I appreciate where you are coming from. It just seems health care is not something that can be fixed piecemeal. Changes will not come quickly, so it seems impractical to say, allow competition across state lines and wait 5 years when costs are increasing steadily and people are dying for lack of coverage now. We have problems now because of a multitude of factors. Putting a band-aid on a severed limb seems short sighted.
Finally,
suggests you are arguing against something that has never been proposed, i.e. a single payer system. I think you would find Obama agreeing with you completely. Obama appears to be placing guidelines around a market to ensure companies do not take advantage of their customers. It is then up to the customers to choose what they would want in that system. In other words, a fair free market system.
I get that, but, again – and, man, I must be getting close to an SDMB warning for saying the same thing over and over, but I can’t really do otherwise – while we have problems now, IMHO the starting point has to be that most people currently report being satisfied. Putting a band-aid on a severed limb is short-sighted, but cutting out a lung that doesn’t yet have cancer seems to be – uh, “too clever by half,” or something.
I’m fine with providing some guidelines; even ardent free-market guys tend to be okay with minimum-wage laws and product-safety regulations and half-a-hundred other restrictions atop bans on false advertising and price-fixing and so on, which get justified in other ways. But a given proposal doesn’t need to include single-payer before it impacts free-market competitors in ways I’m not crazy about; not all suggested “guidelines” are good ones. We can consider 'em one by one, if you like; again, at the risk of running my point into the ground, that’s what a majority of Americans want Congress to do rather than passing the current legislation: start back over and debate it piece by piece.
This seems to be your thesis (duh, you have repeated it several times). I will say to this - what Americans want is mostly arbitrary, capricious, uninformed, selfish, and wrong when analyzed by history. I’m sorry, that is simply how it is. Continually trotting out what Americans want in days of hyperpartisanship and an astounding lack of grasp of basic facts is not a convincing argument.
Most people weren’t slaves in 1860. Shall I trust, that according to your bullshit ideology there was no reason to do anything about it?
And the fact is most people are happy because they can’t see the real issues. Most people are healthy. So they don’t know how easy it is to be booted from health care. Most people have their jobs cover most of their health insurance, so they don’t see the massive rate hikes as a line item that sticks with them.
Most people are getting pretty shitty service, that they don’t know that doesn’t mean nothing should be done.
If you want to get rid of pre-existing conditions you need a mandate (so that insurance prices don’t spike). If you have a mandate you need subsidies for the poor. This is pretty much the Senate bill. What, exactly are you pissed off about?
That’s because they’ve been lied to by Republicans for over a year. Death panels, abortion coverage, government takeover, cutting veteran benefits, illegal aliens, these things are lies that have been repeated so long people don’t know what’s real anymore.
Exactly how you extrapolate my preference for voluntary choices in a context of informed consent into a perpetuation of slavery is mysterious, but let’s pretend that’s not the case so I can play along: I’m not saying there’s “no reason to do anything” about health insurance, so, no, you can’t trust that there would have been “no reason to do anything” about slavery.
Then address that. In a democratic republic, the idea is to pass legislation by garnering public support for the real issues; the philosophical underpinning for our system is that the value of a marketplace of ideas is rather like the value of free-market competition in other contexts.
It means we should bring it to their attention. It means we should get a mandate.
So tell them. Obama beat the Republicans when he ran for office – as a guy who distinguished himself from Hillary Clinton by talking about how he wanted to ensure coverage for kids but didn’t want to step in likewise for adults. Why do you figure he can’t beat the Republicans on this issue the way he did on issues in general? He was a hell of a campaigner before he gained the ability to give prime-time speeches on live national television whenever he pleases; he can get reporters to show up any time he decides to hold a summit, he can throw a press conference at will, he’s got a majority of Senators and a majority of Congressmen on his side with all their media might; why do you figure he can’t megaphone truth to combat error?
Again you seem to be arguing against some sort of single payer straw man. The proposals leave most of the current system intact, and even add protections to it (like reducing the ability for insurance companies to dump you for bogus reasons) - so for this most part the current proposal either doesn’t affect the people who are currently happy with their coverage, or it actually improves it.
Isn’t this what they’ve been doing for the better part of the year? There were several bills up for debate, and several revisions. Starting over is just a stalling tactic, we’d just repeat what happened before.
