Federal Reserve Chairman Ben Bernanke's Thoughts On Health Care Reform

Federal Reserve Chairman Ben Bernanke shared some thoughts on health care reform from “an economist’s perspective” today. He was short on proposals, but did suggest that we concentrate our attention on improving the cost-effectiveness of our health care system:

From the economist’s perspective, the question of whether we are spending too much on health care cannot ultimately be answered by looking at total expenditures relative to GDP or the federal budget. Rather, the question, whatever we spend, is whether we are getting our money’s worth.

He suggested that in our current system, decisions were made with the idea that “someone else will pay for it,” either the government, or private insurance.

“The best way to reduce the fiscal burdens of health care is to deliver cost-effective health care throughout the entire system,” Bernanke said.

You can read the full text of his remarks here.

Challenges for Health-Care Reform [FED]
(AP Photo/J. Scott Applewhite, File)


Edit Your Comment

  1. Angryrider says:

    Cost-effective health care = MORE PROFIT!
    If we can do that, we’ll have an even better system.

  2. squatchie44 says:

    wow that is a good read

  3. sp00nix says:

    Ive counted at least 3 times i have seen Health spelled wihtout an L

  4. hypnotik_jello says:

    I think we all need to chip in and by Meg a new keyboard.

  5. BobCoyote says:

    Looks like Meg was hungry…

    (Heath bars are AMAZINGLY delicious.)

  6. shoelace414 says:

    The current Republican health care proposals, and this includes Bernanke’s statement is that we are paying too much for health care is because “someone else pays”, so the way to fix that is make sure individuals pay more for health care so they shop around while looking for the hospital when they need catastrophic care. (catastrophic care is the biggest cost for health care).

    The way to fix the high costs is to make you pay more!

  7. johnva says:

    @shoelace414: His statements are actually pretty balanced when I read them in full and mostly just list facts about the problem. He, unlike most Republicans who are talking about this, at least recognizes some of the diverse reasons that people don’t have health insurance. But he also seems unwilling to make the jump to the possibility that eliminating private insurance altogether might be the best answer. At least he seems to recognize that we aren’t getting our money’s worth.

  8. bmorg003 says:

    Well it make perfect sense from an economic standpoint. The more time you spend “shopping” for a cost-effective solution the more likely you are to either find a more cost effective solution or die. The burden of the system is minimized in either case. From a moral standpoint, the issue is much less clear, but it does make perfect economic sense.

  9. Brain.wav says:

    Anyone else think that the picture was Bre’Tak from Stargate SG-1 at first?

  10. nedzeppelin says:

    the best way to reduce the costs of healthcare overall, is for AMERICANS TO STOP BEING SO FAT AND LAZY

    let’s face it, we created this problem. we’re a nation full of fat, lazy, smoking, drinking, fast food eating couch potatoes, and the country thinks we should demand a magic pill to cure it all

    as long as we allow people those freedoms (which i think we should), then don’t expect me to pay for it for someone who made those choices.

  11. I have enough money in my trust fund to have health care for life. I think if poor people didn’t have children our problems would be solved much quicker.

  12. Bladefist says:

    @johnva: Compare our health care with the socialist health care all day and night. You may believe Europe’s is better. Fine, I’ll accept that. But I just got back from the DMV, and I know that OUR government could never pull it off to be cost effective. What a bunch of collective idiots. If you think our Government, can do it, with your best interests in mind, I want to smoke whatever it is you are smoking. Because all I see is profit and corruption out of our government.

  13. ironchef says:

    @nedzeppelin: umm how about people who are fit, responsible, and lead healthy lives yet get stricken by cancer, or get their lives shattered by an accident (like spinal cord injuries, etc), or by some dumb luck born with a birth defect?

    It’s not like you care.

  14. Bladefist says:

    @PrestonBerryworth: At face-value your comment is extremely rude and, well, just plain dick.

    But you have a small point, and that is, lots of people who can’t afford kids, have kids. I know for myself, I won’t have kids until I can afford to give them everything they need. I think the government should regulate when you are financially prepared to have kids.

  15. That was a great read. It’s important that people learn more about the preventable deaths that are happening at hospitals today due to medical error. These errors are a lot worse than people realize. And most of them are due to the fact that many hospitals are falling apart financially.

    And if anything, this would make a decent argument that if we had more of idea of what exactly we were paying for our healthcare, then we would know if we really are getting our moneys worth or not and that seems to be Bernanke’s key issue. Are we getting our moneys worth for what we’re paying?

