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October 18th, 2007 at 1:46 pm
First of all, this has never been only about children and when you refer only to children, you are being ignorant or dishonest about S-CHIP and the bill that had the Presidential veto sustained.
Secondly, a major defect of the bill is that it did exactly as you suggest and involved even more employers than you give as examples: it expanded coverage (new options to subsidize insurance, gaining a flow of federal dollars, which is why these options would of course be exercised) not only to pregnant women but also to employer-based coverage. This is deliberate “crowd-out” (which supposedly would be reduced or prevented by the bill by having Congress do … a study on the issue, another defect) and this is what knowledgeable people find most objectionable. (It has never been only about children, or even primarily about children!)
But at least you advocate their being honest about what they seek, which is a change and improvement.
Thirdly,
No, it isn’t a tax, though excessive charges (to reap what some would view as excessive profits) are certainly an insult and injury as well as a competitive disadvantage.
Ironically, while you are advocating deliberate crowd-out, at the same time the federal government, to achieve cost savings (which we will see more, not less, of in the future) is proposing something that deliberately is injurious, extending the period private insurers must pay for dialysis before Medicare coverage begins,lengthening the period from 30 to 42 months. While there are legitimate gripes independent of this government proposal itself (the typical payment employer insurance must make, $180,000 annually versus $67,000 for Medicare, smells of excess), the point here is that what you see here is a real example of government cost-shifting; failure to enact crowd-out in S-CHIP is not cost-shifting, so don’t claim or even insinuate that it is. Furthermore, everyone who believes federal money is the issue is going to have to face the hard fact that we are going to see more cost controls like this in the future.
October 18th, 2007 at 1:57 pm
The democrats should have done something more substantive, such as creating and expansion that allowed those middle class workers a way to purchase the insurance at a lower rate, instead of some big freebie. They also should have provided an option for those who are childless, and poor, who are denied medicaid, to buy into SChip as well, with prices based on income level.
What they came up with instead was heartless and wrong. It’s immoral for states to refuse to require checks to ensure that situations like that of the Frosts, where someone is able to hide income property, investments and trust funds under LLC’s and blind trusts. No one who can afford three cars, who has an income property and other deliberately hidden assets be eligible for SChip.
I’m a democrat, and what the expansion that failed represented was an exploitation of power as a means to curry favor, the creation of a priveleged class of beneficiaries. Even worse, it’s a farce to claim you care about the health of poor children, when you rationalise and assist in the outsourcing of American jobs, and the importation of illegals and other foreign nationals to take away American’s jobs, undermine wages at a time when we have had a declining job pool since the ’80s, while costs continue to rise. American children can’t be healthy when their parents can not afford to feed them, fruits, vegetables, protein and other crucial foods needed for good health. The democrats have regressed to the party of slavery that they were more than a hundred years ago, and haven’t a leg to stand on ethically.
October 18th, 2007 at 2:28 pm
Jenny P., here is the bill itself. It includes — or, thankfully, we can now say included — subsidies for insurance to people currently insured through their employers. This, of course, will lead to huge numbers of people replacing their current coverage with the subsidized coverage, which will cost them less (and cost the taxpayers more). It is this provision most of all to which Bush has objections.
October 18th, 2007 at 3:57 pm
In the next round, Democrats should try pushing forward restaurateurs, realtors and owners of small construction firms instead the tots of people who work for them.
They probably won’t get the opportunity, because hopefully the GOP crafted alternative plan will now get through- it’ll give a tax credit to employees to purchase their own insurance, and it’ll encourage states to find other ways to reform the system to pick up the slack that isn’t covered by the tax credits.
October 18th, 2007 at 4:20 pm
(In fact, there’s no reason why the federal government should be involved in this at all.)
The states (who get federal matching funds — the more people on S-CHIP, the more money the states get; New York wants effectively all its children on this program), the insurers (who get subsidized payments), those who want to replace their current insurance with publicly-subsidized, cheaper insurance want the program enlarged as much as the Congressional Democrats and pro-government-health-care activists supporting this incrementalist expansion of coverage.
I believe many (if not most) will reject a tax credit like that that have been proposed by Mel Martinez (in Congress) as a gimmick.
October 18th, 2007 at 4:20 pm
CS- The Democrats aren’t going to vote for a plan like that. They’ll continue the plan as is, and try again after the election.
October 18th, 2007 at 4:40 pm
In the Republican mind there is nothing more important than providing money to those insurance corporations whose greatest joy is provided by successfully denying payments to the people who pay them for insurance.
