, 2009 8:04 pm UTC

Spacemilk wrote:but this is the first time anyone has sat down and written out a plan. (at least, anyone in Congress)

Not really. We had this president, elected on health care reform, and this democratic congress, but divisions within the Democratic Party and outside pressures kept it from passing. So really this is round 2, with a very different plan.

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Re: Report your fellow citizens' remarks about health care!

Postby Mr. N » Fri Aug 07, 2009 8:05 pm UTC

A quick image that captures exactly the atmosphere of health reform debate:

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The lady on the left (dressed in what looks like a Fisher Price inspired HopeyChangey shirt) is trying to rip away a sign from the lady in the middle (dressed like she's attending a funeral, complete with gigantic pearl accoutrements). Note the lady on the right -- it appears as though she's about to apply a beatdown with a yardstick.

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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Fri Aug 07, 2009 8:16 pm UTC

@Spacemilk You... don't seem to remember the nineties. Or that we tried and failed to do this during the Johnson and Carter administrations. Under Truman, the AMA killed all attempts at reform through a then-unprecedented multi million dollar smear campaign. We have been down this road before. When I say that we've been working on this for sixty years, I mean that we've been fucking working on this for sixty years. Each time, reform was killed by attrition. The people who say "let's not rush this" are well aware of that fact.
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Re: Report your fellow citizens' remarks about health care!

Postby Vaniver » Fri Aug 07, 2009 8:27 pm UTC

EsotericWombat wrote:Also, any effort to upgrade our healthcare system should include an effort to upgrade the general health of the populace. Basically, we need to stop being fatasses.
I would rather own my health than have the government have a partial interest.


No industry does well after someone slaps a top-down plan on it. The history of that is far more than 60 years old. I'm not sure why people think health care will be any different.
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Re: Report your fellow citizens' remarks about health care!

Postby Crius » Fri Aug 07, 2009 8:41 pm UTC

EsotericWombat wrote:@Spacemilk You... don't seem to remember the nineties. Or that we tried and failed to do this during the Johnson and Carter administrations. Under Truman, the AMA killed all attempts at reform through a then-unprecedented multi million dollar smear campaign. We have been down this road before. When I say that we've been working on this for sixty years, I mean that we've been fucking working on this for sixty years. Each time, reform was killed by attrition. The people who say "let's not rush this" are well aware of that fact.


The proposals failed because they didn't have enough votes. If you think yay's are going to change to nay's if we spend time reading and discussing the proposal,then there's a problem with the proposal.

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Re: Report your fellow citizens' remarks about health care!

Postby Vaniver » Fri Aug 07, 2009 8:54 pm UTC

Crius wrote:The proposals failed because they didn't have enough votes. If you think yay's are going to change to nay's if we spend time reading and discussing the proposal,then there's a problem with the proposal.
Indeed- that's why part of Change We Can Believe In was five days of online review of legislation before signing it.

Change We Got, however, is rushing a bill through Congress to get the impression that something is being done, not ensuring it's the right thing. Ah, Obama.
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Re: Report your fellow citizens' remarks about health care!

Postby Mega D » Fri Aug 07, 2009 8:56 pm UTC

Crius wrote:The proposals failed because they didn't have enough votes. If you think yay's are going to change to nay's if we spend time reading and discussing the proposal,then there's a problem with the proposal.

If legislation passed or failed based on its actual merits, this would be true. When some of those nays are generated by active and deliberate misinformation campaigns, however, reading and discussion can make a difference. Politicians do listen to their constituents, on occasion at least. If the public opposes it because they really disagree with the program, so be it. But when you have people who believe someone's going to come knocking on their door to sign them up for a euthanasia service then obviously there's still room for a little more education on the subject before we make an informed decision.

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Re: Report your fellow citizens' remarks about health care!

Postby SummerGlauFan » Fri Aug 07, 2009 8:58 pm UTC

EsotericWombat wrote:Also, any effort to upgrade our healthcare system should include an effort to upgrade the general health of the populace. Basically, we need to stop being fatasses.

