Judging by the fact that 3 of the 16 remaining candidates for “Worst Company in America” are insurance companies, we suspect that some of you are not happy with the state of health care in this country. With that in mind, we thought we’d direct you to an interesting episode of the PBS documentary series Frontline.
In this documentary, Frontline examines 5 capitalist democracies to see if there’s anything that can be learned from how those countries run their health care. No system is perfect, but there are some interesting ideas being implemented all over the world.
Sick Around The World [Frontline]
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The US Gubmint currently has $85.6 trillion in unfunded liabilities for Medicaire.
And yet people still think that if only the government would take over MORE of our healthcare responsibilities, everything would be fine.
Has the government run a single service for citizens that is even remotely efficient?
Anything? And some folks want to let them choose how we get healthcare?
@h0mi:
Regarding your statement – What are our rates of mental illness, heart disease, cancer, pulmonary disorders and trauma vs. the rest of the world (these are our 5 most expensive conditions to treat)?
Some things aren’t going to be fairly comparable…
A few examples:
mental illness is woefully under treated in this country…with our without health insurance. Most health insurances have must stricter caps on mental health copays and limit the amount of visits. And other countries, such as England can be worse and view many mental health issues as taboo, thus these folks won’t get treatment, even if it’s available (see depression) or believe that some issues really don’t exist (see ADHD), even though the scientific evidence is overwhelming.
Stats regarding treatment for alcohol abuse will be different in England than in Japan and the U.S….because of cultural views regarding drinking and the fact that many more Asians lack a specific gene responsible for the body’s ability to procession alcohol.
Americans are overweight, esp. compared to other countries, but Japanese and most of the European nations are starting to catch up with us in obesity -thus more pulmonary disorders.
We need to be careful if we want to use this as a criteria for the basis of “affordability” for the U.S. Maybe if we looked at the fact that IF things like mental health coverage was affordable and available for everyone, we would have a more productive, mentally and physically healthy society. And if the poor and uneducated had access to preventative health care measures (rather than only going when it’s a dire emergency), we’d have also have a more productive, wealthier society as a whole.
@IamNotToddDavis:
Well then, it’s a good thing our current health care program is working so well!
Nobody is saying that gov’t is perfect, but those that make laws in gov’t are representative of the people that elect them…so if you’re so unhappy, then I bet you’re working really hard at the local, state and gov’t level to change that. Right?
Many programs aren’t perfect, but I’m glad for the fact that public schools were available when I was a kid since my mother couldn’t afford to send me to a private one…public school education is a better choice than no education at all….I walked to my public school but the kids with more money drove to private schools….on roads created by “gov’t programs”! I take a medication that was researched and developed mainly through a grant from the NIH……another gov’t thing!
@Voyou_Charmant:
I respect your empassioned arguments, but you unfortunately glossed over or willfully ignored the fact that many of your mentioned problems would be fixed by such a reform.
thegirls@thegirls:
You are missing my point, and I imagine it’s intentional.
The point, again, is that the Gubmint is already trying to run a healthcare system for people who cannot afford the costs of their healthcare for whatever reason. And this system is horribly bankrupt already, to the tune of $85 TRILLION (that’s with a “T”) in unfunded liabilities.
I don’t understand how anyone can make the argument that the GOVERNMENT would be better at spending MY MONEY on healthcare based on these figures. This is not a “DMV” comparison. This is an example using a US government run healthcare system that is operating RIGHT NOW at an enormous deficit.
Do you honestly believe that anything will get “cheaper” in terms of healthcare costs if Medicaire was running EVERYONES healthcare, and not just those who currently can’t afford it?
