You're just talking in circles that have no relation to anything I've said. I've never defended insurance companies, except to point out that their profits are insufficient to finance much new health care, even if we were to loot them as liberals demand. As I've said multiple times before, they're not the solution. They're a bunch of staffers. What matters is the line workers, who are making too much money doing too many tests that don't matter and treatments that don't work.

The only people defending anything resembling a big health insurer are you and the other single payer advocates. Only yours will be much better because it will be non-profit, low overhead, run by humble philanthropic civil servants. You simply won't hire any of the bureaucratic automatons who have infiltrated so many other government agencies. Yeah, whatever. It's still a bunch of staffers who have already proved they can't fix the line.

GreenDreams, I don't know if you can't do the math or won't do the math, but the math behind your position is not getting done. And your reading is weak too. I'm weary of you making the same arguments over and over again against positions I've explicitly disavowed. I did my best in my last post not to match your accusation of greed with another accusation, but you obviously read that differently too.

Anyway, you might as well get back to what you're saying. You know the poor better than I do, and they don't need innovation. They should just move out of the US to just about anywhere else, because health care is world class in country X. Bills are no problem there, because they're illegal.

Glad you've got that problem solved, Uncle GreenDreams. Now tell me again about those evil insurance companies.

Again you fail to read, Green Dreams (at least for correct comprehension). I dispel the myths of government magic and express intelligent and obvious concern for the costs and well as other problems we'll acquire in exchanging private for public health care. But don't let me divert you from your fiction if you find it more entertaining. By all means, continue. But not without criticism…

I think your suggestion innovation in technological advance is waste when it comes to insurance companies. What makes you think that any of the money paid to marketers, sales staff, brokers, product developers, claims denial or executive salaries to insurance Co. staff does anything to improve health care? I think there's a lot of ignorance, driven by conservative ideology, about how much profit is driving innovation. For example, our newest cancer drug was developed by the federal government through the National Institutes of Health in partnership with a drug company. We paid the cost. We bent the rules to make it easier to approve. They got the patent. We pay 12 times what the drug costs and 4 times what Europeans pay, your insurance company tacks on 17% more, and you call that innovation.

If a dollar we spend today might pay for a dollar's worth of someone's cancer treatment that they couldn't otherwise afford, or it might be invested in ways to make all future cancer treatments 0.01 cents cheaper, to spend it on the first is worse than shortsighted, it's a massive betrayal.

Over 9 billion people will be walking the planet within the next 30 years, almost all of them financially worse off than our 40 million uninsured. Even within the US the current generation of people who can't afford health coverage will not be our last. They will have children, grandchildren, great-grandchildren, and so on–fewer and fewer of whom (on present trends) will be able to afford health care.

What will improve their lot is technological and economic development–making their incomes rise and the price of things like decent medical care fall. If you are really concerned about helping people, you won't confine your view to the short-term bills of a half-percent of the population in the richest country in the world.

I don't believe people on the left are truly unconcerned with the other billions and the generations yet to come. But they sure don't talk about them much when it comes to health care. Terms like “economic development” and “cost efficiency” don't pass their lips, which suggests they either don't appreciate the problem or don't have a plan for fixing it.

Instead, the plan they're advocating sounds to my ears distinctly retrograde: put in charge a government that has a lousy track record in health care and for that matter in any other field requiring good commercial execution and getting maximum value for resources. Government makes decisions based on politics, not on optimal resource allocation. Look at schools, or medicare, or ethanol subsidies, or NASA, or the DMV, or the war on drugs, or…well, you name it. I've seen Uncle Sam's resume, and he's simply not the right guy for the job. In fact he's so obviously not the right guy that I have to think anyone who would nominate him doesn't really understand how big the job really is.

It's our decision what kind of a “tribe” we want. Some tribes abandon the old and sick to die, sparing their strength for the young and fit (oh, and fertile). I kinda hoped we were beyond that; that in the richest nation on earth, we could care for our sick and fallen.

Dr.J: No one on the right has said anything resembling “keeping what's gained is the highest goal,”

I know I have put it harshly, but that is the message of “the virtue of selfishness.” Perhaps I've over-composited the opinions of “the right” in the same way you homogenize “the left.” That composite includes the way every government action and plan (except military) is reviled as bureaucratic and inefficient and as DLS put it, “stealing from us.” AR seems even to think interstate highways were not the legitimate province of government. The composite attitude is that “the right” hates government and wishes they could, as Norquist put it, “shrink it to a size that we can drown it in the bathtub.” “Conservatives” seem to agree with Reagan “government is not the solution. It is the problem.” None of the conservative icons, Friedman, Reagan, Thatcher, have made any secret of their philosophy: “privatize, deregulate, cut social services.” Conservative commenters here consistently slammed Social Security and Medicare, “entitlements”, poverty alleviation and the “safety net” AR speaks of, “the nanny state.” Every single thing that is proposed is blasted if it means the government, using tax revenue, does something for the less fortunate, while tax cuts and deregulation and everything that advantages the wealthy is heralded as “good for America.”

