We're up against more than the military-industrial complex that exercises undue influence over our political decision-making: Now we've got a “medical-industrial complex” (in Jon Kingsdale's phrase), one-sixth of our economy partly grafted onto our government; the petro-industrial complex, which milks the taxpayer for subsidies even as it enjoys high prices and record profits; and so on. This should be troubling for everyone: Whether you're a social-justice liberal or a low-tax conservative, the current looting of our public till ought to shock and offend you. It's. Your. Mun-ny.
This is the essential conflict for the Democratic Party, whose history and destiny is to be (relatively) populist, progressive, and utilitarian — in other words, the party of “the little guy.” Money-interest politics divides the Democratic Party and strengthens the GOP: On any given issue (bankruptcy, CO2 emissions, health care), one can depend on a few critical Democratic votes defecting from a progressive, utilitarian position to defend a parochial, moneyed interest. Carl Levin and John Dingell vote with the automakers against critical environmental legislation; Joe Biden and Joe Lieberman vote for a misanthropic bankruptcy law; Barack Obama abortively supports CO2-belching coal-to-liquid technologies (ahem), and so on, forever and ever Amen.
And so, even though the public widely agrees with many progressive positions (yes, depending on how they're framed and phrased), in the face of a bought-and-paid-for Republican opposition and internal dissension, the Democrats seem powerless, impotent. At least since the health care debacle of 1993-94, the GOP has been perfectly happy
to obstruct and deny progress the public demands in order to deny Democrats credit for success. They're happy enough to be thought “just plain evil,” as long as the Dems are thought to be worthless.
So this incisive critique of our system is much of why I've found Edwards to be compelling. But in addition, at this year's Take Back America conference, I was moved by his idealism, by his concern for the poor and ignored, and by his vision for America's positive place in the world, its potential for leadership by example. (At the same conference, I was wowed by Obama's oratorical skill, and generally underwhelmed by Hillary's case for herself.) I think he's genuine. His wife Elizabeth is, if anything, even more direct, clear and effective than he is. If she's saying what John feels but somehow can't or oughtn't say himself, that's a good sign. I believe them when they say that their lives together are defined by their mission of service. Together, they sound like people who realize that life is short, and there's no time to sugar-coat, to dance around the subject, to equivocate. That's a pretty typical and I think noble response to tragedy. (Do see this fascinating personal look at the Edwards family in the New York Times.)
Policy: The Out-Front Leader on the Big Ones
Edwards has led the Democratic field on policy in the areas that to me are morally non-negotiable: Universal health care, and climate change. On health care, Edwards took the Massachusetts model of shared responsibility (yes, and mandates) and did it a few steps better, calling for subsidies higher up the income ladder, and for a public alternative to private health insurance.
On climate change, he was the first to roll out a plan that calls for 80% reduction of CO2 emissions by 2050, considered to be the scientific baseline for dealing with the problem. Grist Magazine calls Edwards the “prime mover” behind the Democratic candidates' eventual consensus on this issue as well. These rock-solid requirements, strong enforcement, and visionary leadership are simply non-negotiable for my support of a candidate. The means are negotiable, but the ends are not. Fortunately, Obama and Hillary Clinton have followed suit with their own credible plans; but would they have done so without Edwards? (And what was Obama thinking, flirting with coal-to-liquid? Is that leadership?)
Caveats: No Quixote for me; More hope, please
Edwards is not perfect by any stretch. I have mentioned before his annoying tendency to portray himself as the lone hero, the knight in shining armor. Actually, if he's elected, he will need a vast public mandate, a truly historic attitudinal shift to deliver on his agenda. Congress will need to feel the heat; hacky corporate pols will have to fear for their seats, and a President can't do that all by his lonesome. What's the mechanism by which he shames Congress into shunning corporate influence and acting on behalf of the broad public again? It's all a little hard to believe — but having the power of the President is certainly a good start.
Furthermore, I think Obama's onto something in his role as “hopemonger”. History plainly shows that the electorate favors optimistic, high-flown rhetoric — and why shouldn't we? Who wants to wallow? Edwards could do a better job pivoting from his searing indictment of our political culture to a brighter, more hopeful vision of the future. Where's the shining City on the Hill? Edwards needs to start working that into his speeches. As Bill Clinton wisely said, “There's nothing wrong with America that can't be cured by what's right with America.” We need to believe that. Hope isn't just about feeling good; it's a moral necessity.
But while I admire Obama's hopeful rhetoric, there just isn't quite enough bite, enough contrast, to really create a mandate for a post-corporate, post-DeLay era politics. I don't see him throwing the money-changers out of the temple. And Hillary apparently has no interest in even trying, since Bill Clinton managed to thrive politically in the 1990s even in the height of the soft-money era. I have little doubt that she can work the system, but the rest of us are entitled to ask, What's in it for us?
I think that any of Edwards, Obama, or Hillary Clinton could be elected. But I have my doubts about whether any of the Big Three can actually execute their strategies as President. At the very least, I'd like the next Democratic President to understand what he/she is up against. Hands-down, that's Edwards. He gets it. And in this campaign, he's led, again and again. Is that going to count for something, or not?
I can see why it took you a while.
scratch to the Obama campaign, but I’m leaning towards Edwards for many of the reasons that you cover. I’m also leaning his way because he’s pushing harder to the left than either BO or HRC, and I believe that’s where we need to go.
<
p>The political center has shifted so far to the right, that FDR is commonly vilified as a Socialist, while torture and illegal wiretapping are shrugged off as necessary in a post 9-11 world.
<
p>Concessions to corporate America and the modern GOP are not the solution. I want a candidate to stand up and say it, and push the goal posts left. All the backbiting that I’m reading, claiming that Edwards is a phony populist, makes me wonder if some of the other candidates aren’t fearing his message at a time of looming recession.
I have come to the same conclusion, for all the same reasons. He is the candidate concerned with the big picture — and not just a picture of himself. Environment, health care, economic inequality, and underlying it all, the corporate take-over of our country, these are the issues of the future. If we don’t deal with corporate power, we will continue to lose not only our economy but our democracy.
<
p>Naomi Klein’s new book, The Shock Doctrine, is a breathtaking expose of the role of the American corporate-political complex and how it is mercilessly destroying whole countries to lay them open to private profiteering. The United States is falling prey as well, perhaps more gradually than the militaristic dictatorships we have set up to topple democracies and open the gates for our market-uber-alles profiteers, but it is happening. Corporatism, fascism, by whatever name, it is happening.
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p>I don’t hear any other candidate daring to lay this on the table.
<
p>I’ve been painfully disillusioned by Deval Patrick, whom I passionately and hopefully supported, but I still hope that some public officials will do what they promise. It’s worth giving him a chance. We don’t know for sure what he’ll do, but we can’t risk electing leaders who don’t even ask the right questions.
If you have the time, you might offer a book review post on Klein’s new book which sounds significant.
Still reading; will post a review when I finish. There are several YouTube videos related to the book that are worth watching. This should be required reading and viewing in our schools.
<
p>Her previous book, No Logo, is also excellent.
I have also decided to support John Edwards. I was drawn to his message in the 2004 presidential race and worked for the Kerry/Edwards ticket. He has the message that resonates with our family and our region where the middle class is an endangered species. People are feeling enormous anger at government (local, state, national) yet disempowered to fight against corporate power.
I have strong reservations about Hillary’s corporate ties and Obama’s thin resume on the national and international stages.