@thegirls: I’m not saying they should all leave the service industry, far from it. My daughter sometimes brings home $400 for an 8 hour shift. She does not have health insurance, or paid vacations or weekends off, but she chooses to have that job. I was also a single mother of 3 children under the age of 3 (set of newborn twins) for the 2 years I was on Welfare. Within 5 years of getting off Welfare I bought my first house, because I worked my butt off. I have been in the very-low income bracket, we lived in HUD housing where I saw numerous women in the same condition as myself, yet I was one of the very few that worked my way out of it. I am no super woman, and I don’t have a college degree. I’ve been working on my AA degree since 1992 mainly because of finances and the last 2 years because of my health. One of the women that lived in that HUD housing where I lived, was 25 and had 5 kids, the oldest being 11. Her youngest 2 ended up in the hospital for over a week because she didn’t bother to get them immunized for measles (it was a measles outbreak in Phoenix, not mumps as I stated in earlier post) She had state health care, and she had a car, she just didn’t feel like getting off her butt to take them for their checkups and vaccines. I knew her personally, so I’m not just guessing that was the reason. The preventative care was there for her, and she refused to use it, thereby costing a lot more money to have her children in the hospital for a week, this was all paid by our taxes, of course.
I think our health care does need reform, but until I can be guaranteed it won’t be run like the Welfare system I would never vote for it. Just because the healthcare is there does not mean 100% will use it. There must be other solutions than putting it in the governments hands.
After the years I spent fighting with Welfare, child support enforcement, day care assistance, and food stamps, the less the government is in charge of the better.
@IamNotToddDavis:
Actually, it wasn’t intentional!
But since you asked…Correct me if I’m wrong here, but I seem to remember a relatively solvent SS system around the year 2000 with large reserves of cash. Then GWB came into office and well, with funding the war and all, he needed to get the money from somewhere and the SS fund seemed to be ripe for the pickin’. So if we stop rerouting the money, then problem solved! The “borrowing” from SS crap started under Reagan and needs to be made illegal. Remember Al Gore’s Social Security lockbox? I guess Big Al was right after all.
@thegirls: I haven’t said anything about SS or any lockbox. I would argue with you that SS has been “solvent” at any point in the last twenty years, but that’s a different discussion.
What hasn’t changed is the fact that the Gubmint currently is running a healthcare system and it is a complete fiscal disaster. This makes any argument FOR MORE Gubmint involvement in running a universal health care system completely insane and irresponsible.
Name me ONE SINGLE GUBMINT system that is currently efficient, solvent and pays for itself.
@speedwell: Are you really this clueless, or do you just play it on the Internet? Of course you can’t have loopholes without a net, but you don’t NEED them. Think about it this way: Without any sort of regulation whatsoever, what’s to stop someone from starting up a fly-by-night, lying outright to potential customers, and running away the moment they pay out? History says… nothing! Regulation does not encourage predatory practices in anything like the manner you’ve described. People have pointed you to power deregulation before as an example of this; read any one of the IDT posts here and think for ten seconds.
I think Americans would be glad to wait 18 – 36 months for their hip replacement, or 8-12 for their cancer treatments, like in countries that give health care.
@Bladefist: I would have come in and covered your back on this one, as I’m (predictably) in complete agreement with you on the issue, but I find that UHC is the an issue where people’s willingness to loudly argue is massively disproportionate to their command of the complex issues involved. A quick sampling of the comments validates this observation. It also sort of raises my blood pressure, which, even with my self-funded and rather satisfactory health coverage, isn’t a good thing to let happen.
@ConsequencesIX: Do you always walk into a discussion and make shit up?
I’m late to the party because of the time difference…
I can’t speak to the quality of public care in Hong Kong, where I’ve been living since last October, but I can say the implementation of private health insurance is worlds better than in the US and the cost is significantly lower. With my insurance (through my husband’s company), we pay the full amount of a visit or treatment, and then we receive reimbursement.
An hour-long visit to the head of a teaching hospital’s neurology department costs US$120 and X-rays cost US$25. When I became concerned about certain symptoms I was experiencing, I was able to schedule an appointment for the next day, the blood work cost US$6, and the doctor’s office both SMSed me and called me two days later with the results.
Compare that with going for, say, a pap smear in the US, where it can take up to three months to get an appointment for a regular check-up and then you’re told, “If we don’t call you, everything should be okay, but then, if we don’t call you, it could also mean we misplaced your results or forgot to call you to say you have cancer and are going to die, so you should probably call to see if everything really is okay, but then when you do call, we’ll be annoyed that you did and thus have to look for your results, because didn’t we tell you everything was okay if you didn’t hear from us?” Ugh.
