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Posted by on Sep 21, 2009 in Health | 55 comments

Did Barack Obama Read the Baucus Bill?

o_laugh.jpgYesterday I took some friendly fire from readers for my dubious response to President Obama’s claims to George Stephanopoulos that charging people money if they don’t have health insurance was not a tax increase. George broke out the dictionary definition of “tax,” which the President blew off. In other areas, people like Steve Benen crowed about how Obama had “schooled” George on what “tax” means. Rather than looking at Merriam-Webster, Stephanopoulos should have just broken out a copy of the legislation in question.

Let’s all open up our copy of the Baucus plan and turn to page 29. We find ourselves in SUBTITLE D: SHARED RESPONSIBILITY. And what does the bill tell us will happen if you fail to purchase health insurance?

Excise Tax. The consequence for not maintaining insurance would be an excise tax. If a taxpayer’s MAGI is between 100-300 percent of FPL, the excise tax for failing to obtain coverage for an individual in a taxpayer unit (either as a taxpayer or an individual claimed as a dependent) is $750 per year. However, the minimum penalty for the taxpayer unit is $1,500. If a taxpayer’s MAGI is above 300 percent of FPL the penalty for failing to obtain coverage for an individual in a taxpayer unit (either as a taxpayer or as an individual claimed as a dependent) is $950 year. However, the maximum penalty amount a family above 300 percent of FPL would pay is $3,800.

So, Mr. President… would you care to explain to us one more time how this isn’t a tax?

Follow more of this argument at Memeorandum.

UPDATES: Spelling of “Merriam-Webster” corrected. Thank you for pointing that out. Of course, since the original spelling was incorrect, the entire premise of the article must be faulty. (/sarc)

Second, one of our frequent commenters is continuing to describe this as “gotcha journalism.” How utterly convenient of Obama’s supporters. Allow me to clue you in on something… When an elected official refers to the capital of Oregon as Portland instead of Salem in a momentary lapse of high school lessons and people jump all over him saying he doesn’t even know anything about his country, that’s “gotcha journalism.”

This is a President who has consistently gone out of his way to assure everyone that he wasn’t going to be funding his various initiatives by taxing the middle class getting into an argument with a journalist who called him out and claiming this wasn’t a tax increase when he knew full well that it was. This is, to invoke a recent town hall instance, a case of “peeing on our legs and telling us it’s raining.”

And let us also be very clear on the fact that this is not a “fine” we’re talking about. The word “fine” has a very specific meaning in this context, and it is a penalty imposed by the court system on persons who have broken the law. If you are caught driving without liability insurance (again… note liability against damage to others) you can be taken into court for breaking the law and given a fine. If the President wishes to extend this discussion to make it illegal to be breathing while not having health insurance and taking citizens to court to fine them for it, we’ll be happy to have that discussion as well. But this is not a fine. It’s a tax which would frequently be imposed on a specific sub-set of citizens who, for whatever reason, feel that they can’t afford to purchase health insurance. And the President getting into an argument claiming that it’s not is simply dishonest.

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  • Still playing gotcha I see.

    One thing, the Baucus Bill is not the only Democratic bill under consideration, and it wasn’t written by the President.

    • Cindy Whitehair

      Let’s also look at the context to which Jazz refers to. The question that Stephanopoulos posed was this:

      “STEPHANOPOULOS: Yet this week, Senator Rockefeller and several other Democrats say that this bill by Senator Baucus is a big middle class tax increase.

      Do you agree and does that mean you can’t sign it?

      If the President were going to abide by his “No tax increases for the middle class” promise, he would have had to have said “no” if he had read the bill. That in a nutshell is the essence of Jazz’s point.

      LL

    • Post updated just for Chris.

      • *Presses the “like” button on Jazz*

  • redbus

    Of course it’s a tax, and of course Miriam-Webster is spelled Merriam-Webster.

    • Post also updated just for redbus.

  • Cindy Whitehair

    Chris if you want to get technical NONE of the Democrats bills were written by the President. The President does NOT write legislation per the Constitution. However, when you look at the two completed bills – the ones that the supposedly meet the President’s “goals” (HB3200 and the Baucus Bill) both have large tax increases in them so Jazz’s larger point is quite germane.

    LL

  • HemmD
  • Fair enough LL. I retract that point.

    But I still think the question of is this a tax or not obscures the actual policy questions at stake.

  • Silhouette

    This is an excercise in what’s called “showing the public what the compromise really means”….and it ain’t good. Obama is bringing the Baucus Bill to show-and-tell. The bottom line is that any levering of people’s health for cash is objectionable & amoral and I imagine [just a guess here] our President is letting that penetrate people’s minds in a tactile way.The bottom line is you’re going to pay one way or the other, why not a way that is regulated and won’t escalate arbitrarily based on how many CEOs want to take their bevy of prostitutes to marble mansions in Italy?A far greater way would be a health tax straight up. Per person a nominal fee per month. Add that to a soda tax and I imagine you’ve gone great lengths to pad a fund that could provide the fourth leg of American welfare protection: 1. Police 2. Fire 3. Military 4. MedicalVery simple and oh how the MedMob want$ to make it complex..lol…There’s an article on how capitalism has two forms; one of which depends on PFMM and one doesn’t. The second is not a true form of capitalism but instead is an undermining of capitalism. Food for thought: http://placeofnopity.com/cgi-bin/blog

  • tidbits

    Call it a tax. Call it a fine. Call it a penalty. Call it a mandate. Whatever it is, people have to pay it out of pocket if they, for whatever reaason, choose not to drop $10,000 to $20,000 into the insurance company coffers every year.

