A Public Health Care Option Would Save Consumers Money

And that is why Olympia Snowe wants to keep it out of the Obama administration’s health care reform bill. Chris Bowers quotes from an AP article published in the Baltimore Sun:

The main goal of health care reform is to lower the cost of health insurance. Apropos, Olympia Snowe thinks that the problem with a public health insurance option is that a public option would… wait for it… lower the cost of health insurance:

In an Associated Press interview in Portland, Snowe said it would be unfair to include a government-run health insurance option that would take effect immediately.”If you establish a public option at the forefront that goes head-to-head and competes with the private health insurance market … the public option will have significant price advantages,” she said.

Well, duh. That is the whole point. You can’t lower the price of health insurance unless you start offering lower-priced health insurance. It’s a tautology.

So, naturally, during the fight to lower the price of health insurance, so-called moderate Senators think that the problem with the public option is that it would… lower the price of health insurance. While it may be news to so-called moderate Senators, protecting the crappy products of large corporations is not their job description.

Ezra Klein thinks Sen. Snowe is being a bit less than completely honest:

When Olympia Snowe says that they public option will have “price advantages,” she’s saying that it will be able to negotiate lower prices with health-care providers and thus offer consumers lower premium costs. This will make it hard for private insurers to compete because no one will want to pay more for worse service.

I imagine that Snowe’s concern extends a bit further than that: If private insurers can’t compete, they’ll go out of business. If they go out of business, the government will control the market. If the government controls the market, various bad things will happen.

Klein goes on to point out the “weirdness” of plugging concepts like “fairness” and “advantages” into a debate over public policy:

But markets aren’t fair. And public policy is about producing beneficial outcomes, not setting up some sort of arena battle between various forms of insurance companies. It would be useful to know what Snowe fears would happen in a market dominated by the public plan. How much money does Snowe think they would save (as that, of course, is why they’re voluntarily choosing the public plan and its “price advantages”)? Would this harm innovation? By how much? Would this decrease access? By how much? Why does she think that? Why should consumers prefer her world over Bernie Sanders’s world?

Snowe’s “trigger” idea is a no-go, says D-Day:

But Snowe’s concept, which would undoubtedly set an unrealizable standard to prevent the public option from ever coming into existence – that’s how it works with Medicare Part D, which has a trigger as well – is a complete non-starter. And keep in mind, EJ Dionne informed us yesterday that the main GOP negotiator in the Senate, Chuck Grassley, will not sign onto a deal if only Snowe supports it, which means it would have to move to the RIGHT of Snowe’s concept. And those Republicans are out there today demonizing the public plan as a “Washington takeover”.

Steve Benen gives us the killer logic:

As you’ve probably heard, a public option would improve the system by lowering costs, expanding access, and using competition to improve efficiency. Those who like the idea of a “trigger” argue that if we pass a reform package and private insurers can lower costs, expand access, and improve efficiency on their own, we wouldn’t need a public option. It’s better, they say, to wait for the system to get really awful before utilizing a public option to make things better.

The problem should be obvious: if proponents of such an idea realize that a public option would necessarily improve the overall system — and they must, otherwise there would be no need for the trigger to kick in when things got even worse — then why deliberately delay implementation of the part of the policy that lawmakers already realize would help?

Or, put another way, if Snowe knows a public option is a good idea, there’s no reason to push it off to some arbitrary date in the future, as the system deteriorates in the interim.

That’s much too sensible for Congress:

A significant price advantage is, of course, a good thing if you’re interested in delivering quality affordable coverage to everyone. Cheaper is a good thing. But not to Senator Snowe. As Chris Bowers says “It is pretty amazing that many moderates and industry figures are actually arguing that the problem with including a public option in health care reform legislation is that a public option would lower the cost of health insurance.” Unfortunately, it’s not just a handful of moderates. The more liberal of the two Senate committees working on health reform has come up with a weak public option that would do some good but ultimately lack significant cost advantages over private insurance.

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Author: KATHY KATTENBURG

  • GeorgeSorwell

    Very good post. Thanks.

  • http://www.blogtalkradio.com/msr Jazz

    It is beyond amazing that someone can sit down and write, in a serious fashion, that Olympia Snowe opposes the public plan option because it would “save money for consumer.” Oh yes. I'm sure that's exactly the platform she's run on for elected office and why she keeps getting reelected by the voters. “Vote for me! I'll make sure everything costs you more money!” Hogwash.

    Having dispensed with the ridiculous hyperbole which passes for logic on the Left regarding this issue, I'm silly enough to hope that perhaps we can still have a brief discussion on the real reasons that people like Snowe might oppose the public plan option, rather than the artfully clipped straw-men some of you choose to put words in their mouths in a transparent attempt to make your opponents look like they spend all their time hating Americans.

    First, let's look at this farcical meme about how “competition” will lower prices. Go look up the definition of “competition” some time. In the business world, when two parties are competing and one of them doesn't have to justify their costs or model and simply declares by fiat what they are willing to pay while the other side has no such luxury, that's not competition. Medical providers hate Medicare / Medicaid claims. They screw up their billing operations and cost them money. They actually have to charge more to everyone else to make up the difference. That's because the government gets to “compete” on an unfair basis.

    If you offer a public option to everyone, then everyone gets cheaper health care, right? Great! Except now, everybody and their brother signs up for it. I mean, who wants to pay more money, right? And to “pay for” this concept, you'll start taxing the health insurance benefits of people with good plans from private insurers, making them more likely to switch. From there, the ripple effect starts. First, you essentially drive the private health insurance industry out of business. Unemployment, and all the trickle down loss of spending, savings, etc. ensue in their normal course. And now the health care provides have nobody but govt. plan customers. As a wake-up call you all of you Utopians, hospitals and doctors' offices are still businesses. They actually need to make money as opposed to being charities. As it becomes less and less profitable to do business on government pay models, regardless of their costs and overheads, they go out of business. So less people are there to provide services. This leads to what? Let's all say it together now…. Rationing of Health Care Services.

    You act as if there is no competition in health insurance or provider services today. Our consulting firm has changed insurance providers twice in the last six years. They are always shopping for the best deals to cut costs. But none of them will be able to compete with a government program that dictates what it will pay, even if it means running the providers out of business. If you really want to go after an industry that engages in price fixing and lack of competition, try the petroleum and gasoline folks. They're doing their level best to dance around the laws and fix prices everywhere while making record profits. Of course, the vast majority of what you pay for gas still goes to taxes, but…. Oh wait. That's right. You guys don't mind paying through the nose for something as long as most of the money goes to taxes. What was I thinking?

    Do you really, honestly think that government has the ability to wave a magic wand and just make everything cheaper? Or free? Then why do we pay for anything? But you still think there is some Utopian society waiting just around the corner where nobody has to work everyone has a mansion with an in-ground pool and a limo with a driver available 24/7. And you'd all HAVE IT, by golly, if you could just get the evil “man” out of the way who is holding you down.