A few years ago, my uncle, who had already had one heart attack, experienced chest pains and went to his PCP-affiliated hospital, where he was told it was indigestion and he should go home and take antacids. Instead, he went to an out-of-network hospital, where they told him that, yeah, he’d had another heart attack and needed to be admitted for observation. Then he spent close to a year fighting with his insurance company to pay for the out-of-network treatment.
The problem with the US health care system is that even with insurance, there’s no guarantee of treatment or that your insurance will cover the cost of treatment. Because most insurance companies are for-profit, of course they’re going to search for a way to lower costs, including routinely denying claims they should cover in the hopes that members will not fight it and pay it themselves. How strange is it to support a system where you can easily pay upwards of $1,000/month for insurance (if you have a family) that doesn’t guarantee coverage?
While I think having some type of socialized health care system is a good idea, I don’t think it’s feasible in the US because there’s too much of an “I got mine” streak. What we need to do is find a way to fix the way private health insurance operates.
What you’re describing is not Marxism. It’s called “risk pooling.” At any given time, you’re probably not sick, but other people are, so you pay premiums (or taxes) and they get care. When you get sick or hurt — and you will, tearing an ACL on the ski slope or running in front of a bus or something — the risk pool covers you.
At least this is the way it was supposed to work, before insurers decided that they couldn’t make enough money that way.
The Constitution puts it this way: “We the people, in order to … promote the general welfare.” Universal health care, doctor-patient focused health care that’s focused on outcomes, NOT PROFIT, is the right thing to do as a society. That it can be done at a substantial net savings is almost beside the point.
@AtomicPlayboy: I would have sparred with both of you on this one, but we’re already 200 comments in and I don’t want to even attempt to sort through them. You’re right that it’s hard to hold a conversation over all the noise coming from all sides.
I had this coherent response advocating some modest health-care reforms, but I opted instead for the snark in my preceding comment. Snark is at least 50% more fun, anyway.
@RandomZero: @speedwell: Taking RandomZero’s point about regulation one step further, there’s a reason why there’s never been a sustained anarcho-libertarian society. It’s an unstable system, based on some fantasy that people play nice with each other.
It’d only be a matter of time before someone figured out that the one with the most toys gets to make the rules. When that happens, you end up with mafia-like “microgovernments”: they make the rules, and you better not disagree with the new order unless you’re prepared for battle.
Will the same mafia be running the show tomorrow? I don’t know. Tonight might be a fine evening for revolution. Who knows? Maybe the Bolsheviks will win this time.
(In other words, an anarcho-libertarian society doesn’t have enough power to protect itself from those who seek to do it harm.)
My question is where is the Church in this?
Why haven’t organizations that claim to have love and compassion for their fellow human beings stepped up and provided basic health care for the poor?
Going point by point…
@Bladefist: All I can say is, we are a much different country then the ones above. We are physically larger, and our costs will be much higher.
Utter nonsense. Or have you never heard the phrase, “economies of scale”?
Canada is physically larger and would cost more per person due to the distances involved, yet manages to run an efficient system. It’s the same in sparsely populated Australia.
The real reason why universal medical care is not funding or bureaucracy, it’s American litigiousness. The US is a “me, first” culture with no sense of personal responsibility. All nations which have universal health care also have “loser pays” in the court system which tends to eliminate frivolous lawsuits. Similarly, these countries have more open drug patent laws allowing drugs to be made at lower cost in a shorter time; US patent laws protect pharmaceutical companies’ profit margins, not the public’s health.
@Bladefist: The rest of the world gets to enjoy cheap health care, because our capitalistic nation keeps providing all the innovation. If we cut funding to innovation, then everybody is screwed.
“Wow, the US invents everything.” You sound like a blowhard propagandist from the Soviet Union.
First off, most medical advances come from other countries, especially those with universal health care; only a small portion come from the US. Second, university funding in the US is now almost always profit driven – if the research won’t make money, it doesn’t get funded. That’s not how scientific advances happen, they happen when somebody says, “That’s strange…” and decides to investigate.
