This is a post I pulled from democraticunderground.com – their title, not mine. I’m curious as to BMG’s readership’s take on this:
http://www.democraticundergrou…
From the post:
“Well, I just went to the site in Massachusetts that helps uninsured families find and enroll in these plans. I typed in my income was above the 54,936.00 limit for assistance for a family of three and choose to find plans for a family of three of the following ages – 38, 41, & 14.
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Okay, there is your first option….for between 836.84 – 952.45, you can buy a family plan with high premiums, deductibles, and co-payments. Now if you make 55,000 dollars a year, you and choose this plan, you would be paying 19.63 percent of your income for health insurance that DOES NOT FULLY COVER YOU, CAN DENY CLAIMS, & WILL COST YOU MARKEDLY MORE IF YOU ACTUALLY USE IT….(I used 900 dollars a month as a mid-way figure between the costs presented for purchasing this plan). It may be slightly more or slightly less.
Looking closer, I went into the program and looked at some of the deductibles. One plan the deductible is 2000.00 per family member up to 4,000 dollars total before they pay for hospital stays. Prescription drug copayments could be as high as 180.00 co-pays for some prescriptions. There is a 250.00 dollar fee for emergency room visits. The cheapest plan had a deductible of 35% for hospital stays.”
etc.
should center around the core issue of who gets to decide what substances are put in their own bodies.
When government and media fail us completely then we are truely on our own.
http://www.theflucase.com/
Have the right to refuse any medications they want. I do it.
S2028 Mass legislation passed and awaiting Deval’s signature.
There’s always a piper to be paid. The question just boils down to: will the cost be worth the product? The way we procure healthcare now is abysmal. Traditional employer assisted healthcare needs a rethink. Too many are left out. Healthcare costs are absurd (Is there a study about where the money goes?). But, whatever solution is hammered out by elected officials, the taxpayers’ voice will be muted by the moneyed lobbyists.
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p>Government mandated or provided healthcare will exact a price and governments use force to settle debts. Is this what we want? Maybe.
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p>Now that Massachusetts has mandatory healthcare, what are the numbers of increased tax delinquencies with DOR? How many more tax enforcement activities are necessary? These figures should give an idea of what a national program would generate in increased tax revenue and enforcement.
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Democratic Sen. Max Baucus has introduced his healthcare plan. It would be mandatory for everyone to get health insurance. They would fine people who didn’t get it, and If you don’t pay the fine, you could go to jail. The good news is, once you’re in jail – free healthcare! –Jay Leno
At least it is my conclusion that those are the balancing factors in this equation. I could live with a bill that leaves out BOTH of those and focuses on banning denial for pre-existing conditions, caps on annual and lifetime expenses, more efficient record access, and even a couple of GOP ideas like addressing malpractice and being able to shop across state lines. I CANNOT support mandates without the public option and of course I still prefer single-payer.
I don’t get why you can’t support mandates without the public option. You mean, as a political demand, a quid pro quo type thing? Or do you mean they are linked in principle, it would be wrong to mandate private insurance, but OK to mandate public insurance?
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p>And you are making pretty self-interested demands as a consumer, you basically just want everything, for cheap, etc (though not with the cap on malpractice, but maybe you’re not a lawyer and still have an objective view of that). Maybe you should have to make some concessions, like less access to every new technology, fewer specialists, more care by nurses, denial of radical surgery, etc.
If you are going to require me to pay for insurance, you’d better darn well include the public option as one of my choices either so I can take advantage of it directly or so that all the other plans from which I might choose are forced to lower costs. Besides, there is no mandate for a public OPTION – what do people not get about that word? In a lot of ways, yes, I do want it all. If other countries can figure out how to do it certainly that famous American ingenuity can! If by mandating public insurance you’re refering to single-payer then yes, it is definitely preferable to mandating private insurance, but even so the way I envision it working you could still purchase supplimental insurance just like you can now if you’re on Medicare. I shouldn’t have to concede anything you list in your last sentence, but this isn’t about me – this is about EVERYBODY. Universal access has to be the sine qua non otherwise this exercise is pointless.
Because Americans should have a choice as to whether they want to meet their obligations under the law to have health insurance while enriching inefficient private sector interests or without enriching the private sector.
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p>for-profit insurance puts .70 – .85 on the dollar toward health care services, the rest of profit and overhead.
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p>nationwide non-profit health insurance medicare puts .97 on the dollar toward health care services.
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p>Individual mandates without a public option creates a 37 million person market and no systemic cost control mechanism.
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p>What’s worse is that the Baucus bill has has an individual mandate and NO employer mandate.
No Mandate if there is no Public Option.
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p>Excellent.
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p> Without the public option, it’s surely not reform if we have to buy into it. It is simply lining corporate healthcare pockets thicker than they are already lined.
