For those of you who missed it, there was a very worthwhile report on PBS's "Newshour" show tonight (Tuesday, Oct. 6) about Health Care in the Netherlands. You can find it by going to the PBS website ; on the main page you should see a header for the show--if not, click the tab for "recent shows" and, if necessary, search for Health Care in the Netherlands. In a nutshell: everyone must have health insurance; all coverage is through private insurance companies, but they are tightly regulated and (a) must insure anyone who wants to buy from them, and (b) must charge everyone the same price for the same coverage regardless of age, health condition, etc. The upshot is that, since the companies cannot compete for customers on price, which is established by agreement between the government and the companies, they must compete on quality of care. There is some kind of formula by which the government reimburses companies that have a lot of high-cost patients (e.g., the elderly, or patients with chronic, expensive conditions). But just listen to the newshour show, it takes a few minutes, you won't be disappointed. The best part: they pay about half of what we pay in the US per patient, and for better results. There is also an interesting short article that compares health care in five countries--the US, Canada, Netherlands, Japan, and Mexico. Also very revealing.
Hi Fred and company. Certainly "liar" is too strong an indictment of President Obama. But he is apparently not possessed of all the facts, though he can be forgiven since the health care bill is seemingly not to be understood as much as simply believed. There is nothing to refer to. But it is my understanding that it was proposed that language that made it illegal to check on citizenship status existed and that Democrats refused to allow it to be removed. Two days after Joe Wilson's rude and disrespectful outburst the language was quietly removed. The President was apparently misinformed.
The President also continues to insist that we can keep the health care plan we currently have. (He should say "may" instead of "can". I don't think we "can". The bill evidently does not propose to force anyone to change. But, if the government plan premiums or penalties are less expensive for me as an employer I will be forced to accept the cheaper alternative. Thus, about 25 people will be forced to change. We have a first class plan that all are very happy with. Since the government can print money and doesn't have to make a profit the usual benefits of competition will cease to exist. The government will ultimately win. I don't know if the President knows and ignores this reality or not.
Name calling is juvenile and demeans the debate. (Now, I'll just take a wild guess here that just a few of the 2003 protesters carried placards that called Bush and Cheney war criminals, or worse). Nor do I believe that the President is "bankrupting the country". Congress is doing that. The protest was held on their front lawn, not the Presidents (It's our lawn, anyway.)
I think any President needs to be uplifted by the people. He can't do it alone. That's why Christians pray for the President of the United States. As I saw it there was a collective wisdom present in that 9-12 throng. We are all different and we all have our biases. But what there is in the country is the growing sense that something is very wrong. Spending money that we don't have 100 years into the future is scary to people. People want today's problems solved before embarking on more economic irresponsibility. I, for one, have not heard anyone explain why we are not headed for an iceberg. I haven't even heard anyone assert that the progressives are not intentionally steering us into one. It is very troubling to people. And we know perfectly well that both parties are guilty.
We are the tugboat that will help guide the ship away from the iceberg. We'll do it with votes in 2010 and 2012. It appears that the administration is not making any group very happy. He has begun to betray the Left by doing what a administration must do. He has alienated the Right for obvious reasons, and he is fast alienating us Independents By being way too far left. He'll be forced to the middle like Clinton was for his own survival. The election cycle is the reason for the rush to get things passed without due process and deliberation.
The President is beginning the shift. He is wise to distance himself from the "racial" accusations. He doesn't want to be the Black President who allowed the "race card" to define his Presidency. And neither do we. We want him to succeed and be a great President, don't we? But he won't be if he doesn't disassociate himself from the many destructive elements who claim to represent him. We must help him raise himself above the fringe groups that cling and claw at his coattails. Some of the more unsavory individuals have been jettisoned. More will surely follow.
So I am not disheartened by what I saw and see in those photos. I am uplifted. People can see through the malarkey. You know what Lincoln said about fooling the people. And who in their right mind would call for a protest in January, anyway. All right, I know it was the sense that war was imminent. God bless those souls for speaking their mind. Though, maybe not the ones with the war criminal signs.
The pictures are disheartening to me, because they reveal the degree to which many, many people are willing to accept patent malarky rather than the unpleasant realities with which we live. Our country seems to have become incredibly polarized and many people are all to willing to accept smears about the "other side," even ones that are profoundly misleading or simply untrue.
A favorite theme seems to be that Obama is a "liar," though I don't think he has lied about anything. I doubt these people were objecting when George W. Bush and Dick Cheney lied repeatedly, to Congress, to the U.N., and to the American people, about the need to go to war in Iraq. That fact, and the prevalance of mottos about "Marxism" (which is a caricature of Obama, who is surely not a Marxist) and "bankrupting the country" (they didn't squeal when Bush or even Reagan did the same) reveals that this is largely partisan rhetoric.
Much of the furor over the proposed health care reforms seems to have been orchestrated by industry groups (health insurance companies, pharmaceutical concerns, etc.) and right-wing groups that have spread a lot of misinformation, which these people have clearly bought into.
For something more reasoned, I attach a helpful memo from Bob Graves's congressman, Joe Sestak, which Bob forwarded to me some time ago--in which he answers the shrill and mostly false accusations of health care reform opponents with some un-shrill and patient explanations of what is actually in HR 3200 (at least as it was then). (webmaster's note: memo to be posted soon)
These big rallies are enjoyable--I greatly enjoyed attending the big one in January, 2003, opposing the buildup to war in Iraq, which something like 350,000 people attended. As with the one you attended, Cal, it was large, full of humorous signs, and extremely cordial--everyone from infants in strollers to octogenarians, ex-hippies to corporate execs, laborers and teachers and physicians, all united with one common concern. Our country is full of good, decent people! Our rally didn't seem to make a dent in Bush's policies, however, he ignored it--so maybe these things are mainly good for venting. One big difference between the two rallies--yours was in shirt-sleeves weather, whereas when we came up to the mall from the Metro at 9 AM it was 11 degrees!
I think this gathering should be appreciated as the extremely important historical event that it is. This is the first great conservative anti-statist manifestation in American history. The conservative movement, which developed in the post-WWII, Cold War environment has now fully matured into the most significant political movement of the 21st century. I believe that this day could be referred to in the not too distant future as the day that changed America . This was the day the great silent conservative majority finally found its voice.
Many of the attendees were quite meek and timid and were unsure of exactly what to expect, this being the first time in their lives theyd been involved in a protest movement. Their fears evaporated early in the day and I saw people reveling in the camaraderie , the joy and sheer civility that was exhibited at the entire event. Chants of Freedom, freedom, freedom, No more czars! No more czars! carried through the air without the slightest hint of rancor or incivility which is the norm at the leftist rallies I have photographed over the years.
Hi Christa and friends. I am sorry to hear of your friends troubles with his health care coverage. His situation certainly demonstrates the need to widen accessibility to coverage. I’m afraid that until the issues of portability and pre-existing conditions, among other things, have been addressed, people in his position will be left out. His like yours, as I recall, is partly due to having part time jobs or being self-employed. That needs to change.
I don’t think we even know if these issues are being addressed in the various bills being debated. And therein lies the problem. Folks expected to see a reasoned discussion on reform and instead have been faced with an undefined “plan” that was being forced through too quickly. This was a very poor calculation on the part of the congressional leadership. They are still stuck on the “public option”, even though it appears dead. There is still scant discussion in the mainstream about the very fundamental factors that need addressing: elimination of fraud and conflict of interest as in your Texas example, malpractice tort reform, portability, pre-existing conditions, repairs to Medicare and Social Security, among others which should have been the first step in the discussion. These need to be resolved before any more careless spending is proposed. It makes sense to us in our personal lives. It applies to government as well.
I blame congress (democrats and republicans)) for not coming to grips on this. They have made a royal mess of it. And they needed to be especially deliberate in the wake of all the horrific spending that was rushed through by Presidents Bush and Obama. Enough on that issue, though I hope your friend finds some relief.