October 18th, 2007 at 4:43 pm
Yes, Jim, I live for that. What a ridiculous statement.
Kim: I guess compromise is only attractive when the other side is meant to be doing it then.
October 18th, 2007 at 5:04 pm
If you mean “not change anything in the bill and send the same bill once more to the President,” that would be childish and stupid of them.
If you mean “retain its nature of subsidized payments to insurers rather than change in at least some instances to tax credits,” I agree.
They can correct some or all of the defects in the current bill, and trim its cost, i.e., compromise, now and be more ambitious after the election if we have a Democratic President in 2009.
October 18th, 2007 at 7:41 pm
CS, every single plan you’ve approved of and every plan that I’ve seen proposed by Republicans does it. Every one. No exceptions. So how is my statement ridiculous?
Look at the Medicare drug plan. It’s greatest beneficiaries have been the drug companies and the insurance companies. Look at your own statements concerning what is acceptable. Your only proposal is to subsidize people to make payments to prop up the existing system, warts and all. Once again, what about it makes my statement ridiculous?
October 18th, 2007 at 7:48 pm
DLS quotes this part of the bill
Note the “as defined in subparagraph (C)”. Let’s look at it.
As I’m reading it what it’s saying is that if someone is able to manage to afford the basic employee-only coverage but cannot afford the difference between it and the cost of family coverage (an amount that can be quite sizable to a poor family) that the state will help pay the difference. If you believe in helping low income people afford insurance from the private system what is the problem with this part of the bill? Seriously.
October 18th, 2007 at 8:19 pm
Jim you are right. Most Repubs. and Conservatives would rather see the money go to private companies. Not for the reasons you state in your cartoon characterization, but for the simple reason
most conservative do not want health care to be Govt run. Logically it follows that private companies would indeed be the recipient’s if the govt doesn’t run healthcare.
October 18th, 2007 at 9:40 pm
True, conservatives trust corporations more than government. They do this no matter how many times corporations defraud the government, rip off consumers, conspire to rig markets and cook the books to deceive investors. Government is not perfect. It screws up. But so does the private sector and the profit motive gives it even more reason to misbehave. Not all companies do so, of course, but they are not the panacea that conservatives attempt to portray them as in solving our problems.
Markets fail. Corporations have no motivation to fulfill social goals where there is no immediate profit to be made by doing so. But most conservatives refuse to take these things into account, deferring to their faith in the inherent superiority of private business. But markets fail. They are not perfect. They are not capable of doing anything about certain things. Yet “market based solutions” remain the tool of choice for American conservatives for virtually every aspect of life.
October 19th, 2007 at 6:27 am
Well said Jim. There needs to be a healthy balance between govt. and business. This over reliance on the private sector has really worked to diminish and undermine democracy in recent years. Even a few republicans are starting to figure this out. Huckabee’s comments about a “plutocracy” are right on the mark, and while he was talking about campaign finance, he was making a wider reference to the negative effects of unfettered power based on wealth, “We will end up with a ruling class and servant class and we will ruin the middle class,” he said. “We will make it so politics will become the domain of the extraordinarily wealthy.” Well guess what Mike? It already is. Think about how much corporations are able to design and influence legislation that works in their best interest, regardless of harmful effects on the country as a whole. Think about how insulated the powerful and wealthy are from the consequences of irresponsible actions? And yes, think about how our countries leaders rise to their positions of power. Democracy? Make that a very, very small d… and getting smaller.
October 19th, 2007 at 6:30 am
CS- The bill that passed WAS a compromise bill- the Democrats initially wanted to put 50 billion into the expanded program but cut back to 35 to pick up Republican support. Illegal aliens were not eligible for the program, and legal immigrants could only apply after 5 years- another compromise. The much touted 80,000 limit was a fallacy- the real limit was 60,000. The bill was backed by 80% of the public- which can’t just include liberals. Or does public opinion only matter when it supports yours?
October 19th, 2007 at 6:39 am
Jim,
Your statement was ridiculous for the reasons Bones mentioned: wanting to avoid a shift to govt run healthcare does not mean that to conservatives “there is nothing more important than providing money to those insurance corporations whose greatest joy is provided by successfully denying payments to the people who pay them for insurance.” The motivation is not that we want corporate bigwigs to profit at the expense of the public, it’s that we see the general private system as the least of all evils- and where problems exist, we’d want to address the problems without turning them over to a new system which would be fraught with even greater problems.
Do you not see the false dichotomy? That a belief that the govt would run the system in an even worse manner doesn’t mean that we think the insurance companies are doing a terrific job?
