When I call my doctor in Michigan, I get an appointment in about 3 weeks. Is that a short waiting time? I had a specialist look at a spot on my back. I first had to be referred by a doctor. Then I waited at least 4 months before I could get an appointment. Is that a short waiting time?
Gotta hand it to Der Trihs, he’s one prescient motherfucker. And he ain’t shy about laying the wisdom on us mere mortals neither.
SB–CM’s answer to your question doesn’t really say a whole lot about what CM actually thinks, and I think the reason is the ambiguity on the terms “efficient and effective.” And others are accusing him of being an ideologue when it appears that he is considering factors they are not considering (or at least he is weighing them more heavily). So, the whole exchange was rather worthless (not that that makes it different than any other exchange on an internet messageboard).
He said he opposed federal health care because it’s not authorized by the constitution. So I was curious if that was the only thing holding him back, so I asked if we passed an amendment that gave the federal government that power, then would he support it or does he have other objections? I was just satisfying my own personal curiosity about his views. He places the importance of not involving the federal government in health care over any potential benefit from the gain you’d see by federalized health care. That’s fine, it’s a valid philosophical position, and I didn’t argue with it because again I was just curious.
That’s because it wasn’t so optional. We were going to be taxed to fund it, and then you had the option of getting the coverage. It’s like if you had a cupcake and I had $2. It’s one thing to say “You have the option to buy my cupcake for $2 or not.” It’s another thing to steal my two bucks and then go “So do you want the cupcake or not?” It’s not so optional anymore, is it? That’s where the opposition came from.
Also, imagine this scenario: There are 3 people in a country. They all need surgeries but only two of them have the coverage to pay for it. Let’s say it costs $50 for a premium every month and otherwise, the surgery is prohibitively expensive. So you’ve got two guys spending $50 for a total of two operations while the other guy pays nothing and gets nothing. Now there comes a system where if you have money, you have to pay $60 but you get coverage. If you have no money, then you don’t have to pay. Now all three get to have the surgery.
At first, you’ve got $50 per operation. Then you have 120/3 = $40 per operation. So then you get statistics pushed out that go something like “See? With this system, we get more for less!” What it doesn’t say is that there’s two guys who are pissed off that the third guy is getting a free ride, albeit at a discounted price. They’re paying more and getting what they already had.
It all boils down to who “we” is. The statistician says that all three guys make up “we”. But for all we know, Guy 2 hates Guy 3 and wants Guy 3 to DIAF because he…I dunno…voted differently than Guy 2.
So is it so surprising that in a situation like the US, where 80% of us are happy with our current coverage, that there’s such heavy opposition to a plan where there’s a bunch of "Guy 3"s? It doesn’t shock me.
As to what evidence I would accept, I’d want to see numbers on paper. I don’t want promises like “it’ll be cheaper, we swear”. I want to know that for $X, I, too, can buy a plan that gives me $Y in catastrophic coverage, pays z% of the pharmacy bill per year, etc. That way, when the system goes bankrupt, like all government programs do, and they cry for more money, we can point to the sheet and go “Nope, you said you’d deliver this much coverage at this price. Make it happen or we’ll elect people who can.”
And why do I think we can handwave away stats from elsewhere in the world? Because we’re special. We’re bigger, richer, and fatter than everyone else. We’re less socialized, too. We eat more and exercise less. We spend more time in front of electronic boxes than the rest of the world. That’s enough reason for me to believe that we need our own case studies and can’t just point to correlations in Europe for our data.
Well, special’s one way of putting it…
From what I understand, it’s not as though everyone would be taxed equally. The people who used the system would pay into the system. Others would partially fund it through ordinary taxes, but there’d be user fees for most. There’d be subsidies for those who had trouble paying - which I guess is the part you’re stuck on - but it’s not as if it were funded out of the general fund entirely, and then only a few freeloaders signed up, which is what your analogy implies.
It’s not too unlike the post office in that regard - user fees cover most of what the post office does, but it’s still in the red a few billion, which I would assume comes out of the general fund.
Incidentally, without seeing some numbers, I’m not sure I’m inclined to trust the idea that everywhere else is so much healthier than americans that they only have to spend half as much on health care. It defies, for example, the real-world study that 35-40% of our health care costs are administrative. It also defies that there are mcdonalds all over the world and pretty much everywhere in the western world is fat and lazy these days.
The public option wouldn’t have cost anything. It was to be a paid for insurance plan, just like any other, it just wouldn’t have a profit structure built in.
It also would have had the benefit of providing price competition with private plans.
Well, what I’m saying is that I don’t think you are actually able to say the bolded part based on the conversation.
http://voices.washingtonpost.com/ezra-klein/2010/03/cbo_health-care_reform_bill_cu.html The healthcare bill is slated to cut 1.3 trillion off the budget during the next 20 years. Is that a reason to dump it?