Back to the Tea Party. We saw that young YouTube fellow and his cameraman trolling through the crowd. I also saw them at the April 15 protest. They make a beeline for the most incendiary placards and exhibits and have a rehearsed method of questioning that catches the subject off guard. Asking for specific examples is an old trick that almost always succeeds in making the subject look air headed because few expect to be interviewed and it’s hard to think under pressure. And those who want to receive attention are drawn to the camera like moths to a flame. Their idiocy is usually immediately apparent. There is also the exaggerated coverage of people with a religious message or point of view as if this is not a valid part of the discussion. Example: the bearded fellow in the red shirt railing about the “right to life” points out that something like 46% of abortions are those of performed on black babies (fetuses?) but blacks comprise only 12% of the population. This fellow is probably a enthusiastic Christian but he makes a legitimate point. This fact is troubling to many black leaders. Thought provoking whether you’re pro-life- or pro-choice. No?
The point of a protest is to get your voice heard whether through united voices or signs. People have only a small space to express themselves so sloganeering is king. These folks were not violent or even angry. Most of the signs were funny, clever, and or just patriotic. The rabble rouser on stage repeatedly asked” Can you hear us now” (congress)? If they were anywhere near the Mall they certainly could hear us. I haven’t raise my voice like that since 1970. Very cathartic. Oh, and we thugs and troublemakers packed out nearly everything we carried in. We left the lawn cleaner than before our arrival. You know how those mid-western moms are about keeping it clean! Not many gatherings of this size can make that boast. Though I’ll bet there are quite a few spots of yellow grass there now. The park service rigged it so that if you left to go to the jiffy-johns they wouldn’t let you back in. Six hours of standing after a couple of large coffees is tough. I’m just sayin’.
Cal, thanks so much for sharing your report. It's heartening to read, as I just saw some video footage from the event that really concerned me:
I wholeheartedly support the sort of thoughtful protest and free speech you've described. What disturbs me is that many others seem to have jumped into the fray with little to no understanding of the issues they're protesting for or against, forming opinions based on fear, panic, and willful ignorance rather than on taking time to look up or reflect on basic information. It makes me feel a great deal of concern for our country, as a sort of fast-food alternative to productive dialogue and informed decision-making.
Hopefully these folks were in the minority at the protest. However, from what I've seen posted in online forums, YouTube responses and other un-edited public forums in print and on the web over the past several months, there seem to be no shortage of people willing to base their opinions and votes on wild rumors rather than history, discussion, or basic facts. It's a trend that should worry all of us, no matter what side of the issue we're on. It makes me truly appreciate the level of dialogue we're able to share in this group, and the articulate viewpoints each of you has to offer.
I just got off the phone an hour ago with my good friend James, who has worked as a freelance computer consultant and a part time college administrator for many years, and have a somewhat upsetting story to share. His rates and deductible for private health insurance had nearly tripled over the past two years, and he'd called his insurance company (Allied) to see if he could get a more affordable plan. The insurance agent assured him he could transfer to a new plan with the same company, but just as he was about to switch over mentioned that it would not cover any pre-existing conditions. James happens to have had some major health problems, which is in part why he needs health coverage in the first place. Needless to say, James decided to stick with his original plan despite the cost... only to find the plan canceled due to complications with the proposed plan change.
As a result, he now has no health coverage at all. Because of his preexisting conditions, his application has been rejected by every insurance policy he's applied for since this happened. Currently, private insurance companies have no obligation to offer their services to anyone who already has a serious medical condition. It's all the more clear to me how and why so many people go bankrupt or suffer and sometimes die without the care they need. Does anyone know what a person can do in this situation under the current plan? Any experience or resources I could pass along would be wonderful and much appreciated. In the meantime, we'll hope for the option of "required health insurance" once both parties can work out the details.
Hello folks. I promised a report on our experience at the DC March on the Capitol.
We joined a gathering of very enthusiastic citizens on the West Lawn. I don’t know how many were there but I have been to July 4th fireworks, concerts, Earth Day, and Vietnam War protests on the Mall and this crowd was comparable in both size and spirit. Certainly far larger than any football stadium could hold.
As I expected, everyone was very civil (zero arrests). Also as I expected, and no doubt re-assuring to all, was the complete absence of any racial element to the program or amongst the protesters. There were a few vulgar signs but most were clever and concise. There were old folks, older folks, kids, young adults, men, women of all races. And the only sign of organization of the attendees was that people were encouraged to join others from their state of origin, though the gathering areas were never identified.
Issues included big government, excessive spending, health care reform, bailouts, and most of the protest was aimed at the Congress more than the President. If there was one outstanding sentiment it was the mortgaging of our children’s and grandchildren’s futures. It was clear that the protesters were there to demand the needed corrections to social Security and Medicare, illegal immigration, and the contraction of the federal government.
Speakers included a few politicians (current and former), a few performers, one or two celebrities. No one from any of the TV networks spoke, including Fox News, though the crowd was chanting for Glenn Beck and Sean Hannity.
Lastly, this was not a “lock-step” group. Lot’s of diverse points of view were represented and there was even some uncomfortable stirring and booing when some more strident views were expressed. This was clearly NOT a right wing fringe group, but rather a frustrated and thoughtful cross section of Americans who are concerned by the nations rapid drift to socialism and growing government.
I am curious how the event came across in your areas. I think a healthy discussion of the “fundamental changes to America” as promised by the President and pushed by the progressives might be in order. What say you?
I came across this interview with investor extraordinaire Warren Buffet, who I know some of you respect a great deal. Here he weighs in on Obama's proposed health care plan, and I thought it might be of interest to our group. He clearly questions how the plan will be paid for (which I do as well), while also addressing "socialism" and the way that health care itself is distrubuted, as discussed more in-depth in the "Cost Conundrum" article posted earlier.
Hello again, all. Over a few sleepless nights I have lain awake, as we all do from time to time, wondering what about the true meaning of life; “Who is John Galt?”; why, if there was enough gravity to hold Buzz Aldrin’s feet on the moon the flag stands straight out; and whose lamebrain idea was it for Michael Dukakis to get in that tank and put on that helmet? We’ve all had these thoughts slam around in our heads like pin balls at 3:30 AM. If we’d just stop hitting the flipper buttons the game would be over and we’d go to sleep.
But here’s what troubled me the most. I spent a good portion of Friday/ Saturday choking back tears while watching the Edward M. Kennedy funeral service, wake and burial. I didn’t like Ted Kennedy. I didn’t like his family. Not even the children: the chubby boys with their Prince Valiant haircuts all dressed in shorts and flip-flops with a blazer forced onto them by Aunt Kennedy; the girls simply dressed but with the blank expressions of total lack of interest in the goings on. In fairness, I guess they’re like all teens. Death means nothing to them. I don’t know why I kept watching, but I did. And it slowly dawned on me that the Kennedys are, after all, just regular people. Rich, flawed, star-crossed, and largely annoying, but regular. Boy, if you want too see a Catholic funeral or an Irish wake it’s the Kennedys pulling away. These poor souls must have whole rooms set aside for the mourning clothes, decorations, and procedures needed for these occasions. They put on a pageant, Don’t they? But I don’t think they mean to. I think they are simply regular folks who, with the blood and sacrifice of their members, have earned a good send-off. And we are all attracted to a good drama, a good story. I think that’s why we watch.
But, why was I tearing up? Somewhere near the fourth hour of sleeplessness on Sunday morning it came to me. Ted Kennedy stood for something. I didn’t like much of it, but it was real. This flawed fellow who had every reason to drink heavily in the 6 years and 1 year after John and Bobby had bullets shot into their heads, who had grown up drinking and carousing, not growing up at all, really, was forced by tragedy to face his demons. He did not succeed. He drank and caroused and drove off the bridge and panicked. The next 15 minutes must have been lived in chapters. 1) Christ what happened, I’m alive, I have to get her out. 2) I tried, she’s stuck, I’m too drunk to go down there. 3) I have to get help; well, wait. She’s gone—too late for help, I have to report this. But I’m drunk. Okay, I’ll go report this, but the last thing we need is another scandal, so I’ll sleep it off and report it in the morning. It can’t hurt Mary Jo. Looking back Teddy should have tried his best to save her. Then failing that, he should have reported the accident and taken his chances. He lived with the fallout for the rest of his life in the Senate, a friendly confine of comrades, carousers, and drinkers. He would be happy to take the liberal fight to the opposition. His mistreatment of Robert Bork was disgraceful. His demagoguery was legendary and shameless. His life had meaning. And I, who new all of this, nonetheless supported the views he espoused.