    I'd like to eat candy and rainbows all day too, but I live in the real world. The system currently being pushed for, like so many things, sounds great from the outside if you don't think it through. But in the end, it turns into the government meddling in things it doesn't adequately understand and ultimately destroying what it tries to fix. In some small way, I almost hope you get what you're asking for. Then, some few years down the road when you've got a govt. bureaucrat telling you that you just can't have that operation you need for another six months and you'll just have to make do with Tylenol until then, you can come back and let me know how Utopia is working out for you.

    Oh, and as an addendum, please stop posting links to those bogus, rigged “studies” which show how great Canada's health care system is compared to ours. Why do you think everyone keeps coming here for their major medical needs?

    Should you actually be interested in fixing the real health care problem in this country, identify the actual pool of people in need of health insurance who actually have no way of getting it, (a much smaller number than most of you want to admit) and set up yet another program to provide basic coverage just for them – complete with a means test – and administrate like another welfare style program. It would cost one hell of a lot less, not wreck two industries in the process, and likely do some actual good. Oh, but once again, I forgot… you don't like means testing, do you? It's not “fair” to everyone, is it?

    Jesus. No wonder I can find no major party candidates to support. I'm stuck with a choice of Republicans who want to blow up the rest of the countries in the world, and Democrats who want to implode this one.

  • kathykattenburg

    Wow, that's quite a rant, Jazz.

    I actually happen to like Medicaid. I pay nothing for prescriptions, which is great because that's the income I have — nothing. When I wasn't on Medicaid, I often could not pay for medications. I had a heck of a time explaining to my doctor at the hospital (clinic, charity care) why I could not fill the prescriptions she wanted to write me for high blood pressure, or for vitamin D. “But you have to have it,” she said to me. Funny, huh?

  • http://www.blogtalkradio.com/msr Jazz

    And so, by the means test I laid out above, how is it exactly that the current system is not working for you? Or, if you happen to fall into one of the “gaps” which I fully acknowledge exist and need to be fixed, why would it not be suitable to simply expand a welfare type solution so each person falling through the gaps had coverage *available* (we can't make everyone take it) and paid for without forcing a national public plan down all of our throats and beating two large industries and all of their jobs into the ground?

    Perhaps that's the big follow-up question for those of you flogging this destructive public option. Can you define exactly the problem you're trying to solve? Are you trying to help people or are you just so angry at “big pharma” or whoever the enemy is this week that you want to punish them by making them unable to compete with a government plan?

  • DaGoat

    Jazz is spot on here. Kathy's post is valuable though in that it shows how many left-leaning bloggers (Bowers, Benen, et al) are intentionally dense when it comes to economics.

    The problem with a public health plan is it has to be competitive enough to lower insurance rates but not so competitive as to put private insurers out of business. Now maybe the government is economically skilled enough to hit that narrow window, but judging by other government programs it's not likely. What is likely is that the public plan would put private insurers out of business with the end results as outlined by Jazz.

    The end result of a public health plan will most likely be nationalized health care. Since that really is what most on the left want, they are the ones being dishonest here when they talk about a public plan being used to stimulate competition.

    And yes Medicaid is fine if you're a patient and can find a doctor. I'm on the Iowa/Illinois border and Illinois Medicaid is so bad there's only one doctor within thirty miles who will take it. Illinois Medicaid was ten months behind in paying doctors last month. Like most government health plans it over-promises and under-funds. That's a great model to adopt.

  • GeorgeSorwell

    Wow, that is indeed quite a rant, Jazz.

    People who disagree with you depend on ridiculous hyperbole and straw-man arguments and bogus studies and magic wands.

    Your personal anger is absolutely no reason for me or anyone else to agree with you.

    Can you support any of your arguments with any data?

  • GeorgeSorwell

    DaGoat

    It seems to me that what's likely in your scenario is for private employers to dump their health care costs, in to become more competitive.

  • kathykattenburg

    Can you define exactly the problem you're trying to solve?

    Sure can. We're trying to lower health care costs, which have been spiraling higher and higher over the past 30 years. The cost of health care is putting health insurance increasingly out of the reach of American citizens. Plus it's a significant part of the deficit.

    You (Jazz) and DaGoat are both ignoring the fact that competitiveness is defined by quality as well as cost. Private insurers are providing increasingly inadequate coverage at increasingly higher cost to employers and individual consumers.A public health care option would need to provide better coverage than private insurers at a lower cost in order to attract consumers. If the public option can do that, and private insurers cannot, then private insurers are not competitive. In that case, why should the government give the advantage to private insurers when we're trying to come up with a public health care policy that benefits consumers? It's not the government's job to prop up uncompetitive business enterprises out of an ideological preference for the profit model.

    As to how exactly the current system is not working for me: It's working for me right now at this moment, because I am completely destitute. Middle-class Americans cannot get Medicaid, and private health insurance is also out of their financial reach. I don't know offhand exactly what the income limits are, but I do know they are not high. In addition, if I lose my cash assistance, for any reason (and it's very easy to lose it through various bureaucratic snafus), I lose my Medicaid as well. That happened to me, and for several months I could not pay for prescriptions.

    The larger point, however, is that people should not have to jump through hoops and constantly worry about failing means tests, etc., in order to get health care. Every American citizen should have access to the same high-quality health care, whether it's public or from private insurers. We should not have a two-tier system that stigmatizes and segregates poor and low-income Americans and makes them “prove” that they meet an arbitrarily imposed “means” definition before they can get health care. I don't want to have to have my financial worthiness reviewed every six months for the rest of my life to make sure I'm still poor, still worthy of health care coverage. All Americans should have access to the same system of health care coverage; it should have nothing to do with ability to pay. That's the way it is in every other Western industrialized nation, and they don't seem to be clamoring for a system like ours where 50 million citizens are uninsured or underinsured.

  • GeorgeSorwell

    I've been looking for an article from The New Republic comparing American and European health care. I haven't been able to find it, but this has a large excerpt.

    Here are a few things I'd like to see in a rational discussion:

    1– The source to the assertion that lots of people come to America from Canada or Europe in search of the health care quality they can't find at home.

    2– Some sensible reason why we have a lower life expectancy here in the US than Canadians and Europeans.

    3– Some actual data indicating that large numbers of American health care providers refuse to accept Medicare.

  • http://www.blogtalkradio.com/msr Jazz

    I'm getting ready to take off to the mountains shortly (though we have wi-fi up there now so I'll be able to post and chat on and off when I'm not fishing) so I can't continue this much longer this morning, but this discussion certainly merits reply.

    First, an aside to George S. – Following your recent decision to start being so insulting and abusive toward me (and any other old, white racists who are obviously “uncomfortable” with the idea of equality) you've pretty much lost all standing to demand civil discourse.