I completely disagree with that premise. For the ‘government sector’, the same perverse incentives exist, except that instead of profits on a ledger sheet, the incentive is power and votes.
Jim, time and again I’ve pointed out to you that I have an understanding of the failures of the market system, particularly with healthcare (in that case, it’s because we don’t actually HAVE a market system, so the checks and balances that are inherent in capitalism simply aren’t there). Yet you continue to insist that your caricaturization of the typical Republican is true for me and for every other conservative.
You start from one premise (govt better than private sector) while I start from another (private sector, when real market forces are in place, is generally the best way to allow distribution of resources- it’s not always perfect, but better than all the other imperfect ways to do that).
You continue to allege that people like myself overlook the failures of the market system, yet of the two of us, I’d claim that I’m more likely to see the possibility for failure of my preferred system than you are of yours. When have you ever admitted that govt programs are subject to a great deal of fraud, waste, and mismanagement?
October 19th, 2007 at 7:16 am
Kim,
The point about compromise is that the movement on the part of the Dems was deliberately just enough to get some Republicans on board in Congress, but not enough to address the real complaints with the bill. And given that the other way they got the GOP on board was through deceptive PR so that the vulnerable congresspeople had no choice but to support the bill or lose their seat, I don’t think the compromise was genuine. And public sentiment matters to me when the public is well informed, not when they’ve been misled. Look at the polls- CBS does one which doesn’t explain what the ‘expansion’ is all about and the results favor the expansion- but when Rasmussen polled people and included the salient details, the public favored Bush’s proposal.
And besides, there’s never a situation where I think it’s appropriate to justify a policy shift strictly on the basis of public opinion. That is one factor, but you have to also be able to justify why the policy is an improvement, and be able to answer critics- not just say that we should do this because the public wants it. Look at the Iraq War- 70% approved the invasion. But should people not have questioned it more?
October 19th, 2007 at 7:16 am
CS claims
For the ‘government sector’, the same perverse incentives exist, except that instead of profits on a ledger sheet, the incentive is power and votes.
Prove it. Over and over and over again conservatives make this claim with absolutely no proof. Why? In order to defend their own prejudices in favor of corporations and businesses doing everything they demonize the government and those involved to make a claim that “They’re just as bad!” with no facts to back up their claim. Prove it or quit claiming it.
In addition you claim in one sentence that you recognize the limits of free markets and then say that really it’s only failing in places where there is no real free market. Which is it? Do the free markets fail to meet some needs of society or is it just because the evil government doesn’t let markets be free? Even Adam Smith recognized that the free market did not have a place in certain areas of society and that businessmen had to be watched because of a natural tendency to rig the markets. Why don’t modern conservatives who practically worship the man conveniently forget those parts of his writings?
My point about government is not that it doesn’t have problems but that they are no worse than the private sector and that they do not have the demands of Wall Street for unrealistic profit margins and growth rates or multi-million dollar bonuses at stake.
October 19th, 2007 at 7:56 am
In addition you claim in one sentence that you recognize the limits of free markets and then say that really it’s only failing in places where there is no real free market. Which is it?
Both. There are limits of how well the free market can perform, but in the case of healthcare, the main reason it doesn’t work well is that the push and pull of supply/demand isn’t there. Supply is limited but demand is noneleastic, third party payments limit the ability of the consumer to even know what they’re paying, etc, etc.
Jim, I wouldn’t even know where to start in giving you the evidence that you demand, to show that govt bureaucracies are not any more virtuous than private sector businesses. The fact that this isn’t intuitively obvious to you proves my point: I’m not the one who resists the notion that my preferred ’sector’ has warts.
I can think on it a bit to find some good specific examples to highlight it, but from my perspective every single bureaucratic program is fraught with the problems of unaccountability. Reauthorization and even expansion of programs is justified more on the basis of need than on the basis of effectiveness. That’s a perverse incentive; bureaucrats are given the incentive of creating more of a problem so that they’ll get more resources to deal with it, instead of the incentive to fix the problem so that more funds won’t be needed.
I’m not trying to besmirch some of the good people who work for these programs; no doubt many of them have the best of intentions. All I’m saying is that the whole reason we accept the superiority of a capitalistic system is that the system itself provides checks and balances on human nature. Most people want to do good, but they’re also hard wired to maximize their personal interests and to rationalize when those personal interests clash with the greater good. I believe those are pretty universal traits, though certainly more prominent in some individuals than in others- but I don’t exempt any one group of individuals such as those who work in the public sector (and esp not those politicians who create and maintain the bureaucracies.)
