McCain Needs Strong, Limited Government Solutions for Healthcare
By Alan Stewart Carl | Related entries in Health Care, McCainAs a John McCain supporter, I know he has an uphill battle. He can’t afford many missteps and will have to work hard to convince voters that he offers change from a better and more sensible position. As he moves into the general election, he’s going to have to buttress issues that were of less importance in the Republican primaries. Most notably, his healthcare plan needs work.
Currently the McCain plan is a series of disjointed tweaks and bromides that don’t offer a compelling limited-government alternative to the Democrats’ big government initiatives. McCain needs to embrace strong ideas that acknowledge federal government’s usefulness without falling into the trap of advocating a nationalized healthcare plan that just reconfigures the current system without addressing the cost/quality conflict at the heart of the problem.
Healthcare costs are high for a variety of reasons. Some are uncontrollable, such as the increasing number of older Americans whose advancing age requires a great amount of medical care. Others are directly related to the high quality of care we’ve come to expect: we use the newest (thus most expensive) technology and expect highly skilled (thus well-compensated) medical professionals. We could fairly easily lower costs if we substituted older technology and less-skilled medical providers, but we’d have to settle for lower quality care.
In many ways, we’re already making the cost/quality tradeoff. Healthcare providers, following the demands of the free market, are increasingly using nurse practitioners in lieu of board certified physicians and hiring lightly trained medical assistants over more highly trained nurses. Many insurance companies take a more draconian approach, telling patients and doctors what level of quality care is acceptable based partially on what the insurance company is willing to spend. That kind of cold, cost-benefit analysis results in the rare but heart-wrenching stories of people suffering because they were denied treatment.
Using fewer physicians and registered nurses can only go so far until quality of care becomes dangerously insufficient/incompetent. There’s little reason for the federal government to force even more lesser-trained providers into the system. Similarly, mandating what insurance companies must pay for would require a massive government intrusion into private business with unknown and likely undesired results. The solution, therefore, will not come from artificially controlling the cost/quality relationship. Instead, we need to look at the risk management aspect.
Where the plans of Barack Obama and Hillary Clinton go wrong is in their assumption that lack of affordable insurance for millions is the core problem when it’s actually just the most obvious symptom of larger issues. Making sure every American has insurance is a nice idea but without addressing the underlying risk/reward problems, simply shoving more people into an already unbalanced system will decrease the quality of care for everyone.
The lack of affordable health insurance is not due to greedy insurance companies or the quality-control initiatives of the American Medical Association or even because we Americans are leading relatively unhealthy lives (the obese and smokers actually cost less to treat over their lifetime than do more healthy individuals). Health insurance is expensive because high quality healthcare is expensive. Insurers must take on significant risk and thus charge significant prices. The most expedient way to lower prices is to spread the risk over larger numbers but, thanks to ridiculous regulations, many Americans are not allowed to buy insurance as part of a group and instead must opt for staggeringly expensive individual plans.
So, step one is deregulation/re-regulation. Allow individuals as well as small businesses to band together with others and buy group rates. More radically, instead of requiring businesses to provide health coverage for their employees, we can sever the business/insurance relationship and let each individual citizen choose a plan based not on where they happen to work but on their healthcare needs.
Without large corporations footing the bill, insurers would have to innovate to create plans affordable for individuals. Plus, individuals would have fully portable plans that would allow them to change jobs or start their own businesses without fear of losing coverage. A more fluid and less risk-adverse workforce would be a boon to our economy, as would freeing our businesses from the burdens of paying for healthcare.
Deregulation alone will not be enough. Step two is increasing the level of choice available to consumers and the level of responsibility expected from them. Right now, health plans are stratified but not particularly customizable. It’s a collection of prix fixe menus with designated courses at each price level but no real choice. This has the effect of disconnecting the consumer from the real costs of what they are purchasing. If it’s covered, they’re going to opt for it, even if it’s not medically necessary. The current coverage system creates a disconnect in patients’ minds between care and cost and is actually one of the leading causes of higher healthcare expenditures.
However, if more customizable plans were available, individuals could choose coverage based on the level of risk they were willing to assume and the level of premium care they desired. There could even be different deductable levels for different procedures and medications, rather than one flat deductable. That way, patients would know the cost of the care they seek and have to take personal responsibility for choosing excessive procedures and medications. This, of course, is not something the government could mandate but it could encourage innovations by providing tax incentives to those companies willing to reform their coverage.
The final significant way the federal government can help is through providing tax credits which individuals and families can apply to health insurance (John McCain’s plan already has this provision). Additionally, the government can expand health savings accounts allowing families with more expensive coverage or additional health needs to put aside extra tax-free funds.
Clearly and inarguably, what I’ve laid out here has huge holes. This is a profoundly long blog post but a terribly insufficient description of a healthcare plan. My thoughts are really nothing more than the very basic outlines of ideas I’d like to see developed and advanced on the federal level – I realize they are not devoid of fallacies or complications and I do not consider them anywhere near a complete list of available remedies. There is a lot of room for states to promote their own plans and take other measures such as preventative care initiatives and malpractice lawsuit reform. There is also a lot of room for free market solutions from both insurers and providers. What’s important is we avoid restricting the marketplace of ideas by federalizing the healthcare system and cutting out the vast majority of the innovators in this field.
As a general rule, I like a narrow federal government focused more on clearing the road of obstacles than trying to design and drive my car. Right now, Obama and Clinton are focused on building the car while John McCain is either unaware of the huge piles of junk blocking the way or is unmotivated to develop the bold actions needed to remove them. I think the best solutions will come from a conservative-leaning mindset, but I’m still waiting for a Republican to champion pro-market, limited government ideas that can win out against the Democrats’ big government plans.
This entry was posted on Tuesday, February 26th, 2008 and is filed under Health Care, McCain. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
February 26th, 2008 at 11:52 am
McCain’s plan’s are not plans - they are quips and sound bites and “straight double-talk”. Your blog post can be summarized as follows: McCain has no healthcare plan because he thinks that healthcare is not a provision of the federal government. And where the federal government is “forced” to provide care it is in direct competition with the civilian healthcare industry and needs to be of lower quality. The man has no punch on any of the issues that are important to the majority of Americans. He is pro war, he is a war monger quite frankly. He is against torture but supports that means to obtain information from non American citizens. He is against the federal government removing civil rights to “spy” on American citizens - but votes in favor of those exact same bills. He is against big government but voted in favor of nearly every spending bill in the last 7 plus years greater than doubling the National Debt. John McCain cares about John McCain - and only John McCain. Most of the money he raised never came from anyone in Arizona - most of his money comes through PAC’s from every state in the country. He is a national hero because he got shot down and didn’t die when he was tortured (at the risk of sounding insensitive) I call that luck - but we need heroes so I’ll give it to him (why aren’t the “ace” pilots who shot down dozens of Migs and brought their plane back classed as heroes?). He like’s to fashion himself a maverick when the object is watered down enough to make no real difference - I call John McCain “The Man Who Shot Liberty Valance”. He is exactly what’s wrong with the government - he’s not a solution, and doesn’t offer any.
February 26th, 2008 at 12:01 pm
Of course insurance company CEOs earning nine figure salaries have nothing to do with it. Of course 1200 insurance companies that generate more red tape than any government office have nothing to do with it. There’s no such thing at an insurance company as someone whose job description is “Come up with a way to deny the benefits we agreed to so we can save money by cutting this person off.”.
Alan, you will never see your desire come true because the whole thing is based on one faulty assumption which is that the Free Market is perfect and capable of solving anything with a for profit corporation. You think that there are innovators in the field that have somehow been thwarted from saving us all. The truth is that no publicly held corporation in the United States of America is capable of offering viable solutions in health care. The levels of growth and profit expected of them by the financial services sector are incompatible with good patient care. This is your private sector at work.
February 26th, 2008 at 12:46 pm
That dude got nine million dollars. I doubt that the insurance company will be fraudulently cutting off patient care in the future. Others will take note. Meanwhile, in Brave New Britain, this happened. And there is nothing she can do about it. No 9-million pound check for her. Also, obesity related diseases might be refused treatment treated by the NHS, or obesity could even become outlawed in the future. God forbid people have the right to make health care decisions about their own bodies and lifestyles, that is, unless they want to kill a foetus.
Anyway, I got a solution. Since health care costs are so high because new treatments require huge amounts of investment by large pharmaceutical and medical technology companies, lets just prevent those companies from developing new treatments! That way, everyone would be forced to use the older, outdated treatments that cost less. It would be very easy to pull off. All we need to do is socialize medicine.