    But for Kathy, you're most always polite and reasonable in discussions. I hate getting this worked up and agitated so early in the morning, but the very beginning of your column was nothing short of offensive. Do you really feel a need to defend your position by stating that Senator Snowe has no other reason to oppose the immediate implementation of a public than some hidden, evil agenda to prevent people from saving money? (And Snowe is one of the most reasonable, moderate members of the GOP. If there were a dozen or so more like her in the Senate and having a hand in the national platform, I wouldn't have left the party.) But to a couple of the points from your last response:

    A goal of reducing costs wherever possible withing the structure of the system is admirable and I support it. But you are still starting from a baseline assumption that there's some hidden health care agenda trying to rip everyone off and that it's not competitive. That's simply not the case. Health care is more expensive because… well… health care is more expensive. More on that shortly.

    Private insurers are providing increasingly inadequate coverage at increasingly higher cost to employers and individual consumers.A public health care option would need to provide better coverage than private insurers at a lower cost in order to attract consumers. If the public option can do that, and private insurers cannot, then private insurers are not competitive. In that case, why should the government give the advantage to private insurers when we're trying to come up with a public health care policy that benefits consumers?

    Why do health services keep costing more? Have you stopped to consider that the average doctor spends roughly a quarter million dollars making it to the point where they can begin getting paid? You mention how everyone should have the same access to top flight health care. Any idea how much new MRI machines cost, or the host of other technical wonders which are used to provide that care? Who's going to pay for all of that, Kathy, short of waving magic wands. It's an expensive service. As much as you may hate to think it, somebody has to pay for it or it goes away.

    people should not have to jump through hoops and constantly worry about failing means tests, etc., in order to get health care. I don't want to have to have my financial worthiness reviewed every six months for the rest of my life to make sure I'm still poor, still worthy of health care coverage.

    Tell me why. If you want the government or anyone else to pay for your coverage when others have to pay out of their own pocket for their coverage, please explain to me why we shouldn't ask you to verify that you are actually below the income level where you could afford it yourself? The nature of human beings may be sad, but there are far too many who will abuse any such system when abuse is possible. Look at the current Medicare / Medicaid system. Not a month goes by when we don't find people abusing those to the tune of millions of dollars. You may not like a means test, but until we can magically summon free health care services for everyone out of the ether, we do need to guard against such things.

    You seem to feel that the very best health care is a basic right of American citizens. That would be lovely, but I don't happen to agree. We're lucky to be able to afford bare bones coverage and services for everyone. If you think it's a basic right, then you need to show us how you plan on paying for it. Everyone should have access to *some* sort of transportation to get to work, to the doctors, to go shopping, etc. But some of us have to take the bus. Not everyone gets a Porsche.

    I have to take off now on a very long ride, but I'll try to check back on this later this afternoon or evening.

  • GeorgeSorwell

    Jazz–

    I have not, not, not been abusive or insulting to you.

    I just see the world differently from you.

    I invite the readers of this very thread to decide who's abusive and insulting.

  • AustinRoth

    kathy – you want to reduce costs by turning it over to the government. No doubt, you are indeed socialist/communist. There is no one else who can believe that the government is the most efficient delivery system.

    And of course you liked Medicaid, if it got you something for free. But it cost someone, somewhere (hmm, the taxpayers, maybe?) The problem with the 'free for me' model is that it cannot be sustained except for a small group. The money has to come from somewhere.

    And again, only socialists/communists believe that the government is a magic money tree.

    I know that those are hated words on the left (when talking to the right, but not amongst yourselves), but it is the truth of the matter.

    BTW – have you seen the latest government revenue numbers? Looks like the stimulus is having the exact effect those of us on the Right warned about:

    http://newsbusters.org/blogs/tom-blumer/2009/06

    How exactly are we to pay for this fantastic new expansion of the Federal government? Why new taxes and more borrowing. That is working SO well right now.

  • AustinRoth

    Jazz – I have to say I agree with GS. he has said nothing out of bounds or derogatory, IMHO. I think you are being a little too sensitive.

    And this from someone who pretty much agrees with what you wrote, and doesn't think it is a rant, just a reasoning and explanation of your position.

    I think you need that time in the mountains, dude. Don't take the wi-fi. Disconnect. It is good for the soul.

  • DaGoat

    A public health care option would need to provide better coverage than private insurers at a lower cost in order to attract consumers. If the public option can do that, and private insurers cannot, then private insurers are not competitive.

    Private insurance companies have to keep large cash reserves on hand and pay taxes. The government public insurance does not have to keep cash reserves on hand (in fact they happily go into debt) and does not pay taxes. This is a skewed competition and the end result will be to put private insurers out of business.

    Posters like Green Dreams are honest enough to say what they really want is a “Medicare-for-all” system. If that is what you want then that's what you'll eventually get with a public option since the private insurers are being set up to fail.

    Even if the goal is 100% nationalized health care this is a bad way to accomplish it. Transitioning from a system that is based on capitalism to one that is based on socialism (and I'm not using the term in a negative way here) requires a lot more and better planning than we are getting. As Jazz points out most physicians and hospitals are actually businesses, and not set up as social institutions.

  • http://greendreams.wordpress.com GreenDreams

    Good post Kathy. Lousy and very inaccurate rant Jazz. You can demonize “the Left” all you want, but most Americans and doctors are not with you here. Nearly 3/4 of Americans see a problem you don't, and want a public option. Doctors want a public option by 59% to 32%, nearly 2:1. You say Doctors hate Medicare, but 97% of them take new Medicare patients, same as take private PPO. DaGoat has previously retorted that 97% take “some, not all” Medicare patients (true according to the report from MedPAC). But that's the same with private PPOs. Some docs aren't taking new patients of either type. As for billing, I had to laugh at your characterization. One thing docs like most about Medicare, my doc included (and no, I'm not on it), is the ease of billing and the fact that Medicare facilitates payment while private insurers work like hell to deny it. That's because of the simple fact that an insurer's main goal is to make more profit. They will never care more about your health than their profit. That's the wrong goal in this case.

    And talk about bureaucracy, a common myth about a public option: My doc has to employ two people to deal with insurance company bureaucracy,
    preauthorizations, attempts to deny payment and a myriad of different
    forms.

    Oh but you love competition and a free market, gotta protect that. Well, it's gone. According to a report linked below, the market is not competitive, with serious ramifications for cost.

    The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country's insurance markets are defined as “highly concentrated,” according to Justice Department guidelines. Predictably, that's led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.

    Far from healthy market competition, HCAN describes the situation as “a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments in the markets they dominate.”

    Look at those numbers. That's far more than actual costs have gone up. A monopoly system allows insurance companies to gouge customers in the pursuit of profit, and you on “the Right” call that a free market, and gush about “the best health care in the world.” Then you rant about “taxing health benefits”. Funny. The same crew who don't want tax dollars to pay for poor people's health care have no problem with poor people paying for theirs. I don't have employer provided coverage. That means I SUBSIDIZE YOU who do. I know you big company employee types don't want to see your little government handout go away, but the truth is, small businesses are the major source of new jobs. And they are hurt by that handout.