Since nobody is refuting my OP, and given the generally highly-knowledgeable readership of BMG, I’m thinking that this is real – that the rates really are (still?) totally out of control.
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p>I recently skimmed an article that claimed to show that the number of uninsured has actually increased since “reform” came to our commonwealth – I should have bookmarked it for review, but didn’t. In any case, can someone at least refute that, and demonstrate that we have more people covered than previously?
Between the expansion of Medicaid and the Connector, significantly more people have been insured.
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p>Also, check out this fact sheet from the Connector.
http://www.pnhp.org/news/2009/…
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p>From the release:
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p>I guess somebody has to figure out which part is being more honest, PNHP or the Connector.
While I completely agree with the conclusion of that release (actually, I’m in favor of a complete government takeover of health care, nationalize the hospitals and doctor’s practices, not health insurance) I’m not sure a 0.1% increase in the number of uninsured during a terrible job market demonstrates that the insurance mandate isn’t effective.
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p>Between December 2007 and December 2008, Massachusetts lost over 66,000 jobs and the unemployment rate went from 4.5% to 6.4% (seasonally adjusted). In a year where the worst recession since the early 80’s, if not the Great Depression began and 66,000 people lost their jobs, only 12,000 people lost their insurance. If I were the Connector, I’d trumpet that fact, not hide it.
We’d need to tease that out.
Our premiums don’t actually pay for care, our co-pays and co-insurance cover that (at least with my minimally credible HMOBlue Basic plan, which costs $300 a month, but still sticks me with $500 bills for some pretty standard tests that took maybe 20 minutes of a skilled technician’s time.)
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p>Most of my steady monthly money is clearly going to subsidize the health care industry, including all the equipment makers, drug companies, researchers, administrators, etc, not into any insurance “pool” at all. Massachusetts doesn’t mind this, because those companies supposedly provide jobs and revenue and political contributions.
A family of three with an adjusted gross income of $54,936 is at exactly 300% of the federal poverty level and under the law isn’t obligated to pay for insurance if the monthly premium is above $232.
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p>I went through the same process the original poster did and it told me I might qualify for Commonwealth Care. Out of curiosity, I answered one question differently and it was explicit that I couldn’t afford health insurance, would face no tax penalty and pointed me towards a way to get the certified.
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p>There are problems with the MA health law, but this isn’t one of them.
Trying to solve the health care problem without eliminating the health insurance industry is like trying to treat cancer without destroying the tumor.
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p>The goal is high-quality affordable health care for every American. The risk pool is, by construction, all Americans. The “insurer” is government, federal and state. Health care providers should compete for patients based on the quality of services they deliver. They should be paid for those services by the government.
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p>Quality affordable health care for every American is our goal, and the health insurance industry is steadfastly committed to blocking our achievement of that goal.
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p>Existing health insurance companies will fight this every step of the way, because they correctly see this as threatening their very existence. This is gut-check time, my friends. This industry is committed to stopping any effective progress.
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p>None of us should be surprised at this reality. No amount of “reaching out” was ever going to attract GOP support for President Obama’s economic plans; the monolithic GOP rejection of those plans was the proof. In the same way, no amount of “reaching out” is ever going to attract insurance industry support for health care reform.
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p>I think its time to take these half-measures that don’t work off the table and start over.
I was talking with my mother in law this weekend, and sort of stumbled upon this idea:
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p>1. Let Medicare take what’s working from other gov’t (and private I suppose) health insurance/care plans. The VA gets to negotiate for drugs? Let Medicare do it. Whatever. Fine tune Medicare to be even better. Is it good now? I have no knowledge or personal experience, but when wingnuts have signs reading “Keep gov’t out of my Medicare” it suggests that it’s doing just fine.
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p>2. Lower the age of entry from 65 to something younger. 62. 60. Whatever. Just drive it downward.
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p>3. Now, this is the big step… start phasing out all other gov’t programs and just put people in Medicare instead. Medicaid? Nope — if you qualify for Medicaid, just have ’em enroll in Medicare. Gov’t employee insurance (Blue Cross/Blue Shield, whatevs): Medicare. VA? Medicare.* SCHIP: Medicare. This isn’t easy to be sure, and it doesn’t have to happen overnight.