Prices will be fixed by the government so there would be no incentive to invest in pharmaceutical companies because profits would be extremely limited; Federal grants for new research will be curbed because of the astronomical expense of distribution of care, let alone the most risky form of investment - medical research; And the entire world’s pharmaceutical industry would collapse because America is the only rich country left that the can actually earn profits in. No New Cures! Its simple, but it may work because once the grass is no longer greener on the other side of the fence, no one will know what they were missing out on.
February 26th, 2008 at 1:19 pm
McCain’s plan’s are not plans - they are quips and sound bites and “straight double-talk”. Your blog post can be summarized as follows: McCain has no healthcare plan because he thinks that healthcare is not a provision of the federal government. And where the federal government is “forced” to provide care it is in direct competition with the civilian healthcare industry and needs to be of lower quality. The man has no punch on any of the issues that are important to the majority of Americans. He is pro war, he is a war monger quite frankly. He is against torture but supports that means to obtain information from non American citizens. He is against the federal government removing civil rights to “spy” on American citizens - but votes in favor of those exact same bills. He is against big government but voted in favor of nearly every spending bill in the last 7 plus years greater than doubling the National Debt. John McCain cares about John McCain - and only John McCain. Most of the money he raised never came from anyone in Arizona - most of his money comes through PAC’s from every state in the country. He is a national hero because he got shot down and didn’t die when he was tortured (at the risk of sounding insensitive) I call that luck - but we need heroes so I’ll give it to him (why aren’t the “ace” pilots who shot down dozens of Migs and brought their plane back classed as heroes?). He like’s to fashion himself a maverick when the object is watered down enough to make no real difference - I call John McCain “The Man Who Shot Liberty Valance”. He is exactly what’s wrong with the government - he’s not a solution, and doesn’t offer any.
February 26th, 2008 at 1:56 pm
Jim, the insurance companies are indeed a pain in the ass. Some of that is based on typical free market ineffeciencies, some on greed. But MOST is due to the cost inherrent in providing high quality care. Insurance companies are fighting the same skyrocketing costs as the rest of us. You can regulate them to death if you wish, but it’s not suddenly going to make an MRI cheaper or suddenly make a highly skilled surgeon stop expecting just compensation for his unique skill. So then what? Regulate doctors salaries? Regulate the cost of new technology? That then removes the incentive to spend 10+ years becoming a physician as well as the incentive to develop new medical technology.
The result is piss poor care for everyone.
Obama and Clinton are smart enough to realize that and that’s why they aren’t advocating the dismantling of insurance companies. But their plans rely far too much on shifting costs around rather than competently reducing them. They’ll flood the system with demand which will raise costs even more which will create a breaking point where quality of care will greatly suffer because there won’t be the resources to go around.
The only economic model that has proven effective in reasonably allocating reasources is the free market. Yes, it can be clumsy and problematic and sometimes requires governmental oversight but it works. When governments get in the business of allocating resources, everyone loses. Nationalized healthcare sounds like a reasonable plan until you start carefully researching its implications. We’d come to a much faster and satisfactory solution if we step back and follow a more limited government approach that permits the best aspects of the free market to operate.
February 26th, 2008 at 4:11 pm
ASC
The free market allocates resources that are paid for by consumers effectively. The government allocates resources that are paid for by tax dollars effectively. Governments job is to effectively allocate societies resources through the power of taxation and distribution of those taxes. The healthcare industry straddles public and private industry by choice. I would love to get my bill from the doctor directly, read it, pay my portion (say a $100 deductible), then I sign it - and mail it in to my government agency, and I’m done. The government agency then looks at the drug charges, audits the bill, insures the doctor/hospital/clinic are certified. It would work, and it would work well - no one would be making a profit off my illness so it would behoove all of us to try and be more healthy.
The American people deserve the right of government subsidized healthcare - it is a right plain and simple. Healthcare companies want to provide healthcare only so far as they can make a profit. They want to provide care for those areas they can make alot of profit on, and pass off to the government or deny care completely those areas they can’t. It is easy to say that private industry most efficiently allocates resources when they get to choose the resources to allocate. You can’t have it both way’s - what exactly is the value add insurance companies provide when it comes to healthcare?
The government could do a very good job allocating healthcare resources if they chose to. Business wants their cut though - they think they will do a better job administering patient care, taking a profit, distributing drugs the drug companies give them, outsourcing much of the diagnostic work to India and Low Cost Labor Markets (LCLM), and by and large efficiently administering a race to the bottom as quality is sacrificed in favor of the bottom line. Government won’t do that.
Nationalized healthcare is is a reasonable plan because it allows for the greatest good for the greatest number - and if someone chooses to have better healthcare above and beyond what the government offers they can purchase a supplimental policy. In Europe everyone is covered - plain and simple - there is a very competitive and very efficient private healthcare network as well - but the patients pay for that themselves if they choose to - but they have a choice.
February 26th, 2008 at 5:11 pm
Terrence, I just wrote a long response that seems to have gotten eaten. I don’t have time to repeat the whole thing but I will repeat these two points:
1) in Europe a private pay system exists because the national system isn’t very good and people want another option. Wealthy people buy private insurance because the free market system provides higher quality care than the government system. Is this really the model we want? We can do better, I’m sure.
2) If healthcare is a right, how much care is included in that right? Is it just preventative care and emergency care? Are knee surgeries included? Cholesterol medication? Do you really think the government will do a better job of drawing those lines than a private system with competing ideas? We all want a system the creates the highest benefit for the most number of people but I am strongly skeptical that a government controled or a government funded system will produce the best results in a nation where choice and innovation are already so ingrained in patients expectations.
February 26th, 2008 at 6:25 pm
by the way, that was a great post, ASC.
February 26th, 2008 at 7:26 pm
Are you arguing in favor of rational choice theory, Alan? Your arguments would seem to be doing just that. Did you even read the article I linked to? Do you realize that private insurance companies spend four times as much on administrative overhead as Medicare or Medicaid? Current common practices by private insurance companies are more than a pain, they would distort any possible market system and they have nothing to do with government regulation.
I suggest that in fact health care is a field completely immune to classical market forces for many reasons. First there are the emotional and psychological factors that enter into it when the rubber hits the road. I don’t think I have to expand on that too much. Secondly there is the fact that it is virtually impossible for most people to wade through the jargon, the math and the actual financial implications of health insurance plans. The companies like it that way and there is absolutely nothing that will change that. There is no market force to encourage that change. If you can’t understand the full implications of what you are buying, count on predictable and reasonable pricing and get what you believe you paid for the system will break down. And finally for this post, any argument that depends on treating health care the same as a color TV or automobile is doomed.
February 26th, 2008 at 8:20 pm
Alan wrote: “Making sure every American has insurance is a nice idea but without addressing the underlying risk/reward problems, simply shoving more people into an already unbalanced system will decrease the quality of care for everyone.”
True and true for both items.
For those with a sincere interest for what “universal health care” feels like or what the rest of the country can look forward to, if either O. or H. gets into power, look no further than Massachusetts.
What has been sold as UHC by the State of Massachusetts is none other than * Mandated Insurance. *
Now mandated insurance doesn’t have the same exciting ring as ‘universal health care,’ nonetheless some still argue that it’s a “good” concept. They forget the world is full of “good ideas” that translate into terrible policies (i.e., socialism or communism).
Anyway, for Massachusetts residents the reality of the great UHC scheme… err, plan, aka Mandated Insurance means:
Those who were uninsured before this law took effect are punished by being forced to buy plans with outrageous premium in exchange for low-quality care. The alternative is to remain uninsured and be mulcted by the State.
But it doesn’t end there.
Those who were already insured will be required to upgrade their premiums in exchange for lower-quality care. Fines will be assessed if they won’t or can’t.
Ah, let’s not forget the care providers.
The doctors are either refusing to take on new patients from the State’s plans (due to overloading and low returns), or are threatening to leave this State.
Or, the impact on businesses.
These too are faced with an analogous decision. Small businesses with fewer than 11 employees are exempted from providing insurance for their employees. Those with more than 11 employees will be forced to buy plans or be penalized.
Thus far, many individuals and businesses are opting for the penalty.
MA’s response to this “public disobedience” has been to heighten the threat by hiking the fines to its citizenry for non-compliance. Also, lack of health insurance” is being treated as a tax evasion!
Lots of sticks in UHC, but where are the carrots?
For the Utopians, turned armchair strategists, stroll over to MA and see if YOU like it!