I think Bill Richardson would be both a strong POTUS or a VP. I will never let shiny campaign phrases and speeches woo me again. If they’re not walkin’ and talkin’ about the working middle class then I ain’t listening.
<
p>Edwards/Richardson ’08
that I also voted for Edwards in the 2004 primary — not like it meant anything by the time it came around to our primary.
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p>Love me some Super Tuesday! Go MA!
Charley, John Edwards made his professional bones as a plaintiff’s attorney gaming the same medical-industrial complex he now decries to enrich himself and his family and provide compensation to his allegedly injured clients. Now, we are supposed to believe that Edwards, if elected president, is prepared to destroy the same medical-industrial complex that has prevented universal access to health care, while permitting Edwards and his colleagues in the civil plaintiffs bar to recover billions of dollars every year in medical liability awards and contingency fees for themselves and their allegedly injured clients.
<
p>Edwards’s medical cost control proposals are ineffectual and overly optimistic and reveal his unwillingness to take on, at least, one entrenched interest, the civil plaintiffs bar. For example, his proposals for containing malpractice costs constitute unadulterated pablum. According to the John Edwards Web site, he supports “supports mandatory sanctions for lawyers who file frivolous cases, stronger state medical disciplinary boards, and a knowledge bank that encourages doctors to report medical errors voluntarily, making others aware of preventable mistakes.” Increased self-policing by physicians and attorneys who abuse the practice of medicine and the civil legal system has not solved the medical malpractice crisis in the last twenty-five years, Strident jeremiads by a President John Edwards against incompetent doctors and avaricious ambulance chasing attorneys will not make a difference to reduce medical liability costs either.
<
p>Indeed, Edwards opposes many legal reforms of our corporate health care system that would reduce the inflationary costs we all pay in higher insurance premiums. For example, John Edwards opposes monetary caps on non-economic damages, a sliding scale for attorneys fees, mandatory mediation or arbitration of some medical malpractice claims, abolition of the collateral source rule, and eliminating third party liability for physicians when their patient harms another person (a non-patient) as a result of a failure by the physician to provide a recognized duty of care to his patient. (The Supreme Judicial Court recently endorsed this form of indirect, third party liability for physicians in the case of Coombs v. Florio. This dubious decision by the SJC to expand medical malpractice liability in the state will undoubtedly result in higher medical malpractice premiums and consumer health care insurance premiums in Mass. for years to come.)
<
p>Maybe, John Edwards rails like a contemporary Jeremiah against the medical-industrial complex because he feels a tad guilty about profiting handsomely from it for many years while other “sons of mill workers” lost their health care insurance when their jobs went overseas because of globalization. Nevertheless, his long-term professional experience as civil plaintiffs’ lawyer represents the life experience of a man who has effectively manipulated a vulnerable component of the medical-industrial complex, the medical liability system, to the substantial personal benefit of himself, his family, and, to a lesser extent, his clients. The ability to game the civil legal system profitably may qualify one for the presidency of the ABA (American Bar Association), but it falls woefully short in the holistic life experience I expect from the next President of the United States.
<
p>Finally, if John Edwards has truly experienced a “Nixon goes to China” self-revelation regarding health care reform, he would be advocating the destruction of the corporate health care system through the adoption of a SINGLE-PAYER health care system in the United States. Instead, like all effective civil plaintiffs lawyers, Edwards, if elected president, will make the necessary accommodations with the corporate health care interests to reach a political settlement that expands health care access for some, modestly reduces health care costs for a few selective, politically influential stakeholders, and perhaps, introduce greater competition into the drug market to reduce the cost of prescription drugs.
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p>An Edwards presidency would only postpone the necessary political fight to overturn the profit-driven corporate health care system with a SINGLE PAYER health care system. Unfortunately, it may take several more cycles of double-digit health and medical malpractice insurance premium increases that squeeze middle-class Americans and physicians so tightly that they finally cry in unison “ENOUGH IS ENOUGH” and demand a SINGLE PAYER health care system be implemented across the country.
like the girl in this case http://www.morelaw.com/verdict… ??
how do you delete comments??
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p>Anyway, the assertion that medical malpractice suits are behind rising medical costs is largely a myth. There is no clear evidence that litigation is behind rising medical costs. Medical malpractice premiums are shown to be cyclical, and not determined by ‘frivolous litigation.’ The sharp spikes in malpractice premiums in the 1970s, the 1980s, and the early 2000s are the result of financial trends and competitive behavior in the insurance industry, not sudden changes in the litigation environment.
<
p>See: Baker, Tom. The Medical Malpractice Myth. University of Chicago Press, 2005. Pages 1-14.
This is a topic deserving larger treatment. It’s one liberals really need to be able to shoot down.
Quoth Kevin Drum:
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p>The total dollar amount of the lawsuits is like 2% of the rise of insurance costs.
out of George Bush’s playbook as well, and it’s been shot down here:
The savings from elimination of “pain and suffering” awards (aka lottery payouts to some lucky plaintiffs) would be minimal for the system as whole. Bush is wrong to pretend otherwise. But that doesn’t mean they are not a laudable and worthy goal in themselves.
a lottery payout (and avoidable pain at that).
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p>How much would you charge me to let me punch you really hard in the arm. No long term damage — just a numb arm and a bruise. $10? $100? $1000? Surely you’d let me do it for $10,000. If so, we’re establishing a market rate on pain. I inflict pain on you, you charge me for it.
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p>Why any different in the hospital?
The savings from elimination of “pain and suffering” awards (aka lottery payouts to some lucky plaintiffs…
<
p>the P&S portion of a contingent fee award is largely the source of the attorneys’ fees, and other costs and expenses associated with a lawsuit. Capping the P&S award would generally effectively deny severely injured people access to the courthouse, particularly since the costs and expenses (experts fees) in such cases would be much higher.
How does that follow?
Instead of a lawyer just taking on one or two lucky plaintiffs and making all their money with a huge score, they’d have to represent more victims to make that money.
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p>I think the “lottery” aspect is that very few of the people who truly suffer pain get any money at all. Just a lucky few reap an unfair portion, but that’s good enough for the lawyers. Lawyers have a conflict of interest, they don’t want to help people get the money they deserve, they want big cases and big payouts to make themselves essential and make filing a case imposing and expensive.
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p>Maybe we should get rid of lawyers and juries and expert witnesses and settle malpractice cases in special courts or boards that do their own research and call their own experts? Then it wouldn’t come down to how folksy and handsome your high-priced lawyer is, it would be how negligent your doctor was.
Robert, I sincerely do not know where you got that (Costs of trials would be higher without P & S awards?) out of my comment. What I was telling you was that caps on P&S awards would largely deny severely injured people access to the courthouse. I don’t know how more clearly I can put it. Most severely injured people don’t have the ability to finance a lawsuit on their own, and they are relying on the “contingent fee” to give them access to…the courthouse. If the judge believes that the jury’s verdict (remember, it is the jury that awards the damages, not the lawyer) is excessive, the judge can order a remittiture. (I’ll presume that you have legal training and know what that means.) Query why they don’t more often.
