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Please choose the way you would prefer health insurance in the US.

Total: 42 votes (2 blank votes)

  • The current system.
  • 10 %
  • The current system with some regulations changed.
  • 32 %
  • The current system with a public option added.
  • 13 %
  • A government system w/o private plans offered.
  • 20 %
  • Health insurance completely outlawed and all the company bureaucrats and politicians locked up for life.
  • 27 %
September 1, 2009 6:01:42 PM

Wanted to find out how at least the tech savvy portion of the population views the current US health insurance overhaul debate. Non-US citizens welcome to vote too, especially those of you who currently live under a system similar to that which is currently being proposed.

More about : healthcare

Anonymous
September 1, 2009 8:14:24 PM

f off
September 3, 2009 4:12:12 AM

Bolbi said:
Wanted to find out how at least the tech savvy portion of the population views the current US health insurance overhaul debate. Non-US citizens welcome to vote too, especially those of you who currently live under a system similar to that which is currently being proposed.


The "reform" being pushed by Obama is not really solving the actual big problems with the current health care system but will make some of the existing problems worse and also add a bunch of new problems. The big problems with the current health care system are:

1. "Health insurance" is not really insurance any more as much as it is a third-party payer for all healthcare expenditures. People expect everything to be covered by insurance, so they demand treatment far in excess of what they can really afford. The result is that health insurance premiums end up costing more than what people can afford. Also, every dollar billed through an insurance company rather than handed directly from a patient to the doctor gets about a third cut out of it for overhead related to the insurance company (coding and billing staff, insurance company overhead and profits, etc.) This also causes doctors to have to charge more than they otherwise would have.

2. Reimbursement schedules for Medicare and Medicaid make primary care unappealing for many physicians, so they go become specialists instead. Patients can't get a primary care doc in many places and instead haphazardly go see specialists and rack up a much larger bill than they otherwise would have. Also, the payment schedule is done on a percentage of actual billings, so if a doc actually wants to get $50 and the reimbursement rate is 25%, they have to bill $200 to get their $50. This ends up screwing over people with high-deductible insurance as the doctor is required by law to charge everybody the same amount. But of course the individual paying out of pocket actually has to pay 100% of the billed $200; they can't tell the doc to shove it like the Feds or a huge insurance company can.

3. Malpractice lawsuits. The fact remains that just about every doctor in the U.S. will be sued at least once during their career. Malpractice insurance is expensive because of that, but the real cost is in a lot of tests and procedures done more for covering one's liability rather than an actual diagnostic or therapeutic purpose.

So how will the government's plan address these issues?

1. Will make this one worse. They plan to put in minimum coverage requirements that will make the handful of plans that are still set up like actual insurance (high deductible, covers catastrophic problems but not your day-to-day meds or office visits) illegal.

2. Will make this one worse too. The government on one hand says they are going to increase primary care reimbursements by some small percentage (yay) but will take it away with another hand by forcing physicians to adopt expensive EMR setups and be subject to fines if the physicians don't jump through the maze of regulatory hoops the government sets up. Read HR 3200 and look at the whole fine schedule if you don't believe me.

3. This topic is very notable by its complete and utter absence from the government's plan or Obama/Democrat discussion. At least they're not making it any worse...
Related resources
September 3, 2009 3:20:39 PM

It seems the simplest solution is to require everyone to have at minimum, high deductible health insurance to cover catastrophic illnesses, and on the corporate side, require that any insurance company has to provide that high deductible coverage at a maximum price point (8000 a year or whatever) for anyone. If there are truly people out there who can't afford 8000 a year, provide a tax credit voucher that can be used towards it for those people.
September 6, 2009 1:07:44 AM

Speaking as a Canadian, it just boggles my mind that people who seem to be perfectly rational can be so paranoid about a universal health care solution. I mean come ON folks, everyone else in the industrialized world has it - and the politician that tried to take it away from them would be booted out of office faster than spit.

It is true that there are some horror stories which some people are quick to blame on universal health care - but if you think the percentage of those stories exceeds the percentage of similar stories that come out of the US private health care system then you're just not seeing the big picture. And that's not even including the countless untold horror stories of people without access to the system...

