Anthony Weiner Tears off the Mask

Weiner.JPGOn this morning’s edition of Morning Joe on MSNBC, Congressman Anthony Weiner (D-NY) showed up to talk about his version of health care reform which he will be pushing for a vote on in September. He also expressed regret about President Obama’s lack of enthusiasm for insisting on a public plan and his general unwillingness to go “far enough” in restructuring health care in this country. But he even managed to shock me when Joe Scarborough got him to rip away the mask entirely and ask him if he was looking to completely eliminate private health insurance in America. You know… those plans that 83% of us have and we’re being assured that we can keep them if we like them? I’ll include a transcript of the video below with time stamps in case you can’t load the video, but I encourage you to watch it. It’s jaw dropping.

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2:31
Weiner: … people standing up at town hall meetings and saying, oh, you can’t provide a strong public option because then poor insurance companies won’t be able to compete. That’s a strange thing for a citizen to say. Most people don’t like their insurance company.

Scarborough: Well, I don’t know who is saying… [crosstalk]

W: Why are people against the public plan?

S: Because over the past six months, government growth, they believe, is happening at too rapid of a rate and they’re skeptical. I don’t think there’s been an explanation of how the government plan is not equal to a government takeover of health care, which we all know it’s not a government takeover, but that’s how it sounds to people.

W: Right. But I have heard people say repeatedly that if the government plan is too muscular, then they won’t be able to compete. Well, if they can’t compete, then they’re not going to get customers. They’re not going to get patients coming to them. And isn’t that what we want? To give people that choice? Look, the problem that we have here is that we’re trying to jury rig the system so that insurance companies still continue to make healthy profits. Why? What is an insurance company? They don’t do a single check-up. They don’t do a single exam, they don’t perform an operation. Medicare has a 4% overhead rate… The real question is why do we have a private plan?

S: Wait, wait. Now you’re sounding like you want the government to take over. You say why do we have insurance companies in the health care business, it’s because we are a country that is… we believe in free enterprise, if I’m not mistaken.

W: Well, tell that to people who get Medicare.

Now, skip ahead a little to 4:44 in the replay.

S: You just asked, Anthony, why have insurance companies that make profits?

W: What’s the value? What are they providing?

S: What’s the value of Wall Street companies?

W: It’s not the same thing. They’re not providing, essentially, a government service!

Now for the kicker… go to 5:15 in the replay.

S: It sounds like you’re saying you think there is no need for us to have private insurance in health care.

W: I’ve asked you three times. What is their value? What are they bringing to the deal?

(At this point, look at Scarborough’s face. He’s absolutely speechless and stares at the table for a moment.)

S: Again… I’m astounded by your question. It sounds like you’re suggesting that there’s no need to have a country that’s run on free market principles.

W: Time out. Let’s focus on one thing at a time. This isn’t a commodity, Joe. Health care isn’t a commodity.

S: You’re saying that health care is different than everything else.

W: Health care is not a commodity.

S: But you are making the conservatives’ point. You are making the point of the people at the town hall meetings who say this is Barack Obama’s opportunity to get rid of private health care and turn it completely over to the government. I’m sitting here stunned, saying Oh My God, you’re making the point of the health care protesters.

W: If Barack Obama doesn’t want to do it, I want to do it.

Now we skip to 7:15 after some cross talk.

S: You’re sitting here advocating for a complete takeover, a government takeover of health care.

W: Only if you think Medicare is a government takeover. Do you?

S: So, Anthony, I figured it out over the break. You actually do want the federal government to take over all of health care.

W: Only in the sense that the federal government took over health care for senior citizens 44 years ago.

S: You want to expand that for all Americans.

W: Correct. I want Medicare for all Americans.

It just goes on from there, with Weiner clarifying and expanding on exactly the same point. Scarborough actually thanks him for a “level of clarity” rarely seen on these interviews, where most Democrats will not come out and actually admit it. Weiner makes no bones about it. He has no desire to “reform” the health insurance industry as laid out in “The Weiner Plan” as he calls it. He wants to eliminate it entirely and put everyone in the country on Medicare.

My hat is off to you, Congressman. I agree with Joe Scarborough. Rarely do we see such refreshing honesty. You want to destroy the health insurance industry in this country and you make no bones about it. Thank you, sir, for the moment of clarity.

134 Comments

  1. I saw that interview as well and I was loving the HONESTY of Rep. Anthony Weiner. He is now a political hero of mine even though I feel his plan “ain't jiving” (translation: is loopy). But this is what I like, freakin' clarity!

    Your turn President Obama…

  2. So Joe was speechless in trying to defend insurance company profits? Medicare functions with a 4% admin margin and the people who receive Medicare tend to universally approve of it (other than it could cover even MORE medical expenses, say dental and vision).

    Jazz I think from your posting history that you are very concerned about the “trojan horse” of incremental healthcare reform, so I am surprised at your glee upon hearing a congressman finally speak the truth and having his conservative interviewer get totally flustered in his inability to refute the logic. Joe had nothing left to throw at the argument..”but…the free…*gasp, cough*…market…gasp…sputter.”

  3. jazz

    I saw this interview too. What I heard (besides your jaw dropping) was that Joe never addressed the congressman's question.

    Jazz, I take it that you believe health care is a commodity? Would that be correct?

  4. I'm not sure, Jazz Shaw, if you watched the same Weiner/Scarborough piece that the rest of us watched. Everyone I know was and is loudly cheering Weiner's views that he stated on the show this morning. Your main fear seems to be that your beloved health insurance might be taken away. I hate to be the one to tell you this, but your health insurace, as you know it today, is a slowly dying dinosaur that is plodding toward its demise. No industry can last long in this country which depends on denying its services to more and more people, all the while raising its prices and taking a larger and larger share of the profits for a select few within the industry. Your health insurace is not going to be around much longer anyway. And I would ask you the same thing that Weiner asked Joe, “What is it about your health insurance that you love so much?” Almost everyone I know hates their insurace company, and would desperately love to have another option. And for those that fear a public option, I would say, “Why not a public option?” It works in most other industrialized nations, and despite what your Republican friends tell you, (who are being paid by the insurance companies, by the way), most people in those other countries love having a public option health care system. I know you're not going to see this the same way that I do, so I will simply end by asking you, “What are you going to do when your insurance company cannot sustain itself any longer and goes out of business? What will you do for health care coverage then?”

  5. We already know that there are some people out there that want to do away with private health care insurance. We have a number of bills being looked at and worked on…this guy has his plans, Obama has other plans, Waxman has his plans…the list goes on and on.

    As TS stated…at least this guy is being clear and honest.

    It would be nice if we could get one bill to debate…and some clarity on its details.

  6. Of course health care is a commodity like any other! If you don't have the bucks just screw off and die already! And please don't whine while you're doing it. That's the Republican way!

    BTW, lurxst is right. Scarborough didn't answer the question. Other than being a profitable business what positive do they bring to the system?

  7. Well done, Jazz. How dare this clown question the value of the middleman?

  8. “Health care is not a commodity.”

    That's the key, there. And no, I don't think that any government plan (even if it's a takeover) will destroy health insurance companies completely the way folks are saying that they will be. The private security industry survives and profits despite a socialized police force. Indoor sprinkler systems are still sold despite socialized fire protection. Private Ivy League schools still exist and do quite well in the face of public funded schools and colleges. Delivery services still do well in competition with the USPS.

    No, health insurance companies aren't going to make as much money as they did before, but they won't be obliterated because a lot of folks will likely want coverage that goes above and beyond the basic coverage of a government plan. But as I said before, life and death decisions and the health of human beings is far more important (and always SHOULD be) than corporate profits.

  9. This guy was great. He forced joe to defend the health insurance companies and it turned out joe had nothing to say. It was joe's mask — and that of republicans — that we saw behind. When put on the defensive for once, it was clear who they are defending and it's not us. This is what the Democrats should be doing all the time.

  10. Jazz, I take it that you believe health care is a commodity? Would that be correct?

    Hemm, you regularly demonstrate far too powerful of a vocabularly to have even asked that question. I don't need to ask you, because I already know that you are perfectly aware what commodity means. Any goods or services which have the potential to be used for fiscal gain are commodities. And yes, insurance policies are commodities, just like everything else.

    For the most part, I've stopped responding to (and in some cases, sadly, even stopped reading) the comments for any of my posts on health care because, as I previously pointed out, this subject has turned into the new abortion debate, with both sides screaming at each other as loudly as they can and not listening.

    But on this one, some of you guys really take the cake. I have, in comments on these very pages, previously been called both “paranoid” and “silly” for suggesting that government run health care could limit or eliminate private policy options. Now that Congressman Weiner has come right out and said it, some of you are now willing to do a 180 degree turn and say, “Yes… of COURSE we want to eliminate the private health insurance industry. That's the idea!

    Amazing. There's no other word for that sort of mental gymnastics hoping to deny reality. So, for the cheering section here, let me ask you. What about all of the other types of insurance? Car insurance? Why should you have to pay for it? Why not let the government do it? How about homeowner's insurance? Aren't you “entitled” to a nice home and to have it repaired for you if it's damaged or flooded or burns down? You can't very well live without a home, can you? So why should the evil homeowners insurance companies be allowed to make a profit?

    Oh.. I forgot. You still think health care is a “right” that you have, though you can't say where it's guaranteed. Well, you're supposed to have a “right” to life, liberty and the pursuit of happiness, right? So why do we have life insurance companies? Those evil bastards turn a profit. Why don't we all have free life insurance from the govt?

    But no…. no… you go right on thinking that all health care products and services are magically created off in oompa loompa land and are trucked in to our country for free. How could they be commodities? It's all free, right?

  11. I truly believe health care is different. It obvious if you look at less developed nations and they very low life expectancies and high infant mortality rates. But I just can't get behind a full government solution simply because it gives way too much power to a central authority on an issue that is SO PROFOUNDLY DEEP. Am I saying that private industry is the knight in shining armor: no, no, and triple no. What I want is an attitude change about health care. And that attitude change lies with all of us. We have to accept that you just can't engage in ANY behavior without consequences.

    A large percentage of illness can be prevented. But when we talk about not engaging in certain behaviors that contribute to illness, many Americans balk. “You can't tell me what to do!” “Stay out of my business!” Etc… Just think if 33% of Americans stopped excessively drinking, eating, and smoking. Cost will be driven DOWN! But then people argue that you are eliminating a jobs in the drinking, eating, and smoking industries. Your right but you can't have it both ways. If your SERIOUS about health care reform, you HAVE to get serious about prevention.

    I just don't feel we need to spend what is being said for health care reform if we made prevention the holy grail. Come up with some good health tax credits and incentives. Cash for clunkers my foot. POUNDS FOR DOLLARS! This is America. Home of Hollywood, the NFL, NBA, NASCAR, X-Games, etc. Let's make it fun and drop some dollars in Americans pockets!

  12. Jazz

    So, I know you answered everybody in your post, but allow me to follow up on my single question.

    If, as you say “Any goods or services which have the potential to be used for fiscal gain are commodities,” How about our police forces? They are to be run by private companies too? These aren't specified anywhere either.

    I believe the right to security, ie police forces, are covered under the “general welfare” clause in the Preamble. I guess the issue comes down to that clause. I'd truly like to know how your interpretation of this clause fits into this discussion of what are rights and what are commodities.

    Thanks

    I know you'll probably heap ridicule upon this line of thought, but

  13. “Etc… Just think if 33% of Americans stopped excessively drinking, eating, and smoking. Cost will be driven DOWN!”

    Right, lifetime costs of healthcare for the obese? Lower than for the healthy.

    Statistical analysis of healthcare costs if everyone stopped smoking tomorrow? Slight dip in the short term, rising costs in the long term.

    You're forgetting one important thing. Everyone dies eventually. Dying sooner means you cost less in healthcare. Anything that causes you to die sooner generally reduces your healthcare costs.

    And because people shouldn't believe random statements like your or mine without some sort of verification:

    Smoking costs, peer reviewed medical article on overall costs:
    http://content.nejm.org/cgi/content/abstract/33

    Not peer reviewed, but sourced:
    http://www.usatoday.com/news/health/2009-04-08-
    “Vanderbilt University economist Kip Viscusi studied the net costs of smoking-related spending and savings and found that for every pack of cigarettes smoked, the country reaps a net cost savings of 32 cents.”

    Obesity costs, again peer reviewed medical article on overall costs:
    http://www.plosmedicine.org/article/info:doi/10

    “…total lifetime health spending was greatest for the healthy-living people, lowest for the smokers, and intermediate for the obese people.”