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p>they Maybe we should get rid of lawyers and juries and expert witnesses and settle malpractice cases in special courts or boards
<
p>Several things that you might want to consider. One, what you are suggesting is little more than arbitration. That was supposed in the 1960s and 1970s to decrease litigation expenses, but it really didn’t. Two, you make references to boards for this and boards for that, but I’lll give you a little example. I don’t know whether or not you remember the Interstate Commerce Commission, the “board” that regulated truck traffic in the US. The trucking companies quickly learned how to rig the board to benefit them. We’ve seen that also more recently with the Fed Communications Commission and telecom de-regulation. I have no doubt that the interested parties (physicians and insurance companies) can rig the boards that you are suggesting in their favor.
They readily acknowledge that premiums are a function of the prevailing interest rate.
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p>The problem is that they still spend an inordinate amount of time playing defense on frivolous legal crap. They went into healh care, like everyone else who does, to do health care, and are bitter that they spend up to a quarter of their time dealing with risk management issues.
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p>The Democrats have lost health care professionals on this, which will ultimately injure any Democratic attempt at healthcare reform.
John Edwards is untrustworthy to take on the insurance companies because he took them on in court! I’ve seldom read anything as ridiculously backward that didn’t come from a Republican propaganda machine. And, of course, delivered in tandem with another GOP bullshit talking point about the eeevils of legal accountability for medical malpractice.
To be convincing, please include facts and links in your comments, if you would be so kind. Your words are good ones, but without reality-based data to back them up, they are just political invective. And Lord knows we have enough of that in this country.
However, I thought loveable liberals comment was worthwhile.
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p>I have read eddiecoyle’s comment five times now, still doesn’t make sense. I might be missing something, but I don’t undestand that point about Edward’s work as a trial lawyer being part of the “medical industrial complex. How does the “M-E Complex” benefit from malpractice lawsuits. As a cover to charge higher rates? or is it an argument similar to “Corporations actually love unions, because without them the workers would be demanding socialism.”
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p>I don’t get what the argument is, others below take up the issue of whether/how much malpractice lawsuits affect the costs of medical care in the US, where “reality-based” facts are critical. Loveable liberal was arguing that a different point, more about pure logic, maybe they could have linked to Aristole, I guess.
The plethora of frivolous malpractice lawsuits and other dubious medical liability claims provides a convenient pretext for health insurance companies to raise their premiums well above the inflation rate, increase their profit margins, and hire more insurance lawyers to defend and settle these lawsuits, causing the administrative and medical malpractice insurance costs of health professionals to go up exponentially each year.
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p>Some of John Edwards’s best friends and and most ardent supporters in North Carolina are his fellow lawyers who represent health insurance companies, hospitals, and physicians. Edwards’s success as a medical tort trial lawyer has assuredly funded the homes, vacations, and child college educations of the array of “opposing” attorneys who represent insurance companies, hospitals, and physicians and have “opposed” him so vigorously in the courtroom.
<
p>Finally, health insurance companies absolutely do prefer negotiating and sometimes litigating with plaintiff’s attorneys over medical lawsuits compared with the prospect of their entire profit-driven industry being obliterated by a cost-controlled SINGLE PAYER government health care system that encouraged certificate of eligibility screening, mediation, and binding arbitration of medical liability disputes. Instead, under Edwards’s health care reform plan, all stakeholders will continue to bear the heavy financial costs and the frustrating time-consuming burdens of protracted litigation, which benefits handsomely the wallets of the plaintiff’s and the defendant’s attorneys alike.
Funded the homs, vacations, and child educations of the opposing lawyers representing insurance companies?
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p>I guessing you don’t know any of these guys.
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p>They bill by the hour, not on a contingent fee. They are nickeled and dimed TO DEATH by the insurance companies. If they are very talented trial lawyers, they can probably double their income by moving across to the other table.
People don’t have to be richly rewarded to be rewarded enough and dependent on their jobs. The fact is they’d lose their jobs if we got rid of this system, whether they like their jobs or not. And they’d lose the chance to move across to the other table someday, which no doubt they all do after a while.
…a town which is too small to support one lawyer can easily support two…
Here are the government, scholarly, professional association and industry-sourced facts included in the 2006 Medical Liability Reform-NOW! Reportpublished by the AMA (American Medical Association) about the costs, reforms, and consequences associated with the medical liability crisis in the United States.
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p>1) Costs of Current Medical Liability Crisis
<
p>A)The Direct Cost of Medical Liability Coverage and Defensive Medicine for Federal Government Health Care Programs,
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p>The U.S Health and Human Services Department has stated that the direct cost of medical liability coverage
and the indirect cost of defensive medicine increases the amount the federal government must pay for Medicare, Medicaid, the State Children’s Health Insurance Program, Veterans’ Administration health care, health care for federal employees, and other government programs by $33.7 to $56.2 billion per year. [Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Addressing the New Health Care Crisis: Reforming the Medical Litigation System to Improve the the Quality of Health Care 11 (2003)]
<
p>B) The Medical Liability Crisis Results from Litigation Excess
<
p>Insurance premiums are largely determined by the expensive litigation system. Although most cases do not actually go to trial, it costs a significant amount of money to defend each claim–an average of $24,669. The most dramatic cost driver, however, is the effect of the few cases that result in huge jury awards. Even though very few cases result in these awards, they encourage lawyers and plaintiffs in the hope they can win at the litigation lottery, and they influence every settlement discussion as well.
<
p>According to the American Academy of Actuaries, insurers’ costs began to increase in the late 1990’s, fueled by increases in both the size and frequency of very large claims and in the costs of defending lawsuits. Case in point: the size of the median jury award more than doubled from $475,000 in 1996 to $1 million in 2000. This means that half of all jury awards are currently above $1 million.
<
p>In 2001, the average loss ratio (the ratio of claims paid to premiums collected by insurers) in states without caps was 100.86 compared to 68.98 in states with reasonable limits on non-economic damages. Simply put, claims have outstripped premiums in states without such reforms. With no limits on further increases in enormous jury awards and hence in future liability costs in sight, insurers in non-reform states are raising premiums dramatically, limiting coverage, or eliminating coverage altogether.
<
p>C) Projected Savings to Costs of Federal Government Health Care Programs Resulting from Medical Liability Reform
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p>A 2003 HHS report provided updated figures documenting the scope of the medical liability crisis, including a revised update on the costs borne by the federal government. This report found that direct tort reform, including but not limited to reasonable limits on non-economic damages (e.g., pain and suffering, mental anguish, physical impairment, etc.), would reduce the amount of taxpayers’ money the federal government spends by $28.1 to $50.6 billion per year.
[Source: OFFICE OF THE ASSISTANT SEC’Y FOR PLANNING AND EVALUATION, U.S. DEP’T OF HEALTH AND HUMAN SERVS., ADDRESSING THE NEW HEALTH CARE CRISIS: REFORMING THE MEDICAL LITIGATION SYSTEM TO IMPROVE THEQUALITY OF HEALTH CARE 11 (2003)]
<
p>D) Increases in Medical Liability Costs Exceed Other U.S Tort Costs
<
p>1) Evidence that the litigation system is broken is further established in a study released by the consulting firm, Towers Perrin Tillinghast, U.S. TORT COSTS: 2006 UPDATE: TRENDS AND FINDINGS ON THE COST OF THE U.S. TORT SYSTEM published in 2007 concerning, among other things, the disproportionate increases medical liability costs relative to tort costs in other sectors of the economy.
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p>a. Medical liability costs have risen an average of 11.4% a year since 1975, outpacing increases in other U.S. tort costs (8.7%)by almost 3% through 2005.
