Health care debate confirms this is not the Barack Obama we elected

[kg_veteran]

Health care debate confirms this is not the Barack Obama we elected

Michael Goodwin

Wednesday, August 19th 2009, 4:00 AM

Taking the stage for a town hall meeting on health care the other day, President Obama emerged from behind a curtain in a fake jog. He pumped his arms in an exaggerated fashion, but his smile looked forced as he waved and shook hands with a few audience members.

It all seemed a campaign ritual, dulled by time and beleaguered by circumstance, prompting a flashback in my head to the Paul Simon song about Joe DiMaggio.

Where have you gone, Barack Obama? Where is the sunny-side-up young man who promised to inspire and unite an unhappy nation?

Gone into the partisan sinkhole of Washington, that's where. Like some novice swimmer too confident of his own ability, Obama is suddenly finding himself in water over his head.

His flailing, including a foul habit of demonizing dissent, is not pretty. And that brief foray into e-mail tracking of critics showed a win-at-any-cost side.

Where is the appealing man we elected? Where is that Barack Obama?

Let's find him quick because the whole nation is paying the price for this impostor's irrational exuberance. Or hubris.


Americans, more of them every day, are growing disenchanted with the expansion of government and the massive pile of debt. Yet the President, certain he can change their minds if only he talks to them again, keeps trying to sell bigger as better.

The public's not buying it. And as a measure of the nation's mood, a recent poll was practically cruel: Nearly half think the President is on television too much. Ouch.

Obama fatigue occasionally surfaced during the campaign, but this is different. He's the President, and if the country tunes him out, there is no Plan B. He's the rock star-turned-salesman, and everything in his administration depends on his stage act.

That the novelty is wearing thin is obvious. The danger is that the health care fiasco turns him into an unpopular and ineffective President.

Those who say it can't happen should study a recent New York Times/CBS poll. Among the lowlights:

* Sixty-nine percent believe Obamacare will hurt the quality of their own health care.

* Seventy-three percent believe they will have less access to tests and treatment.

* Sixty-two percent believe Democrats' proposals would force them to change doctors.

* Seventy-six percent believe Obama's changes will mean higher taxes for them.

* Seventy-seven percent expect their health care costs to rise.

All those findings run counter to the claims Obama makes. Even as he talks in vague ways about what exactly he favors, he promises the bill that emerges from Congress' sausage factory will be a magic elixir.

Writing in The New York Times, he guaranteed everything for everyone: "If you don't have health insurance, you will finally have quality, affordable options once we pass reform. If you have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care you need.

"If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan."

Those claims would be credible if they were a multiple-choice question, where only one is true. To say they can all happen at once is a crock, and the country knows it.

Heck, throw in a free puppy for everybody, too.

With stubborn wars in Iraq and Afghanistan and an economy still bleeding, you'd think a new President would have challenges enough. Yet Obama has plunged into the health care mess as though it is a battle of absolute necessity.

It isn't. It is his choice. And it is a mistake.

If he's the man we thought he was, he'll now choose to make peace, before the country concludes he's the mistake.

[Flacolaco]

His flailing, including a foul habit of demonizing dissent, is not pretty. And that brief foray into e-mail tracking of critics showed a win-at-any-cost side.

Those sounds you hear, the ones that sound like plungers being removed from a clogged drain, are the sounds of media types all over the north east removing their proverbial mouths from Obama's charismatic penis.

[Flacolaco]

http://www.bloomberg.com/apps/news?p...d=aJ01reSCujDQ

...For example, asked at the Portsmouth town hall how private insurance companies can compete with the government, the president said the following:

“If the private insurance companies are providing a good bargain, and if the public option has to be self-sustaining -- meaning taxpayers aren’t subsidizing it, but it has to run on charging premiums and providing good services and a good network of doctors, just like any other private insurer would do -- then I think private insurers should be able to compete.”

Self-sustaining? The public option? What has Obama been doing during those daily 40-minute economic briefings coordinated by uber-economic-adviser, Larry Summers?

Capitalism Explained

Government programs aren’t self-sustaining by definition. They’re subsidized by the taxpayer. If they were self-financed, we’d be off the hook.

Llewellyn Rockwell Jr., chairman of the Ludwig von Mises Institute in Auburn, Alabama, and editor of LewRockwell.com, put it this way in an Aug. 13 commentary on Mises.org:

“The only reason for a government service is precisely to provide financial support for an operation that is otherwise unsustainable, or else there would be no point in the government’s involvement at all.”

Rockwell sees no “economic reason for a government postal system” and would abolish it.
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[alexamenos]

three things 'bout 'bama.....

1) his intelligence seems vastly over-rated. I can't see that the dude is an order of magnitude smarter than bush....he seems pretty ordinary and when he goes impromptu he makes me wonder how could have gotten through law school.

2) his blackness is vastly over-rated. The dude is whiter than these guys. That's what makes the 'you don't like obama you must be a racist' stuff so ironic...Obama isn't nearly as black as clinton.

3) I don't know that it really matters that he's an unspectacular marxist whose chief talent is reading from a teleprompter. The fed gov is out of control and it doesn't really matter who is sitting at the metaphorical helm.

[92bDad]

Is it too early to say "Told You So"...not that McCain would've been much better...

Could last years election be perhaps the weakest of all time?

Is there nobody with a passion for America willing to step up and be a leader, without being a puppet first?

Is the time right for a true conservative group to rise up and get elected without having "R" or "D" beside their name come election time?

Heck I'm a social and fiscal conservative, but I am perhaps finally willing to forgo the social side in order to have a genuine fiscal conservative.

Don't get me wrong, we still need a moral compass, but this should be something that comes from the people and how we live our lives, not from a government who spins one way or another depending on how many votes they can get.

Is it perhaps time to get rid of all the "Lawyer Speak" in Washington, and get back to a truer representation? Where are the Doctors, Businessman, Citizens, Mechanics, Waiters, etc...serving as an elected official?

What will it take to simplify the political and governing process? Who are the leaders that will use plain talk with positive solutions that benefit the majority of Americans? When will people stop trying to please ALL Americans? That is an impossible task.

What will it take to reign in the federal government and allow the States to govern themselves, thus giving people true and genuine choices regarding the states they live in.