February 26th, 2008 at 8:22 pm
Alan wrote: “Making sure every American has insurance is a nice idea but without addressing the underlying risk/reward problems, simply shoving more people into an already unbalanced system will decrease the quality of care for everyone.”
True and true for both items.
For those with a sincere interest for what “universal health care” feels like or what the rest of the country can look forward to, if either O. or H. gets into power, look no further than Massachusetts.
What has been sold as UHC by the State of Massachusetts is none other than * Mandated Insurance. *
Now mandated insurance doesn’t have the same exciting ring as ‘universal health care,’ nonetheless some still argue that it’s a “good” concept. They forget the world is full of “good ideas” that translate into terrible policies (i.e., socialism or communism).
Anyway, for Massachusetts residents the reality of the great UHC scheme… err, plan, aka Mandated Insurance means:
Those who were uninsured before this law took effect are punished by being forced to buy plans with outrageous premium in exchange for low-quality care. The alternative is to remain uninsured and be mulcted by the State.
But it doesn’t end there.
Those who were already insured will be required to upgrade their premiums in exchange for lower-quality care. Fines will be assessed if they won’t or can’t.
Ah, let’s not forget the care providers.
The doctors are either refusing to take on new patients from the State’s plans (due to overloading and low returns), or are threatening to leave this State.
Or, the impact on businesses.
These too are faced with an analogous decision. Small businesses with fewer than 11 employees are exempted from providing insurance for their employees. Those with more than 11 employees will be forced to buy plans or be penalized.
Thus far, many individuals and businesses are opting for the penalty.
MA’s response to this “public disobedience” has been to heighten the threat by hiking the fines to its citizenry for non-compliance. Also, lack of health insurance” is being treated as a tax evasion!
Carrots lacking, but lots of sticks in UHC.
For the Utopians, turned armchair strategists, stroll over to MA and see if YOU like it!
February 26th, 2008 at 8:23 pm
test
February 26th, 2008 at 8:47 pm
Alan SC - It’s obvious your not European - regarding point 1 - the healthcare systems in any of the scandinavian countries or France blow ours away - and it’s all run by the government. The rich can have private insurance and private hospitals because they are the rich - by and large those are not needed for a well run health care system = but they are available for those who want to pay.
What kind of a society penalizes their people for being sick? That’s exactly what we have going on in the USA. Free markets work well for the consumption of manufactured goods - they are horrible for things a quality democracy needs - specifically, education - healthcare - and a secure electorate.
I am convinced that the problems facing this nation are far too complex for the narrow “conservative” point of view. Healthcare is one of those issues but there are so many others - food safety, civil rights, education, fair elections to name some. I believe healthcare should be a right of citizenship, I also believe public service in the armed forces (or some equivolent) should also be a right - but that’s another discussion.
Government is the only solution to this problem because the private sector is so bad at providing this service to millions and millions of people - and they are suffering real pain and real economic insecurity as a result. I’m not suggesting the tax payer pays for cosmetic surgery, dental braces, knee replacements for 80 year olds - but a solid system can be put in place and the government is best equipped to handle this because it effects our entire society, and our long term economic viability.
February 26th, 2008 at 11:59 pm
Ah, terence beat me to it. Alan seemed to have the American Conservative talking points about health care down when it came to putting down Europe but it doesn’t match what I hear from Europeans or from Americans living abroad in those countries that write on blogs I’ve read.
Why not have a government subsidized organization that covers everyone that needs it and that they can pay into according to their ability to pay? Fold in Medicaid and Medicare. Don’t ban private insurers but they’d better be offering something pretty compelling if they want business. Companies can offer private insurance as a benefit or cover individual expenses in the government system. But…if someone loses their job they don’t suddenly have no coverage. If they want to start their own business they don’t have to factor in the fear of the unexpected striking their family.
Jimmy says:
The award is undoubtedly being appealed already. The instant the executives think that they have a way around what just happened they’ll be back at it. It’s a matter of fiduciary responsibility, after all.
February 27th, 2008 at 10:50 am
I see your Scandinavia and France and raise you Canada, Britain, and Walter Reed (since it’s the only indicator of how our gov’t is going to perform).
February 27th, 2008 at 11:37 am
If the European model is so magnificent, why aren’t the Democratic candidates pushing for that? Why are they leaving a major free market component (insurance companies) in place? And, from an argument standpoint, you don’t gain anything by acusing me of reaching for “conservative talking points.” I don’t think it’s mindless to say that we can do better than the European systems.
And in regards to treating healthcare like a tv or automobile, clearly that is not the argument I made. My point is that, ultimately, a private insurance system will provide more care to more people at a higher quality than a government run or government paid-for system. The fact that Medicare and ‘caid are more efficient with their overhead at this point proves very little. They have a regulated pool of individuals and a regulated fee schedule that requires no negotiation with physicians. Are you suggesting we should mandate how much physicians get paid not just for Medicare and ‘caid but for all healthcare services? That would indeed lower costs — and drive doctors right out of business.
February 27th, 2008 at 1:52 pm
Which is better: the European or US healthcare systems? Seems to me to be a erroneous question. In fact, the Europeans rely upon healthcare system in the US to develop drugs and technologies that otherwise would not exist. This comparative analysis reduces to: if the parasite has a better existence than the host, isn’t better for the host to become a parasite. Unfortunately, the parasite requires the nutrition of the host and so when the US goes the way of the parasite — the Europeans will suffer also and the tides will universally recede.
Jim S. and other socialists love to lay blame on the footsteps of the “free-market” for the problems with U.S. healthcare. As if the US healthcare system was entirely a free-market. The fact is, almost all government healthcare intervention has the effect of driving up prices.
I pay 2.9% for medicare which neither I, nor my family, are eligible to receive and 12.4% for social security which I will never see. Hey Jim Socialist, what kind of return or safety am I or my family getting for the first 15.8% of day I spend working for the U.S. government.
Hard working people don’t want your safety-net - they’d settle for you getting out of their pocket.
February 27th, 2008 at 2:09 pm
They aren’t pushing for it because of people like you, Alan. How much do you really know about it? Yet you condemn it without thinking or doing the research. What do you really know about the European systems? Many of them still have private insurance companies as well as extensive government involvement. You say it isn’t mindless to say that we can do better than Europe. What is your basis for that belief? The truth is that you are saying that somehow through some miracle if we just let the insurance companies do whatever they want to do and then wait long enough the private insurance companies will do better. Where is your proof?
You say that
Of course it is the argument you make. You are claiming that the same type of market system of consumer shopping around and weighing the facts will work for health care systems as works for TVs or cars. You make absolutely no response to my points of why it doesn’t really work that way. None. You just know that Free Market makes no mistakes. Praise Free Market! Hallelujah!!
Then you state as part of your argument against government involvement that
You do realize that what you describe is the precise thing that every one of the insurance companies do, don’t you? “If you want the pool of patients we represent, take this much money. Take it or leave it.” is their mantra. And if you think that doctors are in the position to turn down every insurance company that does that we can discuss the value of bridges and swamp land later.
February 27th, 2008 at 7:50 pm
Dos: “Hard working people don’t want your safety-net - they’d settle for you getting out of their pocket.”
Amen!! A concept totally lost on the majority of liberals.
Incidentally, I have lived in Europe… and all the propaganda in favor of aligning the U.S. to the old continent as it pertains to health insurance is nothing more than pie-in-the sky foolish thinking.
Of course, “health insurance for everybody” sounds wonderful. However, let’s also consider, At What Cost?
Let’s preface that the state, not the individual is in charge of where he can go and whom he should see.
What good is health insurance if your choice is taken away? What good is medical care if the quality is wanting? What good is a doctor’s visit if the so-called-doctor is incompetent and only concerned in fulfilling his daily, monthly quota?
Furthermore, if people decide to see a specialist of their own choosing or need certain tests done, they can either get on a long waiting list for the state lab or, again opt for a better facility and foot the bill.
All Europeans may ‘enjoy’ health insurance, but they also carry some of the highest tax rates in the world.
February 27th, 2008 at 8:58 pm
Hey, Louise!! How’s Harry doing these days? After all, the “free choice” argument was BS when you made your first ad and it still is. The typical American who has insurance from work doesn’t have free choice either. The insurance company has their list of doctors in their network. They have a list of preferred medications they will cover and if you find yourself with a new insurance company because of your employers choice, not yours, you can suddenly have to change doctors and medications or pay a lot more money. Maybe money you can’t spare from your family’s budget.