"Death Panels" - geez. The only death panels I've heard of are the HMO claims adjusters denying people coverage for any old reason they can cook up...
October 24, 2009 1:45:53 AM

Sminlal, the reason so many Americans are weary of government run healthcare is because they already have it for seniors and it's a huge mess. It's broke, failing and a scam on many levels.

On top of that, every government run program that should be run by the private sector has failed/is failing. Every. last. one.

Further more we have a dollar crisis on our hands and this government healthcare will require more borrowing and money printing which inflates the dollar supply and deflates the value.


We can achieve even better results by deregulating the insurance industry and getting the government out of the healthcare cycle altogether. Prices for medical services not governed by our government have dropped by the same percentage that prices have increased in the sectors the government has its nose in. That's not a coincidence.
October 31, 2009 8:23:16 PM

Its very simple ! i too am canadian, our system works! we get called communists and insulted by the mainstream American media, the propaanda in your country is unbelievable! It used to be Bush that made your country look bad but now its the Religious right wing Conservitive Crazy Media and those people to blind to see that santa and jesus are the same guy. Mr. make beleive! Other coountryès have better systems then canada and they work good ! the problem is the power is out of the peoplès hands. You pay tax and shut up ! thats the reality of a capitalist democracy! it does not work. They are spending trillions of daollars on murder and bailing out the people who have been raping your income for a roof to live under and they tell you that your not worthy to get a treatment to save your tax paying life. PAY TAX GET ANY TREATMENT YOU NEED. GOVERNMENTS PROBLEM TO PAY THE BILLS AND FIGURE OUT THE REST JUST FIX EVERY PERSON WHO PAYS TAX. DONE! dont run for office and then say È i cant, i wont or dont know how ! thats your job to govern the country and give value for tax dollars! If i get sick i know that i will get every chance3 to survive and be healthy without being hundreds of thousands of dollars in debt! thats a human right not a priviledge this is a very terrrible country you live in!
October 31, 2009 8:46:40 PM

Live in the UK... Yes - the NHS service does have it's faults - but I would not want to live with a US style system. Let’s look at the basic facts, like child mortality, in the UK 0.6% of children will die before they are 5, in the us this is 0.78% - so the UK must be getting something right - and all this with healthcare costs 50% of what you spend in the US per GDP.

It is true that true that there is a national panel (NICE) that decides what drugs and treatments are to be available - but this generally results in any treatment where there is a genuine benefit being authorised. Where you have two treatment options and one is 10x the cost, you know what one will be given the recommendation.
November 7, 2009 7:53:37 PM

jamesgoddard said:
Live in the UK... Yes - the NHS service does have it's faults - but I would not want to live with a US style system. Let’s look at the basic facts, like child mortality, in the UK 0.6% of children will die before they are 5, in the us this is 0.78% - so the UK must be getting something right - and all this with healthcare costs 50% of what you spend in the US per GDP.


The infant mortality statistic has a lot of things that affect it and make it appear much worse in the U.S. than it really is, if you actually read the scientific literature on the topic rather than just hear the propaganda that the wankers on the telly spout. First of all, not all countries even calculate infant mortality the same way, so you have non-comparable statistics from some countries. Secondly, the biggest reason why the U.S. infant mortality rate appears so high is that we have a much larger percentage of preterm deliveries than Europe does, and these infants don't do as well as term infants. We deliver them and try to save some threatened pregnancies that the European docs would not intervene in and just chalk it up to a miscarriage. The U.S. infant mortality rate for pre-term infants is also lower than Europe's. But of course that would never make it onto the Beeb, because it would make Americans look better than the Europeans in that regard, and we mustn't do that now, not when there is political hay to be made.

Quote:
It is true that true that there is a national panel (NICE) that decides what drugs and treatments are to be available - but this generally results in any treatment where there is a genuine benefit being authorised.


Who is better-qualified to decide what is the best treatment for the patient than their own doctor? They are the ones that have the best clinical picture of the patient and know the patient's medical history and prognosis much better than anybody else since they've been following the patient for some time. I will also doubt that the people at NICE that make the decisions aren't all physicians, either, and if they are, it's doubtful they do much more than a chart read before rendering a decision.