For those that have faith in a liberal ideology, no doubt there will be geographical locations that are more geared to meet your values. For those that have faith in a more conservative ideology, no doubt there will be geographical locations that are geared to meet your values.

Why is the federal government so hell bent on one way or the highway, thus disenfranchising half of America?

Again Obama or McCain was nothing other than more of the same.

[dude1394]

Obama is nothing like mccain.

[Mavdog]

Originally Posted by kg_veteran

Those who say it can't happen should study a recent New York Times/CBS poll. Among the lowlights:

* Sixty-nine percent believe Obamacare will hurt the quality of their own health care.

* Seventy-three percent believe they will have less access to tests and treatment.

* Sixty-two percent believe Democrats' proposals would force them to change doctors.

* Seventy-six percent believe Obama's changes will mean higher taxes for them.

* Seventy-seven percent expect their health care costs to rise.

pretty clear that the right has done a good job of promoting their message, even when the message is not accurate.

never underestimate just how successful a campaign of disinformation can be with a gullible american public.

[Mavdog]

Originally Posted by Flacolaco

http://www.bloomberg.com/apps/news?p...d=aJ01reSCujDQ

quite a gap in the understanding of "public benefits".

services provided by the government can't be looked at through a profit/loss prism, the benefits to the public aren't quantified or ascribed in simple numbers.

take the fire dept, or the police dept. code compliance? traffic and engineering? does trash collection need to break even, or is there a benefit to the public in having their trash picked up at regulary scheduled times, at their residence, with little waste lost, worth something?

as for lew and the post office, do you actually believe that if ups or fed ex was obligated to visit every home, every business every day, even if they don't deliver a package there, that either of them would be profitable at the rates they charge?

no. there's no way they would, and that public benefit is why the post office loses money. and why the post office is valuable to society.

[Gus]

Fire Departments and traffic lights and all of these public agencies are paid by tax dollars. There is no profit for them, but they do have a budget that they have to operate in. There fore there is no "breaking even." If not enough taxes are collected to pay for this, the employees get laid off. You usually are billed for ambulance service and there are private ambulance services you can sign up for.

Also you pay a bill each month for trash collection so it's not exactly some kind of public service. If you don't pay for it, they don't come get your trash. So yes it is worth something; The $30 a month or whatever it is you pay for it.

And UPS and FedEx have routes just like the Post Office. If someone has paid them to deliver something to your house, they stop at your house. Just like someone paid the USPS money to deliver all that junk mail to your house. The postman doesn't stop at my house if there is no mail for me that day. Maybe they need to charge more for regular mail. But they certainly aren't losing money because they offer some kind of "public benefit."

Originally Posted by Mavdog

quite a gap in the understanding of "public benefits".

services provided by the government can't be looked at through a profit/loss prism, the benefits to the public aren't quantified or ascribed in simple numbers.

take the fire dept, or the police dept. code compliance? traffic and engineering? does trash collection need to break even, or is there a benefit to the public in having their trash picked up at regulary scheduled times, at their residence, with little waste lost, worth something?

as for lew and the post office, do you actually believe that if ups or fed ex was obligated to visit every home, every business every day, even if they don't deliver a package there, that either of them would be profitable at the rates they charge?

no. there's no way they would, and that public benefit is why the post office loses money. and why the post office is valuable to society.

[kg_veteran]

Originally Posted by Mavdog

pretty clear that the right has done a good job of promoting their message, even when the message is not accurate.

never underestimate just how successful a campaign of disinformation can be with a gullible american public.

Ah, yes. The American people are just too dumb to understand. I never figured you for an elitist.

But while we're at it, do you really think that President Obama's plan will lower costs? Do you think it can be accomplished without a tax increase?

If so, well....

[dude1394]

I thought I would help you channel your inner Pelosi.

Originally Posted by Mavdog

never underestimate just how successful a campaign of disinformation can be with an evil, terrorist, rube, nazi like, gullible american public.

[Mavdog]

Originally Posted by kg_veteran

Ah, yes. The American people are just too dumb to understand. I never figured you for an elitist.

the phrase "dumb" is yours, not mine. do you believe that the word "gullible" means the same as "dumb"?

But while we're at it, do you really think that President Obama's plan will lower costs? Do you think it can be accomplished without a tax increase?

If so, well....

lower costs over what thiose costs could be in the future? yes, the proposal can accomplish a reduction in the future increase of these costs.

can the reform proposal be accomplished without a tax increase? I really cannot give you a certain response, but one point to make: the reform proposal may result in lower costs to other programs elsewhere in the budget (medicare, medicaid, etc), making it fairly neutral.

[aquaadverse]

Originally Posted by kg_veteran

Ah, yes. The American people are just too dumb to understand. I never figured you for an elitist.

But while we're at it, do you really think that President Obama's plan will lower costs? Do you think it can be accomplished without a tax increase?

If so, well....

It's amazing how we have suddenly gotten collective amnesia and forgotten we had a quality, affordable 90% private system about a decade and a half ago, but every large entitlement program has been mismanaged into a mess.

It's also telling a number of people seem to think you can't possibly understand the situation and still disagree with them.

Is this a bad time to mention my city contracts out trash pickup and the private company is profitable even with an added second weekly pickup day and bulk pickup once a month instead of every 60 days?

[Mavdog]

what is amazing is that the "quality, affordable 90% private system about a decade ago" was quality for those who could pay for it, and non-accessible for those who couldn't.

it's also telling that a number of people don't want to take the effort to actually read the proposal and understand the situation, but still want to act like they do and disagree about it.

is this a bad time to mention that the city of dallas does my trash pickup (regular and recycled) 2x's a week and bulk trash once a month? oh, and if you want them to pick up bulk trash outside of the regular day they will arrange to have that done at no addl costs?

[kg_veteran]

Originally Posted by Mavdog

the phrase "dumb" is yours, not mine. do you believe that the word "gullible" means the same as "dumb"?

Gullible means "easily duped or cheated". Let's insert that into your sentence:

"never underestimate just how successful a campaign of disinformation can be with an easily duped and cheated american public."

Wow, that's a lot less condescending and elitist than calling Americans dumb.

lower costs over what thiose costs could be in the future? yes, the proposal can accomplish a reduction in the future increase of these costs.

can the reform proposal be accomplished without a tax increase? I really cannot give you a certain response, but one point to make: the reform proposal may result in lower costs to other programs elsewhere in the budget (medicare, medicaid, etc), making it fairly neutral.