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p>This accomplishes a few things:
a. It minimizes overhead. Do we really need all these different gov’t programs with different bureaucrats, forms, funding mechanisms, and confusion? They all exist to provide health care to specific groups of people: poor, kids, veterans, gov’t employees, etc. So, why not just provide them care in the single largest government program designed to provide care?
b. It creates a situation where people can get on Medicare only to be taken off later (poverty, SCHIP, gov’t employee). This is brilliant. The problem we face now is that seniors have Medicare and can’t lose it, so they sure as heck aren’t fighting hard to share it with others. Once workers go back to private insurance, once parents have to find new insurance for their children, they’ll fight to expand Medicare even further.
c. It expands the largest gov’t health care program. If larger is needed for efficiency, this is the place to do it.
d. By putting non-seniors on Medicare, you’re setting up Medicare to have more expertise. Currently, Medicare doesn’t have much infrastructure for dealing with pregnancy, child diseases, etc. This allows Medicare to more slowly gain access (and bureaucratic knowledge) of these areas. They don’t have to re-invent the wheel either; you shrink one program as you expand the other, and some employees will move with the transition.
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p>4. Now, you go after the Compassionate Conservatives. Every baby deserves to be born into this world, you say? Great. Let’s put every single pregnant mother on Medicare. After all, that unborn baby deserves a healthy uterus in which to live. Newborns? Same game. They didn’t choose their parents — they should get good health care guaranteed because we all love babies. So, now we’ve expanded again, only instead of going from 65 downward, we’re going from “-.75” upward.
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p>The idea is to create a situation where there are a large number of voters who have had Medicare at some point in their life, but no longer have it. They’ll be motivated to demand the option be available again — and that’s how we move to a single payer system: Medicare for all. Doing it all at once is just too dang hard. Employment is sticky, real estate is sticky, corporations (for or non-profit) are sticky. We’ve got to ease into this a little bit. The key is to ensure that each time we move closer toward Medicare for all, we end up with more voters who are happy with the transition — resulting in more pressure to expand even further. The other key is to shrink, and yes eliminate the other gov’t programs… after all, this stuff isn’t free, so eliminating cost elsewhere to pay for expanded Medicare is essential.
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p> * This doesn’t mean I advocate for shutting down VA hospitals; rather open them up and use them as specialty shops. VA hospitals should be particularly good at PT, gunshot/explosion wounds, etc. They shouldn’t be particularly good at treating diabetes. So, send veterans with diabetes to a regular hospital or specialty care, and send civilians with gunshot wounds and prosthetics to VA centers. Furthermore, if Medicare isn’t “payment free” for users (and it isn’t), there’s no reason why we can’t simply keep it as “payment free” for veterans if that’s what we want to do.
I like it.
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p>I think this illustrates a valuable premise: if we start with a vision (“High quality affordable health care for every American”), this in turn stimulates a series of missions, like this, that describe the work we do realize the articulated vision. The vision provides the rationale and focus for each mission. Each mission can be evaluated and measured in the context of the stated vision. A “plan” is then a statement of how to execute a particular mission.
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p>I think that the national (and local) debate about health care has stumbled because we skipped over the “vision” and “mission” parts — and find the participants working at cross-purposes. The vision of one set of participants is, first and foremost, a profitable health insurance industry. The vision of another set of participants is health care for every American. No participant has articulated a vision that encompasses both — I suggest because the two are fundamentally in conflict. Our premature focus on a “plan” has consequently resulted in conflict, paralysis, and distrust.
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p>The first step is to loudly and aggressively affirm an American vision for health care:
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p>Every American is entitled to quality health care, regardless of economic standing.
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p>I think it’s time for President Obama to give the equivalent of MLK’s “I have a dream” speech, focused on health care. I think it’s time for progressives to rally behind the vision we share. The missions and plans will follow.
They should be paid for those services by the government.
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p>Unless it’s organ transplants, IVF, birth control, abortion, euthanasia, end of life counselling, sex chages, etc…
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p>I’d be happy to pay for everyone to get most of their illnesses treated, but I’m even more restrictive than the Pope when it comes to what is ethical treatment and what isn’t.
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p>How about, single payer for the basic things, and private supplemental plans for people that want to contribute to the biotech and pornography industries?
Though I don’t necessarily agree, I do understand the difficulties associated with procedures like IVF, birth control, abortion, euthanasia, and sex changes. I’d go ahead and add erectile dysfunction medication to the list. I’d also acknowledge that some procedures may be widely considered OK some of the time (abortion in medical emergencies, plastic surgery to repair severe aesthetic damage) but generate considerable opposition other times (abortion when mother and fetus are believed to be healthy, ‘vanity’ plastic surgery).
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p>But organ transplants? What’s unethical about using a cadaver or a living donor to replace a failing liver/heart/kidney/etc?