It was I, after all, who stood for nothing. As a voter I was (and am) a register independent. I refused to call myself a liberal (though I thought I was one). I voted for every democrat from McGovern to Gore. I was anti-war (but never anti-soldier), pro-choice without ever once acknowledging that abortion is the taking of a human life, not a piece of protoplasm, or that it is genocide against African- Americans, eugenic-like in the way it keeps the ranks of the poor from growing. I like government give-away programs because they did what I could not do as a poor young fellow. Give charitably. I was wrong, of course.
In truth, though I believed I was thoughtful, I really was not. I just followed the liberal line, but never claimed to be a liberal. Ted Kennedy was a card carryin’, full fledged, rootin-tootin six-gun shootin’ icon of a liberal. He was a Patriot. And he was wrong. God rest his troubled soul. He is one of the last of his breed. Nowadays, people in congress and senate care less and less about the People, The Constitution, or Right or Wrong. There is capitulation, there is favor-trading, there is cronyism, and there is corruption.
And that’s where Cal’s Crazy Movie Metaphors enters. I’ll make this quick. Remember in “Close Encounters of the Third Kind” when Richard Dreyfus decides to take off his gas mask because he no longer believes the Governments claim the anthrax scare is real? When he does, of course, he can breathe. The air is fine.
That’s kind of what I experience on 9/12 and the days/years since. I have “Question(ed) boldly” as Jefferson counseled. Not just what Senator Kennedy believed, but what I believed. And I have arrived at this one true thing. I love my country like I never have before. This is no vice. If you believe it, say it. I can see too many politicians who care about nothing, who think about nothing but their next election, and who have set in motion all of the economic nightmare we are now living through. This must change, starting with term limits. Congress must be subjected to any law of program is foists on the American People. I am angry, but I am also frightened for the possible loss of the soul of this country. A Trojan Horse filled with radicals, communists, eugenicists, and other social engineers has cantered right into the White House on the coattails of politicians who were, as young men and women, so close to the trees they couldn’t see the forest. They cannot tell the wolves from the sheep. Or, if I am wrong, they are all wolves. I pray not.
I am an independent. I will vote for the right person. I re-visited the assumptions I made 45 years ago. I will now call a spade a spade. I will assign blame. I will vote to kick the bums out. I am going to the Tea Party on 9/12. If you can’t attend, then watch. There will be no more crazy people there than there are on any public green on any given day. You all know, feel really, that something is wrong in this country. All this spending. All the debt. All the deficits on the backs of our kids. All the indebtedness to China. It’s Bush, its, Obama,--it doesn’t matter. It’s the Trojan Horse.
We are the pod people. Please attend or watch. Question boldly.
Christa, First, I wanted to express how thoughtful your comments are and that I agree with your comments on the discussions. I was thinking before you wrote your last piece how it would be so great if the intelligence of this family could be productive and constructive as well as entertaining and thought provoking.
I just finished reading "The Cost Conundrum" and was overwhelmed with thoughts. Visualizing my own health-care and how sometimes it's been like McAllen and some times Mayo depending on where I've gone. Also, my daughter, Kellie, is pre-med out in Colorado and the discussions we've had on medical ethics. She's found that UCC is much more focused on teaching empathy and compassion than USF or UNC. This is her third university because her husband is in the army. It has however given her great perspective. But they are finally settled for a while and bought a house. She will graduate in the Spring w/ a Masters in Biochemistry. I am going to forward this article to her as she will enjoy it also.
Teaching hospitals such as Johns Hopkins University Hospital can be much like McAllen. Same result, but different reasoning. I will not go back there with the exception of my eye doctor who is completely different from the three other specialists I've seen. But he has studied and teaches medical ethics. He has also been disgusted with my treatment from the other doctors there and doesn't recommend anyone anymore. He spends as much time as is necessary with his patients and told me years ago that I would not go blind on his watch. I only have to see him once a year now.
This article also caused a light-bulb moment for me regarding pain scales and how they ask you on a scale of 1-10 how bad is the pain? Sometimes this is evident like when I broke my arm, but most of the time pain scales are totally subjective and relative to the patient. I thought - a more appropriate question might be "On a scale of 1-10 how much does this problem affect your productivity?" And maybe that's the question they ask at places like the Mayo Centers.
However, the issue that stood out the most to me was the horrible conflicts of interest. The Renaissance Hospital reminded me of the person/company cutting your grass also being the one to fertilize it. Blatant conflict of interest. But most homeowners don't know this. All they're thinking is that they only have to call one person and my grass is green. "caviat emptor"
So the bottom line for me is that I want to support the Mayos and Grand Junctions of health-care and what's the best way to do this? I am going to take it with me to visit Congressman Bartlett next week.
Christa, thanks for a truly wonderful (and somewhat scary, at the end) article that is, indeed, informed, informative and thought-provoking. And not partisan at all. I encourage everyone to read it. For my part, I've no objection to sharing our semi-private conversation, under the conditions you outline (identities purged, etc.).
Wikipedia offers the following summary on the "Pursuit of Happiness" question raised by Cal:
"The famous phrase is based on the writings of English writer John Locke, who expressed that "no one ought to harm another in his life, health, liberty, or possessions."
The first article of the Virginia Declaration of Rights adopted unanimously by the Virginia Convention of Delegates on June 12, 1776 and written by George Mason, is:
That all men are by nature equally free and independent, and have certain inherent rights, of which, when they enter into a state of society, they cannot, by any compact, deprive or divest their posterity; namely, the enjoyment of life and liberty, with the means of acquiring and possessing property, and pursuing and obtaining happiness and safety.
Benjamin Franklin was in league with Thomas Jefferson in downplaying protecting "property" as a goal of government, replacing the idea with "happiness." The United States Declaration of Independence, which was primarily written by Jefferson, was adopted by the Second Continental Congress on July 4, 1776. The text of the second section of the Declaration of Independence reads:
We hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."
Sorry, this is just an excerpt, for the references you'll have to go to the Wikipedia article itself. Just Google "Life, Liberty, Property" or "L, L, Pursuit of Happiness" and you should find it.
Hello Christa and all. No quarrel from me about sharing our collective ideas. But, yes, no addresses as I am certain some on our short list are finding their involuntary participation tedious.
Thanks for sending along “The Cost Conundrum”. (I notice in the first paragraph mention of “Lonesome Dove” which Marsha and I began re-viewing last night. And may I say that our Blue-Ray HD DVD player really does it justice. As some may know these players upgrade standard DVD’s to near HD quality and full picture. We just watched John Adams this way. Just gorgeous. And with HD DVD’s it’s even better.) Anyway, I’ll gladly pry myself away from the tube to read this article.
The Constitution is certainly a document born of compromise, but based on the moral absolute “that all men are created equal and endowed by their Creator with certain unalienable rights”. After all the “pursuit of Happiness” was originally the “pursuit of Property”, a turn of phrase that was problematic since slaves were considered property. I don’t know history well enough to know who insisted on this change, though no doubt it was the delegates whose sensibilities were informed by the “created equal” assertion. Some truths are, in fact, inviolable.
My most fervent wish is that those we elect to represent us truly believe this. My most profound disappointment is that many , in both parties, appear not to. And even if they do, the powerful influences of lobbyists, special interests, and their own advisors stain their every utterance with doubt. I do not suggest that they are bad or immoral people (though many obviously are). But they take an oath to “serve, protect, and defend the Constitution”. Therefore, they should serve with moral absolutes planted firmly in their hearts. That’s what I expect of our government.
A fruitful Saturday to all. Especially corn, tomatoes, and peaches. Cal.
