While some conservatives claim that Obama wants to kill your granny I hesitate to accept that as Obamas sole reason for pushing the health care reform.
From the private insurers point of view it makes perfect sense to oppose the reform ... if they didn't, they'd face an immense decline in profits if either the government option provides better care or if regulations bar insurers from avoiding costs by their current methods.
But it's a bit too simplicistic to merely claim that one party acts out of altruism (or a loathing of old ladies) and the other out of greed.
So, what do you think are the driving motives in this dispute ?
(Note that I don't ask you what you think is the better solution.)
Pro (Motives of the health care reform advocates):
Con (Motives of the health care reform opponents):
Two key issues that make the health care reform necessary in the eyes of the proponents are quailty and cost.
Quality has been discussed to death and information (and misinformation) is freely available.
Cost is harder to estimate - one simply can't understand what estimated costs of trillions of dollars over decades means for your paycheck. So I started a different thread where I want to compare the personal average cost of health care in different countries.
For example: German average gross income is about €2,500. After deductions (including health insurance) a single person without kids gets to keep about €1,500.
And what can germans do with that money in germany? Why, buy beer, of course. €1,500 get you 1,200 litre of high quality Pilsener beer - twice as much if you don't care about quality and go for the cheap labels.
Health care costs: €185 per month (currently $264)
Cheers!
Culturally, Americans value freedom over social justice -- at least traditionally. As a result, Americans don't tend to rely on their government to express their moral or ethical beliefs - separation of subjective morality (i.e. church) and state runs deep here.
So, for instance, the US, on a GDP basis, gives less than some countries in foreign aid at the government level but when you add in private charity, the US dominates, by far, the overall charitable giving internationally.
Historically, transferring wealth or property from one individual to another has been done voluntarily on a per person level and has resulted in a great deal of generosity. Americans, after all, aren't going hungry, quite the opposite.
But with freedom comes responsibility. American governments - state and local, are much more vigorous in enforcing laws than other countries. And what I mean by that, before anyone gets their hackles up, is that a lot of crimes in the US result in jail time where in other countries they would be ignored. For example, a huge portion of the US prison population is in there for drug related charges. In Europe or Russia those same charges would likely be at the equivalent of a misdemeanor.
Regarding rationalization of the confiscation of property:
I'm not hinting at communism at all. What I am saying is that when people advocate for welfare programs paid for by taxes in which the beneficiaries are not some small group but rather nearly half the population what they are really doing is making it easy for people to rationalize supporting the government confiscating other people's property (money is property after all) to give to them.
For example, on the issue of health care, a tax-payer based system means that 40% of the population would suddenly be getting something paid for by the other 60% (because of the way tax credits and deductions work on US federal income taxes, anyone who earns less than around $35,000 pays little or no taxes, especially if they have a child).
Most people would feel shame going from house to house in their neighborhood begging for money to pay for their pills or doctor visits but when we start to frame health care as a moral "right" suddenly these same people can accept supporting programs that are really about them getting something from someone else -- and even demonize those who object to paying up.
Whether you use the public "option" or not you will still be taxed to pay for it. The public option is paid for by taxes. The people who would, for starters, be getting that public option are, by definition, people who fall into that 40% of the population who pay no net federal income taxes (or virtually none).
It'll be like public schools where you pay taxes for it whether you use it or not.
Match girls already qualify for Medicaid.
HR 3200 isn't about providing health care to poor people. They already get it today. It's called Medicaid.
A lot of people who debate this tend to be non-Americans so they don't realize that the United States already spends BILLIONS a year providing health care the poor (not just hospitals but prescriptions, doctor visits, etc.).
HR 3200 presently would cover those who don't currently qualify for Medicaid which is largely those who could easily afford it, illegal aliens, and around 10 million of people who, due to pre-existing conditions, would have to pay what most would consider an unreasonably high amount for health insurance.
Incorrect. You've been lied to. Malpractice has come way down in Texas, the ratio of doctors to patients has gone way up, and cost changes are way down from the national average.
The brain drain from the surrounding states has been quite substantial. Rates are still dropping too. TMLT, a mutual(most malpractice insurance is through mutuals), has been paying historically massive dividends back to their policy holders as they keep dropping the premiums from year to year without managing to break even. For those of you that don't know, a Mutual is non-profit, and pays the excess revenue back to the policy holders, that's the above mentioned dividend. They've dropped rates around 30% so far, and are still paying out dividends around 20%.