Quote:
Where you have two treatment options and one is 10x the cost, you know what one will be given the recommendation.


It is obvious you are not involved in medical care delivery with a statement like that. Yes, you try to use the lower-cost options first, that's just common sense. But sometimes you need to use a higher-cost treatment in a patient. Sometimes you even need to use it before a lower-cost one due to any one of a various number of very legitimate reasons (patient unable to tolerate the side effect profile of the less-expensive treatment, less-expensive treatment will not work in this patient for some reason, specific contraindications to one and not the other, etc. etc.) It is absolutely horrible to have your treatment options constrained by some government bureaucrat who is trying to save a buck but isn't smart enough to know when you can and when you can't do that. Just look up "Medicare prior authorization" in your favorite search engine and you'll see what kinds of crap doctors have to deal with when those kinds of rules are strictly enforced. The funny thing is that the strict rules trying to cut costs commonly increase costs. One example is a frequent rule that you have to get an X-ray before a CT scan to try to reduce the numbers of expensive CT scans performed, the doctor that knows the patient needs a CT will get the X-ray, look at it and see nothing because it wasn't the right scan, and then be able to get the CT. So what happened? There was a needless X-ray that cost extra money and exposed the patient needlessly to radiation. Doctors aren't stupid. They know what they need to do to get a patient better in many cases. Letting them do their jobs instead of having non-medical personnel or medical personnel who are not involved in that patient's care making the rules would be a major improvement.
November 14, 2009 3:29:44 PM

I would like to add that most of the life saving drugs come from America because of the incentive to create such drugs is high in our private sector insurance. Price controls are then put on these drugs in other countries, causing the fake statistic that Europe spends less money on healthcare than we do.
December 18, 2009 5:37:49 AM

when i person is kicked to the street with serious health problems, its a sign of american greed gone to far.

the government should be helping anyone who cannot afford healthcare. this should be the absolute first thing tax dollars do.
they pump money into weapons and wars, while people in thier country die becasuse they cant afford a lifesaving operation.

now my knowledge is limited on the matter, but this is the very reason why i do not belive america to be the great nation they claim to be.
December 18, 2009 12:05:50 PM

I think many people don't realize that there's a difference between health insurance and health care. The latter is freely available to anyone who walks into a hospital emergency room. It's just not very cost-efficient to do it that way, thus the upheaval trying to provide everyone with the former. Personally, I think the system would be overall less efficient if the government ended up being the mechanism to provide the insurance. Not to mention federal abortion funding and the potential abuse of "end-of-life counseling".
December 19, 2009 1:39:10 PM

Bolbi said:
I think many people don't realize that there's a difference between health insurance and health care. The latter is freely available to anyone who walks into a hospital emergency room. It's just not very cost-efficient to do it that way, thus the upheaval trying to provide everyone with the former.


There are really two issues here.

- Issue #1 here is that health insurance today in the U.S. isn't insurance so much as it is a third-party payer for all or almost all of your medical costs. Actual insurance is something that is designed to protect against catastrophic losses, such as what house insurance does. It has a relatively high deductible so that you pay for maintenance and minor issues, which keeps the cost of the insurance down a lot. Health insurance generally covers most all medical costs to some degree, not just the catastrophic stuff. If house insurance were like medical insurance, it would buy a new rug for the kitchen when your kid spills a glass of grape juice on the rug and stains it. The covering of almost all costs is partially why medical insurance is so expensive. The other reason is that it is just about certain that you will run up decently-sized medical bills at some time or other in your life, which is unlike other types of insurance. Most houses do not burn down or get destroyed by tornadoes, but the vast majority of people die of some chronic medical condition. Other types of insurance are basically a bet between you and the insurance company as to whether something major will happen to whatever is insured. If your house had a 90+% chance of burning down and the insurance company having to pay for it, your house insurance would be far, far more expensive than it already is. It would be much closer to health insurance in price.

- Issue #2 is that providing the actual health care isn't free, although the government requires some groups (such as emergency department staff) to provide care for free. You mentioned this in your comment, and it really is a huge deal. The hospital has to make up the cost of providing this care, so they make everything else more expensive. Thus all of us have to pay for this care in the form of increased insurance premiums and medical bills.