    The proposals coming out of Congress are enhancement and enrichment bills for the insurance industry, not serious reform. Somebody needs to tell the people what these proposals really mean and what the real effects would be. Thanks to Stephanopolous and Jazz for holding this up to the light.

    The next topic might be the absence of serious and specific cost controls in these proposals.

    • HemmD

      tidbits
      “Whatever it is, people have to pay it out of pocket if they, for whatever reason, choose not to drop $10,000 to $20,000 into the insurance company coffers every year.”

      Are you suggesting that we shouldn’t require accountability? No one expects to get sick, get hit, or break that leg. What mechanism do you suggest to keep you and me from paying for people who think they’re immune to illness and injury?

      • tidbits

        HemmD –

        I have said repeatedly here that I think single-payer is a more honest approach than the hocus-pocus of bills designed to feed special interests. If one’s goal is to enrich the insurance industry and protect other special interests while doing very little about cost containment, the Baucus Bill is for you. Personally I believe there is a better alternative than what is currently on the table or single payer, but it’s not on the radar screen and is far too detailed (as in 20 pages in outline form) to lay out in a comment.

        You’re correct that we all pay for the uninsured.

        I personally dislike the comparison to car insurance. People have a choice to not own or operate a motor vehicle. If you choose to own a vehicle, you accept (by that choice) the obligation to have liability insurance. You do not have a choice about breathing.

        The Baucus Bill, by the way, has fines, taxes, penalties (whatever you want to call them) that are much lower than the cost of health insurance. There will be those who will make the financial calculation that it is cheaper to pay the tax, fine, penalty than to purchase insurance. Frankly, I cynically believe the Baucus Bill supporters are counting on this (the collection of the tax-fine-penalty) to get to budget neutrality.

        • HemmD

          tidbits

          Just to be clear, it’s not that I support the Baucus private insurance welfare act. I was responding to the current distraction, is it a tax or a fine or a whatever.
          The single-payer system would require a complete re-write of current medical service in the US. Public option is more feasible, but neither coverage plan will work as long as costs continue to rise. Cost containment and reduction is the real issue, and it’s obvious that the current plans make no real attempt in that area.

          • tidbits

            HemmD – If you are a supporter of single payer, my admittedly unsolicited advice would be to not give in to the canard that it would require a complete re-write of current medical service. The same argument was used to try to derail Medicare, and, in another context, Social Security.

            Whatever reform turns out to be, a near complete re-write of current medical service will be necessary if we are to get serious about cost containment and reduction. Drug costs, duplication of services, excessive diagnostic procedures and treatment procedures, administrative insurance cost, multiplicity of billing procedures, 50 separate regulatory schemes adding administrative costs and generating quasi-monopolies on a state-by-state basis, medical malpractice reform with its inherent costs as well as the collateral costs of defensive medical practices, permissive hopsital/clinic cooperation as opposed to competing for physician privileges and coercing physicians with privileges to order unnecessary testing and procedures to justify unwise medical equipment purchases..

            Well, I could go on, but the point is that we need a re-write for any reform to be serious in the cost area, whether Baucus, the House Bill with Public Option, single payer or another, yet unnamed alternative. The problem, and I am being redundant from prior comments on other threads, is that the current atmosphere in Washington, dominated by special interest money and influence, won’t permit it to happen.

          • HemmD

            Tidbits
            ” Whatever reform turns out to be, a near complete re-write of current medical service will be necessary if we are to get serious about cost containment and reduction”

            The re-write that we both see as required is nowhere to be found in current legislation. I fear the lack of serious effort to couple total coverage with cost reduction and procedural efficiencies is by design. Private Insurance profits are pegged to higher costs, and all current efforts seem to guarantee those profits at any price.

            This has been the crux of my frustration with the entire reform effort. If a physician only attempted to treat each of my symptoms in such a piecemeal manner, I would quickly conclude that he didn’t know what illness I had. Healthcare reform is by its very nature a systemic problem, and treating the cough, the runny nose, and itchy eyes alone will never resolve the hemorrhaging that is efficiently draining the US economy.

      • mikkel

        What’s likely to happen is that many people will buy non-conforming insurance that is much much cheaper and then pay the fine as well. They’d save thousands a year and for most people under 40 it’d make much more sense.

    • Rambie

      Tidbits: “Call it a tax. Call it a fine. Call it a penalty. Call it a mandate… The proposals coming out of Congress are enhancement and enrichment bills for the insurance industry,”

      Exactly!

      Getting true healthcare reform isn’t going to be free or “budget neutral”. That’s like making a perpetual motion machine, it’s not going to happen. Real reform (not this enrichment of the insurance industry farce) is going to take some money.

      Instead of fighting over if it’s a “tax” or not, why not discuss ways to have REAL insurance reform and how to pay for it.

  • HemmD

    jazzThe purpose of liability insurance is to protect the public from the costs incurred due to a non-insured person’s actions. The penalty proposed here serves the same purpose. Uninsured patients presenting themselves at ERs incur costs that both you and I must cover through higher health costs and government payments to cover these costs. The uninsured motorist no more intends to have an accident than an uninsured patient intends to incur hospital costs. Mandated coverage is for the public welfare, not the individual interest.