On the opposite end of the equation, health insurance premiums have increased 25% over the last six years. That's well below the national average of 33%. In the stupid states, where they haven't even done half witted tort reform, it's around 45%.
As far as the new policies bit goes, if they have to conform to a set of requirements on what goes in a policy, there isn't any private insurance. Having multiple people sell you the exact same policy the government has, at a higher cost thanks to the insurance companies not having a tax payer subsidized price, isn't having an option.
They've been trying to kill them for decades, anyone that believes they wont use this framework to take them out at the first opportunity is deluding themselves. As long as they've shifted enough of the population onto the public dole first, it wont even hurt them politically when they do it.
Rather than quoting lots of text here, I'm going to reference a few posters:
Frogboy: Thank you for pointing out the reality of healthcare spending, the nature of American politics, and the context of HR 3200. It seems that much of this debate, especially the arguments of foreigners, is heavily derived from misinformation.
psychoak: You understand that doctors will follow quality of care and better rates. Many physicians would relocate in order to avoid frivolous lawsuits, poor working conditions, and state regulations that interfere with medical decisions. If we make our states, or rather, our nation, less attractive to doctors, they will practice elsewhere. A medical education is taxing in both time and money, and medical training is miserable. Do not expect physicians to go through so much to receive so little.
Daiwa: I appreciate your perspective. You are a physician, and you have experience with government-funded care. You speak to the dysfunctional reality of VA hospitals and the like.
Obscenitor: I may not agree with your opinions on this topic, but you attempt to justify your beliefs, and generally do so with sound reasoning ability. Thank you for contributing a meaningful, challenging voice.
Leauki: In an age where common sense is lost, you employ it to counter sophism. Well done.
Aroddo: You've been a good sport, even when your logic is questionable. Thank you for keeping this debate respectful.
I'm curious as to how many of you have heard of Wendell Potter. He formerly had the top PR job at CIGNA until he retired recently. He testified before the senate about the motives of the for-profit insurers:
http://voices.washingtonpost.com/ezra-klein/Potter%20Commerce%20Committee%20written%20testimony%20-%2020090624-%20FINAL.pdf
I would strongly encourage anyone who is interested in the health care debate to read his testimony.
Comments on it?
Lots. None of the major insurance companies would exist today without the government regulations that created them.
Needing a national company to compete with a national company is a product of the competition restrictions barring the selling of policies across state lines. This is unconstitutional by the way, a restriction on interstate trade. To compete in another state, you must set up an entirely new, separately funded branch, which will lose astronomical amounts of money on the massive beaurocratic requirements until it reaches maturity. This rarely happens, as can be seen by the complete lack of new insurance companies. It's very, very expensive, and they aren't making much money.
Just starting a company to begin with is ridiculous. It's not a simple matter of going to your hundred employees and saying hey, lets start our own insurance? We'll all pay into the pot and get rid of all the bullshit ourselves. That's how insurance was started to begin with, it's illegal now. Major multi-national companies can afford to do it. The local super market chain can't even get close.
All of these massive insurance companies that spend 40% of their budget on administrative costs would have been wiped out by corporate raiders before they got anywhere near that high. Anyone anywhere near that high would have been a gold mine for a take over. The profit potentials from doing some minor cost cutting in management are ridiculous. You could double your money without even trying. Corporate raiding has been thoroughly hamstrung. Corporate raiding doesn't happen anymore.
Limitations on new competition plus removal of optimizing agents equals really fucked up industry. A free market works just like any other organic system. When you stop minor fires from burning away the brush and dead wood, forests become a mass of fuel that turns into a blazing inferno at the drop of a match. When you spray the bark beetles to keep old, sick spruce trees alive, you get the same thing. We are preventing the natural order of things, and then complaining when the shit hits the fan. We need to let it burn, the longer we wait to get out of the way, the worse the pain when it goes.
He's dead on. I've had happen to me exactly what he describes - our small group health plan was 'purged' late last year and we were 'lucky' to get any coverage for our employees - we were 'bare' for 3 months and ended up paying nearly twice as much (and had to pony up 'first & last' premiums, to boot) for much less in the way of benefits when literally the only other option was telling our employees, sorry - we can't offer you health insurance. It wasn't entirely altruistic that we bit that bullet: we were over a barrel, too - we couldn't get any coverage for ourselves otherwise.
I'm not a proponent of UHC and, given a limited choice of two, would prefer, even with my experiences and knowing what I know about large insurers, a Wall Street-run plan to a government-run plan. I'd rather identify and prohibit the egregious practices highlighted by Potter, setting equitable rules of the game with suitable consumer protections, than throw out the baby with the bathwater.