  16. Bladefist says:

    @ironchef: I’m young, muscular, and just plain gorgeous, and lately I’ve found that I have some medical ‘issues’. So I definitely keep that in mind when I’m debating. But, I think what he means, is our risk pool is terrible and it ends up costing all of us more. Obviously there are people who always going to be a cost to the system, at no fault of their own.

  17. bleh says:

    How about not-for profit insurance companies?




  18. stupidjerk says:

    @PrestonBerryworth: better yet, lets round up the poor people and ship them to canada, get rid of them now instead of phasing them out gradually

  19. @Viva La Volvo: @hypnotik_jello: No, this is about the care that Heath Ledger received. It didn’t go to well, so we need Heath care reform.

  20. stupidjerk says:

    @Bladefist: you think the government should regulate when you can and can’t have kids??? when did you move here from China?

  21. backbroken says:

    If only doctors and hospitals would require you to show your receipt on the way out the door, health care would be a lot more affordable. 28% of the cost of health care is shrinkage.

    Seriously now… can we just start providing children with health care? It would be nice to include everyone, but while we bicker about the particulars of that, can we just start covering the kids? I know it costs money, but I can think of a few billions we are spending every month that might be put to better use. Or maybe I’m the only one who thinks its a shame that some toddler’s course of cancer treatment has to be approved by some anonymous a suit in a cubicle.

  22. HIV 2 Elway says:

    @Bladefist: People who need to freeze their credit cards to prevent frivolous spending need to be sterilized.

  23. ThinkerTDM says:

    @ Bladefist : It’s too expensive to live, so I will just fade into the background and die. Life is for rich people anyway.

    Health care is not expensive because people are fat and lazy. It’s expensive because people (corporations) are greedy, plain and simple.
    There are many, many diseases (and injuries) that occur not because of fatness and laziness, but because of living.
    What’s next, putting elderly people on an ice flow because they cost too much money to keep alive?

  24. ThinkerTDM says:

    Shoot, now that I think about it, isn’t that why America was founded? Rich people were stepping on the masses, so they came over here, to America, to try to build a nation that wasn’t based upon the amount of money you had.

  25. Bladefist says:

    @worksintheory: blue cross blue shield. :) I’d google before you asked questions like that.

    @HIV 2 Elway: lol, nice work.

    @ThinkerTDM: Wow never heard that part of the argument before. Life changing.

  26. AmbiUbi says:

    @nedzeppelin: Maybe fixing fat “lazy” Americans might be the right answer, but then you have to ask yourself how we got that way in the first place….could it be the rising costs of EVERYTHING, making all the more common that BOTH parents have to work now, thereby leaving less time for a mom to plan and cook healthy well rounded meals for her family?

    That’s it’s easier and quicker to heat up that box of mac n cheese or go to McDonald’s after working 9-10 hours a day to get that limited health care or other benefits….that the cheaper foods are chock full of HFCS, trans fats, and everything else that’s making us all sick and tired? That eating healthier might actually cost a family twice as much each month, something they might not be able to afford? Or do you just assume that these issues don’t affect the average family?

    and @Bladefist: Nice thought, but if you wait for that to happen, you’ll never have kids. I read a report the other day that a kid will cost (on average) about $218K to raise from birth to 18. That’s up from $100K about 10 years ago. That’s almosot an extra 20K a year you’d have to make. Think that’s easy? If so, maybe I’ll switch to your line of work.

  27. AmbiUbi says:

    And I’m tired of this stupid DMV argument. I don’t pay 6K a year to the DMV for them to provide me service, unlike what I pay for my health insurance. If we all had to pay 6K towards the DMV, I would imagine it would be running a lot smoother that it does now with the limited amount of funding it actually gets. For government programs to work, you actually have to FINANCE them.

  28. johnva says:

    @Bladefist: Our government is ripping us off RIGHT NOW on this issue, but on behalf of corporate insurers. My main point is that social insurance couldn’t be any worse than what we’re doing right now, because what we’re doing right now is horrible.

    @AmbiUbi: Like I’ve said before, I think the reason that a lot of free-market healthcare advocates frequently talk about “fat lazy people”, “smokers”, etc, is to rationalize their own opposition to sharing costs with others. They want to imagine that most people who get sick deserve it somehow so that they can feel less guilty about being greedy because they currently don’t have severe health problems.

  29. AmbiUbi says:

    @johnva: True dat….I mean, I’m healthy now and rarely have to use my health insurance, but I want it to be easy and affordable when I need to do so.

  30. @AmbiUbi: “If we all had to pay 6K towards the DMV, I would imagine it would be running a lot smoother that it does now with the limited amount of funding it actually gets.”