Well, I'm sorry to see this devolve away from productive dialogue again in favor of partisan jabs. Most of these comments aren't really worth addressing, though if what any of you expect out of our government is one particular set of "moral absolutes" without compromise, I really do suggest you re-read the text of those documents included in the last e-mail one more time.
I was referred to an article called The Cost Conundrum recently, and wanted to share with you all as a part of this conversation. I'm still mulling it over, but found it to be thoughtful, thorough, and an interesting way to consider healthcare reform. I'd love to hear some of your thoughts if you have the chance to read it all the way through. The author touches on issues of medicare overspending that I think Fred and Cal raised, and studies several existing models that do and don't work.
I also wanted to ask a question/permission to share our conversation. Overall, I've been really interested in this discussion and I think it's made many of us consider the issue of health care much more in-depth than we would just talking about it with those who already agree with us. With all of your permission, I was thinking to informally publish this ongoing series of e-mails (without any addresses) in an informal blog, so that others (congresspeople, friends, etc.) can follow our discussion on the topic. It seems pretty rare to have such an articulate bunch of people (within the same family no less!) discussing these issues on both sides in such a thorough manner. If you don't want your words shared, I completely understand... just an idea. Let me know. If anyone strongly opposes, I won't do it.
Thank you Bob. I think perhaps the President could do more for American health by mounting a “quit smoking” campaign with himself as poster child. But, hey, it’s a free country, right?
Of course most members of congress haven’t and won’t read the bill. And I wonder how many have read the Constitution since 8th grade history class. I’d bet very few. I also do not believe they allow the document to inform their thinking much either. Most are self-described Progressives, after all, which means that they view the Constitution as arcane and largely irrelevant; an quaint document that changes with the times. In their world everything is relative and there is no right and wrong; there are no moral absolutes. Not surprising in an arena where everything is a compromise. This flawed view naturally leads to corruption. Why wouldn’t it?
Anyway, I attach, for convenience sake, the text of the Constitution and Bill of Rights If you will re-read them you will one up on you representatives and, I suspect, The President.
We're going to pass a health care plan written by a committee whose head says he doesn't understand it, passed by a Congress that hasn't read it but exempts themselves from it, signed by a president that also hasn't read it, and who smokes, with funding administered by a treasury chief who didn't pay his taxes, overseen by a surgeon general who is obese, and financed by a country that's nearly broke.
Back to you Fred. I have read that the most widespread Medicare fraud is through home care services for the elderly. They are the one's who allegedly stick their heads in and charge for several hours. The elderly are not as apt to notice, I guess. It's not so much doctors, though we have all experienced that 30 second visit. Still, they see more in those 30 seconds than I would see ever see. Sometimes less is more, I think, when you're being poked and prodded. But in my case it's not Medicare.
One possible contributing factor to the "look-in" Dr. visits might be this: Medicare pays a fee for service rate of about 50% of the going charge rate. If a surgeon operates she might be paid $700.00 for a knee replacement. That fee includes follow-up visits for several months. I've read that surgeons end up making as little as $30/hr. when all is said and done. If true it would help explain the short visits.
Anyway, we've come up with some good questions in our little tribe. It's doesn't appear that congress, in their wisdom, bothered to address any of these issues. They got the cart before the horse. Or to quote Bo--"bass ackwards".
Cal, I really appreciate the way your wit, always apposite, helps keep this an enjoyable exchange, thanks a lot. John's suggestions are ones many of us can support, I think. The idea of a two-tier system is not bad, it's what actually exists in some places (maybe many)--I think Austria, for example, but maybe they just have a parallel private system for those who can pay. Anyway, two-tier should be considered.
As for medicare fraud--is there some easy, foolproof way to prevent unscrupulous doctors from claiming whatever the medicare-mandated "patient visit" fee is ($80? $100? $60?) when they just stick their head in the patient's room, say "How are ya?" and sign a form in his room? So they claim to have "visited" 100 patients in a day? Or isn't that even the main problem in medicare fraud? Does anyone know?
Here are a few constructive ideas for eliminating waste: Tort Reform. Absolutely essential. I saw my doctor yesterday, and he told me that 35% of health care expenses have nothing to do with health care, and that includes insurance premiums.
Elimination of duplicate insurance forms. Every insurance company has their own forms, so why not produce a standardized form.
I believe we eventually (but maybe not this year--the odds are getting longer) will have a two tiered system--a universal tier for everyone with limited but essential treatments--and a more expensive tier for those who can pay for it.
I'm sorry, but in such comments I see mainly ideological broadsides, not practical suggestions for how to improve things. Sure, we can move to a Hobbesian world where everyone is on his/her own, the fittest survive (even thrive!), and the rest get ground out of existence. But I think that, as a society, we are all in this together and have some responsibility to prevent catastrophe (sometimes deserved, more often not) from overwhelming those whom, after all, we choose to call our "fellow citizens". The talk of "socialized medicine" and references to USSR-style commissars are scare tactics--no one is seriously proposing such things. (And, probably, notions circulated by the health insurance companies.) A comprehensive health care system is not unattainable within the context of a democratic society: Canada does it, France does it, England does it, Germany does it, Denmark does it, Finland does it, Sweden does it, Norway does it, Spain does it, Portugal does it, Austria does it, Israel does it...so why can't we do it? Their systems are not perfect, but they're better than the mess we have today, unless you're very wealthy.
Our national health care situation will not get better by doing nothing: the number of uninsured will continue to grow, and costs of medical care will continue to increase. Yes, there are serious cost concerns that must be considered, we don't want to bankrupt the country. The question is: what can we do, in practical terms, to provide, at reasonable cost, some level of comprehensive health care/coverage for our citizenry? At least for basic medical needs? OK, you don't like Congress's current plan. But I'm still waiting for constructive alternative proposals from the more conservative side of this conversation on what we *should* do; Bruce's suggestion that medicare fraud be reduced is about the only exception--a good suggestion, too, we should explore it further. Other than that, I've heard mainly a lot of reasons to sit on our hands and let things continue to spiral downward.
Hi George and all. You are correct. And I think it is time to put this very bad idea to rest and begin again. The proposed health care reform was not scheduled to begin implementation until 2011, anyway. It has been a blunder by the administration to attempt to push this bill through given the economic climate. Under normal circumstances arguing that this reform is needed to keep us from going bankrupt might have worked. But not after the meltdown and especially after the insanely expensive and unpopular "cap and trade" scam. Nancy and friends were so hell-bent on pushing their agenda they ignored economic reality. The President erred badly in turning these efforts over to Rahm Emanuel and congress. Now, he's dealing with the wreckage. It must not be passed now because it has become a mess. Time to start over in earnest and with an eye on the Constitution.
Wal-Mart, eh? Yes, I can see it now. Maybe a price war with Babies-R- Us, followed by a buy-out of Toys-R-Us. I purchased my $229.95 dutch oven at Wal-Mart for $35.00. Love that competition! The stew takes great, too.
I am very dubious that Mr. Obama's plan for socialized medicine is the answer; and the White House's huge marketing blitz makes one even more suspicious. When governments get involved with commerce, they impose price controls, and price controls bring shortages. Happens every time. That's why central planning didn't work in the former Soviet Union.....or, rather, it did work quite well, if the desired result was to force Russians to do without. Everybody will be covered, they say, no matter how sick, and you can see your doctor whenever you want. Sounds great, but won't costs explode? Of course they will. How could it be otherwise?
Liberals/socialists/collectivists always have these great reasons why we should turn over our money, our choices and our liberties to them, "for the common good", because they know better how to spend money than we poor ignorant slobs who earned it. This time around, the argument is that if you just let Washington run health care, everybody will have access, nobody will be refused, and the costs will be modest -- all sweetness and light and soft music. I don't believe it. The insurance employees will be replaced by more bureaucracy at the federal level - who have a far more generous benefit program and can't be fired if the program isn't working out. How is that more efficient?