One of the (many) ironies is that Cigna, United and several of the other big players got big thanks to government subsidies to incentivize HMO development. HMO's were always intended to be field trials of top-down 'managed care' - mini single-payer experiments, if you will. The government consciously sought to use 'stockholder interests' in for-profit HMO's as a way of holding down expenditures - low and behold, they inevitably succeeded, as Potter eloquent confirms. By the time the HMO model fell somewhat out of favor, the companies were big enough to apply those principles to commercial indemnity insurance. They had learned that heavy command-and-control bureaucracies were more expensive than simply binging and purging. Now that success is being used as a club against them. The way of the world in big-league politics.
psychoak is also quite correct - the big insurance companies are the Frankenstein creatures of the governmental & regulatory climate of the last 30 or so years.
True, but let's put taxation "principles" in perspective;
Income brackets already use a pro-rata variation based on deductibles which can lower their participative effects when tallied in a number of different ways.
1- Capital gains off-shooted as investment growth owned & kept.
2- Percentages relative to actual taxable incomes... not in a sense that maximums can be reached but rather if such maximal ratios carry stable (or consistant) value when paid up.
3- Capacity to share outside the scope of business stability concerns IF cash-flow is obtained from necessary risk reserves. In which case, the taxable incomes must be obtained before protected liabilities rather than within gains mentioned in #1.
4- All of this, presuming personal assets are solvable "values".
Then the fair share you introduced is more about responsabilities than probable lackthereof if justified by any economic "laws & regulations" that protect (without which growth and innovations wouldn't exist, btw) such values as stated in #2 or made available by #3.
Zyxp -
You should apply for a job writing healthcare legislation.
It would be easier to understand if he did it, but not by much...
I think that opposition to health care reform is more an issue of political frustration and economic scale than an expression of a consistent political philosophy in most cases.
If people with pre-existing conditions are allowed to get health insurance at non-astronomical rates you're going to pay for it one way or the other. If you either agree that they shouldn't be given insurance or you're fine with that so long as the government doesn't control the pot, then your beliefs are consistent, but otherwise they are not.
Yeah, because they sentence people to dismemberment, stoning, or beheading instead of jail time. Most of the drug offenses we jail people for are capital offenses in Islamic nations, and their appeals processes are sketchy at best. It doesn't take them more than a few weeks to go from arrest to chopping block.
Very well, since you can't seem to get the point: No one here really thinks people with preexisting conditions should be uninsurable, or any of the other bullshit brought up in the testamony linked to earlier. Most of us don't have much issue with paying for other people's problems with our insurance premiums. The situation we want to avoid is that the people with insurance will be paying the insurance that covers themselves AND the premiums for those the public option is going to cover (many of whom make far more than me, BTW).
What we need to do is straighten out the ratfuck that we let the insurance laws become, then get the hell out of it. The very poor are already covered with existing systems and if we fix the existing insurance system it will work for almost everyone else.
In 2008 we had about 1.6 million people in jail. We could quadruple China's execution tally in spite of our smaller population and still have the highest incarceration rate by a (not-so) comfortable margin.
It's a limitation of our two party system I suppose.
Not that I'm advocating this, but something like the Saudi drug sentences would result in hundreds of thousands of executions each year until people wised up. China also avoids long drawn out legal affairs and has some pretty severe penalties as well. And almost no country coddles inmates as much as we do. Come on, cable TV is a Constitutionally protected right for inmates.
There were just short of two million drug related arrests last year. Less than a quarter were juveniles, but still well north of one point five million adults were arrested at some point last year due to drugs. How many of those offensives do you think would have occurred if a conviction was a near certain death sentence carried out within weeks, not decades?
An actual effective death penalty had a substantial deterrence effect.
In fact the states with the death penalty have consistently higher murder rates.
The whole thing is pure conjecture and completely immoral and unconstitutional by your own admission anyway.
I get to be a racist. Sweet.
It's them damn black people! Seriously!
Iowa, the bottom of the list, 2.7% black. Louisiana? 32% black. We should just exterminate the black people and then there wont be any high murder rates! ZOMG!!!
If anyone takes that seriously and decides I hate black people, please sterilize yourself. Immediately.
I know the bars look really cool, but you're just as dumb as the idiots in the drive by media when you fall for such narrow minded crap. Population demographics are and always have been the primary contributor to crime rates, and it doesn't even take thirty seconds to find out for yourself. Start here.