    This is crazy. Bernanke states above “Spending on health-care services currently exceeds 15 percent of the gross domestic product”. And the argument is “we aren’t spending enough” to get it to run more smoothly?

    The answer is allowing each individual to control more of their healthcare dollar so they can judge if they are getting their moneys worth or not. Allowing people to buy health insurance for carriers from different states would at least begin the process of giving us more control of our spending.

    The government does not know how to spend MY MONEY better than I DO.

  31. CRNewsom says:

    @ThinkerTDM: There are also many health issues that are caused by obesity and leading a sedentary lifestyle. Diabetes, heart disease, many joint problems, high blood pressure, gallstones, etc. could be reduced greatly if the *average* American was more physically active. While it is true that, even if you lead a healthy lifestyle, you oould get cancer at any time, you greatly increase your standard of living by being proactive about your health.

  32. redhand32 says:

    Definition of health care reform: Fat cat Republicans with Gold Standard health care plans saying “I’ve got my stash, go get yours whiner. Work 3 McJobs and save up for brain surgery or die. And that goes for you and your kids. If you can’t afford it you shouldn’t have had kids. But, we’re pro-Life just the same Sport.”

  33. AmbiUbi says:

    @IamNotToddDavis: Maybe you missed my point? I wasn’t saying that I think it’s underfunded; I was talking about the comparison some use that government run health care would never work because “just look at the DMV”, a vastly UNDERFUNDED government program. You reiterated my point by stating what Bernake said about GDP. I was trying to draw out the fact that it’s comparing apples and organges..that maybe what…$200 of my personal yearly taxes goes towards the DMV (no actual idea, just throwing a number out there), which runs like crap, compared to the 6K out of pocket I pay for insurance, which ALSO runs like crap? At least I’d be paying less for insurance if it were government funded.

    I feel that problem is that insurance companies are a for-profit system…why would anyone in their right minds think that ANY company is going to chose their profits over your health? If it were government controlled, I would imagine it would revert to a non-profit system. And, as far as I know, insurance companies already can be based in other states? I know at least car insurance can…and I believe although my BRANCH of BCBS is based in PA, the main BCBS is elsewhere.

  34. nedzeppelin says:

    @ironchef: right, a natural disaster can strike anywhere, sure, but living along the gulf coast is certainly a riskier proposition to build your house than the middle of nebraska, right?
    so why should the people in nebraska pay to build homes in the gulf coast? get the point?
    also, a major cause of cancer is smoking, which is preventable.

    we could easily afford all the healthcare for everyone in the country if we were only paying for injuries or illnesses not caused by personal lifestyle.

    so it’s up to you.. govt paid healthcare, and the govt gets to tell you what to eat, exercise, what activities you can do, how often you can drink,
    or you can just choose on your own and pay for your own healthcare.

    i don’t like big brother having any more power than he already has so i go with option B there.

  35. nedzeppelin says:

    @AmbiUbi: absurd. healthy food is cheap. you don’t have to go to whole foods, you know.
    processed food always costs more than fresh. check out fruit and vegetable prices sometime.
    people are fat and lazy because they choose to be that way, and because exercise is hard.

    i think it’s funny that you compare mac n cheese to mcdonalds? neither of those is healthy. but i guarantee you a box of mac n cheese costs less than 3 or 4 mickey d’s meals.

    if you think poverty makes people fat, go to a 3rd world country sometime. not having enough money to buy food makes you skinny, not fat.

  36. LogicalOne says:

    @worksintheory: Add to that, not-for-profit pharmecutical companies, hospitals, and doctors and then maybe you’ve got something there. How about that? Health care for the benefit of its patients and not the wallets of those in the industry? Wow, now that would be something to see!!!

  37. smonkey says:

    The DMV argument might be a bit of a strawman, but we can look at other government programs as an example. For instance 75 cents on the dollar of federal wellfare goes the bureaucrats in overhead. When you compare this to 25% overhead at the red cross, it a serious contrast. I won’t even touch Social Security vs a standard union pension plan.

    Sure HMO’s and insurance company’s are evil. I’m not going to claim they aren’t. However look at the GWB and the cronyism that has that has been rampent in his administration. While difficult to change insurance companies, it’s easier than changing governments.

    We could get into the morality of the system as well. Think of what could happen when they need to cut costs. Your personal choices will be made for you in the interest of your health.
    For instance:

    No motorcycles, morbidity rate is to high
    Manditory condom use to lower STD rates,
    Mandatory exercise time.

    Sure these are far fetched and fanciful, but 20 years ago do you think they would have outlawed smoking and talked about taxing fast food in the interest of public health?