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p>b From 2003 to 2004, medical liability costs rose by 8.5%
while other U.S. tort costs rose by 5.7%. For 2005, medical malpractice tort costs totaled $29.4 billion, up from $28.3 billion in 2004, an increase of just over 4% as compared with an increase of 0.5% increase in tort costs overall.
<
p>E) Excessive Medical Liability Costs Account For a Significant Percentage of the Increasing Costs of Health Insurance Premiums
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p>A 2002 PricewaterhouseCoopers study “The Factors Fueling Rising Healthcare Costs” concluded that litigation accounted for 7% of the increase in rising costs of health insurance premiums . “Litigation” includes the effects of defensive medicine, liability premiums, risk management and reinsurance, outsized awards and legal costs, and class action lawsuits.
<
p>F) The State Bar Associations, Regulators and Medical Liability Laws DO NOT effectively Discourage Frivolous Medical Liability Claims From Being Filed, Harshly Sanction Ambulance Chasing Plaintiffs Lawyers, NOR Bar Non-Meritorious Medical Liability Claims From Going to Trial
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p>1) The vast majority of medical liability claims, 75%, do not result in any payments to patients. Only 1% of cases result in trial victories for plaintiffs. Moreover, data show that 40% of closed claims were filed with no
merit: 37% did not involve a medical error, and another 3% did not involve an injury. [Source: David M. Studdert, et al., Claims, Errors, and Compensation Payments in Medical Malpractice Litigation, 354 N.ENG. J. MED. (2024-2033) 2006.]
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p>G) The medical liability crisis is causing doctors from many states, including Massachusetts, to practice costly defensive medicine, reducing the number of available high-risk and other specialists to care for patients, and spurring physicians to leave these high insurance premium states to practice medicine in states that have passed sensible medical liability reforms.
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p>Here is the AMA’s summary report and testimony from physicians on how Massachusetts patients are losing access to care because of the medical liability crisis:
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p>Massachusetts
<
p>i. A 2004 Massachusetts Medical Society Workforce
study found that high-risk specialists are limiting their
scope of practice and altering how they practice,
including practicing defensive medicine because of the
fear of being sued. Among the high-risk specialists
affected are:
– 68 percent of emergency medicine specialists
– 64 percent of neurosurgeons
– 64 percent of obstetrician-gynecologists
(MMS 2004 Physician Workforce Study, April 2004)
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p>ii. Jane Confort, 52, is one of more than one dozen
patients who had to be airlifted by helicopter to Boston
from Saints Memorial Medical Center in Lowell since
it had lost 24-hour neurosurgery coverage after two of
six neurosurgeons in the region retired, and the
facility’s medical group had been unable to find
replacements. Mrs. Confort was okay, and Dr. Gary
DeLong, director of emergency room services at
Saints Memorial in Lowell, said although he believes
the shortage hasn’t hurt the quality of patient care, ”it
has affected orderly, convenient patient care.” But, he
said, ”when someone has an acute hemorrhage inside
the brain, those patients need surgery quickly.”
(Boston Globe, April 28, 2004)
<
p>iii. Some of Massachusetts’ most experienced orthopedic
surgeons say that it is growing more difficult to recruit
new physicians. “I have been trying to recruit a
partner for several years,” said hand surgeon William
Ericson, MD. “And no one wants to come to
Massachusetts. My most hopeful prospe
ct just
informed me that he is leaving the state.” R. Scott
Oliver, MD, also has had difficulty recruiting and said
that “in the last year, I’ve interviewed five young
doctors for positions in my group practice, have turned to other opportunities.” (Massachusetts
Medical Society, September 18, 2003)
<
p>iv. A study of voters conducted in mid-2004 found that
nearly 70% favored limiting awards for non-economic
damages. (The Boston Herald, June 8, 2004)
<
p>v. Insurance premiums in Massachusetts rose 132% from
1994 through 2006. Neurosurgeons have been particularly
hard hit-there are fewer than 60 practicing in the
state in 2006. (The Boston Herald, May, 8, 2006).
<
p>H) John Edwards is a wholly-owned subsidiary of the Trial Lawyers of America
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p>Finally, John Edwards will never be an agent of reform and change for the health care system in America because if one “follows the money,” on the Center for Responsive Politics Web site, instead of listening to the political rhetoric from this “son of a mill worker,” one learns that nearly 27% or over $8 million of the $30 million the Edwards campaign has raised in the 2008 presidential cycle comes lawyers and law firms. Does anyone truly believe that the facile success of John Edwards has had in reaping millions of dollars of recycled legal contingency and hourly fees from his legal colleagues will have a negligible influence on the content and scope of health care reform proposals, including necessary cost controls and limits on medical liability, he would advance as president? If you do believe that assertion, I have a bridge I would like to sell you.
Here are arguing here that malpractice cases are causing the increases in medical care. Others are arguing against it, I don’t know enough to engage on this issue.
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p>But I still don’t buy that the Medical-Industrial complex (not really sure what they means, but surely the AMA is part of right, and they are not in love with trial lawyers, right? We can agree on that, I presume?) likes the current system.
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p>I also don’t understand why the insurance companies want this. Not sure where you do the research on this, but I would be willing to bet that their trade groups are lobbying for these caps that you are recommmending. I bet that they would prefer to take the risk of large settlement against them than the “cover” to increase rates. Who is this cover from?
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p>Finally, single payer, has seem to have dropped out of your argument. I don’t remember any political movement about to achieve single payer and being stopped by any of this. Where is the causation here: Because insurance companies have the cover to increase rates they have more money to oppose single payer. I bet regardless of their situation they are going to put a heck of lot of resources into avoidign single payer. If anything, rising premiums could increase the political desirablilty of single payer as more people would want to make radical changes.
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p>In your first post you argue that Edwards is a problem because he won’t go to single payer (not that any viable candidate is advocating that), but when you make your argument in detail, it is that Edwards won’t put in the reforms you believe are necessary.
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p>So what was the whole “Medical-Industrial Complex” and “Single Payer” stuff. Because the “Medical-Industrial complex” overwhelming would support, IMO, the reforms you are advocating, but are vehemently opposed to single payer.
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p>Maybe I am being cynical, but it seems like you are puffing up your argument with lefty buzzwords (single payer, anything-industrial complex) to sell your argument to a progrssive audience. Maybe I am dumb, but I can’t see the connection. Let me know what I am missing.
the Medical-Industrial complex (not really sure what that means
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p>it means it’s complex! Not all the parties in a “complex” like each other or work together, they make money at each other’s expense and take advantage of each other ruthlessly. Trial lawyers are part of the complex, they take advantage of insurance companies that take advantage of hospitals that take advantage of patients who take advantage of lawyers, etc. But they all take advantage of the system and work to maintain it. it effectively siphons money into their wallets from somewhere, but like “the man” who gets a Sprint phone plan as his “little way of sticking it to the man”, you just don’t care when you are sticking it to yourself.
…is confused about COMplex (the noun) and comPLEX the adjective. You were–to me–obviously referring to the first, but the American English language has many ambiguities.
Eddie, your entire point is utterly incoherent, as pointed out above. Edwards is beholden to our health care system because he sued docs for malpractice? Whuh? That’s some serious logical three-card monte you’re playing.