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p>End of life counseling? What’s unethical about an expert explaining to a person who still has his or her mental faculties and isn’t under duress the options one has when things get bad? This is consultation, not advocation. I want my mother to understand — and decide now — how we are to handle her medical care if she has a stroke and can’t make those decisions for herself anymore. Life support to the bitter end? No machines? Something in between? I want her end of life care to be the way she wants it… I don’t want to guess, and I don’t want to require lawyers to keep politicians away from my
Schiavomother.With dead people, it desecrates the dead, with living people, it desecrates the living. They both contribute to the idea that we can build a Frankenstein monster for a body and live forever, instead of appreciating the one brief and delicate body we were born with. And they’re both expensive. The more prevalent they become, the more everyone will expect to have organs swapped in and out like car parts, the more guilty the healthy will feel (like Will Smith in 7 Pounds – a really sick evil film if I ever saw one). It would be much better to consider organ transplants unthinkable, and try to take better care of ourselves and resign ourselves to early death when organs do fail.
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p>And end of life counseling is controversial, so I included it in the list. It is controversial because there is also a euthanasia movement, and the fear is that the combination would be putting pressure on elderly or sick people to stop being burdens and stop wanting to live. It’s unethical to suggest that people are burdens and should kill themselves.
With dead people, it desecrates the dead, with living people, it desecrates the living. They both contribute to the idea that we can build a Frankenstein monster for a body and live forever, instead of appreciating the one brief and delicate body we were born with. And they’re both expensive. The more prevalent they become, the more everyone will expect to have organs swapped in and out like car parts, the more guilty the healthy will feel (like Will Smith in 7 Pounds – a really sick evil film if I ever saw one). It would be much better to consider organ transplants unthinkable, and try to take better care of ourselves and resign ourselves to early death when organs do fail.
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p>And end of life counseling is controversial, so I included it in the list. It is controversial because there is also a euthanasia movement, and the fear is that the combination would be putting pressure on elderly or sick people to stop being burdens and stop wanting to live. It’s unethical to suggest that people are burdens and should kill themselves.
with that argument after you or someone close to you has an organ fail.
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p>Oh, and “a euthanasia movement”? That and your going on about ‘desecration’ makes you look like a crazy person. Are you a crazy person?
Sheesh, where have you been. There’s Compassion and Choices which used to be called the Hemlock Society, there are all those Oregon groups, there are people in Switzerland, there’s Dr. Kevorkian, Peter Singer… The fact that people like you think that it is “crazy” to say there is a euthanasia movement, or that there is such a thing as desecration of the dead, proves that there is a euthanasia movement – you’re just part of it so you don’t notice it.
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p>And say I have an organ fail, I am now up against two moral imperatives: to do everything I can to live, and the desecration of the dead, which everyone tells me is crazy to worry about. So of course I’m going to choose the organ, the rest of humanity be damned. It’s not even close, and that’s why it has a huge effect on everyone’s dignity and their participation in society as moral leaders. It destroys everyone’s dignity and makes us all guilty cowards and selfish shameful shmucks, none of us can ever talk about duty or dignity or principles again. But if it was considered immoral and bad public policy and illegal, then I would be able to accept death with dignity, instead of going along with society to demand that it prolong my life with other people’s organs at any cost.
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p>It’s simply unsustainable to give everyone organ transplants who need them, and immoral to give them to just the rich or privileged. Consequently, we have an explanation for why medical costs are so high.
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p>(And this is where I disagree with the Pope, btw, who approves of organ donation. But he’s not perfect.)
If I were to die, I see no reason to not donate any healthy and medically transplantable organ; they certainly aren’t going to do me the slightest bit of good when I’m six feet under!
Heck, why not sell your body for dog food? Your femurs would get 50 bucks each, easy, and provide days of canine enjoyment.
…at giving another PERSON a second chance at LIFE – good try though.
As a “frankenstein monster” who had a kidney transplant, I have to take issue with this comment. The relatives of my donor chose to donate his kidney after his death. They, and I do not feel we desecrated his body. I am grateful for their gift and take extremely good care of his kidney which is now part of my body. People should not just resign themselves to early death if other proven options exist, and everyone involved consents.
Sorry, but I think people should resign themselves to death.
So I assume you never use the healthcare system. True, if nobody ever sought life-saving treatment, it would save billions.
Or even demanding 72.5 years, or whatever the average is. There really are people expecting to live forever, and their attitude leeches into everyone’s and directs public policy. It’s unsustainable for everyone to live forever (I would think that’d be obvious, but apparently it’s not – maybe they only want themselves to live forever, not everybody else), and it starts with organ transplants. I don’t consider them medicine to keep the body healthy, they are ghoulish attempts at immortality, by replacing the body with other people’s body parts.
unusual ideas. You think organ transplants are “desecrating” the dead and the living, and are about “seeking immortality.” I think you are the only person I have ever heard or read who holds those ideas.
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p>Not wanting to die in the moment is not seeking immortality. It’s entirely consistent to consign yourself to eventual death while attempting to prolong your life. Your philosophy would consign many thousands of people to widowhood, and deprive many children of parents. That’s unnecessarily cruel, and – to use your word – despicable.