    As I've pointed out before, there are some very difficult choices ahead about how much we can afford in terms of costly end of life procedures. You could call that rationing (earth to Jazz. Insurance companies call it “coverage limits.”). But the low hanging fruit is the insurance company inefficiency, greed and incompetence. Medicare pays doctors 19% less and insurance companies cost 12% more in admin and profit. That's 31% savings right there. Hospitals get 25% less under Medicare, yet nearly all accept it. That's 37% savings. You don't want to raise taxes, but want to deny the savings just to keep the fat cats in the insurance industry, well, fat.

    I note you haven't risen to the challenge I have posted here repeatedly. So I'll repeat it again. It's HERE, along with details on malpractice and more links.

    There is fully as much data on government paid health care as there is for privately paid health care. Medicare wins hands down. Not sure? Name a single other insurance policy, outside of a government one, that has these features:

    no eligibility requirements or physical
    no exclusion of pre-existing conditions
    no cancellation for excess use of services
    no penalty for moving or changing jobs
    no re-applying for coverage if moving or changing jobs
    a stable, mature program known to both physicians and patients
    no marketing cost
    no sales cost
    no commissions
    no bloated executive salaries
    no palatial executive suites
    no corporate jets or limos

    Oh but you love competition and a free market, gotta protect that. Well, it's gone.

  • GeorgeSorwell

    DaGoat–

    There is an article in today's New York Times about how people with health insurance often end up declaring bankrupcy. Here's a quote:

    Last week, a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to “confuse their customers and dump the sick.”

    Confuse their customers.

    Dump the sick.

    I'm sure that neither you, nor Jazz, nor Austin Roth wants to defend the current threadbare health insurance patchwork. But there was until recently a so-called conservative party running the government. They didn't do anything but this problem (as so many others) down the road for the next guy to worry about.

    For that matter, there is still currently a so-called conservative party still in existence. They could be proposing solutions to this problem–and to other problems. What are they doing?

  • tidbits

    This has been one of the most informative threads I've read in some time. Thanks to all.

    My only comment is that, while information can be gleaned here, everyone seems to be too ideologically positioned on the issue. This morass that we call a health care system requires pragmatic problem solving at every level from excess diagnosis to inefficient duplication of services to unnecessary overhead to multiple billing platforms to malpractice costs to denial of coverage to absence of coverage for some and under coverage for others to a de-emphasis on preventative care to emphasis on profit versus patient to patient bankruptcy.

    All of this weaves together to provide a current system that is too costly, too inefficient and leaves too many people out completely or only partially covered. Any solution needs to go beyond who, private insurers or public plan, is the payor. Comprehensive reform of an out of control system will not be brought to task simply by choosing who will pay the (exhorbitant) bill.

  • Dr_J

    Jazz's criticism of Kathy's post was quite accurate, she was not making any attempt to represent the positions of the people she quoted fairly.

    In a way the two aren't saying contradictory things. I see Kathy speaking to individual needs: “I pay nothing for prescriptions, which is great.” “People should not have to jump through hoops.”

    Jazz is speaking to the needs of the system as a whole–how to make the ends meet, how to make it sustainable. “Somebody has to pay for it or it goes away.” If you're designing public policy, these seem like important concerns.

  • http://www.whyweworry.com ChrisWWW

    Ohhh AR… for shame:
    “No doubt, you are indeed socialist/communist. There is no one else who can believe that the government is the most efficient delivery system.”

    There are many public services that don't operate maximally in a for-profit market. We've got roads, the police & fire departments, the military, and more. Are we all communists for believing that the government is the most efficient deliverer of military protection?

    As for Jazz, he is deathly afraid of “Rationing of Health Care Services”. I want to know what country he lives in where health care services aren't already rationed in one manner or another. There is a limited supply of health care professionals, medical equipment and drugs. It doesn't matter if the insurance is provided by the government or by a private corporation, no one will be provided unlimited access to those resources.

  • http://greendreams.wordpress.com GreenDreams

    The current system is patently unfair, specifically to me. I pay taxes, and as a small business owner, have no employer paid health care. Consequently, I subsidize health care for:

    the poor through Medicaid
    the old through Medicare
    legislators
    the military
    state and local officials
    Native Americans
    veterans
    everyone with employer-paid tax deductible insurance

    Now I'm a generous guy, but HOW can any of you justify me getting stuck with the bill for all of these groups (I subsidize health care for about 75% of those who HAVE health care), while I get ZERO benefit from that generosity? As I pointed out above, insurance companies are 500% more profitable than in 2000. On MY tax dollars! They're on the dole. HOW do you defend that, fiscal conservative, low taxes private insurance proponents?

  • CStanley

    GD, if public programs operate so efficiently (as you've informed us, cutting out 31% of cost by negotiating lower payments to providers and cutting out profit), then why is it that Medicare currently has unfunded liabilities in the trillions of dollars?

    It's completely disingenuous to act as though Medicare is equivalent to a private insurance company, sans the profits. That ignores the facts that the smaller premiums are subsidized not only by payroll taxes but also by future taxes that will need to be raised to cover the difference now that the demographics have upset the Ponzi scheme (too few workers to pay for all of the beneficiaries.)

  • http://www.whyweworry.com ChrisWWW

    It's completely disingenuous to act like Medicare is equivalent to private insurance companies, because Medicare is stuck with the oldest most expensive patients.

    Medicare exists out of the realization that no private insurance market would insure such high risk people.

  • CStanley

    I completely agree, btw, GD, about insurance companies growing too large and squelching competition.

    But from that HCAN article you quoted, this is utter nonsense (note that this argument is presented without any supporting evidence, and when you think about it it makes no sense:)

    “To try to reform healthcare in the current market structure is like setting sail across the Atlantic on a raft,” Balto added. He noted while renewed antitrust and consumer protection enforcement is essential, it is not sufficient to begin to restore some semblance of a functioning market. Only a public health insurance option will be able to force private insurance companies to adopt new pro-consumer policies.

    Why would the solution to monopolistic power not be breaking up the monopolies? I've seen studies projecting that adding a 'public option' competitor to the insurance market hurts the smallest insurance companies the most, and will quickly put most of them out of business. That runs contrary to the goal of adding competition to the private market.

  • CStanley

    @chris: Right, but then why pretend that that system isn't heavily subsidized? You can't have it both ways; it's either a government subsidized program to handle people who can't be handled through an insurance pool, or it's an incredibly efficient nonprofit insurance model which should be expanded to other groups of people (if not the population as a whole.)

    If you're admitting that it's taxpayer subsidized, great, we agree. But now we need to figure out how to handle the exploding costs, and I see no reason to think that adding more beneficiaries is going to help rather than harm efforts to reach that goal.

  • http://greendreams.wordpress.com GreenDreams

    CS, truth is, private insurance also has “unfunded liabilities in the trillions of dollars”. That's why you'll see them going belly up soon. Except that despite their obscene profits, when they fail, you and your “fiscal conservative” buddies, will be telling us we have to bail them out, because they're “too big to fail” and we'd be without health care without them.