And if the republicans were actually interested in substantial debate and actually working out some sort of compromise bill that everyone is at least somewhat happy with, we’d be in better shape. But when one side was trying to do this debate you’re calling for, the other side was lying and obstructing. Starting the debate over would just reinvent the wheel, and give them more of a chance to lie, stall, and obstruct.
So it is Obama’s fault that the American people chose to listen to a hundreds of millions of dollars campaign against a bill instead of reading the bill and making an informed decision on its merits? :rolleyes:
There is a difference between campaign mode and governing. When campaigning, one can say whatever he wants whenever he wants. When that practice is backed by the office of the Presidency, it becomes government propaganda. I am not suggesting he should not have done more. Frankly, he blew it. But an all out assault against the disinformation campaign would offend me just as much as that campaign.
Yeah, Americans suck. That’s why the country needs to be run by liberal elitists who will force us to do what’s best despite our fervent wishes to the contrary.
Have you ever considered that, a.) Things can merely SEEM wrong when analyzed by history simply because everyone has gotten used to the current way. There were people in Russia who were furious over the fall of the Soviet Union, firmly convinced that communism was still the best form of government, and b.) People in this country VOTE! It’s a keystone of our republic. And why do people vote? So the government will do what they want! This country was founded on the proposition that the people should be able to get what they have collectively decided they want, and not what the political ruling class has decided is best for them whether they like it or not.
People like you and Nancy Pelosi may disagree, feeling as you obviously do that you know best and that we ignoramuses need to have things crammed down our throats for our own good (even, according to Pelosi, if it costs lawmakers their jobs). What kind of representation is that?"
People in this country are allowed not only to have a voice in government but to set the direction it takes. The Constitution makes no educational restriction on who gets to vote. Everyone gets to vote, no matter how stupid or ill informed you or I think they are. And trust me, I think that many stupid people have been behind much of what has gone wrong in this country over the last forty years. But never once have I said they shouldn’t have a voice.
It’s easy to potshot aspects of the legislation when it’s up-or-down on a whole omnibus. What the public supports would dry up much of that; if the Republicans can muster one or two objections to each aspect of the current plan, then funnel the debate by only giving them one aspect at a time.
If you offer up a bill that’s set to eliminate the antitrust exemption for insurers and require employers to provide coverage or pay a penalty tax and offer a public option that may or may not cover abortions and something that could get twisted into a death-panel talking point and, just for the hell of it, change the rules on Medicaid eligibility at the same time – look, offering up all of that at the same time (a) just gives the Republicans too much ammunition by giving them too many opportunities to change the subject, and also (b) gives you a patchwork approach that’s very probably going to only get this or that Dem on-board with special favors for Nebraska and Louisiana and so on.
Don’t give them those talking points. Give them one debate at a time.
Are you suggesting, then, that the proper course of action for people who’d like to reform the current medical laws in the US should’ve perhaps voted for a party whose candidates had this initiative as part of their platform? And if enough people voted accordingly, that party could have a legislative majority with which to pass those laws that they campaigned on.
Okay, so we want to provide a public option for whoever can’t manage to find a private insurance program that works for them, including people with pre-existing conditions. Ah, but what about the people who abuse the system by waiting until they get sick to get that new form of insurance? Well, okay, so I guess we can mandate that everyone has to carry some sort of insurance, to create a larger risk pool and prevent gaming of the system. Ah, but now we have people who can’t financially meet this mandate even if they wanted to, so…
Which part of that did you want to take one at a time?
The part I want to take first is the antitrust exemption. The part I want to take second is dropping the barriers to selling across state lines. The part I want to take third is then expanding Medicaid eligibility if too many people are still falling through the cracks once the free market has been given a chance.
Oh, right. So you dress up the issue of “let’s move slowly and take it one thing at a time” but what you really mean is “let’s not do that stuff that’s being proposed at all, and let’s just do my agenda one step at a time”.
I find the claim that the free market hasn’t been given a chance specious. Certainly there’s not an absolute, unregulated free market attempt - but what about the current laws do you think prevents the current system from being validly claimed as free market based? Every industry has some sort of regulation or limitation - you could make a case in almost any industry that a true free market has never been given the chance. If the current system isn’t a free market system, what would you consider/call it?
Do you think that if the antitrust exemption were removed, we’d have insurance companies broken up immediately? Do you think that despite the lack of competition across state lines, there isn’t competition within a state? Do you have any evidence, or any projections, that any of those specific issues will provide for significantly better costs and/or outcomes?