  38. HIV 2 Elway says:

    @nedzeppelin: Many economists feel that low income people eat fast food and smoke because it provides instant gradification. They don’t have the long term gradification that comes with a successful carrer so they take the easier more instant approach.

    I have a hard time believing that someone is so overworked they can’t fix healthy meals. My gril friend and I work full time and go to grad school part time in the evenings and still have fresh meals everyday. Its a choice, some see their health as a priority and exercise and eat well, others would rather watch TV.

  39. PunditGuy says:

    @nedzeppelin: This just in: Fast food is readily available in Canada. European nations don’t tell their citizens that they can’t drink or smoke.

    Meanwhile, in the U.S. of A., your employer can regulate whether or not you smoke in your own home, as an attempt to keep health care costs down.

    Private health care is better than public… why, exactly?

  40. randombob says:

    I think the disconnect here is that the Repubs have a point, and in fact are largely right.

    EXCEPT that the system they point to is CORRUPT, and in fact does not work like they want to say it does because of the kickbacks, backroom deals, and tie-ins with the gov’t.

    Most republicans look at it and say “keep gov’t out” and that’s a great concept, except that it DOESN’T HAPPEN THAT WAY; instead the private sector buys off the gov’t, makes deals with it, to the detriment of the layman. If you don’t think so then why does Canada get cheaper drugs than Americans, from American Drug Companies….?

    liberals look at it and say “Gov’t run would be better” when what they really mean is “since they’re dealing w/ the gov’t anyway, we want it regulated as such with full transparency.” As in, they want the fact that they’re playing together to be recognized and dealt with fairly for all.

  41. ThinkerTDM says:

    @ CRNewsom: Type II diabetes is *influenced* by lifestyle. Type I (me) is not.
    If I am reading this right, the thought is that prices should be higher to punish those who choose an unhealthy lifestyle, with you as the basis for healthiness.
    If you smoke, then you should pay more. If don’t exercise, then you should pay more.
    One glaring issue is defining who should decide what is a healthy lifestyle, and what is not. We all agree that extremes can easily be determined, but what about the majority of us who are not in the extreme? Who decides what is healthy?
    People like you, apparently the healthiest among us, think that they have the right to decide what is healthy for the rest of us. I am pretty sure I can find something about you that would put you in a risk category, no matter how perfect you think you are.
    Fill up your vehicle with gas? Gas fumes can be toxic. Drink any alcohol at all? Alcohol is a poison. Do you live in an area with a high number of pollutants? Bad mistake.

    In fact, I have seen many people- the so called fatties and lazy who have no problems at all, while your so-called healthy person has multiple health conditions.
    Why? Just dumb luck. And that is my point.

    Bad luck is responsible for just as many medical conditions as a so called unhealthy lifestyle.

  42. Trai_Dep says:

    It’s fine that the chairman of the Fed addresses the Heath Bar crisis, but I’m deeply concerned that he’s neglecting the Snickers crunch.

  43. @AmbiUbi: “ I was talking about the comparison some use that government run health care would never work because “just look at the DMV”, a vastly UNDERFUNDED government program.

    The DMV argument is idiotic, and I agree that this is a useless analogy. What I can use instead is our current Government run health care programs -Medicaire and Medicaid. They are not fiscally solvent by any reasonable measure, and the costs of maintaining these programs and benefits at current levels is already more than we can afford. All this does is reinforce my point that GOVERNMENT PROGRAMS ARE NOT A FRUGAL AND COST EFFECTIVE WAY OF SPENDING MY HEALTHCARE DOLLARS.

    What is proven by both history and economics is the free and open market is a much more cost effective means of distributing goods and services than the government.

    This isn’t a republican/democrat thing. It’s a logic vs. insanity thing.

  44. AmbiUbi says:

    @nedzeppelin: I don’t go to whole foods, and think that places like that shouldn’t even be in existence (but that’s for another day lol). I do the shopping for my house. I know what I spend. Maybe we have different definitions of “expensive”. To me, 9 bucks for one small steak, 4 bucks for one artichoke, or 12 bucks for 3 chicken breasts is “expensive”, and adds up quickly. Maybe not for you?

    Kraft Mac n cheese (around $1.40 a box where I live) is comparable to a cheeseburger on the McDonald’s menu prices (I don’t know ANY poduct of mac n cheese that would be equal to 4 mcdonald’s meals). The only point was, neither was a “healthier” option, like you said, yet these are “cheap” and “quick and easy” foods that can work their way into every family’s budget, and do, probably more often than they should. But I pose the question again, WHY is that so? I think it’s because people have less time.

