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. 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.

  2. 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.

  3. 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.

  4. @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?

  5. 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.

  6. 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.

  7. 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?

  8. 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?

  9. 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.

  10. 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.

  11. 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.

  12. “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.

  13. “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.

  14. 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.

  15. 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.

  16. “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

  17. 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.

  18. 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.

  19. 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.

  20. 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.)

  21. “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.

  22. 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.

  23. 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.

  24. “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.

  25. 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?

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

  27. 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.)

  28. 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.

  29. 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”.

  30. 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.

  31. 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.

  32. 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.

  33. 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?

  34. 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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