    As I've pointed out before, 14,000 Americans are losing their insurance EVERY DAY. That means every day, insurance companies are losing 14,000 customers. The biggest, UnitedHealth, has lost 9 MILLION customers since October. Care to buy their stock today? Despite their obscene profits, their stock is worth less than half what it was in December! Maybe you're already a stockholder and desperate to see they survive and recover. Only with a TAXPAYER SUPPORTED gimmee can they keep customers. And those companies that DO offer employees health insurance (bet you have that, don't you, and you're welcome); they are at such a competitive disadvantage that it hurts America in every way. There's more cost of health care in a Ford than steel. That is just SO wrong. Of course we can't compete.

  • CStanley

    CS, truth is, private insurance also has “unfunded liabilities in the trillions of dollars”. That's why you'll see them going belly up soon. Except that despite their obscene profits, when they fail, you and your “fiscal conservative” buddies, will be telling us we have to bail them out, because they're “too big to fail” and we'd be without health care without them.

    Ah, I see you're preparing your arguments for when the public option forces insurance companies out of business, when we'll be told that despite fair competition from the public option the private companies were just unable to compete and that's why we need to go to a single payer government plan for all (which of course was the goal from the outset, but couldn't be sold to the public on that basis.)

    BTW, in case you've misremembered, I was not for a single corporate bailout. I'm not sure where you get off making all kinds of assumptions about my investments (not a single health insurance company in my portfolio, if you must know.) It's my own health care and the fiscal sanity of the country I'm concerned about, not my personal wealth.

  • http://www.whyweworry.com ChrisWWW

    CS,
    I agree that Medicare has to be subsidized because of the nature of the risk involved.

    But it doesn't follow that a public plan for the rest of the population will need the same subsidization because the risk is a lot lower. In fact, all of the current plans being floated require the public plan to be self-funded. It only gets a break for the initial setup period for creating the infrastructure necessary.

  • CStanley

    You can also stop arguing against me as though I support the coupling of health care and employment. I've long thought it was idiotic, and the obvious solution (which would also help make the insurance market more competitive) would be to even the playing field so that everyone can deduct their health care costs whether paid as an individual or through an employer.

    In almost all of these cases, you and I agree about the problems in the current system but for some reason you choose to ignore the more obvious solutions which would make the health care system operate with more market competition.

  • http://greendreams.wordpress.com GreenDreams

    OK, you won't bail them out. Then what? With no other option, what other choices are you offering? (and I assume you ARE getting your health care subsidized by me and other taxpayers). I don't care at all if they go under. Good riddance. But why pretend it will take a “public option” to kill them, when they're hemorrhaging customers every day, and charging you AND ME more every year in THEIR Ponzi scheme?

  • CStanley

    In fact, all of the current plans being floated require the public plan to be self-funded.

    Forgive me for my cynicism but as soon as that turns out not to be the case, do you actually believe that the program will be killed?

  • CStanley

    GD, I haven't seen the stats your talking about (you seem to be referring to something you brought up in another thread?) so I can't really address or rebut something without reading it.

    I have to go out for a while, so if you care to provide links about the losses that the insurance companies are facing, I'll see if I can get back later to address the point.

  • http://www.whyweworry.com ChrisWWW

    CStanley,
    If it needs reform, it should get it.

    The alternative seems to be letting the private insurers continue to raise prices at a staggering rate, while insuring less and less people.

    Something has to be done to a) limit costs and b) provide universal access. The kinds of regulations required for that system would be so draconian that a truly private system wont exist.

    At least with a public option, private insurers can be largely deregulated. Let's see what they can do without the watchful eye of the government.

  • Dr_J

    GreenDreams: “Private insurance also has “unfunded liabilities in the trillions of dollars.”

    Whoa, can't let that one pass. Do you have any data to support that claim? Climbing rates and vanishing customers indicate the opposite: the companies are being forced to cover their growing liabilities, and they're having to raise rates to do so.

    If their customers bolt as a result, that means the insurers' business model simply doesn't work. I've long been saying exactly that: insurers should not be covering routine care or acting as big gatekeepers for the whole industry; that's just not what “insurance” means. If they go broke, no way in hell should we bail them out. That's one claim I'd deny right quick.

    Let them fail, just like we should have let the car companies fail many billions of dollars ago. This is the main virtue of the private enterprise over the public sector: private enterprises built on unworkable business models die quickly, freeing investment for something useful.

    Contrast with Medicare, which has an even less workable form of the same business model. But it gets to sweep trillion-dollar problems under a taxpayer-woven rug, where they live on and squander our limited resources for decades.

  • http://greendreams.wordpress.com GreenDreams

    CS, Not sure which data points you want to challenge, CS. Much of the data is linked on my blog HERE. The 14,000 a day losing their insurance is from the Census Bureau HERE. 7 million lost their coverage during the Bush administration. A summary is HERE. The stock chart for UnitedHealth is HERE. The lack of competition in private insurance, with links to source is HERE. THIS is the full report on private insurance monopolies nationwide. Auto companies paid $5.2 billion in 2004 for health insurance, all tax deductible. That adds $1525 to the price of every car, more than the cost of the steel.

    I assume you don't need a link to the obvious fact that when employer paid insurance is tax deductible and privately paid is not, we are subsidizing those with employer paid insurance. That's discrimination and hurts small businesses and all individuals who don't get that taxpayer-funded benefit. Furthermore, why should I subsidize insurance CEO salaries that average $14.2 million? Do you really think we should be spending taxpayer dollars on that? Or the sales, marketing and underwriting costs? Why? So would you support dropping the tax exemption for private insurance? More about the companies you trust with American health care.

    A Senate report and testimony from a former PR executive [charges that]: Insurance companies routinely make consumers pay for bills the companies themselves should cover, sell “junk” policies, try to drum out sick people to keep up profits, and purposely make paperwork almost impossible to understand, reports the Washington Post and ABC. Insurers “confuse their customers and dump the sick, all so they can satisfy their Wall Street investors,” said Wendell Potter, a former PR exec for Cigna. While noting that he wasn't implying wrongdoing at Cigna, Potter said the industry as a whole “is really going in the wrong direction and taking this country in the wrong direction.”

    Folks, these are not the champions of “gold standard” health care at all. We need to take a hard look at whether it's really in our best interest to design our health care system around keeping them profitable.

  • DLS

    Talk about bottom dragging, Kathy. [rolling eyes] Snowe, a liberal “Republican” who should be a Democrat, is just thinking of alternatives to something even too extreme for her and her liberal-leaning constituency. (New England is notorious for being blue-shifted way out of the mainstream, though not as bad as the freakish Federal District.)

  • DLS

    Also, I await Kathy's “treason” thread about Sibelius, who bleated recently about co-ops as an alternative.

  • DLS

    “Why would the solution to monopolistic power not be breaking up the monopolies?”

    Funny how so many (who may be ignorant, if not necessarily illiterate) have cult-like faith in a federal monopsony (which means 100% control, and retention of “private” legal status being merely legalistic).