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p>Furthermore, nice job finding an independent, totally unbiased source for your research there. AMA, wow, no axe to grind there. Speaking of those who have deep-sixed universal health care countless times in the past …
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p>And, the link to the PWC report doesn’t work. Awesome. Nice cut and paste job, very impressive. Even if it’s correct, that 7% of the increase in health care costs is from litigation … uh, that leaves the other 93%. You think maybe we should concentrate on that?
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p>Furthermore, are you suggesting that there be no medmal lawyers? Have you provided any evidence that payouts are too high — just on the merits?
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p>I’m definitely willing to entertain the notion that a litigious environment leads to more defensive medicine and higher costs. That makes intuitive sense to me, and I’ve heard that from docs. Fine and well. All this junk — larded with anecdotes that are neither here nor there — doesn’t prove that.
Not all lawyers are among the money elite. As the others who, in whole or in part, accept court appointed child welfare work – or court appointments as Guardians Ad Litem. Much of that work is unpaid, and what the government does allow to be billed is at $50.00 an hour – pay your own malpractice, rent your own office, buy your own copier, pay for your own internet – no paid sick time, no help from anyone with paying for health insurance – unless you are lucky enough to get it from a life partner, that is….
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p>All that stands between the citizen and the might of the government, and the rapacity of the corporations is attorneys, Mr. Coyle.
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p>The character who stated “First we get rid of all the lawyers” in Shakespeare’s play was a guy who wanted to squeeze more money out of the yeomanry.
Not having read Henry VI, but I do love it when people quote stupid people or villains from Shakespeare and pass it off uncritically as wisdom — like “neither borrower nor lender be”, quoting the fatuous Polonius.
My apologies if this comment shows up twice. The board didn’t seem to want to accept it the first time I posted it.
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p>It’s interesting that the financial data seems to point to the fact that the actual cost of malpractice cases doesn’t lead directly to increases in premiums. Yet the insurance companies keep raising premiums and pointing fingers at trial lawyers and their clients. Since the financial data doesn’t back them up, supporters of tort “reform” rely on lots of anecdotal evidence about doctors being burdened by malpractice premiums, and patients being airlifted to hospitals because of doctor shortages. Ignored in all this is the fact that lawyers don’t set insurance premiums, insurance companies do. Letting the insurance companies off the hook because the lawyers “made” them raise premiums is just specious. And that AMA study may cite a lot of facts and figures, but what’s not accounted for is the potential contradictory evidence the AMA failed to include. That’s the fundamental flaw in relying on studies from any advocacy group.
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p>I might also add that insurance companies routinely settle cases because they have decided that it makes financial sense, especially since they will pass the costs along in higher premiums. Taking a stand against clearly specious cases would do kore to deter frivolous lawsuits than any “reform” you can come up with.
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p>I haven’t bothered to slog through everything in that post, but I did note that the Towers and Perrin study says “…this study examines only one side of the U.S. tort system: the costs. No attempt has been made to measure or quantify the benefits of the tort system. This study makes no conclusion that the costs of the U.S. tort system outweigh the benefits, or vice versa.”
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p>I’m also skeptical of reports from HHS, since the Bush administration has such a pathetic record of politicizing the work of every executive agency.
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p>Doctors don’t practice defensive medicine because they fear large judgements against them. They practice defensive medicine because they fear the astronomical increases in their premiums as a result. Portraying the insurance industry as passive victims of avaricious trial lawyers is disingenuous, at best.
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p>Sorry, but I realized most of what you had to say should be taken with a grain of salt when I saw unsupported statements like “The plethora of frivolous malpractice lawsuits and other dubious medical liability claims” and especially the laughable “his allegedly injured clients.” You seem to be claiming that Edwards engaged in massive fraud, if he represented clients who weren’t actually injured. Care to enlighten us more on that?
…I suspect that US doctors perform most of what is characterized as “defensive medicine” because the tests that they have performed (the doctors don’t do the tests themselves) are largely profit centers for their institutions. We’ve had similar tests performed in Germany and the costs there are 1/5 to 1/10 the costs of their counterparts in the US. Tests that Lahey Clinic would bill USR50 for, are billed in Germany for something like Euro8.
…good job on the essay. I am all in with Edwards. Going to NH tomorrow for more.
Your characterization of Edwards as the one really taking the lead on critical issues is spot-on.
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p>The institutionalization of control mechanisms should be key issues in this “post 911 world”. It is wholly about the media conditioning American citizens to assume the proper S&M position when “authority speaks”. No, I obviously don’t buy alqueda as the replacement enemy after “the fall” of the global threat of “communism”. We are buying lead toys, contaminated toothpaste and dog food from a “communist” nation fully supported by the entire western world. An industrial gold rush of unprecented proportions.
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p>Now I could be wrong but even my casual observations of John have shown him to be a suck up to major globalist organizations. That is contrary to his sales pitch of champion of the common man.
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p>Yes, I like the view from atop an Apocalyptic horse.
Edwards “has shoot in his eyes.” I like that he’s pissed off, because so am I. Enough of the milquetoast bullshit from the Democrats. Our democracy is eroding before our very eyes. I didn’t serve in the military–the 18th member of my family to do so since we came here during WWI from Ireland–to serve the NCLB (that’s No Corporation Left Behind) US government. Enough of this already. America isn’t inevitable, and if we don’t start to turn back some of these anti-democratic powers and principalities, we are going to end up like the Romans: history.
Michaeljc4,
Nobody has said so much, so well, in so few words. This is a gem of a post. You have absolutely captured it. You’ve got me thinking about an Edwards-Michaeljc4 ticket.
🙂
This is an excellent and helpful analysis. The essay solidified Edwards as my number two choice. Right know my list is:
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p>1.Kucinich
2.Edwards
3.Dodd
4.Obama
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p>So if Kucinich drops before Feb 5, Edwards has another vote here in Mass. Although, Dodd did date Bianca Jager and Princess Leia…
He says that Barack Obama is the best choice after him. Obama Thanks Kucinich for Encouraging His Backers to Make Obama Their Second Choice:
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p>
And but I still have a stronger like for Edwards. Maybe this Kucinich quasi-endorsement it kicks Dodd down a notch, if push came to shove.
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p>I wonder why Kucinich chose Obama? I wonder if it was as much policy as it was the similarity in hopeful rhetoric both push. Perhaps the idealist in candidate Kucinich admires the idealist in candidate Obama? Kucinich goes on to say “This is obviously an ‘Iowa-only’ recommendation, as Sen. Obama and I are competing in the New Hampshire primary next Tuesday where I want to be the first choice of New Hampshire voters.”
It seems like such a dis on the others. Why not let his supporters pick their own second best? I can only ascribe that to a visceral hatred of Clinton and Edwards, since it was entirely unnecessary and won’t help Obama that much.
You asked the following question downstream:
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p>
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p>Edwards is right in his assessment of the problem, but very wrong in his approach to doing something about it. His campaign displays a striking lack of familiarity with U.S. history, which leads me to my two primary conclusions about him: (1) he is a lightweight i.e. not a very clear or profound thinker, and (2) he will lose. (I think Obama, by contrast, is an excellent thinker, and may win, but that is another story).
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p>First, this country was founded in large part to protect private property. Remember that, “no taxes without representation,” stuff? The Constitution, especially as drafted but still today, was not so much a revolutionary document as an evolutionary document (if you want an 18th century revolution, look to France, not North America). Voting was restricted to property holders. Even those who could vote could not directly elect Senators or the President. Slavery was protected, and a key part of the economy. This could be a 1,000 page dissertation but the summary is simple: the country exists in large measure to preserve and protect private property. It was true in 1787 and even though we have direct elections and abolished slavery, it still is fundamentally true today. Edwards ignores that history to his electoral peril.
