Don’t Buy Health Care? Pay $25,000. Can’t Afford The Fine? Spend A Year In Jail.

Guest Post By Leonidas

Leonidas is a frequent, right of center commenter on The Moderate Voice and has been invited as a Guest Voice.

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GoToJail-main_Full

Policio reports:

Sen. John Ensign (R-Nev.) received a handwritten note Thursday from Joint Committee on Taxation Chief of Staff Tom Barthold confirming the penalty for failing to pay the up to $1,900 fee for not buying health insurance.
Violators could be charged with a misdemeanor and could face up to a year in jail or a $25,000 penalty, Barthold wrote on JCT letterhead. He signed it “Sincerely, Thomas A. Barthold.

Two thoughts occur to me.

First, not everyone will have an easy time scraping up the money to pay, although I know some assistance is planned to be made available.

Secondly (if they can’t pay $1,900 what are the chances they can pay $25,000?), can our overcrowded penal system handle the increased traffic? Should people who couldn’t afford to pay be grouped with thieves, drug dealers, and worse?

To me this type of penalty makes this less appealing than a fully paid public option (as much as I oppose that). What they should do instead, if they must do this at all, is to freely cover everyone with catastrophic insurance and let individuals buy their own “other than catastrophic insurance” on the proposed markets. This should be without threat of legal penalty and with any available assistance, having the cost of the catastrophic coverage taken out of it. Fining and imprisoning people for not buying into health care strikes me as against the principles of our nation.

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Author: Guest Voice

  • shika_one

    At first I thought this was some sort of Sunday TMV funny but as I followed the Politico links my jaw just dropped. Why are we even talking about penalties like this in health care? Someone please tell me I'm premature in being concerned about this?

  • shannonlee

    Shika, you can't really mandate something without having a penalty for not abiding by the mandate.

    My vote is for single payer.

  • http://www.newshoggers.com/ Ron Beasley

    We don't often agree but this is an exception. I oppose forcing people to give money to private insurance companies.

  • Almoderate

    So if I understand you correctly, Leonidas, you would rather have the taxpayers and others who are insured privately pay for an uninsured person's health care than to have someone be required to pay for his own health care. Either way, they're still going to show up in the ER, and those costs will have to be covered. Now, I also assume that you have an alternate suggestion as to how to remedy the situation.

  • Dr J

    Why is anyone surprised at this? Whether you write the check to a private insurer you chose or to the tax man you didn't, of course universal coverage has to be paid for, of course the government has to require payments, and of course there there have to be penalties.

  • http://blog.360.yahoo.com/blog-cjQ4r_Y_cqXPXpxyIWQePYrgXHbB nicrivera

    I was listening to a liberal talk radio show the other day (The Young Turks), and they actually accused Ensign of being a liar simply for pointing out that imposing a Mandate would lead to people being put in prison for refusing to buy insurance. The radio host went on about how Ensign was simply trying to scare people and that no one would ever be put in prison for refusing to buy health care insurance.

    This, to me, shows an extreme naivety on the part of people who are so quick to insist on government laws without stopping to consider the consequences.

    Let's think about this. If there is a Mandate, every individual HAS to purchase health insurance. There is no choice in the manner. If you refuse to obey government law, there's got to be some kind of punishement, otherwise, how would you ever enforce the law. Even if the punishment is some small fine, what is to become of people who refuse to pay the fine? Or what about the people who pay the fine but still refuse to buy health insurance? Ultimately, they run the risk of going to prison.

    So yes. In creating a Mandate, the federal government is now criminalizing not having health insurance, and can now threaten people who do not comply with prison.

    This doesn't sound Constitutional…because it isn't.

    The Constitution does not give the federal government any power that would allow it to force people to purchase anything…let alone health insurance.

  • Leonidas

    So if I understand you correctly, Leonidas, you would rather have the taxpayers and others who are insured privately pay for an uninsured person's health care than to have someone be required to pay for his own health care.