You do research without direction, then decide how to use it. Not the other way around.
@Bladefist: I’m okay with national health care if its optional, and those of us who want to opt out, don’t have a tax increase.
False inference. You wrongly assume that universal health care will lead to tax increases. An efficient system costs less, not more; Canada pays roughly half what the US pays per patient, so the issue is not taxation, it’s proper management and efficient spending.
@Bladefist: Also our Government is notorious for screwing everything up. I prefer paying a little more then getting a DMV-quality health care.
Another false inference. Are you always so dishonest?
If government-run universal health care cost more because of government inefficiency and corruption, you can blame corporate interference and corrupt politicians, not universal health care itself. Unfortunately, the US has only a two party system which makes lobbying and bribery possible.
All other nations with universal health care are multi-party democracies, with at least three parties, and minority governments are possible. Minority governments pay attention to their coalition partners for their own political survival and will ignore lobbyists.
If universal health care failed in the US, it would be due to American culture and immaturity of the political system, and not universal health care as a system.
I’m actually surprised that you didn’t make the false claim of “the US has the world’s best health care!” That means you must have heard that the US’s average life expectancy has dropped below some countries with universal health care; if you hadn’t heard, no doubt you would have said it.
I would gladly wait in an emergency waiting room for hours on end to have a broken bone mended if it meant i would actually get treated. It is scary not living with health insurance. It is either stay healthy, die, or declare bankruptcy.
@P_Smith: You say I sound like the soviet union, but you support more government socialism? That statement made me not interested in arguing the rest of your points.
All I know is if other countries want to learn from the U.S. they’ll find the perfect example of what NOT to do with healthcare.
@Pithlit: Before people got this notion that there had to be a safety net, there was something called responsibility that really worked quite well. People who were truly in need got the help they required, either through family or charity. Like anything else a government has ever gotten its hands on, any assistance program turns into a way for politicians to buy off huge blocs of the population by broadening the requirements for assistance. Take the number of uninsured in this country, which seems to float around 45-50 million (so says the media). Shave off illegal immigrants, people who can afford to buy insurance but choose not to do so for whatever reason (self-insure, gotta have the premium cable package instead of health insurance, etc), those
@Voyou_Charmant: Like our current energy situation, the problem is TOO MUCH GOVERNMENT. Give people CHOICE and FREEDOM to shop around and insurance companies and care providers will have to lower their prices! You folks complain about the power of the insurance companies and how corrupt they are, but how do you figure it got that way? Because the GOVERNMENT allowed it! They passed laws that stifled competition in the market and added layer upon layer of regulation and rulemaking.
Let’s try something new for once. Let’s demand that the GOVERNMENT give us, the consumer, some of our choice back. Don’t put me at a disadvantage because I choose to buy a health insurance plan that fits my lifestyle better outside of my employer. Don’t tell me I have to carry coverage for lifestyle or family decisions that may never affect me. Don’t bury my doctor in paperwork and forms that don’t do anything to improve my health. Stop making me subsidize the healthcare costs of people who have led unhealthy lifestyles. Simple fact is, we do not have a free and open market in health care. When the day comes that I can tell my employer that I would like to decline their coverage and be compensated in cash, tax free (so I enjoy the same tax benefits I would if I stayed in house), to buy my own health insurance policy that better fits my needs and budget, only then is the market free and open.
My problem with single payer/universal systems is that the GOVERNMENT has already done so much to screw up our system as it stands, I cannot see how they can possibly do a better job running the ship. Basically all that happens is that the responsible people in society will end up paying even more (through higher taxes) for the same amount of care. The rules and regulations will still be there. The bloat and inefficiency won’t magically disappear. We’ll get to pay for more government bureaucracy and waste. But all the socialist Utopians out there will rejoice because someone won’t have to make the choice between healthcare or cable TV, cigarettes, beer, $200 tennis shoes, etc. People who are truly in need and just aren’t freeloading the system get help, many times free of charge. I’ve seen churches or communities come together and pay off entire medical bills for people who faced putting a child through a heart transplant.