    Be overweight, smoke, die 10-15 years sooner; and cost less overall in health care. Your advice is a good way to live longer; but will do nothing to help health care costs.

  14. Jazz…health care is a legal right if we as a society decide to make it a right. It doesn't need to be in the bill or rights…we can just add it. I think the debate over whether or not health care is “right” within current law is silly.

    Whether or not it should be law…now that is a reasonable debate.

    Personally, I feel that health care is special…like national defense…infrastructure…law enforcement. Car insurance…not so much.

  15. Darned right, Hemm. Security is a commodity, but the police and the military are non-profit entities. If, just for the sake of argument, we decided as a nation (or a state or community) that we could afford enough police to have cops on every corner and outside of every home and business 24/7 then people would still have the right to sell the commodity of security (as in private security companies) if they wished, but they would soon go out of business, as there would be no customers. (Any of this sounding familar yet?) But the govt. can not effectively provide that much security, so the market remains open. If you proposed a plan for the govt. to provide such a level of security, you'd have to explain how you planned to pay for it, because … again… of all the commodities involved. Somebody has to pay for all of the cops' uniforms, their guns, their cars, weapons, maintenance, construction and staffing of jails, etc. But if you managed it, yes, you could put the entire private security industry out of business.

    Boy, you must be really glad you picked that example, huh? :-)

    But again, as others have pointed out, to a limited degree you actually are assured some modicum of security as a “right” of sorts. It's the federal govt's charge to maintain the military and each state has established their own systems of law enforcement to protect the citizens. Now, show us where the assurance for health insurance comes in. Not health CARE… health INSURANCE. Where is that an assured right?

    And do none of you really understand that concept of what insurance is? It's a group risk, spread around over a large number of people. The companies who do it are private and in business to make a profit. Nobody makes you have health insurance. You are free to count on not getting sick or being able to pay all of your own medical bills and have no insurance at all if you wish. But you don't want insurance. You want the govt. to just pay for your health care. If we could get people to be at least honest enough to admit that much, we'd have a starting point for a conversation, but I'm not hopeful that we will. At least Weiner admitted that he wants to destroy the health insurance industry and that he doesn't understand what commodities are.

  16. In a sane country, a single payer system would be on the table. But that idea doesn't please our corporate masters, so they use their immense fortunes and media ties to keep it from even being mentioned in good company.

  17. I stumbled in here because I Googled Anthony Weiner, looking for other blogosphere links after seeing his riveting performance this morning on Morning Joe. I had emailed MSNBC looking for a transcript, but it looks like our host has done most of the heavy lifting in that area.

    Clearly, I'm not a “moderate” as defined by Jazz's reaction. I'm not horrified — I'm electrified! The clarity of Weiner's positions in dialogue with Scarborough is a welcome relief amid all the veiled self-interest issuing forth from legislators, talking heads, MSM, town hall screamers, etc.

    I worked during 2006 – 2008 in Australia and observed firsthand what far-reaching effects guaranteed healthcare (along with freedom from fear of medical bankruptcy) can bring to a society: employees have a more level playing field with employers because the threat of losing family health care is not part of every (unspoken) negotiation, people can change jobs, relocate and/or take risks with new areas of employment without threatening the wellbeing of their family, the individual seems to internalize a concern for the health of the whole city/state/nation and many other beneficial changes in attitude.

    Health care is NOT a commodity. Our current system is an artifact of WWII wage freezes: it's not codified somewhere on stone tablets. Those whose unmasked positions are revealed to be the unexamined defense of the (unfair) status quo and/or the defense of an insurance industry which adds no value to health care while reaping obscene profits must be forced to confront and defend such sentiments.

    Go Rep. Anthony Weiner — my new hero!

  18. It's Ironic that Jazz mentions car insurance.

    What happens if your driving record is so bad no underwriter will cover you?

    In almost every state there is a public pool option.

    Why not for health care for those with pre-existing conditions?

  19. OWNED. COMPLETELY OWNED.

    Massive respect to Cgrsm. Weiner.

  20. OMG Weiner OWNED Jive Scarborough. Owned him. This man should have been pointman on this debate from day one. Obama has managed this thing terribly. We can almost believe a handshake deal between the WH and the industry industry. All Jive had was the usual Repub talking points about “free enterprise”. Massive respect to Anthony Weiner.

    Jslamen. Your comments were on the money.

  21. Gekk,

    I disagree strongly. I used to be morbidly obese (weighed 415 pounds at my heaviest). I had high blood pressure, borderline diabetes, primary lymphedema in both legs, and headed towards heart disease. My medical bills were very high (especially managing lymphedema) and I was a wreck. Now I'm am back to my college football weight of 265 (I'm 6' 3″), walk 3 miles a day, and eat much more balanced. I have shaved 95% off my medical costs. 95%!! My high blood pressure has disappeared. No longer borderline diabetic. Heart disease? What heart disease! My lymphedema will always be with me but you can't tell (my legs look normal instead of being swollen) and it SO easy to manage with some compression socks. I'm living proof of being “low cost” to the health care industry by changing behavior. So it's not all about dying sooner. It's about the cost of just living with the conditions I had.

  22. My medical bills were very high (especially managing lymphedema) and I was a wreck. Now I'm am back to my college football weight of 265 (I'm 6' 3″), walk 3 miles a day, and eat much more balanced. I have shaved 95% off my medical costs. 95%!!

    First of all, T-Steel, you have my profoundest respect and admiration for that accomplishment, and I mean that. Unfortunately, I don't understand what your larger point is with regard to the health insurance industry and health care reform. Presumably, you lost all this weight under medical supervision — especially given that you specifically say your weight-related medical conditions had to be “managed” while you were losing the weight. Did you have health insurance to pay for that medical supervision? Or how did you pay for it?

  23. I am not prepared to debate the merits of single payer versus public option versus coops versus insurance pools versus no change. But as a political point, I agree very much with Shannon Lee's earlier comment. Yeah, some congressmen are in favor of single payer. It's a respectable position as many countries use it to some success. Of course, there are drawbacks as well, and so many more do not support this notion. Apparently, Obama, for instance, does not support the move to single payer, largely, it appears, because the transition would be so enormous. I don't know why one Congressman arguing for single payer rips the mask off of anything unless we fall back on “the Left has one mind” idea.

  24. Kathy, I think t-steel's comment is just in opposition to gekk's comments that we save money from obese people in the long run because they die faster.

  25. Jazz — Health care will be free no matter who is running it. We pay for it now — we would pay for it if govt runs it. (Unless you assume none of us commenting here are taxpayers?) What Weiner argued very effectively is that we (the people) would pay less if govt. ran it. Simple and true. That's why he was so effective.

  26. I meant to say — health care will NOT be free no matter who is running it.

  27. Hi Kathy and thanks for the kind words. When I say managed, I was taking about my lymphedema condition that had to be strictly managed while being morbidly obese. If I left a compression garment for a minute, my legs would swell like crazy. So the managed part was for the lymphedema aspect. As far as losing weight under medical supervision, I went to my family doctor and was referred to a dietitian. The dietitian set me up with a great program that effectively destroyed my poor eating habits. During the weight loss period, various conditions of mine started clearing up of becoming more easily managed. And of course I had to visit my family doctor from time to time.

    But I see where you are going with this Kathy (especially considering the uninsured). What I am saying is that entire health care issue COULD cost less and cover more by investing more into preventative medicine. I want the uninsured covered but I don't think we need to overhaul the entire system. The best way to get the insurance companies “in line” is to use them less. If we get serious about prevention and behavior modification, we can take some volume out of the system that can be used for “uninsured” coverage, accidents, and non-preventable illnesses without spending AS MUCH. I'm trying to be as equitable as possible. It annoys me when a heavy smoker complains about getting gouged for health care when he/she has to go to the doctor to treat illnesses related to the heavy smoking. How about working on the heavy smoking.

    To me, health care isn't just about services provided, it is about better health. Yes, let's get the uninsured covered (numbers are debatable but I'm not going there right now). But we need a serious culture change regarding our health. Government nor private industry isn't the total answer. We have a lot of answers and it starts directly with us.

    I hope I'm more clear. LOL!

  28. Weiner should have been out in front on this. Then people would understand that Obama's plan is a reasonable compromise. Weiner's idea of Medicare for everyone represents what some (not all) on the left want and it is a reasonable possiblity that should have been considered by the American people. As a country we all lose when fear rules the day so that we can't even talk about the range of options available to us.

  29. Hi Patricia and welcome to The Moderate Voice.

    So you have absolutely no issues with full government control of health care that Rep. Weiner (who I absolutely respect for being straight up honest and direct) believes in? No problem with that level of centralization? I'm not being sarcastic, just very curious.

  30. I don't watch MJ because my stomach can't take it. However thanks to dailykos I found out about this interview. Weiner is my hero. He stopped Joe in his tracks. The silence when he asked Joe what insurance companies bring to the table, was priceless.

  31. T-Steel, I think Gekk's point as it applies to you was that while before you might have had a lethal heart attack five or ten years down the road, you now have a much better chance of living long enough to get one or more expensive somethings. You might appreciate the not dying part but it means extra health care spending in the (very) long run.

    On an unrelated note, car insurance is different for two major reasons:
    -If you can't afford a car, it might cause problems but it's not as bad as dying
    -If your car is too badly damaged you write it off. How does a $20k lifetime cap on health insurance sound to you?

  32. I understand Ryan. But so we should just overhaul a system without being serious about modifying behavior? All I see is single payer, public option, etc. But no behavior modification talk. How can you inform a large system that affects our lives SO much without really examining the “behavior quotient” with severe earnestness?

  33. Hi T_Steel and thanks for the welcome. I found this site by googling Weiner and Scarborough because I wanted to see what others were thinking about their discussion. Never been here before.

    To answer your question, Weiner never said he wanted full government control of healthcare. He stated very clearly that he does NOT want that. The hospitals and doctors provide healthcare. He wants full government control of health insurance — just like Medicare.

    I don't know about you but dealing with my private health insurance company has not been a picnic. And so far, thank God, no one in my family is even sick. On the other hand, my mom is on Medicare, my dad was covered by VA (disabled vet), and they didn't have many problems getting the care they needed. None at all, in fact and they had some significant health issues as they aged.

    I am not naive enough to think we will have single payer. But single payer is not a crazy whacked out left-wing idea as the media pundits would have us believe. It should be considered rationally, along with all the other ideas on the table. I think the American people are being cowed by fear again, and it's a sad sight to see. On the other hand, I'm glad to see the debate return to reality after a crazy turn at the town halls.

  34. Patricia Maher said: “But single payer is not a crazy whacked out left-wing idea as the media pundits would have us believe. It should be considered rationally, along with all the other ideas on the table.”

    I agree 110%. I absolutely detest the demonization tactics used by some on the Left and the Right regarding this issue.

  35. Jazz

    “Security is a commodity, but the police and the military are non-profit entities.”
    “Boy, you must be really glad you picked that example, huh? :-)”

    You're exactly right. The police are a commodity that is no where mentioned in the Constitution. Don't even think of calling the police an offshoot of the militia, they're not. Security is a right not specifically enumerated, yet it is a right in which we all agree.

    So Security is a right, or so it would seem considering that cops are paid for via taxes, that's state, local, and federal taxes. No one in their right mind would even consider making the cops a for profit enterprise. Or by your logic, is that what you now advocate? No, the right of security is universally acknowledged and provided by the government. If you wish more “insurance,” feel free to purchase from the private sector.

    Which brings us to health care, the right, not the commodity. The commodity is health insurance. Just as you can purchase additional private security, you are free to buy insurance to cover expenses not covered by a government supplied right for health care. And yes, that right exists under the general welfare clause in the preamble. Jefferson made the case that the general welfare clause supported manufacturing interests, but you already knew that. I submit the door he opened allows the right of health care for the populace. You know the argument from there.

    I look forward to hearing how you trash my argument and yet explain the general welfare clause.

  36. Jazz I have to agree about the arguments on this issue. Given that one side has a degree of misinformation and disinformation which actually proves that ignorance is NOT bliss, while the other side has a whole lot of information that either folks won't listen to and the disseminators (media) won't give air, print or bandwidth to. The Morning Joe interview was a significant exception to the latter.