SummerGlauFan wrote:I'm just concerned that, by rushing healthcare legislation, congress is going to botch up. I'm all for a total revamp of our health system, but for frak's sake, do it carefully!


We've been trying to do this for 60 years. This isn't rushing. And when the people who seek to kill healthcare reform indefinitely say openly that the first step to killing reform is to delay it, that's a pretty clear-cut clue that we can't afford to be Ents about this.


You seem to be misunderstanding what I am saying. I am saying that the plan congress makes should be carefully thought out, not rushed into service in a couple of months. That way, you can catch the inevitable mistakes, loopholes, and glaring omissions that are going to pop up in something of that complexity that is rushed. If that means lawmakers and experts have to go over it step-by-step, page-by-page, so be it. Obama and congress want a reform ASAP, and are sacrificing quality for speed. It's freaking health care, so it's kinda important we don't botch it. I'm not saying "Let's wait another sixty years debating whether or not we need reform," as has been the case over the last 60 years.
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Re: Report your fellow citizens' remarks about health care!

Postby Crius » Fri Aug 07, 2009 10:56 pm UTC

Mega D wrote:
Crius wrote:The proposals failed because they didn't have enough votes. If you think yay's are going to change to nay's if we spend time reading and discussing the proposal,then there's a problem with the proposal.

If legislation passed or failed based on its actual merits, this would be true. When some of those nays are generated by active and deliberate misinformation campaigns, however, reading and discussion can make a difference. Politicians do listen to their constituents, on occasion at least. If the public opposes it because they really disagree with the program, so be it. But when you have people who believe someone's going to come knocking on their door to sign them up for a euthanasia service then obviously there's still room for a little more education on the subject before we make an informed decision.


Lack of public support is a problem with a proposal, and shouldn't just be dismissed. While I see your point here, it doesn't mean that something should be rushed through before anyone has a chance to even form an opinion.

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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Fri Aug 07, 2009 11:41 pm UTC

70% of the public want comprehensive healthcare reform. A supermajority of the voting public wants there to be a public option, even if it means more taxes. 58% of people who are given a solid factual understanding of what is currently being considered support it specifically.

The will of the people on this matter is clear. So are the merits of the legislation. The only thing that isn't clear is whether or not our elected officials can be bullied into ignoring both to satisfy the deep pockets funding their campaigns.
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Re: Report your fellow citizens' remarks about health care!

Postby athelas » Sat Aug 08, 2009 12:08 am UTC

EsotericWombat wrote:The will of the people on this matter is clear.

No, it's not. And unlike you I have cites. Only 28% of people favor raising taxes to increase coverage, and a majority believe that Obama's plan tackles the wrong problem, increasing coverage rather than containing costs. The arrogant assumption that your side is The Right and Holy Cause, and your opponents are misled or liars is, well, arrogant.

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Re: Report your fellow citizens' remarks about health care!

Postby zug » Sat Aug 08, 2009 12:16 am UTC

athelas wrote:
EsotericWombat wrote:The will of the people on this matter is clear.

No, it's not. And unlike you I have cites. Only 28% of people favor raising taxes to increase coverage, and a majority believe that Obama's plan tackles the wrong problem, increasing coverage rather than containing costs. The arrogant assumption that your side is The Right and Holy Cause, and your opponents are misled or liars is, well, arrogant.

Well at that, I don't know if I support it or not with increased taxes. I mean, if we're all paying into this, will it simply replace the medicare and health insurance money that comes out of every paycheck? Because if it does, I'd pay a little more every month. If I'm still forced to pay for those programs, I wouldn't.

It would be ridiculous and redundant to pay for health insurance twice anyway. I guess I'm kind of confused about that whole thing. Will this become the new medicare, except for everybody? Because that's kind of what I was thinking.
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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Sat Aug 08, 2009 12:41 am UTC

Last edited by EsotericWombat on Sat Aug 08, 2009 12:49 am UTC, edited 1 time in total.
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Re: Report your fellow citizens' remarks about health care!

