just my $0.02

Moreover the fear of government run “death panels” becomes very real when the House Bill includes over 500 billion cuts in Medicare despite the fact there will be a 30% increase in Medicare enrollment once the baby boomers hit 65. The real fear is once the government has more control over the health care dollar how will they go about reducing costs other than rationing which is par for the course in other Nations who have government run health care?

If Congress is sincerely interested in lowering the costs of health care
insurance and making it more available and affordable for everyone Congress could do it with a one page Bill by: (1) Allow insurance companies to compete across State lines, (2) Do tort reform and (3) lift all the government mandates that increase the cost of insurance so that insurance companies can tailor their plans based on the wants, needs and pocket books of the people. That is how costs can be lowered and free choice can reign.

AGAIN, A 9 TRILLION DOLLAR DEFICIT IS UNSUSTAINABLE AND THE DEMOCRATS AND PRESIDENT OBAMA MUST FACE UP TO THE FACT THAT THE NATION CANNOT AFFORD ANOTHER HUGH GOVERNMENT PROGRAM LIKE MEDICARE, SOCIAL SECURITY AND MEDICAID THAT WILL BANKRUPT US ALL.

The 'private sector' that I trust refers to private individuals, empowered to actually make choices (which we don't really have the ability to do now.)

Wow, Hemm, I'm sorry but I didn't know that people were unaware of this. Tax credits have nothing to do with whether or not you have a net income tax liability. We pay out tax credits right now to people who pay nothing in income taxes (the EITC.)

So, these proposed tax credits would work the same way- not refunding people an amount that they paid in income tax, but actually giving them a net positive amount of money above and beyond their earned income.

“Those are some of my reasons for doubting the efficacy of any private sector solution to our health care problems at least as much as Polimom distrusts the government.”

Fair enough your entitled to your own bias, but understand one very big difference. The Private sector can be monitored and disciplined by public watchdogs with the force of law behind their regulators and and criminal investigators, the government has no check on its power outside of itself. I'll make a guess (and it is a guess) that you are not a fan of George Bush (I'm not either), would you trust the Bush administration to run an honest healthcare system and be diligent in investigating violations if those violations forwarded his political agenda despite being illegal acts? I wouldn't. So why should I want this type of thing left in the hands of politicians and their appointees? Why should you want this?

” “I dispute the premise. The main observation guiding fiscal conservatives' thinking is the central authority model doesn't work”

Fine, costs are increasing beyond control under the current system which is private oriented. They clearly won't do anything on their own, so fiscal conservatives must not have an option. “

and I dispute your implication that the federal government is not at present responsible for a good portion of the current rising costs. Laws allowing huge rewards in malpractice suits drive up doctor costs, regulations about where you can purchase healthcare insurance drive up insurance costs, level upon level of bureaucratic function drive up hospital and doctor costs, other insurance regulation that interposes itself and prevents usage of indeminity insurance increases the cost across the board.

One problem is the lack of honesty and full disclosure. How do we address this kind of problem in a “free market”?

Even people buying insurance will–in a functioning market–have a wide range of choices. If one company has a bad reputation, they can sign up with another one. Say it with me: “exactly the way competition works in every other industry.”

At the macro level, because it has a much better track record. Countries that leverage their private sector enjoy much better economic growth than those that try to centrally manage their economies.

At the micro level, because it's opt-in. If you don't trust company X to provide good value for your money, you keep it in your wallet.

“Private-oriented” is to competitive market as “fruit-flavored” is to fruit or “creme filling” to cream. The health care market is laboring under huge distortions that inhibit competition, garble pricing signals, and squeeze out all accountability for value-for-dollar. The way the system works today, no one really cares how much 98% of the transactions end up costing. Of course costs are going through the roof and millions of people are simply priced out. We simply need to remove these distortions and let the market do what it does well in every other industry.

By all means, keep a list. But like I said, the longer and shrewder your list is, the more trouble you'll have acting on it from above. Complex political systems like our cannot be changed that way, at least not much. If you want really meaningful change, you have to embrace the profit motive and unleash the entrepreneurs to subvert the old order from below.

Those are some of my reasons for doubting the efficacy of any private sector solution to our health care problems at least as much as Polimom distrusts the government.

Fine, costs are increasing beyond control under the current system which is private oriented. They clearly won't do anything on their own, so fiscal conservatives must not have an option.

You don't trust the central authority, but year after year increases in the private sector clearly demonstrate they have no ability or willingness to bring down costs. That's the premise of yours that I reject. A scary central bogeyman authority or a runaway price rise via private industry only concerned in enlarging the amount that passes through their hands..

What do you want to believe, your fear or your lying eyes

Every idea we talked about the past few days should definitely be put on the “list.”

For the Right, what are your specific means to avoid this collapse without addressing the non-competitive aspects in the present system.

Hemm, it's a good question, but I'd first unpack a couple of its premises.

First, who's against competition? Competition is precisely what will bring down costs. It's the only thing that ever does, and it has worked great in every other industry. We need dramatically more of it in health care.

Second, “what specific measures will reduce costs?” implies the wrong thing. I can and have listed a bunch of inefficiencies that are begging to be corrected and will result in lower costs. But your question implies that there ought to be some central authority spotting inefficiencies and taking action to correct them, and that if conservatives can't sell you on a specific list, they're talking out of their hats.

I dispute the premise. The main observation guiding fiscal conservatives' thinking is the central authority model doesn't work. The authority can only spot problems big enough to see from outer space, and even those it has limited ability to fix because they tend to be very political. It's not working yet again in Maine, which is no surprise.

Look at a business model like record stores. Politically speaking no central authority could have decided to kill record stores, but they've been eroded from underneath by small degrees, and now they're being replaced by cheaper, more efficient distribution channels. Driving efficiency is a grass-roots activity that can ultimately bring huge changes in the landscape.

“That depends entirely on the size of the tax credit.” Sorry, but I'm a little dense here. How can a tax credit exceed the tax charged? The poor don't make much and the don't pay much in taxes. It seems to me that any medical charges exceeding those taxes would have to be provided by you and me.

Isn't that what we don't want now? Like I said, I'm obviously missing how you see a credit would work.

I appreciate your ideas.

I would say up front that the current bills don't really address Medicare, and I think that is a major failing. Health care today is divided into pools of good risk and bad risks. Older Americans run higher medical bills, and I don't see private insurance wanting to work that segment as their profits would be at risk. For the participants, private insurance rates who go ever higher just when their incomes decrease due to retirement.

The current system could certainly gain by strong cost reduction incentives Part D is a great example. Import those drugs made in the US and exported to Canada. They cost 50% less up there. pharma profit is one thing, gouging is quite another.

I don't trust you. You're poor. Jazz the reasonable moderate said so.