    I would suggest that some of the confusion about the argument and the intent comes from folks not operating with the same information base. For instance. Of all the insurance and health care providers in America, based on care outcome statistics, the three best are: the active military, the VA – both true socialist systems- and medicare (a single payer system). So the US Gov holds the triple crown in delivering high quality care, with taxpayer dollars, for a much lower per-capita amount. Medicare was established 44 years ago, it was up and functional in less than a decade. NASA began in 61. In 8 years there were two Americans and a flag on the moon.

    In 60 years, the private health insurance industry has created a 'health care' system which delivers enormous salaries, terrific ROI for investors, also being a travesty and tragedy for Americans who need health care. Instead of being effective, efficient and world respected, it is unraveling, taking the US economy with it.

    A significant amount of misinformation that has been thoroughly debunked (how bad other industrialized health care programs are), yet the ideas still are trotted out by individuals and media. Without the counterbalance of debunking information or sources. Very interestingly, the 12 million health care workers are treated as though we have nothing to add to this discussion.

    Don't trust anything the health insurance companies are saying. If we have to do more regulation 'to keep them honest', there is clearly a problem with ethics to a degree that government bureaucrats cannot dream of. This is grossly apparent in the financial industry as well. Which has also brought the country to its knees because they got into really high stakes gambling with other peoples money.

    Ask your physician if s/he would like to go to a billing system that involved just the Federal Government. The majority will tell you YES. The stats bear this out. They are spending far more time and money on billing and appealing denials than is necessary for Medicare patients.

    This amount is so much higher than what is spent on malpractice insurance and claims, it makes the tort reform argument look idiotic. Keep in mind, this is not the 27% administrative costs that the insurance companies charge over the 4% administration fees that Medicare costs. This is another significant percentage which varies according to type of practice.

    It has long been considered that going straight to single-payer would involve too much detangling, restructuring and job losses in the insurance industry. The public option has been one of the transition ideas that could be implemented to eventually establish a totally single payer system, or to progress until we find a balance in the public-private mix that works well.

    Just to sum up, the biggest problem with the whole debate is that people who have vested interests, or have just joined the discussion, are running them or creating too much noise to to have one. The people who have been involved in health care delivery for decades and studied the problems from every possible angle, are usually not allowed at the table or consulted by the media.

  37. From lousgirl84:
    Weiner is my hero. He stopped Joe in his tracks. The silence when he asked Joe what insurance companies bring to the table, was priceless.

    This one is definitely worth addressing, and perhaps because some of you don't watch MJ very often and you simply didn't grasp what was going on. So many comments here were like this one, somehow imagining that Weiner “stopped Joe in his tracks” or left him “without an answer.” It's incredible. Scarborough was in no way without an answer… he was obviously shocked that anyone – particularly a seated member of Congress – could even ask the question in the first place.

    What does an insurance company “bring to the table?” Really? Do some of you honestly not understand the obvious answer to that question? I was being mostly tongue in cheek before when I asked if some of you understood how insurance actually works, but now I have to wonder if you don't.

    Granted, I've heard some obscure arguments against insurance in general based on the premise that it's a form of gambling, so they oppose it. And, in general, it's true. It is very much similar to gambling in that you're making a “bet” with the insurance company every time you take out a policy. If that's your objection, then fine. I don't happen to agree, but I will respect your opposition to gambling in any form.

    But for those of you who missed the Cliff Notes, what insurance companies “bring to the table” is a pool of funds. They amass those funds from people who want “insurance” against the fact that they may get serious injured or sick, or have a car accident, or their house burns down. For all the people who do not have that happen, money goes into the pool. If you are one of the unlucky ones who has those things happen, the money is then there to pay off your debts incurred from such unfortunate occasions. How Weiner didn't know this is a mystery, but if you want someone that dense making policy for the government, I have to question your stability and understanding of exactly what insurance is.

    Weiner may as well have been asking Joe what Whole Foods “brings to the table” when they sell you a head of lettuce. Did you people know that those bastards at the grocery store actually have the nerve to charge you more than what they pay for each head of lettuce they present in their stores? The fact is, you don't have to shop at a grocery store. You can grow the lettuce yourself. Or you can drive out to a farm and negotiate to purchase it from the farmer. But you pay more to them because they are providing you with a service and they are in business to make a profit. There is NO DIFFERENCE between that and what insurance companies do. Nobody is making you buy insurance.

    Joe Scarborough was flabbergasted (along with many of us watching) that somebody that astoundingly stupid could sit in that chair and ask such a nonsensical question. What do insurance companies bring to the table? How the hell did you get elected? This is your hero?

    We're in deep doo doo if that's your hero. The man is an idiot.

  38. Jazz, do you somehow not understand that some members of Congress, even those in the same party, may disagree?

    It just goes on from there, with Weiner clarifying and expanding on exactly the same point. Scarborough actually thanks him for a “level of clarity” rarely seen on these interviews, where most Democrats will not come out and actually admit it.

    Is it not possible that those Democrats who “will not come out and actually admit it,” don't actually want what Weiner is advocating? Or are they all just lying about their secret plan?

  39. For Ginny in CO …By the way… nice name. My Mom is Ginny. :-)

    For instance. Of all the insurance and health care providers in America, based on care outcome statistics, the three best are: the active military, the VA – both true socialist systems- and medicare (a single payer system). So the US Gov holds the triple crown in delivering high quality care,

    There are two major issues with your portion of the discussion to address. The first, while important, is not as germane to the topic at hand but is worth a look. Speaking as a veteran who had to make use of VA services myself and a follower of news on the subject today, VA healthcare is actually rife with problems. The level of care we deliver to our vets is often disgraceful and they deserve much better. One of the jewels in the public care “crown” you failed to mention is another govt. run system… that for Native Americans on reservations, where the conventional wisdom remains, “Don't get sick after June” because that's when the money runs out. But both of these deal with the actual delivery of health care services, not the payment for those services and private industry insurance issues.

    To that, when you point out how successful Medicare and Medicaid are, for example, what you fail to tell us is the other side of the story. That's the fact – and yes, it's a fact – that the govt. does not pay the full bill required to cover the cost of services rendered, and doctors uniformly let us know that they pass those extra costs on to the people with private insurance. The Govt. covers something between 85 and 90% and the cost for the rest gets spread out over the rest of us with private insurance. If, as Weiner suggests, everyone is on govt. care, who will pay for the rest? The answer, as is so often the case with some of these Democratic proposals, is either “nobody” and it gets tacked on to the debt, or “we do” in the form of higher taxes across the board.

    I understand the desirably nature of this unicorns and rainbows theory where we can all punish the evil insurance companies who dare to make a profit, but health care (even if you think it's a “right”) costs money and somebody has to pay for it eventually. Top down price control attempts by governments have been uniformly disastrous sooner or later, and this one is no different.

  40. “…life, liberty,and the pursuit of happiness, and that to SECURE these rights, governments are instituted among men, deriving their just powers from the consent of the governed.”

    Jefferson wrote it – the proper purpose of a government is SECURITY. Primarily, it is to secure rights. We willingly surrender a small portion of our possessions to pay a government to be a big force operating within our laws in order to squelch other forces (domestic bandits and foreign invaders) operating outside of our laws, so they don't infringe upon these rights.

    That is the only role any government has ever played well.

    Compassion is done well by individuals, civic groups and churches. They don't have to use force to be compassionate, as governments must, even when governments force the minority to do the will of the majority.

    I do not want any government to provide my health care, prescription drugs, or retirement. I do not want any government to feed me, clothe me, or educate my children or grandchildren. I do not want any government to make arts and humanities available to me. I do not really even want any government to transport my mail.

    I want a government dedicated to the protection of those few basic rights. Otherwise, I want every government to remove its influence from my life and its hand from my pocket.

  41. Anthony Weiner's clarity is to be applauded. Kudos to him.

  42. “…life, liberty,and the pursuit of happiness, and that to SECURE these rights, governments are instituted among men, deriving their just powers from the consent of the governed.”

    Jefferson wrote it – the proper purpose of a government is SECURITY. Primarily, it is to secure rights. We willingly surrender a small portion of our possessions to pay a government to be a big force operating within our laws in order to squelch other forces (domestic bandits and foreign invaders) operating outside of our laws, so they don't infringe upon these rights.

    That is the only role any government has ever played well.

    Compassion is done well by individuals, civic groups and churches. They don't have to use force to be compassionate, as governments must, even when governments force the minority to do the will of the majority.

    I do not want any government to provide my health care, prescription drugs, or retirement. I do not want any government to feed me, clothe me, or educate my children or grandchildren. I do not want any government to make arts and humanities available to me. I do not really even want any government to transport my mail.

    I want a government dedicated to the protection of those few basic rights. Otherwise, I want every government to remove its influence from my life and its hand from my pocket.

  43. “I take it that you believe health care is a commodity?”

    Hemm – going by your logic, do you and the others who do not think that health care is a “commodity” think that food and shelter are commodities? After all food and shelter are just as important to human life as health is. Do you think it is the governments place to guarantee everyone food and shelter in addition to health care?

    LL

  44. They operate on a 4% overhead cost yet are still going broke. If rising costs are such an issue why is tort reform not at the front of the discussion? How is it that these private insurance companies have a huge overhead cost yet are still profitable? Could it be that our govt is not efficient at anything it does? Shall I discuss social security, medicaid, post office, medicare, federal debt and deficit? They know not what a budget is. Lets regulate and control costs, give vouchers for those who can not afford insurance and have everyone in the pool, I will guarantee costs will go down tremendously with these changes.

  45. Another point, medicare reembursement rates are atrocious. Getting 30-40cents on the dollar that limits the number of patients I can take that have medicare or medicaid. If this happens and the reembursement rates remain the same, you will see a massive efflux of primary care physicians.

  46. LadyLogician

    Let's see, we pay farmers to not plant so that the market is stable. It also provides food stamps and unemployment payments when people lose their jobs.
    We provide public housing for those who can't afford the more expensive private housing.
    The Fed also has a national oil reserve that buys oil and holds it against possible fluctuations in the market.

    So I guess my answer would be we already have accepted the government's role in common commodities.
    I take it you would prefer that these programs be eliminated?

  47. Jazz what you and several others have touched on is, to me, the fundamental debate that is not held enough on the talking head shows. My father insures doctors for malpractice making a six figure income. He obviously has a lot of connection with the health industry/insurance/etc. and has a lot of knowledgable opinions about the whole thing. I'm a working class musician making (hopefully) 50K a year, haven't been able to get insurance for a while until recently when my wife's employer began offering reasonable, if somewhat skimpy health insurance. While having a civil if somewhat lively discussion over the issues with my pops, the problems, and the solutions to what is an obvious mess of a health care system, we discovered that there is an impasse with our philosophies. He believes as you do. Health insurance and the care that follows are commodities like a nicer house, or a boat, or tickets to the opera, or anything that can be afforded by the consumer. I have no problem not begrudging certain acroutement of lifestyle to those who have worked hard and prospered, but I believe health care in this country is a right and NOT a commodity. In an age when every industrialized nation save the US of A has found a way to offer their citizens basic care, it's inexcusable to tell someone who cannot afford health insurance that no matter how hard they've worked, their lack of expendable income is enough reason to deny them some reasonable access to a health insurance plan. And to answer your questions about other forms of insurance, if my home, auto, or life insurance were as outrageously inaccessible and expensive as health insurance, then we'd all be up creek with no paddle. There are also a myriad of government programs and monies that have saved or assisted victims of natural disasters, helped farmers like my grandfather who received subsidies when things were tough, and made grants for brilliant students like my wife get through grad school. All those things improve lives in this country which makes for a better society overall. I believe that a healthier and more secure middle class is what will make this country better, not Aetna and BC/BS making a nice profit in the third quarter.

  48. As a Canadian I obviously come from a much different experience but I have found this entire debate over the last few weeks fascinating. I too was impressed by Congressmen Weiner's candor on this matter however what I have difficulty understanding is why there is so much fear of government run insurance in the first place?

    Our system up here is by no means perfect and neither is any other countries system however, the thought of providing health care as a for-profit industry is incredible. Shouldn't it be mandated that health care be provided as a non profit service? I can think of no reason why any American would want to support the idea of paying out giant insurance companies massive profits in order to get medical treatment when you need it except fear generated by these very same insurance companies who want to go on profiting every time you need to see your doctor.

    The obvious solution seems very simple, the US government pays your doctors directly and not insurance companies who's paramount interest is to turn a profit.

  49. jhayes
    “They operate on a 4% overhead cost yet are still going broke. ”

    Private insurance operates on a 30% overhead and has increased profits by over 400% since 2003.