    No that is not my position. My position is that having taxpayers pay for an uninsured person's insurance is a lesser evil than putting people in jail for not buying healthcare coverage. To me this is a violation of liberty.

  • Dr J

    I'm missing the distinction, Leonidas. You'll go to jail for not paying taxes just as surely.

  • Leonidas

    I'm missing the distinction, Leonidas. You'll go to jail for not paying taxes just as surely.

    The 16th Amendment.

  • http://blog.360.yahoo.com/blog-cjQ4r_Y_cqXPXpxyIWQePYrgXHbB nicrivera

    I'm missing the distinction, Leonidas. You'll go to jail for not paying taxes just as surely.

    But Dr J, the Sixteenth Amendment granted the federal government the power to impose an income tax.

    Thus, the federal government imposing an income tax is constitutional. The federal government forcing you to buy something (whether it is health insurance, car insurance, life insurance, etc.) is not constitutional.

  • http://greendreams.wordpress.com GreenDreams

    Leonidas, having researched “catastrophic plans,” I have not found the insurance industry to be open to this. The cost of an extremely high deductible plan with no frills is almost as expensive as full coverage. If you have any example to the contrary, I would be VERY interested. Insurance companies apparently would rather pay for a few office visits a year than to ONLY be called when there's a super expensive need.

    As you know, I pretty much despise the health insurance industry and I fully agree with you that we should not be forced to give them money. Do remember, though, that there's exactly zero chance of the Baucus bill becoming law. No one likes it.

  • Dr J

    Hey, I just read it, and it turns out the 16th Amendment doesn't mention health insurance at all. You're not one of those fundamentalist crazies who believe some clause in the constitution forbids the federal government from doing things that aren't explicitly mentioned, are you? How very quaint.

    Constitutional quibbles aside, it's a greater infringement on the public to make them fund universal care through taxes than leaving them latitude to shop. One size and one price point for insurance does not fit all, and people should be able to choose what fits them best. Millions of people shopping and demanding value for money is exactly the shake-up the industry needs too, but I'm a broken record on that topic.

  • Father_Time

    The Republicans caused this with their obstructionism of real healthcare reform. National Socialized medicine is the only way to reduce costs and provide for the people’s healthcare needs. The world has already proven it. While we play around with jackass republican hardheads or blue-dog dummies, our people fall deeper into debt over healthcare costs.

  • Dr J

    The cost of an extremely high deductible plan with no frills is almost as expensive as full coverage.

    You're late to the party, GreenDreams, but welcome all the same. Health care costs too much. And not the 10-percent-overhead-too-much you natter about, but factor-of-five-too-much.

    I know you'd rather sweep these costs under the rug by burying the bills in everyone's taxes, but it's the wrong approach. We need to drag the monster into the light and let everyone hear it snarling. That's our only hope of slaying it.

  • Dr J

    Father Time, the world has proven no such thing. The rest of the world is poorer than us, so they spend less on health care. And milk, and shoes, and defense, and you name it.

    Our system definitely needs reform, but their systems do too. The same rising tide of costs is threatening to drown them just like it is us.

  • http://blog.360.yahoo.com/blog-cjQ4r_Y_cqXPXpxyIWQePYrgXHbB nicrivera

    You're not one of those fundamentalist crazies who believe some clause in the constitution forbids the federal government from doing things that aren't explicitly mentioned, are you? How quaint.

    That “some clause in the constitution” you're referring to happens to be the Tenth Amendment, which states:

    The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

    .

    But hey, it's only the Bill of Right's we're talking about–not to mention–the entire basis of our Federalist form of government (as opposed to a Unitary form of government).

    Following the Constitution? How quaint!

  • Father_Time

    The world is NOT poorer than us you dumb bunny. We are sixth in standard of living, not first. Socialized Medicine is cheaper by far and better by farther!

    It works on the same mechanism that capitalism works, a little bit from everybody makes you rich, or in this circumstance, pays the medical bills.

