Hillary outspoken socialist

[JosephH]

Once again, "Corporations without proper government oversight are indistinguishable from organized crime."

 

[JayB]

Works as a bumper sticker, not terribly helpful elsewhere. And proper oversight equals...nationalization?

 

 

[JayB]

BTW - why are all of the passionate advocates of nationalization so unenthusiastic when someone volunteers their profession/industry for the same treatment.

 

Strange.

[JosephH]

Millitary procurements take place within a single payer system, and we've certainly never seen any corruption, waste, inefficiency, or politically motivated misallocations of resources there, have we?

 

Our defense procurement system is not a service system, it is a corporate and state welfare system first and foremost and a defense procurement system second. The problems are wholly related to the closed-loop nature of the purpose of defense and states desires to share in the largess.

 

The U.S. desperately needs a single, universal health insurance system. We can retain various healthcare service providers, but again, we need a single healthcare insurance system where every citzen is covered and all coverage is uniform. Our current healthcare system is killing both people and their employers unnecessarily.

 

BTW, how would you feel about transferring control of IT/electronics/programming to the government? Again, surely the benefits of a single-payer system would be equally valuable in this sector of the economy.

 

Ah, clearly a happy Microsoft customer. Outside of operating systems, we don't sell to a uniform base of customers who would benefit greatly from the sort of large-scale aggregation desperately needed in healthcare. There is no, repeat, no advantage for all citizens to not be in a single health insurance pool.

[ericb]

I had a wonderful vacation in Costa Rica after blowing my ACL skiing in February. The bar-tender at one of our resorts was very jealous that I got to get my ACL repaired at the expense of my private insurance. He's been unable to play soccer aggressively for the last four years since he completely tore his ACL. The reason - the government doesn't consider it a necessary surgery for someone who works in the hospitality industry - too bad he's not a professional soccer player. He might not have to save up to pay for it out of pocket.

 

 

Edited May 31, 2007 by ericb

[mattp]

Faced with yet another brilliant argument from JayB, I am totally flummoxed. You're right, Jay: socialism sucks. Clearly what is good for roads and public health and even individual health care would have to be good for the civil side of our legal system. The older clients that I serve with guardianships and estates, or the businessmen who are doing real estate deals and the corporate acquisition investors all deserve equal protection under the law, by god! If they don't have it provided for them, nobody should have public education or basic health care.

[JayB]

Let's compare apples to apples here. Your argument was that that because some subset of the population benefits from health care administered and paid for by the government, it follows that nationalization of the entire medical economy is clearly the optimal model for the provision and delivery of health care for everyone, as well as fostering lifesaving innovations, etc. One could easily make the same arguments for legal services, or any other sector of the economy.

 

Why is it that you are so sure that such an arrangement would be optimal for a segment of the market that is much larger, many times more complex than the sector of the economy in which you make a living, but unsuitable for legal services?

 

 

[cj001f]

JayB - if you didn't work in the bioworld, your current line of argument might work

 

Instead of nationalisation - how about allowing sale of all but scheduled narcotics OTC?

[mattp]

Are you truly arguing that the broad range of things that attorney's do is in any way comparable to the provision of health care in terms of the actual need for such services?

 

Public defenders in criminal cases certainly are, and what you derisively term "ambulance-chaser" services in the case of personal injuries might be, but much of all the other stuff lawyers do is more akin to cosemtic surgery for someone who wants to work as a model but may or may not be "qualified" or already established in the profession, or maybe they want to work in the cosemtic surgery clinic or want to or already own it, than it is to actual health care.

 

Surely you realize that a great deal of what attorney's do is related to the accumulation of or persevation/protection of wealth rather than the maintainance of any basic standard of subsistance or well being.

[archenemy]

At this stage, I'd settle for a lobotomy.

[mattp]

Spend an hour arguing with JayB and you've got a lobotomy.

[JosephH]

JayB - dollar for dollar our healthcare system is a complete and dismal failure. It is utterly sinking under the weight of everyone that wants a piece of the pie. Employers are bailing on it faster than rats off a sinking ship, insurers are dumping any and everyone with any risk of serious illness, growing tens of millions are without any coverage. Which part of the system is it that works - your policy? Congress'? Corporate executives? Hopefully you won't get cancer, get laid off, and try to get coverage at a new job - or just get a new job for that matter.