You claim to have lived in Europe. Did you ever need health care while you were there? What country did you live in? Did you have friends who had really needed health care? The people I’m talking about are Europeans or Americans who actually interacted with the systems in Spain and France. What was your experience, Elisabetta? I will state right up front that I have my doubts because every single post you’ve ever made here has been 100% RNC talking points with no exceptions.
February 28th, 2008 at 12:46 pm
Stuck your foot in your mouth again, huh, Jimmy boy?
Before accusing others of falling back on talking points, take ownership of the left-wing propaganda you submit to.
Frankly, I don’t care what doubts you have about me. Personally, I have none whatsoever about you being a left wing lunatic as exemplified by your posts that regularly and categorically berate conservatives and their ideas, at the same time pushing the left-wing madness.
I don’t give a hoot about what you think, either, as that doesn’t change that I have lived, more precisely, grew up in Europe. Consequently, I have firsthand knowledge of the healthcare services. Further, my family and friends continue to reside there, hence I am current on the system’s deficiencies.
While you may pontificate on the ‘goodness’ of your liberal ideas, your feelings or rely solely on secondary information, I possess firsthand experience. Just as I have, unfortunately, primary experience and corroborating facts with regard to mandated insurance in Massachusetts.
Apropos the individual who has insurance via his job, depending on his employer’s ability to provide a certain amount of variety, he has without doubt more choices than the individual that is part of a State/Government run health insurance.
By the way, several in this thread don’t agree with your take, also.
February 28th, 2008 at 1:36 pm
Thank you for proving my point about you, Elisabetta. I notice that you don’t answer my questions. Where in Europe? All systems are not the same. Be specific about the strengths and weaknesses of the system(s) you are directly knowledgeable about. In other words, prove your claims.
I said that I had doubts about your claims because of your history of positions in your posts. You replied with ranting, raving and name calling.
February 28th, 2008 at 1:51 pm
Jim, disagree with me but try not accuse me of not thinking. I’ve thought a lot about this. My own insurance situation is a HUGE mess. I’m a freelancer and my wife owns a small business meaning we have no company subsidizing our insurance. We pay for it privately and we pay dearly for it. A European model would actually be useful to us. But I don’t think those models are the best possible (and I DO know how they work — just because I disagree with you on their perfection doesn’t mean I don’t know what I’m talking about).
I also have an intimate knowledge of how doctors offices work and how they negotiate with insurance companies. I have much contempt for a lot of those companies but at least there are a lot of them. Those being the most unfair/ineffective eventually go away. If the government controled it all, then the low payments they enforce and the problems they create will have no remedy save passing more laws which, without the input of the free market, will likely create more problems than solve.
You seem to have a reflexive dislike and mistrust of the free market. Why? To even claim that the free market works the same way for a TV as for healthcare is to ignore the deep and complex economic layers involved in the free market. Different industries react differently to free market principles. Some require more monitering and regulation, some require almost none. But I have yet to see any industry that involves individuals making private choices that has been improved by the government taking over the system.
I don’t see why you wholesale reject the idea of a free market solution. If we don’t have all ideas on the table we’re sure to come up with an inferior system.
February 28th, 2008 at 10:10 pm
I make no claims for perfection. You make those claims on behalf of the Free Market. How do they work? What do you know of them? Notice I keep using the plural but you keep trying to lump a variety of systems into one monolithic entity.
Show me where an insurance company has failed because of unfair or unethical practices. To the best of my knowledge it has never happened. Your faith may require that you believe it will happen but I’d prefer some evidence. Yes, there are lots of insurance companies. And that is part of the problem, not the solution. Over 1200 different bureaucracies. 1200 different sets of paperwork for doctors to fill out. 1200 different sets of people whose job it is to see if they can come up with a way to deny claims. 1200 different companies that pay doctors on a schedule that would result in policy cancellation for any of their customers.
My reflexive dislike and mistrust is not of the free market. It has its place and its limitations. You apparently do not realize that it has limitations. My dislike is for that kind of attitude. You are the one saying that health care can be shopped for like any other commodity, not I. Because if it can’t then every word you say about how the free market can work is wrong. Without a fully informed buying populace the free market breaks down. I pointed this out in an earlier post and you completely ignored it. Do you even know what rational choice theory is? Do you understand that the reason it is largely discredited now is because some economists were bright enough to realize that irrational thought and emotions have their place in decision making? And what would encourage more emotional decision making than health care? Yet some classical economists refuse to abandon the old belief that everything can be determined by everyone with simple examination of the facts and that it is available for everything in our economic life. You also completely ignored the question of jargon, complicated methods of calculating who owes what, summary decisions on the part of the insurance companies and everything else in the real world. Then you say that some need more regulation and others less. Do I really have to remind you that a major part of your initial post was on how the insurance companies need to be deregulated? You led off with “deregulated/re-regulated” but then never, ever mentioned any regulation, only deregulation. That’s right. We need the health care equivalents of securitized mortgage funds, sub-prime mortgages, Enron, Worldcom, Adelphia Cable, toys with lead paint and the recent massive beef recall. What are those things? The results of combinations of deregulation and when you couldn’t deregulate you just don’t give the responsible agencies the resources to enforce those nasty, evil government regulations. There are no deep and complex layers in the modern free market system. It consists solely of grabbing for the most you can get by hook or by crook and knowing that if you get caught the crime is so confusing that you might not even get prosecuted much less convicted. And then you’re just as likely to get a slap on the wrist as any real punishment. If you doubt that consider that the list above is a very partial one.
In addition you keep going on and on about the innovative solutions that the insurance companies will come up with. Where are they? How many years have we known that the system has had deep problems? Yet the only innovation that the insurance companies have shown is in protecting their bottom line while jacking up fees at consistent double digit rates. Years ago I was paying for my own insurance and I noticed something very telling. Every year my insurance went up at anywhere from 30 to 50% faster than the rate of inflation for actual medical costs. Where are these giants of innovation for the disabled? Where is their voice pointing out how they will help those with pre-existing conditions? Those innovations do not exist. The insurance industry has lobbyists, not researchers. They have accountants, not counselors. The primary if not only role that doctors and nurses who work for them have is to figure out how to turn down claims. Quit trying to give them characteristics they do not have. They are creatures of fiduciary duty to the stockholders, not compassion. The two are mutually exclusive.
Then you give me this really easy target:
Please. Where in modern America have you had the opportunity to see first hand an industry being taken over by the government? Heck, you couldn’t find an example in American history. You read accounts about what happens in other countries to oil companies or utility companies. Guess what? People making choices have almost nothing to do with those industries, especially in developing countries. But that’s the least of why it’s an easy target. As I wrote and you ignored completely I propose a system like that in the European countries where there is a government system that does what the private companies refuse to do. Provide a useful health care system for those that can’t pay enough to produce profits that will make big companies happy. It’s available to everyone regardless of income with those who can afford to pay more doing so. But anyone who wants to use the private system for whatever reason are perfectly free to do so.
Then we get to your last statement. I will really try to refrain from name-calling but it really pisses me off.
HOW DARE YOU??? You are the one who refuses absolutely to put all ideas on the table. You are the one who says absolutely and unequivocally that the only acceptable approach is a “market based solution”. You are the one who denies any government role in the system. And then you have the unmitigated gall to say that I am the one who refuses to consider all options and therefore would cause an inferior system. Got news for you, buddy. We already have the inferior system based on most outcome metrics. Your innovative suggestion is more of the same, forever and ever, amen. Praise the One True God, Free Market!
February 28th, 2008 at 11:08 pm
Jim S. — I couldn’t disagree with you more, but that was one hell of an entertaining comment.
February 29th, 2008 at 12:10 am
I would really suggest everyone read: “Rationing of Medical Services in Europe: An Empirical Study”, google it and read the future. Rationing measures occur when the public price is less than the market price. In the health industry it results in “waiting lists.” A waiting list is the difference between the number of treatments considered necessary and the number of patients that a health care system can treat.
Rationing measures are taken in almost specialty in Europe and it has varying effect on the wait lists. Obviously the wait lists are going to be higher for treatments in greatest demand. Of course, it will take the government a while to figure out what treatment is in highest demand, because has no money communicating the demand. It will then have to mobilize its bureacratic management.
From Von Mises, 1944 “Bureacracy”
So demand will not be a great issue or at least not a very efficient one.
I don’t have the solution Jim, but I can recognize what is not the answer.