  • http://blog.360.yahoo.com/blog-cjQ4r_Y_cqXPXpxyIWQePYrgXHbB nicrivera

    The Republicans caused this with their obstructionism of real healthcare reform. National Socialized medicine is the only way to reduce costs and provide for the people’s healthcare needs. The world has already proven it. While we play around with jackass republican hardheads or blue-dog dummies, our people fall deeper into debt over healthcare costs.

    No one in congress is proposing “National Socialized medicine”–Republicans or Democrats. Some Democrats have proposed nationalizing the health insurance industry–as has been done in most European nations–but that is NOT the same thing as “National Socialized medicine.”

    If you're solution is “National Socialized medicine”, then there's no point in singling out Republicans and Blue Dog Democrats since just about every elected Democrat is also against “National Socialized medicine.”

  • Dr J

    A little bit from everybody makes you rich, or in this circumstance, pays the medical bills.

    Except, as the original story illustrates, it's not a little bit from everybody. It's quite a lot.

  • Father_Time

    Well the cost of healthcare in the United states is beyond reason and is double or triple the costs of healthcare in other MODERN nations. We cannot possibly control the outrageous and unaffordable healthcare costs, caused by capitalist healthcare, in the United States without the full control provided by Socialized Medicine.

    Costs will continue to rise in this nation regardless of government intervention unless full control is established with National Socialized Medicine like in every other modern nation on earth. Otherwise its like spitting into the ocean in the vain attempt to raise the level.

  • EEllis

    There seems to be something missing from the post. First for the record I am against most of the so called reform. I think it's just wrong to mandate coverage. That being said all this would be done thru and as a part of your taxes and anyone under a specified income amount amount will get a tax credit that would more than cover almost everyone's insurance costs per individual. So in reality you are talking about getting that money back from the Govt then not buying the insurance. That is where the crime would occur.

  • Leonidas

    Hey, I just read it, and it turns out the 16th Amendment doesn't mention health insurance at all. You're not one of those fundamentalist crazies who believe some clause in the constitution forbids the federal government from doing things that aren't explicitly mentioned, are you? How quaint.

    Constitutional quibbles aside, it's a greater infringement on the public to make them fund universal care through taxes than to leave them latitude to shop. One size and one price point for insurance does not fit all, and people should be able to choose what fits them best. Millions of people shopping and demanding value for money is exactly the shake-up the industry needs too, but I'm a broken record on that topic.

    LOL, we think very much alike on this. Still if having to chose among evils I wouldn't select one that jails people for not paying insurance.

  • Father_Time

    That’s only because they have no choice. The stigma of “Socialized” is used by republicans as a negative, but in this circumstance the world has proven that Socialized Medicine is the best way.

    I propose it because the world proposes it and advocates it as a solution!

    Why do we even have to have these arguments when the rest of the modern world has already solved the problem? He answer is right before our eyes in dozens of viable systems for us to shop through, but they are all Socialist Methods and the word “Socialist” has been turned into the boogy man by the stupid assertions of Republicans and conservative Democrats. The whole thing is childishly ignorant. We do no suddenly become Communists or even Socialists because we Socialize Medicine. Capitalism does not go away, just the profits are regulated down to a fraction and wages are controlled to a reasonable level as well as civil liability is reduced.

  • Dr J

    …unless full control is established with National Socialized Medicine like in every other modern nation on earth.

    Father Time, it's very easy to imagine them as nirvana in the abstract. But every time I read about the details of one, such as Japan for example, they've got exactly the problems fiscal conservatives foretell, with rising costs at the front of the pack.

    If you know of a single country on the planet that has health care as good as ours and isn't facing shortages and/or rising costs, please name it.

  • shannonlee

    Dr J, have you ever lived in a country that has some sort of public health care option? European countries are not facing half of the cost problems that we are and they can deliver equal health care quality.