I guess you haven't seen the CBO analysis.

Also, from a strictly common-sense (or maybe you'd call it "gullible") point of view, there is no way that you can require coverage for millions of additional people and added coverage for many millions more (e.g., pre-existing conditions) without a huge increase in costs. And at some point, you can't just keep printing money. If Obama's plan passes, he'll inevitably have to break his campaign promise not to tax people making less than $250k.

[kg_veteran]

Originally Posted by Mavdog

what is amazing is that the "quality, affordable 90% private system about a decade ago" was quality for those who could pay for it, and non-accessible for those who couldn't.

The fact that the system needs changes does not mean that this proposal is the right one to change it.

[Mavdog]

Originally Posted by kg_veteran

Gullible means "easily duped or cheated". Let's insert that into your sentence:

"never underestimate just how successful a campaign of disinformation can be with an easily duped and cheated american public."

Wow, that's a lot less condescending and elitist than calling Americans dumb.

you deal with words every day, is "easily duped and cheated" the same as "dumb"?

hows this: Steven Spielberg was duped and cheated out of several million dollars by the bernie madoff scheme.

is that the same as stating Steven Speilberg was dumb?

no, it isn't. wow, it's a lot different in connotation isn't it?

I guess you haven't seen the CBO analysis.

the cbo analysis doesn't take into account the change in costs to other programs, it does not "net" out the affect.

it also does not assume what the costs would be if the structure remains static, or the delta between what the costs to the population would be if no change is made vs the costs to the population if the reforms as done.

Also, from a strictly common-sense (or maybe you'd call it "gullible") point of view, there is no way that you can require coverage for millions of additional people and added coverage for many millions more (e.g., pre-existing conditions) without a huge increase in costs. And at some point, you can't just keep printing money. If Obama's plan passes, he'll inevitably have to break his campaign promise not to tax people making less than $250k.

you must be under the mistaken assumption that the additional insured, and those with pre-existing conditions, who are covered under the plan won't pay any premiums.

don't know about if the tax rates will need to be increased to those under $250k. it seems to me (from a "common sense" view) the need for additional taxes hinges more on the total amount of spending and not just this particular program. doesn't that make more sense?

[Mavdog]

Originally Posted by kg_veteran

The fact that the system needs changes does not mean that this proposal is the right one to change it.

that is a fair statement, yet the problem is this: those who are shouting down this proposal aren't doing so with any alternative.

I believe there is a process that could bring forth a good compromise which incorporates ideas from both sides of the debate. however, one side is putting out a proposal and the other side is just throwing hand granades.

the concept of an insurance co-op was a step in the very direction that I point to, yet how was that received? no dialogue, not discourse, merely more screaming and yelling, with more accusations of :"government takeover" and "socialism", more hand granades thrown.

[aquaadverse]

Originally Posted by Mavdog

quite a gap in the understanding of "public benefits".

services provided by the government can't be looked at through a profit/loss prism, the benefits to the public aren't quantified or ascribed in simple numbers.

take the fire dept, or the police dept. code compliance? traffic and engineering? does trash collection need to break even, or is there a benefit to the public in having their trash picked up at regulary scheduled times, at their residence, with little waste lost, worth something?

as for lew and the post office, do you actually believe that if ups or fed ex was obligated to visit every home, every business every day, even if they don't deliver a package there, that either of them would be profitable at the rates they charge?

no. there's no way they would, and that public benefit is why the post office loses money. and why the post office is valuable to society.

Actually, it's more like having not one but two companies enjoy strong growth and profits duplicating a function the government was already providing, in spite of having to completely ramp up from zero and build trust and reliability. When I get express mail it's from a different carrier making a special stop. They had a big advantage, they already had the people and the facilities. The post office has attempted to play catch up for decades and is failing big time. You still can't track a package with reliability from them.

It's more accurate to say they just watched the business packages segment, the one that couldn't be faxed or emailed, go away from them. To get anything done in Government it has to get through 400 hundred people with differing agendas. That's great if you are passing law and you have enough diversity in the participants so you have checks and balances.

Not so good if you have to make adjustments to a changing environment. No for profit business would have left all those locations open as long as they did. It's why I distrust them for functions like health care.

There is absolutely no reason for Social Security and Medicare to be in their current state. The health and viability of the programs are secondary to keeping their position and influence. You can say the same for the executives in any company, but if a private for profit company raided the pension fund to expand foreign markets like say in South East Asia it's unlikely they would be around after it became public.

How many Freddie and Fannies do we need before it sinks in that direct mucking about in the free market, instead of trying to keep the field level, is a bad idea.

Oh, say hello to gennie mae:

http://www.istockanalyst.com/article...icleid/3410493

[aquaadverse]

Originally Posted by Mavdog

that is a fair statement, yet the problem is this: those who are shouting down this proposal aren't doing so with any alternative.

I believe there is a process that could bring forth a good compromise which incorporates ideas from both sides of the debate. however, one side is putting out a proposal and the other side is just throwing hand granades.

the concept of an insurance co-op was a step in the very direction that I point to, yet how was that received? no dialogue, not discourse, merely more screaming and yelling, with more accusations of :"government takeover" and "socialism", more hand granades thrown.

The suggestions of tort reform, pooling for catastrophic coverage which is different from the co-op, medical savings accounts, opening the entire country for marketing policies etc... was and has been out there and refused.

You ignore the fact that the House was perfectly fine with ramming their version through prior to recess and having little problem marginalizing people who started trying to voice objections as shills, racists and idiots.

" We won deal with it" is hardly the "come let us reason" you seem to think it was earlier in the process. Treating voters and citizens as some kind enemy to overcome and dismissing them as the administration did with those tea baggers early on was the worst action he could have taken.

The flaying around for some way to marginalizing them pissed them off. They watched huge game changing spending bills being pushed through with no time to examine them.

Obama doesn't seem to have statesman in his makeup. Everything is a winner and loser with him. He didn't spend time with the opposition during the Stimulus dust up, he went to the Dems caucus and belittled and mocked the opposition.

The actions you find so distasteful just happen to be the only thing that stopped the "Hulk Smash" political tactic of the previous couple of Bills.