I’m just getting sick and tired of people thinking the government is the only solution to society’s ills, while completely ignoring the fact that government is in large part the reason why we are where we’re at today.
@barty: I understand that it’s an ideology-based thing for you. The problem with anti-government ideology is that it often becomes a self-fulfilling prophecy. The Republican Party puts people who hate government in charge of government, and surprise surprise, we get bad government. No government is perfect, and we constantly have to work to maintain and improve it, not tear it down.
As for the idea of charity, it’s a great thing. But it’s not sufficient to solve the problem of universal healthcare. Not even close. And the whole reason why social safety nets were established in the first place was situations like the Great Depression where private charity, family support, etc breaks down. Churches and such may be part of the solution, but they shouldn’t be the only choice.
You’re totally missing what everyone has been saying. Many, many people CANNOT simply “shop around” for better insurance. Individual insurance is not really the answer. Here’s the problem: if the insurance companies can accurately predict who will cost them the most money, then they can either deny those people coverage or charge them more money. The problem with that is that, unlike with people who are a poor risk for auto insurance or something like that, health problems often are not the fault of the person who has them – they may be because of bad luck or bad genetics. So individually underwritten policies shift costs onto the sick. That would compound the already horrendous problem of people going bankrupt because of medical bills even WITH insurance. And it would make insurance unaffordable for virtually all of the medically uninsurable.
@barty: Oh yes, totally, let’s make sick people responsible for getting well.
That
Makes
PERFECT
Sense.
By the way, I’d love to see you toeing that line after you get cancer. Oh no, wait, you’re too perfect to get cancer. Silly me.
The “good old days” were full of dirty hospitals, abandoned victims and people dying at the age of 40 from preventable illnesses. How about we stop lionizing them?
And, I know some of us are healthy, but perhaps even we can muster some compassion and understanding for those that aren’t, eh? Just because your body works fine doesn’t mean your brain doesn’t need exercise.
A good system is one that helps as many ill people as possible to get healthy, and which helps as many healthy people as possible to stay healthy. I really don’t think there’s any valid measurement other than that. If it’s costing too much to get and keep people healthy, then it’s time for those who are getting rich on the system to stop, period. It’s not ‘time to help less people’ or ‘fuck the poor, they deserve it’ or whatever other ridiculous is probably lurking in this thread.
Health system = about getting and keeping people healthy.
First and period.
Until nobody is getting rich off it, nobody has a reason to complain that it costs too much. Again, Period.
@johnva: I’m not anti-government, just anti-BIG government. Just like individuals, a government that tries to stick its nose in everything ends up doing more harm than good.
I think alot of you completely miss what the point of INSURANCE is in the first place. It is asking someone else to assume risk for you. Its not meant to be charity! I’d also be willing to wager that most of the people you claim can’t find a better deal on insurance have health issues brought on by lifestyle choices, not because of something that got passed down through the family. Why shouldn’t someone who smoked their entire life pay more than I? Or someone who never exercised a day in their life and feasted on fast food, yet tried to push off their obesity on bad genes? In any event, your “many, many people” probably represents a relatively small minority of the population. But failing to make any distinction at all, ie., saying the smoker is entitled to the same price and level of service as someone who is 100% healthy is one of the biggest issues I have with so called “Universal” health coverage. Some people ought to pay more. If it weren’t for the government interfering as it has already, I can almost assure you that health and life insurance companies wouldn’t cover a smoker at all. You want to talk about reducing the cost of healthcare in this country, make someone decide between smoking and being eligible for health insurance.
Also, we need to review quality of life vs. spending billions just to keep someone around in our society. I think this is an increasing problem with the elderly in particular. We look at life expectancy as some great yardstick of civilization, but are we really adding meaningful years onto people’s lives? Or are we just condemning them to years spent wasting away bedridden somewhere? I know that modern thought looks at letting people who are chronically ill die as a barbaric thing, but is it really? I think one of the biggest problems we have is the attitude that every available means needs to be taken to keep someone alive, just because the technology or procedure may exist. Doesn’t matter if that person doesn’t stand a chance of meaningful survival, but we’ve got to do it nonetheless. Before anyone calls me a heartless bastard, I’ve seen too many family members of my own and of my friends basically waste away because of “maintenance” medications and surgeries and procedures that do nothing more than stall death for another year.