  • Father_Time

    Practically ALL European countries are as good or better! Costs are a half to a third!

    Shortages? What shortages could possibly be worse than the shortages we have here?!

    Your arguments here are designed to obscure the reality that our system costs twice to three times any other modern system, has the shortage of 40 million completely without, another 60 million under insured and thus still unable to afford any serious health problem, and, most of all these numbers will never decrease, only grow and grow rather rapidly, simply because nothing can be done to stop the increase without Socialized Medicine.

    Nobody wants our system. Nobody. We need what virtually everybody else has, Government Run Healthcare!

  • http://sovereignmind.wordpress.com/ adelinesdad

    It seems to me the $25,000 fine or jail time is the penalty for not abiding by tax laws. The fine for not buying insurance is $1,900. I don't like the individual mandate either, but let's be clear with the facts.

    EEllis, no, even those who don't get the subsidy would be required to pay the fine ($1,900) if they don't buy insurance.

  • tidbits

    Penalties, potential fines and potential jail time are what come with mandates, and mandates are one of the two principal reasons I have opposed these proposals coming throughCongress from the beginning. The other is the absence of meaningful cost control.

    Redundant, I know, but the Dems should have gone all in for single payer with FICA like withholding. Some, myself included, might not like it, but at least it's a clean option.

  • D. E.Rodriguez

    “Dr J, have you ever lived in a country that has some sort of public health care option? European countries are not facing half of the cost problems that we are and they can deliver equal health care quality”

    I have—several countries and for several years in each, and as I have commented before I have nothing but praise for the quality of the health care I and my family have received…at hardly no cost (But, but, some will say, how about the higher taxes…yes somewhat higher than in the US, but there are not millions and millions of those countries' citizens going around without adquate health care and health insurance, or having to face bankrupcy when encountering a medical emergency).

    Just an observation

  • Dr J

    European countries are not facing half of the cost problems that we are.

    Which country, Shannon? The data I've seen hasn't borne that out. Although European countries may look better in terms of the fraction of GDP they spend, they're facing much the same cost increases and are often undertaking their own reforms to contain them.

  • RememebrNovember

    may be off-topic, but why does that pos Ensign still have a job?

  • Rudi

    Dr J,
    Coming back at you, where is your citations showng any EU countries spending more per person or GDP with worse care thann the US.

  • EEllis

    “EEllis, no, even those who don't get the subsidy would be required to pay the fine ($1,900) if they don't buy insurance”

    Yes but those would be at an income level where they clearly could “afford” it. No one would be going to jail for lack of money.

  • http://greendreams.wordpress.com GreenDreams

    DrJ, I'll admit two things; every system faces the demographic problem we do, as people are living longer and more effective and expensive treatments late in life are increasing cost. And nothing in our current reform debate will do anything to change that. And that is the limit of our agreement. As I've noted before, the fear tactics of the GOP make a meaningful dialog impossible. Ultimately we will need to talk about limits to costly end of life procedures, but the “death panel” extremism makes that completely impossible at this time. Suggestions? Furthermore, there is no proposal from either party that addresses the demographic facts. But that is completely irrelevant to this debate, because private insurance DOES NOT WANT to insure 65+ year old Americans with plenty of pre-existing conditions and entering their medically most expensive time. There is NO SOLUTION in the for-profit insurance model. So it is a purely disingenuous argument that includes warnings about Medicare insolvency (it isn't, but that's irrelevant) or the rising costs of single payer systems. The “free market” has no answers for these issues, and they are unadulterated red herrings in this discussion.

    Next, it's not a “10% savings” I'm “nattering on about.” It is true that we pay two to three times as much for worse outcomes. Single payer systems have more than proven their case, worldwide, and our model has proven it's case, for cruel distruction of personal finances (60% of personal bankruptcies due to medical costs and 70% of those bankrupted HAD INSURANCE.) As for the numbers, glad to remind you.