You keep saying no one has any plans or alternatives, but it's just not true. It was perfectly possible to have a bipartisan bill already signed and done. Everyone knows the system is broken. Everyone wants to make it better.

But simply spouting "If you don't want this bill to pass, you don't want anything done " is false. Having all this rancor and anger was avoidable.

[Mavdog]

first, tort reform is a states issue, not a federal one.

second, medical savings accounts exist today, I have one.

third, allowing for nationwide insurance competition is in the obama plan.

last, where was a proposal from the minority? what, not a single bill was offered?

the 'rancor and anger" was cultivated from day one. it was not a product of the process, it began the process.

[kg_veteran]

Originally Posted by Mavdog

you deal with words every day, is "easily duped and cheated" the same as "dumb"?

hows this: Steven Spielberg was duped and cheated out of several million dollars by the bernie madoff scheme.

is that the same as stating Steven Speilberg was dumb?

no, it isn't. wow, it's a lot different in connotation isn't it?

You took out the word "easily", which would make Spielberg sound dumb. But I digress, because I don't want to debate semantics.

If you think that opposition to Obama's plans (I have to use plural because there is no final bill, yet) is the result of a misinformation campaign foisted upon the "easily duped and cheated" American public, I'll just have to beg to differ. Certainly, there are false claims out there which don't help the debate and allow "Obama Care" supporters to paint all opposition with a broad brush (like you've done). Certainly, there are people out there who believe the false claims and oppose Obama's reform proposals on that basis. But the way I see it, the majority of the opposition to Obama's plans is because people realize where those plans would take the country, and they don't like it.

the cbo analysis doesn't take into account the change in costs to other programs, it does not "net" out the affect.

$1 trillion in new spending. You think that there will be $1 trillion in savings because of cost-cutting in Medicare and Medicaid? Really?

you must be under the mistaken assumption that the additional insured, and those with pre-existing conditions, who are covered under the plan won't pay any premiums.

I know that you are sophisticated enough to understand how insurance works. It's about risk adjustment. If you add higher risk people to the pool (e.g., those with pre-existing conditions) and require that they can't be removed from the pool, premiums are going to increase. If you say that those with pre-existing conditions are going to have affordable premiums, that necessarily implies subsidization. And if you somehow try to fix prices by setting ceilings on premiums, insurance companies will simply stop insuring people.

Bottom line, you can't seriously expect me to believe that the premium payments (whatever they may be) from the new folks in the system will cover the costs of their care. If they did, why would we need "reform" in the first place? If those people could already afford coverage, we wouldn't.

don't know about if the tax rates will need to be increased to those under $250k. it seems to me (from a "common sense" view) the need for additional taxes hinges more on the total amount of spending and not just this particular program. doesn't that make more sense?

Every cost estimate I've seen makes it abundantly clear that you can't just squeeze the money out of the "rich" people. You're going to have to tax everyone more. Quite a bit more.

And, of course, the other elephant in the room is rationing. There's no way that you can add a huge increase in demand to the system AND control costs without rationing care.

[kg_veteran]

Originally Posted by Mavdog

that is a fair statement, yet the problem is this: those who are shouting down this proposal aren't doing so with any alternative.

Lack of an alternative is not a good excuse to pass horrible legislation. The reason that the Democratic proposals receive the vast majority of attention (and criticism) is that those are the proposals that are realistically going to be voted on this term. Do you honestly think that a Republican-sponsored bill (e.g., the Patients' Choice Act) is going to see the light of day?

FWIW, I think this debate should have occurred long ago, but that doesn't mean it should be rushed. This should be a top priority, but acting like something has to be done this month is irrational. The reforms passed could potentially affect our economy, culture, and nation for the rest of the century. That's something that is worth taking the time necessary to get it right.

I believe there is a process that could bring forth a good compromise which incorporates ideas from both sides of the debate. however, one side is putting out a proposal and the other side is just throwing hand granades.

As noted above, one side is the majority party and has control of the executive and legislative branch. It is natural that their plans would be the focus of the debate.

I'm not sure that I'm completely sold on anything I've heard from the Republicans, either. But some of the things that they have been talking about resonate with me a lot more than the Democratic proposals.

the concept of an insurance co-op was a step in the very direction that I point to, yet how was that received? no dialogue, not discourse, merely more screaming and yelling, with more accusations of :"government takeover" and "socialism", more hand granades thrown.

I think you're making generalizations.

Co-ops will face the same problems that group insurance does. As long as you require that everyone receive coverage, it is going to substantially drive up the expenses for the healthy folks at the expense of the unhealthy ones.

Speaking of proposals, I will post an interesting article that I read in this thread...

[kg_veteran]

August 19, 2009
How Free Health Care Got So Expensive
By Steven Malanga - link

Recently I was listening to a radio program in which the host explained that in a few states health insurance policies issued by Blue Cross/Blue Shield were available at extremely reasonable prices, about $100 a month. The very first caller into the program demanded to know exactly what the annual deductible was in plans like this. When the host said $3,000 to $5,000 the caller responded, that isn't health insurance but catastrophic insurance. It's too expensive and that's why we need health care reform from Washington, he continued.

And there lies one of the problems with the health insurance reform debate. State government mandates and favorable tax treatment in Washington have so distorted the market for health insurance that a generation of Americans now look on medical coverage as something very different from other kinds of insurance that we buy. While we will pay several hundred bucks out of our own pockets to have a plumber come repair a leaky pipe, we'll balk at deductibles and a $50 co-pay for a doctor's visit. We've been schooled in this attitude by politicians who have mandated that health insurance do things that we'd never expect from other kinds of insurance, and by consumer advocates who will demand our legislators do something about a health insurance company that doesn't cover some optional procedure that has nothing to do with life and death.

It's worth keeping these differences between types of insurance in mind now that it's becoming clear that a solid majority of Americans do not want health reform that involves an even more expansive role for government. That's why the so-called ‘public option' of a government health insurance entity competing with private insurance is rapidly losing favor in Washington. That's good because a public option won't restore sanity to the health insurance market. What will, is getting get rid of the rules, mandates and tax exemptions that treat health insurance different from other coverages.