@johnva: I wrote you a huge comment, I think back on Page 1, it was my last comment directed to you. I’ve been eagerly waiting for your response, you mind?
@Bladefist: Sure, I’ll get to it shortly. I got tied up with real work
@johnva: Thats unacceptable.
@Bladefist: I think our country was “founded on” a mix of conservative and radical ideas, actually. Remember that a lot of the ideas in the Constitution and DoI were VERY radical at the time. Regardless, society changes and evolves over time. In a sense, it’s not that relevant to me what the original ideals of this country were. I care about that because it’s part of the base for our tradition of democracy, but I’m more concerned with making things better in the here and now. And I think one of the main goals of the government should be to improve the lives of its citizens, not just to be the arbiter of law.
This is one of the fundamental differences between liberals and conservatives, and also between idealists and realists. Your way of looking at the world seems to be that if things are going okay for the majority of people that we shouldn’t tinker with what has worked well. I agree with that, but only to a point. I, by contrast, tend to try to look at the data and evidence for what works and what doesn’t. And I don’t believe what we are doing right now in healthcare is working well, for anyone except for investors in and executives for insurance companies. I also think that the evidence clearly shows that single-payer is a superior system if your goal is to get some guaranteed level of healthcare to everyone as efficiently as possible. I know you may not agree with that goal, but it’s at the heart of my support for single-payer.
I’m not discounting the value of self-sufficiency. I certainly agree with you that that is a core American value. My problem with this healthcare issue is that it’s placing way too much of the burden of risk and cost on individuals, and disproportionately on some individuals at that. I do think we need some compromise between shared and individual responsibility, but I don’t think the way to do that is to let private insurance companies do what they want and pick and choose their customers and rates. The fact is, there are plenty of people who right now cannot afford decent healthcare DESPITE the fact that they are hard workers who don’t lead unhealthy lifestyles. I don’t think people should be able to push all costs that are their own fault onto the government, but I don’t think people should be totally screwed because of bad luck, bad genes, etc. Our current system makes no differentiation in this regard, and it won’t as long as the profit motive drives social policy. An insurance company doesn’t care if you’re sick because you’re a smoker or if you’re sick because you have a genetic disease. Either way, they don’t want you as a customer unless they can charge you rates high enough to cover your risk.
@barty: I think you’re outright wrong that most people who can’t get affordable health insurance for medical reasons are in the situation because of lifestyle choices. Insurance companies are increasingly denying coverage to anyone with a vast array of preexisting conditions, even if the customer is willing to sign an exclusion absolving the insurer from having to cover that known preexisting condition. I guess their actuaries have determined that people with one health problem are more likely to have others or something. I also think that you’re making that rationalization to avoid dealing with the inhumane nature of your own stance. Chalking up health problems to “lifestyle” or whatever lets you view it as a moral failing and dismiss it as a personal responsibility issue. Reality is more complicated.
Also, there is absolutely zero reason to believe that under a universal coverage plan that smokers or other people who genuinely DO cause their own health problems would necessarily be “entitled” to the same coverage and cost as everyone else. If you think that’s a problem, then they could easily do things to provide incentives to people to quit smoking, like charging them higher copays or whatever. It could work just like regular private health insurance in that regard, or you could simply do things like raise cigarette taxes and use the money to fund any extra costs to the system caused by smokers. There is no reason to believe a compromise couldn’t be reached just because it would be a government plan. Actually, it’s PRIVATE INSURANCE that makes no differentiation between lifestyle-based disease and genetic diseases. Insurers only care about whether you are going to cost them money, not why. I think that’s perfectly understandable, since they aren’t charities after all. So I don’t really fault the insurers so much as I fault our society for making for-profit insurance companies the sole gatekeepers to affordable healthcare. Insurance is simply incompatible with what I consider the important social goal of everyone having some minimal standard of healthcare.