  • http://greendreams.wordpress.com GreenDreams

    Dr_J, insurers gamble that they will get to dump customers if they get sick, that their investing of our money will make them more than they “lose” by what they call “medical loss” (paying for health care), and that we'll die before costing them too much. If a fraction of us used the allowable limit, they'd be bankrupt, hence “unfunded obligations.” As for Medicare's “unfunded obligations” Medicare spent $300 billion for 43 million elderly patients. We can afford that. Besides, private insurers are not even interested in insuring that high risk population. While 80% of private insurance customers are in “very good or excellent” health, only 40% of Medicare patients are. Bush accidentally gave us a perfect comparison of Medicare vs private insurance with the Medicare part D program. Insurers get 30% credit, prices on medications are higher, doctors hate it and are calling for its repeal.

  • Dr_J

    “So would you support dropping the tax exemption for private insurance?”

    It's not an exemption for private insurance, it's an exemption for employer-sponsored insurance. It's employers (and the employed) who benefit from the subsidy, not the insurance companies. Yet the government rigs the market this way, to the detriment of the unemployed, anyone else shopping for individual coverage, taxpayers in general, and consumers who want to see a more competitive market.

    Conservatives will point to this as evidence of Uncle Sam's incompetence to design a well-running health care system, but cut them some slack, guys. The government has only had since World War II to fix the problem.

  • Dr_J

    “Medicare spent $300 billion for 43 million elderly patients.”

    …which money it raised from 200 million non-elderly patients, with a promise to cover their hospital bills after retirement. That involves statistical guesswork about what the bills will be, but it is clearly not putting away enough money to make good on that promise. By the time these people do retire and the well starts to run dry, we will have to raise taxes and/or cut benefits by tens of trillions of dollars to keep the scheme going.

    Private insurers are working the same actuarial tables, and you're probably right that their math includes how many claims they will likely deny based on the terms of their policies. But they are also doing what the government is failing to do: raising rates and cutting costs *now* rather than stalling for decades.

  • http://greendreams.wordpress.com GreenDreams

    Dr_J, since private insurers won't insure 65+ Americans, what choice exactly do you think we have. Just let Mom die? As for “cutting costs” where's the evidence of that? Their price increases are WAY above the increase in actual medical costs. Back to my starting point, Medicare pays less for both doctors and hospitals. Unless forced by law (thanks Bush) NOT to negotiate, they'd be paying less for drugs too. Their admin costs are rock bottom, they're nonprofit, no big salaries or executive suites, etc.

    As for the companies not being to get into trillion-dollar debts, they don't need to. First they'll beg for a bailout (guaranteed), threaten to leave millions of Americans without coverage, then if necessary, they'll ditch their obligations, take the mountains of cash they've been making for years, and declare bankruptcy.

  • DLS

    I doubt anyone who is desperately in need of learning the obvious will learn it this time any more than when I've made this known in past years (_years_), but here it goes again:

    “The projected 75-year actuarial deficit in the Hospital Insurance (HI) Trust Fund is now 3.88 percent of taxable payroll, up from 3.54 percent projected in last year's report. The fund again fails our test of short-range financial adequacy, as projected annual assets drop below projected annual expenditures within 10 years—by 2012. The fund also continues to fail our long range test of close actuarial balance by a wide margin. The projected date of HI Trust Fund exhaustion is 2017, two years earlier than in last year's report, when dedicated revenues would be sufficient to pay 81 percent of HI costs. Projected HI dedicated revenues fall short of outlays by rapidly increasing margins in all future years. The Medicare Report shows that the HI Trust Fund could be brought into actuarial balance over the next 75 years by changes equivalent to an immediate 134 percent increase in the payroll tax (from a rate of 2.9 percent to 6.78 percent), or an immediate 53 percent reduction in program outlays, or some combination of the two. Larger changes would be required to make the program solvent beyond the 75-year horizon.

    The projected exhaustion of the HI Trust Fund within the next eight years is an urgent concern. Congressional action will be necessary to ensure uninterrupted provision of HI services to beneficiaries. Correcting the financial imbalance for the HI Trust Fund—even in the short range alone—will require substantial changes to program income and/or expenditures.

    Part B of the Supplementary Medical Insurance (SMI) Trust Fund, which pays doctors' bills and other outpatient expenses, and Part D, which pays for access to prescription drug coverage, are both projected to remain adequately financed into the indefinite future because current law automatically provides financing each year to meet next year's expected costs. However, expected steep cost increases will result in rapidly growing general revenue financing needs-projected to rise from 1.3 percent of GDP in 2008 to about 4.7 percent in 2083-as well as substantial increases over time in beneficiary premium charges.

    It is expected that about one quarter of Part B enrollees will be subject to unusually large premium increases in the next two years. This occurs because it is projected that the other three-quarters of Part B enrollees will not be subject to premium increases in those years due to low projected Social Security benefit COLAs and a “hold-harmless” provision of current law that limits premium increases to the increase in Social Security benefits. …

    Social Security could be brought into actuarial balance over the next 75 years with changes equivalent to an immediate 16 percent increase in the payroll tax (from a rate of 12.4 percent to 14.4 percent) or an immediate reduction in benefits of 13 percent or some combination of the two. Ensuring that the system remains solvent on a sustainable basis beyond the next 75 years would require larger changes because increasing longevity will result in people receiving benefits for ever longer periods of retirement. …

    Concern about the long-range financial outlook for Medicare and Social Security often focuses on the exhaustion dates for the HI and OASDI Trust Funds—the time when projected finances under current law would be insufficient to pay the full amount of scheduled benefits. A more immediate issue is the growing burden that the programs will place on the Federal budget well before the trust funds are exhausted. …

    In 2017 and later for HI, and in 2037 and later for OASDI, there is no provision in current law that would enable full payment of benefits, once the trust funds are exhausted. If asset exhaustion actually occurred, benefits could be paid only up to the amount of ongoing dedicated revenues. Further general fund transfers could not be made to finance the deficits.”

    http://www.ssa.gov/OACT/TRSUM/index.html

  • DLS

    “That involves statistical guesswork about what the bills will be, but it is clearly not putting away enough money to make good on that promise. By the time these people do retire and the well starts to run dry, we will have to raise taxes and/or cut benefits by tens of trillions of dollars to keep the scheme going.”

    Why isn't the federal government insisting it, first and foremost, be subjected to Generally Accepted Accounting Principles? (Why don't we get a periodic balance sheet and income statement and even the real equivalent of an annual report, incidentally?)

    Where is the accounting and at least the beginning of provision for (currently) unfunded future liabilities?

    Why do the sillier, mindless, and amoral leftist defenders of Social Security and Medicare openly and blatantly as well as dishonestly deny these programs are unsustainable in their current forms, and that once these programs begin to run deficits, redemption of “trust fund” bonds requires additional taxes or debt?

    What plans do the Dems in Washington (who were robotically in denial and in opposition to any reform during the past eight years) have to reform and rescue Medicare (if not also Social Security, as they should have, too) before rushing so stupidly to expand its scope to everyone else? Lowering already-too-low payments to providers obviously isn't the “solution” [sic] or part of it.

    (What plans do the Dems have to reduce future government retiree benefits and payments? Sacrilege!)