    • EEllis

      “The purpose of liability insurance is to protect the public from the costs incurred due to a non-insured person’s actions.”

      I disagree, the purpose of liability insurance is to protect an individual from incurring costs due to a insured person’s actions or to state it otherwise purpose of mandating liability insurance is to prevent any one individual from incurring costs due to the actions of another. It is not to protect society but individuals.

      • HemmD

        EEllis

        You either didn’t understand what I was saying or don’t understand liability. If a person has no liability insurance and hits another person’s car, liability insurance covers the damage to the other persons property. It is an attempt to guarantee the public’s safety against the actions of a person not following the rules. Because no one knows who an uninsured driver may hit, the liability insurance serves to protect all on the road; thus, it protects the general public against loss from someone not fiscally responsible for his actions.

        It appears from your comments that you see “individuals” where I see a collective of individuals, i.e. the “public.” This may be where we misunderstand. The salient point is that those who do not take fiscal responsibility cannot be allowed to endanger the fiscal resources of anyone else. Those who do not have health insurance also risk your and my financial well-being when they fail to pay hospital bills that are then passed on as higher costs to us.

      • HemmD

        EEllis

        You either didn’t understand what I was saying or don’t understand liability. If a person has no liability insurance and hits another person’s car, liability insurance covers the damage to the other persons property. It is an attempt to guarantee the public’s safety against the actions of a person not following the rules. Because no one knows who an uninsured driver may hit, the liability insurance serves to protect all on the road; thus, it protects the general public against loss from someone not fiscally responsible for his actions.

        It appears from your comments that you see “individuals” where I see a collective of individuals, i.e. the “public.” This may be where we misunderstand. The salient point is that those who do not take fiscal responsibility cannot be allowed to endanger the fiscal resources of anyone else. Those who do not have health insurance also risk your and my financial well-being when they fail to pay hospital bills that are then passed on as higher costs to us.

        • EEllis

          “You either didn’t understand what I was saying or don’t understand liability.”

          I understood I just disagree with you definition and reasoning.

          “It is an attempt to guarantee the public’s safety against the actions of a person not following the rules. Because no one knows who an uninsured driver may hit, the liability insurance serves to protect all on the road; thus, it protects the general public ”

          See I believe the reasoning is that it protects the individual from the possibility of financial loss due to others actions. “The public” are not a party here in Texas. You have the State and an individual, but no claim of public good in Texas but rather that people must show the State they can pay for any accident they cause. You have decided that it’s because of some “collective” but that is what you perceive not what my State says

          • HemmD

            Sorry EEllisBut the “state” has no meaning without the general public that gives the state existence. Texas without Texans is just Mexico.

          • EEllis

            “But the “state” has no meaning without the general public that gives the state existence. Texas without Texans is just Mexico.”

            The State does have meaning on it’s own separate from the general public. Don’t let ideology blind you to facts. Besides now you argue some extraneous point instead of your original claim that auto insurance was for some “collective” good. It is not in my state and you have shown nothing to make your case in any other location just your “philosophy” of who knows what.

          • HemmD

            EEllis

            “Don’t let ideology blind you to facts.”

            I don’t have time to teach you the entire history of the US Constitution and the Texas Constitution that draws its authority from the Federal Mandate. However, let’s start at the beginning. The governmental system you live under is special in that it derives its authority from the people. This is different from say monarchs who like to say they derive their authority from God. That’s why the Constitution starts “We the people,” and not “And God said.”

            The fact that the government derives its power and authority from the consent of the governed, you are wrong to think the a state exists outside of that consent. All of those people who give that consent are also known as “the general public,” and laws defining and protecting all individuals in this society are laws that are defined to serve and protect the general public.

            The person owning liability insurance receives nothing for the money he puts out for that insurance. If he hits someone and smashes himself or his car, he gets nothing. Every person in society he hits, ANY ONE, receives payment covering damage or injury from the accident. Everyone in society is also known as the general public, so the liability insurance one is forced to buy by the State is designed to protect the general public.

            If liability insurance was designed to protect the individual from loss, it would not be required just like comprehensive insurance is not required. In simplest terms, a millionaire who could afford to pay for damages he caused out of pocket is still required to carry liability insurance. It’s a law to protect the general public, not the individual.

          • EEllis

            “Every person in society he hits, ANY ONE, receives payment covering damage or injury from the accident. Everyone in society is also known as the general public, so the liability insurance one is forced to buy by the State is designed to protect the general public.”

            I see what you are trying to say I just don’t think like that and there is no reason to believe that Texas passed it’s laws based on your beliefs. Did they say “Lets require insurance so someone won’t be be screwed over by some irresponsible person” or “Lets require insurance so society won’t be damaged”.

            “If liability insurance was designed to protect the individual from loss, it would not be required just like comprehensive insurance is not required. In simplest terms, a millionaire who could afford to pay for damages he caused out of pocket is still required to carry liability insurance. It’s a law to protect the general public, not the individual.”

            First off in a two party accident the have to be two parties so yes it is to protect a individual, just not the individual who purchased it. Second you don’t have to have liability insurance rather it’s actually proof of financial responsibility which for us broke suckers = insurance. I again believe that it’s to protect an individual, not the “public”, who is damaged. Texas law states that “Financial responsibility” means the ability to respond in damages for liability for an accident. Nowhere is it stated or hinted that the reason is for some “public” good. Show me where any state says that. If it is so obvious then it must be stated somewhere. I know it is not the case in Texas.