When doctors told you they could prolong your life by giving you someone else’s kidney, they created a life-long transplant advocate. The donor’s family (did they do it despite him not identifying himself as an organ donor? That’s despicable.) also is now a lock to support organ donation and medical research funding. What a racket. Where will it end?
What about voluntary transplant? I could see having a problem with involuntary transplant (John Does), but you’re telling me it that it’s unethical for me to donate a kidney to my brother? My friend? A total stranger?
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p>Neither contribute to the idea that we can build a Frankenstein monster for a body and live forever any more than prosthetics, artificial heart valves, skin grafts, or any number of hundreds of procedures.
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p>You’re worried about ethics, but you universally state that “it would be much better to … resign ourselves to early death when organs do fail.” Yet, later you state that “It’s unethical to suggest that people are burdens and should kill themselves.”
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p>So, to recap:
1. Completely consensual organ transplants are unethical because they don’t allow for the appreciation of the one brief and delicate body we are born with (and they’re expensive!), but
2. Allowing people to choose to end their own life, acknowledging their brief and delicate body (and saving money!) is also unethical?
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p>Methinks you need to think through a set of ethical principles first, then get back to us. Because right now, I can’t make any sense out of your framework of ethics.
It’s one thing to want to stay living as long as possible, that’s a moral imperative, and it’s best pursued by staying healthy, though seeking medical help is also moral. It’s something else though to exploit that moral imperative for profit, or when people do illegal or immoral things to stay alive. It’s an imperative right now to accept a transplant when the doctor tells you you need a transplant, it’s not unethical on the part of the patient, or the donor.
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p>Perhaps prosthetics, artificial heart valves, and skin grafts also should not be mandated, or covered by the public option, either. Making them compulsory for all people that can use them will make costs skyrocket and use up way more energy and resources on the medical-biotech industry than the planet can sustain, as well as change the way we think of health and life, turning it into a commodity we are owed by society, rather than a gift from nature.
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p>To recap: Organ transplants diminish the appreciation of our brief delicate life we all live, and are expensive and environmentally unsustainable. Pressuring people or ourselves to end one’s own life also diminishes the appreciation of our brief and delicate life, instead of desiring continued life for as long as possible, with what is possible limited by means, laws and ethics as public policy requires. Sometimes, maybe even often, two moral goods are in conflict, usually when one is taken too far.
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p>Where on Earth are you getting these ideas? If beagle had not wanted to get a transplant, for whatever reason, nobody would force him to get one. That’s not going to change with anybody’s proposed reforms. It’s not ever going to be compulsory.
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p>It seems almost like you’re extending the moral hazard argument to life-saving surgery.
Moral hazard is a good analogy, nice. A moral hazard doesn’t compel anyone, but it certainly causes voluntary behavior to the point where it’s less than voluntary. People WILL feel compelled to undergo transplants, by their family, by their doctors, by their own duty to live, by the fact that they’d have been paying for transplant coverage their whole life so its time to get their money’s worth.
In my view, the standard should be efficacy towards generating desirable outcomes. I think the government should avoid imposing any except the broadest ethical restraints.
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p>In my view, the reason we have a vigorous free press and avoid any governmentally-established religion is to move decisions like this out of the government domain and into the domain of individual choice.
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p>Let those who believe that abortion is wrong not get abortions, just as we believe that those who think eating meat is wrong are free to seek vegetarian alternatives. Let them proselytize, just as we encourage any other group to proselytize — within the limits of constitutional protections on all of us.
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p>I feel, passionately and strongly, that building an industry based on profiting from the sensational gratuitous violence is immoral and wrong. I accept that, as an American, I have no right to impose my fervent beliefs on those around me. In my view, this is the fundamental genius of the First Amendment.
Don’t you see how that is crossing a line? There are things that are uncontroversial and almost everyone can agree on (and for the few who believe that all surgery is wrong, or any medicine, like Christian Scientists, maybe they can opt out or get a tax rebate like Conscientious Objectors did from the draft, but I think CS aren’t really against other people seeking medicine, the way people are against other people seeking abortions, they just think they are missing out on a better way to get healthy).
for a boneheaded war in Iraq, and for keeping Goldman-Sachs afloat? That line you like is way less important to me than those other lines. Where’s my special exemption for paying for those things?
bone-headed war funding, and Goldman Sachs payouts, would you approve of the public option then? Say if Bush had mandated we all pay, in addition to our taxes (which you ARE exempt from, taxes are ON something, they aren’t a tax on merely existing), a special war and bank monthly fee?
How am I exempt from taxes? That’s not what my paycheck stub says.