February 29th, 2008 at 6:40 am
OTOH, my proposed solution doesn’t line up completely with any of the European models. Things change. We need to adapt. It’s just as true of any European government health system as the private sector. And as far as Von Mises is concerned I’d have to have some respect for his school of thought to really care what he has to say but I will point out that the quote is just as applicable to large insurance companies as any government agency.
February 29th, 2008 at 8:29 am
“All Europeans may ‘enjoy’ health insurance, but they also carry some of the highest tax rates in the world.” - Elisabetta
Yet the total is far less than our taxes PLUS our insurance costs.
Jimmy says:
That dude got nine million dollars. I doubt that the insurance company will be fraudulently cutting off patient care in the future. Others will take note.
But don’t you want to limit lawsuits as a way to lower costs? Kind of blows your own point out of the water, huh?
February 29th, 2008 at 9:16 am
DJtheDJ is right about Jimmy’s post. I too, have heard the same conservatives who want to wipe out the awarding of large settlements in health care lawsuits point to awards like this as a corrective measure. They can’t have it both ways.
February 29th, 2008 at 12:33 pm
I know analytical distinction may not be the fortee, but I believe the primary emphasis is on tort reform, i.e. suing doctors on bogus malpractice claims and not essentially breach of contract claims against health insurance companies. There is a difference, a substantial one.
February 29th, 2008 at 1:24 pm
If the idea of tort reform is to eliminate bogus suits then the answer is not to limit awards but to treat all malpractice suits differently. Take them out of the general civil courts and give them their own arena, much like you have family court. The judges would have special additional training. Carefully vetted professionals would serve as a perpetual pool of professional experts. Work with the AMA. Think they wouldn’t love this kind of system? And if someone still brings a bogus suit…have penalties. Stiff ones. Ones where people have roommates they probably won’t like for quite a few years. But if it’s real and the doctor really did screw up badly he has a record that will follow him everywhere in the U.S. so he can’t run from being a bad doctor.
I was on a jury in a malpractice suit a few years back. After we’d all been there a week and the jury was about to go into deliberations the doctor’s insurance company settled. Too bad. On the way out we were being asked if we had come to a conclusion. I told them I considered it a shame that they’d settled and asked them to please convey to the doctor that I felt that he’d done absolutely nothing wrong and that I certainly wouldn’t have any worries about being treated by him.
February 29th, 2008 at 1:57 pm
Jim - We absolutely found a point of agreement. (I feel like we just made a break-through in therapy.) Now all you have to do is convince the trial lawyers association. BTW, the TLA is generally not viewed as a conservative Republican organization.
February 29th, 2008 at 2:27 pm
Wasn’t you Jim that penned, “Hey Louise!!…” Not a compliment or an isolated incident. In previous discussions, you insulted my intelligence, questioned my motives and now challenged the accuracy of my statements, after discarding them, a priori, as RNC talking points.
So, I decided to play ball and answered, minus the specific country, your questions. Plus, I commented on your M.O. when responding to my posts (attacking me, instead of the issues). After acting like a jerk, you went for a second round of arrogance and craziness, declaring that my answer proved your point. Something was proven, albeit, not what you think.
Unlike you, I allow people to express their views without the need to offend or provoke them. Of course, don’t be shocked - when you constantly opt to degrade - that I call it like I see it.
FYI ~
I made some assertions on the Europeans healthcare that contrasted the position of those that affirm that European healthcare far exceeds the U.S. and it’s a model we should adopt. Others, besides me, disagree with your opinion. Also, I believe, among those involved in this discussion, no one but me has ever lived in Europe. You didn’t know it. However, you didn’t ask any of the others that dissented with you whether they had lived overseas or used the European Healthcare to buttress their arguments. No, again, you chose to start a foolish argument with me on that basis.
Following your arrogant demand that I prove my claims, coupled with the presumption that you “knew” I was rehashing “talking points,” I revealed that my assertions were grounded on three things:
a. Personal experience
b. First-hand knowledge of the system
c. Others’ account of their direct experience
I POSIT THAT PROOF IS REQUIRED OF YOUR CLAIMS AS THEY ARE SECOND-HAND ANECDOTES OF “SUPPOSEDLY” AMERICANS AND EUROPEAN CONTACTS THAT BOAST OF THE WONDERS OF THE EUROPEAN HEALTHCARE.
February 29th, 2008 at 2:46 pm
E: All Europeans may ‘enjoy’ health insurance, but they also carry some of the highest tax rates in the world.”
DJtheDJ responds: “Yet the total is far less than our taxes PLUS our insurance costs.”
You agree with the premise that Europeans have some of the highest tax rates, then go on to affirm their Tax rate + their insurance costs is less than our taxes? Got some hard facts to bolster that argument?
February 29th, 2008 at 3:24 pm
To Jim:
After, posting my last reply to you I thought important to point out that the questions (rhetorical) I had in the post that spurred your “suspicions” are at the center of the issues I have with Government-run health Insurance. The country is Italy.
Let me share a few recent examples.
Few weeks ago my mom needed a brace to help her with two fractured vertebraes. The choice was: to wait several months to get it “free” or go ahead and purchase it with her own money. Needless, to say, she opted for the latter.
Her primary also ordered medication (shots, pills) none of which was covered.
Although, she has “free” insurance if she uses the State’s designated doctors, she often chooses to pay for specialists (cardiologists, dentists, etc.) out of her own pocket, so that she can pick a doctor with a good reputation.
It’s also, widely known and understood that the doctors that work for the “free” insurance the State provides (through taxes) offer substandard care and are not nearly as educated and competent when compared to those not on the State’s payroll.
And if you’re in need of Hospital care whether it’s a for a pregnancy or any surgery, you better make sure you have enough money and go to a privately-owned hospital.
Incidentally, her complaints are shared by family and friends alike.
February 29th, 2008 at 3:29 pm
Well, Jim, I had another reply for you with specifics on Government-run health insurance. Unfortunately, it didn’t post, and I didn’t save it beforehand. Somehow, I hope it prints later.
Very irritating when comments vanish for no apparent reason
February 29th, 2008 at 4:47 pm
Jim’s Qs - My Answers. Different than what I wrote and lost, but it’ll have to do.
1. You claim to have lived in Europe. Did you ever need health care while you were there?
Answered when I said I grew up there. Even healthy people go to the doctor now and then.
2. What country did you live in?
Italy
3. Did you have friends who had really needed health care?
Answered in the context that I have family and friends over there who use the services.
4. What was your experience, Elisabetta?
Negative. Doctors that work for the state have lower educational requirements and earn lower incomes. That translates in incompetent providers that offer substandard care. Often, people will opt to see a specialist of their choice and pay out-of-their pocket rather than the State’s doctor.
Many RXs are not covered.
Hospitals are in same category as doctors. It’s not uncommon for people to go to private clinics at their own expenses vs. using State’s hospitals.
February 29th, 2008 at 8:08 pm
First, let me apologize in advance to Justin if parts of this post cross a line.
Elisabetta,
So, you have experience of one European country. Interestingly enough your experience is of the European country that has the lowest level of satisfaction with their health care system of any European country including Great Britain. As I said, there is no such thing as a European health care system, there is a different one for each country. You know that you were not happy with the system in Italy. Lots of Italians apparently share your opinion. That doesn’t mean that making the claim that what you experienced applies to every European country or that the existing American system is perfect has any validity.
Like it or not every position you’ve ever written is straight line 2008 Republican talking points. If you want to get upset about it try pointing me to something where that isn’t true. I will be more than willing to apologize. But that is all I’ve seen in your posts. Then you come up with this:
Followed by:
I said “Hey, Louise!” because what was passing for an argument that you posted was the exact same one made by the insurance industry backed TV ads in the early ’90s featuring those “iconic” figures of Harry and Louise. The claim was false then and it’s false now. Many companies offer one plan and one plan only and you are limited by what they offer. In addition in a desperate bid for savings plans can change yearly or close to it and you can suddenly find your existing doctor to be out of network and medications you’ve been on for years to not be in their formulary.
At least after that I have no doubts about you. You are in fact an ideologically lobotomized follower of the Right of the lowest order who is apparently convinced that she can be the heir to such luminaries as Michelle Malkin and Ann Coulter. You’d have to actually have an idea for me to berate it, wouldn’t you? In addition you’d have to have some intelligence for me to insult it. Your rant against me pretty much disproves any claims you might have in that department as does your inability to distinguish between Italy and Europe. Given the intelligence that displays let me explain that Italy is in Europe, not is Europe and that generalizing from Italy to every possible variant on health care systems that have government involvement does not reflect well on whatever intelligence you are claiming to possess. I would say that you should shove it where the sun don’t shine but I do believe that your head is already there.