One example that comes to mind is education; we keep spending more and more federal money on education yet schools are getting worse instead of better. The further the funding gets from home, the worse the situation is too: local school boards may not run things as efficiently as they should, but when they’re spending money from DC, fiscal responsibility goes out the window and again here, you have these perverse incentives since funding per district is based on need, so the more need you have the more money you get.
October 19th, 2007 at 8:05 am
Kim: one more point about ‘compromise’. If you are correct (and it looks that way so far) that Pelosi and co. won’t compromise on accepting a tax credit based plan for families in the higher income brackets, then they’re being just as ideologically stubborn as Bush and the GOP holdouts are. If you think that’s fair because you think the principle is important (though I can’t understand what the problem with tax credits is from the liberal perspective), then you’re admitting that sometimes refusing to compromise is acceptable because you feel there’s a principle at stake. But then don’t complain next time the other side feels the same way.
October 19th, 2007 at 8:21 am
If you believe in helping low income people afford insurance from the private system what is the problem with this part of the bill?
You can be superficial if you want (or dishonest in reframing the issue), as you have already been with the new benefit given to pregnant women, but we who are intellectually honest will remain opposed to this part of the bill because of the real issue here, which is that this is an expansion of government involvement in health care into the private sector.
And in fact, this is a deliberate, an intentional, expansion into the private sector, a deliberate increase in the “crowd-out” phenomenon.
That is a defect in the bill that should be removed.
October 19th, 2007 at 8:23 am
It’s as if to question the Gospel of Good Government (or to have voted for Reagan or for Bush) is not only heretical, but criminal.
October 19th, 2007 at 8:26 am
CS, you specifically claimed that the people involved in government programs had motivations of power and votes, not that they were simply in a bureaucracy. You claimed that this motivation was just as strong as the profit motive for the private sector. Given that the only goal that exists for the private sector is profit how they can be equivalent without you in fact besmirching all of the people involved in government is beyond me. And no, the capitalist system does not inherently provide any checks and balances on human nature. It is not, without government regulation a transparent system that would reveal transgressions.
You admit that in health care “Supply is limited but demand is noneleastic, third party payments limit the ability of the consumer to even know what they’re paying, etc, etc.”. But in fact the market will fail in health care because the market system that conservatives claim would solve our problems cannot function in health care because unlike buying a car or television psychological factors will always overwhelm rational analysis.
October 19th, 2007 at 8:56 am
Gee, Jim, do you want to now explain to me how this differs from what I already said: that the market forces don’t function normally in the healthcare system?
Jim, I’m not the one doing the besmirching here. All I said is that I believe that people who work in bureaucracies are human and subject to the same forces of human nature as everyone else. If refusing to believe that people in the public sector are saints is a problem to you, then so be it.
You, however, besmirch every business owner in America by assuming a blind greed for maximum profit, no matter who they have to trample over to get it. You don’t think business owners have any other motivation besides profit? People don’t want the satisfaction of creating good products and services, creating income to support their families, and creating jobs for their employees? Ohhhkay.
I assume that most people have a lot of positive motivations for their vocation in life, but that they’re all also susceptible to human foibles, including the tendency for self interest to sometimes trump altruistic desires (often unconsciously). You’re the one who attributes only the baser motivations to certain people and refuses to acknowledge that the other group has those baser motivations at all.
October 19th, 2007 at 8:59 am
And Jim, as you are well aware, I’ve recently commented here about one suggestion I’d have for helping to fix a broken healthcare system which was not reflective of a belief that a market system would “would solve our problems”. There’s no market force present to bring up the supply of physicians and other healthcare providers (nor to distribute them as needed), so I suggested a way that the govt could intervene in that regard with incentives. Seems that you felt that was a pretty good idea, yet now you’re falling back on your rhetoric about conservatives focusing exclusively on free markets as the answer.
October 19th, 2007 at 9:08 am
CS first you accuse the Dems of not compromising at all, then say they only compromised enough to get the GOP on board and by threatening them with the political consequences of a no vote.
You are deliberately ignoring the fact that two of the bill’s biggest sponsors are conservative Republicans- Orrin Hatch and Charles Grassley. Grassley actively fought for its passage and wrote a letter to Bush because he was so angry about the veto.
The truth is this is a bill that had wide public support, bipartisan support in Congress, support from the medical profession, support from a majority of governors,and even support from the insurance industry. To simplify it and say its Pelosi, who is unwilling to compromise with Bush is ridiculous.