The fact that is ISN'T FREE seems beyond the comprehension of others too...
How about this?
We just do away with any kind of insurance for anything - for everyone.
Let everyone pay for what they need on their own, or through the simple charity of others - or suffer the consequences thereof.
Because, you know what? Once everyone has 'insurance' premiums at a cost below that of the actual care or benefits they receive - whether it be for car or house or health or whatever - there will be some (many) that will be 'opted out'. Because you can't pay for something with not enough money. It will always turn into a system where the 'most important' get covered at the cost and detriment of the 'least important'.
The whole 'insurance' game has never been more than what we had in the early 1900's with the mob demanding 'protection' money. It has simply grown/evolved into a 'legitimate' business, which now the government want's a piece of.
The right to bear arms guarantess me my right to defend myself... from everyone... including the police, Gov't or any other power foreign or domestic. Thanks its a keeper.
Once again your FREE healthcare isn't free its bought and paid for with your taxes. How'd you like to have 15% more income a year because YOU and Your countryman are being upstanding responsible people and actually accountable for your own health?
Too much to ask... ??
We the people didn't push for a War in Iraq... if you look we the people were quite a bit distressed about the "Bush family war" and there is AMPLE protest that is lodged all over this world wide web.
Some of the world's largest purges of hatred are Christian led.. so don't get on your I'm with Jesus soap box..
And if citing an actual example of a people that totally mismanaged their own care during a problem and came running to the world for help, is racist you sir are a fool.
I wasn't gloating either. Glad you saw it that way. PS the KKK is a Christian organization.. they'd like to talk to you about how to better serve your people (chances are you won't agree with what they intend is best for your people as they are full of hate)
Again if you want to run a CHARITY WARD... do it with your OWN MONEY...
Goodwill does it
There are VAST number of Christian Charities too numerous to count that do it too...
The GOVERNMENT doesn't and shouldn't be involved in CHARITY WORK...
There are two kinds of folks in the world, Those that provide (for themselves and others) and those that don't. This measure is MOSTLY supported by those that don't.
You shouldn't be interested in free health care for junkies, the unemployed, the catastrophically ill.
Were you aware that 70% of all your medical costs are spent in the last 5 years of your life?
That's right.. 70% of the money you spend on medical care will be spent in a last gasp effort to live just a little bit longer.
Instead of logically assessing how much your continued existence is worth and deciding that exiting with dignity you will go kicking and screaming. Why?
Doesn't paradise await the faithful? I know it does for me.
Overtunring Roe V Wade is a bad idea... do you want Rapist babies brought into the world because the law doesn't allow for their elimination?
She could have had a much less painful and more dignified passing at Hospice, with charity care paid for by those that support that sort of thing. It would have been sooner and she would have suffered less.
And ending Medicare doesn't bankrupt families, unless they are simple enough to sign away everything to keep mom and dad alive 2 years more...
do you want Rapist babies brought into the world because the law doesn't allow for their elimination?
Yes.
It's not the baby's fault now, is it?
I can understand that it's very hard on the mother and I even agree that abortion would be fully justified in the case; but I would want the baby to be brought into the world.
Who am I to want bad things, like death, for innocent people???
I like this idea. However, the VAST majority of sheeple are incapable of thinking in terms of long term (more than a month away) planning ..
Insurance as a medium SHOULD be available for EMERGENCIES.
The problem, the biggest problem, with Healthcare is that it seems MANY people want other people to 'care for them'.
I have never asked anyone outside my mom and dad to help me with managing my Juvenile Diabetes. I have lived almost 30 years with a disease that kills if untreated.
I have had to make choices, not all of which I liked, to work for companies large enough to provide insurance coverage for 'pre-existing conditions'
I manage as best I can. I own my own home. I haven't ever maintained a long term relationship out of respect for those I love and not wanting or desiring to saddle my care needs onto anyone else.
I don't need America to provide me my health care. If they can't I can do it myself, it just gets expensive.
I know beyond a shadow of a doubt that my death will be 16ish times more likely to be from Heart Attack or Stroke, which run on both sides of my family.
It isn't YOUR concern to care for me.
It isn't MY concern to care for you.
I happen to know a great deal of people that would gladly do so, but my own pride won't allow them to.
Americans on the whole seem to be getting progressively weaker, mentally, physically, spiritually.
The overriding reason? PERSONAL ACCOUNTABILITY.
No one is willing to hold themselves responsible for their own failures.
You realize you are rewarding the rapist?
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