Do you think the full advantages of the free market will apply as well to health care as they do to selling ipods or groceries?
Eliminating the antitrust exemption is in the bill. Likewise, expanding Medicaid eligibility is in the bill. And dropping barriers to sales across state lines – well, okay, granted, that’s not in the bill, but it’s certainly being proposed.
The antitrust exemption and the barriers to sales across state lines.
I don’t think there’s sufficient competition within the states, but I could be wrong. It could be that the antitrust exemption currently makes no difference. It could be that allowing sales across state lines will likewise make no difference. I’m not interested in projections; I’m interested in seeing what happens once we’ve made those changes. If it turns out not to be good enough, then, by all means, move on to the other stuff that’s in fact being proposed (such as expanding Medicaid eligibility) after trying some of the stuff that’s in fact being proposed (such as eliminating the antitrust exemption).
I hope so. But they might not. So let’s run the experiment and find out.
I know you think you are blowing my mind here, but yes, I often consider this. I view this country as a tree of sorts. The constitution is the roots and over time it has grown into a blossoming canopy. We live under it and never venture from it. And why would we? It protects us from the elements and gives us fruit. The fruit tastes great and we rarely feel the rain.
But this tree is just part of a forest. There are other trees with different fruits. Some might taste better and some might taste worse, but we will never know because we think we have the best tree around.
Every now and then there is a disease in the tree that prevents it from growing; thus creating a hole in the canopy. This hole lets some of the rain in, falling on certain people under the tree. What can we do? One thing we can do is look away because only a small group of people are getting wet. That’s how nature intended, after all. Or, we can treat the disease and prune the tree to allow new growth to cover the area so those people don’t get wet any more.
In rush people like you. You see someone pruning the tree and only see a huge hole opening up in the canopy, leading you to get wet. Then there are people like me, who see the value of letting the tree grow in time to protect everyone.
What is the point of this? I understand that sometimes pruning the tree doesn’t cover everyone. And sometimes it grows in a different direction than we intended. But I do know that blacks, women, (most) workers and child laborers are no longer getting wet because of the pruning of some “liberal elitists” who “knew what was best for everyone.”
This country was founded on the proposition that white men can decide the direction of everyone else. White men voted and everyone else had to go along with it. It looks like you are kind of buying into this idea of liberal equality.
You were dressing the argument up as “let’s just take it one thing at a time”, but really what you were mostly saying was “let’s not do the main stuff that’s in this bill” more or less.
You can keep repeating these as much as you want, but you aren’t even proposing mechanism by which they’d work. Unless there are specific problems here that would be solved leading to a meaningful improvement, then taking the time to do this “experiment” is essentially just stalling.
If you feel that removing the antitrust exemption would produce substantial positive results, you must think that it’s currently supporting monopolies that are damaging the industry. Otherwise why would we need to “experiment” to fix a non-problem?
Since we can’t sell insurance across state lines currently, that actually gives us a wealth of data from which to make a comparison. In which states are the monopolistic behaviors of insurance companies causing them to perform worse compared to other states in which there is healthier competition? Or do you think that all states are equally affected by the issue?
For that matter - some states have more insurance options than others. Do those states have significantly lower prices or significantly higher quality of care?
Hell, you could even point out a golden insurer in one state that’s super efficient and everyone loves them - and it’s just too bad the whole damn country doesn’t have access to them. Is there anything like that?
Do markets need to be a certain size before you can consider them free? Is there something to prevent competition from existing on the local or state level? If some company decides they can do a better job of complying with state X requirements and providing better insurance, or cheaper insurance, are they not coming into the market because they’re only interested in competing on a national level?
You haven’t tried to make a case for your specific ideas. You haven’t said “states with more than X amount of competing insurance companies have Y% lower rates than states with less than X amount of companies, therefore we need more competition”, or “this insurance company in this state exhibits monopolistic behavior, and removing the antitrust exemption would allow us to break it up” or any sort of specific problems that your proposal is even a solution to. You are essentially just saying “uh the free market is good and shit, so let’s open up competition nationally and give it a few years and see what happens”.
Health care is a very serious issue - people die, and go bankrupt, and have their quality of life seriously degraded. We should not treat the problem to randomly trying things in the hopes that they make it better. At the very least, you should be able to describe the specific problems your solution hopes to tackle.