Bladefist: Also- When you open up free health care, everybody is going to go to the dermatologist for each and every zit.
This is the biggest fallacy. Most people don’t wake up and think, “Gee, I think I’ll have a colonoscopy today!” People avoid medical care whenever possible, no matter the cost. Spending will initially go up under Obama’s plan, but whether that’s spending on preventative care that will reduce the later spending on palliative care for that ailment, or whether it’s spending on care that someone other than the patient wouldn’t deem necessary, will be hard to distinguish, and probably not the job of people other than the patient, the healthcare administrators, and the caregiver.
There’s actual data on outcomes. This is a doable thing.
There’s a great blog I read that often covers this stuff, called Stayin’ Alive.
I’m sorry, Bladefist, but I don’t know of any mature adult that holds to an ultra-libertarian viewpoint. It’s just not consistent with reality and human nature. We all get along better when we take care of one another, but just as we have people to manage our investments and prepare our taxes and grow our food, we also have people who manage our efforts to help our fellow man.
You have a personal, selfish, self-interest in people around you being educated and healthy, even if you don’t realize it right now.
@johnva: So what you’re saying is, you believe in constantly updating the Constitution, that it’s a living document? I believe it’s dead. You can’t interpret it, you can’t add to it, unless you go through the rules of adding to it. Which we never do anymore. We just make laws right and left.
@Mr. Gunn:
1) You need to get out more then.
2) I’m not a libertarian, let alone, an ultra-libertarian.
3) What makes America so great, is that it is not Western Europe. If you think Western Europe is so great, thats fine. Move there. Enjoy it. I don’t care how great people think it is, America is built on an entirely different view point. Capitalism. And it works!
@Bladefist: Yes, I support the Living Constitution idea ala Justice Stevens. I actually think it’s insane to say that you can’t “interpret” the Constitution. It was clearly designed to be interpreted; that’s why it doesn’t contain explicit authorization for all the laws we have. And moreover, I think that people who say they support “Strict Construction” or “originalism” or whatever usually do so solely out of a political position that they think is supported by that rather than a sincere belief. Justice Scalia, for example, goes on and on about this stuff but then he contradicts himself, in my view, whenever his principles would force him to make a decision he finds morally repugnant. So I basically think he’s a hypocrite.
But that’s getting way off topic.
@johnva: Okay. Well that helps me in understanding you. I’m you won’t be surprised for me to say, I think Justice Scalia is absolutely amazing. I believe it’s a dead document. Making it a living document will take us back to the exact reasons we fled Great Britain. We aren’t there yet. But when you remove the absoluteness of the Constitution, men will NOT stop. They just will not. Right now you agree with what they want to do. But if you know people, and I’m sure you do, then I hope you realize this is a snow ball effect. That is how communism is born.
I hope to God that I am completely wrong.
@Mr. Gunn: I think its a complete fallacy that just because its cheap/free that you’ll see a drastic increase of people using preventative medicine and a drastic decrease in the amount of spending treating the people who have become ill. Unless you’re going to put a gun to someone’s head forcing them to get a checkup (hey, it wouldn’t be beyond the government to do that!) every year, you’re still going to have the same issues, regardless of cost. I have health insurance and the last time I stepped in a doctor’s office outside of a health insurance physical was about 2 years ago.
@johnva: I think we, the people, are probably the ones directly responsible for allowing insurance providers to have the leverage they do on healthcare costs. People have willingly absolved themselves of most responsibility when it comes to this matter. Used to, people used to keep some money in a rainy day account and MAY carry some degree of coverage to protect themselves from catastrophic events. When people had greater participation in the billing process, you better believe people paid more attention to what their doctor charged them. Then some employers started offering more comprehensive health insurance as a fringe benefit, it quickly caught on industry wide, and by in large people stopped buying their own personal policies. When we moved towards these larger employer provided plans, people stopped paying attention to what they paid, both at the doctor’s office and for the insurance policy itself.