Consider auto insurance, which is typically required of us by states, and home insurance, which mortgage lenders demand. Both give us protection from financial ruin at more reasonable prices than health insurance because our options are greater and the scope of the coverage narrower. When we buy home insurance we are essentially purchasing security against a catastrophic event that could cost us our investment in our home and possibly ruin us financially. We don't expect this insurance to cover everything that goes wrong on the property. Instead, we accept that we will pay out of our own pockets the tradesmen who come and install our new water heater, fix our electrical short-circuits and repave our driveway. Many of us haven't gotten a health care bill in years equal to what we paid the plumber for his last visit because the cost of a home insurance policy that covered every leak and crumbling piece of pavement would be prohibitive.

There are significant other ways that government mandates treat health insurance differently, at great cost to all of us. Consider this scenario: You don't have home insurance and a big storm comes through and knocks over a tree into your roof. You can't just phone up an insurer, buy coverage and then submit a claim, even if you face financial ruin by not having the coverage. But that's more or less what you can do in health insurance under so-called guaranteed issue rules, in which someone who hasn't purchased insurance and gets sick can't be turned down for coverage. Needless to say, states that have guaranteed issued, like New Jersey and New York, have the highest health insurance premiums in the country because healthy people know they can run the risk of not buying insurance until they get sick. Insanely, the health reform package now on the table in Washington would create a federal version of guaranteed issue.

In auto insurance, some states have given us our own private version of tort reform to keep premium prices low. In these states, a driver can opt out of the litigation lottery when he purchases auto insurance by promising not to sue for pain and suffering if he's hit and injured by another driver. By doing this a policy holder can save hundreds of dollars a year on premiums. And yet for some reason the same option, that is, allowing us to buy a health insurance policy where we agree not to sue a health provider for pain and suffering if a treatment goes wrong, is not available, even though I imagine the cost savings would be enormous.

Government regulators also require us to buy so much more health insurance. In auto coverage, for instance, states will generally mandate that we have certain minimum coverage to compensate anyone we may crash into, but otherwise regulators will leave us alone to decide which options (towing, collision) we want to buy. By contrast, states will require buyers of individual and small group health policies to load up on mandatory coverage, including options that many people don't want to pay for, like fertility treatments. Politicians will often claim that they demand these coverages because they are looking out for our own good, but that's a difficult case to make persuasively when mandates help make insurance unaffordable for many people.

Still, now that the public mood is turning away from health reform that involves significant new government initiatives, a few voices are starting to argue for an alternate system which gets back to treating health insurance like other forms of coverage. In a much discussed piece in the Wall Street Journal, Whole Foods CEO John Mackey explained how his company was able to offer coverage to its retail employees with a high yearly deductible ($2,500) that protects employees from steep health care bills but also encourages employees to spend their own health dollars wisely. In an industry where many workers don't have health insurance and profit margins at many businesses are small, Whole Foods has been able to provide coverage using the same model that Blue Cross/Blue Shield plans offer individuals in a few states. Yet the company has been threatened with boycotts for suggesting that health reform should follow the same sensible model.

A few states are also leading the way. Washington State has rescinded guaranteed issue rules. Colorado, Georgia, New Hampshire and Nevada are among the states which allow the kind of high-deductible policies I described in the first paragraph for individuals needing coverage.

There's resistance, of course, mostly from politicians and advocates who keep trying to convince us that somehow it's un-American to have to pay a health care bill out of our own pocket. But the reality is that until we take more control of buying our own health care, our insurance costs will continue to spiral upward.

Steven Malanga is an editor for RealClearMarkets and a senior fellow at the Manhattan Institute

[92bDad]

Can we make some type of analogy to the Housing/Banking crisis?

Did some organization to include the government push to allow underqualified buyers to have access to purchasing a home...which they couldn't afford and thus lead to one of if not the largest economic collapse in the history of the USA?

So now we are trying to apply the same principal to Medical Coverage?

So who pays for all this? The insurance companies will only go so far, until they reach a breaking point and no longer find it profitable to insure certain people without going under.

So now the government steps in...they cast this wide net out, make sure that everyone is in some type of system.

As it becomes more challenging for the "Private" sector to compete with the price to consumers based on the Government "Wal-Mart" pricing, we will see Insurance companies decline and fold.

This in turn will be the government manipulating free market into a Government Controlled one payer system...which in turns means that the Government will have a monopoly on Healthcare and we the people will no longer have choices.

Now we will get taxed more...but mind you, this will be something that evolves over time, thus Obama will be long gone before everyone experiences the pain of the tax hike.

What we see is the government under Obama applying the same tactics against the people as ACORN and such applied to banks who wanted to stick to good business practice...thus after these tactics forced these banks to vanquish their own principals, we saw the collapse and the open door for the Government to take over business.

It's not Obama personally, but rather this whole Liberal Ideology and ultimately Socialism Ideology.

There's this belief that the Government knows best what its people needs and the people are too foolish to understand the merits of what the government is doing. Basically its a return to England before we escaped on the Mayflower. It's just disguised, not as a monarchy...but rather Deomcratic Rule.

[Mavdog]

Originally Posted by kg_veteran

You took out the word "easily", which would make Spielberg sound dumb. But I digress, because I don't want to debate semantics.

If you think that opposition to Obama's plans (I have to use plural because there is no final bill, yet) is the result of a misinformation campaign foisted upon the "easily duped and cheated" American public, I'll just have to beg to differ. Certainly, there are false claims out there which don't help the debate and allow "Obama Care" supporters to paint all opposition with a broad brush (like you've done). Certainly, there are people out there who believe the false claims and oppose Obama's reform proposals on that basis. But the way I see it, the majority of the opposition to Obama's plans is because people realize where those plans would take the country, and they don't like it.

interesting, you "don't want to debate semantics", yet you took the initiative to start the debate in the first place. you also failed to address the question of if speilberg being duped by madoff equated to speilberg being shown to be dumb by losing millions in madoff's scheme. clearly the two are not synonymous.

we just disagree. a majority of the public beleive that the plan calls for a single payer format (false), that it will have the federal government take control ie nationalize the health care industry (false), that illegal aliens will get coverage (false)that there will be government decisions on who gets treatment (false) and that it will mean the consumer will not have a choice in who is their doctor (false).

all those false ideas didn't come out of thin air, they came out of a campaign of misinformation hoisted upon the public by those who oppose the reform initiative.