March 1st, 2008 at 12:11 pm
Jim, in general, you need to cool it with the attacks. You usually make decent points and then throw in something like “lobotomized follower” or some such nonsense. Unnecessary. Make your points, make them well and leave it at that.
Elisabetta, the reason your comments don’t show up is they sometimes get caught in the spam filters. This is a completely automated process, so I have to then go in and check the comment moderation queue probably 20 - 30 times a day to make sure all comments that aren’t spam get through in a timely fashion. This isn’t a big deal because it doesn’t take long, but that’s the reality. Additionally, if you actually lose a comment and you don’t see it show up later, that probably has to do with something on your end. Nothing in my system automatically deletes anything and I very rarely delete real comments. I know for a fact I’ve never deleted anything of yours. Usually only truly inflammatory drive-by racist comments get axed. And nobody who comments here on a regular basis is guilty of that.
March 1st, 2008 at 6:46 pm
Justin,
I suggest you look at what Elisabetta wrote and I quoted. I do not in fact always use those phrases. I admit that I do use them in certain cases but I had not used them with her until her ranting attack on me because I pointed out that her arguments were straight line Republican. Using the reference to the Harry and Louise commercials was in no way meant as an insult but a point about the nature of her argument concerning lack of choice only when the government gets involved. I also asked if she could point me to any comments she made that weren’t and that I would apologize for the generalization if she could. I notice you offered absolutely no critique of her rant.
March 1st, 2008 at 6:53 pm
And Justin, read my use of “lobotomized”. In fact the phrase I use is ideological lobotomy to refer to those who hew to a given ideology and/or party loyalty so much that they basically shut down the part of their brain capable of actually thinking about the issue. And if you’ll do some research you’ll realize that it comes from actual research that shows that certain kinds of hardcore party loyalists do just that.
March 1st, 2008 at 7:01 pm
And all that said I will try to honor your request, Justin.
Hmmmm…my captcha phrase for this post is health illusion.
March 1st, 2008 at 7:03 pm
Elisabetta, et. al;
If your mother is in Italy and she is over 63 years of age she is eligible for a government sponsored supplemental health insurance policy to protect her from that exact problem. In addition, I know of no “lowered standards” for doctors in private versus public service - can you point me to those references please - as I understand it licensing for doctors is actually standardized in the EU = government practice has stricter controls on hours worked, mandatory time off, volunteer work, etc. All people fall under the same pension system so there is no negative or positive gain there. I have quite a few friends in the medical profession(s) in France, Germany, and italy and things are not that different between these countries - not quite the same, but not that different
Finally, in one of theprevious posts a string of comments was made stating that most of the development work for medicine, medical equipment, and medical research was done in the US and the rest of the world benefited from it, and didn’t do much of it themselves because they were burdened by their own medical systems. I am mystified how such ridiculous opinions can be adhered to. That is simply not true, the list of medical discoveries and pioneering advances just n the last 10 years is far to lengthy to annotate here.
Let’s just leave it with the comment that we don’t have national medical care here in the US because the insurance companies, American Medical Association, and Bio-medical corporations don’t want us to. There’s no other reason. If you ask a conservative or a liberal or a moderate if they would like national medical care - the answer is unanimously “yes” (differences of opinion, but essentially everyone agrees) - so if all the “people” are in agreement why don’t we have it after 60 years of trying (yes 2008 is the 60th anniversary of Harry S. Truman ;obbying congress for that “right” of citizenship). Because it could take money away from the DOD, and because the lobbies are too strong.
March 3rd, 2008 at 2:17 am
Jim,
your inflammatory retorts are part and parcel of every response thrown in my direction, in this thread and elsewhere.
It’s no secret that you approach my comments with a sense of superiority. By claiming from the get-go that my beliefs or opinions are tainted by ideology or ignorance, you hope to discredit them and avoid real debate. How would you feel if others accused you of spewing DNC mantra, time and time again?
Jim S. builds a straw man:
“let me explain that Italy is in Europe, not is Europe and that generalizing from Italy to every possible variant on health care systems that have government involvement does not reflect well on whatever intelligence you are claiming to possess.”
Logical argumentation left Jim S. long time ago. He creates a non-issue on which to toggle his biases and anger. After boasting of **Europeans** systems (France and Spain) faring better than their American counterpart, Jim S. singles out Italy (another European country) for the sole purpose to impugn my ability to differentiate between the continent (Europe) and the country (Italy) and lecture me!
Reality check:
a. Jim, your straw man creation and consequent deduction defines the irrational use of your intellect.
b. The demagoguery, the absence of direct info and lack of experience you offer for your claims on foreign healthcare do not qualify as facts. Your opinions of the European model are based on the judgments of people you don’t even know.
c. Your statement that I claimed the U.S. system is perfect is another untruth. I never contended any such thing.
With regard to that hooey of the “lobotomized” comment, you made another illogical argument. There is no correlation between my healthcare experience overseas and my political beliefs, except in your head. Therefore, every time, you fall back on “RNC talking points” it screams loony.
March 3rd, 2008 at 2:54 am
Justin,
thanks for shedding some light on why comments, at times, delay their posting. I never thought my replies were deleted, only lost. Your input was duly noted, but I have to disagree that “truly inflammatory” remarks get deleted, always.
Terence,
I appreciate your concern in European affairs and I offer again the pretty solid reality that State public services, including the medical staff are not on par with private practices. At least, for what concerns Italy. I do not believe the EU has implemented medical standards across the board throughout Europe. Each country continues to run independently from the Union as it pertains to their infrastructures.
“I have quite a few friends in the medical profession(s) in France, Germany, and italy and things are not that different between these countries - not quite the same, but not that different.”
You may want take that up with Mr. “know it all” as that appears to contrast with his assertion: “So, you have experience of one European country. Interestingly enough your experience is of the EUROPEAN COUNTRY THAT HAS THE LOWEST LEVEL OF SATISFACTION WITH THEIR HEALTH CARE SYSTEM OF ANY EUROPEAN COUNTRY INCLUDING GREAT BRITAIN.” [Caps mine]
This discussion has reached lows I never expected. I find it more interesting to discuss this topic with people I know personally and who are intimately acquainted with the issues.
March 3rd, 2008 at 8:32 am
Elisabetta,
Truly inflammatory remarks include racist statements and things of that nature. The stuff you and Jim bat back and forth between each other don’t reach that level, at least not that I’ve seen. If it ever does, contact me and I’ll take a look.
March 3rd, 2008 at 11:22 am
Jim,
I was away this weekend so I couldn’t respond to your last comment directed towards me. This discussion has reached the breaking point so I won’t weigh it down with too many more words. I’ll only say I’m more than willing to consider government activity in health care. I’m not dramatically against mandated coverage (MA system is having problems but I’d consider it as part of a solution). I’m not against subsidies per se, even those unconnected to tax rebates. I’m not even against expanding medicaid so that others can buy into it. The only thing I’m 100% against is any plan that doesn’t allow the better aspects of the free market to keep going (notably medical technology/pharmacuetical innovation and incentives for doctors to be well trained and provide top notch care).
You’ve done an excellent job of accusing me of holding all kinds of positions I don’t hold and of making me sound downright ignorant. Just because I defend the free market when you prefer to demonize it doesn’t mean I’m unwilling to consider hybrid solutions. This is an evolving debate. You say the insurance comapnies haven’t innovated, but they actually have. HMOs were a disaster but they were an innovation. PPOs have worked better. Both were developed within the last 20 years — that’s not that long of a time for an issue this big.
I’m sorry that I angered you — that’s the last reaction I want to create as it kills any chance we’ll ever stop talking at and start talking to each other.
March 3rd, 2008 at 1:03 pm
Alan,
I don’t demonize the free market I just admit that it isn’t infallible and that it doesn’t work everywhere and in every field of human endeavor. Why do you fail to acknowledge that? Why do you think it works everywhere? Or do you? Health care is one of those places, IMO. If the free market works everywhere why do we have millions uninsured and even more underinsured? Why do the insurance companies fight so hard against including mental health care or dental care, both of which are vital to overall health? Did you see Sixty Minutes last night by any chance? A charity that at first envisioned themselves as being needed purely to provide health care in the Third World has started operating in the United States. They bring in volunteer doctors of every specialty including dentistry and vision, set up in a large public facility and provide treatment to whoever comes in over the weekend. People start lining up the night before. But hundreds leave without being treated because there just isn’t enough time. Private charities just don’t have enough resources. The free market has done nothing to change that. Those who do defend it at all costs (I am not including you in this.) and do not want government involvement refuse to acknowledge just how deep the problem is.