Incidentally I don’t oppose the idea of removing antitrust exemptions - I can’t really think of a reason offhand that any industry should get any sort of exemption from antitrust laws - but the issue is whether or not we have reason to believe that trying that will substantially improve the problem.
Have you ever thought about how the incentives line up for health care compared to other industries? If the price of rice is too high, you can buy corn. You can put off buying that new TV until prices come down. If the price of open heart surgery is too high, you can’t get a colonoscopy instead. People don’t really comparison shop both because the primary mode of gaining insurance is group plans through employers (and you have little to no say who you do business with) and because if you are unhappy with your current provider and want to switch, you may be fucked - if you have anything they can deem a pre-existing condition, you’re stuck with your current provider for life. This has been hashed out in other threads in much greater detail, there are actually dozens of reasons why the incentives don’t line up for health care like consumer products and services and why the free market model isn’t really suitable.
“I hope so” combined with faith that the free market can handle anything is not anywhere near a valid argument when we’re talking about implementing major policy changes that have life or death implications for hundreds of millions of people.
Do you understand in the slightest that when you repeatedly write, “let’s run the experiment and find out” that you have no credibility at all on this subject?
I don’t want useless and idiotic “experiments” so you and your ilk can adhere to your free market extremism.
I want what works. I want to know that whatever happens I, like my fellow Americans, will not lose my access to health care should my husband lose his job. I want to know that I will not go bankrupt should my husband, myself or my daughter suffer a major illness that can be treated with proper medical care.
Those are reasonable, rational, civilized goals. Every piece of evidence indicates that such worthy goals can be accomplished for nearly all Americans with UHC at much lower cost than our present stupid and expensive system.
Your absurd mantra of the free market will solve all is completely irrational and based on nothing more than a combination of wishful thinking, Republican propaganda and assumptions not demonstrated in the real world that the rest of us live in.
As repeatedly indicated in polls on this thread most of your fellow Americans are sick of it. Admit you’re wrong and STFU.
Let’s recap: you said, falsely, that what I really meant was “let’s not do that stuff that’s being proposed at all, and let’s just do my agenda one step at a time”. I pointed out, accurately, that I was proposing we do the stuff that’s actually in the bill. You make statements when you should be asking questions – and you ask the wrong questions at other times. Let me see what I can do:
That’s – well, that’s better, I guess; it’s pretty much a rhetorical question, but that’s an improvement.
Still: yes, I’m with you so far.
That’s a question instead of a false statement, which is good.
The problem is, I think you’re missing the point of my argument. I don’t want to point at the insurer I think is best and recommend it for the whole damn country; I don’t have that much faith in myself, just like I don’t have much faith in top-down solutions from the government’s experts. My whole point is that I want the market to take a shot because I don’t want to field the questions you’re asking; I want the market to do that.
I don’t want to set the price for a can of Pepsi; my whole point is that I want the free market to do that. I don’t want to decide whether they should discontinue their cherry-flavored version or charge double for it; I don’t want to weigh in on whether they offer a better product than Coca-Cola does, either. If you ask me about any of that, my only answer is that I want market forces to supply the answer for me.
I want consenting adults to make voluntary choices among genuine competitors because I don’t have any better ideas; if I did, I wouldn’t be advocating the free market.
You keep making this out to be too big an issue to be left up to consenting adults making voluntary choices among genuine competitors in a free market despite the fact that most people say they’re doing just fine. We don’t need a valid argument for a free market; we need a valid argument against one.
Then deal with those “dozens of reasons”, one by one.
As repeatedly indicated in polls, what most of my fellow Americans are sick of the current legislation making its way through Congress; what most of my fellow Americans want is for our legislators to start over and address the problems one by one, starting with proposals that have bipartisan support. They want backers of the current bill to admit they’re wrong and STFU.
(That said, I’m still mystified as to why folks think I have an “absurd mantra of the free market will solve all”. I’ve only ever stated the exact opposite, and folks with poor reading comprehension skills keep making the wrong claim sure as they can’t provide cites to the contrary.)
Is there a good place to read a summary of the major changes the reconciled bill will make? I find articles that mention the changes, but I wanted to review what the full laundry list is.
The majority of Americans are also reasonably healthy most of the time. I’d be interested to know the actual percentage of Americans who are both satisfied with their coverage and have had cause to call upon their insurance company in any meaningful way.