Bush has very lately remembered that he’s supposed to limit entitlements and the size of government, so to do so at this late date lacks credibility. The Democrats would be justified in making this fight the hallmark of their campaign in ‘08. Democrats are already outpacing their opponents 2-3 to 1 and this issue will help tremendously.
October 19th, 2007 at 9:15 am
Kim,
Where did I say that the Dems haven’t compromised at all? The point I”m making is that they compromised certain things but won’t compromise others (and I’m sincerely questioning what it is about tax credits, for example that would cause them to draw a line in the sand- if there isn’t a good reason for them to oppose a plan that would help the middle class families in that way, then it smells suspiciously like their principle really does involve a desire to expand the government’s control of healthcare insurance).
And yeah, they did use the threat of political consequences to strongarm Republicans. It was obvious in the type of PR campaign they ran and even more obvious in some of the direct statements of Dem Congresspeople who flatly admitted that this was their goal.
As to the support of the bill by physicians groups, governors and insurance groups- you’re not helping your case with me by citing that. Those very facts make me more suspicious that the bill isn’t good policy for the consumer and the taxpayer.
October 19th, 2007 at 9:43 am
CS- You have not addressed Bush’s own history of expanding government- you do know that he expanded it twice as much as his predecessor. To claim that he is taking a principled stand now is ludicrous.
And public opinion may not be the only factor that matters, but it certainly does matter. Otherwise, why would the administration keep quoting statistics on how unpopular Congress is? At 11% approval, by your reasoning they must be doing a heck of a job.
Yes, 70% supported the invasion, but that was because of the storm of uber patriotism and the fact that the media lay down and rolled over after 9/11. There was a lot of false information disseminated to support the invasion which they not only failed to question, but openly spread around. In this case the actual bill is available to anyone who cares to read it.
Both sides have done a lot of political maneuvering, but that is true on any issue. The Republicans have threatened the dems with reprisals on national security and war funding- so it certainly is not unheard of for the Democrats to use this vote at election time.
October 19th, 2007 at 9:50 am
This sentence jumped out at me:
“The capitalist sstem provides checks and balances”
Not so.
This is a blanket assertion based on faith, not reality.
.
What capitalism provides is competition.
Competition, by itself, is only a race for profits and power. There are no inherent checks and balances that guarantee that the outcome will provide value.
Competitors in a captialist race are tempted to cheat and game the system in exactly the same way that individuals are tempted to cheat and game the welfare system. Human nature is at play, no matter what the arena is.
Capitalism, like any race, needs to be managed and regulated if it is to provide more benefits than harm.
Calibrating the best amount of regulation is a weighty subject in its own right, but the answer can never be ‘none’.
When government inserts the power of its money into private businesses, it puts itself into the dubious situation of needing to oversee and regulate that in which it is a participant. This is exactly the same situation as when government needs to manage and oversee direct governement programs. The dfference is, however, that the private sector is much less transparent Few audirors could even understand the maze of hedge fund manager records, for example.
I don’t think anyone has undertaken to study comparative circumstances leading to increased corruption. I can’t cite the source from memory, but an international rating system has noted that the US is rising on the corruption scale. It would be foolhardy to make any cause and effect conclusions from correlations, but this should provide reason for pause, as it does correlate with increased government reliance on the private sector.
After Katrina, there have been numerous news stories about individuals milking governemtn funds fraudulently. Few stories have surfaced, however, about the tons of money siphoned off by fraudulent and corrupt capitalist businesses providing next to no value for the government contracts they received.
There are well educated adults walking around with Ayn Rand’s ‘Atlas Shrugged’ as their guide, even their Bible.
While the author, and this book, set forth important principles to consider, both have all the depth of children’s fairy tales or Hollywood oaters. Fairy tales can provide good lesson, too, but the world does not consist of black/white alternatives,
Thee is no knight in shining armor with a dollar sign on his cape.
There should be no such knight. Society, a nation, is more than its economics, for Pete’s sakes. Look at how China is struggling to keep the economic tool from endangering its stability, the societal factor.
While praising captialism, I would say it’s high time the US paid attention to its own stability in view of the churning unrest among the populace.
This is the advice coming from an increasing number of leaders in the private sector, BTW. It’s somehing else that should be considered while debating SCHIP.
And no, I am not against capitalism. I am for balance, however, when weighing the pros and cons of its aplicaiton in a particular area.
October 19th, 2007 at 9:53 am
Never said it was, but I want you to be honest about what they’re doing.