Mr. Obama and his worshippers want us to trust them on this. Sorry ----- but trust is sorely lacking at this point. My fear is that unintended consequences of his program would bring us much higher taxes, fewer choices, and shortages. That's my own bias --I believe in the private sector (free people making decisions in their own best interest) much more than I trust government compulsion. I would rather see some combination of already-existing organizations - charities, volunteer health clinics, pharmacies, etc. try to put together a low-cost program to help those without insurance. Things are already evolving in that direction. I bet Wal-Mart could deliver babies for $99, if they were allowed to do it.
Bruce, you returned from your Northwest fishing trip too soon. You have stolen my thunder in responding to my honorable cousin Fred. I would not accuse Fred of assuming conservatives are of one mind. I, for one, find "corporate welfare to be repugnant. I also hold the abuses of corporations to be unethical. But most of the abuses are taken legally. At least in the technical sense. Corporate lawyers lay waiting in the shadows of the complexities and obtrusiveness of the language of regulations that are built-in by lawyers (members of congress). Lobbyists and the marriage of convenience between congress and corporations is a cancer that the people must demand be ended.
Now as to redistribution of wealth, "spreading the wealth around"* see below as the President put it, the example of risk insurance is misapplied. Purchasing risk insurance is a business contract the value of which is that the premium is shared, not the benefit. It is the high number of premium payers compared to the actuarial risk that makes it beneficial for the buyer and the seller. Both buyer and seller hope the fire never happens. But it will happen somewhere. Kind of like Health insurance.
Re-distribution, in this argument, is the mandatory taking from one person and giving it to another. This is not a popular idea. But if we can separate the rich from the not so rich, then the not so rich might not mind taking from the rich. This is what is proposed to pay for health care. *"To each according to his needs from each according to his ability". This is one of those notions that seems to have a smiley face pasted to it. The only one smiling is Karl Marx.
Death panels? Lord, why did Sarah Palin ever use this term? It is incendiary and inaccurate. But Bruce is correct about the potential intervention of bean counters between patients and care givers. It may not be operative in good times, but what happens in bad times when revenues are down or availability of care is limited. The models cited by some of the President's advisors that weigh the value of human lives as a function of their age are a recycling of the civil defense models regarding who should survive a nuclear war. It's good to be between 10 and 45 years old. Everyone else just sucks resources. I'm not saying this will be done, but it could be done.
Now, after all, it sounds as if we have settled upon some common ground. As Fred has said the time has come for us pool our ideas. We are not any of us rubes or shills. Let's exert our will on our incompetent and corrupt leadership and demand improve on the situation that we have.
It just so happens that a venue to do just this is available to us all on 9/12 Tea Parties. Everyone, regardless of political or philosophical belief, should attend. This is a ready-made opportunity to be heard, covered by all networks and newspapers, and to leave our message right on the front porch of congress. There are many sources for Tea Party information but one you can visit is FreedomWorks.org. There are links to other organizations, plus a list of all locations. It's a starting point.
You guys are too fast. This reminds me of the old "Certs" add. "Stop, you're both right! It's a candy mint and a breath mint." (Way too much tv as a kid.) Fred is right. We don't want folks with buboes hanging around our doors. Bruce is right. We are responsible for ourselves. But we intervene to prevent industry from dumping chemicals into our rivers. It could also make sense to prevent the health care system from doing the moral equivalent with uninsured patients. I think the operative phrase is "Common Sense".
If you think quality health care is expensive now, wait until it's free.
While we're at it proving health care for all, let's guarantee 3 square meals a day, a roof over our heads, heat, clothing, cable tv, recreational facilities, and some type of employment that serves the common good. Wait a minute, that sounds like prison.
The CBO does not share your cost lowering assumptions. I doubt that you can find a consensus of credible financial forecasts that do either.
Bottom line, There ain't no free lunch. If the people we're not having such a large % of their incomes taken from them in taxes (much of which is needed to pay interest on the debt), there would be more $$ to pay for health care. Or would that money go to cigarettes, drugs, and gambling in our state run lotteries. It really comes down to people making good choices. Some will and some won't, and you can't legislate a change in human behavior.
I would like to see government fix the fraud and abuse in the current Medicare system before they venture further into a new arena.
To pick up only on the insurance analogy: as a civilized society, we should simply consider everyone in the country as our insurance "pool" for health care. Unlike with home ownership, we mostly don't have a choice in whether we have good health or injuries or not. As we all know, the poor health of some can be positively dangerous to the rest of us, too, and can be a drag on the productivity of the economy as a whole. We don't want the grievously/dangerously ill roaming our streets and dying there. So make everyone in the country one health insurance pool and provide at least good basic care for everyone. Yes, it will be some redistribution of assets, but worth it in my view. And it would lower overall health care costs by eliminating the 30% or so that now goes to the "insurance overhead"--the amount insurance companies spend trying to avoid paying the claims you file. More anon!
Fred: I think you are making some assumptions and generalizations that may not be accurate.
I do agree with you on the corporate welfare argument. I doubt that you will find a true conservative that supports corporate welfare.
I'll make some rebuttals and comments:
a) Redistribution: Using your example, I think what people are referring to is in addition to the 100 people that have the insurance pay for their houses that burn, we pay for an additional 100 homes that burned for people that never paid any insurance premium. Insurance is a voluntary pooling of risk. Your example and subsequent suggestion that I would cancel my insurance is a false argument made on an incorrect premise.
b) Social Security: This is nothing more than an elaborate Ponzi scheme gone bad (courtesy of politicians). Yes, you can make anything appear to work by changing the terms. SS is not actuarially sound. When you increase the retirement age, you are lowering costs. If your employer pays you $1,000 every two weeks then changes it to $1,000 twice a month, you have lost money. It's the same argument. Keep the amount the same and change the terms. Google Galveston/Social Security. This was the last municipality that opted out of SS before the law changed. See how they did after 25 years.
c) 50 million uninsured: I have heard a more realistic number is 12 million. I guess it depends on who is spinning the plates.
d) Death Panels: This sounds pretty ominous, but what do you call it when a bureaucrat decides that the treatment is not worth the cost given your age? Oregon has this now. Is Pres. Bush or Ted Kennedy going to be subject to this? How about our members of congress? They are all way to arrogant. I'll quote Marie Antoinette when the peasants were starving, her response - "Let them eat cake" Then the French revolution ensued. Want a public option, make every member of congress the first subjects. Lead by example.
Hello again, everyone. Sorry to have been offline a while, I have had to attend to my "day job". Thanks to Mary Kay for sharing some of Bo's and her dad's wisdom and optimism! I know I tend to get long-winded so I'll try to keep this short. No promises, though, it's 3 AM and I can't sleep so you're all in for it.
(1) Our mutual discussion, which has been endlessly enlightening and enjoyable, seems to have moved from the health care reform issue to much broader philosophical/political issues that people have been debating for centuries with no resolution. This isn't really helpful in helping us to decide what we should do about health care here and now, and I think we should try to move discussion back to the specific problem of health care reform. Regardless of your political persuasion, what do you think can be done to make health insurance more affordable and avaialble to everyone? So we don't have 50 million uninsured, amother 50 million underinsured? To keep medical costs from rising so fast that companies can't afford to provide insurance, and to ensure that people aren't bankrupted by medical costs even though they had insurance? The fact is, like it or not, the system we have in place is what we have to start with, so how do we make things work better (which, to me, means more predictably, affordably, and equitably)?
(2) Some of the more general political issues raised take the form of canards that are not really true, and shouldn't be allowed to pass unchallenged: introducing them into the discussion only muddies the waters. Just a few that I have noticed saiing by in past postings--and I bring them up NOT to provide a "definitive" rebuttal or to open the broader issues for debate yet again, but simply because I want it on the record in our mutual discussion that these things are NEVER so simple as the sound bites/canards would have it:
(a) "Redistribution" is a bad thing...Obama wants "redistribution", etc.: Well, let's see, if 100,000 people pay for fire insurance on their homes but only 100 people in that group have their homes burn down...they get to collect the insurance for their casaulty, while the other 99,900 merely pay their premiums, that's (horrors!) redistribution. So I assume that Bruce and others who rail about this sin have long ago cancelled their fire insurance and now self-insure? Or maybe redistribution isn't always such a bad thing? In which case, let's drop this canard. Do I hear conservatives complaining about what is usually called "corporate welfare," or huge government subsidies or tax breaks to various industries (sugar, dairy, cotton, motorcycles), which also amounts to "redistribution", from the lower part of the income pyramid to the upper parts? Not usually, so it seems that redistribution is only a problem in their mind when the money is going from the rich to the poor, not the other way around.