And please note that I didn’t claim that they didn’t innovate, it was just that the only goal of their innovations was to help their bottom line, not necessarily the patients. Patients and their health is not the concern of a publicly held company, the stockholders are. In some areas this is a good thing. In health care it’s doubtful that it is a good thing.
March 3rd, 2008 at 1:07 pm
Justin,
I find it a little disturbing that you apparently assume that I am the one who would go that low. Might I suggest you re-read this thread and look at who was the first one to start the real ranting and name calling?
March 3rd, 2008 at 1:20 pm
This will be my last post to respond directly to Elisabetta because frankly, she isn’t worth it.
I did not extoll the virtues of “European” health care systems because I know that there is no such thing as one European system, however much they may share some characteristics. I love how she takes a comment from TerenceC out of context to support her views when in fact the overall post was criticizing her claims.
She calls me lots of names because I say that her posts are just RNC talking points, do not contain anything that indicate actual original though or research, etc. I respond that if she would show me where she made posts that did not reflect those criticisms I would apologize and that still stands. She just called me more names.
And then in the post she addresses to TerenceC she says this:
If in fact she had really read my post she might have noticed that I was not making some kind of blanket assertion but had done some actual research and linked to this paper that studied the perception of the Italian public versus W.H.O. study results of their health care system. Experience is often equivalent to anecdotes, which contribute to but are not the begin all and end all of examining a system, any system.
And of course her ideology affects her views of health care policy. Everyones ideology affects their views on subjects like that. The question is simply how much.
March 3rd, 2008 at 6:52 pm
Enough. I have thought about how this whole thing spiraled and wish to offer my unqualified apologies to anyone I offended. I will try to not get into this kind of thing in the future.
Alan,
If you are still reading this I look forward to further reasonable discussions concerning this issue with you in the future. If in this morass of text you can find where I discuss my actual opinions on where we ought to go you would find that I do not say that we should do anything that would eliminated private insurance but in fact come up with a system that rather than subsidizing them with government funds there should be a government agency that would take care of what private insurance has shown they have no interest in doing.
March 4th, 2008 at 9:15 am
Elisabetta Says:
DJtheDJ responds: “Yet the total is far less than our taxes PLUS our insurance costs.”
You agree with the premise that Europeans have some of the highest tax rates, then go on to affirm their Tax rate + their insurance costs is less than our taxes? Got some hard facts to bolster that argument?
Can you read? OUR TAXES PLUS OUR INSURANCE RATES is what I said so you just decided to insert “their” into it, huh? I know that doesn’t fit into your narrow little world but that doesn’t mean you just get to change my words to fit your idiotic ideas. You really aren’t worth talking to. You embody everything that is wrong with American politics today, especially the lunatic brainwashed right wing. Twist everyone’s words, use nutty strawman arguements and false premise anecdotal evidence to back up your ridicules claims. Bye now.
March 4th, 2008 at 1:09 pm
Dj, sounded like you were projecting your liberal m.o. (modus operandi)
Can I read? Positively!
The question should be: Can you see you wrote an incomplete thought that left room for logical assumptions?
Let’s suppose for the sake of discussion that I misunderstood what you wrote. You then, had the opportunity to clarify your opinions.
I expressed what I thought you said and asked a question. That’s feedback.
Conversely, you reacted with irrational, poppycock accusations. That is negative feedback.
If your opinions or the expression of those opinions come across muddled, then by all means, set the record straight, calmly and reasonably. Berating the questioner and alleging preposterous things creates unnecessary distraction from the topic.
Ironically, you twisted my words, took offense, devised my intention (wrongly), and lashed back with highfalutin hogwash.
Here’s to one more opportunity to clear up your statement, b/c it remains a mystery.
Statement #1 (by me):
All Europeans may ‘enjoy’ health insurance, but they also carry some of the highest tax rates in the world.”
Statement #2 (by you):
“Yet the total is far less than our taxes PLUS our insurance costs.”
I was talking about European having health insurance, plus HIGH taxes. You declare that the “total” is far less than “our taxes and health insurance.”
What comprises that TOTAL that you use to compare to the sum of “our taxes plus our insurance” ?? Please, explain yourself.
.
March 4th, 2008 at 1:17 pm
Djthedj, sounded like you were projecting your liberal m.o. (modus operandi)
Can I read? Positively!
The question should be: Can you see you wrote an incomplete thought that left room for logical assumptions?
Let’s suppose for the sake of discussion that I misunderstood what you wrote. You then, had the opportunity to clarify your opinions.
I expressed what I thought you said and asked a question. That’s feedback.
Conversely, you reacted with irrational, poppycock accusations. That is negative feedback.
If your opinions or the expression of those opinions come across muddled, then by all means, set the record straight, calmly and reasonably. Berating the questioner and alleging preposterous things creates unnecessary distraction from the topic.
Ironically, you twisted my words, took offense, devised my intention (wrongly), and lashed back with highfalutin hogwash.
Here’s to one more opportunity to clear up your statement, b/c it remains a mystery.
Simple logic.
Statement #1 (by me):
All Europeans may ‘enjoy’ health insurance, but they also carry some of the highest tax rates in the world.”
Statement #2 (by you):
“Yet the total is far less than our taxes PLUS our insurance costs.”
I was talking about European having health insurance, plus HIGH taxes. You declare that the “total” is far less than “our taxes and health insurance.”
What comprises that TOTAL that you use to compare to the sum of “our taxes plus our insurance” ?? Please, explain yourself.
.
March 4th, 2008 at 1:36 pm
Dj, sounded like you were projecting your liberal m.o. (modus operandi)
Can I read? Positively!
The question should be: Can you see you wrote an incomplete thought that left room for logical assumptions?
Let’s suppose for the sake of discussion that I misunderstood what you wrote. You then, had the opportunity to clarify your opinions.
I expressed what I thought you said and asked a question. That’s feedback.
Conversely, you reacted with irrational, poppycock accusations. That is negative feedback.
If your opinions or the expression of those opinions come across muddled, then by all means, set the record straight, calmly and reasonably. Berating the questioner and alleging preposterous things creates unnecessary distraction from the topic.
Ironically, you twisted my words, took offense, devised my intention (wrongly), and lashed back with highfalutin hogwash.
Here’s to one more opportunity to clear up your statement, b/c it remains a mystery.
Statement #1 (by me):
All Europeans may ‘enjoy’ health insurance, but they also carry some of the highest tax rates in the world.”
Statement #2 (by you):
“Yet the total is far less than our taxes PLUS our insurance costs.”
I was talking about European having health insurance, plus HIGH taxes. You declare that the “total” is far less than “our taxes and health insurance.”
What comprises that TOTAL that you use to compare to the sum of “our taxes plus our insurance” ?? Please, explain yourself.
March 4th, 2008 at 7:19 pm
Noticed certain similarities between djthedj and another poster: same tone and inability to stay on topic. Also, an uncanny manner of miss-spelling the word *ridiculous.*
In this thread
djthedj Says:
March 4th, 2008 at 9:15 am
…your RIDICULES claims.
In another one http://donklephant.com/2008/01/24/stimulus-more-like-wealth-redistribution/#comment-389674
David Says:
February 4th, 2008 at 5:51 am
…Whatever. I’ll await your RIDICULES reply.
March 5th, 2008 at 8:39 am
OK Elisabetta, it seems almost impossible that you could somehow take the word “our” and substitue “their” and claim it was because I was unclear, but I’ll give you the benefit of the doubt. Add what Americans pay for health insurance and taxes and you’ll see that the tax rates in the rest of the civilized world don’t look so bad anymore. Plus, they can’t be dropped or refused care by insurance companies. Is tha clear enough for you?
I’m not sure why you would be surprised that more than one person here would find you “ridicules”. It seems to me most all of the sane posters here would agree with that description.
March 5th, 2008 at 8:52 am
BTW, Why do you insist on posting things 3 or 4 times? Oh, and sorry about the typo, of course pointing out typos is always the best way to dodge actually answering someone…way to go!
March 5th, 2008 at 8:42 pm
Djthedj - or is it David? - the cause of the misunderstanding was not the word “their”, but your answer to “Europeans …also carry some of the highest tax rates…” Keep things in context, please.