October 19th, 2007 at 9:54 am
Oops, second paragraph should not have been in the blockquote- that was part of my response.
October 19th, 2007 at 10:01 am
That was a blanket assertion only when you twisted it into one. Note that my statement did not say, “Capitalism provides perfect checks and balances” or “capitalism provides all the checks and balances on human behavior that are needed to create perfect fairness of distribution of resources.”
But yes, I stand by my statement that capitalism does provide checks and balances. Competition itself is a check- because businesses which have to compete are forced to provide better products and services. That doesn’t mean that I think it always works out that way and of course transparency (and education of the consumers) is essential.
As to transparency in govt programs- I call foul on that claim. Every time a budget is questioned by conservatives, the standard ‘heartless’ attacks are made. Programs are defended on the basis of need, not on the basis of whether or not they’re efficiently fufilling the need.
October 19th, 2007 at 10:30 am
Speaking of ridiculous (see CS;s commnet re JS), I think many of the arguments put fotth by he and DLSr have skewed the whole argumetn far to the ridiculous side.
They start with premises that are nothing but the creed of a basic political philosophy. Then they nitpick this and that factoid as if one factor could negate the whole. Then they make blanket assertions about capitalism and ‘let the states do it’.
And surprise, surprise, their conclusions lead right back to the premises they started with.
I prefer to look at how this affects real people.
When the private sector took over the President’s Drug coverage plan, it was a clear boon to the wealthy.
For the not so wealthy, however, the doughnut hole in coverage can be a nightmare. States like NY had their own programs for lower income groupts, providing coverage for all medicine for a reasonable annual fee and co-payment.s
Recipients eligible for Medicare are now forced to enroll into one of a maxe of private insurer plans, each with its own dizzying rules, included and excluded medicines, etc. The elderly have to navigate this maze, instead of applying in a one-step easy to understnd manner.
This is an example of how the private sector fails to serve while it completes for profit.
This gets to the heart of why the privates sector does not provide adequate checks and balances.
It used to be the case that all businesses were expected to incorporate a policy of serving the customers. That has changed iinto serving the investors. Thtose unable to be both customers and investors, are left out in the cold.
This is, in large part, about the haves and the have-nots, and the inablity of some haves to accetp that the have-nots are citizens, too, and their interests should be condiered in framing a course for a nation. Ignoring those interests, does not make them disappear. They atay right here to haunt us all in myriad ways. In extreme cases, revolutions are the result, or nation-wide chaos.
These short-sighted navel gazing arguments fail the reality test, if they remain circular: assumed premise to predestined conclusion.
October 19th, 2007 at 10:50 am
On the contrary (once more), I have posted specific examples of what is wrong with the bill along with fully legitimate reasons why it is wrong, as well as provided examples how a compromise could be crafted, while you frequently have diverged from the subject into the speculative as well as outright fictitious realms.
October 19th, 2007 at 10:55 am
Much less justify them.
The Dems should remove the new options that were in the bill and lower the income limit to 250 per cent. Or if they want to be combative and risk another veto, remove the new options but keep the income limit at the 300 per cent originally sought. They continue to be underhanded incrementalists if they keep the new options in the next bill.
October 19th, 2007 at 11:00 am
CS-
The competition in capitalism does not provide any inherent checks to guard against monopolies by conglomomeration, insider trading, price fixing, or any number of other practices that need to be checked if the product is, indeed, to provide best value.
Government programs, by their nature, are more transparent. If they’re set up by the government, the rules are there, and the practices available for audiitng. Not so for the private sector, unless regulations require it, and the private sector, with its philosophical allies, oppose most regulation on principle. As long as the practices are off the premises, there is always the tempaaion to obscure those as well.
In both government and private sector run progams, politicians obscure transparency rather than avail themselves of whatever there is.
To choose one over the other, then boils down to assessing potentials, not actualities.
In pracice, both systems are failing miserably, thanks to our politicians, but the potential is greater in governemtn run povernment run programs.
Ideally, the two could work together. Then, as I have repeatedly said, the choice should be made by how, in a particular case (no blanket endorsements one way or the other) it affects the people, and various classes of people.
I repeat: a government has to manage its ecomony, but a nation is more than its economics.
The private sector is imperfect and government programs are imperfect. A knee-jerk choice of one over the other is just: a knee-jerk choice based on philosophical premises.
October 19th, 2007 at 11:18 am
I prefer to look at how this affects real people.
Well, in the case of Medicare Part D, I already posted such information. Did you ignore that [, too]? Here it is again.