    The insurance industry says its overhead plus profit is 16.7% and is “not likely to vary by more than a percent or two” in the future. The same industry admits Medicare overhead has steadily declined and is at 3.3%. Plus, Medicare pays doctors 19% less and hospitals 25% less than private insurance. The cost savings look to me like 33-39% savings for a Medicare option for all. Since we can't talk about anything that could be twisted into “death panels” the only low hanging fruit I can see here is insurance company waste and profit. You, Jazz and a few others keep trying to make this about “tort reform” but that's only a half percent savings.

    You claim not to be an insurance company booster or employee, but you continue to malign systems that work for the rest of the world quite well, and try to besmirch them for having the same demographic problem that we do.

    With respect to the “mandate” v.s. “tax” debate, there is a big difference. The government should have NO RIGHT to force people to give money to a for-profit company. I despise these greedy and heartless creeps and (though I pay them every month), it is an outrageous suggestion that we could be FORCED to pay into the pockets of fat cats who make hundreds of millions of dollars. That is just. wrong. With a public option, at least it's nonprofit.

  • Dr J

    You continue to malign systems that work for the rest of the world quite well.

    How well they work is precisely the question. If you seriously want to improve our system, you have to assess the pluses and minuses of alternatives realistically. Accusing anyone who asks “which country, exactly?” of a bad attitude is unhelpful, and sadly you're the most data-centered of the leftist writers here. Your colleagues saying “hardly no cost” and “shortages? what shortages?” reveal a disturbing lack of curiosity about the policies they're advocating.

  • Rudi

    Our present system costs twice per person in comparison to all other Western countries. We rank at the bottom in care; so I guess free markets provide the best care(not).

  • shannonlee

    I'll pick two…Germany and France. I'm sure you can dig up problems in each system, but even combined, they don't have the problems that we do. I've received great health care in both countries.

    I think the reason you aren't getting specific countries named is because the right loves to cherry pick problems and use them as an example of how the entire system is broken, when that simply is not the case. We've seen it done hundreds of times…it gets old.

  • Almoderate

    “You don't have to drive a car, but you pretty much do have to live.”

    Which is precisely why having health insurance is far more important than having car insurance. Costs don't disappear just because a person is uninsured. It's not a question of making it a law for others to pay for the uninsured. It's already happening and will continue to happen. Those costs are simply passed on to the rest of us in the form of either taxes or higher prices (which would mean higher insurance premiums).

    It's not that I don't agree that single payer would be better. I do, and in fact I was arguing for single payer not too long ago while you and DLS were shooting it down as the apocalypse. But the costs do have to be controlled in one way or another, and making sure everyone is covered is the best way to reel in a good chunk of those costs.

    The problem is that the right fought so long and hard against any public option and/or single payer system that they didn't consider that the alternative might be worse. You guys didn't want single payer. You didn't want a public option. The Baucus bill is in fact a direct result of the Republican wish list. In fact, it's nearly a clone of RomneyCare, which just happened to be the talking point for many Republicans not so very long ago!

    The purpose of this legislation, aside from insuring those who need it, is to lower the costs for those of us who are already insured and might face some very real problems in spite of that. The concern from the right (after you weed out all the “death pannel” crazies) was that private insurers couldn't compete or that it might hurt their profits. If you don't believe me, go back and look at the discussions on this very site not two months ago.

    I think what we're seeing here is that the right (including you, Leonidas) are now living the old saying that you should be careful what you wish for because you just might get it.

    So again I ask you… If you believe so dearly that someone should be made responsible for his or her own actions (outside of letting them die in the street for not having insurance), what is YOUR suggestion for handling the issue of people who can afford insurance but refuse to purchase it? I've yet to see your alternative to a legal penalty. What is this grand scheme for an issue that really must be addressed? Ignore it and maybe it will go away?

    “The federal government [insert alternate argument here] is not constitutional.”