Postby zug » Sat Aug 08, 2009 12:45 am UTC

EsotericWombat wrote:http://www.nytimes.com/2009/06/21/health/policy/21poll.html


FTA: "Republicans in Congress have fiercely criticized the proposal as an unneeded expansion of government that might evolve into a system of nationalized health coverage and lead to the rationing of care."

Uhh, they say that as though health care is not currently rationed. It already is. It's just that Republicans in Congress don't give a shit if poor people don't get their share.
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Re: Report your fellow citizens' remarks about health care!

Postby Heavenlytoaster » Sat Aug 08, 2009 12:45 am UTC

zug wrote:
athelas wrote:
EsotericWombat wrote:The will of the people on this matter is clear.

No, it's not. And unlike you I have cites. Only 28% of people favor raising taxes to increase coverage, and a majority believe that Obama's plan tackles the wrong problem, increasing coverage rather than containing costs. The arrogant assumption that your side is The Right and Holy Cause, and your opponents are misled or liars is, well, arrogant.

Well at that, I don't know if I support it or not with increased taxes. I mean, if we're all paying into this, will it simply replace the medicare and health insurance money that comes out of every paycheck? Because if it does, I'd pay a little more every month. If I'm still forced to pay for those programs, I wouldn't.

It would be ridiculous and redundant to pay for health insurance twice anyway. I guess I'm kind of confused about that whole thing. Will this become the new medicare, except for everybody? Because that's kind of what I was thinking.


Who woulda thought to get something we don't have, it would cost more money! But don't worry, we can just borrow it instead of raising taxes!

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Re: Report your fellow citizens' remarks about health care!

Postby zug » Sat Aug 08, 2009 12:51 am UTC

Heavenlytoaster wrote:Who woulda thought to get something we don't have, it would cost more money! But don't worry, we can just borrow it instead of raising taxes!

If you are addressing that to me, don't be fucking stupid. I was saying, if this program intends to slightly raise the money that comes out of my paycheck by eliminating or grouping into what I currently pay for health insurance and medicare every month, then I'm OK with that. But if they're just going to take another $50 out of everyone's paycheck without taking away those other expenses? I have to eat.
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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Sat Aug 08, 2009 1:03 am UTC

Care rationing exists among the insured too.

This spectre of government bureaucrats lording over people's care completely ignores the fact that corporate bureaucrats-- who internally refer to care payouts as "losses"-- are currently doing exactly that, only they stand to profit from your coverage being denied.
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Re: Report your fellow citizens' remarks about health care!

Postby ddxxdd » Sat Aug 08, 2009 2:01 am UTC

EsotericWombat wrote:Care rationing exists among the insured too.

This spectre of government bureaucrats lording over people's care completely ignores the fact that corporate bureaucrats-- who internally refer to care payouts as "losses"-- are currently doing exactly that, only they stand to profit from your coverage being denied.


They don't stand to profit from getting sued for violation of contract, though. And likewise, government bureaucrats-- who have a budget to balance-- also have an incentive to deny coverage.

However, I'm supportive of letting the government bureaucrats compete with the corporate bureaucrats. The gov. kept Medicare costs under control much more efficiently than the corporate bureaucrats.

zug wrote:
Heavenlytoaster wrote:Who woulda thought to get something we don't have, it would cost more money! But don't worry, we can just borrow it instead of raising taxes!

If you are addressing that to me, don't be fucking stupid. I was saying, if this program intends to slightly raise the money that comes out of my paycheck by eliminating or grouping into what I currently pay for health insurance and medicare every month, then I'm OK with that. But if they're just going to take another $50 out of everyone's paycheck without taking away those other expenses? I have to eat.

Behave, you two. You don't want Az popping up and surprising you like a serial killer in a horror movie.

SummerGlauFan wrote:You seem to be misunderstanding what I am saying. I am saying that the plan congress makes should be carefully thought out, not rushed into service in a couple of months. That way, you can catch the inevitable mistakes, loopholes, and glaring omissions that are going to pop up in something of that complexity that is rushed. If that means lawmakers and experts have to go over it step-by-step, page-by-page, so be it. Obama and congress want a reform ASAP, and are sacrificing quality for speed. It's freaking health care, so it's kinda important we don't botch it. I'm not saying "Let's wait another sixty years debating whether or not we need reform," as has been the case over the last 60 years.