    And malnutrition does a variety of things to a variety of people. Depends on what you manage to get to eat in one day. You may have killed your own point by trying to imply earlier that skinny must automatically mean healthy (or at least, that’s what I took out of it when you said Americans are fat and lazy and therefore, UNhealthy). One may be 100 pounds over weight yet can still be malnourished.
    I’m glad for you that you are seemingly healthy and have time to get all the excercise you need. That doesn’t mean the rest of us do, nor does it mean you’ll always have it that easy.

  45. gibbersome says:

    A free market does not require the existence of competition, however it does require that there are no barriers to new market entrants. Hence, in the lack of coercive barriers it is generally understood that competition flourishes in a free market environment. With increased competition the consumer’s satisfaction becomes paramount to success.

    Why does this free market principle not work with health care? Anyone have a thought?

  46. Wormfather says:

    @Viva La Volvo: You mean “heath”, you were having a Heath Bar, I so jellous, I feel like I got wtfpwnd.

  47. ironchef says:

    @nedzeppelin: Cancer happens to people who don’t smoke. Fat people, smokers and people with birth defects are nearly impossible to self insure right now.

    And if you are unlucky to be 50 and over but don’t qualify for medicare yet, it’s almost impossible to get covered.

  48. cef21 says:

    @LogicalOne: Not-for-profit doctors?

    So, let’s get this straight. You expect somebody to go through college, medical school, internship, residency, plus any time learning a specialty and then be willing to accept a “Not-for-profit” wage??

    As for “non-profit” drug companies, are you aware that every year, the pharmaceutical industry spends billions of dollars developing drugs, a very small portion of which will make it to the market. Do you think that they’re going to spend those billions if they’re not allowed to recoup that investment or to earn a profit when they’re successful?

    And, incidentally, most hospitals ARE not-for-profit.

  49. johnva says:

    @IamNotToddDavis: Except that Medicare and Medicaid actually have lower administrative overhead than private insurers do. The only sense that Medicare is “insolvent” in is that costs are growing at a rate beyond the funding available. But that’s also true of private insurance that pays for healthcare. The underlying problem for both is just that healthcare is getting too expensive. Your argument isn’t a valid argument that government-run healthcare is worse. The only difference between the two is that private insurers have more methods available to them to dump the most expensive patients on the government, while the government has noone to dump them on. So a lot of the people who can’t get private insurance end up on Medicaid, etc, inflating the program’s cost.

    The real question is which way of managing healthcare dollars is more efficient? And the answer to that seems to be a government system, not a patchwork of private insurance providers.

  50. AmbiUbi says:

    @IamNotToddDavis: Okay, thanks for clarifying, because I do agree with you about the DMV argument.

    However, it does bother me that we throw billions at war without blinking an eye, yet have reservations at providing the same amount of funding for something like Medicare that might SAVE lives instead of taking them away. It also bothers me that some CEO makes the decision on whether or not I get quality health care if it doesn’t meet his bottom line. While I think that completely funded government health care may be too “socialist” for some (though I can’t understand why), I do not believe the current system is working good enough for most, and SOMEthing needs to be done. Leaving it alone, or giving me a crappy 2K tax writeoff for something I spend 6K for is not good enough for me.

  51. ironchef says:


    Healthcare is an inelastic market.

    -drugs are protected by exclusive patents and enjoy protectionist restrictions.
    -once you are in an emergency room, you can’t exactly shop around for treatment or haggle on the operating table.
    -medical care providers could charge practically any price for nonelective treatments.
    -hospitals don’t have to quote a price for treatment and stick with their quotation.
    -patients have little or no substitutes for treatment.

  52. Trai_Dep says:

    I could buy the fact that “socialist” health care was subpar, irresponsive and wasteful if the GOP politicians who have “socialized health care” (for life, with ZERO deductible) turned it down because it was so awful.
    But they don’t. They love it. For themselves, not the unwashed masses. In fact, the current GOP Presidential candidate has never had non-“socialized” health care for his entire life. And do you know that he’s really, really old?!
    I’d gently suggest that if gov’t-run health care was THAT bad, the Republican pols would flee from it. I’d also suggest the rank hypocrisy they show, but that goes without saying…
    Although I am wryly amused that their followers don’t realize they’re being played. That brings chuckles.

  53. @randombob: “liberals look at it and say “Gov’t run would be better” when what they really mean is “since they’re dealing w/ the gov’t anyway, we want it regulated as such with full transparency.”

    Then there are those of us who are neither liberal nor republican who look at the 9% leaving their paycheck each month for Medicaire/Medicaid and wonder how anyone can make the argument that giving the government MORE of my money will somehow resolve this issue.