    The answer to affordable health care lies somewhere between the two. Maybe that's the discussion that needs to take place instead of the current all or nothing debate.

  50. HemmD,

    I would agree, I do like the idea of co-ops or not for profit that is run as a company that must be efficient and offer viable plans at affordable rates, but as stated earlier we need to address costs first and foremost before we can even consider anything else. I just wonder why more is not being done on the cost front. The notion that preventitive care will drastically reduce costs is a misnomer.

  51. Jazz — There is a difference between “what does a health insurance company do” and “what does health insurance bring to the table”. Did you really honestly think that the Congressman and the readers who liked his response don't know what a health insurance company does? We know what they do; we're not actually idiots. We think that there are myriad better ways to do it, and these ways are being used in most other industrialized nations in the world. So, the point of the question is: Why are insurance companies so darn valuable that they can't be replaced with a better system? Now, posing the question as to whether a certain system is better than insurance companies as they work in this country now is something that we can debate, but it does start with the question: what do insurance companies bring to the table? Why is *this* system worth perpetuating?

    Also, a person's body is actually different from a head of lettuce. Or a car. Just sayin'.

  52. Jazz — It seems like it's standard for Republicans to ridicule those who disagree with them, instead of arguing the facts. You ridicule those commenting here, implying they don't understand insurance. For the record, I am in the insurance industry, and in fact, wrote textbooks on life, health and property/casualty insurance. I know exactly what I'm talking about. What I saw when I watched Joe was a complete inability to answer a simple question. It's as if he (and many Republicans) think using the phrase “government takeover” means you automatically win any argument. We're all supposed to cower in fear when it's uttered. That's just plain lazy. Republicans have been hiding behind Ronald Reagan's slogans for a long time. I think the jig might finally be up.

  53. @jhayes “They operate on a 4% overhead cost yet are still going broke.”

    It's important to remember that Medicare/Medicaid operate at a loss because they don't cover everyone — they cover, specifically, only the sectors of the population that is by far the most expensive: the elderly, the disabled, the extremely poor. In fact, insurance companies make their huge profits because they *won't* cover these groups. If the government programs could cover a wider range of people — including one of the healthiest but least insured groups, 20-somethings — they would be able to break even, or at least come much, much closer.

  54. Hemm – actually I do think we should get rid of farm subsidies but you still didn't answer my question.

    If “health insurance” is a right and therefore not a commodity, why shouldn't we put food and shelter into that same category? After all they are just as “necessary for human life” as health……

    LL

  55. jhayes
    “I just wonder why more is not being done on the cost front. “

    My belief may seem jaded, but consider the simple fact that private health derives its profit from a relatively small percentage of the total negotiated contracts it makes. Isn't 2-3% of a 100 million more than 2-3% of 50 million? I'm afraid care costing less just reduces their profits.

    Its also the reson blue dogs have axed set pricing for drugs and made illegal their import from Canada. That's the problem that keeps price reduction out of the discussion.

  56. Patricia,

    The fundamental issue is whether you think the govt will do a better job. No matter how you cut it, there will have to be rationing as there is in almost every country with socialized medicine. Many are not willing to make that concession.

  57. jhayes, to your point about medicare reembursement rates, this is definitely something most people advocating for the program don't bring up. However, we do not see this trend in countries with single-payer programs. While doctors in those countries don't make as much as doctors in the US, they also don't spend half of their time on the phone with insurance companies, nor do they have to spend the astronomical amounts on malpractice insurance. They take the pay hit, but work 40 hour weeks, like normal people, and don't have to be constantly worried that they'll be sued.

  58. roro,

    You hit on the fundamental issues that should be addressed prior to any single payer system or insurance overhaul. Physicians in this country will run for the hills if the current rates are applied along with the current tort laws.

  59. jhayes 71 — Because no one has been effectively explaining that health care is being rationed right now by insurance companies with a profit motive. Why trust a for-profit more than you trust a nonprofit entity? I've worked for both profit and non-profits and don't see that for-profit moves any faster, is more effective at cutting waste or coming up with creative solutions to problems. In fact, the CEO at the last for-profit company I worked for is in prison for falsifying profits to boost the stock price. Of course, there are good and bad in both, but at least the government is US. When we finally disabuse ourselves of the unthinking, kneejerk reaction against government, maybe then we can have a logical, fact-based discussion of our options.

  60. LL
    first
    I never said health insurance, I said health care. insurance is a private industry device.

    So you're willing to pay $12 gallon for milk? I suppose you can afford it.
    I happen to believe people require help as they need it. To that end, giving food or shelter to the hungry or the homeless is a national responsibility.

    Your debating tactic is of course easy to return. Are you willing to allow people to starve and children to be be homeless waifs in our cities?

    Maybe your question posed to me is little too contrived. I would rather discuss the real issues, not all-inclusive theoreticals that sound astute, but belie the real issues at stake.

  61. “Physicians in this country will run for the hills if the current rates are applied along with the current tort laws.”

    Where are they going to run? China? UK? Canada? Most 1st world countries have government health care plans and doctors that are paid less than US doctors.

    NOW..to be fair…here is the real issue.

    We have a shortage of doctors and have been imported doctors from overseas for quite some time now. Some people are talking about reducing the number of exams that doctors need to pass in the US in order to work here…all an attempt to get more doctors here.

    IF, we go public and reduce what we pay doctors…we no longer give them a reason to leave home and come here.

    That is a real issue. I also completely agree that our tort laws MUST be changed. Reducing malpractise insurance is a must.

  62. I understand the desirably nature of this unicorns and rainbows theory where we can all punish the evil insurance companies who dare to make a profit, but health care (even if you think it's a “right”) costs money and somebody has to pay for it eventually.

    And you would rather that somebody is you, and that you pay more for it rather than less?

  63. Navigator, the word “secure” in “secure those rights” has nothing to do with the word “security.”

    “Secure those rights” means to get and keep those rights — to ensure that we will have them and continue to have them. It refers to all our rights enumerated in the Constitution — free speech and press, freedom of religion, the right to a trial, all of that. “Secure those rights” does not mean “right to security.”

  64. These healthcare threads are truly generating the most discussion I have ever seen on TMV.

    I agree with many posters that there does appear to be some disconnect in ideology over what healthcare is, a basic right that we want to afford ourselves, or a commodity where only the privileged can afford. If the will is strong enough, there will be minimal problems in coming up with a way to pay for universal coverage for all. I think there is a tremendous amount of misinformation and effort being spread by those who stand to lose money due to changes. So, thats it, money. Money is more important than our public health, our competitiveness in the world market, more than freeing millions from the yoke of lack of preventative care or rehabilitative care.

    Oh I did find one innovation from the Health Insurance industry. They invented the “pre-existing condition.”

  65. Simple question Hemm. If health CARE is a right because it is necessary for human life and it is is SO necessary that the government must guarantee it, why is food and shelter, which are equally necessary to human life not guaranteed by the government?

    Acrtually you already answered my question…if government guaranteed food will give us $12/gallon milk what makes you think that government will be able to control the cost of health care if they take IT over?

    LL

  66. LL — I think you missed Hemm's point. The government subsidizes food so that you DON'T pay $12 for a gallon of milk. So, in order to provide enough food for the people, the government most certainly does pay farmers to farm. The items they pay farmers to farm is another question, and certainly has been criticized, but make no mistake: the federal government has a heavy hand in keeping the populace fed.

  67. LL — I think you missed Hemm's point. The government subsidizes food so that we DON'T pay $12 for a gallon of milk. The particular items the government subsidies pay farmers to farm are often criticized, but make no mistake: the government already has a heavy hand in keeping the populace fed.

  68. Jazz,

    First, the studies addressed the care outcomes, a very important key to how to spend our health care dollars. The point being that you can have really good care at lower cost than is spent by the insurance companies. Second, the access problems for VA are definitely an issue for me and have been for 2 decades at least. The problem with those issues are that they directly relate to Congressional limits on funding. I totally resent that some Vets are not considered eligible because of the inability of the program to spend as much money on their health care as we do on the wars the create the need for it. I have said for most of those decades that the first debt America MUST pay is the health care for all the vets who deserve it. We have to get over the idea that our tax dollars are being wasted by this.

    The budget for our House of War is, as I pointed out, the ultimate example of how much gov can achieve when it is financed so far above and beyond the actual need. Yes, it is one of the Constitutional directives for the government. On amphetamines, growth hormones and steroids. To have an annual budget 15% more than the COMBINED total military budgets of all other nations is indescribably absurd. It is the result of the Gunbelt industries that own Congress. We are way beyond the standing army the founders did not want established. I would be the first to point out the world has drastically change since then. Not that much.

    Medicaid is NOT medicare. It is not as effective or efficient as the other payment systems. Because it is a federal and state funded program which is state administered. As the government has cut back on funding many programs, the states have had to pick up the differences – for more than medicaid. One of the bills contains a very intelligent plan. It would do away with Medicaid and put all those individuals on the Public Option. There are several ripple effects in this whole dysfunctional system. Cutting the excessive costs that providers incur due to the complexity of the billing (and denial) system allows more money for primary care. A statistic I used in the 2004 campaign : in Colorado 20% of the kids were on medicaid. In Colorado Springs main hospital, 50% of the kids in the Pediatric ICU were on medicaid. Due to the low reimbursement to providers, the parents often could not get care with a primary care physicians (family or pediatrician) because they could only take so many patients per practice (cost shifting the care to those with insurance). So the parents had to wait until an ER visit was necessary, which all too frequently resulted in an admission, including the ICU kind. Much more expensive in the long run than raising the reimbursement rates. Putting this group into the public option will take them out of the third class system they are currently in.

    The inter-related loop of all these underpayments, cost shifting and inadequate access has been studied and solutions proposed for decades. We keep falling back on the idea that the magic market system will take care of it. The facts do not support this as much as the facts that the Government can manage a variety of health care systems quite well.

    The IHS? I have some direct experience with this because as an RN in Alaska for 14 years, I saw a lot of the system. It can be just as excellent as others. There are some significant issues that have nothing to do with the government or health care that contribute to the severe, disgraceful and immoral problems there. The first is the reality of how this nation has treated Native Americans for 520 some years. The related problem is discrimination, very simply. Yeah, it needs to be overhauled, big time. The IHS is part of the PHS, which is difficult to put into that type of assessment because much of the care is directed at epidemiological problems and maternal infant care.

    Your concerns about who will pay for the rest reveal some significant gaps in the knowledge base on how the whole system is so tangled and inefficient, there are many savings that could easily cut many of those costs which the CBO cannot really assess. Meanwhile, the CBO and OMB have both looked at the bills to determine what additional funds need to be raised. Obama has talked about some of the ways the bills address this and what else can be done. Seems to me that out of 544.7 million, a few million could be cut without anyone feeling much pain. Just ask Winslow Wheeler and Franklin Spinney. Full disclosure; I married into an Air Force family and lived near Elmendorf (where my brother in law worked) for 11 years, working with a lot of military wives. Ultimately, Americans have to face the reality that we also have to face up to whether we are ever going to pay for what we want through our taxes. This is particularly due to the prime contribution to the debt: WAR.

    The reality is that given what most of us are already spending on health care premiums, deductables, and co-pays, the competition from the exchange is expected (per the CBO and OMB evals) to cut some of those expenses while increasing coverage for both the policy holders and uninsured.

    Obama has zeroed in on electronic technology that would be a big help in decreasing health care communication costs and gaps. Another one that has been in the works and should be part of this are established health histories. Hippocrates maintained that 95% of diagnosis is (medical) history. Today I would put it at about 80% due to the amount of diagnostic testing we have available. The other pieces is a really thorough physical assessments. When an elderly person is admitted to an ER and hospital due to illness, their memory is too dysfunctional to provide a complete and accurate health history. Plus it's an unnecessary time waster to recollect the data that has not changed. If the physician can get a very complete history from the electronic record technology, they can start there and be more focused on the new signs, symptoms etc. I can't find the stats on the amount of unnecessary tests, treatments and cost of delay of appropriate treatment, but it is quite significant.

    While I understand your concerns and frustrations, it's quite imaginary to accuse someone who has been involved in health care in this country as much as I have, and extensively studied the new information and statistics, to be advancing a 'unicorns and rainbows theory.' Try spending even a week in the tough reality of bedside health care in an acute care facility and see if your perspective is a little more reality based. I have worked every critical care unit except NICU, and including the 'Thermal unit in AK -for burns and frostbite. Every regular floor and a jail unit, a very small amount of ER, almost as many years of home care and enough insurance case management to know just how they think and operate.