          • HemmD

            EEllis

            ” there is no reason to believe that Texas passed it’s laws based on your beliefs.”

            Actually, they did.

            http://www.tdi.state.tx.us/news/2008/news200846.html

            from that Austin link:

            ” Texas law requires people who drive in Texas to be financially responsible for the accidents they cause.”

            And further:
            ” The 80th Legislature amended the current financial responsibility law in 2007 to increase the auto liability limits amid concerns that the current limits aren’t enough to cover the costs of an accident resulting in severe injury or major vehicle damage.”

            The Texas legislature is clearly only concerned with the fiscal safety of the general public. What happens to the guy that doesn’t have insurance is in no way part of their thinking.

          • EEllis

            Nothing you linked to backs your point and you continue to misstate my remarks.
            “What happens to the guy that doesn’t have insurance is in no way part of their thinking.”
            They want individuals to be responsible for damage caused. When did I state otherwise or even mention “the guy” without insurance? How does that have anything to do with anything?

            You interpret those comments to mean the concern for individual liability is because of the public interest in such but Texas law has a dearth of such things. Nowhere in the financial responsibility law is any language that even vaguely refers to that legal idea.

          • HemmD

            I give up.

            The quotes I last sent demonstrate clearly the purpose of the law, to protect the general public from uninsured motorists. If that concept is too difficult to grasp, I can’t help.

            From your original comment:

            ” I disagree, the purpose of liability insurance is to protect an individual from incurring costs due to a insured person’s actions or to state it otherwise purpose of mandating liability insurance is to prevent any one individual from incurring costs due to the actions of another. It is not to protect society but individuals..”

            ” to protect an individual from incurring costs due to a insured person’s actions”

            Completely wrong.

            From Texas’ own web site discussing the reason for mandated liability insurance:

            ” ” Texas law requires people who drive in Texas to be financially responsible for the accidents they cause.””

            The law protects all people from uninsured, thus, it protects the general public. Period.

          • EEllis

            By the way any acknowledgement about you being totally wrong about everyone needing insurance? At least in Texas.

  • Almoderate

    Those who are not covered by a private plan (through employer or otherwise) and qualify for Medicaid are automatically enrolled. Those who do not qualify and make up to a certain amount are given affordability credits to purchase a plan. This is something that’s squarely directed at those who can afford to purchase insurance but choose not to. Should they show up in an ER, then they’ll face the consequences of that rather than everyone else.

    Now, I will agree that the numbers need to change, but it’s almost guaranteed based on the remarks from DEMOCRATS that they will.

    So again I say… Either you can have people pay for their own care, or you can force the rest of the public to pay for their care. Pick your poison. I personally prefer the option that more encourages personal responsibility for one’s actions.

    It could easily be argued that if you have an issue with folks being required to purchase their own insurance (if they can afford it) that you might be okay with the concept of everyone else paying for the cost of them showing up in an ER and possibly defaulting on medical bills later on.

    And no, that situation doesn’t only occur when you try to insure everyone. It occurs now.

  • StockBoySF

    Yes, if this is a tax in the Baucus bill and Obama says it isn’t then he’s.. not being honest. This isn’t a tax on the middle class. This is a tax on certain people who do not buy health insurance.

    So let me get this straight. We don’t like the “excise tax” because it imposes a tax on others and not on those of us who do have health insurance? In other words, without the excise tax on certain people we’d all pay, through taxes, for their medical needs.

    Too bad we have not reached the point where we can talk about nationalizing healthcare and getting rid of those pesky insurance companies who goal is to maximize shareholder returns.

  • Jim_Satterfield

    Jazz, do you support the “Do nothing, the market will work it out.” crowd? Serious question. If not, do you have any ideas on what you feel would work?

  • tidbits is right. a single payer system does not require a re-write of medical service, unless by that you mean a national health service. That’s not necessary or desirable. We don’t need to become the employers of doctors, just the payer.

    Implementing Medicare-for-all (who want it) could be done with a bill about 5% of the size of the current one, if that. It needs only two provisions: 1) those under 65 can purchase Medicare coverage, and 2) Medicare is entitled to negotiate the price of doctors, hospitals, drugs and medical supplies.

  • tidbits

    Rambie and HemmD –

    Agree with both of you. I just don’t know where the political will comes from.

    Remember the history of this “reform” effort. Before anything went to write-up, the insurance companies, drug companies, AMA, trial lawyers, AHA were all “consulted” to assure their buy-in to the deal. Real reform cannot take place when the package is being designed from the get-go to secure the approval of the special interests who profit from high cost health care delivery.

    Hate to say it, but I’m beginning to believe that the best approach is to tackle a few problems like pre-existing condition coverage, non-recission and uncapping coverage, then leave the rest until the crisis becomes so acute that real reform cannot be ignored. I’m not quite there yet, but my growing fear is that we will adopt something now, call it reform, claim we fixed it, and be stuck with consequences (lack of real reform or cost containment) for a generation.

  • Leonidas

    If you want him to read it, hack his teleprompter.

  • $199537

    The importance of whether we call it a fine or a tax relates to Obama’s promise not to raise taxes on people making under 250K. He doesn’t want to admit he is breaking his promise, which of course is exactly what he’s doing. Of course there is no practical difference whether it’s called a tax or something else, except possibly in computing state or local taxes.