    That can always be remedied, and that's the fatal flaw of that argument. In fact, the whole purpose of the legislative process is to make a thing a legal or illegal practice. At one time it wasn't constitutional for women to vote or for the federal government to tell states whether or not people could own slaves. Don't get me started on the Eighteenth Amendment. Regardless, if we stuck to that philosophy in all things that the government does (and actually adhered to the Tenth Amendment), we'd see a much different government than we have today. And while we have the “health care isn't a right because it's not specifically mentioned in the Constitution” crowd yanking away at the Bill of Rights, why not pull out the Ninth Amendment and preamble as well?

  • D. E.Rodriguez

    “Dr” J:

    “Your colleagues saying “hardly no cost” and “shortages? what shortages?” reveal a disturbing lack of curiosity about the policies they're advocating.”

    Since I am one of those “colleagues” who have actually lived in several foreign countries and observed, and used their health care systems, and offered my opinions of them, rather than “advocating policies”, I take offense at your accusation of “lack of curiosity,” doctor.

  • Dr J

    Dorian, it's great that you had terrific experiences with health care in those countries. Plenty of people have terrific experiences with ours too, and most–including most of the writers here–show very limited understanding about how even our system works.

    Nothing wrong with anecdotes about your experiences, but they are no substitute for a systematic analysis of what's good and bad overall, which is what we should be doing in the context of a discussion about reforming our system. I'm afraid I still find it disturbing that you and others will make statements about “no cost” treatment in other countries. Obviously there is a cost, it's not a small one, and it matters.

  • D. E.Rodriguez

    “I'm afraid I still find it disturbing that you and others will make statements about “no cost” treatment in other countries. Obviously there is a cost, it's not a small one, and it matters.”

    Of course, there is a cost, and it does matter. There is no free lunch, and if you revisit my original comments, you'll see I addressed higher taxes. And I do understand, that such a cost is only one of several costs. Some may quote horror stories about other costs: the long waits, the “rationing” of health care, the alleged “inferior” quality of health care, etc.. But here is where, Dr J., what you call “anecdotal experience, “having been there” and “done that” counts more than all the other “hearsay experiences” that one sees flying around so freely, so irresponsibly here and elsewhere.

  • http://greendreams.wordpress.com GreenDreams

    agree, Dorian, and furthermore, many here, myself included, have posted links to the best objective analyses we have available for non-subjective studies and the opinions of experts. I just scratch my head when reform opponents denigrate our finest medical schools if they agree that other models make sense, or dismiss objective data if it's compiled by the UN or some other out-of-right-wing-favor organization. If I cite research done by the Bush administration supporting my points, it's “out of date”. But of course if it's from the Obama administration it may be up to date but it's biased. How convenient.

  • DLL83

    Dr J, you said

    “If you know of a single country on the planet that has health care as good as ours and isn't facing shortages and/or rising costs, please name it.”

    Please correct me if I've misunderstood, but to me it seems like your argument boils down to the fact that all other countries' health care systems have problems, too. This is certainly true, but the point others seem to be making is that the problems here in the U.S.A. are significantly worse than those elsewhere. Even if we did adopt one of the other systems it would be an improvement. Seeking the perfect solution is an ongoing process because no one will ever agree what the perfect solution is. But I think the other systems at least point in the right direction.

    If the people of other countries allocated as much money per capita on health care as Americans currently do, they'd be going to the doctor all the time. They'd be getting MRI's and CT scans just for the hell of it.

    Personally, I don't really care whether my health care expenses come in the form of premiums to an insurance company or taxes to support a government-run program. I just want to get value for my money, and I don't want to pay way more than the rest of the world for the same thing.

  • http://greendreams.wordpress.com GreenDreams

    Here again is some data about the cost, coverage and comparison of the Canadian system and ours:

    Myth: Taxes in Canada are extremely high, mostly because of national health care.

    In actuality, taxes are nearly equal on both sides of the border. Overall, Canada's taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

    Myth: Canada's health care system is a cumbersome bureaucracy.