  69. LL — The question of right vs. privilege is a straw man argument. People are getting healthcare and will continue to get it. We are paying for it and will continue to pay for it. Let's be smarter about how we do it so costs go down, and outcomes improve.

  70. The right vs. privilege question is a strawman argument. People do get healthcare. They will continue to get it. We already do pay for it, and we will continue pay for it. The relevant and practical question is what is the smartest, most efficient way to get quality care for the greatest number of people?

  71. Single payer and single payer only. I personally don't care if the bloodsuckers running the insurance companies starve to death.

    I personally have TOTAL medical coverage. I have no problem with the expense of health care in the US. It is all covered. My problem is allergies, fantastic number of allergies so I moved to a third world part of a second world country where they cannot afford to buy chemicals to put on the food or in the fields.

    Do you have any clue as to how many chemicals are in your hospitals? How many patients are killed each year because doctors are god? I do. I am allergic to penicillin. Three times in my last 10 years in the states, I had doctors prescribe a shot of penicillin for me. The last doctor that I dealt with in the states gave me a prescription for a pain killer with acetaminophen. Refused to change it. I had to have pain killers to get home. I was shitting blood by the time I got to Miami. Should his license be pulled? Fuck, yes. But the tightest richest union in the us is the AMA.

    However, I live somewhere where I have 6 excellent doctors that do HOUSE CALLS. The most expensive, and the only one who does not speak perfect english, is my psychiatrist. The MOST expensive is $30 american for an hour.

    Feel like you are being screwed, you are.

    I spent 7 weeks in the hospital with a problem that would have killed me in the us. Here, I paid cash for everything and when I got out of the hospital, I had more money in my bank account than I had before from my pension.

    Word had passed up through the grapevine that an american was in a public health service hospital. The head of Health Services flew 1800 miles round trip twice to try and talk me in to going to the states, I refused. The head of the hospital system flew down once begging me to ask for a Medevac flight. I totally refused. Their national pride would have been hurt if I died, they went beyond what anyone in the us would have done for me.

    I bumped into someone on a blog who has a friend that suspected she had cancer, but couldn't even afford to go to a damn General Practitioner. I have paid her way to a country that has better results from health care than the united states. Yes, it is cancer. Yes, they operate tomorrow. I lost my soul in vietnam but no human will die if I have enough money to pay for necessary medical care. I am a total atheist, so many of the comments that I read on these blogs make me look like a fucking saint.

    I am so ashamed of my country and it's “all for me, none for you” attitude.

    Wars that are going to increase the number of my fellow veterans on the street from 100,000 (over 7,000 female vets on the street) to what 500,000?

    Now tell me again how important it is that one man, Microsoft's Bill Gates needs all of the money he has and the money he will get in the future. How many damn meals, housing, and medical care is his family going to need for the next twenty thousand years? The interest on the interest on the interest would keep the Gates family comfortable for the next thousand years.

    Compromise shit. Hang any bastard who takes the insurance companies bribes, then hang the briber, then hang the Chairman of the board, with the president of the company and the rest of the board of directors.

    How many of you have stock in insurance companies? Rockefellers do, Kennedy do, Mellons do. Buffet doesn't, he just dumped all of his insurance stock.

    But do you?

  72. joeinhell, One thumb up… your points are well made… And if Berkshire Hathaway is panning the industry I think I'll buy another 1/4 share (I can't afford more than $25,000) can't afford more in this economy.

  73. Ginny you need to run for public office!! You have nailed these weasles at every turn! KUDOs to you! I too live in CO and came to this site to see the video of Joe “mourning” getting a schoolin'. This has been my question all along: What do health insurance companies add to patient care and atient outcome? Answer: NOTHING! so Why do they take 30+% of our health care dollars??? If every health insurance company disappeared tomorrow, would we as a nation be able to provide health care? *BTW: My wife is a 25+year RN. Mom is a retired 40year RN. Universal Single Payer's time is NOW! Call your reps. every day. It only takes a min. and they need to know that we sent them to do this for us! Thank you!

  74. The best Joe could muster as a response was something like, “Well, you have a very different ideology.” I would have liked Congressman Weiner to reply, “Yes, and I think I've explained it very well. I haven't heard you offer any defense to your own ideology.”

    Weiner was awesome. His arguments were lucid and complete. I want to see him go far.

  75. THANKS to MSNBC for having Anthony Weiner as Joe's guest. Americans are getting sicker with either no health insurance or one they can't use due to high deductibles, co-pays, etc. Without a single-payer plan, we cannot compete globally. U.S. car manufacturers are insurance companies who just happen to make cars. Canada builds cars for $3,000 LESS than the U.S. because the employers don't have to provide health care. Also, despite the lies re Canadians not liking their national plan, when given the choice of signing up for a private plan, not ONE person signed up! ASK your legislators get behind Rep. Weiner and really make a difference for the people, instead of keeping the insurance companies rich!!

  76. You seemed to miss that Weiner is speaking for himself, no Obama, not Democrats and not “libruls”. Obama has made it clear that given the current US system, single-payer is not achievable (too disruptive or wouldn't pass, take your pick). That doesn't make HR3200 a Trojan Horse.

    I don't shop around for health care based on price. I also don't pass on surgery because it isn't in my budget, and I certainly don't need an insurance company “helping” me find a doctor. We have “middle men” to sell electronics, furniture, or clothing because it is a tad difficult going door-to-door in China looking for the right material in color. Health care is different. It is not a commodity.

    You know it, and Joe knows it.

  77. To use your word, 'Amazing'. That you would attempt to compare an automobile or a home to a human life? A damaged roof to a broken leg? Rust to cancer? BUT I will grant you this…the two types of insurance you mentioned, auto and home, are legislated. They are required in order to drive a car or own a home. But health insurance is not? So what IS more important…your car, your house, or your health?

    Doctors and hospitals create provide health care services, not oompa loompa land and CERTAINLY not insurance companies. Why should we pay a middle-man a 30% margin for what we could pay Medicare to do for 4%?

  78. Weiner simply expressed the opinion that if he had his way, Medicare would be expanded to cover everyone. There's nothing shocking about that, and it would be no more of complete “government takeover” than Medicare is, but Scar acted as if Weiner was proposing the Commie takeover of the entire federal government. He did a poor acting shocked.

  79. I am coming late to this discussion and haven't gotten through the whole thread yet, but I noticed that some are arguing that healthcare is not a commodity. Well, depends on which definition your using (in some sense of the word, commodity refers to raw goods, but I presume by the way some of you are using the term that this isn't the way you're using the term.)

    If it's not a commodity- anyone who thinks that, please feel free to answer…then how do we go about accessing unlimited supplies of it?

    If healthcare is a right which should not be subjected to market based rationing, and if the govt has an obligation to ensure that it is available to all according to need- how does that work, exactly? If there aren't enough primary care physicians, should specialists be conscripted and force to forego their specialty for general practice?

    It doesn't make sense- and obviously since we're not going to enslave healthcare workers, we're going to face shortages on the supply side if we increase demand. The market does ration things right now- but the govt will have to ration too, it will just do so according to top down attempts at planning for regional and demographic needs for the goods and services. Many of us see that this has never really worked out well when it's been attempted.

  80. Why should we pay a middle-man a 30% margin for what we could pay Medicare to do for 4%?

    Since both of those numbers are false, there's no reason to engage the argument on those strawman terms.

  81. CS

    And good morning to you too.

    For my end of this discussion, let's agree of terms

    Health care insurance is a commodity. Health care is a right under the general welfare clause. Check my comments to jazz for the logic used.

    As to the figures cited, let's just cut to the chase and discuss the 400% increase in profits since 2003(i think that's the year)

    Good to hear from you.

  82. The problem with Weiner's clarity (which I do appreciate, BTW- I'd much rather hear people honestly express their ideas than to obfuscate) is that it demonstrates that the real divide is within the Democratic party, and not the fault of the GOP or the corporate lobbyists.

    The bills that have come through committees have supposedly been attempts to create a public option health insurance company that would compete, fairly, side by side, with private insurance without stacking the deck so that the private companies would have to fold.

    By admitting openly that he does not favor this kind of competition (just as a few others like Barney Frank and Schakowsky), they undermine the segment of their party that needs to convince skeptical voters that their plan is not meant to incrementally usher in a single payer system.

    And that goes to Jazz's point too- it's disingenuous to criticize conservatives for opposing the current public option plans on the basis that the plans seek to put us on the path to single payer- when many Dems are simultaneously saying that they think single payer is the ultimate solution that we need to aim for. With quite a few Dems openly saying this- it is obvious that the conservative concern about that is not unfounded.

  83. OK, Hemm, regarding those terms.

    Again I ask you- if healthcare is a natural right- the kind that our Constitution guarantees no one can take away from us…then where does it come from? SOMEONE has to provide it by investing years of their life and a sizeable chunk of their monetary resources to become trained in order to give you or me or any other citizen their 'healthcare'… and if you argue that the government HAS to ensure the provision of unlimited amounts of healthcare to all citizens, how can it possibly do that without taking away the rights of other citizens?

    Re: the security/general welfare clause stuff…I have some thoughts on that but not sure I have time to adequately cover them right now….off to a doctors appt in a little while.

    Ditto for the part about the increased profit numbers- you're opening a new can of worms that I don't have time to address. My comment about false numbers has to do with the overhead costs which were misstated by another commenter. The private insurance number isn't as high as he/she stated, and the Medicare number isn't as low as he/she stated if you really compare apples to apples. Medicare overhead is reported differently but a lot of it has to do with what is accounted for and what is not. Plus, there's a reasonable argument that the Medicare overhead cost is TOO low and that's why they fail to weed out a lot of fraud (and when attempts are made to deal with fraud, those costs don't end up on the Medicare spreadsheet because it's handled by law enforcement.)

  84. Hemm, let me try to put it another way regarding the question of whether healthcare is a 'right' or a 'commodity'

    The Constitution describes our natural rights which govt can't take away from us, and which govt has an obligation to protect from other citizens who might try to take away from us.

    You can't include in that category things that don't exist unless another citizen chooses to provide them for you. Healthcare is such a thing- a commodity, in that sense.

    Now, you can certainly say that healthcare is a unique sort of commodity that carries with it some moral obligation, and for that reason we as a people can choose to subjugate some rights to the govt in order to permit the govt to act as a distributing agent for the healthcare commodity- rather than allowing it to be distributed purely according to free market forces. We already do that to a great extent.

    But if you try to say that healthcare isn't a commodity at all, there are two problems with that. One is that however much we'd like to suspend the laws of supply and demand, they are as persistent as the law of gravity. And the second problem is that the amount of power that we have to turn over to the govt in order to give it complete authority in the rationing of the limited healthcare resources, is IMO beyond the amount of trust that our government has earned. Until it can prove that it can better handle the costs of the 40% of our healthcare system that it currently oversees, I can't imagine why we'd expand its reach over the rest of the system.

  85. Let's make a deal. I'll pay taxes for your health care when you demonstrate you can do 10 pushups, run a mile in any time, and stop eating quad-stacker shitburgers.

    If I'm paying for it, I get to require you take care of yourself and don't neglect MY property.

    Otherwise, I hear the French like their health care plan. Feel free to move there.

    And before you start screaming, I'm an immigrant from the UK and Canada, and enrolled in the VA system here, and you can take their health care programs and shove them up your ass.

  86. Well said C Stanley

    Hence my point about many physicians running for the hills at the current reembursement rates if a single payer system is implemented. It would put the typical salary of a primary care provider equal to that of Germany (about 50k). Germany is having a huge problem at this time with many of their physicians leaving to other countries. I am saying there are too many flaws in the current system to somehow justify adopting it across the boards. As I have stated several times, costs need to be addressed prior to anything else, once that is under control then lets re-evaluate.

    As to healthcare being a right, I would have to agree with C-Stanley, someone had to sacrifice years of their life and make massive financial and familial concessions in order to become a physician. Therefore claiming it is your right is at the sacrifice of someone else, hence it can not be your right. I will say it is your right to go out and go to school for 12 years and pay 300k in tuition and expenses and provide your own healthcare.

  87. CS

    Let me clarify what is clearly a tough point for us to mutually understand.

    “You can't include in that category things that don't exist unless another citizen chooses to provide them for you. Healthcare is such a thing- a commodity, in that sense.”