I concur. Our employer-based healthcare system was whipped up quickly during WWII, and it lasted half a century and through 12 presidential terms. This is a massive reform that needs massive consideration.

And this issue is a complex one. We have to deal with low-income families, we have to deal with people who choose to be uninsured, we have to deal with costs that have doubled in the past 8 years, and we have to deal with mounting deficits. Several sub-issues that need to be addressed.


I don't agree with completely socializing healthcare and giving people no choice, but I also don't agree with leaving the free market naked, where insurers can deny coverage for no reason with no prior notice, or where consumers are crippled from shopping around for the lowest priced insurer, or insurance companies are crippled from shopping around for the lowest-priced doctors and hospitals.
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Re: Report your fellow citizens' remarks about health care!

Postby zug » Sat Aug 08, 2009 2:26 am UTC

ddxxdd wrote:Behave, you two. You don't want Az popping up and surprising you like a serial killer in a horror movie.

I'm not the snarker. I'm the conscientious objector.

Also, N&A != SB
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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Sat Aug 08, 2009 2:42 am UTC

Right. Because every person who is ever wronged by their insurer sues. And every person enrolled in an insurance company has access to high-powered attorneys with the juice to take on the insurance industry. And the aforementioned contracts reflect a true meeting of the minds between the insurer and the insured, as opposed to being, for instance, deliberately full of loopholes for the insurers to exploit later.
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Re: Report your fellow citizens' remarks about health care!

Postby ddxxdd » Sat Aug 08, 2009 3:06 am UTC

EsotericWombat wrote:Right. Because every person who is ever wronged by their insurer sues. And every person enrolled in an insurance company has access to high-powered attorneys with the juice to take on the insurance industry. And the aforementioned contracts reflect a true meeting of the minds between the insurer and the insured, as opposed to being, for instance, deliberately full of loopholes for the insurers to exploit later.


Interestingly enough, one of the lesser known, technocratic parts of Obama's healthcare bill is that all insurance plans will be limited to a normalized, pre-set plan that's written by Congress (refered to as "standard benefits packages"). That way, there will be fewer loopholes and legal jargon that can be sneaked in, and more clear, normalized communication between the insurer and the insured.

Here's my source, although the tone of the article is one of bitterness and partisanship.
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Re: Report your fellow citizens' remarks about health care!

Postby SummerGlauFan » Sat Aug 08, 2009 3:14 am UTC

ddxxdd wrote:
SummerGlauFan wrote:You seem to be misunderstanding what I am saying. I am saying that the plan congress makes should be carefully thought out, not rushed into service in a couple of months. That way, you can catch the inevitable mistakes, loopholes, and glaring omissions that are going to pop up in something of that complexity that is rushed. If that means lawmakers and experts have to go over it step-by-step, page-by-page, so be it. Obama and congress want a reform ASAP, and are sacrificing quality for speed. It's freaking health care, so it's kinda important we don't botch it. I'm not saying "Let's wait another sixty years debating whether or not we need reform," as has been the case over the last 60 years.

I concur. Our employer-based healthcare system was whipped up quickly during WWII, and it lasted half a century and through 12 presidential terms. This is a massive reform that needs massive consideration.

And this issue is a complex one. We have to deal with low-income families, we have to deal with people who choose to be uninsured, we have to deal with costs that have doubled in the past 8 years, and we have to deal with mounting deficits. Several sub-issues that need to be addressed.


I don't agree with completely socializing healthcare and giving people no choice, but I also don't agree with leaving the free market naked, where insurers can deny coverage for no reason with no prior notice, or where consumers are crippled from shopping around for the lowest priced insurer, or insurance companies are crippled from shopping around for the lowest-priced doctors and hospitals.


Exactly. It's like congress and Obama want change for change's sake, and so they try to rush stuff as vastly complicated as this.

Our current system sucks, I get it. The new system will likely suck much, much more if it isn't carefully thought out, carefully planned, and carefully implemented.
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Re: Report your fellow citizens' remarks about health care!