Well, you’re wrong. His attitude is that it’s not a question of whether or not a federally run system would be the best - for any reasonable definition of best, again, because he didn’t fight the hypothetical, you are - because it’s more important that people not have it forced on them nationally. That’s fine, it’s a consistent philosophical point of view, and I’m not even contesting it.
So for him, the question isn’t “would a federally run system have the best results” but rather “is it right to let it be a federal power?”. He accepted the hypothetical and answered anyway. I find his position to be logical and valid. So why are you fighting the hypothetical on his behalf?
I’m not fighting it on his behalf, I’m just pointing out that your conclusion doesn’t necessarily follow from what he said. He could be considering practicalities that you just don’t find important.
Perhaps I’m reading some of my own experience into this. People here are constantly calling me an ideologue when supporting a fically conservative position, but I support that position for practical and not ideological reasons.
In any event, CM could clear this all up for us if he wants to.
Correct.
I am apparently one of the few Americans who still believes we have a limited federal government.
The assumption is built into the hypothetical. I think most reasonable people would conclude that the most efficient and effective health care system is the one that delivers the best outcomes for the least cost. Now, even if we were to hypothesize that federally-managed health care were to provide that, you could still object to it on other philosophical grounds because you feel those things are more important than the efficiency gained by running it that way. I’m not saying at this point that federally run health care would provide the best effectiveness - I put that forth as a hypothetical, that even if that were the case, would you still object to it? He answered yes. Obviously he feels that other factors are more important than the efficiency and the effectiveness of the delivered medical care. That’s fine. I didn’t contest that. You seem to be either fighting the hypothetical, or pointing out the obvious (ie that he has reasons that non-federal medical care is better outside of the medical efficiency itself). If it’s the latter case, I’m not contesting that and it doesn’t conflict with what I said.
Edit: It looks like I had the correct interpretation of what he said. Again, I wasn’t attacking him for his stance, just clarifying it by posing a hypothetical.
I’m not sure what to clear up. To me, it’s rather simple… nowhere in the federal constitution does it give the federal government the authority to have anything to do with healthcare. According to the 10th Amendment, then, any and all government involvement in healthcare must be done at the state and local levels. (Please don’t bore me by playing the “general welfare clause” card. Heck, just about anything can be defined as promoting the general welfare. Playing this card means you believe the federal government can do anything.)
Not only that, but even if the federal constitution *did *give the federal government authority over our healthcare, I would *still *be against it (though I supposed I would have live with it). See me earlier posts for more info.
The United States is a federation of states. Each state has its own government and constitution. Unlike the federal government, the powers and authorities of state governments are numerous; states have a wide latitude in what they’re allowed to do. The beauty of this is that you’re not locked into just *one *system… you are free to move to the state of your choosing. Likewise, states will compete with each other for workers, and state governments can learn from each other’s mistakes.
Yep, cleared up, thanks.
Sorry to shatter people’s notions of monolithic conservatism, but I disagree with CM. I’m concerned with the best practical results, and I don’t think the case has been proven for UHC yet. Cue Euphonious Polemic bringing up an old argument that he didn’t understand þhe first time around In 3 . . . 2 . . . 1 . . .
I really don’t like to use the term “efficiency” when referring to government functions. Stalin had a ***very ***efficient government. But I know what you’re saying… you want the most bang for the buck. As a taxpayer, I agree. But I can’t be a proponent of something that I believe is blatantly unconstitutional. Not only that, but (as mentioned in previous posts) I would much rather pay more for state-run healthcare (where I have a *real *choice) vs. paying less for federally-run healthcare (where I am stuck with one system).
Understood, CM. Another variable at play here is the idea of the ideal government as a concept and what the U.S. government can do under the Constitution. I agree that the Constitution limits the activities of the federal government to much less than what many liberals want it to do.
Lobo, I have shit out turds that have more brains and common sense than you do.
First-this is the best explanation for opposition to this issue that I’ve ever heard. Your argument is clear and easy to understand, and it makes perfect sense.
Second-isn’t this already true anyway? I pay just about $300 per month for medical/dental/vision insurance for myself and my family. It’s good coverage, but I work for a cheap-ass non profit so $300 is a big chunk of my paycheck.
Now, there are many people in my community who either don’t work or work but don’t have insurance. When they get sick they go to the ER and get the help they need, and although I’m not clear on the details I’m thinking we all pay for their care with our taxes. How is this any different from your $2 cupcake?
What seems clear to me is that we need to find a way to lower the cost of healthcare for the people who show up sick at the ER because they don’t have insurance. One way to do that might be to find a way to get them access to a regular doctor so they can stay healthy and/or resolve health issues while they’re still small and manageable instead of waiting until they are in expensive trouble and have no choice but to seek emergency care.
I think this should be the priority not just because I care and don’t want poor sick people to suffer, but because I imagine that this will somehow save me money either in lower taxes or lower insurance premiums. Am I wrong?