    When I state that health care is a right, I am not attempting to say that government must provide the care directly. I of course agree that those who provide the physical care have every right to be paid just like every other profession. The government's position for the service of health care is well documented. Federal funds support the profession by providing funds for schooling, funds for hospitals, aned care for those who cannot afford the costs. The University Teaching Hospital here in town regularly receives such funds. Additionally, all hospitals must respond to emergency room vists even if the patient is uninsured, and the government mandated that resonse along with funds to help offset these costs. Thus, the government has demonstrated a belief that the right of health care service is fundamental.

    Health insurance, the commodities market's private insurance entity, is another matter. This “pool” insurance is devised for making a profit for the shareholders, a great American tradition. Earlier in the thread, I think it was jazz who pointed out that health insurance functions like car or house insurance pools. Someone else responded that the comparison is a problem not only because people's lives are not equatable to people's cars. Most importantly, they also went on to point out that many (or most?) states also have public plans for those who cannot get insurance due to risk factors. Again, we have an established pro forma response to a private concern's intended omissions. What private company would serve a high risk group? Because insurance is required by the government, the concordant support follows logically.

    I believe this argument was demonstrated with the First National Bank of the US. It came into being to offset the excesses of private banks of the time; fraud, inflation, and wild ly gyrating booms and busts. Jefferson said that the bank's formation was not found anywhere in the Constitution, so it was illegal for the government to create such an institution. Hamilton's view, however, became the view that has now come down to us.

    I believe this comparison may be useful to our discussion. Private banks were driven by the profit margin exclusively, and the formation of the US bank had at its core a desire for the general welfare of the nation's economy. Jefferson who fought the bank idea ironically had no problem buying half a continent. From where does he draw that right?

    Don't forget your insurance card :)

  88. Hemm D,

    See as you worded it I can agree, but the key facet is who pays for your right? It appears that you think others should be responsible for paying for everyones “right”. EMTALA was put into place so people could not be left on the ER floor to die, we will always care for patients, the question boils down to who is responsible for the bill. Single payer system places the burdon of everyone elses “right” in their wallets. I am for reducing costs and reducing insurance premiums, regulating them, and vouchers for those who meet certain income criteria, but people need to have some sort of stake in this. As stated earlier, not for profit works with some changes to the regulations of not for profit health insurance. If you think healthcare costs are obnoxious now, lets continue on without addressing costs and implement a single payer system. Care here will become even more subpar.

  89. nice mike
    you talk to your mom with that mouth?

    I'll assume from the fact that because you're new to this country you don't realize we support the right of everybody to make a complete fool of themselves. As to your quaint idea that people must meet your criteria for your tax support, I have but one question.

    For those who are wheelchair bound or have been in the past, suffer from pre-existing conditions that their insurance company has dropped, or generally can't meet your standard, please explain they should apply for your largess?

    Maybe you should develop that muscle between your ears before you go making lazily thought out comments.

  90. jhayes

    I think your argument suffers from what we already do. We all pay for the poor patient, and pay more than we should because private insurance wants nothing to do with patient rights, just profit. I make the same argument you have heard before, why should I pay for the street outside your house, I don't use it. We share costs with each other all the time.

    The cops, the mail, the tax advantages given to corporations, we pay for these every day. Health care for the poor is a right, but the way we pay for it is the least efficient. Emergency rooms are high resource locations that don't need to be employed to cover what private insurance refuses.

  91. Obviously, exceptions should be made for those with bona fide disabilities.

    But if your only “disabilities” are smoking cigarettes, eating greaseburgers and surfiing for pr0n instead of getting exercise, why should anyone be obligated to interfere with your slow suicide?

    Though of course, if we tax cigarettes the way they do in Europe, it might deter a few people.

    So let's see: 42% of the population supports national health care. That's 127,705,084 people. Times $100 each, $12,770,508,400. Sounds like you can buy all the health care insurance you want on a yearly basis if you just work together.

    And if you think I'm rude, you should hear my English mother on the subject.

  92. I have no problem paying for schools. Schools educate useful members of society. Of course, private schools are tremendously better at it.

    I have no problem paying for roads IN MY TOWN. Those roads provide access to services, like trash pickup, which I pay for, and delivery, which I pay for, and the post office, which supports itself and is not a taxpayer funded entity for about 15 years now (Except, of course, for the $47 billion or so injection a few years ago, to keep it “competitive”).

    What do I gain from paying for your bypass, now? The “Benefit” of being able to pay more taxes to support you in a nursing home?

    Have you actually read the bill in question? If you don't have insurance, or don't want it, or can't afford it, you'll nevertheless be required to pay for it, because your money increases the pool for others. If you reach a catastrophic level of care, the government will be able to cancel your care (as it does in most nations that have public health care, btw).

    Go try Britain's health care for a decade. Then try Canada's. Then we'll talk. And if you like them, feel free to stay there. You have an absolute right to leave America for a better place, if you can find one.

  93. MichaelZWilliamson

    “But if your only “disabilities” are smoking cigarettes, eating greaseburgers and surfiing for pr0n instead of getting exercise, why should anyone be obligated to interfere with your slow suicide?”

    I guess you expect me to pay for your shin splints, stress fractures, and pulled muscles? Of course the system would pay for your disabilities like everyone else.

    You appear to be young, healthy, and indestructible. Next time you're out running, I hope that careless driver chowing down on cheeseburgers doesn't provide you with a pre-existing condition that your insurance company uses to drop you. You'd be hurt and bankrupt in no time.

  94. Hemm D,

    Yes, I understand will still pay, but they are still accountable. The right arguement is lost when it requires financial, time, and familial sacrifices to provide said “right”. I am someone who will have to pay more in order to provide people their right, therefore it should be my right to require they live up to certain standards, no smoking, drinking, exercise 5x/wk for 30min or more. Since I am required to pay for their right, I should be able to require that many change their lifestyles or is that not my right?

    As to your other statements, street, police etc etc is local govt and everyone has access to it, there is a large difference to the federal govt taking over healthcare. As I stated, I want to see everyone covered, but people need to have a stake in the system otherwise it is a few paying for everyone and how can anyone change if the responsibility of the bill is on everyone else? It is the old adage you will appreciate something far more if you pay for it yourself.

  95. Hemm D,

    your arguement on pulled muscles etc is extremely flawed. We all know that 5% of the population consumes over 50% of the resources. These are not your healthy people, you have debated well until that post.

  96. Nope. I'm 42 and a partially disabled veteran. Thanks for asking.

    Of course, my medication is cheaper at WalMart than at the VA, curse those evil capitalists, and the VA suggested that I hire a private doctor to do the tests they don't do.

    Are you aware that for every 100 medications approved in the US, the Canadian government only approves 43? The others are “Too expensive,” so people have to do without.

    One of my Canadian counterparts in an airfield engineer unit is currently non-deployable, and hence, non-promotable, due to a bum shoulder. As soon as he gets it fixed, he can see about promoting, which will also affect his pension, of course.

    It's only been three years, but the government is sure he can get that surgery Real Soon Now.

  97. jhayes

    “Yes, I understand will still pay, but they are still accountable. The “right” arguement is lost when it requires financial, time, and familial sacrifices to provide said “right”.”

    I submit that every right you have costs everyone time, money, and sacrifice. That being the case, I don't follow your selective criticism. Rights have no meaning without concordant responsibility. Like you said, people don't appreciate what's given to them for free. Lastly, no one is making the argument that anyone receiving the benefits of this right do so without a required giving on their part.

    Your second argument assumes that the reason people currently are not insured is due to their lack of wealth or income. Should we fail to create and maintain roads in front of their houses? And the state/local argument also fails due to the simple fact that these government's budgets are regularly augmented with federal dollars. What federal dollars do not directly effect police, streets, etc go to a local government's balance sheet, thereby freeing up funds that do not have to pay other costs.

    As to the more general idea that people must meet your criteria of healthy lifestyle, the current distorted system takes a dollar from the price of every pack of cigarettes to pay for S-chip health care. I would argue that smokers are currently doing more to resolve the health care problem than non-smokers.

    Until your lifestyle cow gets gored, the concept of standards appears logical. Want to pay an extra $5 a steak to cover your “unhealthy” choice?

  98. MichaelZWilliamson

    “Of course, my medication is cheaper at WalMart than at the VA, curse those evil capitalists, and the VA suggested that I hire a private doctor to do the tests they don't do.”

    I take it you received your injuries outside the line of duty. My understanding is they'd be free in that were the case. So you have a choice to find medicine at the lowest price. Great. The current lobbying efforts by big pharma has made it impossible for the government to do the same for medicaid and the current reform bills in question.

    So if you receive care from the VA, have you thanked anybody for paying the bulk of the costs? My point is not to play tag, my point to attempt to find a way that all people receive health care as cheaply as we can make it. If you'd ever leave the VA's system, you wouldn't be able to get health care due to your pre-existing condition. As the VA care is lifetime, consider those who got their coverage from work and then were fired. What do you say to them?

  99. jhayes
    “your arguement on pulled muscles etc is extremely flawed. We all know that 5% of the population consumes over 50% of the resources. These are not your healthy people, you have debated well until that post.”

    And what you fail to realize is that all of us will some day be part of that 5%. The current system works great until you reach 65, then your company drops your coverage. Medicare was at least created in part to cover that drop.

    Why do you think that medicare is always running on the edge. The private companies won't cover such financial losers as the old. So the current system allows private companies to maximize their profits by covering the basically healthy and then drop them when they start to become a “negative risk.” If you're unlucky enough to get sick young, you either keep working for the same company so as not to lose the coverage, or you pay for treatment by going bankrupt. Health costs are the 2nd highest reason for bankruptcy in the country.

    No one gets out of here alive, and just because good luck has kept you healthy, don't think that the private insurance net will hold your weight if you fall. It's designed for short term profit, not health care over the entirety of a human life. Eventually, that pulled muscle turns into a heart attack.

  100. Actually, my civilian insurance, which I pay for, covers it just fine, does a better job, and is actually treating me. It costs more, but IT WORKS. The VA just shoves drugs at you and asks if you feel better.

    We're still arguing over whether or not it's service connected. Until then, the VA pro-rates care. It's not free. They also expect to now charge my civilian insurance when I do go there. _IF_ it gets ruled service connected, which I know from others has taken years, THEN it will be paid for retroactively.

    Look, if you accept the figure of 50 million “uninsured or underinsured,” that means 83.5% of the population are adequately insured, USING FIGURES MOST FAVORABLE TO THE NATIONAL HEALTH CARE CROWD. Define “underinsured.” When I was in college, I had insurance for car accidents, the school was responsible for any accidents it was party to, the Guard covered me on duty, which left falling down in my house or heart attacks as risks. I still have BP of 110/70, so I'm not at statistical risk of heart attack, and if I fell down, I'd pay for the ER and STILL be ahead of things. My wife had a non-covered visit 6 years ago. $1100 out of pocket is cheaper than the taxes OR the insurance. Neither of us considered ourselves “underinisured,” but I'm sure the people pushing this scam would.

    Now look at this: http://www.ourfuture.org/blog-entry/2009062515/

    Do you strongly support, somewhat support, somewhat oppose, or strongly oppose the following:
    Creating a new public health insurance plan that anyone can purchase:

    “ANYONE CAN PURCHASE.” Yes, most people favor that.

    Of course, once it's pointed out that you WON'T HAVE A CHOICE

    http://www.rasmussenreports.com/public_content/

    http://www.rasmussenreports.com/public_content/

    So, to summarize:

    The government will force you to join, so it gets your money for someone else, even if your economic condition doesn't support it, or you don't want it.

    AND

    The private companies are welcome to “compete” using anyone who volunteers to pay them, while not being allowed to deny anyone, thus being forced to accept high risk clients who put the price up for everyone else, but WILL NOT be allowed to force people to enroll.

    Yeah, that seems fair and equitable.

    If your name is Benito Mussolini.

    “Fascism should properly be called Corporatism, because it is the merger of the state with corporate power.” (Benito Mussolini)

  101. Hemm D,

    I am not sure why you continually bring up local govt in comparison to the federal govt, they are totally different and have different roles. I am not sure how you consider not paying for anything as having any sort of accountability.

    For you to say it costs everyone time and money is a fallacy. A complete lie, the majority of the tax burdon in this country is paid for by a few, almost 50% of the population does not even pay federal taxes, so please lose that argument as it is false.

    Many are currently not insured due to their choice. I see it daily in my pracitce, patients come in, smoke 2 packs a day and go out to dinner 3-5 days/ week but dont have insurance, or are on medicaid and complain. It would be shocking how much they could afford if they made different choices, or the younger ones who think nothing will happen to them, therefore they do not opt in.