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p>Second, populist appeals do not win the White House. From Bryan to Gore, fighting for the little guy makes for great speeches but a sorry result at the ballot box. FDR is the only even modest winning counter-example that I know of in the 20th century (and he was actually pretty moderate) but he won in a condition of national economic collapse when a huge fraction of the voting population was desperate. We are nowhere near that today: some people are desperate, but not a huge fraction. If you want to do something about the ills that Edwards flags, you have to build a coalition, not saddle up and ride out like a lone ranger with the Angry 5% and another substantial minority who decide to go along for the ride for a variety of reasons. That approach just leads to a flaming sunset, lots of memories, and matinee fluff instead of real results.
I cant really add much to what he said since I was planning on saying it myself.
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p>But I will just add a few more things. Angry candidates do not win no matter what political stripe they are, the public likes nice, warm, compassionate candidates that empathize with them and make them feel warm and fuzzy inside. This is not to say that Obama does not have gravitas, but the public likes to be reassured by a calm warming presence. Not too warm like Jimmy Carter, but definitely not angry. The Dean campaign was considered too angry and all it took was one little slip up of screaming to confirm that. A coincidence Joe Trippi is the anger manager of this current incarnation of the Edwards campaign?
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p>Also for someone who had and ran on a DLC record in the Senate to suddenly embrace far left anti business positions seems just a tad bit strange for me. There may have been a conversion and a Damascus for John but I think its far more likely that polling among the base inspired him to steal Deans rheotric and campaign staff.
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p>Lastly we need a sensible unifying candidate, any of the six serious Dems could beat any of the Republicans, the country is tired of Bush, tired of the war, any Democrat represents change. But Edwards and Clinton especially will win razor thin close elections, Obama is the only one with truly landslide potential especially because moderate Republicans are embracing him and will certainly embrace him if Huckabee or Romney wins. We need a candidate who wont govern for 51% of the country like Bush has, we need one who can unite it, Obama to me is the best bet for the job.
FDR, Truman, and Thomas Jefferson used economic populist rhetoric in their campaigns.
…snip…
From his Nomination Speech.
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p>So, Democrats can win with populism.
Pardon my ignorance, but I’m not understanding your point here.
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p>I’m not a lawyer, but are you referring to intellectual property, or something else?
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p>From Edwards website I see this regarding labor & property rights:
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p>Secondly, RE your point regarding populist candidates electibility; Gore actually won the popular vote, and but for a GOP SC “decision”, won the 2000 election.
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p>One other thing. Robert Kennedy was running as a populist candidate for POTUS when he was murdered in 1968, 3 months before the election. That was 2 months after another populist, Martin Luther King Jr. was murdered in Memphis, of course he wasn’t running for office. But this idea that leading “the Angry 5% and another substantial minority” results in “flaming sunset, lots of memories, and matinee fluff” I find curious coming from a progressive.
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p>
<
p>…Where did you get this from
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p>The Constitution, especially as drafted but still today, was not so much a revolutionary document as an evolutionary document (if you want an 18th century revolution, look to France, not North America). Voting was restricted to property holders.
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p>It certainly wasn’t from the US constitution. Check Art. I, Section 2, 1st paragraph. There is no requirement of property ownership therein.
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p>If you want to understand the severity of the violence of the French Revolution, you have to understand the strangle-hold that the Roman Catholic clerics held over France for centuries prior to the revolution. If you don’t understand the latter, you will not understand the former, and you will not understand the anti-clericism of France today.
Voter qualification was then 100% a state issue. Universal manhood suffrage was the first expansion of the franchise, and didn’t happen, if I recall correctly, until the 1820s. In Massachusetts, it was opposed by, among others the Federalsists and Daniel Webster.
…to the Constitution, which was the clear import of your paragraph. Note your introducttory sentence.
But I don’t think the import was even slightly unclear. The American Revolution was not even slightly a social revolution, but is peculiar in history as being an almost purely political one, waged by the upper crust who objected to confiscatory taxation.
The overthrow of social hierarchies was a central tenant behind American democracy, as expressed by Jefferson, Franklin & others.
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p>
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p>As for the Revolution being “waged by the upper crust”, again this is incorrect. The American Patriots were made up of the full spectrum of inhabitants, the majority including yeomen farmers, craftsmen and small merchants.
… redefining the nature of the ruling class not a social revolution?
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p>Wow. Just wow.
Kindly identify the North American aristocrats whose rule was overthrown by the American Revolution.
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p>How exactly was the nature of the American ruling class changed from 1775-81?
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p>In what sense did the social order change from 1765-81?
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p>Here is the answer: there were none overthrown. There was no change in the nature of the ruling class. The social order in 1781 was the same as that from 1775. George Washington was a large, slaveholding landowner, the very image of aristocratic prestige. The signers of our Declaration of Independence were the political overclass in 1774, and remained so in 1789, except they no longer owed allegiance, or tax payments, to the British parliament.
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p>Hell, as pointed out elesewhere in this thread, you could not even vote unless you owned real property until the mid 1820s.
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p>The real American revolution–in the true sense of the word– did not occur until 1860.
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p>The Revolution of 1776-81 was effected by wealthy North Americans who rebelled against excessive taxation, hamhandedly imposed. And, for all its rhetoric, little else for nearly four score and seven years, except to plant the seeds for what was to come.
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p>As for Jefferson’s particularly overheated rhetoric, it was indeed the insipration for a true revolution, in 1789.
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p>They weren’t atheists (though they weren’t evangelical in the modern conception either), they didn’t care about the separation of church and state as presently conceived, they didn’t seek or care for universal manhood suffrage, never mind extending the franchise to brown people or women. They did leave writings that inspired these ideals in later generations of Americans, and were often quoted by Lincoln.
It was not the rule of North American aristocrats that we fought to overthrow in the American Revolution, but the rule of the British Monarchy under King George III.
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p>
By overthrowing King George III’s rule, it put an end to the control of absolute monarchy in the American colonies.
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p>
In the ‘sense’ that we overthrew the ruling British Monarchy and began forging a democracy based in part on the ideas of the Enlightenment, especially the notion that authority should be based on reason rather than tyranny & nobility.
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p>Your original statement that “The American Revolution was not even slightly a social revolution” completely ignores The Enlightenment, and your later attempt to remove the overthrow of the British Monarchy from the issue is a diversion, but not surprising, bless your heart.
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p>
And here’s some more “particularly overheated rhetoric” from Jefferson:
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p>It’s interesting that you choose to ignore the contributions of both The Enlightenment and of the working class in your analysis of the American Revolution.
Wow, just wow.
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p>Britain had an absolute monarchy? Where do you get this stuff? George III was an extremely limited monarch, as the real political power in Britain had passed to Parliament over 100 years earlier. The political power prior the the American Revolition was wielded by Parliament, through the Prime Minister, then Lord North.
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p>Up until 1765, the colonies were already largely self-governed, under the same (limited) Enlightenment principles that held sway in Britain itself: representive democracy and certain political rights held by those represented, though the ones represented were limited to white, propertied men.