    Medicair/Medicaid is currently dealing with the reality of $85.6 trillion in unfunded liabilities for the forseeable future. Either taxes will have to be raised significantly or benefits restricted to keep from bankrupting the system. And this is the shining example those who are for US government run health care?

    “If you think healthcare is expensive now, wait until it’s free” PJ O’Rourke

  54. nedzeppelin says:

    @PunditGuy: that’s beside the point, as americans are twice as fat as canadians and europeans. that’s just the way it is.

    your employer cannot regulate whether you smoke in your own home.. that’s dumb. they can choose not to employ you, but they can’t force you to stop.

    however, if i’m going to pay your health bills, then the govt should force you to stop.

    i’d rather keep my freedoms and pay for my own healthcare.

  55. nedzeppelin says:

    @AmbiUbi: a box of mac n cheese can feed 3 people.

    a mcdonalds hamburger can’t even feed one.

  56. nedzeppelin says:

    @PunditGuy: tha@ironchef: if so much of the pie wasn’t going towards preventable illnesses and injuries, we’d have more than enough to pay for when you happen to get cancer as a result of something else.

    how many billions get spent every year just on diet pills that do nothing? case in point.

  57. gibbersome says:


    I think you’ve raised a very good point. Subsidize medical education to lower the burden on students. Also reign in malpractice insurance, better hours for residence (so they’re not working 36 hour shifts).

    As it stands now, most doctors graduating come from wealthy backgrounds. I’m in a medical school and there are barely a dozen students out of a class of 160 that come from lower income families; hence, most have no clue what it is like to live without adequate health care.

    Big pharma will continue charging exorbitant prices since the cost of successfully bringing a drug to the shelf is enormous. For every one drug that makes it, there are several others that fail. This means there needs to be increased funding to government sponsored programs. How about a health care tax that funds this “non-profit” drug research? Also, we need to completely rethink the way we do drug testing, not only how they are testing, but where.

    Once China and India catch up technologically, I think we’ll see many more peer reviewed articles and research in medicine.

  58. AmbiUbi says:

    @nedzeppelin: Ugh, forget the price issue. The point is, whether you eat a serving of boxed mac n cheese, or one fast food burger, BOTH are cheap, NEITHER are healthy.

  59. HIV 2 Elway says:

    Anyone who values their freetime over their child’s health and nutrition (“because people have less time”) is far to selfish to have children.

  60. nedzeppelin says:

    @AmbiUbi: price check on a bag of apples? a bunch of bananas? a bag of rice?

    healthy food is cheap. it just isn’t loaded with high fructose corn syrup and hydrogenated oils that americans are so used to.

    how do people in other parts of the world who make so much less than americans manage not to spend even more on mcdonalds?

    it takes processing to make foods unhealthy, they don’t come out of the ground that way. that processing adds cost, it doesn’t take it away

  61. gibbersome says:


    Thanks, you raised some good points! What about the other side of the coin, insurance?

  62. HIV 2 Elway says:

    @gibbersome: How about doing away with the FDA?
    /totally serious

  63. @johnva: “ Your argument isn’t a valid argument that government-run healthcare is worse. The only difference between the two is that private insurers have more methods available to them to dump the most expensive patients on the government, while the government has noone to dump them on. So a lot of the people who can’t get private insurance end up on Medicaid, etc, inflating the program’s cost.

    My argument is simply that the government will not be more efficient at spending MY MONEY than I am. And if people truly want healthcare costs to go down than they should support any efforts to take more control of their own spending. HSA’s have been extremely efficient in helping people save money tax-free for health care costs, which supports the fact that individuals know how to spend their own money better than the government.

    The government also restricts a true open market in healthcare services by preventing people from being able to shop for services throughout the country. If the government takes over healthcare insurance for everyone, sooner or later I will be paying a lot more than I am now.

  64. nedzeppelin says:

    monopolies result in higher prices for the consumer.

  65. helloashley says:

    I don’t think that subsidizing medical education will significantly help our healthcare system without reform of the rest of it, too. Even with additional scholarships and grants for all medical students or even special scholarships for students who agree to become primary care physicians, it’s still not enough incentive. A medical student is smart enough to do the math that even with subsidized medical education, they will make more money over a lifetime as a cosmetic surgeon than a primary care physician working with Medicaid patients.

    Also, isn’t it funny that the American Medical Association hasn’t approved the opening of new medical schools or increasing teh number of new physicians? The number of physicians graduating from American medical schools every year has stayed stagnant but the US population is increasing.