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p>You’re objecting to specific medical procedures being covered by a health-care system, because you don’t like those procedures. Some exercise junkies probably would object to paying for Cheney’s pacemaker, because he doesn’t properly care for his body-temple. Tom Cruise would object to everyone getting their psychotherapy paid for, because a little Dianetics would cure all of them. They aren’t going to swing a lot of weight when it comes to deciding what health care gets paid for, and I hope you don’t either.
You can be exempt from taxes by earning at the “poverty level” and not buying consumer goods, only food, clothes and shelter.
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p>And right, pacemakers should not be part of the public option, either, nor psychiatry. If you want those, either because you want to pay for them for other people or because you might want them yourself, get a supplemental private plan.
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p>The public option should include only the most basic uncontroversial care. It would be really cheap, it would cover everyone, it would not offend anyone or force them to pay for immoral things. It would be so basic, that not even Jeff Jacoby would object if it covered an illegal alien or a deadbeat drug addict, because they wouldn’t be getting liver transplants, just basic medicine. And EVERYONE could have their basic care covered by the public plan, so that private plans would all become supplemental plans for procedures not covered by the public plan. Only the public plan would be mandated, and we wouldn’t even need to make it a “plan” at all, it would be automatic, single payer, paid by taxes without anyone having to sign up or choose.
You sound like the Amish, anything after ‘this’ point is against god’s will…
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p>How are vaccines, which just prolong the life of the fools who don’t avoid getting polio or measles any different than liver transplants?
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p>How are antibiotics, which only prolong the life of those buffoons who got bacterial infections, different?
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p>Maybe we should just make it easy, anything a barber won’t do, is out of the Public Option.
and effective and polio and measles strikes children who then have problems their whole lives, and don’t desecrate dead people or demand an organ from a living donor’s body. There might be a vaccine or antibiotics that protect against the causes of liver damage, and other medicines for keeping the liver healthy and ward off diseases. Those are all different from taking someone else’s liver. Gee, if you can’t tell how those are different, how do you find your car in the parking lot? You probably go home to a different house every night.
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p>Am I to understand that you object to the very idea that there might be limits to what is funded by the public option? It must include organ transplants?? It must include psychiatry? It must include IVF?
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p>(And yes, I’m aware that some people avoid vaccines and advocate against them, but, like Christian Scientists, they don’t object to other people doing it, they don’t argue that no one should be allowed to do them or that the government shouldn’t pay for them. If enough people were to insist that vaccines were evil, then OK, I’d say put them in the private supplemental plans, or let people pay for them out of pocket, or maybe charities could pay for them.)
This nation is chock full of such “lines”, lines that the government has been crossing for as long as there has been compulsory taxation.
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p>The fallacy of using “uncontroversial” as a threshold is that anything can be made controversial by throwing enough money — and therefore media manipulation — at it, particularly in a nation that values free speech (and therefore permits the publication of demonstrated falsehoods) and freedom of religion (and therefore permits any group of believers to proselytize against any practice they choose).
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p>Denying tax benefits to inter-racial married couples is wrong and discriminatory, no matter how many people find it objectionable. The same is equally true for gay and lesbian married couples. The fact that certain religious traditions prohibit marriage outside their tradition has — and should have — nothing whatsoever to do with tax benefits. Teaching evolution to public high school biology students is right, no matter how many religious extremists oppose it.
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p>Your views, as expressed here, are far more restrictive than the current limits of government power as those limits have evolved in the modern era based on the underlying premises of the founders. You are welcome to express them, promote them, and live by them as you wish. You are most certainly not welcome to impose them on my and my children.
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p>Your proposed restrictions on the use of public funding for life-saving organ transplants epitomizes, for me, the error of your proposed approach. In my view, such restrictions have no place in US health care policy.
Because of a kidney transplant. I am so glad you’re not in charge.
you’d be able to purchase supplemental plans from private insurance companies, or pay for transplants out of pocket if you need to, by mortgaging your house. They just wouldn’t be – shouldn’t be – part of the public option. And, it certainly shouldn’t be mandated that everyone contribute to the organ transplant business.
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p>I’m not saying it was wrong of you to prolong your life however you were allowed to; if you were allowed to steal and kill to do it, I wouldn’t judge you for doing that either.
to mortgage, and not enough money to buy supplemental insurance, you’d be saying “Die, peon” as you turned your back on him?
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p>That’s a continuation of the problem with the current system – only the relatively wealthy can afford all the medical miracles that supposedly make our health care system “the envy of the world” to quote GWB. For people of lesser means who have major illness, your philosophy consigns them to wholly preventable death, because they don’t get to benefit from those miracles. You apparently see no problem with that. I find it reprehensible.
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p>Don’t pretend we can’t afford to extend full coverage to everyone. Other countries do it, and at far lower cost than what we spend treating just the well-off.