October 19th, 2007 at 11:19 am
DLS-
I don’t respond to your comments, because you have a narrow focus on this particular bill
It’s my postions that one can not evaluate the bill outside its context of the health care situation in general and even broader, the economic situation in general.
We are not even looking at the same picture.
October 19th, 2007 at 11:22 am
DLS-
I am enrolled in Mecidare Par D.
I have all the information I need, in practice, not theory.
October 19th, 2007 at 11:33 am
The competition in capitalism does not provide any inherent checks to guard against monopolies by conglomomeration, insider trading, price fixing, or any number of other practices that need to be checked if the product is, indeed, to provide best value.
Forms of “cheating” are anti-capitalistic. As to monopoly or other intentional deviation from the ideal or theoretical model (even such things as protected territories for sales), not only Rex Tugwell’s Progressive-Era-influenced views come to mind*, but Adam Smith: “a conspiracy against the public, or in some contrivance to raise prices.” More here.
* Tugwell was one of the Brain(s) Trusters with FDR who engineered the New Deal’s early fascistic plans, such as for labor and industrial “codes” that harnessed and even formed cartels under the management, or control of the federal government.
October 19th, 2007 at 11:40 am
Well, staying on the proper subject is better than being falsely accused of this,
but it would help us all if you could make up your mind, and it’s not an excuse for ignoring what I post.
* * *
I will defer to your experience here, at least until I’m on Medicare myself sometime soon. (*wink* There’s no telling when. This doesn’t involve retirement, at least not voluntary retirement.)
October 19th, 2007 at 12:15 pm
So what do you think about Pete Stark’s comments? Is that the kind of “spine” you want to see from the Democrats?
October 19th, 2007 at 12:32 pm
Which is why I said that my statement about checks and balances was not a blanket statement, but you choose to keep interpreting it as one.
Government programs, by their nature, are more transparent. If they’re set up by the government, the rules are there, and the practices available for audiitng. Not so for the private sector, unless regulations require it, and the private sector, with its philosophical allies, oppose most regulation on principle. As long as the practices are off the premises, there is always the tempaaion to obscure those as well.
So, your claim is that since the government programs are set up for the govt. to police itself, that’s a better example of checks and balances than a market based system which has those in the form of competition providing incentive for efficiency and quality?
Look, my simple analysis of the comparison goes like this: in the private sector (absent any irresponsible tinkering by govt acting on the side of corporations-which is not what true conservatives endorse even if the US conservative party too often engages in it), generally businesses that provide crappy service or product, or are wasteful of their resources, will not last because a competitor will outdo them. In the public sector, a bureaucracy has no competition, and accountability for providing good quality service is weak (if you disagree, show me where the quality controls are). And on top of that, if they are failing to solve the problem that they were designed to create, then they use the ‘need’ as a means of getting more revenue, and if they are having some success, they are often inclined to still ask for more funding or to expand their mandate.
You’ve yet to say why you disagree with that analysis, and instead you say that you choose to focus on the people. It’s like someone advertising a product, and they keep telling me how much I need the product but when I say that I don’t think their product fits the need that I have they again keep focusing on how bad the need is instead of telling me how their product would really function to help. Forgive me for skepticism, but when that happens I tend to think that they probably have a pretty lousy product and since they can’t demonstrate otherwise, they’re instead appealing to my emotions to try to get me to buy it without thinking about it too much.
October 19th, 2007 at 1:37 pm
CS-
I iterated examples of how the checks and balances in capitalism fail, because your previous response was a breezy ‘it’s not perfect’.
The quality control in government programs, whether or not operated through the private sector,
liews in its oversight agencies and Congress, as well as in citizen watch groups.
When it’s a direct governemtn program, the books are open, by law, and those responsible and accountable are easy to locate. When the road ot accountability goes through the private sector, it’s a road with more twists and turns, The books are not as readily available and those reponsible harder to identfy.
As I said, and to expand on your observatiion about not being perfect, neither system of managing a program is perfect. Both systems are corrupted by politics and greed.
The government is policing itself in either case, so that’s neither here nor there.
I’m speaking now about the relative ease/difficulty of rectifying imperfections.
That’s not to say, that a direct government program is ALWAYS the best solution. There are other considerations, like efficiency and overhead. I am saying that the choice should depend on the particular program in question.
Here is where the change in the nature of capitalism
comes into play. When capitalism scuttles it’s serving the customer model in favor of serving the investor model, it changes its role in society. It no longer has a commitment to the customer who is not an investor. This is the whole in the economy as it is today, in particular when it comes to health care.