(b) Government can't manage anything as well as private business: social security (broke), medicare (broke), etc. as examples: well, again, not so simple. First of all, I seem to recall lots of companies that have gone broke/bankrupt over the years--remember Enron? TWA? American Motors? Pan Am? --at least some of which also pillaged their workers' pension funds on the way down, or defaulted on pensions of workers who had been loyal to them for decades, leaving them without the retirement pension they had earned. So mismanagement is just as much a private as a public quality. Second, the problems with Social Security and maybe Medicare are fixable. For SS at least, if we raise by a few years the age at which one can begin to collect benefits (and thus extend the time in which workers have to pay into the system), we can I think put it on an OK footing. The problem with SS is not really mismanagement but demographic change: people are living in 2009 much longer than they were expected to in the 1930s when the system was created, and population growth has slowed, so the system has gotten increasingly out of kilter: too few workers supporting too many retirees, for too long. Congress can solve it by changing the payout age; you can say it's mismanagement that they haven't made these changes, but then as I said many private firms similarly failed to make changes and were bankrupted by their original assumptions. Medicare faces different something similar, perhaps, augmented there by the fact that the cost of health care (PRIVATE!) is skyrocketing--so how is that the government's fault? Anyway, I think it's just too simple, and misleading, to say that "government = mismanagement." So let's drop that canard too.
(c) Government regulation makes business inefficient, etc.: but one can just as easily argue the opposite, that our problem is not too much government regulation of business, but too much business interference in government. As Christa pointed out, if you visit Europe today you find that many systems there (public transportation, health care, etc.) are superior to ours in terms of providing a good basic product fairly to everyone at reasonable cost. This enhances the quality of life of everyone there. We lack the same level of quality in these arenas (transit, health care) because the private industries affected by them have warped the political process. The pretty good light rail systems that most large and many smaller American cities had until the 1950s, for example, were axed in the '50s and '60s because the oil, auto, and tire industries jointly hired high-powered lobbyists to suborn the city councils of those cities so they would scrap their light rail and buy, instead, buses. This is a well-documented fact. So now, instead of a cleaner light rail network in our cities, we have a polluting system (perennially underfunded, too, because everyone was encouraged to buy a car, so no one wanted to use public transit any more). The same thing is happening now in the health care debate: the insurance companies, hospital corporations, and pharmaceutical concerns are pouring billions into lobyying to thwart change to a system that is making them rich and bankrupting everyone else. And many of their talking points/scare tactics are showing up in our own discussions: "socialized medicine"; "redistribution"; "death panels"; "health care rationing"; etc. C'mon, everyone, let's get beyond these empty phrases (many of them patently untrue), get back on track, and put our heads together to see if we can figure out what will make the system we have--which is where we must start today-- into a system that helps more people (ideally everyone) at a cost we can afford!
I don't know if anyone remembers some of Bo's sayings? "Every day above ground is a good day." His favorite color was "Sky-Blue-Pink". I am so grateful for these thoughts he shared. They show faith and hope. Two feelings that are priceless to me. Fortunately, they cost nothing, but bring me much wealth. Because of Bo, and my Dad I have faith and hope. But, faith and hope need not be blind but are choices and I chose to have them because I need them everyday. For me, if I didn't have them I would need anti-depression meds. It sounds like some don't have hope. That's all.
When I think about it, it was amazing that my Dad had so much hope for us since he worked for the federal government for thirty years and his favorite joke was that military intelligence is an oxymoron.
We have heard many anecdotes regarding the hardships, the horror stories, and the unfairness of the availability and application of American health care. It would be too easy to simply suggest that life is unfair, though it is. That might apply my coming down with cancer while my neighbor does not, but not, I think, to access to medical care. The central question, it seems to me, is how one goes about making access more available at reasonable cost, and without punishing restrictions. I have seen no evidence here or in watching the town hall protests, or from any opponents of the current proposals that anyone believes access should be denied (with the notable exception of illegal aliens). That begs a different discussion, though it is easy to include them in the abstract if we insist.
The fact is that when federal mandate is brought to bear we can never be sure of the unintended consequences, no matter how many pages comprise a bill. I have noted earlier how it can be foreseen that the proposed plan(s) will force me to cease providing access to health insurance to my employees. It is all but written in the plan. They will be on their own and will have no choice, being of modest means, but to join one of the "co-ops". They will be stuck with whatever they are offered, and, what ever the co-op becomes over time. That may not be pretty.
Consider that the housing mortgage and economic meltdown (and the loss of our retirement money) was caused by the passage of a well meaning congressional act called The Community Re-Investment Act of 1977. For anyone who does not know about this the act forced lenders to lend money in the neighborhoods where their branches were. It abolished the unfair practice of "red-lining", the lenders' policy of not lending in certain low-income areas, even to qualified borrowers. Clearly this was wrong. The Act sought to correct the injustice. But over time the mandate was changed, mostly for political gain-but that's another story.
By the mid 1990's lenders were encouraged to make mortgage loans to people who had no down payment money, not enough income, and poor credit records. Lenders, of course were reluctant, but were given assurances that they would be backed with mortgage default insurance which was provided by AIG, among others. Why would AIG do this crazy thing? Because the house banking committee headed by Barney Frank and Christopher Dodd provided pledges that the federal government would back them. Besides, what could go wrong? Well here's what did go wrong. The housing bubble burst (the bubble having been caused by the subsidized demand for housing), home values fell, people who had borrowed 125% of the original value and who were stuck with balloon loans could no longer afford the payments. Many had taken second mortgages and bought stuff. They walked away. Now the lenders looked to AIG to make good on the mortgage default insurance claims. AIG said, Who us? We don't have that kind of money. The rest is history. Hence, the market collapse. Hence, the loss of 40% of personal wealth. I don't think congress meant to do it. They're not that smart. But they are that incompetent. Can you name a single government program that came in on budget? Medicare Part D (prescription drug coverage) has already run up an unfunded liability of $17 trillion!
That's a long winded way of illustrating how the governments' intentions often morph into something unanticipated and ugly. The New Deal, which many say extended the Great Depression; Welfare, which trapped the poor in their poverty; the ban of chloro-flourocarbon (sp?) propellants, the replacement for which is many times worse for the ozone layer; the complete banning of the production of DDT, the result of which is the needless deaths of tens of millions of Africans to malaria.
Access to health care needs to be improved. It can be done through means much less draconian than federal programs. The needed changes are relatively simple. Make insurance portable, make it available to everyone, pre-existing conditions included, make it available to part-time workers, make it available to anyone who will pay for it (or who might need help with paying for it).
In America we do not have a guaranteed right to be born. We do not have a guaranteed right to a funeral. We do not have a guaranteed right to happiness. And we do not have a guaranteed right to health care. The governments role is to "promote the general welfare". The right that we have is the right to pursue it.
The Constitution of the United States of America is consists of about 1,100 words. The federal health care plan about 1,100 pages. What is congress afraid of?
Hello to all, The link below gives the opportunity to voice your opinion. Not part of the solution? Then part of the problem. So far there are 54 people signed up for my location and time.
After studying Mr. Burke's words, what I found were excuses to do nothing. We've been doing nothing. Nothing has changed in Maryland since the late nineties. President Obama's primary plan is to level the playing field of all states, (The United States of America). This is the first step. This costs little or nothing for the government. It will however cost the insurance companies to change the infrastructure of their computer software. The insurance companies have been left to their own devices. That's what we have right now.