For starters, your premise, ‘Americans pay more in taxes and health insurance than Europeans pay for taxes’ is vague, unproven and can easily be dismissed as an apples to oranges argument. Therefore, before you can compare A to B you must elucidate on the specifics.
Further, the crux of my last post was not whether people agree with you, or to correct misspells (you do know the difference between a typo and misspelling a word, don’t you?). Additionally, the ‘sanity’ of those you think agree with you is a matter of opinion, namely yours.
The hub of my observations was the uncanny resemblance in mannerisms between you and ‘David.’
As to the multiple comments it happens to others, as well. When replies don’t post, we retry, then, poof, all at once!
Finally, it’s incredibly asinine that you accuse me of “dodging” answers. For Pete’s sake, what do you think I did in reply dated March 4 2008 at 1:36 pm?
March 6th, 2008 at 6:17 am
It seems to me it was perfectly clear, however, since it wasn’t to you, I already explained it again but you choose to keep babbling on about it instead of addressing the issue. Americans spend more on health care than any other country yet by most measures our care is not the best. That’s the bottom line. There are good ideas to addresss this but they will never be explored as long as people like you howl “liberal” and socialist at anybody who dares to try.
Here’s an article from the Heritage foundation that has some good ideas and points. How could a “liberal” like me point to the Heitage foundation? Oh, because I’m not a liberal, I was simply making a logical point and that made a partisan brainwashed hack such as you instantly howl “liberal” in order to dismiss it without thinking. http://www.heritage.org/Research/HealthCare/HL711.cfm
Or perhaps doctors know something about health care, of course they couldn’t possibly know as much as you, but then they are all “liberals” too, right?
http://www.pnhp.org
You truly embody all that is wrong with American politics. Absolutely no ability to think outside your tiny little brainwashed partisan hack world. Just howl “liberal” at everyone who doesn’t march in lock step. Pathetic.
March 6th, 2008 at 7:13 pm
David…or Djthedj, different name, same inanity.
March 6th, 2008 at 8:54 pm
Logical point? In which galaxy?
David, besides the obvious fact that you shifted the premise from “Americans pay more in healthcare and taxes than Europeans do in taxes (alone),” to “Europeans have better healthcare,” the next unquestionable fact is that neither of those assertions have been corroborated. Not by you. Not by the piece you posted.
Moreover, did you even read the article you linked to or did you pick a title you thought propped your contention, not sure which, without knowing the substance of it?
I have been hard pressed to find anything even remotely bolstering any idea of yours. Missed the mark, again.
A sample of excerpts from the article
July 9, 2001
PERSPECTIVES ON THE EUROPEAN HEALTH CARE SYSTEMS: SOME LESSONS FOR AMERICA
by Robert E. Moffit, Ph.D., Philippe Manière, David G. Green, Ph.D., Paul Belien, Johan Hjertqvist, and Friedrich Breyer, Ph.D.
Heritage Lecture #711
Some Surprises
Americans will probably be surprised to learn from the remarks that follow that Switzerland’s health care system relies almost entirely on a system of private insurance. They might be surprised to learn that there is a growing reliance on the private sector in the financing and delivery of health care in Europe, particularly in the Netherlands, Germany, and Sweden. Even the Labor government in Britain has entered into an agreement with representatives of the private health care industry to improve health care delivery in certain vital areas.
Reforms in Europe, where they are diligently pursued, have taken on a certain urgency. A major factor affecting recent health care policy making in Europe, including privatization efforts, is the rapid aging of the European population. Continental Europe is comprised largely of countries that have rapidly aging populations. Although life expectancy has increased, fertility rates have decreased, and much of Europe faces demographic stagnation. This unfavorable ratio of old to young persons is far worse in major European nations than in either Canada or the United States.
The unfavorable shift in the demographic balance is particularly rapid in France and Germany, and will impose tremendous financial pressures on their existing health care-social security arrangements. America’s Medicare and Social Security reformers should take note.
Some Lessons
For Members of Congress and state legislators, there are some valuable lessons from the European experience that should be less surprising.
* If you insist on government management of the health care system, do not expect freedom from waste, inefficiency, or inequity in the delivery of care (look at France).
* If you want to promise citizens a national or state program of universal insurance coverage, don’t expect that you will be able to deliver universal access to high-quality health care. You won’t and you can’t (look at Britain).
* If you want to fix prices for medical services, prescription drugs, or other medical devices, don’t expect demand for these goods and services to be met or investment in research and development to continue apace. It won’t (look anywhere).
* If you insist, with a straight face, that in a government-run health care system, all of your fellow citizens will be treated equally–regardless of their class, station in life, or disease condition–you are not merely enthusiastic or well intentioned. You are lying.
Health care policy is complex and difficult. In the reform of America’s public health programs, and in creating new opportunities for individuals and families in the private markets, policymakers at the state and federal levels should learn as much as they can about what works and what doesn’t in every health care system. In that way, they can better determine what should and should not be done here. The experts assembled by the Centre for the New Europe who came here to speak are an excellent resource.
Also…
France’s health care system is typical of those of most European countries: It is a state-oriented system that operates with little concern for the economic dynamic of supply and demand or efficient management. As the client base of the system increases, without innovative policies to augment finances, curtail waste, and more effectively target services, a crisis is increasingly more imminent.
And…
Problems in France’s System
France’s health care system is the epitome of mismanagement, riddled with opportunism. In France, about half of all the hospitals (and all the largest ones) are state-owned. They are run on the assumption that people will not pay. With high rates of refunds to patients, the system provides virtually free care, attracting clients from beyond the country’s borders. It has been said that people from developing nations take cabs directly from the Charles de Gaulle airport to hospitals in Paris and that they can expect that even their taxi fare will be taken care of through French largesse.
In toto, this series of lectures does more to buttress the argument that Europeans healthcare is riddled with problems - that we should learn from, not imitate - and attest to the need of European countries to mend their systems, rather than anything you have implied.
March 7th, 2008 at 5:54 am
You are truly amazing! I never said anything like “Europeans have better healthcare,”. I simply was offering you some ideas but you already know everything so what’s the use in talking to you. Fact is we do spend more on health care than anyone else and by many measures don’t have the best…period. I was simply pointing that out and showing you that there are many ideas out there but everything has to be a partisan battle to you so you just spew your moronic crap endlessly. I wasn’t trying to score points or hit a mark. That’s for partisan hacks like you. Real people read and think and look for ideas, bleating sheep like you just twist things and try to score against the dreaded “liberals”. Grow up.
March 7th, 2008 at 3:50 pm
Jim,
If you are still reading, I know we agree on one thing: the system is not working as is. I think my argument has been misconstrued as a do-nothing argument, which it isn’t. We just have very different ideas on how to approach this. Right now, I think the free market is being choked by regulations (many of which the insurers have pushed through to benefit themselves). My political philosohphy leads me to always want to try private solutions before imposing big government. I think there can be much good from stripping away the regulatory shackles and letting the free market breathe. Mind you, I’m talking about the regulations that stop people from obtaining quality, affordable insurance, not regulations that stop the insurers from abusing the system.
My concern with your position is that it could result in throwing the baby out with the bath water. I do not believe the free market is 100% effective all the time but I do believe there are good solutions there. Ones that have not been tried. And ones that would ultimately result in a a higher quality system for all Americans.
But do note, I do not hold my political principles to be as immutable as my moral principles. Political principles are just well-considered opinions relying on facts and experience. If facts or experience change, those principles should change. And there is no shame in compromise as long as the ultimate goal is the same. If you and I were tasked with coming up with a solution all by ourselves, we’d find a way. This debate got overly heated and hurt our ability to have a real conversation. I’m not a yeller. I hope I can keep from angering you next time out.
March 10th, 2008 at 11:39 am
David,
I see you are still clueless about your own words and unable to comprehend others’.
Repeatedly, you have demonstrated an inability to express a cogent point or answer questions brought on by your half-witted statements. When I called you on them, the response was more insensate insults and more diversions.
Enough time wasted.
March 10th, 2008 at 4:22 pm
Elisabetta, thanks for the laugh. The only possible response a sane person can have to your blithering drivel is laughter. You have never, ever addressed any point that is derected to you by anyone on these boards and yet you always claim they make no point.
Good little neocon, just keep destroying America, one borrowed billion at a time as long as you don’t have to pay any taxes, right? Don’t forget to always vote for the lying scum that spend more and grow the size of government more than anyone in history too, OK? See, anyone with half a brain would have figured out that they were being lied too by the filthy thieving neocon scum by now, but not you! You go girl!
Bye bye.