  • Dr_J

    “First they'll beg for a bailout (guaranteed), threaten to leave millions of Americans without coverage, then if necessary, they'll ditch their obligations, take the mountains of cash they've been making for years, and declare bankruptcy.”

    Right, insurers will take their “obscene” 6% profits and head for the Bahamas. Just as well, right GreenDreams? All they ever do is deny coverage anyway. We're better off without them.

    And if they did all those things exactly as you described, that would make them much more honorable than the politicians overseeing Medicare. Politicians dare not even speak of Medicare's losses lest their colleagues accuse them of trying to kill it. Look how you swooned at that Kaiser CEO's don't-worry-be-happy message you posted on a previous thread. Medicare genuinely does need a bailout, and politicians are causing us a world of harm by *not* screaming for it.

  • http://greendreams.wordpress.com GreenDreams

    DLS, again, I'll bother to read your comments when you stop with the “sillier, mindless and amoral” ad hominem attacks. I have no time or energy for your hatred of “the left.”

    Dr_J, that alarm has been raised many times, in fact _for years_. The fund was projected to be bankrupt by 2001. Congress fixed it. Now it's “projected” to run dry by 2017. It will no doubt be fixed again. I know you think the sky is falling, but again, what do we do with our elderly? You KNOW the private insurance option isn't viable–they only want healthy young customers. So, what then?

    Now, as to “balance sheet” as you're making this sound so scary. Do the simple math. $300 billion paid out by Medicare / 43 million covered = <$7,000 annual cost per covered individual. That's actual, including all “waste” and “fraud” (a not insubstantial $40 billion, just about the same rate of fraud in the private insurance biz). Average employer-provided insurance premium last year was $12,680 (Kaiser Foundation) for family coverage of healthy individuals. Employer contribution was $9,325. At a 25% tax rate, the employer insured is getting a $2,331 tax-payer free ride. Each. That is what I am subsidizing for you, and DLS and CS and all the other employer-insured. Not only am I subsidizing your healthcare, but since I pay in after-tax dollars, I am doubly screwed. Of COURSE you don't want me to get a break. I'm footing a major chunk of your bill.

  • JSpencer

    “DLS, again, I'll bother to read your comments when you stop with the “sillier, mindless and amoral” ad hominem attacks. I have no time or energy for your hatred of “the left.””

    Megadittos. Losing credibility is the price of bad behavior… which is unfortunate and unnecessary. Think heat vs. light.

  • Dr_J

    At the risk of being pedantic, saying “your argument is wrong, therefore you're a mindless liberal” is not an ad hominem. Saying “you're a selfish conservative, therefore your argument is wrong” (how you've dismissed a couple of the links I've posted) is.

    “It will no doubt be fixed again” is the response of an ostrich. The question is how it will be fixed, and the answer is by raising taxes and/or cutting services a lot. We're in an unusual situation, too, one of only four industrialized countries that thanks to immigration isn't graying much…yet. That's going to change.

    What's Mom supposed to do? Well, if the bills are only $7,000 per year, simply pay them. Everyone should be saving for retirement, including health care they're likely to need.

    Or even better, if the economics are as cut-and-dried as you like to represent, why don't you set up an insurance company of your own? One that doesn't overpay executives, advertise, or make obscene profits, one that doesn't deny coverage and gives great deals to everyone. If you believe even half the numbers you put out, it should be a great bet. I'd just rather you make it with your money rather than mine.

  • http://greendreams.wordpress.com GreenDreams

    Wow. that really was pedantic. You get the idea, though. I'm open to civil discourse.

    Actually, it's the response of an optimist. When private insurance crashes and burns, the public will demand Washington fix the problem, and finally, finally, we'll join the rest of the civilized world (all communists of course, according to AR) in deciding that everyone should have medical care just for being a citizen, regardless of wealth or employment status.

    Let's face it, you can no more predict our fiscal status in 2017 than I can predict earthquakes. Things are changing mighty fast, and there is every likelihood that we will be a second class economic power, a tarnished has been. DLS will get his way and automakers will be sold off to China, we'll sacrifice what manufacturing we have left (do we?) on the altar of globalization, and turn to single payer out of necessity.

  • GeorgeSorwell

    Dr J–

    Haven't you previously said the government should be writing checks to people who can't get insurance so they can pay their health care providers?

  • Dr_J

    All communists indeed. But I'm glad you're coming clean, comrade.

    Did you know that Medicare won't pay for vision or podiatry? How do they expect people to see or walk?

    Anyway, I'm not against Medicare, I'm just against the waste it permits and the dishonesty it's funded on. If we could find an honest way to fund it and a more efficient way to run a system that includes it, I might even warm up to the idea of expanding it. And those two are linked. Honesty about economic tradeoffs is the first step toward improving efficiency.

    2017 is only 8 years away. It will surely take longer than that for Mr. Obama and likeminded socialists to bankrupt us completely, won't it?

  • GeorgeSorwell

    I agree with Dr J that honesty about economic tradeoffs would be a very good step toward improving efficiency.

    But, honestly, I find the cries of communism and socialism kind of ridiculous.

  • http://www.blogtalkradio.com/msr Jazz

    First of all, sorry for coming back to this so late and so briefly, but the trip went a lot longer than anticipated and was far more busy than usual. We've arrived in the mountains in one piece (I'll try to put up a post on that this morning) but one of the only roads through the area was obliterated in a rock slide this spring and it made things tricky. There were also family members to greet who we rarely see, etc.

    You guys have had a great discussion on this, and it's an important topic, but I'm going to take part of AR's advice and not allow myself to continue to get wound up or bogged down in it too much right now. I'm just in too good of a mood. I still think the public plan defenders here are, in some aspects, being either intentionally misleading or don't grasp the long term effects of what we're discussing, but I can also see how the prospect of free or cheap healthcare for everyone with nobody ever having to pay for it is appealing to the masses. Also, there's that natural, populist, “let's stick it to the man” (in this case the insurance industry) that's really tempting to some.

    But as to AR's point about insults, etc. it was not this thread I was referring to, and George knows exactly which one I'm talking about, where he decided to “enlighten” me about how old white guys are “understandably” uncomfortable with the idea of minorities or women having equal rights. Still, on a bright, sunny morning in the mountains with a boat full of bass gear waiting for me, I find it pretty hard to get annoyed with anyone.

    Anyway, I don't know of this public option will make it out of Congress in one piece. But if it does, and you all get what you're wishing for, let's meet back here in a few years and chew the fat over what happens after you've driven that industry out of business. Be careful what you wish for. You just may get it.

  • AustinRoth

    GD –

    all communists of course, according to AR)

    Please, at least be honest and accurate in describing my position, as my words as on this very thread. They are NOT all communists; most are socialists. I allowed for that. But man, you put the communist out there (which SOME on this board sure seem like they are, huh Kathy?), and the result is a feeding frenzy of denial from the left.

    “We don't believe in communism! We just think the government should control the means of production, provide for all the workers, determine the amount everyone should get paid, and make sure everyone is equal (except for those who are more equal than others, of course”

    Certainly no one could think THAT sounds REMOTELY communistic.