    As to your cigarrette point, yes money is made, but the cost associated with smoking is far greater then the revenue generated, once again, you are wrong. I am just appalled that so many people think the politicians have their best interest in mind, corporate america and the politicians are one and the same. The only difference is corporate america has motivation to be efficient, the govt has zero motivation for efficiency. There is a happy medium with corporate america running insurance and the govt placing the correct groundrules on these companies which will result in a far more efficient system. I can not end this without the obligatory, address the damn costs first.

  102. Hemm D,

    You just proved care will have to be rationed. It is impossible to keep everyone alive as long as possible. I however agree with this aspect of govt care, with our technology we could use our entire budget on healthcare. Medicare is bankrupt for a lot more reasons than its demographics it serves, if you believe otherwise then you have drank the forbidden kool-aid.

  103. So,12% of the population is over 65. Let's say each of them needs $500K in care before they die–if you have a better figure, please offer it.

    So, each of us will have to pay $62,500 toward that, PLUS our own care. Plus administrative costs. Plus pet congressional projects.

    Write the check.

  104. @Hemm:
    When I state that health care is a right, I am not attempting to say that government must provide the care directly.

    My argument about healthcare being a limited resource doesn't depend on whether or not you're saying that the govt should provide healthcare directly vs. indirectly though.

    If healthcare for all, with no rationing and no limitation, is the right of every person, then the govt has to figure out a way to provide it no matter what. And if, as will obviously be the case, there aren't enough doctors or other medical personnel to provide that care, then the govt would have to coapt the services of existing healthcare workers and/or force other individuals to become trained to provide those services.

    Since I think we can all agree that we're never going to see that level of totalitarianism here in the US, the only other way to deal with the limited resource of healthcare is through rationing. Those who argue that we have rationing now are correct, but then when those same people advocate the current public option plan, they're either naively assuming that the supply problem just magically disappears if we all will it away, or they're disingenuously pretending that the govt won't have to impose its own system of rationing in order to accomodate the increased usage of the healthcare services by the newly insured individuals.

    And then any of those folks who also continue to insist that healthcare is a Constitutionally guaranteed right need to explain how it is that our rights can be rationed, or if they can't, then how do you square the circle when its impossible to give one group of people their right without depriving liberty from other individuals?

  105. jhayes

    Thanks for both comments. I'll try to combine them here.

    I don't know to do with your objection in citing the money trail that goes from Washington to your local government by way of state government. The trail is well documented. But fine, consider the interstate highways. My argument is still totally valid. Why should my money go to your federal highway? Seems unfair to me.

    I'm sorry your patients lack the healthy insights you wish. How and why do you treat them if they can't pay you? The cigarette point I made went right by you. Our system is so thoroughly screwed up we have “evil smokers” paying for the insurance of kids who would not otherwise receive it.

    The costs you wish to address first are also the costs I am talking about. You believe costs are high because of lifestyle. People live according to their lights, no matter how much you'd like to change their habits. Free people are really a pain that way.

    The private insurance you advocate makes no attempt to reduce costs, except by denying your requests for tests and procedures you wish to administer. How much time do you waste dealing with insurance companies instead of patients? What about that cost? Doctor's I've talked to have entire departments dedicated to appeasing some accountant somewhere. At the least, you have to spend time to file the appeal. Money down the drain that serves absolutely nobody. And you say I'm not concerned with cost? If we are wasting money, let's waste it on patients with bad habits, not companies with an eye for an extra buck at your expense.

  106. I am not sure why you continually bring up local govt in comparison to the federal govt, they are totally different and have different roles.

    I find this is happening a lot in this thread and other similar discussions lately.I think it's unfortunate that the lines have become so blurred in regard to those different roles.

  107. CS

    “If healthcare for all, with no rationing and no limitation, is the right of every person, then the govt has to figure out a way to provide it no matter what. And if, as will obviously be the case, there aren't enough doctors or other medical personnel to provide that care, then the govt would have to coapt the services of existing healthcare workers and/or force other individuals to become trained to provide those services.”

    Sorry CS, that argument fails in the real world. Defense is one of the proscribed duties of our government, but Pearl Harbor and 9/11 demonstrates that trying to fulfill it's duty is not the same as accomplishing that duty.

    The health care issue is quite similar. People currently uninsured show up in emergency rooms or at the offices of doctors like jhayses. They get at a minimum, some treatment. There are successes and failures to this current method. The mandate from the government makes this a moot point, if they show up, treat em. Clearly, there are enough docs and medical personnel, or we would be inundated with countless news flashes how people die untreated. Your rationing argument is thus untrue unless you can show huge numbers succumbing to untreated illness. Where are your stories of patients left outside because we lack beds or doctors to treat them? Supply is there and the dreaded rationing is not nearly as bad as you'd have it.

    The problem is that this right is serviced in the most inefficient manner possible. The cold today turns into the pneumonia of tomorrow. A cheap antibiotic now, or iv push in a hospital bed later. We already take care of the emergencies, but our system requires that people become badly sick. Why does that make sense to anyone?

  108. CS
    “Hemm, with regard to funding for Interstate highways, we all 'use' the roads in different states other than our own- not only when we travel to different parts of the country, but by using the goods and products that are transported over those roads. That's why it makes sense to fund on a federal level.”

    So, if I leave missouri and have an accident in alabama, i should expect that my health care would cost the same there as here? You know the answer to that one.
    We all “share” the health care system in this country. You don't pay more for driving in Missouri, do you? No, it's shared amongst us equally if we use it or not.

    I can't take a swine flu shot, why should I have t pay the government to fund it?

  109. So, if I leave missouri and have an accident in alabama, i should expect that my health care would cost the same there as here?
    No, costs vary from state to state, as do the costs allocated to each state for building and maintaining the interstate highways. But healthcare in AL is something I don't necessarily use, while I do indirectly use their interstate highways every time I purchase a product that travelled across their highways to reach my local stores.

    I can't take a swine flu shot, why should I have t pay the government to fund it?
    Because public health costs do benefit you even if you're not the patient. The swine flu shot that another person gets, according to their epidemilogical risk, helps prevent you from getting the disease too- and of course the jab that goes to your doctor and his/her staff keeps them able to provide care for you in the event that you do contract the virus.

  110. Sorry CS, that argument fails in the real world. Defense is one of the proscribed duties of our government, but Pearl Harbor and 9/11 demonstrates that trying to fulfill it's duty is not the same as accomplishing that duty.

    Bingo, Hemm. You're making my point for me- defense is a proscribed duty we've assigned to our federal government, but that's not the same thing as a natural right.

    So, go back to the drawing board and take my suggestion to call healthcare a moral obligation which you believe should be another one of those proscribed duties of the federal govt. But then you have to defend that position by explaining how and why you believe that's the best way to fulfill society's moral obligation. Trying to call healthcare a 'right' which implies that it is a Constitutional right that MUST be fulfilled by the federal government is an attempt to weasel out of explaining why you've defaulted to the position of advocating for expanding the federal role.

  111. The problem is that this right is serviced in the most inefficient manner possible. The cold today turns into the pneumonia of tomorrow. A cheap antibiotic now, or iv push in a hospital bed later. We already take care of the emergencies, but our system requires that people become badly sick. Why does that make sense to anyone?

    Morally it isn't right to perpetuate a system where people who have treatable illnesses can't afford treatment, and have to wait till their illness becomes life threatening and then show up at an ER to get publicly subsidized treatment.

    But economically, you're wrong to think that we will pay less in the aggregate to give every insurance coverage than we currently do to treat them when they present as emergency cases. You actually chose a good example to once again make my point. Colds are viral illnesses that are not treatable by antibiotics, cheap ones or IV ones…and giving people the ability to see a physician for a minor and nontreatable illness is a vast waste of money. And even though it is costly to treat that one patient who does develop pneumonia, even if he/she could have been treated at a lower cost if he/she had sought care by a PCP before it got to that point, it still doesn't offset the cost of hundreds of unnecessary doctor visits.

    I'd suggest you read up on what has occurred in MA since their universal health plan was implemented. The savings that they thought would come from reduced need to subsidize hospitals for visits by uninsured patients didn't materialize. And the shortage of physicians, particularly primary care physicians, has happened. This real world evidence, instead of hypotheticals and speculation, undercuts your belief that expanding coverage will actually save money instead of costing more than what we do now.

  112. “No, costs vary from state to state, as do the costs allocated to each state for building and maintaining the interstate highways.”

    My point passed you on the highway. My health cost difference is due to the fact that I'd be “out of the system” so I 'd be required to pay a higher deductible. Of course, if my coverage was similar to medicare, that wouldn't be true.

    “Because public health costs do benefit you even if you're not the patient.”

    So does the general welfare of the population. If swine flu funds are for the general welfare, ten even more so is public health care for all.

  113. “Bingo, Hemm. You're making my point for me- defense is a proscribed duty we've assigned to our federal government, but that's not the same thing as a natural right.”
    “rying to call healthcare a 'right' which implies that it is a Constitutional right that MUST be fulfilled by the federal government..”

    The first weasel was Hamilton.
    Only conservatives talk of a natural right, I'm talking general welfare. Just like Hamilton's logic that allowed for the 1st national bank. Unless you want to forgo such amenities as a federal banking system, the SEC, and all the rest our economy rests upon, you also have to accept health care under the same umbrella.

  114. My health cost difference is due to the fact that I'd be “out of the system” so I 'd be required to pay a higher deductible.
    I thought you were referring to regional differences in actual cost, but even so…why is it such a problem to pay higher out of network fees for an occasional need for health care while travelling out of state?

    And MY point about public health has passed you by. You don't seem to understand the basic difference between epidemiological implications of highly communicable disease, vs. societal costs of noncommunicable illness.

  115. Unless you want to forgo such amenities as a federal banking system, the SEC, and all the rest our economy rests upon, you also have to accept health care under the same umbrella.

    LOL, and yet conservatives get blamed for making supposedly bogus claims about slippery slopes. One program justifies another and another and another. No need to actually defend your argument for why this new or expanded program is the best way to handle existing problems- just claim that anyone who accepted the first move in that direction of expanded government control MUST accept the further steps in that direction.

  116. “But economically, you're wrong to think that we will pay less in the aggregate to give every insurance coverage than we currently do to treat them when they present as emergency cases. You actually chose a good example to once again make my point. Colds are viral illnesses that are not treatable by antibiotics, cheap ones or IV ones…and giving people the ability to see a physician for a minor and nontreatable illness is a vast waste of money”

    My cold was a layman's mistake:

    http://nashvillecitypaper.com/content/city-news

  117. My cold was a layman's mistake:

    http://nashvillecitypaper.com/content/city-news…>

    Right, although I'm not sure that the meningitis example is much better either to make the point you were aiming at. The problem in that case is that there's so little time from the onset of symptoms to get the diagnosis nailed and start appropriate treatment, and if mistakes are made then it's too late to correct them. It's not clear from that story whether or not the insurance status of the family was an issue or not- they apparently took the child to an ER but the diagnosis was missed (perhaps they were uninsured and the doctors/staff didn't give her the same level of care, but no one seems to be alleging that in the article.)

    Anyway, even if that were an example of an illness that would have been caught early and treated cheaply if someone's insured but not if people lack insurance, you're still missing the point that comparing costs of one individual's cost of care is not the same as measuring the overall cost of 'preventative care' vs. treating advanced disease. Generally there are far more 'false positives'- people who seek medical care when they really have illnesses that will resolve without treatment, or people who are screened for an illness but test negative.

    Overall, I really don't think you can win this argument on economics. There may be a few exceptions- I think high blood pressure may be one of those because it's cheap to screen and treat- so even if you factor in the cost of testing everyone and treating some people who might not have had bad side effects if untreated, you still come out ahead economically.

    Make it a moral argument if you're going to press this point. People should have the ability to get treated when they have treatable illnesses.

  118. CS


    LOL, and yet conservatives get blamed for making supposedly bogus claims about slippery slopes. One program justifies another and another and another….”

    Remember how this thread has run.

    jazz was perplexed that anyone would see health care as anything more than a commodity.

    Hamilton opened the door to government doing more than was strictly detailed in the constitution, so try as you might, you can't escape the fact that the general welfare clause allows for this interpretation. You may call it a slippery slope, but you fail to address the argument. Sound bytes don't defend a position, especially when the government has a strong history of providing the service for its people under the general welfare clause.