    The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

    Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

    What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

    http://www.denverpost.com/portlet/article/html/

  • D. E.Rodriguez

    I agree, GD. It's very frustrating. It seems that if a study or research doesn't have the “Good Housekeeping” seal of the Limbaugh Institute for Advanced Republican Studies (LIARS) embossed on it, it doesn't mean anything.

  • Dr J

    Your argument boils down to the fact that all other countries' health care systems have problems, too.

    DLL, that's at least the beginning of it. My comrades on the left have been unable to grant even that much, much less to engage in any serious discussion of relative costs and benefits. You're right that they believe the benefits of socialism outweigh the drawbacks, but they would be more convincing if they demonstrated more familiarity with the latter.

    In fact they don't seem very clear on what they are asking for. People are aghast at the idea of forcing people to buy insurance, but that's what the Swiss do. Germans pay 15% of their payroll for their universal coverage. Do Europeans enjoy the same freedom to sue that liberals prize here and fight any effort to reform? IMHO, if you're not asking questions like this and showing you're comfortable with the answers, you're premature to conclude that “their system” (whoever “they” are) is better.

    Do I think the mere existence of drawbacks in other systems disqualifies them? Of course not, any system is going to have drawbacks. I'm even convinceable that adopting some European model would be a great move for us. I just have yet to hear an unbiased, data-centric, non-hysterical case made for it. At the moment the balance of the evidence I've seen is coming down on the other side.

  • http://sovereignmind.wordpress.com/ adelinesdad

    “Yes but those would be at an income level where they clearly could “afford” it. No one would be going to jail for lack of money.”

    I agree for the most part. As I said, I don't agree with Leonida's description that the choice is between buying health care and jail. And I agree that, at least in theory, those who can't “afford” coverage wouldn't be penalized because they would receive subsidies. However, that's assuming we can all agree on what “afford” means, which is a big assumption. And then there's the question of whether people should be forced to buy something by the federal government, no matter how much money they have.

  • http://sovereignmind.wordpress.com/ adelinesdad

    D.E. Rodriguez: “I have—several countries and for several years in each, and as I have commented before I have nothing but praise for the quality of the health care I and my family have received”

    D.E. Rodriguez: “Some may quote horror stories about other costs: the long waits, the “rationing” of health care, the alleged “inferior” quality of health care, etc.”

    So your experience is sufficient to form an opinion of an entire health care system, but I should not listen to people who have a less favorable experience? I have received excellent health care in the US as well.

  • EEllis

    “And then there's the question of whether people should be forced to buy something by the federal government, no matter how much money they have.”

    I agree I'm not in favor of these many versions of health care reform. I just felt the characterization of this aspect was misleading.

  • D. E.Rodriguez

    adelinesdad:

    “So your experience is sufficient to form an opinion of an entire health care system, but I should not listen to people who have a less favorable experience?”

    Where did I say, or imply that, adelinesdad. Please get your facts straight before making accusations.

    I have nor control over how you decide to interpret comments.

    “I have received excellent health care in the US as well”

    So have I, the best in the world! And guess from who?

    That big, mean, U.S. government that now wants to provide adequate health care to all Americans.

  • Leonidas

    Another interesting aspect of this mandated coverage, is you have to wonder how it will be enforced. Will people be forced to report to the government evidence of having insurance and thus with whom? An invasion of privacy issue perhaps?

  • http://sovereignmind.wordpress.com/ adelinesdad

    D.E, I'm not making accusations. I put two of your comments together and pointed out what appears to me to be a contradiction. It happens to the best of us at times. It appears that you would agree that one person's experience does not reflect on the entire system. We agree on that, but then we need to be careful when we say things like “I have nothing but praise for the quality of the health care I and my family have received” as a rebuttal to claims about the flaws of those systems. Again, I didn't intend my comment to be accusatory. I'm a debater at heart, and I have a record of pointing out contradictions and flaws in arguments, even in cases where I agree with the conclusion (as this post and my comments are evidence of).