Postby athelas » Sat Aug 08, 2009 4:18 am UTC

EsotericWombat wrote:Right. Because every person who is ever wronged by their insurer sues. And every person enrolled in an insurance company has access to high-powered attorneys with the juice to take on the insurance industry. And the aforementioned contracts reflect a true meeting of the minds between the insurer and the insured, as opposed to being, for instance, deliberately full of loopholes for the insurers to exploit later.
The argument against "evil insurance companies," dropping coverage when you get really sick, is seductive. The problem with this argument is that it proves far too much. The same argument applies to life insurance and home insurance. You dutifully pay your premiums for years. Then you suddenly die, or your house burns down. What's a profit-maximizing insurer to do? Say you died or the house burned down because you were smoking in bed, of course! Can you prove otherwise?

Yet in practice, people almost never complain about disingenuous disputes with life or home insurers. Why not? The obvious explanation is that life or home insurance companies that shirk their responsibilities hurt their reputation. It might seem profitable to reject expensive claims, but in the long-run, an insurance company that mistreats its expensive customers is going to have trouble attracting any customers at all. After all, what's the point of buying insurance from a company that won't pay when you need it most?

I agree that there is a popular perception that health insurance is an unusually crooked industry. My main explanation is that customers of health insurance companies have more latitude for unreasonable demands. If your dad dies, the life insurance company owes you $X. If customers ask for $X+1, the firm refuses, and no one sees this as proof that the free market can't be trusted with life insurance. If you get sick, in contrast, it's hard for an insurance company to decisively prove that they've lived up to their agreement. You can always insist on another expensive test, even if the insurer knows it's useless.

Furthermore, there is not as much competition in the insurance company as there could be. The linkage to employment means that everyone has only a few choices. Even in this case, consumers are free to reject the package - job+insurance, if the insurance company has a really bad reputation. As it happens, one way to introduce more competition is to revoke the tax-exemption of employer-provided insurance, something that John McCain proposed during the campaign and Obama ridiculed.

I agree that there is a popular perception that health insurance is an unusually crooked industry. My main explanation is that customers of health insurance companies have more latitude for unreasonable demands. If your dad dies, the life insurance company owes you $X. If customers ask for $X+1, the firm refuses, and no one sees this as proof that the free market can't be trusted with life insurance. If you get sick, in contrast, it's hard for an insurance company to decisively prove that they've lived up to their agreement. You can always insist on another expensive test, even if the insurer knows it's useless.

Am I saying that health insurance companies never play dirty tricks on their customers? Of course not. It's a big world, lots of bad stuff happens. What I'm saying, rather, is that reputation works well even in industries where firms have big, lumpy liabilities. There are plenty of examples. What reason is there to think that health insurance isn't one of them?

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Re: Report your fellow citizens' remarks about health care!

Postby athelas » Sat Aug 08, 2009 4:20 am UTC

That all said, the central question concerns remedies. Presumably the critics believe that egregious violations of law and contract are occurring, in particular on the dropping-coverage side of things. If that is the case, why not just enforce the law more strongly and raise the penalties -- significantly -- for unjust treatment of sick individuals? You can call this market failure, which it is, but it's also legal and regulatory failure as well. Presumably if illegal breaches of contract were occurring, the ambulance-chasers would be having a field day.

If those legal parties cannot implement and enforce basic laws, can other legal parties successfully take on larger responsibilities for managing the U.S. health care sector? Somehow it is assumed that the answer here is "yes." I'm less certain.

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Re: Report your fellow citizens' remarks about health care!

Postby EsotericWombat » Sat Aug 08, 2009 4:49 am UTC

Right. The existence of employees whose sole function is to find new and exciting ways to deny coverage isn't damning at all.

Here's an audio interview with one of them
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Re: Report your fellow citizens' remarks about health care!

Postby The Reaper » Sat Aug 08, 2009 5:25 am UTC

Man I'm all kinds of confused right now. People say the insurance companies are evil, then Palin says that socialized health care is evil.... Is there some way I can vote for a 3rd option? Or both? One should never vote for the lesser of two evils. Then you end up with a wussy Vadar that attacks the Emperor at the end.