Quote:
Personally, I think the system would be overall less efficient if the government ended up being the mechanism to provide the insurance. Not to mention federal abortion funding and the potential abuse of "end-of-life counseling".


Health care is just like every other tangible good or service- it is not an unlimited one. This whole debate over "solving" health care is a ridiculous one as health care is just another example of the Law of Scarce Resources that we all learned in Econ 101. Nobody is ever going to "solve" health care as it is impossible to make everybody happy.

- If you decide to tax the snot out of anybody that makes any money to pay for complete universal health care, you'll see tax revenues drop sharply as people who make money either leave the country or work less, resulting in nobody really getting any health care paid for at all. Some may disagree as they feel that the people who make money are so greedy that they'd work more to end up with the same amount of net income as before the tax hikes. This is incorrect as many economic studies have shown that the substitution effect (people will work less when they get to keep less of what they make) outweighs the income effect (people will work more to overcome the increased tax burden.) This makes a lot of sense as people are far more lazy than they are greedy. :D 

- If you decide to have a universal health care scheme that doesn't break the bank, there will have to be rationing of care, such as what is happening with the U.K.'s NHS. A lot of people don't like the fact that the government is making a decision to limit their quantity or quality of life, which is why the whole "end-of-life counseling" bit got so much attention. The actual language in H.R. 3962 doesn't have anything to do with "death panels" (it merely says that physicians can get reimbursed for talking to patients about hospice care and such), but people do realize that the "death panels" stuff is very possible and don't like it.

- If you decide to simply have everybody pay out of pocket or by money they saved up, then people without much money can't get much for health care. You get into the whole class warfare and "haves versus have-nots" argument that brought about a lot of the "health care crisis" stuff in the first place.

The end result is that there is no perfect option, else we would have figured it out a long time ago and implemented it. We are not oh-so-much smarter than our predecessors, unlike what some people would have you believe.

Personally, I believe that the third option is the best. It doesn't leave the country insolvent or have some government bureaucrat telling me what I can and cannot have for treatment. It also is the only option that realistically will leave the individual with the responsibility for modifying their own behavior to be healthier. A government program will either completely ignore this (having the guy who lives on Big Macs, Budweiser, and Marlboros pay the same amount in taxes/premiums as the triathlete who wouldn't come within a mile of a cigarette, liquor store, or a McDonald's) or penalize everybody (via taxing "unhealthy" foods.) Yes, some people do get the short straw and are born with few marketable skills and inherited medical problems. But that's where private charity can step in. That already works quite well as there are numerous charity clinics out there that take care of those kinds of people. I know this pretty well as I have worked at one! Even then, the number of people who came in who legitimately were unlucky were very few compared to those who were just irresponsible and/or extremely lazy. The latter group largely could have paid for themselves if they had to get up off the couch and got a job instead of sitting on welfare.

welshmousepk said:
when i person is kicked to the street with serious health problems, its a sign of american greed gone to far. The government should be helping anyone who cannot afford healthcare. this should be the absolute first thing tax dollars do. they pump money into weapons and wars, while people in thier country die becasuse they cant afford a lifesaving operation.


First of all, you should read the U.S. Constitution if you believe that health care is the absolute first thing that tax dollars should go to as the Constitution is pretty specific in what are the responsibilities of the federal government. National defense is actually one of the few important responsibilities. The debate over whether or not what the U.S. is doing over in the Middle East is another debate altogether and is not germane to this argument.

Secondly, read the part I posted above about scarce resources and the substitution effect vs. the income effect. If you excessively tax the people that make money, they will work less hard to make money and the government will end up with less tax (see the Laffer Curve for a graphical depiction of this.) You'll end up in the same position as before with people not being able to afford health care, except now the businesses and capital that provide jobs are in some other country. I know that in an ideal world it would be great to provide as much health care as anybody needed, but this is not an ideal world and we simply cannot afford it.

Quote:
now my knowledge is limited on the matter, but this is the very reason why i do not belive america to be the great nation they claim to be.