That being the case, making NEED a part of the considerations is not only legitimate, but necessary.
Capitalism has no room for need that can’t be answered by a cash transaction.
The NEED does not vanish just because a government ignores it. It has to deal with it in some form, sooner or later. The federal government has to deal with the need created by Katrina, regardless of economic considerations, because any government would collapse if it chose to just leave the bodies to rot.
Once again, then, we are looking at how best to address the need in a cost effective way. What is cost effective today may lead to much higher costs down the road, so unless we take a long and broad view of how one thing affects another, we will fail.
A stitch in time saves nine.
It is absolutely true that government programs have failed or had unforgeseen consequences, and that they need to be under constant scutiney and consequent adjsutment.
Capitalist systems have also failed.
Neither fact is suffiicient grounds for abolishment.
It all depends on the context.
October 19th, 2007 at 2:33 pm
I’m still reeling from this gem from C Stanley:
Poor Bush… he’s always compromising with everyone else, and now look at how those mean Democrats treat him when they are in power.
October 19th, 2007 at 3:36 pm
How many vetoes has he chosen to make?
Intelligent criticism of Bush includes criticism of how willing he has been to spend the public’s money (”compassionate conservatism”) — like a Democrat rather than what is supposed (or merely claimed) to be like a Republican. The intelligent criticism of this veto is that it is not merely ironic, but hypocritical of Bush to name excessive spending as one reason why he vetoed the bill, when he has routinely permitted such excessive spending in the past. (In this case, the excess is obvious and the original $50 billion increase sought was outrageous or ridiculous. Bush will accept more spending but Democrats who are realistic, and who aren’t immature, will have to expect to substantially lower the increase in the next bill.)
When it comes to spending, Bush has been all too happy to compromise, and to spend money (a true “compassionate conservative,” indeed). That compromise (deference is more like it!) is indisputable fact despite his antagonistic and defiant behavior toward Congress on other matters (requests for information about various scandals and non-scandals).
Less growth than what Democrats want in spending (and in S-CHIP’s case, expansion of the scope and the very nature of the program) has traditionally been described by Democrats as “cuts,” and in this case (as in others), “heartless,” et cetera.
October 19th, 2007 at 4:10 pm
CS- Chris has a point- conservatives really admire Bush when he doesn’t compromise with Democrats- seeing as he had no vetoes for 6 years and now has vetoed or threatened to veto every bill the Democrats have passed (and then has the colossal nerve of criticizing them for getting nothing done!) it does seem like he’d rather have the admiration of his base than have a legacy of getting anything done.
October 19th, 2007 at 5:53 pm
Yep, all correct, Kim, but my opinion of the bill simply has nothing to do with Bush. Likewise the comment Chris quoted- I wasn’t complaining that anyone is being unfair to Bush, just pointing out that everyone’s view of compromise depends on what they believe are the important principles which should not be compromised.
October 19th, 2007 at 6:23 pm
First, CS says
Then claims that she is in fact simply saying that they are human and subject to human foibles no greater than the private sector. She claims that this is no different than the profit motive in the business world. Of course there are good people in the business world, but especially in the corporate world it’s much much easier to lose sight of anything but the profit motive. Do I really have to list every one of the business executives doing time in the pen for varying types of fraud and malfeasance? What about the rigging of the energy market in California done by Enron and other energy trading companies a few years back? What about the accounting and law firms that helped these corporations ruin their investors and employees? These people did what they did to gain millions of dollars for their own pocketbooks. The typical government employee does not have any incentive as strong as that no matter what is claimed by the modern conservative movement.
When it comes to health care what about the fact that those insurance companies you want to keep in their current roles have employees whose sole goal is to find any reason possible to deny claims? How about the fact that they don’t pay health care providers in anything approaching the timely manner they expect to receive their premiums in, often taking almost a year to pay off and in that time the providers often go after the patients in order to try and recover their money? Where are those checks and balances provided by the desire for a good product?
At one point you claimed that you recognized the weakness of the market in health care and asked what the difference between your acknowledgment and my criticism of market forces in health care was. Your acknowledgment was this:
This seems to imply (As I believe I’ve heard you say before.) that the failure in the market as applied to health care is primarily due to the existence of insurance and the use of it as an employee benefit. This is not the primary reason that market forces don’t work in health care. It is the psychological and emotional aspects of health care that apply more to this than to any other part of our society that involves the exchange of money and services that breaks down the rational choice theory that neoclassical economics is based on.