Our media is great at sensationalizing a few isolated cases and I’m sure everyone has heard the “so and sos, sister’s brother in law’s cousin, was refused insurance by the big, bad insurance company” but the statistics say those left chronically without health insurance by no choice of their own is far less than the number we seen tossed around. Certainly not high enough to push the entire country into some bloated government program that we’ll never see the end of, particularly until the government finally gives the insurable the power to shop for their own insurance and take back control of their healthcare spending.
@Bladefist: Great Britain hasn’t turned out all that badly (though they have some problems with civil rights abuses, etc just like we do). My belief is that we keeps us free isn’t what’s on that piece of paper so much as the ideas behind it and the popular support for those ideas. The Constitution IS a practical bulwark against tyranny, don’t get me wrong, and neither I nor Justice Stevens want it thrown out altogether. I just think the interpretation needs to change as society changes. And I still say that EVERYONE is interpreting the Constitution according to their own agenda. It just so happens that “strict construction” coincides with a more conservative political agenda, so conservatives support it.
@barty: Well, public health studies have shown that when preventative medicine becomes more expensive because of high-deductible insurance plans, people make much less use of it. This is true even with clearly beneficial preventative care like Pap smears and vaccines. That’s sort of the other side of what you’re arguing, but it’s a data point nonetheless.
What this shows is that people don’t always perform good cost-benefit analysis when it comes to health if it’s left up to them. There is a good reason why we rely on highly-paid doctors, and that is that normal people do not have the expertise and knowledge necessary to make good judgments about which tests are actually necessary, etc. This is a fatal flaw of consumer-driven healthcare, which is the hot idea in Republican circles to fix healthcare. Just look at how many people spend tons of money on crap like homeopathy for which there is no scientific evidence for efficacy. The public simply isn’t good at knowing what they need and what they don’t, and where the best places to save money are.
And I don’t believe that you have an informed picture of how bad the individual health insurance market is. It’s not just the media sensationalizing it. It’s a real issue. It can be really hard to get insurance, except through a group plan at an employer, if you have ANY preexisting condition. Even having taken an anti-depressant drug in the last 5 years can get you denied. And this is the environment John McCain wants to dump us all into by undercutting the tax benefits to employers who offer group plans. I agree that insurance should be decoupled from employment, but I don’t agree that individual underwriting is a good solution. Government risk pools are the only other option I can see.
@johnva: Like I said. For better or worse, our two countries are different. And I like America better. If the Constitution, sounds conservative to you, it’s because it is. America is supposed to be conservative. The constitution came first in America. So there is coincidence or political Agenda here. Conservatives are just defending how America was intended to be ran. The party of the change, is the threat. Sorry. I still like you though!
@Bladefist: I don’t think the Constitution sounds conservative at all (though I think parts of it sound archaic since it was written over 200 years ago). I think the interpretation of the “strict constructionists” is meant to serve a conservative agenda. And your idea of what America is isn’t the only one. Progressivism is just as American as conservatism is, and has been a major part of our politics for a long, long time.
I also think that sometimes sticking with the status quo can be more harmful than changing things. There are good examples of this throughout our history: slavery is a good one. And now I think healthcare is an example of that. The status quo is failing an ever-growing number of people. Will you agree that change is needed if 100 million people are without good healthcare? That may happen sooner than you think, especially with the potential for an economic downturn. The system is breaking down, and needs to be fixed. My proposed fix is simply what I’ve analyzed and found to be the most efficient and equitable solution.
I like debating you too, or I wouldn’t do it. And I like to get these points of view out there. The American people have a choice to make, and I think the differences couldn’t be starker. John McCain’s plan is terrible, in my opinion, and will only accelerate the crumbling of the system. Of course, I’m not happy with Obama’s plan to fix healthcare, either, and I don’t think it will work very well unless the Dems end up going significantly farther than he seems willing to commit to. The problem with McCain’s plan is that it’s a move in the absolute wrong direction. The problem with Obama’s plan is that it’s a half-measure.
@Bladefist: Medicaid/Medicare is one of the best run insurance programs they only have a 3-5% overhead cost while private insurers have 14-18% overhead thanks to absurd upper tier salaries–nobody in the government is going to make a seven figure salary let alone eight–corporate jets, and retreats at four star hotels on the backs on the backs of the customers.