I would agree that your knowledge is limited on the matter as you have made a largely uninformed and emotional argument. I also agree that America is not as great of a nation as we once were. But, it's because of the unrealistic idealist thinking and lack of responsibility that the "lets penalize those who work hard and reward those who don't" mentality that you espouse.
December 19, 2009 3:10:50 PM

^Has done his homework.

I wish more people understood the Laffer Curve.


I myself feel the market is best suited to providing the service of health coverage (care and insurance). If the government would remove some of its asinine regulations then we could have a real market based insurance industry instead of the artificially cost inflated, government initiated and controlled discombobulated mess we have today.

Let the doctors actually compete for your business. Let the market dictate costs. Let the people decide where they want to go for treatment. Let the people have their health care back.
December 19, 2009 4:40:27 PM

1 comment here.
The normal return for government run programs vs company run ones is, the government , you get 60 cents on the dollar returned, whereas, in almost all business scenarios, a profit margin of 20% is considered very good
December 25, 2009 7:57:46 AM

This is for our future so I am happy.
December 25, 2009 10:28:25 AM

The proposed Healthcare Reform does nothing to address tort reform, too many dem lawyers - Edwards comes to mind.

The proposed Healthcare Reform does nothing to increase competition among insurance companies. I live in north Texas. If I find an Oklahoma plan that I like better, I'm not eligible.

And if the current plan passes, they'll start to collect money now, but they will not start payouts until 2014.

And the current bills are about 2200 pages long. No single person knows everything that's in them. I think that if it is too big to read and understand, it's too big to pass.
December 25, 2009 2:39:42 PM

Yes, it's terrible but it passed... (sigh). (With a few million dollars incentive for Landrieu and Nelson, courtesy of us poor taxpayers.) I downloaded a copy of the Senate's "Manager's Amendment" to the bill from my Senator's website and glanced through some of the interesting parts. (The Manager's Amendment, proposed by Harry Reid and passed on a strict party-line vote, is really an entire re-working of the bill. In PDF format, the amendment is 2,074 pages, the first 14 of which are just the Table of Contents!) One section that I find particularly, well, odious is Sec. 4001. It establishes a "National Prevention, Health Promotion and Public Health Council" whose purpose is to "develop a national prevention, health promotion, public health, and integrative health care strategy that incorporates the most effective and achievable means of improving the health status of Americans and reducing the incidence of preventable illness and disability in the United States." For starters, who will be making these medical decision? MD professionals from each state? Or MDs at all? Not many of them. This is the list of those who are on the council:
1) Surgeon General, Chairperson (appointed by the President)
2) Secretary of Health and Human Services (appointed by the President)
3) Secretary of Agriculture (appointed by the President)
4) Secretary of Education (appointed by the President)
5) Chairman of the Federal Trade Commission (appointed by the President)
6) Secretary of Transportation (appointed by the President)
7) Secretary of Homeland Security (appointed by the President)
8) Administrator of the Environmental Protection Agency (appointed by the President)
9) Director of the Office of National Drug Control Policy (appointed by the President)
10) Director of the Domestic Policy Council (appointed by the President)
11) Assistant Secretary for Indian Affairs (appointed by the President)
12) Chairman of the Corporation for National and Community Service (appointed by the President)
13) Head of any other Federal agency that the chairperson determines is appropriate. (But remember, the chairperson, in turn, is appointed by the President.)
Does anyone else see a problem with so much power being given to the President? He appoints most of the council, and the rest are appointed by the Chairperson (who is appointed by the President). I'm sorry, but no matter which party is in power, I do not trust one man (who is currently not even an MD) to control the council which controls the overall healthcare situation in America.
About the Council's duties... There are six enumerated duties such as filing reports, conducting studies, making recommendations, etc. One of the worst: "[C]onsider and propose evidence-based models, policies, and innovative approaches for the promotion of... public health on individual and community levels across the United States." (Emphasis added.) Why is this council proposing what should be done for public health on an individual level?
However, the seventh (ambiguous) duty is what really blows me away, though not really surprising: "[C]arry out other activities determined appropriate by [guess who?] the President." More power over healthcare to one man (who, again, is not an MD)...
Ok, rant's over, but you can tell I'm totally against this so-called "healthcare reform", which is in reality "healthcare deform".
December 28, 2009 4:11:12 PM