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p>2. “people flocking to our borders”? Those would be wealthy people, wouldn’t they?
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p>3. The ERs can’t turn seriously ill people away. However, people seeking preventive care so they won’t get to the point that they need an ER? Out of luck, unless they have the money.
I’m not happy that 30, 40, 50 or whatever the number of millions of “Americans” who have no medical insurance. I do however believe there has been too much hyperbole about this number and the facts should come out and then address them. Do 15 million of these people have the money to buy medical insurance but chose not to and if so let’s stop lumping them in with the heart wrenching cry of “50 million Americans who have no insurance” since that segment are “choosing” to go without it. I don’t like that they chose to “go without” and I know they will get treatment and we’ll all pay for it, but it’s disingenuous at best to present them as part of the “victims” without insurance. I also keep hearing (right or wrong) that so many millions of this total are qualified for Medicare and other public insurance but have not applied. Bottom line, let’s get the total of people truly in need of some support and figure out how to help them.
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p>As for flocking to our borders to come in for medical care… I was not referring to their wealth but was implying they come “here” for medical care because it is so superior to their medical care.
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p>Lastly, I wasn’t referring to preventative care being unavailable to “poor” people but instead was replying to your comment on “lesser” people not getting urgent care (miracles). I am in ernest agreement with you about the need for preventative care for all Americans to stop the need for urgent care later down the road. We fail miserably here with very few exceptions.
Your job: find them. They’ve been linked to on this forum recently. Pretending it’s something no one knows is either dishonest or lazy. You pick on the people who don’t buy insurance because they don’t want to, and ignore the larger number who don’t because they can’t. And those numbers are out there, too.
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p>You may not have been referring to the wealth of those foreigners who come here for treatment, but it’s relevant to this discussion, since many of our own citizens are shut out from those procedures – because they are not wealthy enough to get them. Even some not-so-poor Americans are finding treatment here too expensive.
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p>Those only-in-America medical miracles most certainly are unavailable to poor people. If you were genuinely not aware of that, you could have found it out. What do you suppose happens to the Wal-Mart checker who suffers kidney failure?
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p>Oh, and that “85% very happy” claim you made? Not so much.
The numbers are out and they are all over the place. FOX has some very solid numbers so would quoting them satisfy you? I left it vague because I don’t think there are definitive numbers of how many people there are with no medical insurance and how that groups breaks out with regard to “opting out”, “illegals”, “qualified for Goverment progrmas” and “genuinely need help”. Factcheck.org has a good analysisof the numbers so I’ll go with approximately 14 million really needing help.
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p>I won’t argue with you and will assume WalMart workers in the US are dying daily from kidney failure and many other maladies although it odd the media hasn’t reported it.
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p>I’ll also stick with my 85% being happy (although I will remove the “very” qualifier) since you seem to want to start a dueling poll battle. This comes from your link…
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From industrialized countries?
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p>Any numbers that you’d care to share, or is that just something you heard?
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p>I think it’s rare.
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p>Our medical outcomes are, at best, crappy until people hit 65 and go on Medicare. At that point our outcomes become pretty average.
But it seems to me WF’s plan could be a lot better than the $900+ Insurance you have detailed above.
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p>Again, the jist of Whole Foods’ plan was …
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p>The “out of pocket” expenses for your plan would be $10,800 ($900*12) with a $2,000/4,000 deductible vs Whole Foods’ $700 ($2,500 minus $1,800).
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p>Although, I would say the take away message from your diary is our claim in MA. of “leadership” in healthcare due to 98% of our citizen’s being covered is a bit misleading if it costs $900/month (varying on income levels) for an unattractive plan. Too bad the Whole Foods plan isn’t among the options being offered on the Commonwealth Care plan… maybe we should “boycott” Commonwealth Care?
So they can support lower rates. And most of the older employees (from what I can see) are retirees, so they get Medicare.
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p>Personally, I think we should simply keep doing what works – expand Medicare. It’s far cheaper and provides better outcomes as compared with our current health care mess, and it’s time-tested so we know it works even when applied to the most high-risk group of Americans (65+).
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p>(Keep doing what works? I guess that makes me a Conservative!)
And a VAT can pay for it. Let’s drop these pie-in-the sky ideas about “saving money” here and “taxing the rich” over there. Adding 45 million people to an insurance program is going to cost money, and the VAT is the fairest way to do it. By the way, is it just persnickety me but has anyone else noticed how many of one’s healthy friends are having knee and hip replacements lately? Sort of reminds me a bit of when I was a kid and we all had to have our tonsils out.
but way to work in your pet tax policy into a discussion that was not about favorite tax policies.