What we don't seem to get and hasn't been addressed are the millions-billions of dollars that are already being absorbed by health care providers for services that are not being paid for because of personal debt. This will only get worse. Have your credit card interest rates gone up? Has anyone paid down their balances only to have their credit limits reduced? All of my rates went up in May 2008, and there was nothing wrong with my credit, but now there is. Banks are charging good customers higher interest rates to pay for the defaults of others. That's exactly what health insurance companies have been doing all along. Taking advantage of younger, healthier individuals, and not covering pre-existing conditions.
Making health care more comprehensive will make a healthier society and that does not remove ones individual rights to make their own peaceful agreements with one another. I believe that ones health is not ordinary but rather extraordinary. Health is necessary to be happy, ones emotional and physical health is necessary to make a living, go to school, be a productive human being. Do you know why there are so many support groups for individuals who suffer from long term illnesses? Because they cause depression. The trickle-down effects of poor health are poor people. This is why I agree with Fred and Christa. We have a duty as a society to take care of our own and provide health care for the underprivileged. It will ultimately pay off by giving people hope who had little or none before. Taking care of our own is what sets us apart from third world countries. Third world countries also don't educate their people. "Mushrooms" keep them in the dark and feed them shit. Did you know that Mexico does not pay for their children to go to school past 6th grade. You must have a scholarship given by the pueblos. Any wonder they come to America?
Anyway, I've chosen to be part of the solution. For the first time in my life, other than election day, I feel like I can make a difference
Hello, all. And thanks, Christa, for your illuminating observations. Having seen the health-care systems of several European countries myself, and spoken to people there about them, I'd say most of them do provide a level of security in matters of health care that we manifestly do not enjoy in the US. No one there has to worry whether they will be financially ruined by illness or injury, or hesitates to visit a clinic to check on a "minor" complaint, to make sure it isn't the beginning of something more serious and, if necessary, begin appropriate treatment in a timely fashion. It provides them with a tremendous amount of peace of mind.
As for Mr. Burke's comments on "coercion", let me add this to Christa's completely justified objection: My wife's younger daughter has diabetes. She also has a job as a social worker--good, steady job, important work, modest pay. If she leaves her job in order to have a child, she loses her health insurance. She also wouldn't be able to get new health insurance because of her "pre-existing condition," and she wouldn't be able to afford the medications that keep her alive. She is forced, in short, to choose between the dream of having a child and her own financial and physical health. THIS, it seems to me, is real coercion, imposed by our profit-driven health care "system."
America's founding documents begin by emphasizing the importance of "Life, Liberty, and the Pursuit of Happiness" as the highest goals of government. We repudiated the British crown because it wasn't providing these things. We hear a lot about the importance of Liberty. But, note that the first item is LIFE. It seems to me that our present health care "system," which rations health care according to ability to pay (and according to the whims of insurance company bureaucrats), is a repudiation of those founding principles. It endangers the very lives of millions of fellow citizens, arbitrarily and through no fault of their own, because they have less money or higher health care needs. Thousands (maybe even millions) of Americans die, or are first bankrupted by medical bills and then die, because they can't afford the health care they really need. (Or they don't die, but become homeless: one of the biggest factors contributing to homelessness is medical costs.) These may be admirable people in every way, otherwise young and vibrant and hard-working, but they have a low-paying job and get seriously ill and simply can't afford treatment. "Your money or your life." If this isn't an immoral "system,"I don't know what is! We must do better.
The current health care reform does not, as I understand it, coerce anyone. If you like your present health insurance plan, you can keep it. No one is being coerced to join anything; all that is being done is to create an alternative plan that is available for people who are left out by our profit-based health insurers. It's high time we provided something like this, so we no longer have 50 million citizens without health insurance--a national disgrace.
In regards to Mr. Burke's argument, I have to say that it's astounding to me that this language about "force and coersion" is being used to discuss NOT our country's complicated history of military force (which *is* funded by the government / us) but instead to attack a kind of health care support that millions of Americans have in fact called out for.
Mr. Burke objects to making everyone "poorer" as the frightening penalty for taking care of the country's poor. It may indeed even the playing field a bit more than some would like, but to confuse this with national "impoverishment" surprises me coming from someone of his professional stature. Has anyone ever been to Finland? Denmark? France? Any other "developed" country? These are not impoverished or unhappy places, though the average person may not pull in the kind of income that our top paying executives (and basketball stars) somehow manage to.
In 2006 - before the economic collapse forced us to take the cost of health care more seriously - psychologists at the University of Leicester in the UK released a study mapping 'subjective well being,' or happiness, worldwide, interviewing over 80,000 people across the globe in their research. Interestingly, Denmark, Switzerland, and Austria came out at the top of this list. The US ranked 23d. According to the responses they received, a nation's average level of happiness "was most closely associated with health levels. Prosperity and education were the next strongest determinants. " and "People in countries with good health care... were much more likely to report being happy." Well being may be a sort of wealth that many Americans have yet to experience on such a level, as most of us have always had to be so preoccupied with the other kind.
There is clearly a lot of anxiety about who might suffer as a result of national health care, which has led to a lot of rash and inaccurate hypotheticals. For instance, an ill-informed assertion in Investor's Business Daily claimed that disabled people like physicist Stephen Hawking wouldn't have survived under a national health care system (Hawking is in fact British, and responded that he is alive today because of national healthcare). In response to such misunderstandings, the London Telegraph published a concise clarification of several recently mis-cited US concerns about NHS coverage in the United Kingdom: Telegraph Article
I hope you will consider this commentary from a friend of mine.
Notes from Wynnewood August 11, 2009 America's Health Care
One of the chief marks of a civilized society is that its members are reluctant to use force or coercion to solve the problems of human interaction and prefer voluntary means such as reasoning, persuasion, entreaty and agreement. If we see that someone possesses something we would like to have, we might possibly take it by force, if we have the force, but the civilized way is to make a voluntary exchange, to buy it. Every adult human being has the power of free will, the ability to make his own decisions about his own actions, the other person as much as I. To use force on him is to place my will above his, to override his freedom and subject it to my freedom. But this is the essence of injustice. Justice consists above all in respecting other people's freedom of will. For they have as much right to their freedom of will as I do to mine. This is why it is universally felt that force can legitimately be used to remedy injustice, because injustice is always coercive, and it takes coercion to prevent or overcome coercion. Primitive and savage societies do not respect the inherent freedom of will of individuals, but impose their desires on them by force. We now have the privilege of witnessing this daily in graphic detail on our television screens as suicide bombers around the globe inflict their destruction on others who do not conform to their will. It is no accident that these societies are economically underdeveloped. The chief reason why the third world (as it used to be called) is third is that the rule of unnecessary force prevails there, through the common use of violence and corruption in place of the peaceful means of the market. But every action of government in our own country is an act of force or the threat of force. To ask the government to take action in any case is always to summon the use of force. This is why we have police and courts of law and prisons. Government has no other way of acting. In a civilized society the role of government is therefore very severely restricted. There are occasions when it must necessarily be used, as in the prevention or punishment of crime. But beyond narrow limits, the more government, the more brutal the society and the less civilization. Those who have the passion for redistribution do not care about civilization. Rousseau, their ideological father, considered civilization was precisely the cause of humanity's problems, for nature, he claimed, was the realm of equality, but civilization introduced inequality. Those who favor redistribution will often not even speak of "civilization," for it is their opponent. Some believe the world would be better off without human beings at all. But if we respect human dignity and wish the human race to prosper, we will cherish civilization and its freedoms. Now Mr. Obama wishes to redistribute health care. This is not to be done by voluntary and civilized means, through the peaceful agreement of the market, but by coercion. Whatever the details of the final plan, it will be imposed by force. This is an offense against human dignity. Each of us is a center of free will and initiative of equal human worth to Mr. Obama. We have the ability to take measures for our own well-being just as he does, and to take the chance of succeeding or failing just as he does. The real redistribution will not be so much from those with health insurance to those without, but a redistribution of power from America's citizens to the government and its clumsy bureaucracy. He should withdraw his plan and turn his attention to the realm where the physical force of government has its legitimate employment, such as the defense of our nation against its armed enemies. But perhaps someone will object that redistribution can contribute to civilization: a society that takes care of its poor is more humane than one that callously leaves them to fend for themselves. Certainly, if to make everyone poorer is humane, this will be true. But true humanity is a quality of the heart, and so of individuals in their dealings with other individuals, it is not a quality possessed by the large, impersonal bureaucracies of the state.