Hey we love our government, and no, dont go thinking alor of government is for pure power to garner votes, as thatll never happen, and why shouldnt a democrat president have all this power, accept it, and use it? It wont bring votes, it wont address peoples desires, only their needs


OK, sarcasm off, yes, its too federally driven/overseen
January 8, 2010 8:44:44 PM

MU_Engineer said:
Quote:
It is true that true that there is a national panel (NICE) that decides what drugs and treatments are to be available - but this generally results in any treatment where there is a genuine benefit being authorised.
Who is better-qualified to decide what is the best treatment for the patient than their own doctor?
...except that the doctor doesn't get to decide - the insurance company does. I'm not particularly convinced that the decision of a for-profit insurance company is any more in the patient's interest than that of a government bureaucracy.
January 8, 2010 9:40:52 PM

Time to get both out of the damn way. Let the doctors be a doctor once again. Few people in Congress and in the insurance industry can make that qualification themselves.
January 9, 2010 2:30:49 AM

I've worked in a hospital setting for over 5 years now and I can assure you that anything the government tries to force on us (despite sometimes good intentions) ends up costing the patient... both in terms of quality of care and in terms of cost. There are really only two guaranteed ways to lower the cost of health care... either subsidize it less so fewer people can afford it... thus lowering the viable demand... and tort reform. I'm not suggesting the first idea, but the second? Well, that's a sure-fire way to lower the cost of health care... too bad most Democrats ARE lawyers. Insurance companies are most definitely evil, but malpractice lawyers are ten times worse.
January 17, 2010 1:36:04 PM

MU_Engineer said:

- If you decide to tax the snot out of anybody that makes any money to pay for complete universal health care, you'll see tax revenues drop sharply as people who make money either leave the country or work less, resulting in nobody really getting any health care paid for at all.

Or you exempt political groups with clout. In this case, the Obama administration is considering exempting union groups such as autoworkers from the payroll tax on health benefits.
January 17, 2010 1:57:10 PM

jsc said:
Or you exempt political groups with clout. In this case, the Obama administration is considering exempting union groups such as autoworkers from the payroll tax on health benefits.


Well, yeah, of course you exempt your backers from paying the higher taxes. You have to actually pay for the votes you bought on credit during the election... :fou: 

Also, the exemption of unions and government workers from the tax is now part of the bill. They don't have to pay the taxes for five years after everybody else does, and when they do, they get an extra ~$2500/year exempted from being taxed. It's just disgusting, isn't it? But hey, that's the "Change We Can Believe In," right?
April 30, 2010 12:03:06 AM

Although personally benefitting from the health care bill (my daughter from my first marriage is full-tine college student and turns 22 in August and Aetna boots her off my family plan at the end of that month - the health care bill restores her on my plan next January I believe), I still disagree that the gov't can force everybody to buy health insurance whether they want it or not. When I first started my career a couple decades ago, I declined the company-subsidized health plan because (1) I was young, single and in excellent health, and (2) comparing my premiums to those of my older, married colleagues, it was clear that I was subsidizing them, not quite to the extent as with life insurance but still pretty unfair IMO. So I didn't elect to participate until I got married & had a kid (actually my first wife was in the military so we had free health care anyway - Champus which is now Tri-Care Prime or something similar).

Of course now I'm a middle-aged fart with 2 kids, so logically I should favor this bill but it still seems unfair :p . Not to mention that last week another gov't agency shot the so-called savings espoused by the Dems and the administration, full of holes...
May 9, 2010 2:27:11 AM

fazers_on_stun said:
Not to mention that last week another gov't agency shot the so-called savings espoused by the Dems and the administration, full of holes...


Anybody who takes a few minutes to read over the law's summary and has any common sense at all will realize there are no savings in the law. Here's why:

1. You have 10 years of taxes as part of the bill, but only start to pay out benefits for the last six and only end up with a small surplus. You're going to run a huge deficit once you're out of that 10-year budgetary estimate window as the taxes aren't enough to subsidize this thing (else the payouts would start on Day 1. There's a reason the payouts don't start until four years from now, it was to end up with a "surplus" for the mandatory 10-year budgetary impact estimate.)