Palin: http://www.breitbart.com/article.php?id ... _article=1
Palin wrote:The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil
That alone make me want to vote for this socialized health care. and religion needs to gtfo my governmental politics

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Re: Report your fellow citizens' remarks about health care!

Postby netcrusher88 » Sat Aug 08, 2009 6:54 am UTC

SummerGlauFan wrote:Exactly. It's like congress and Obama want change for change's sake, and so they try to rush stuff as vastly complicated as this.

Our current system sucks, I get it. The new system will likely suck much, much more if it isn't carefully thought out, carefully planned, and carefully implemented.

There is no rushing going on here. This has literally been in the works for decades. What is going on here is Republicans and Blue Dogs and other industry shills doing everything they can to delay reform because they know from those decades of killing it that the best way to kill health care reform is attrition, and the longer they delay it the longer they have to lie and misrepresent provisions to lower public opinion about it.

ddxxdd wrote:And likewise, government bureaucrats-- who have a budget to balance-- also have an incentive to deny coverage.

Yes, but I can assure you they're not interested in minimizing their loss ratio. I don't know what a typical loss ratio is (I hear 80% or lower but I can't find numbers to back that up), but I do know (based on press releases) that the healthcare industry was terrified of a bill in California to limit loss ratio to no less than 85% (their Republican Governator vetoed it). The government is not interested in turning a profit on healthcare, nor are they interested in spending hundreds of millions on lobbying. By these two facts alone, a public plan will have a much higher loss ratio.

athelas, you have a point that all insurance works like this. In fact typical loss ratios for other types of insurance are around 45%. The difference is that because of the way health insurance works (and hand in hand with that the cost of health care), you have millions and millions of people who cannot afford insurance and those very same people cannot afford to pay for care themselves. Meanwhile, more than half of medical bankruptcies come from people who have insurance, so even having that isn't a guarantee. This is wrong. This isn't a house, this isn't a car, this isn't a sum payable on death.

This is a diabetic getting insulin, a drug which despite being decades old most insurance plans consider non-formulary, which means if you're lucky they'll pay half the cost - so for unemployed diabetics insurance just isn't worth it, so they don't get proper care because who can afford a doctor if you're still paying for insulin? This is a friend of mine with APS and probably lupus (both autoimmune disorders) being able to be more worried about losing her foot than about paying the bill for aftercare - and she has insurance, but last I checked they're doing their damnedest not to pay. This is about people who get chronic or terminal illnesses that cause them to lose their job, and therefore their insurance, and therefore everything. This is about the people in this video, all of whom were insured.

That interview Wombat linked there - it's just corroboration. The health insurance industry is horribly, horribly broken, and it won't fix itself because there's no money in it. It needs to be fixed, and it needs to be fixed now. Before the industry and their shills kill reform through attrition and lies again.

EDIT: Here's your example of people explicitly saying the reform will kill people. It's a couple of minutes in.

EDIT2: rephrased that, "your people" didn't sound right
Last edited by netcrusher88 on Mon Aug 10, 2009 4:08 pm UTC, edited 1 time in total.
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Re: Report your fellow citizens' remarks about health care!

Postby SummerGlauFan » Sat Aug 08, 2009 2:26 pm UTC

Oh for crying out loud, stop misinterpreting my posts already. Here's what I said I meant by not rushing earlier in this thread.

SummerGlauFan wrote:You seem to be misunderstanding what I am saying. I am saying that the plan congress makes should be carefully thought out, not rushed into service in a couple of months. That way, you can catch the inevitable mistakes, loopholes, and glaring omissions that are going to pop up in something of that complexity that is rushed. If that means lawmakers and experts have to go over it step-by-step, page-by-page, so be it. Obama and congress want a reform ASAP, and are sacrificing quality for speed. It's freaking health care, so it's kinda important we don't botch it. I'm not saying "Let's wait another sixty years debating whether or not we need reform," as has been the case over the last 60 years.
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