If society is not to be impoverished, the essential thing is that the price mechanism of the unfettered market must be allowed to function, otherwise no one knows what the true value is of anything. That means that government must keep its thumb entirely off the scale. If the health care market, including the health insurance market, is left free to organize itself, probably most Americans will not protest if a small, perhaps means-tested program of assistance is provided. But there is more to having a healthy society than having medical care. A truly healthy society is only one where people rely on themselves and their peaceful agreements with one another, rather than on the coercive actions of government, to take care of their ordinary needs.
Hello Family, friends and others (you know who you are). It's time for another installment of Cal's Crazy Movie Metaphors. In this episode we ask the reader to power up "Mr. Peobody's way-back" memory recollection machine. We travel back in time to the 1950's, yes those thrilling commie-baiting days of yesteryear. You are getting very sleepy (and I haven't even finished the first paragraph). You are remembering the terrific 1956 Don Siegle black and white sci-fi cult classic "Invasion of the Body Snatchers" starring the great Kevin McCarthy, the comely Dana Wynter, and that guy from The Bob Cummings Show who always called him "Bubby-boy". "Smile--I think you're gonna like this picture!"
Remember the premise? Regular caucasoid Americans are abducted as they fall asleep and are placed by previously snatched folks into large incubators which appear to be fabricated from spider webs, Venus Fly-Traps, and the world's most gigantic okra pods, complete with goo? Anyhoo...the sad sacks cook in there for a while and eventually morph into--well, themselves on Valium. Okay, I see a comparison coming on. I am Kevin McCarthy, the misunderstood, but nevertheless insane voice of truth, banging on car windows trying to warn people that "They're Here!! Don’t' you understand?!! They're here!!!" Then the movie ends and everyone presumably becomes and "okrapod" because they didn't listen to me, dammit! I mean Kevin.
Now, if you've read this far you must be aching for more or you really need to get a life. I shall assume the former to be true.
Most of us belong a generation that was "incubated" (am I stretching?) in a climate of government intervention and do-gooderism. Social security (broke), Medicare (broke), Medicaid, Food Stamps, Welfare, a progressive income tax system, and all manner of economic safety net provisions and benefits. According to my handy 2007 Federal Income Tax Booklet these expenditures account for 57% of the Federal budget, not including Federal Housing Assistance and credits such as subsidized home mortgage loans). National Defense, Veterans, and Foreign Affairs comprise 23% combined. That's 2007--before the mortgage and economic meltdown. From Social Security and Medicare alone America has an unfunded liability of $99,000,000,000,000. That's trillions! That's$133,000 for every person now living in this country! This doesn't even count the interest on the national debt. Tick, Tick, Tick.
Now back to the "way back" machine, but only for a second--back to September 2008. Americans have just lost $4.5 trillion in personal wealth from their home values and their retirement plans. Most of us felt that pain. We didn't riot. We took it one the chin. But we made a mental note to find out who and what caused this to happen. Didn't we? What did congress do to make amends? Spent $687,000,000,000 on TARP bailout funds and they bought GM and Chrysler.
Now, I ask the following given all that happened prior to President Obama's inauguration. Are these good ideas?
-spend another $1.2 trillion tax dollars to stimulate the economy -pass a "Cap and Trade" plan that will cause massive increases in energy costs costing more trillions of bleed-out from the economy -try to force feed the nation a $1.7 trillion government mandated health care plan that will forsake the 253,000,000 Americans with insurance coverage for 47,000,000 of whom only 12,000,000 are legal and want to pay for coverage, but can't afford it or qualify. -totally ignore medical malpractice law and tort reform which results in huge awards and settlements, and that causes the massive overuse of testing by doctors in order to protect themselves from such lawsuits.
Friends, we are the pod people. We have drunk the cool-aid for 50 years. "We have met the enemy and they are us". Thanks Pogo. We pulled our heads out of the sand on September 12, 2001 for about 3 months and then we buried them again. We believed "Duck and Cover" would save our lives. We believed we would get 40,000 miles on a set of tires. We believed "We're from the government and we're here to help you."
We are saddling our children, grandchildren, and great grandchildren with perhaps hundreds of trillions of dollars of debt. That is just plain wrong. That is criminal. We are preparing the pods for our descendants and if we allow this to happen then our generation will have squandered it's one chance to achieve greatness. Sleep calls--your Pod awaits.
Please plan to attend your local Tea Party. Your great-great grandchildren can't. Cal.
PS: It wasn't Yogi Berra who said " You could look it up". My mistake. It was Casey Stengel. Yogi said "When you come to a fork in the road, take it". Words to live by.
Thanks, Mary Kay-- We need another family reunion, I haven't seen you in eons!
Back to some of Bruce's points: markets are surely more "efficient" (by which we mean what? I suppose, delivering a quality product at the lowest reasonable cost?) than ossified monopolies. But, pace the acolytes of my erstwhile colleague Milton Friedman, not every arena of life is really appropriate for market systems, and I think health care is one of them. Maybe others don't think so, but I feel that as a community--in this case, a national community, but the point would be the same if we limited it to our own local community--as a community we have an obligation to ensure that *everyone* can be as healthy as possible. It's partly idealism, a commitment to equality of opportunity (b/c if one is ill, one can't really compete), but it's also profoundly realistic, because as I pointed out many emails ago, if one's neighbor is ill his disease might spread to you, too, and more generally, widespread illness undercuts the productivity of the whole economy.
It's one thing to say that those who work harder should be rewarded, and those who are lazy or inept should lose out. In that case, we can rationalize the resulting differences in wealth as the reward to the "virtuous" for hard work, insight, etc. I don't have a problem with that. But when it comes to health issues--it's a different matter. Some people, through no fault of their own, face serious health challenges that others just don't. Look at my cousin Mary Kay: is she to blame for her diabetes? Hardly! But when you make health care something that must be paid for, then the unlucky in matters of health simply have to pay more than those blessed with good genes (or good luck in avoiding injuries). I doubt anyone in our discussion group would be in favor of eugenics, but by making health care something people have to pay for (and hence have insurance for) we adopt a policy that is almost like eugenics, in that we inevitably discriminate against those who get sick or injured or have chronic health problems. This is because the market-based, profit-oriented health insurers will inevitably try to reduce their costs by insuring only those who are healthy, and avoiding ("like the plague," to use a phrase curiously appropriate to this discussion) anyone who can be predicted to have higher health care costs. Either they won't insure such people, or they will charge them astronomical rates, which means many people of modest means can't afford the health insurance/care they need.
So the challenge, it seems to me, is to craft a aystem that provides acceptably good health care to *everyone* in our society: rich or poor, young or old, healthy or chronically ill. We are, comparatively, a rich society: it's little short of obscene that we, alone among developed nations, adhere to this "your money or your life" approach to health care. It's often said that the US has the "best doctors and health care in the world." This is true--if you are rich. This is why a lot of very rich people from other countries come to the US for medical treatments--they can afford to pay handsomely for it out of pocket, and do. Hospitals now compete for their business.
But I always thought the ideals of America were "land of opportunity" and the "level playing field." It seems to me that our current health care system, rather than leveling the playing field in health matters as much as possible, and thereby allowing all citizens are healthy enough to pursue whatever opportunities life affords them, is a cruel betrayal of those ideals--cruel especially to the poor and those of modest means. It's a system that exploits everyone's need for health care so as to maximize profit for the insurers (and some others), and treats those who need serious help but can't afford it as expendable. Uninsurable. "Your money or your life." As a society, we can do better! The question is, how?
There are some other points Bruce made that I'd love to comment on--you're a great interlocutor, Bruce!--but I need to get back to my "day job"...