$1 trillion in new spending. You think that there will be $1 trillion in savings because of cost-cutting in Medicare and Medicaid? Really?

these 2 programs total almost $700 billion/year in outlays, and the $1 trillion is over a 9 year period = $110 Billion a year, so yes a savings of a bit over 15% is not unrealistic.

I know that you are sophisticated enough to understand how insurance works. It's about risk adjustment. If you add higher risk people to the pool (e.g., those with pre-existing conditions) and require that they can't be removed from the pool, premiums are going to increase. If you say that those with pre-existing conditions are going to have affordable premiums, that necessarily implies subsidization. And if you somehow try to fix prices by setting ceilings on premiums, insurance companies will simply stop insuring people.

Bottom line, you can't seriously expect me to believe that the premium payments (whatever they may be) from the new folks in the system will cover the costs of their care. If they did, why would we need "reform" in the first place? If those people could already afford coverage, we wouldn't.

yes, it is about the risk pool of those covered, and if you add those with existing condiotions and add those who are not insured and have no existing condidtions, they should balance each other out.

limits on premiums will not result in no policies being written, if that is the case the insurers would need to just shut their doors. they will raise the deductible, increase co-pays etc, not stop writing policies.

Every cost estimate I've seen makes it abundantly clear that you can't just squeeze the money out of the "rich" people. You're going to have to tax everyone more. Quite a bit more.

And, of course, the other elephant in the room is rationing. There's no way that you can add a huge increase in demand to the system AND control costs without rationing care.

what makes you believe that there will be a "huge increase in demand"? the demand is already out there, it's not going to see a huge increase. what we will see is a better allocation of the costs, and a better utilization of the resources by providing the ability to receive health care earlier/easier.

[Mavdog]

Originally Posted by kg_veteran

August 19, 2009
How Free Health Care Got So Expensive
By Steven Malanga - link

Recently I was listening to a radio program in which the host explained that in a few states health insurance policies issued by Blue Cross/Blue Shield were available at extremely reasonable prices, about $100 a month. The very first caller into the program demanded to know exactly what the annual deductible was in plans like this. When the host said $3,000 to $5,000 the caller responded, that isn't health insurance but catastrophic insurance. It's too expensive and that's why we need health care reform from Washington, he continued.

And there lies one of the problems with the health insurance reform debate. State government mandates and favorable tax treatment in Washington have so distorted the market for health insurance that a generation of Americans now look on medical coverage as something very different from other kinds of insurance that we buy. While we will pay several hundred bucks out of our own pockets to have a plumber come repair a leaky pipe, we'll balk at deductibles and a $50 co-pay for a doctor's visit. We've been schooled in this attitude by politicians who have mandated that health insurance do things that we'd never expect from other kinds of insurance, and by consumer advocates who will demand our legislators do something about a health insurance company that doesn't cover some optional procedure that has nothing to do with life and death.

It's worth keeping these differences between types of insurance in mind now that it's becoming clear that a solid majority of Americans do not want health reform that involves an even more expansive role for government. That's why the so-called ‘public option' of a government health insurance entity competing with private insurance is rapidly losing favor in Washington. That's good because a public option won't restore sanity to the health insurance market. What will, is getting get rid of the rules, mandates and tax exemptions that treat health insurance different from other coverages.

Consider auto insurance, which is typically required of us by states, and home insurance, which mortgage lenders demand. Both give us protection from financial ruin at more reasonable prices than health insurance because our options are greater and the scope of the coverage narrower. When we buy home insurance we are essentially purchasing security against a catastrophic event that could cost us our investment in our home and possibly ruin us financially. We don't expect this insurance to cover everything that goes wrong on the property. Instead, we accept that we will pay out of our own pockets the tradesmen who come and install our new water heater, fix our electrical short-circuits and repave our driveway. Many of us haven't gotten a health care bill in years equal to what we paid the plumber for his last visit because the cost of a home insurance policy that covered every leak and crumbling piece of pavement would be prohibitive.

There are significant other ways that government mandates treat health insurance differently, at great cost to all of us. Consider this scenario: You don't have home insurance and a big storm comes through and knocks over a tree into your roof. You can't just phone up an insurer, buy coverage and then submit a claim, even if you face financial ruin by not having the coverage. But that's more or less what you can do in health insurance under so-called guaranteed issue rules, in which someone who hasn't purchased insurance and gets sick can't be turned down for coverage. Needless to say, states that have guaranteed issued, like New Jersey and New York, have the highest health insurance premiums in the country because healthy people know they can run the risk of not buying insurance until they get sick. Insanely, the health reform package now on the table in Washington would create a federal version of guaranteed issue.

In auto insurance, some states have given us our own private version of tort reform to keep premium prices low. In these states, a driver can opt out of the litigation lottery when he purchases auto insurance by promising not to sue for pain and suffering if he's hit and injured by another driver. By doing this a policy holder can save hundreds of dollars a year on premiums. And yet for some reason the same option, that is, allowing us to buy a health insurance policy where we agree not to sue a health provider for pain and suffering if a treatment goes wrong, is not available, even though I imagine the cost savings would be enormous.

Government regulators also require us to buy so much more health insurance. In auto coverage, for instance, states will generally mandate that we have certain minimum coverage to compensate anyone we may crash into, but otherwise regulators will leave us alone to decide which options (towing, collision) we want to buy. By contrast, states will require buyers of individual and small group health policies to load up on mandatory coverage, including options that many people don't want to pay for, like fertility treatments. Politicians will often claim that they demand these coverages because they are looking out for our own good, but that's a difficult case to make persuasively when mandates help make insurance unaffordable for many people.

Still, now that the public mood is turning away from health reform that involves significant new government initiatives, a few voices are starting to argue for an alternate system which gets back to treating health insurance like other forms of coverage. In a much discussed piece in the Wall Street Journal, Whole Foods CEO John Mackey explained how his company was able to offer coverage to its retail employees with a high yearly deductible ($2,500) that protects employees from steep health care bills but also encourages employees to spend their own health dollars wisely. In an industry where many workers don't have health insurance and profit margins at many businesses are small, Whole Foods has been able to provide coverage using the same model that Blue Cross/Blue Shield plans offer individuals in a few states. Yet the company has been threatened with boycotts for suggesting that health reform should follow the same sensible model.