2. You are covering many more people than before, some of whom were deemed too expensive to insure at present. This has to cost a lot of money.

3. The fines are 2.5% of your income but the government won't subsidize insurance for most people until insurance costs 8-9.5% of their income. Couple that with the no-preexisting-condition-denial part and you'll have a lot of people pay the fine and then jump on insurance right when they get sick as this costs less money. Insurers are going to go belly-up over this unless they get big federal assistance.

4. Healthcare costs almost always overshoot estimates by a huge margin. One example: RomneyCare in MA was several times over budget in only a few years. What makes anybody think this estimate will be any good?

So a little common sense will tell you that any "savings" was a sham.
May 11, 2010 12:29:23 AM

MU_Engineer said:
Anybody who takes a few minutes to read over the law's summary and has any common sense at all will realize there are no savings in the law. Here's why:

So a little common sense will tell you that any "savings" was a sham.


Exactly so. And not to mention the fact that the gov't reliably predicting anything 10 years in the future is an absurdity in the extreme. Lucky for Obama, he's out in either 3 or 7 years and thus won't be around to face the music.

I say that we hold these guy's pensions as guarantees their numbers are correct - if they screwed up, they should pay the price. I'd bet we'd see a lot less wild-arse optimistic guessing on their parts...
May 11, 2010 1:04:04 AM

fazers_on_stun said:


I say that we hold these guy's pensions as guarantees their numbers are correct - if they screwed up, they should pay the price. I'd bet we'd see a lot less wild-arse optimistic guessing on their parts...


The problem isn't with the CBO (the guys doing the estimates), it's with the politicians that ask for the estimates. The CBO is hamstrung in coming up with an anywhere-near-realistic estimate as they are forced to use assumptions and data that the bill's creators give them instead of using remotely-sane ones. That's why one of the CBO officials came out and said the bill was going to be at least $300B over their official estimate.
May 12, 2010 10:08:38 PM

^ Yep. And although I was too busy to read the MSNBC article today, there was yet another story about the healthcare bill cost estimate going up another $128B or so. This story just keeps getting better and better...
May 13, 2010 2:33:47 PM

MU_Engineer said:
There are really two issues here.

- Issue #1 here is that health insurance today in the U.S. isn't insurance so much as it is a third-party payer for all or almost all of your medical costs. Actual insurance is something that is designed to protect against catastrophic losses, such as what house insurance does. It has a relatively high deductible so that you pay for maintenance and minor issues, which keeps the cost of the insurance down a lot. Health insurance generally covers most all medical costs to some degree, not just the catastrophic stuff. If house insurance were like medical insurance, it would buy a new rug for the kitchen when your kid spills a glass of grape juice on the rug and stains it. The covering of almost all costs is partially why medical insurance is so expensive. The other reason is that it is just about certain that you will run up decently-sized medical bills at some time or other in your life, which is unlike other types of insurance. Most houses do not burn down or get destroyed by tornadoes, but the vast majority of people die of some chronic medical condition. Other types of insurance are basically a bet between you and the insurance company as to whether something major will happen to whatever is insured. If your house had a 90+% chance of burning down and the insurance company having to pay for it, your house insurance would be far, far more expensive than it already is. It would be much closer to health insurance in price.

- Issue #2 is that providing the actual health care isn't free, although the government requires some groups (such as emergency department staff) to provide care for free. You mentioned this in your comment, and it really is a huge deal. The hospital has to make up the cost of providing this care, so they make everything else more expensive. Thus all of us have to pay for this care in the form of increased insurance premiums and medical bills.

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Personally, I think the system would be overall less efficient if the government ended up being the mechanism to provide the insurance. Not to mention federal abortion funding and the potential abuse of "end-of-life counseling".


Health care is just like every other tangible good or service- it is not an unlimited one. This whole debate over "solving" health care is a ridiculous one as health care is just another example of the Law of Scarce Resources that we all learned in Econ 101. Nobody is ever going to "solve" health care as it is impossible to make everybody happy.