    I stated before, the intent of my comments is to reduce the cost of health care for all people. I don't understand how a conservative can allow help to private industries in the name of the general welfare, but turn around and resist it when services are provided for the populace.

  119. Hemm D,

    I wanted to point something out, I do not blame our costs on poor lifestyles, yes it plays a role but is not the reason. Tort reform, poor choices, abuses in the system, over use, and doctors recieving compensation based on diagnostic tests. These are the main ones that come to mind for controlling costs.

    Back to healthcare being a right, I still can not seem to understand how if many have to sacrifice their own selves, be it money, time, etc etc, how is that someone elses right? That is justifying legalized robbery, you are stripping one person of their rights on the basis of giving another their supposed rights. It just does not add up.

  120. Sound bytes don't defend a position, especially when the government has a strong history of providing the service for its people under the general welfare clause.

    But having a history of providing some services (I'm not sure I'd agree with that choice of wording but I'll go with it for now) is not the justification for providing all kinds of other services.

    I think rational conservatives can arrive at conclusions that allow for the govt to involve itself in the distribution of some resources or the overseeing of certain industries to some extent- but we arrive at those conclusions only after deciding if that is the best or most efficient way of handling a problem regarding those resource allocations or market instabilities.

    The fact is, that virtually no one on any point of the ideological spectrum argues that it should be all one way or all another- we don't have pure collectivists arguing that we should dispose of capitalism and nationalize all industries, and we don't have pure laissez faire advocates either. But people do tend to look at each case from one perspective or the other as the default position, and then decide how far along the scale they think we should move in one direction or the other.

    That's why it is irritating for you to argue for THIS govt expansion based on the fact that we've allowed for other expansions. It's not that we can't interpret the general welfare clause to mean that we should cede some power and authority to the federal govt in order to accomplish healthcare goals- it's that we believe that we shouldn't. That's why the point about the meaning of 'rights' is relevant- if healthcare is conceptualized as a natural right, then there IS no other interpretation of the general welfare clause other than to say that the federal govt must take on this expanded role.

    (I meant to respond to your earlier comment about only conservatives talking about natural rights…well, first off, maybe that's the problem- people on the other side of the debate are getting the concepts of negative and positive rights muddled. And second, it's actually more of a classical liberal / libertarian concept, but today's American liberal/progressives appear to have moved pretty far away from those underpinnings.)

  121. “Overall, I really don't think you can win this argument on economics. “

    Hamilton made my point for me 200 years ago.

    You know as well as I that the cost of health care is on a climb destined to wipe us out. We don't have to do anything and all our incomes will be drained by the skyrocketing costs. For your part, I believe you have time and again stated ways to reduce these costs. The crux of our debates have centered on the fact that I believe the private interests have worked hard t keep cost reduction off the table.

    I further believe the actuarial tables prove that cost for all go down when the largest group is used to spread out costs across all segments of the population. Health insurance by definition covers a group for a specific time period. Health care costs from cradle to grave removes both the artificial appearance being a good risk, and the absolute certainty that we all will someday be requiring care.

    The current system is just gambling. And the house always wins, especially when it can dump those “lucky” enough to draw off resources.

    Rationing is a term from the private industry. Everybody gets some form of treatment eventually.

  122. I further believe the actuarial tables prove that cost for all go down when the largest group is used to spread out costs across all segments of the population.

    OK, but think about this for a minute. 'Costs for all going down' under that scenario is only possible if the additional people that are added to the pool are paying their own way. There is a segment of our currently uninsured population who will be made to do that under the new mandates- these are the people, mainly young healthy adults, who make enough income that they won't qualify for subsidies but currently they choose not to spend their money on insurance.

    But the rest of the uninsured- and of course everyone argues about what those actual numbers are- will switch from having healthcare services provided on the basis of emergency need, to having health insurance coverage which enables them to access primary and preventative care.

    I don't think the numbers are such that group 1 will add enough money to the pot to cover the extra expenses of group 2. Plus, additional groups which don't even fall into those categories make the equation even more questionable- you have the people who currently qualify for Medicaid but haven't accessed it, and the illegal immigrants who currently get some care in ERs but will not have any change in their status due to any of the current bills.

  123. CS

    “But having a history of providing some services (I'm not sure I'd agree with that choice of wording but I'll go with it for now) is not the justification for providing all kinds of other services.'

    And that's why I started with Jefferson and Hamilton. They kind of demonstrate the “first cause” of this current debate. That natural right is at the very heart of the general welfare clause. The kinds of services have varied over time in direct relation to the changing needs of the populace.

    Bad private banks spawned fraud, waste, and economic downturns. Hamilton's bank was the remedy to those failings.

    Private health care spawns fraud, waste, and an incomplete coverage of Americans. My earlier actuarial argument goes to the heart of the economic distortion that private only health care provides. Cover the basically healthy and leave the less desirable in the care of the government. That's a great way to make a profit but a poor way to provide people with the reasonable expectation of life.
    Understand fully, I am not saying private insurance has no place in this, I'm saying that the profit margin is the wrong criteria for the best solution.

  124. “I don't think the numbers are such that group 1 will add enough money to the pot to cover the extra expenses of group 2. Plus, additional groups which don't even fall into those categories make the equation even more questionable- you have the people who currently qualify for Medicaid but haven't accessed it, and the illegal immigrants who currently get some care in ERs but will not have any change in their status due to any of the current bills.”

    As you well know, we already pay for these groups of people when they partake of the system without insurance. They add no funds currently, any funds would necessarily lessen the bill. The resources they draw from the current system already are factored into the current system. The major benefit of the change would be that there would be fewer emergency visits and more GP appointments.

  125. Private health care spawns fraud, waste, and an incomplete coverage of Americans.

    But currently our biggest public, govt run system spawns even more fraud and waste. So unless it can be reformed and prove it can do a better job at handling those, the public option is not going to be better at cost reduction than the private, profit driven model is.

    As you well know, we already pay for these groups of people when they partake of the system without insurance. They add no funds currently, any funds would necessarily lessen the bill. The resources they draw from the current system already are factored into the current system. The major benefit of the change would be that there would be fewer emergency visits and more GP appointments.

    OK, so have you missed most of what I've been saying in this thread? That it actually doesn't cost less to provide more primary care than it does now to provide emergency care?

  126. CStanley, what would you like to see done?

  127. Done about what, chris? I've outlined what I think should be done in several previous posts. I think cost needs to be addressed, and I think it's incorrect to assert that universal coverage lowers costs (it's the opposite, I believe.) But if you work at the cost side first, a lot of the people who currently fall through the cracks (making too much income to qualify for Medicaid but not enough to afford private insurance) would have their problem solved if costs come down.

    Costs generally come down with increased competition and with easing the supply side. Right now there are governmental policies in place that aggravate those issues- decreasing competition and limiting supply. Fix those first, and see if we can get costs down, and a lot of the coverage problem resolves itself. If we have to also spend more by increasing the threshholds at which people qualify for our current 'public option', that's fine by me. Personally I'd cover that cost by shifting some of the rules for Medicare, but do it gradually so that people aren't blindsided by the changes (ie, shift age eligibility over time so that people have time to prepare.)

  128. If you don't treat the health care industry as a commodity, you will end up with significant shortages in service and stagnate innovations and improvements. Single payer leads to price controls, price controls leads to shortages and no improvements. Profit is required to cover the cost of capital invested into expanding coverage, services, improvements and innovation. Having a health care market with a multitude of plans and options to compete and select from is the path to having the best health care for Americans.

    If government controls this industry, it will do to it what it did to the mortgage industry, drive it over a financial cliff and then have to bail it out. Medicare is not a program to use as a role model; there is a lot it doesn't cover, there are shortages in service providers, and it is going bankrupt. If you are paying for health care coverage on a level playing field, medicare is one of the last programs you would select. If you get it for “free”, then sure its a good deal for you, but someone has to pay for it. So when they start taxing you another 2-7% for the gov's limited one-size-fits-all health care, just imagine the plan and options you could have bought on your own with that money.

  129. Well TSteel, your story is an impressive and relevant anecdote.

    But I'm pretty sure that statistical analysis doesn't take anecdotal evidence with the same weight as it does statistical analysis.

    Your personal IQ doesn't adjust the average IQ being 100; regardless of how far from 100 it might be. And your personal story, while both moving and impressive; doesn't affect the average costs of lifetime health care for people with or without certain conditions.

    You will live longer, happier, and healthier by losing weight; and in your specific case, you might save more than if you hadn't gotten healthier.

    But speaking from a statistical average, a person could only reasonably expect a good chance at the “living longer, and healthier”. Happier would be hard to judge, and overall health care costs would be a wash, or higher by the peer reviewed statistical studies I've seen.

    Now that does make it worthwhile, but it does not make it cost effective; much less an indicator that this would be a good plan for “bending the cost curve”.

  130. Bullshit. Why you think anything you have to say will change my mind is
    beyond me.

    Joe Scarborough couldn't respond period. He was silent and when Weiner
    asked him what the insurance companies bring to the table, he could not
    answer and never did answer.

  131. I just re-read your email about what insurance companies bring to the
    table. Yes, insurance companies make a bet just like casinos where the
    house is always the big winner. Health insurers have as much interest in
    making people well as Casinos do in getting people to stop gambling.

    You must work for an insurance company, otherwise why are you so worried
    about their pocketbooks. They have and continue to rape the consumers with
    their premiums all the while purging people from the insurance rolls to make
    their bottom line look better for Wall Street.

    The country is already in deep doo doo thanks to unfettered greed in
    capitalism starting with Ronald Reagan.

  132. I can't figure out who you are responding to, lousgirl, but whether or not Joe Scarborough was able to formulate a good response to the question of 'what insurance companies bring to the table' is not indicative of whether or not that question actually can be answered. One interviewer who was flummoxed (he appeared surprised by the direction that the interview took and was caught off guard) is not the end of the debate.

  133. CS

    “But currently our biggest public, govt run system spawns even more fraud and waste. So unless it can be reformed and prove it can do a better job at handling those, the public option is not going to be better at cost reduction than the private, profit driven model is.”

    That's the same old justification for the status quo. The devil we know is better than the one we don't. The fact of the matter with fraud in medicare is that the vast majority is generated by private insurance, doctors, and hospitals. That's iike blaming the chickens for the foxes.
    Additionally, I've demonstrated the simply economics that privates use to ever increase their profits. 3% of a hundred million is better than 3% of fifty million.
    Lastly, we both know that every denied claim is worth money to private insurance. Armies of non-medical personnel are tasked with reducing claims.

    :OK, so have you missed most of what I've been saying in this thread? That it actually doesn't cost less to provide more primary care than it does now to provide emergency care?”

    No, I've read your opinion, but seen little data that proves it. Let's take a simple example of my present insurance. A regular doctor's office visit requires a $25 co-pay on my part. For an emergency room visit, my part is $75. Now either emergency room visits cost three times as much or the insurance company merely charges me three times more simply to lower their exposure.
    Thus, either we could provide three times the number of doctor/patient interviews by providing office visits or else the current pricing structure is arbitrarily designed to maximize profit. As I said, we already pay for these uninsured visits, so if the pricing structure is profit driven, it confirms that reducing costs can be accomplished by removing private incentives.

    Simply, we pay for emergency room visits today. Office visits cost less. Office visits curtail medical situations where medical problems spawn critical care costs, so fewer emergency first visits reduces the cost we pay today while increasing the care for those who even can contribute to their care.

    Have you not been listening to the math?

  134. Hemm- I responded to you in another thread about this discussion before I'd realized that you'd written the comment above.

    That's the same old justification for the status quo. No, it's not, not in the least. I stated a problem with the status quo- that means I think that problem needs to be addressed. However, the current plans do not address it. I'm not justifying the status quo- the proponents of the current reform plans apparently are satisfied with the status quo in this regard because they're doing nothing to fix it.

    As far as your math- I imagine the 3:1 ratio is probably about right for ER visit cost to PC visit fee.

    So, for your argument to make sense, you have to be assuming that every uninsured person visits an ER more than 33% as often now as they would visit a PC or specialist if they were insured. I don't know where to find that data, but I'll bet that estimate is insanely high. How many uninsured people (what percentage) have visited an ER at all, and what percentage have visited at least once a year? Compare that to what percentage will use PC services or visit a specialist if they're insured.

    And on top of that, some ER visits will happen whether people are insured or not- for true emergency illnesses and for trauma (which actually makes up a pretty high percentage of the current reimbursements that taxpayers fund for uninsured. Having access to primary care is not going to change that.)

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