A few states are also leading the way. Washington State has rescinded guaranteed issue rules. Colorado, Georgia, New Hampshire and Nevada are among the states which allow the kind of high-deductible policies I described in the first paragraph for individuals needing coverage.

There's resistance, of course, mostly from politicians and advocates who keep trying to convince us that somehow it's un-American to have to pay a health care bill out of our own pocket. But the reality is that until we take more control of buying our own health care, our insurance costs will continue to spiral upward.

Steven Malanga is an editor for RealClearMarkets and a senior fellow at the Manhattan Institute

there's much in this I can agree with.

having higher deductibles with fsa's help keepo the costs down to the insured.

working thru a voluntary limit on claims for pain/suffering would help as well.

the pre-existing coverage point isn't valid however. first, many who have a pre-existing ailment find themselves unable to get coverage because of two primary reasons: one, they fell out of coverage when their cobra ended, or two they were not insured before the malady occured. mandatory coverage would address both of these, and it is not analygous to the "tree falls on the house" story above.

[alexamenos]

straight up kg...

August 19, 2009
How Free Health Care Got So Expensive
By Steven Malanga - link

....State government mandates and favorable tax treatment in Washington have so distorted the market for health insurance that a generation of Americans now look on medical coverage as something very different from other kinds of insurance that we buy. While we will pay several hundred bucks out of our own pockets to have a plumber come repair a leaky pipe, we'll balk at deductibles and a $50 co-pay for a doctor's visit.

Our health care model is just goofy. I think the number of people who express awe and disgust when insurers won't provide insurance for pre-existing conditions is an indication of the degree of goofiness in the system and the degree to which people don't under what insurance is.


(....insurance is a hedge against bad things....when you buy insurance you are basically paying someone else to take the risk of something bad happening to you. ie, if there's a 1 in 10 chance that something bad is going to happen and if the cost of that bad thing happening will be $100, then I might pay someone $10 to bear the cost in the event the thing happens. If the bad thing has already happened, then there is no longer a risk of that thing happening, it's a done deal, hence there is nothing to insure.)

[Mavdog]

Originally Posted by alexamenos

straight up kg...

Our health care model is just goofy. I think the number of people who express awe and disgust when insurers won't provide insurance for pre-existing conditions is an indication of the degree of goofiness in the system and the degree to which people don't under what insurance is.


(....insurance is a hedge against bad things....when you buy insurance you are basically paying someone else to take the risk of something bad happening to you. ie, if there's a 1 in 10 chance that something bad is going to happen and if the cost of that bad thing happening will be $100, then I might pay someone $10 to bear the cost in the event the thing happens. If the bad thing has already happened, then there is no longer a risk of that thing happening, it's a done deal, hence there is nothing to insure.)

employee who gets their coverage from employer is let go. cobra ends in month 18 of unemployment. ex-employee becomes ill in month 20, ex-employee is denied coverage from insurers due to pre-existing condition.

ex-employee is sol. no coverage, period. no providor will take this person on, they don't have to.

now, that is "goofy" if you ask me. the previous insurer received premiums over the course of the coverage but avoided the payout when it was needed.
this is a scenario that happens, it is real.

[aquaadverse]

first, tort reform is a states issue, not a federal one.

That explains all those national commercials trolling for class action lawsuit defendants, the legislation that gets discussed and tabled in every Congressional session. Some actually get passed.
Here's an example:
http://www.cbsnews.com/stories/2005/...in957720.shtml
Federal law is written placing limits on liability and spelling out the boundaries of what is considered negligence all the time. You can have a national health care plan, but liability and punitive damages get set by every State?

Google Federal Medical Malpractice.

second, medical savings accounts exist today, I have one.

My neighbor who is uninsured got treatment at an emergency room. Universal Health Care already exists. Let's just drop the whole thing thing then, Eh?

Medical savings accounts are extremely limited. You have to be in enrolled in a high deductible medical plan. The whole idea was to use pre-taxed dollars to allow you to pay for specific services.

third, allowing for nationwide insurance competition is in the obama plan .

There is nothing in the plan to allow insurance companies to sell their policies across all states.

last, where was a proposal from the minority? what, not a single bill was offered?

Don't understand why Parties like to have a majority, eh? Never mind:
http://coburn.senate.gov/public/inde...3-3d77dc4afa83
http://www.gop.gov/talking-points/09...talking-points
http://online.wsj.com/article/SB124277551107536875.html
http://www.youtube.com/watch?v=xaxXxkro6WQ

the 'rancor and anger" was cultivated from day one. it was not a product of the process, it began the process.

Maybe if you keep saying it long enough, it'll be true, eh?

Blowing off the original tea baggers are what started it.

[alexamenos]

the previous insurer received premiums over the course of the coverage but avoided the payout when it was needed.

Was the insurer receiving premiums when the person became ill in your example?

cobra ends in month 18 of unemployment. ex-employee becomes ill in month 20

apparently not....what's your point?

no providor will take this person on, they don't have to.

Of course no insurance company would do such a thing, that would be amazingly foolish...

....kind of like: I just wrecked my car and it's going to cost $5,000 to fix, will you pay the $5,000 if I agree to give you $500?

Any takers on this deal?

The funny thing, and this is what I was trying to get across to KG, is that people expect insurance companies to behave in a manner which would drive them out of business immediately. When the insurance companies don't behave in a wreckless and foolish manner these goofy people think this is some indication of a problem.

[DirkFTW]

New Rx for Health Plan: Split Bill

The White House and Senate Democratic leaders, seeing little chance of bipartisan support for their health-care overhaul, are considering a strategy shift that would break the legislation into two parts and pass the most expensive provisions solely with Democratic votes...

While the article is wrong about even needing any Republican votes, the breakdown is interesting in that it highlights specific steps that can be taken without the divisive public option.

[kg_veteran]

Originally Posted by Mavdog

employee who gets their coverage from employer is let go. cobra ends in month 18 of unemployment. ex-employee becomes ill in month 20, ex-employee is denied coverage from insurers due to pre-existing condition.