  66. bifloman says:

    Health care insurance is affordable in this country, people just choose not to buy it. I have no choose, my employer forces me to buy it. As a sideline, I own a few condos/apartments and rent to lower income folks. Most of my tenants have big screens, cable, computers, cell phones, call waiting, call blocking, many DVDs, well you get the point. Think about all the money spend every month for all that. It can easily run into the hundreds of dollars a month. There’s your health care premium. Our current system is not perfect and neither is “socialized medicine”. Try getting an appointment in Canada or the UK. There is no incentive for the Doc to see patients. They get paid the same whether they see 1 patient or 20 in a day. I don’t know what the solution is but it is probably a combination of our current system and the Canadian/UK system.

  67. johnva says:

    @IamNotToddDavis: We’re not just talking about you; we’re talking about the most efficient means to provide healthcare, society-wide, to everyone. And private insurance ain’t that.

    People are not always capable of “shopping around” for health services. The fact is, most people don’t know what services they truly need and do not need. You can easily see this when studies show that people on HSA plans consume less healthcare that is clearly beneficial at preventing disease, such as routine Pap screenings and vaccinations. So actually I don’t agree that HSAs will lower costs, long-term. They certainly make people consume less healthcare in the short-term, but at the cost of their long-term health (which may well end up costing the insurers more in the end). So no, individuals do not know how to spend their own money better than the government, if the government or insurer policies are based on sound scientific evidence. Further evidence: look at how popular “alternative health” is. Most of that stuff doesn’t work at all, and yet people spend tons of money on it because they don’t know better. Doctors should be in charge of healthcare spending decisions, not insurers and not individuals.

    Also, HSAs don’t work very well at reducing the costs of chronic diseases and catastrophic care, which consume most healthcare dollars anyway. In those people, even a high deductible would be consumed rapidly because their care is not optional for them. So at that point it just reverts to a normal plan where the insurance company is paying for everything and the HSA provides no incentive to keep costs down. Any proposal needs to recognize the fact that it isn’t all this optional junk that is making health insurance expensive, for the most part.

    And also, how are people who are medically uninsurable supposed to “shop around” for insurance if no insurer wants them? The only way those people get care right now is through group plans where the insurer is basically forced to take them on, or under government care. Eliminate group plans, and they are either SOL or dumped on the taxpayer. And that just means that insurers get all the profits while the taxpayers foot most of the risks.

  68. johnva says:

    @bifloman: Not true that people just choose not to buy health insurance, in many cases. You’re ignoring the fact that in the individual market (ie, not on group plans) everyone pays different prices. If you have a “preexisting condition” then your premium is going to be WAY higher than a few hundred dollars a month, I assure you, if you can even get insurance at all. So for a lot of people, no insurer will sell them insurance at a price they can afford. And the list of “preexisting conditions” that make you uninsurable is growing all the time, because insurers are trying to do all they can to dump people who actually cost them money. They want people to just pay high premiums and never use their benefits in order to maximize profits.

  69. HIV 2 Elway says:

    individuals do not know how to spend their own money better than the government,

    Most depressing comment I’ve read. Even more depressing that people actually believe it.

  70. johnva says:

    @HIV 2 Elway: Your comment is based entirely on anti-government ideology. The fact is that people aren’t equipped with the knowledge to decide what medical tests and treatments they need, much less perform an informed cost-benefit analysis. That’s why they go to doctors, instead of just treating themselves. You ignored the second part of that sentence, which was that the government policy should be based on sound scientific evidence. That is just like what private insurers do with their determinations of whether things are “medically necessary” or “experimental”, only the insurer is the government under a socialized system. I know you don’t want to believe this, but it’s true.

  71. bifloman says:

    @johnva – Look at Walmart they provide health insurance, which incidentally is better than provided by my employer, but most of Walmart employees do not buy into it. Why? Becuase they want it for free. All I am saying if people cut out all the things they really do not need, they would be better off.

  72. johnva says:

    @bifloman: No, it’s not because they “want it for free” that they don’t buy in. It’s most likely that their pay is so low that medical insurance consumes an unacceptably high percentage of it. I agree that people should not waste their money on frivolous stuff before attending to their needs like healthcare. But that’s a lot easier choice to make when you’ve got more disposable income. Also, under a single-payer plan, all those people would be forced via taxation to pay for insurance.

  73. nedzeppelin says:

    @johnva: people don’t treat themselves because:
    a) most medications for treatment are regulated so we’re not allowed to get them
    b) a lot of people are stupid and incapable of caring for themselves, so the rest of us have to have a government-mandated handholding.