  • I agree that current reform is off target for reducing costs. But how can it be otherwise? Remember the “death panel” campaign when all that was proposed was that we guarantee payment for a consult about “living wills,” DNR orders and medical power of attorney.

    Now imagine if there were serious discussion about limiting the spending of 80% of a person’s lifetime medical cost occurring in the last few months of life. How would THAT not rekindle the “death panel” fears? I believe we are incapable of addressing the major cost controls we will ultimately need to face.

    BTW, I oppose the Baucus bill and any attempt to force the public to buy for-profit insurance. It’s why I want a public option. The comparison to liability insurance (which I have for auto, home and business) is a false equivalency. As noted, it is to protect others from harm I might cause them, and of course, to protect me from lawsuits.

  • Bconvis

    I hate people who can’t see the obvious difference between auto insurance and health insurance. Auto insurance is, as noted above, primarily to cover you, while using public roads, in case you damage or hurt someone else. If this wasn’t an issue, if insurance only covered damage to yourself and your car, it wouldn;t be mandated and up to the individual to decide it he wanted the insurance or not. But bceause when we drive we are interacting with others, and pose harm to others and their property, you need to be covered. And that makes complete sense. But health insurance… as long as you understand that if you refuse to buy insurance, you will be on the hook for your expenses, then it needs to be elft up to the individual. Of course, costs are prohibitory in many cases right now, but assuming some form of cheaper option is available, especially to that 18-35 year old group without families and little medical expenses, then it shoudl be their decision whether or not to buy insurance. This is America, people, and many kids out of college with decent paying jobs will… guess what… still choose not to buy health insurance even if it is $200 a month. Bceaus ethey don’t value it. Because they don’t need it. And if they chosse instead to spend that $200 on a car or TV or vacation, that is their choice as Americans. AS long as they understand the consequqnces of doing so.
    Of course this is a tax. anyone with half a brain understands that. But forcing people, especially these young people without families, to buy insurance or pay this tax, is the only way this type of plan has of chance of succeeding. Because you need either the insurance premiums or excise tax from these young people do don’t use a lot of medical care to pay for those who do.
    But this is America, and as Amewricans, we should be free to spend our money as we choose. And if some 21 year old graduates from college and has never been sick in his life and sees more value in spending his cash to live in a nicer neighborhood instead of a health plan he may never use, that is his prerogative. as long as he understands the consequences. But this is an individuals choice to make, and it is not the government’s place to choose how individuals value and spend their money.
    But again, this health plan is not about helping anyone. Not really. Its about control. Does my insurance company control me? Sure. But I CHOOSE to have a certain type of insurance. When the government puts its grubby hands on health, choice goes out the window.
    Last time I checked, by the way, the government wasn’t successful at running anything. Cash for clunkers? medicare? medicaid? When an entity has no shareholders, no personal stake, no threat of bankrupcy… well then, they don’t have to care, do they?
    http://www.notjustaboringdentist.com

    • HemmD

      Bconvis

      “But bceause when we drive we are interacting with others, and pose harm to others and their property, you need to be covered”

      And who do you think pays your hospital bill if you don’t have insurance? Higher health care costs effect all of us poor folks who happen to believe we must protect against catastrophic health costs. If you don’t think that bad things can happen to young and healthy 20 somethings, just ask the last kid that got hit by an uninsured motorist.

    • sheesh, where to start with someone who starts their comment “I hate people?” Nonetheless, I agree that it is wrong, perverse in fact, for the government to force you to patronize a business, especially one in which the fat cat CEO makes $700 MILLION in less than a decade! But the government, Mr Boring Dentist, is successful at running many things. It built and maintains an interstate highway system, air traffic control, largely keeps foods and drugs safe, created the GPS system we all use, developed the technologies that makes our cell phones work, protects us from evil Communists, delivers the mail and yes, cares for the poor and old AT A FRACTION OF THE COST of private health care.

      • Bconvis

        They do a lot of that through regulation, my friend, which is very, very, veeeeery different han trying to run a business. How’s the post office doing? Funny how UPS and Fed-Ex don’t have the same problems. Cash for clunkers? Ran out of money… lets see, 3 months too early? Road projects? They ran out of money a loooong time ago. Its only because of the stimulus that anythign is gettign done. Air traffic control… are you fucking kidding me? The system is so outdated that I believe there are only a handful of people in the country that can fix it when something goes wrong (seriously). They’re not even using GPS yet! medicaid…. social secuirty… going to run out of money long before my 32 year old ass retires. The FDA? I am surprised gthey ahven;t approved the “puff till you feel better” technique for medical marijuana. Government exists to regulate. That is all. Not to run businesses. because, guess what, when you don;t have stockholders to make happy, when you don;t have to show a profit, you get to udnertcut everyone else, and then you get to sell an inferior product.
        And as for caring for the old and poor at a fraction of the cost… you know my friend, there is a reason that we are very short on priamry care physicians in this country. Because no one wants to go to school for 4 years, spend 4 years in residency, and get paid $50 by the government to spend an hour discussing an 80 year olds medications with her. Everyone thinks doctors are ricj, but that isn’t the case anymore, but you knwo what, they deserve what they make because they keep us healthy and alive, and people should not begrudge that. But as medicaid and Medicare are cut, tehy get paid less, but still ahev to watch over their shoudler every minute for that trial lawyer chasing them. So, by tretaing our poor and elderly at a fraction of the cost, as you say, we are slowly keeping young doctors from being priamry physicians. You want health care for all? Hope you like waiting 12 months for a well visit, because thre are not enough doctors to go around. Estimates are we have 1/2, yes one half the doctors we would need to support a population where everyone goes in for a well visit once or twice a year. Half. Because they do not get paid enough by the government for the work they do for Medicare and medicaid. And with the poor population going up, and with people living longer and sicker, until 90 instead of 75, income goes down. And, congratulations, because the government cuts payments every year, no one wnats to do priamry care anymore.
        This is fact, stark, ugly fact, soplease don’t try to argue. Its great we take care of poor and elderly so cheaply. Too bad the doctors who go to school until 31 and have to constantly lvie with the fear of malpractice are the ones to suffer.
        The government turns everything it touches to shit. Sometimes the intentions are good. But intentions don’t matter, only results, and when there is no punishment for failing, no bankrupcy, no going out of business, no hostile takeovers, well then, you don;t actually have to do a good job, do you?