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p>From 1754-63, Britain waged the Seven Years’ War in Europe and North America (there, the French and Indian War) and was victorious, but emerged with significant government debt. In order to defray the cost of the war and the continuing cost of defense of the colonies from French incursion, Parliament institued a series of steep and disruptive taxes, and when the colonials objected (that is, the colonials who owned property, and therefore were affected by taxation), imposed punitive taxation. Wealthy Americans therefore fomented a severance from British authority to keep the money-grubbing government away from their property. Working class– farmers, at that point–folks were recruited, then as now, via propaganda.
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p>If you were not a landowner, you gained little from the revolution: you gained no political rights. You gained no eleveation in social status. You gained no political power. All of that was to come in the following decades. They may have gained rights and power by becoming landowners through westward migration, and their children or grandchildren eventually gained all of the rights implicit in the revolutionary propaganda used to recruit them to the Continental Army in the first place.
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p>Contrast this, if you will, to 1789, in which political power rested almost entirely within the monarch’s will, and any remainder was wielded by ecclesiastical authorities and aristocracy. These were overthrown. We know this because, to a great extent, they ceased to be. The monarch and much of the aristocracy and clergy lost their heads. Property was seized and redistributed. Political power passed to what was previously an oppressed underclass. All of this inspired by Messrs. Jefferson and Paine– the chief propagandists of the American revolution.
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p>I am frankly surprised that this is even slightly controversial to you.
I stand corrected in that I should have used ‘constitutional monarchy’ rather than ‘absolute monarchy’.
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p>Otherwise, you seem to be saying that the American Revolution was merely a tax revolt by the wealthy, with no larger issue behind it. This history is fine except where you dismiss or exclude the parts that don’t match your world view. Comparing the French Revolution to the American Revolution doesn’t diminish the fact that the British monarchy was violently overthrown here, nor does it reduce the impact that those “propagandists”, Jefferson and Paine had in hastening the end of British rule:
Just as I wrote above. A political revolution. Not a social revolution.
… of social institutions is revolutionary, even if the players largely didn’t move from their positions. It defined the way power would propagate from that point on as distinct from the constitutional monarchy.
How does that fit in with those, “Enlightment,” principles of reason you discuss. Unless by, “reason,” you mean, “wealth maximization,” which brings us back to my initial point. And by the way, if you could please provide a concise definition of the, “Enlightenment,” you cite, I’d be interested.
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p>I did think of a good example of a successful populist candidate from U.S. history after I wrote my earlier comment: Andrew Jackson. Of course, he committed unspeakable barbarisms against the Native Americans (still with me on that, “Enlightment,” definition?), but he did win the White House. Sadly for partisans of the good Mr. Edwards, that was in the nineteenth century.
Right after you provide a concise explanation of how “This country was founded in large part to protect & preserve private property (including slavery)” and why “Edwards ignores that history to his electoral peril”.
I thought you’d reply to the mention of Bobby Kennedy’s populist candidacy, since he was 20th century, but I guess he wasn’t a “clear & profound thinker”, like say, Obama on Social Security.
Not trying to be snarky, just want to understand your point.
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p>If Edwards assement of the problems is correct, but that populist campaigns don’t result in victories, who do you point to as doing it the right way.
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p>As I have frequently been turning to, I think Krugman’s graph in his opening blog sums up the problems in the country pretty well.
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p>You have a very short period, from the war/post war (during the presidency of that modest winner) period to the mid-70’s, of greater economic equality, when the American middle class was born (and the labor movement was strong).
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p>So, who are the examples of the leaders who have won, without the populist appeal, that have also done something to improve these issues.
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p>Right now, we have gone through the Bush era, so I guess just having competent leadership (i.e. the Clinton 90’s) does seem like a return to sanity. But I am not on board that the 90’s being the golden age, in terms of the Krugman numbers, it was almost as bad, if not worse, than the Reagan era.
…I actually prefer Elizabeth. Maybe she should kick John out of North Carolina* and the two of them run Elizabeth at the top and John as vice.
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p>*According to the US constitution, the pres and vice-pres can’t be from the same state.
The constitution didn’t stop them then, it doesn’t stop them now.
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p>
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p>http://austin.about.com/cs/geo…
He’s the FOURTH BRANCH.
…Cheney returned his abode to Wyoming before running for VP. You might consider that a fraud, but it was just as much a fraud as Barry Goldwater running for president in 1964 after having been born in the Arizona Territory before it became a state in 1912.
it doesn’t matter where he was born.
…Goldwater’s having been born in the Arizona Territory was a minor issue in the 1964 election. About as minor as Romney’s not having been a MA resident for the requisite number of years before he ran for governor here in 2002.
It was fraud, since Cheney didn’t do it a year prior to the election, as required to fulfill Wyoming’s residency requirement. And he still claimed the homestead exemption in Texas, which would be tax fraud.
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p>I think the 4th Branch of government is the best answer. (Nice one, Joel!)
I’d love to see Elizabeth Edwards running against Elizabeth Dole this November…
For putting this campaign into such a clear perspective.
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p>I am supporting Edwards first, primarily because of a gut feel that is so aptly explained in your essay. And if his campaign doesn’t have legs, I believe that Obama would be my alternate choice.
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p>But for him to effect the changes that we so desperately need, his campaign will have to snowball into a mandate so clear that his proposals cannot be ignored by Congress.
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p>The Eisenhower farewell speech is very impressive, and recent replays of Kennedy’s speech on religion in politics similarly point out the large gap that has developed between past presidents and current candidates, and I’m speaking particularly of you, Mitt Romney.
There’s a simple solution to the question of Edwards, or any candidate, having a mandate.
Act like you have one.
Both Bushes did that, and it worked pretty well for them, up to a point. Wringing one’s hands over whether the victory was large enough to establish a mandate is foolish.
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p>First, regarding the so called “petro-industrial complex”, it seems to me that $2.something billion per year incentive hardly warrants the moniker. Furthermore, if we want to encourage e.g. domestic energy exploration, it would seem that one of the few/only ways the govt has of doing that is with economic incentives. Finally, I don’t know anyone who supports the so-called “oil industry” subsidies, including the oil execs themselves (on the record), so lets just all agree to get rid of them but lets not make them out to be some major factor in America ok? Big corporate boogie men are fun but conspiracy and simpleton theories are unhealthy as a rule.
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p>http://biden.senate.gov/newsro…
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p>
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p>Second, the I find it ironic that someone who decries the evils of the “medical-industrial complex” (which saps 1/6th of our economy) would want to fully integrate said complex with our government via diverse universal mandates, price controls, etc. Who was it that said: “if you think health care is expensive now, just wait until it is free”?
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p>Finally (for now) in opting for the (supposed) figther, the divider, the bringer of yet more political acrimony and division (in hopes of a final victory) I sure hope you won’t complain about bitter partisan rancor if in fact you end up on the losing end the various progressive battles you seek to wage.
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p>
It was PJ O’Rourke. Cleverness is not wisdom. And in any event, our non-“free” health care is more expensive than anyplace else in the world.
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p>Government regulation and market-refereeing of the type Edwards proposes is plainly different from the grotesque parasitism of, say, Medicare Part D. I just don’t see the similarity.
Come to think of it – setting aside any consitutional issues that might arise, the government could theoretically force the price and cost of healthcare to be anything whatsoever that they want. Right?
on healthcare than most Democrats at the moment.
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p>The bigger the project, the more that government or any beauracracy can bloat it up.
… and has no facts whatsoever to back him up. Maybe he did in 1993, though I doubt it. US health care is the most expensive in the world. Period.