- If you decide to tax the snot out of anybody that makes any money to pay for complete universal health care, you'll see tax revenues drop sharply as people who make money either leave the country or work less, resulting in nobody really getting any health care paid for at all. Some may disagree as they feel that the people who make money are so greedy that they'd work more to end up with the same amount of net income as before the tax hikes. This is incorrect as many economic studies have shown that the substitution effect (people will work less when they get to keep less of what they make) outweighs the income effect (people will work more to overcome the increased tax burden.) This makes a lot of sense as people are far more lazy than they are greedy. :D 

- If you decide to have a universal health care scheme that doesn't break the bank, there will have to be rationing of care, such as what is happening with the U.K.'s NHS. A lot of people don't like the fact that the government is making a decision to limit their quantity or quality of life, which is why the whole "end-of-life counseling" bit got so much attention. The actual language in H.R. 3962 doesn't have anything to do with "death panels" (it merely says that physicians can get reimbursed for talking to patients about hospice care and such), but people do realize that the "death panels" stuff is very possible and don't like it.

- If you decide to simply have everybody pay out of pocket or by money they saved up, then people without much money can't get much for health care. You get into the whole class warfare and "haves versus have-nots" argument that brought about a lot of the "health care crisis" stuff in the first place.

The end result is that there is no perfect option, else we would have figured it out a long time ago and implemented it. We are not oh-so-much smarter than our predecessors, unlike what some people would have you believe.

Personally, I believe that the third option is the best. It doesn't leave the country insolvent or have some government bureaucrat telling me what I can and cannot have for treatment. It also is the only option that realistically will leave the individual with the responsibility for modifying their own behavior to be healthier. A government program will either completely ignore this (having the guy who lives on Big Macs, Budweiser, and Marlboros pay the same amount in taxes/premiums as the triathlete who wouldn't come within a mile of a cigarette, liquor store, or a McDonald's) or penalize everybody (via taxing "unhealthy" foods.) Yes, some people do get the short straw and are born with few marketable skills and inherited medical problems. But that's where private charity can step in. That already works quite well as there are numerous charity clinics out there that take care of those kinds of people. I know this pretty well as I have worked at one! Even then, the number of people who came in who legitimately were unlucky were very few compared to those who were just irresponsible and/or extremely lazy. The latter group largely could have paid for themselves if they had to get up off the couch and got a job instead of sitting on welfare.



First of all, you should read the U.S. Constitution if you believe that health care is the absolute first thing that tax dollars should go to as the Constitution is pretty specific in what are the responsibilities of the federal government. National defense is actually one of the few important responsibilities. The debate over whether or not what the U.S. is doing over in the Middle East is another debate altogether and is not germane to this argument.

Secondly, read the part I posted above about scarce resources and the substitution effect vs. the income effect. If you excessively tax the people that make money, they will work less hard to make money and the government will end up with less tax (see the Laffer Curve for a graphical depiction of this.) You'll end up in the same position as before with people not being able to afford health care, except now the businesses and capital that provide jobs are in some other country. I know that in an ideal world it would be great to provide as much health care as anybody needed, but this is not an ideal world and we simply cannot afford it.

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now my knowledge is limited on the matter, but this is the very reason why i do not belive america to be the great nation they claim to be.


I would agree that your knowledge is limited on the matter as you have made a largely uninformed and emotional argument. I also agree that America is not as great of a nation as we once were. But, it's because of the unrealistic idealist thinking and lack of responsibility that the "lets penalize those who work hard and reward those who don't" mentality that you espouse.



I could not agree more. I am sick and tired of peoples lazy "help-me the world owes me something mentality". I am sick and tired of my taxes going up on everything I own, everything I buy, everything I do, and every penny I make to help support these people. I realize that taxes are a way of life, and they are needed to pay for our basic foundation of society, but not this. Any type of program ever ran by the government has turned into a tremendous, expensive, dismal disaster, why? Because no matter how they sugar coat it on the outside, on the inside it is all about putting money into people's pockets and friends, it is not the working person. The only problem is, the freeloaders are coming into the majority, they have now the power to vote nonsense like this into place and earn their perks off the backs of the money earners.
May 18, 2010 5:46:21 PM

^ Too bad the "Tea Party" lacks any charismatic, ideological leaders (at least that I can discern). About time a third political party arose with some clout...
January 9, 2011 1:51:15 PM

This topic has been closed by Reynod
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