 

This isn't manufacturing, it isn't the service sector, it isn't media (though I don't hear you touting what a glowing achievement of capitalism that that consolidation is). It's a basic requirement of every citizen - but instantanced as a shrinking risk pool so as to only cover healthy, young adults and even that at exorbitant rates. Anyone posing a risk is summarily dumped - it is unsustanable, untenable, and unconscionable. It is very much a part of why we are loosing ground in the world economy.

[JayB]

Are you truly arguing that the broad range of things that attorney's do is in any way comparable to the provision of health care in terms of the actual need for such services?

 

Public defenders in criminal cases certainly are, and what you derisively term "ambulance-chaser" services in the case of personal injuries might be, but much of all the other stuff lawyers do is more akin to cosemtic surgery for someone who wants to work as a model but isn't naturally attractive than it is to actual health care.

 

Surely you realize that a great deal of what attorney's do is related to the accumulation of or persevation/protection of wealth rather than the maintainance of any basic standard of health and well being.

 

That's precisely the point. The term health care market is complex and heterogeneous. Health care services administered and paid for by the government might be the best way to provide health care for those who are constitutionally incapable of paying for it themselves - children, the indigent, the elderly poor, etc - but it doesn't follow that this model would be optimal for the remainder of the health care market any more than the fact that we have public defenders for those who cannot afford their own attorneys means that government administration of the entire legal market is the way to go.

 

It's not like there aren't alternatives to the single payer model that would achieve many of the same goals.

 

http://www.nytimes.com/2006/04/05/us/05mass.html?pagewanted=2&ei=5088&en=f0af8c5ff31d540d&ex=1301889600&partner=rssnyt&emc=rss

[JosephH]

children, the indigent, the elderly poor, etc.

 

That's a joke no doubt - the families of those same individuals do not have adequate, secure health insurance coverage either. Hell, who does have decent coverage that wouldn't be canned in a heartbeat at a job change after a serious illness, accident, or cancer? You? Are you sure?

[mattp]

OK then. We agree: basic health should be universally covered. We can argue forever over what might be "elective" or "cosmetic," I bet. But Jay recognizes that, at least in principal, all should be covered. As you point out, JH, his assumption that even most average citizens can pay for their needed care if they have any extraordinary needs or end up having to - god forbit - change insurance companies and encounter bars to coverage of "pre-existing conditions" is just all in the mechanics. But we agree on the basic premise - no?

[JayB]

JayB - dollar for dollar our healthcare system is a complete and dismal failure. It is utterly sinking under the weight of everyone that wants a piece of the pie. Employers are bailing on it faster than rats off a sinking ship, insurers are dumping any and everyone with any risk of serious illness, growing tens of millions are without any coverage. Which part of the system is it that works - your policy? Congress'? Corporate executives? Hopefully you won't get cancer, get laid off, and try to get coverage at a new job - or just get a new job for that matter.

 

This isn't manufacturing, it isn't the service sector, it isn't media (though I don't hear you touting what a glowing achievement of capitalism that that consolidation is). It's a basic requirement of every citizen - but instantanced as a shrinking risk pool so as to only cover healthy, young adults and even that at exorbitant rates. Anyone posing a risk is summarily dumped - it is unsustanable, untenable, and unconscionable. It is very much a part of why we are loosing ground in the world economy.

 

Even if all of the assertions about the state of the medical system here were true, this wouldn't necessarily support the conclusion that nationalizing health-care and forcing everyone into a single plan would be the optimal means by which to address these problems.

 

Massachusetts has adopted a plan that provides for universal coverage without the state taking over the health-care market. It's not perfect, but it's accomplishes many, if not all of the objectives that advocates of a single payer system claim are behind their support of a single-payer system.

 

 

[mattp]

We're not talking about forcing anybody into any system, JayB. The wealthy - or even maybe the motivated - will always be able to opt out and purchase whatever they may desire.

[cj001f]

Even if all of the assertions about the state of the medical system here were true

 

Have you been out drinking with the Senior Senator again?

 

The health care system sucks. It's all the profits of the freemarket with none of the consumer benefits.

[JayB]

children, the indigent, the elderly poor, etc.

 

That's a joke no doubt - the families of those same individuals do not have adequate, secure health insurance coverage either. Hell, who does have decent coverage that wouldn't be canned in a heartbeat at a job change after a serious illness, accident, or cancer? You? Are you sure?