    :)

  • GeorgeSorwell

    If anyone is still reading this, I will find the post Jazz is referring to and you can decide for yourself if I was begin insulting and abusive toward him or just disagreeing with him.

  • GeorgeSorwell
  • JSpencer

    I just read through the thread, specifically the exchange between Jazz and GS. Looks like a misunderstanding to me, I didn't see anything that looked like insulting or abusive intent. I took George's comment to be a general one, not a personal one.

  • Dr_J

    Statements you find insulting are insulting, just as statements you find funny are funny. Your accusation that most white males are bigots wasn't clearly directed at Jazz but wasn't clearly directed elsewhere either. He took it more personally than he might have or than you probably meant it. But you know how old guys are. :^)

  • http://greendreams.wordpress.com GreenDreams

    Jazz, I certainly don't want to sour your good mood, but if you think I'm being disingenuous or intentionally misleading, let me point out the facts. The ACTUAL annual cost for Medicare is under $7000 per person. That's 2007, the latest year I can find. It's $300 billion / 43 million covered. That is 100% of the cost actually paid, including all admin and fraud ($40 billion). That is the per person annual cost of covering the highest cost risk pool in the business, the elderly, from 65 to end of life. The cost of health care for ALL Americans was $7,436 per person for 2004, the latest year I could find, and was going up at 6.7% annually, so should be about $9,000 a year in 2007. There is so much scare talk on this subject, but it appears the actual cost of health care for the highest cost segment of the public is costing us less per person than the average of the overall population, including young healthy adults and children.

    Now if you think I'm coloring those facts in any way, please enlighten me. There is no projection or estimation involved at all, just the actual cost divided by the actual served population. Let me note additionally, that the 65+ population is included in the group of “all Americans”, bringing the average down somewhat, so the cost of health care for the younger pool per covered person is bound to be higher.

  • GeorgeSorwell

    Dr J–

    I appreciate your willingness to defend me in spite of our often contentious disagreements over the issue of health care.

    Seriously: thanks.

    But I didn't say most white males are bigots and I'm not really sure why anyone would say so. Let me quote myself:

    I completely understand that white men (and even more specifically, straight white men of the middle class or higher) are now expected to share what were once their prerogatives.

    Naturally enough, some–maybe most–of them feel discomfort, anxiety, even resentment over that fact.

    The notion that justice should be blind is a pleasant one, but that pleasant blindness is just metaphorical–I think it means everyone who seeks justice should get a fair shake, without fear or favor.

    I don't think anyone can look at our history and say that justice has ever been blind. That assertion is likely to ring hollow in a lot of ears.

    I also think that a lot of people who lived a hundred years ago–Italians, Poles, the Irish, Jews–would be surprised to see their grandsons considered white men, equal to the Boston Brahmins. I think that's good thing. I think that tendency should continue.

    I doubt many people are still reading this thread, but anyone who still cares is certainly free to go to the link I provided a few comments up and read the whole thing.

    Again, Dr J, thanks. As you may have noticed, Austin Roth defended me way up there on this very thread. Austin Roth and I have been butting heads here for something like five years, so I appreciated his willingness to stand up for me. I should have thanked him sooner.

    Catch you on the next health care thread.

  • GeorgeSorwell

    JSpencer–

    Thanks to you also.

  • Dr_J

    George, thank you for the kind words. I appreciate you taking a stand, putting your opinion forth on the issue. You often seem to be holding it back, and instead just picking at other people's opinions. I'm still not sure what your view on health care is, beyond that you don't like mine. This way is much better.

    I'll stand by my reading of what you wrote. “White men resent having to share their prerogatives [with other classes/races]” sounds pretty much the same to me as “white men are bigots.” I'm certainly having trouble seeing much distinction.

  • GeorgeSorwell

    Dr J–

    This is a pretty old thread, so I'm not sure anyone else is reading this beside you and me. But again, I'd like to thank you for defending me. Especially if you think I'm just a bigot.

    But I have a complaint. What you have in quotes is not a direct quote by me. And I have to say I've complained about you doing this before.

    I did not say, as you have in quotes, “White men resent having to share their prerogatives”. That's far more extreme than what I actually said.

    Anyone, anyone, anyone can go back up just a few comments and read the actual words I wrote, which were, “white men (and even more specifically, straight white men of the middle class or higher) are now expected to share what were once their prerogatives.”

    In the next sentence, what I then said was, “Naturally enough, some–maybe most–of them feel discomfort, anxiety, even resentment over that fact.”

    I said there's plenty of racial discomfort, anxiety and resentment in America, because that just seems obviously true to me. And it seems obviously true to me that white people feel those things too.

    But there's a great deal of difference between the three–discomfort, anxiety and resentment.

    You don't have to agree. You are free to say my calling the existence of some discomfort, some anxiety, and, yes, some resentment over racial matters in America is proof of my bigotry. But I think that'd be a pretty hard sell. So hard that, instead, you put forth a more extreme argument as if it were in my words–and then used those words of your choosing to bash me as if I'd said them.

    You're free to mock me for nuance. For that matter, you're free to mischaracterize what I said. Just as I'd be free to come back and point out your mischaracterization. These are public threads, so readers are also free to decide which of us had gotten it wrong.

    But you shouldn't be so sloppy on the factual matter of quotation. Anyone can go back up a few comments and read my actual words. I put them there specifically so people could read my own actual words. I put in a link to the entire thread to people could read the whole thing as it actually happened.

    So please don't take your words and put them into my mouth. It's better for your own credibility that way.

    On health care, I favor the public option. Sorry if that's been unclear.

    And I'm sorry if you think I've just been picking on you. To tell the truth, I'm not really sure where you stand. Unlike so many others, you've agreed there's an insurance crisis. But you think the government should butt. Except that you think sometimes the government should be paying for people without insurance.

    I'm sure we'll have plenty of opportunity to disagree about all these things on other threads. But even if you don't see what I'm saying about the racial issue, I hope you'll see what I'm saying about the quotation thing.

  • Dr_J

    Sorry if you feel misrepresented, George, but I'm not sure what else to tell you. Just substitute the antecedents in your sentences, and they read “Some–maybe most–[white men] feel discomfort, anxiety, event resentment over [being expected to share their prerogratives].” I don't think “white men resent having to share their prerogatives” is an unreasonable paraphrase, and I'm still at a loss to understand the distinction you perceive. Sure, discomfort, anxiety and resentment are different, but it was your original that lumped them together.

    None of this, of course, comes anywhere close to calling you a bigot.

  • GeorgeSorwell

    Dr J, I'm not sure how to answer.

    Even you admit there are differences among discomfort, anxiety and resentment, so why wouldn't those differences stand when they are used together in a sentence?

    Even you admit you were paraphrasing, so why use quotations marks as if you were making a direct quotation?

    Anyone who cares can go back and read what I actually said. That's why I put the quote here. That's why I put the link here.

    And that is really all I've got.

    Catch you next time.