  • Bconvis

    sorry for my spelling in advance
    Look, you simply can not force people to buy something they don’t want to. Don;t want to buy car insurance, don’t drive! It is NOT a right to drive, but if you do, you accept the costs that go along with it. You can not tax people simply for existing. You’re born? here, $3600 tax simply for taking a breath! Of course bad things can happen to people in their twenties. But if there is affordable health insurance, then it should be their choice to buy it. It is NOT the governments place to force people to buy soemthing they do not want. Risk vs reward. Of course, any sane person, given affordable insurance, will buy it. But you can’t force them.You want cheaper health care? Start with the obvious fixes before tearing down soemthing most people are happy with. I want a TV, I can go to Deleware or NY or PA to buy it. Let people shop across state lines instead og forcing people to choose from limited in-state choices. You want cheaper healthcare? Put these goddam trial lawyers in their place. Fix medical malpratice. Fix it so doctors aren;t running every test under the sun for no other reason than to cover their asses. Fix it so its worth it to the insurance companies to actually go to trial if sued instead of always settling out of court even if the doctor is not at fault just to save moeny. Get the malpratice decisions out of idiot jury hands and put into the hands of an educated medical panel. Fix it so only the cases with any merit go to court, and fix it so lawyers don;t get 1/3 the judgement. Start with these two things, and we will eventually get to affordable insurance.But that brings us back to the beginning: this is AMERICA. Land of the FREE. Free to make good decisions and bad decisions. And you know what? If afforable health care is out there for Mr. Smith, but he decides to spend it on a timeshare in Mexico instead, and he is diagnosed with cancer, well then shame on him for not being careful. Shame on him. But this is the US of A, and if Mr. Smith fucks up, will too bad for him. This is not a lack of sympathy issue. This is a “I am tired of taking care of every irresponsible asshole out there who refuses to take care of themself”. This is quickly becoming the United States of Its Someone Else’s Responsibility. Let Mr. Smith go into bankrupcy. Let Mr. Smith be in debt for the rest of his life. You want to gamble if you chose a vacation home over health insurance? Well, when the roll comes up snake eyes, he has no one else to blame but himself.If there is an affordable option, which can be achieved by fixing malpractice and allowing you to buy insurance out of state, and you, as an American choose not to buy it, well then, you have to live with the consequences of your decisions. What’s next? Forcing people to buy life insurance?This is not about health. Does anyoen pay attention out there? We are running out of primary care physicians because the re-imbursement from Medicaid is too low, and we have an increasingly aged population. For all of the bullshit talk about prevention through seeing a primary physician, and coordinated care through a primary physician, is a pipe dream. Bceause if everyone is going to the doctor, then we may be waiting a year just for a check up. Because the governemnt, and the regualtions, and the malpractice, and the cut in re-imbursment, is scary people away from family practice. Its nice to think we’ll all get preventive care and lvie nice long lives, but if you are 25 but can never see your doctor because the waiting list is too long, then what the hell are you paying for?A lot of this could be solved if our goddam government would get out of bed with the trial lawyers, who are simply raping the medical profession. Where is the legal malpractice? Where are fines and disbarment for lawyers who agree to represent fraudulent or frivolous lawsuits?http://www.notjustaboringdentist.com

    • Let people shop across state lines

      No one thinks that will help. Nearly every single insurance company operates in all 50 states. You think Wellpoint of CA will give you a better deal than Wellpoint of NJ? Dream on.

      Put these goddam trial lawyers in their place.

      I really get tired of this chestnut. Malpractice is 0.5% of health care cost. ONE HALF OF ONE PERCENT!!! Even if 100% of it was fraud, which it most definitely is NOT, it’s TRIVIAL! As for doctors doing tests to avoid lawsuits, oh please. Malpractice insurance pays malpractice claims, not doctors. Tort reform simply doesn’t deliver ANY significant savings.

      Does anyoen pay attention out there? We are running out of primary care physicians because the re-imbursement from Medicaid is too low

      Oh man. You buy all the talking points don’t you? 97% of doctors take new Medicare patients, EXACTLY the same % that takes new insurance patients. Nearly ALL hospitals do. And we’re not driving doctors out of the profession; we don’t let them IN. It is insanely difficult for bright, talented, dedicated and capable students to get into med school. And insanely expensive. We can have more doctors any time we want. Why make it so freaking elite?

      So much anger. Take a breath, man.

      • EEllis

        “No one thinks that will help. Nearly every single insurance company operates in all 50 states. You think Wellpoint of CA will give you a better deal than Wellpoint of NJ? Dream on.”