You, Dr. J, automatically assume that a public system is doomed to fail and cost too much, while DLS just sputters that no one should expect any “nanny state” help. I don't think I'm being too harsh to assume that you are biased against a public effort, and that most on “the right” here want everything to be entrepreneurial, profit-driven private enterprise.

I believe the best efforts of humans are driven by values and passion. If health care can be driven by people passionate about serving the health of patients, it can be compassionate and effective. When the passion is for selfish accumulation of wealth, or “maximize shareholder wealth,” the result will be suffused with the kind of obstructionist, stingy and greed-driven denial of care that we so often see from the current profit-driven insurance companies. I have no problem with profit and entrepreneurialism; indeed I am a successful entrepreneur, but let us try to buy low, sell high with widgets, not human health.

* * *

In thinking ahead about health care (not that it's imminent — sorry, activists — but because there are all kinds of other issues related to this and other kinds of growth of government), I wonder if the costs of any vast new health care entitlement specifically are going to not only be the budget breaker (Medicare already is projected to harm federal finance more than Social Security), but be identified in the future as what may lead to inflation by the Obama team (which doesn't hesitate to rush things, as we see), be it merely through monetization of the vast new debts this President has already “secured” for us, or (this is quite likely given the nature of lib-Dem elites) that we may eventually see inflation, not merely as an escape from our slump or from deflation (which would merely be an excuse, a rationalization), or to help meet entitlement costs for retirees (also merely an excuse, but likely), but also because it would enable in the meantime more spending and a low inflation would be the true “opiate” of the masses which Obama and people like him in Washington would like to exploit. It could advance to substantial inflation but not necessarily intentionally, but resulting from another experiment by Obama-team types gone awry.

It's a form of straw-man argument. Next to nobody in the world advocates true anarchism. That is true of most Americans, who share in various ways the English heritage of libertarianism (the true liberalism or so-called “classical liberalism”). Government is a necessary evil, but of course necessary; it's a fine line that should have as little possible on the “government” (compulsory) side and as much on the “private” (free, where “liberal” is derived) side as possible. Where to draw the line is then the basic question to be settled, with as small government as possible the best (for it tends to do wrong and to oppress people; even Obama's most faithful believers can recall how evil they felt the Bush Administration to have been).

Many of us even yield to public sentiment; I've said for ages that federal health care is likely eventually. I know it won't be a magic solution to the current ills, and that we'll exchange one set of problems for another, and I'll be critical of what's wrong with anything that is advocated or advanced.

Speaking of which, CBO has just come out with its assessment of, yes, the costs, as well as failure to achieve spectacular results by the “public option” in the Kennedy health care bill. This is only a prelim assessment, but it shows that the “public option” is not going to achieve what proponents necessarily believe.

Read it for yourselves.

* Projected to cost over one trillion dollars over the next 10 years

* Reduces the number of uninsured by (only) 16 million.

http://www.cbo.gov/ftpdocs/103xx/doc10310/06-15…

Thanks for further clarifying and agreeing that the government may set he table for the private creation of wealth.

This proposal isn't even close to that definition, either. It is turning health care into a basic right for all. Not just life-saving and emergency care, but ALL aspects of health care. And yes, I am such a meenie that I do not think health care is a basic right for everyone.

Finally, once it IS a government run program, and costs escalate (and they will), we will be stuck with it forever as it, like ALL government bureaucracies, grows and grows, and more and more of the budget is consumed by it, and more and more of that budget is consumed by administrators.

Much like the Arabs (the Left) versus Israel (the Right), in fact, in this and in other ways. Stellar analogy.

Go back up the thread, you'll see.”

I looked. Thanks for the directions.

“By the way, 'monopsony' seems like a mighty fancy word.”

The older I get, the more I prefer simple language (and the more down-to-earth I am; I'm no good old boy, but something like it as opposed to the typical lefty youth). In this case, “monopsony” works quite well. (It means “single buyer,” a clarification and correction of the common term “single-payer.”) Lefties hate monopolies and oligopolies so much, but they don't mind something equivalent for a government role in health care (they not only want government to provide it, but insist strongly on universality and thus to prohibit a “private option” for anyone, typically). If I wanted to get _really_ fancy, I'd say “federal government health care command-and-control monopsony.”

* * *

“DLS, you're so fixated on costs and funding sources that you're overlooking the magic ingredient that will make single payer a success: Other People's Money.”