  • http://sovereignmind.wordpress.com/ adelinesdad

    “Even if we did adopt one of the other systems it would be an improvement.”

    Even if we were to agree that our problems are bigger than those of other countries, this statement assumes that a system that works in other countries would work just as well in the US. Some portion (perhaps most) of the increased cost of health care in the US is not due to waste. We demand more health care, and we pay our doctor's more (I believe because of the high competition in the high-skill labor market–in other words, there are more opportunities for highly educated people outside of the medical profession) than other countries. See http://www.worldsalaries.org/. Note that for skilled professions, the US far out-pays other countries. But for unskilled positions, the difference is less pronounced. Why is that? Because there is a high demand and short supply of high skill workers. We need to do more in education in this area, and reduce the barriers to getting into the medical professions (tort reform would help in this area, although I agree with the President that it is not a magic bullet by any means).

    US consumers also fund more specialty research than that which happens in other countries, which is evidenced by the high quality specialty care centers that are in the US, such as the Mayo clinic, Cincinatti Children's Hospital, and Cleveland Clinic. Pharmaceutical companies face price controls in other countries, and so make up for the cost of research on the back of US consumers. Drug companies aren't popular these days, but they are responsible for doing much good by producing medicines that are extremely costly to develop.

    So, I'm far from convinced that we could adopt a European system and we would see our costs go down to their levels. (And I do believe the main problem is cost, which puts health care out of reach of too many people). So I would not necessarily agree that we would be better off in a European system, even if I were to agree that European countries have less problems.

    I'd also point out that the popular rating that puts the US 37th in health care is weighted by cost. So we are not low *despite* of our cost. We are low *because* of our cost (some of which is explained not by waste but by differences in economics as I described above). When not considering cost, it's something like 17th. And that's counting some suspect measurements like access equality (two countries who have poor health care for all would score higher than a country with poor care for some and good for others) and life expectancy, which is more a factor of life-style than health care quality.

    I do now know how the US would rank in a non-biased rating, but I suspect it would be in the top 10, if not top 5. There is certainly room for improvement, but there is also room to screw things up even more.

  • Dr J

    Well said, Dad. A good analysis of facts underlying the stats, sensible cause-and-effect explanations, references to neutral sources. No demonizing this group or that group, no hysteria, no reliance on repeatedly-discredited data, no conspiracy theories. I would love to see more of the left's positions articulated as evenly; they might yet win me over.

  • EEllis

    “Will people be forced to report to the government evidence of having insurance and thus with whom?”

    You may very well need to turn in such paperwork with your Taxes. I see many reasons to be against this bill but this seems to be the least of the issues

  • Rudi

    US consumers also fund more specialty research than that which happens in other countries…

    Please show a citation to prove this point.

  • http://sovereignmind.wordpress.com/ adelinesdad

    The US ranks highest in cancer survivability: http://www.google.com/gwt/x?oe=UTF-8&client=saf

    “The differences in survival are due to a variety of reasons, Dr. Verdecchia and colleagues write. They include factors related to cancer services — for example, organization, training, and skills of healthcare professionals; application of evidence-based guidelines; and investment in diagnostic and treatment facilities — as well as clinical factors, such as tumor stage and biology.”

    The US ranks highest in median life expectancy for cystic fibrosis: http://www.chestjournal.org/content/117/6/1656….

    Of course, those are just two examples. It doesn’t “prove” my point. If anyone has more comprehensive data, I’d be interested in seeing it. But even those on the left have agreed (and the president has said on multiple occasions) that our ratio of specialty care providers to general practitioners is higher than other nations. This is a problem in that there are not enough general practitioners. But in trying to change the system to get more of them, we need to be careful not the throw out the baby with the bath-water. Having a large number of specialty doctor’s appears to be making us a leader at treating those who are very sick.