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p>You will have to show me in great detail the tremendous common sense that Mr. O’Rourke shows in health care.
Forgive me for eschewing statistics (“facts”) but may we discuss this logically, or in the abstract?
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p>
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p>But I have suggested that a properly empowered government may cause healthcare goods and services to cost any amount of money whatsoever. By your lack of response, do you indicate agreement?
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p>If we can set prices for health services and medicine, then we can easily have cheaper care than any place in the world. Cheaper by half. Cheaper by 90%.
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p>So whats the problem with that?
I simply do not want and would not trust health care brought to you by the folks responsible for the RMV and the Big Dig.
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p>NFW.
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p>There is only one reform needed: unlink insurance from employers and employment. Let the consumer, rather than employers, be the customer. Then, if unsatisfied with your provider, you may change, rather than hoping your employer does so.
the people who brought you the rest of the Interstate Highway System, or Social Security, the Clean Air Act, or any number of other programs that work just great?
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p>Seriously, what kind of argument is that?
Just a fact. I simply do not trust the government with this. I suspect that it will be neither efficient, nor competent, nor cheap, nor any better than the devil we know.
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p>The interstate highway system is lovely and all, as is the world of point-source pollution control, but these programs are not models of efficiency. And they need not worry about such niceties as customer service.
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p>As for Social Security, I think of it as a tax paid to support my parents’ generation in their dotage, and I pay it out of gratitude for their supporting me in my infancy. I have no confidence or expectation that the program will be capable of supporting me when I reach that age in any meaningful sense. Rather, I expect that I will have to fend for myself, plan for the worst, and hope for the best.
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p>I would like for the government to let us shop for our own damn insurance, like we do for all of our other insurance, and otherwise to butt out.
Sure, everyone hates the RMV.
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p>But the whole idea that the private sector is the model of efficiency and govt the opposite. I work in the telecom/construction industry in the financial side and I am constantly amazed by the irrationality/wastefulness.
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p>Companies lose data when they don’t back up their servers, a complicated web of subcontractos who charge the customer 15% to hire a subcontractor below them (and not much else), and most stragne the carrier will drop one subcontractor for a different one on a project that is behind timeline (but still 80% complete) and give it to another one that has to start over.
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p>The fetish for the private market is way overblow, I think people would be shocked at the irrationality there. The difference is that is not democratically controlled and not a transparent as the public side.
Any large beauracracy will inevitably be a bloated mass of petty fiefdoms. However, I see no reason to spend trillions to swap one jalopy for another.
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p>And there is already not much of a market: very few get to shop for their health insurance. Employers do. So employers are the buyers, and employees are the consumers. It should be no surprise that the employee’s concerns are nobody’s priority.
…I am constantly amazed by the irrationality/wastefulness.(of private industry)
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p>My father was an engineering manager at GE in the 1960s and 1970s and he explained it all to me. And he was and remains relatively conservative. It’s all about budgeting.
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p>(a) Your department spends the monies budgeted to it for a year, otherwise your department’s budget is likely to be reduced for the next year. If you didn’t need as much money as was allocated to it for year x, it would be unlikely that it would need as much money in year x+1.
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p>(b) The amount of money allocated to your department is an indication of how important the company believes your department to be.
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p>(c) If you are a government contractor (which is what GE was/is) the subcontractors are selected by the government; you have no choice in their selection. Example: my father was an engineering manager at GE’s Large Jet Engine Department in Evendale OH. As such, they were subcontractors to the prime contractors who would supply jets to the US military. One jet program would go to GE’s LJED, the next would go to Pratt&Whittney (now United Technologies) in CT. It was actually hillarious watching the kabuki dance between the two companies.
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p>(d) Regarding Companies lose data when they don’t back up their servers I had believed that backups were an automated process. The primary problem (that we hear of) is when data is released because someone has unencrypted data on a laptop, which laptop has been stolen.
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p>Why am I not surprised? People oftentimes keep their blinders on.
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p>..instead of imagining the way that you believe that things in the US ought to be.
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p>Let the consumer, rather than employers, be the customer. Then, if unsatisfied with your provider, you may change
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p>The first is nice. The second is not. If you have a pre-existing condition, the insurance company will find any way to refuse to pay claims that it might deem to result, however indirectly, from that pre-existing condition.*
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p>I know that first hand. Starting in the mid 1990s, I had to switch to BCBS after the company that I had been working for (which shall remain nameless) went out of business. I had had a rotator cuff injury, and they refused to pay anything that might have been in any way precipitated by that injury, regardless of how remote the “precipitation” might have been, for at least three years. Moreover, while I had BCBS, they paid for virtually nothing, irrespective of the fact that I was paying upwards of US$8k/yr in premiums.
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p>Now, tell us again, unless you are employed and are unlikely to be subject to “pre-existing condition” limitations, how are you going to change your provider without losiing at least some of your coverage?
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p>*We saw that in the Gulf after Hurricane Katrina, when property insurers refused to pay claims based on the assertion that the damage was due to water damage (which was not covered) instead of wind damage (which was covered). Have you ever tried to sue an insurance company?
If it is individualy based and they can’t deny pre-existing conditions, people will sign up when they need a expensive procedure, then drop it.
I have no problem with reasonable regulation of a market, and you and raj illustrate opposite sides of a particular problem.
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p>I just don’t think the government is well-adapted to acting as a service provider, and see no need to expand its purview when it already struggles to provide the services it is presently expected to provide.
…feel free. You’ll be charged accordingly on your insurance premium.
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p>On the other side, apparently you haven’t been paying attention to what I have been telling you about the German system. The fact is that the German government is not the provider, but it has organized the financing. There is a subtle but very real difference.
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p>On the other hand, some health care systems that are government run seem to do very well. The British and French systems are highly regarded by their patrons. Are you really so down on the US governments that you believe that they cannot do as well? If so, let’s have another revolution, this time by the US citizens against their own governments.
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p>BTW, I guess by RMV you are referring to the Registry of Motor Vehicles. I quite frankly have never had a problem with them. They have modernized quite well, and I do all of our renewals over the Internet. Kein Problem. We receive the drivers licenses and the registration stickers within a couple of days.
I am actually sympathetic to the German system, specifically upon your recommendations thereof especially in that it seems to operate as a broker rather than a provider of services, heath services or insurance services. I am not opposed to the recent changes in Massachusetts law along these lines. Most of the present Democratic proposals do not really embrace the paradigm, however.
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p>If I understand correctly, it appears that an awful lot of the German success comes from healthcare delivered at the place of employment, which may not work as well in our economy, in which we change jobs frequently.
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p>I don’t think a British style system would transplant well here, and, again, don’t trust the government to provide that service anyway.
…And that is one reason why I prefer the German model, which I have also described here ad infinitum.
After an absence of several weeks, I have returned to this blog site for a few laughs. And you have not disappointed. When are you lefties going to get a handle on reality. Edwards is viewed by average voters as a phony; he has as much chance of winning as Romney does among Republicans. The guy has a huge carbon imprint, and his fortune was gained through shyster maneuvers. Don’t you guys really want to win this year? Support Hillary.
For what it’s worth, his campaign was the first to go carbon neutral.
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p>BTW, Edwards destroys Romney in polls.
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p>http://www.presidentelectionpo…
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p>Actually, he beats most all the Republicans. He can win.
for Edwards in MA/NH?