Seems to me that the answer is to revamp the system so that coverage isn't tied to employment. Of course, to do so would require Obama to look into something McCain proposed -- tax credit for the purchase of a health insurance policy.

ex-employee is sol. no coverage, period. no providor will take this person on, they don't have to.

now, that is "goofy" if you ask me. the previous insurer received premiums over the course of the coverage but avoided the payout when it was needed.
this is a scenario that happens, it is real.

You're missing the point. Previous insurer received premiums to cover a defined set of risks over a defined period of time. Paying premiums at one point in your life doesn't mean you're always entitled to coverage.

The answer is to disconnect health insurance from employment, offer a tax credit that makes it more affordable, and then let the patient purchase the coverage that they need/want.

After all, if a person chooses not to purchase coverage because they want to try and save money, that ought to be their choice, too.

[kg_veteran]

Originally Posted by alexamenos

The funny thing, and this is what I was trying to get across to KG, is that people expect insurance companies to behave in a manner which would drive them out of business immediately. When the insurance companies don't behave in a wreckless and foolish manner these goofy people think this is some indication of a problem.

Yeah, that was the main reason I posted that article, because of that very truth.

If we're going to have a debate about health care reform, we ought to at least be intellectually honest about what insurance is and isn't.

When you pay in advance to shift risk, that's insurance. When you shift the financial burden the way it's being described by the "reformers", it's called welfare.

[alexamenos]

Originally Posted by kg_veteran

The answer is to disconnect health insurance from employment, offer a tax credit that makes it more affordable, and then let the patient purchase the coverage that they need/want.

I suspect the effect of the tax credit would be to bid the prices up so it's not all that necessary. Other than that, I absolutely agree.

When you pay in advance to shift risk, that's insurance. When you shift the financial burden the way it's being described by the "reformers", it's called welfare.

Welfare!! That's the term I've been looking for to describe what people mistakenly use "insurance" these days.

[Mavdog]

Originally Posted by alexamenos

Was the insurer receiving premiums when the person became ill in your example?

apparently not....what's your point?

uh, "the point" is the person is now unable to obtain insurance, the person needs care, and the burden is now placed on the public for this person's care.

that is unless you advocate this person not receiving any care due to their lack of ability to get coverage, and their just being left to die.

is that your position? are you saying tough shit?

Of course no insurance company would do such a thing, that would be amazingly foolish...

....kind of like: I just wrecked my car and it's going to cost $5,000 to fix, will you pay the $5,000 if I agree to give you $500?

Any takers on this deal?

The funny thing, and this is what I was trying to get across to KG, is that people expect insurance companies to behave in a manner which would drive them out of business immediately. When the insurance companies don't behave in a wreckless and foolish manner these goofy people think this is some indication of a problem.

this person should never have their coverage lapse merely because of their losing their job.

what's amazing are the people who expect that we as a country should not provide all our fellow citizens the ability to receive medical coverage because the insurers want to simply maximize their net margins when they have an opportunity to suspend coverage prior to a claim, when it is possible for the insured to be provided coverage all the way through their life with little material affect on the insurer's viability.

yep, that's what is amazing.

[Mavdog]

Originally Posted by kg_veteran

Seems to me that the answer is to revamp the system so that coverage isn't tied to employment. Of course, to do so would require Obama to look into something McCain proposed -- tax credit for the purchase of a health insurance policy.

You're missing the point. Previous insurer received premiums to cover a defined set of risks over a defined period of time. Paying premiums at one point in your life doesn't mean you're always entitled to coverage.

The answer is to disconnect health insurance from employment, offer a tax credit that makes it more affordable, and then let the patient purchase the coverage that they need/want.

After all, if a person chooses not to purchase coverage because they want to try and save money, that ought to be their choice, too.

the insurer is not obligated to continue coverage, and the reality is they don't. having thousands of individual policies is not as cost effective as insuring a group of people.

that's the idea behind the insurance marketplace, the government sponsored plan or the co-op.

health insurance has been gradually disconnected from employment for a few decades, which has resulted in more and more people being uninsured.

the issue with people not being insured is they become a burden when they get ill, they go to public facilities to get treatment, which of course isn't free, it is a cost that is borne by a few (here it's property owners).

the system should mandate coverage imo.

[alexamenos]

What's amazing is that you expect insurance companies to behave as charities and the federal government to operate as an insurance/welfare company for 300+ million people.

Wait, that's not amazing...that's just stupid.

[Mavdog]

Originally Posted by alexamenos

What's amazing is that you expect insurance companies to behave as charities and the federal government to operate as an insurance/welfare company for 300+ million people.

Wait, that's not amazing...that's just stupid.

if that were accurate, the accusation would be correct.

but that is not the case, insurance cos should act like a business, and they should do exactly what their business does...insure people against risk, and pay when their is a claim.

they should not be able to stop insuring people when the risk is realized. that is removing the downside of the policy they underwrote.

that's not being a "charity", far from it. the premiums will be paid, and the coverage will be extended, and if there is a claim it should be paid.

the false accusation that it is the "federal government..as an insurance/welfare company" is false. wrong. inaccurate. a lie.

the federal governemnt does not write a single policy.

[kg_veteran]

Originally Posted by Mavdog

the insurer is not obligated to continue coverage, and the reality is they don't. having thousands of individual policies is not as cost effective as insuring a group of people.

that's the idea behind the insurance marketplace, the government sponsored plan or the co-op.

If you're going to put a person with a pre-existing condition into a pool with a healthy person, you're going to shift a good portion of the cost for the unhealthy person's care to the healthy person.

How is that going to save money and make health care more affordable again?

health insurance has been gradually disconnected from employment for a few decades, which has resulted in more and more people being uninsured.

Nonsense. Employer-based health insurance still represents the bulk of coverage in this country. When I say disconnected, I mean completely. Set up a system where people have the ability to purchase affordable coverage without getting it through their employer. Instead of giving the employer the deduction for the health insurance expense, give the employee the deduction.

the issue with people not being insured is they become a burden when they get ill, they go to public facilities to get treatment, which of course isn't free, it is a cost that is borne by a few (here it's property owners).

the system should mandate coverage imo.

I'm willing to be open-minded on some sort of mandated coverage, similar to what we have with automobiles. But what that coverage entails is the key. As noted in the article I posted above, if you require the coverage to have "all the bells and whistles", you can't complain when it's cost-prohibitive!