        They may very well give a better deal because State gov. set different requirements for coverage in their State.

        “I really get tired of this chestnut. Malpractice is 0.5% of health care cost. ONE HALF OF ONE PERCENT!!! Even if 100% of it was fraud, which it most definitely is NOT, it’s TRIVIAL! As for doctors doing tests to avoid lawsuits, oh please. Malpractice insurance pays malpractice claims, not doctors. Tort reform simply doesn’t deliver ANY significant savings.”

        You are only looking at the direct savings. Texas passed Tort reform and malpractice insurance went down 30%. Not surprising we also had an increase of practicing doctors right after. California passed tort reform and premiums went down 40%. I saw a study of doctors in Massachusetts, 83 percent of whom said they ordered tests they thought were unnecessary just to protect themselves from liability.

        “97% of doctors take new Medicare patients, EXACTLY the same % that takes new insurance patients. Nearly ALL hospitals do. And we’re not driving doctors out of the profession; we don’t let them IN.”

        I don’t know that you are right. That was from a Govt study 10 years ago and it asked very limited questions. Many doctors limit the percentage of medicare patients they carry in their practice and the problem is getting worse not better.

        “the vast majority of doctors nationally still participate in Medicare. Yet two recent surveys of doctors were conducted in Colorado: One showed only 15% of doctors accepting new Medicare patients”

        From http://www.usatoday.com/news/health/2001-02-19-medicare.htm

        • Bconvis

          THANK YOU!!!! Finally an intelligent person who can see past all of the propoganda! Opening health insurance to inter-state sales would kill state regualtions and open competition that would drive prices down. And thank you for reminding these people that mapractice isn’t only about the premium increases (which are passed on to patients in the form of increased costs), its about the $100 billion dollars in “cover your ass” tests that doctors run. Its amazing that people refuse to understand some simple truths simply ebcause of this insane need to defend our government.
          Unfortunately, our leaders are in so deep with the trial lawyers we’ll never see tort reform on a national level. They don’t want to upset their freinds
          http://www.notjustaboringdentist.com

        • Texas passed Tort reform and malpractice insurance went down 30%.

          Oh really?

          The experience of Texas in capping damage awards is a good example. Contrary to Perry’s claims, a recent analysis by Atul Gawande in the New Yorker found that while Texas tort reforms led to a cap on pain-and-suffering awards at two hundred and fifty thousand dollars, which led to a dramatic decline in lawsuits, McAllen, Texas is one of the most expensive health care markets in the country. In 2006, “Medicare spent fifteen thousand dollars per person enrolled in McAllen, he finds, which is almost twice the national average — although the average town resident earns only $12,000 a year. “Medicare spends three thousand dollars more per person here than the average person earns.”According to the Institute of Medicine, as much as twice as many people are killed through medical malpractice [as traffic accidents]. Yet medical malpractice is one of the least commonly pursued claims, with fewer than 10% of patients who have suffered an uncompensated injury filing suit. We don’t a have a medical malpractice litigation problem. We have a medical malpractice problem.It is true that “tort reform” increases insurance company profits. It sometimes (but not always) also reduces doctors’ premiums. But it does so at the expense of the most seriously-injured patients. The right way to cut down on insurance costs is to cut down on malpractice. “Tort reform” that insulates doctors and insurance companies from the financial consequences of medical malpractice is precisely the wrong strategy.Our study also shows that states that have passed severe medical malpractice tort restrictions on victims of medical error have rate changes similar to those states that haven’t adopted these harsh measures. Finally, our research makes clear that medical malpractice claims and premiums have almost no impact on the cost of health care. Medical malpractice premiums are less than one-half of one percent of overall health care costs, and medical malpractice claims are a mere one-fifth of one percent of health care costs. If Congress completely eliminated every single medical malpractice lawsuit, including all legitimate cases, as part of health care reform, overall health care costs would hardly change, but the costs of medical error and hospital-induced injury would remain and someone else would have to pay.

          Here’s a good rundown on the research to date, including that done for GW Bush by the CBO, which said

          Several studies have found that various types of restrictions on malpractice liability can indeed reduce total awards and thereby lead to lower premiums for malpractice insurance. By themselves, however, such changes do not affect economic efficiency: they modify the distribution of gains and losses to individuals and groups but do not create benefits or costs for society as a whole. The evidence for indirect effects on efficiency–through changes in defensive medicine, the availability of medical care, or the extent of malpractice–is at best ambiguous.

          more links:http://www.cbo.gov/doc.cfm?index=4968&type=0http://www.newyorker.com/reporting/2009/06/01/0http://www.prospect.org/csnc/blogs/ezraklein_arhttp://andrewsullivan.theatlantic.com/the_dailyhttp://www.orlandosentinel.com/news/local/orl-lhttp://papers.ssrn.com/sol3/papers.cfm?abstracthttp://prescriptions.blogs.nytimes.com/2009/08/http://wonkroom.thinkprogress.org/2009/09/11/to