 

Just to take the "job change" example, you could go a long way towards addressing this by transferring the tax deductions for health-care premiums away from employers and granting them to individuals.

 

Affordability varies wildly from one state to the next, and the prime reason for this is the different mandates that are imposed on insurers in some states but not in others.

 

Make it possible for insurers to sell insurance in any state, and transfer the tax benefit for premiums from employers to employees and you've gone a long way towards making health-care more affordable.

 

Another interesting tidbit with respect to affordability comes from the data that Massachusetts collected when they were putting their health care plan together. They found that the single largest segment of uninsured individuals were young men earning decent salaries who could afford health-insurance, but elected not to obtain it, presumably because they figured that they didn't really need it.

 

"Eric Fehrnstrom, the governor's communications director, said that for those people with incomes above 300 percent of poverty, "our assumption was that these would be mostly single mothers who just did not have the wherewithal to get insurance. It turned out it was mostly young males. In some cases they are making very attractive salaries. These are people who just don't imagine themselves needing care, but of course when they break a leg when they're out bungee jumping they go to the hospital and we end up paying for their care anyway."

 

You also seem to be leaving the development of new or better treatments completely out of the analysis, and also seem to be under the assumption that the adoption of a single-payer model would have some meaningful impact on the manner in which people lead their lives. Anyone working on the front lines can tell you what percent of their work is devoted to dealing with ailments that are substantially self-inflicted.

[JayB]

We're not talking about forcing anybody into any system, JayB. The wealthy - or even maybe the motivated - will always be able to opt out and purchase whatever they may desire.

 

Well that's reassuring, seeing as this is decidedly not the case in Canada.

 

How is this different than the current model, other than one can only "opt-in" to the government healthcare system via poverty, disability, old-age, etc?

[cj001f]

They found that the single largest segment of uninsured individuals were young men earning decent salaries who could afford health-insurance, but elected not to obtain it, presumably because they figured that they didn't really need it.

 

One could argue excepting the negotiated insurer discounts, self insuring for catastrophic care is fiscally realistic. In 7 years I, or my employers, have paid probably $20,000 in premiums to health insurers. I have utilized my health insurance a total of twice for a total doctor bill of $150.

[JayB]

Even if all of the assertions about the state of the medical system here were true

 

Have you been out drinking with the Senior Senator again?

 

The health care system sucks. It's all the profits of the freemarket with none of the consumer benefits.

 

So when the pharmaceutical companies develop an entirely new class of drugs, like statins, or TNF blockers like Enbrel, or any of the many anti-HIV drugs and the benefit is confined exclusively to the drug companies?

 

Blow out your knee skiing, and the only one who benefits from the reconstruction is the physician?

 

Etc, etc, etc, etc.

[JayB]

They found that the single largest segment of uninsured individuals were young men earning decent salaries who could afford health-insurance, but elected not to obtain it, presumably because they figured that they didn't really need it.

 

One could argue excepting the negotiated insurer discounts, self insuring for catastrophic care is fiscally realistic. In 7 years I, or my employers, have paid probably $20,000 in premiums to health insurers. I have utilized my health insurance a total of twice for a total doctor bill of $150.

 

I would love to have all of my compensation as cash, and obtain a tax deduction for the premiums that I pay (rather than the tax benefit being confined to my employer) on a plan of my choosing - which would have a deduction on the order of $5K or more. Don't see this happening under any single-payer model.

 

 

[cj001f]

Blow out your knee skiing, and the only one who benefits from the reconstruction is the physician?

 

last I checked I could get it reconstructed under state provided medicine as well.

[cj001f]

I would love to have all of my compensation as cash, and obtain a tax deduction for the premiums that I pay (rather than the tax benefit being confined to my employer) on a plan of my choosing - which would have a deduction on the order of $5K or more. Don't see this happening under any single-payer model.

 

I'd love to be responsible for my personal health and health records instead of having the medical establishment as highly interested party caretakers who except for the rich (or those not rich willing to pay massive fees) provide no user specific services. I needed to receive an antimalarial. A Drs office charged me $100 for the pleasure of following the exact CDC website flow chart. He was nice enough to print out a copy for me. His value added = 0, however he's the gatekeeper to a prescription. How convenient.