As with other benefits, especially when Other People are “contributing” most of the money. Oh, yes. However, at this time it would at least be halfway serious of the advocates and supporters of the current effort and legislation to have an idea what the (initial, underbid to the point of euphemism or even comedy) cost projections or estimates will be, along with suggestions, ideas already at hand, for taxes to pay for these, i.e., how we will get Other People to “contribute” their Money. Payroll tax boost? A VAT? A tax on motor vehicle fuels to please the little green fascists (for that's what so many of them are) at the same time? Et cetera. I'm honestly not fixated on the costs, but rather on the lack of attention given to them in the current legislation and by the current advocates pushing this initiative. They and their silliest fans may be satisfied with “Act NOW! Pay Later” (with Other People's Money), but that's not good enough for the rest of us.

* * *

“By the way, pacifists still have to pay taxes that support the military. And people who send their children to private schools still have to pay taxes that support public schools.”

They should get a tax deduction if they send their kids to private schools instead. And to address the more general point here (you sometimes have to pay for what you don't like or want), just wait until federal health care is extended to child-bearing-age females and the abortion-and-judicial-activism militants demand that services include abortion. I wouldn't be surprised to see not only some GOP opposition but public revulsion if the abortion militants and related lefties became too obnoxious and offensive about it, as I suspect they might (especially if they felt such a service was threatened).

* * *
“Most on the right are far to the right of that” … “I understand.”

You do not, as exemplified by what you say above, alone, but also by other statements, such as –

“My conclusion is that this group is stuck in a selfish place in which individual gain and keeping what's gained is the highest goal. Everyone should just fend for themselves.”

This does not follow logically from what we have been writing on this thread, as well as being incorrect when describing popular objection to governmental overreach.

“For those of us who think it is in our national interest to have available care for sick or injured people, the discussion about how to get there without breaking the bank will go on.”

Failure to address the costs and how to pay for them was a primary defect in the current legislation, as well as having been launched much too early; logically it should wait until both the economy recovers _and_ federal finances are put in order (the second of which is unlikely, so we are likely to settle for only the first).

“The national interest” is grandiose and really isn't applicable here. Sadly, nor at this time are the more intellectually powerful and profound issues relevent any more, such as if the federal government has any legitimate role whatsoever in individuals' lives or direct role as opposed to indirect through state and local governments, or if it's constitutionally authorized to provide health care. Nobody cares about such things, particularly on the Left (whatever is in the Left's way is ignored or attacked and disparaged into a false state of illegitimacy) and we have the Medicare precedent, and most of the public accepts some role for government in health care, and is comfortable with federal health care for reasons of mobility within the USA if nothing else (standardization and theoretical simplification). I've foreseen federal health care as a “default” option after most of the public sees no other reasonable alternative. (Doctors as well as the public hate insurance companies; the doctors hate junk lawsuits, too.) There are a number of ways to get this done. I've been better than most lefties at identifying the best ways or means (consolidating Medicaid, VA, and Indian Health, etc., into Medicare, and extending Medicare to more beneficiaries, the ultimate being everyone, including non-citizens if Dems want this; giving citizens the same benefits that members of Congress and other federal officials and their staffs get, etc.) and I've at least wondered about the taxes (payroll, VAT, income or wealth taxes, the stock-and-bond transfer tax advocated by some) but I also am not naive or fulminantly activist; I know that government control will replace insurance company and HMO control as an intermediary that will meddle; that government control can make things worse as well as better; that our history of politicizing things by government when lefties run things — PC madness, “social responsibility” demands of business, and other lunacies — will infect medicine (words chosen well here), that the current effort is not only premature and childishly rushed (to appeal most of all to the childish) but defective (“Act Now, Pay Later”), and also smacks of rushing to addict the public to a vast new entitlement which never will be subsequently reversed or attenuated, but is being done so almost in a cynical as well as careless manner by neglecting the necessary details while seeking at the same time to be monstrously, unnecessarily, hopelessly complex. (615 pages or so, 388 amendments)

No one on the right has said anything resembling “keeping what's gained is the highest goal,” so if that's really your takeaway, that's disheartening.

So I'm not going to bother debating this any more. I understand. This group does not consider that we have a legitimate public interest in health care for our citizenry. I'm tired of the name calling and unproductive non solution-oriented barbs and insults.

If I'm wrong about that, go ahead and correct me. My conclusion is that this group is stuck in a selfish place in which individual gain and keeping what's gained is the highest goal. Everyone should just fend for themselves.

For those of us who think it is in our national interest to have available care for sick or injured people, the discussion about how to get there without breaking the bank will go on. Elsewhere I suppose.

I disagree. The government, in the case you describe, may set the table for private creation of wealth, and I agree that is the case, but that is not the same as the government creating its own profit revenue stream.

Even in the case of government owned toll roads, those tolls are almost always to replay the bonds floated to build them. Who, pray-tell, is paying said tolls? Citizens.

The deficit didn't just appear in the last 150 days. And much of that newer spending has been in continuation of the previous administration's policies.

And I confess, the cry of “Communism!” is always going to make me roll my eyes.

You said, “The government creates no wealth”. I think my response–government owned and operated roads create plenty of wealth was a good response to that.

I'd guess you're satisfied with the answers you've been giving.