Please explain why it is not fair if it is applied to luxury items and harmful products such as soda, cigarettes, hamburgers, etc? It also relieves our economy (businesses) of the burden of providing health care to employees. Where is it written (except Massachusetts) that businesses are responsible for providing health insurance for employees? I don’t remember seeing that in the constitution.
And, by the way, don’t give me that crap about “working in” something to a discussion. You should talk. Cut the bullshit for a change.
as far as saying “it works”… how do you explain the unfunded liability of $74 Trillion (yes, Trillion) of Medicare which will bankrupt it in 2019.
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p>If this is an example of something “working” then I think we just lowered the bar for what is considered “broken”!
We pay far more (per capita) for health care as compared to any other country – twice as much as the average industrialized country – because we are the only country that does not have a functioning mechanism in place for controlling costs. (We also get almost the worst medical outcomes in the industrialized world, so the extra expense doesn’t seem to buy us anything). While all health care is overpriced in the US, Medicare is incredibly cost-efficient compared to private insurers – lower overhead and better bargaining power. If we made a few small changes to Medicare and expanded it, we’d get the same inexpensive and good health care that every other industrialized country enjoys.
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p>We also don’t tax enough for Medicare – obviously we need to raise the pittance we pay for Medicare tax. We could start by having a fair tax system – the wealthiest Americans pay about 17% in taxes (the aggregate including “capital gains”), while the average Jane and Joe pay a much higher percentage.
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p>If we pulled our heads from the egress of our central orifices, then we could lower costs and increase revenue which would solve the problem.
How are we going to…
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A good start is to redirect most or all of the $174B in health insurance industry revenues(2007) towards directly funding the needed improvements (I only summed the top 15 Fortune list, the actual total is much larger).
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p>Easy – as I (basically) said, raise taxes on the wealthiest Americans by roughly double – so high, in fact, that they pay the same agregate tax rate as a median worker. This would still be far below the tax rate paid by the wealthiest Americans under Eisenhower (and both houses of Congress had majorities then).
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As I wrote, if we just do something similar to what every other industrialized country does to manage health care, then our costs should become comparable to those of every other industrialized country – 30%-60% lower than we pay today. If we can put a man on the moon, we can do this too.
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As with cutting costs, if we just do something similar to what every other industrialized country does to manage health care, then our outcomes should become comparable to those of every other industrialized country, i.e., improve.
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Ever since Bush won re-election, this has seemed insurmountable to me. You got me here.
Are you talking about doubling the 2.9% (1.45% employer + employee) Medicare tax which has no maximum wage base? How are you defining “the wealthiest” who would pay the 2X? How much does that add up to, few bil? For a great summary of where Medicare stands I would suggest this document which concludes…
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p>Decrease Healthcare costs? – How are you defining “every other industrialized country does to manage health care”?
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p>Improve medical outcomes? – How are you defining “Improve medical outcomes?
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p>As for President Bush… I agree that when George Bush tried to face the upcoming Social Security solvency problem in 2005 the Democrats resorted to raucous town hall meetings (astroturf?) and “kicked the can down the road” (or stuck their heads where Christy Mihos suggested) but thanks for the shout-out to our former President. When will Obama tee up the Social Security ball and reduce Grandma’s monthly payment (or will we just tax the wealthiest Americans (again) to pay their fair share?)?
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p>Let me take a page out of your playbook…
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p>This is easy… when you don’t have to supply the details!
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p>Here’s some 2007 income data to play with (Income amounts in thousands)
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p>
Income
Number of returns
% of total
total income
All returns
142,978,806
100
8,687,718,769
No adjusted gross income
19,078,361
-110
781,565
$1 under $5,000
11,930,752
8.3
31,801,165
$5,000 under $10,000
12,114,741
8.5
90,653,578
$10,000 under $15,000
11,914,564
8.3
148,907,608
$15,000 under $20,000
11,061,903
7.7
193,198,281
$20,000 under $25,000
9,963,693
7.0
223,679,496
$25,000 under $30,000
9,005,338
6.3
247,203,999
$30,000 under $40,000
14,740,806
10.3
512,920,308
$40,000 under $50,000
11,150,798
7.8
499,464,110
$50,000 under $75,000
19,450,744
13.6
1,195,768,325
$75,000 under $100,000
11,744,133
8.2
1,014,677,916
$100,000 under $200,000
13,457,877
9.4
1,793,040,262
$200,000 under $500,000
3,492,353
2.4
1,004,658,689
$500,000 under $1,000,000
651,049
0.5
441,439,447
$1,000,000 under $1,500,000
166,363
0.1
200,785,834
$1,500,000 under $2,000,000
70,733
0.05
121,767,964
$2,000,000 under $5,000,000
108,641
0.1
324,592,983
$5,000,000 under $10,000,000
28,090
0.02
192,327,659
$10,000,000 or more
18,394
0.013
561,612,712