          • Bconvis

            First off, anything done by the New Yorker, a schill magazine that holds someone like Barney Frank, one of th greaest cheats and corrupted officials in Congree, in high regard, needs to be taken with a grain of salt. You think Fox News slants right, The New Yorker is far far Left it is invisible. Talk about cutting out whatever facts don’t fit what you’re trying to prove.
            Give me a break. How arrogant to say “We don’t a have a medical malpractice litigation problem. We have a medical malpractice problem.” That is the most arrogant of arrogant, and I am sick even reading this article, thank you. of course there are bad doctors. There will always be bad doctors, and there will always be malpractice. This isn’t Utopia. I have no problem with someon getting paid for negligence (though I do have a problem with lawyers getting 1/3. isn;t the money supposed to go to the damaged party). But again, forget about the actual malpratice court costs and premiums. The amount of defensive medicine practiced is astrononomical, and I’ll believe the hard numbers over whatever liberal leaning, socialist-endorsing articles you reference And your CBO report is just a little out of date… And you know what? We’ll never truly know what savings a decrease in defensive tests will give until we start protecting our good doctors, will we?
            You really see nothing wrong with mortgaging our children’s and grandchildren’s futures for this asinine plan? You really believe this “Obama Math” which will kill us in the long run. There are no savings to be had, not as long as people live longer and live with disease longer. Its all well and good to think we cna save money.

          • EEllis, you can give up shouting at the ocean. On this issue, I’ve read these comments over and over and ironically, GreenDreams – the person who accuses others of spouting talking points – will simply fall back on the same DNC talking points over and over again. Yes, you are correct. The big savings in tort reform have little or nothing to do with the actual damage awards in cases which go to court. They come from costs to medical providers being reduced when their malpractice insurance goes down in price and less doctors being sued out of the business. His response of showing a study in one town in Texas looks more like an anomaly than anything else. Interestingly enough, a study just breaking on CNN this morning indicates that Texas has one of the highest numbers of uninsured people of all fifty states. Do you suppose it has anything to do with the number of non-citizens? Gee.

            Unfortunately, for all of the accusations which get tossed about regarding conservatives “being in the pockets of the insurance companies” the real problem is that certain liberals are sadly all too aware of how well their party’s bed is feathered by trial lawyers. Howard Dean, in a stunning moment of honesty, came right out and said as much this year, but many of our liberal readers will never admit it openly.

            Also, getting back to the other “old chestnut” the way that Democrats argue against interstate competition is baffling beyond words. GreenDreams’ example is preposterous. I moved from New Jersey to upstate New York for my job quite a few years ago and my health coverage premiums (from the SAME COMPANY) dropped dramatically. More and broader competition reduces costs. What the secret reason is for Democrats wanting to defend the status quo on this one is beyond me, but I’m sure there’s a lot of money involved.

          • EEllis

            “His response of showing a study in one town in Texas looks more like an anomaly than anything else”

            Well the article he clipped it from seems to think its from extra tests, services, and procedures. How in the world GD thinks that effects the point I was making I just don’t know. Personally I wonder if that “culture” in the area medical profession may have come about because of the economically depressed nature of the area. Anecdotally many doctors say that they write off a certain percentage of their practice, patients on medicare/medicaid, as only break even, depending on the rest of their practice to make money. What do you do if most of your practice is medicare/medicaid? Extra tests, services, and procedures?

          • EEllis

            GD said a lot of extraneous stuff

            You clipped articles and posted links without really challenging my points just deflecting the discussion as usual. Malpractice insurance went down, the number of doctors went up, it was a good thing. That in one small town in Texas the rates Medicare pays are higher means what? How about the 10 counties that had zero obstetricians before tort reform that now have them?

            Your own article seems to indicate the reason for the high Medicare costs is from a tendency of the medical professionals in that area that were “racking up charges with extra tests, services, and procedures.” How would that effect my point? Right it wouldn’t.

  • Bconvis

    its hard not to be angry when our idiot preisdent gets up in front of the country in an interview and says that a government mandate is not a tax, when the langauge of the bill calls it a tax. I’ll take George Bush any day over this inexperienced, socialist buffoon who has no clue what he is doing. George may have been an idiot, but he was genuine. Obama thinks we’re all stupid and seems confounded that so many can see past his pretty words to what lurks beneath. Ahhh, I remember the good old Bush days when if you disagreed with the president you were a freedom fighter. Now, if you disagree, you’re a racist. The current climate sickens me. It was okay to rail against Bush, but if you disagree with Big Bad Obama, your anti-American. It’s hard, Green Dreams, to see a great country crumble down under the weight of hypocrasy. We’re dealing with a country where a Senator is asked to apologize for calling out “You lie!” when the president was actually lying, but waon’t force our president to apoligize for calling a white policeman stupid for soing his job without knowing all of the facts, which is one of the MOST racist things I have ever seen out of an Ameican Leader.
    I’m done. Peace

  • ProfElwood

    Repeal McCarran-Ferguson, which would subject the insurance companies to anti-trust legislation, allow for competition between states, and reduce the power of the AMA.
    Clarify ERISA preemption to allow normal lawsuits against health insurance companies in ERISA funded plans.
    Allow Medicare part D to negotiate medicine prices. Allow people to buy medicines from other countries (again).
    Eliminate the tax penalty for individually purchased plans.

    Simple, cheap ideas that would reduce costs and the influence of special interests.

  • Jazz and EEllis. The proof is in the lack of pudding in Texas. Here’s an article from THIS year, 6 years after the “tort reform” you herald. Surprise. Both health care and health insurance costs continue to rise apace. SEVEN TIMES the rise in salaries. That’s the cost savings you think tort reform can bring????http://www.dallasnews.com/sharedcontent/dws/bus

    Sorry. I know it’s from that bastion of left wing thought, the Dallas Morning News.

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