  74. anarcurt says:

    Most medical expense occurs in the final 10 years of a persons life. Our medical system is broken because the assumption is that every person should be saved regardless of the cost. We spend more to keep the very elderly alive (kinda) than we do to keep our workforce and future workforce healthy. From an economic point of view that makes no sense. I know noone wants to put a price on a persons life, or at least whats left of it, but we live in a world with finite resources. The truth is that the costs of one person in a nursing home under Medicaid can cover the medical expenses, on average, of at least 3 whole families. If we are going to have the government have any part of the medical system then we need them to triage.

    The youth of this nation can no longer bear the weight of debt being piled on us by our irresposible parents and grandparents.

  75. johnva says:

    @anarcurt: I agree that that is part of the problem, along with new technology that makes it possible to extend people’s lives ever longer. I don’t know what the solution is, but we should probably be careful before we go down the road of deciding whose life is more important than someone else’s. That logic could easily be extended to, for example, kids who are born with nasty conditions like Down’s syndrome, or cystic fibrosis. Personally, I think we just need to come to grips with death better than we have in this country. People probably wouldn’t want this extraordinary level of health care before they die if they weren’t so afraid of dying.

  76. ironchef says:

    @anarcurt: maybe you can start a Logan’s run style of culling society and get rid of all the old people before they burden your poor youthful self.

  77. bifloman says:

    @johnva – you make my point, they can’t afford to buy in because of the all the unnecessary things that consume their income. The premiums the employees at Walmart have to pay are very low compared to other group plans.

  78. HIV 2 Elway says:

    @ironchef: No Sandman ever ran.

  79. Tiber says:

    @gibbersome: “

    A free market does not require the existence of competition, however it does require that there are no barriers to new market entrants. … Why does this free market principle not work with health care? Anyone have a thought? “

    Because there will always be barriers to entry, even though the barriers may be created by the free market itself. For instance, a new insurance company will face competition from the existing large corporations. Those large corporations can offer better rates and better coverage because they can spread their costs among a large number of people, and use their size as leverage to reduce costs and lobby in government. The phenomenon is not unique to health care, but health care requires a lot of capital to get started.

    @Bladefist:@IamNotToddDavis: I am personally for socialized health care, but I do agree that government should be fixed first. Theoretically, the government SHOULD be able to get the best value for the money. Government contracts are lucrative, so the government could have companies bending over backwards for them. Yet something’s clearly going wrong.

    What we really need is to abandon partisan bickering over pointless things like gay rights (No matter what your thoughts are, surely you can agree that there are more important issues), get rid of this whole “America is the bestest country in the world and can do no wrong” attitude, and take a long hard look at how the government is managed. Bring in some business experts and have them look at Government as if it were a business. Europe can apparently do health care right, so why can’t we? Do we need to send guys with butterfly nets to Ireland to hunt for fairies or something? America may have more area to cover, but that’s not enough of a reason.

    I simply think that the government has the POTENTIAL (as in, in the most perfect world possible) to be the best method of ensuring health care for all. I agree with you on many points. The place where our opinions differ is that your solution seems to involve marginalizing an ineffective government in favor of improving upon the free market model, whereas my solution involves fixing the government and marginalizing an ineffective free market.

  80. anarcurt says:

    @johnva: Excellent point made, especially on the afraid of dying point. I have nothing against these people having expensive care given to them to keep them alive, I only have a problem of who should pay for it. Rather than having the rest of us foot the bill it should come down to the choices people make, namely saving enough money or buying LTC insurance.
    I do not support Eugenics, someone born with an abnormality is completely out of their control. However, making the CHOICE to extend your own life at such a heavy cost should also involve the CHOICE of the individual as to how they will pay for it, not just passing the buck to the rest of us.

  81. nedzeppelin says:

    @anarcurt: hey i totally agree.
    i don’t expect anyone to spend millions of dollars to keep me in a coma for a few extra weeks when i’m 80.

  82. johnva says:

    @bifloman: If you’re making just above minimum wage, there isn’t much room for any kind of luxury. But I question whether those people actually are living with a bunch of unnecessary stuff. Anyway, without knowing the actual numbers of what you’re talking about, I can’t speak intelligently.

    You’ve got to admit that it’s a problem that health insurance costs are rising so much faster than wages, especially for people at the low end of the wage scale. It’s not just that those people are choosing not to buy it. That might explain SOME of them, but not 47 million people. And lots of low-wage employers don’t even offer health insurance at all. Individual insurance is more expensive, especially with preexisting conditions, so those people don’t have a lot of options.

    And assuming you are right, that’s an argument FOR universal healthcare. With a tax-based insurance system, everyone would have to pay in whether they want to or not. Low-wage people obviously would pay less, but they would still pay something.

  83. johnva says:

    @nedzeppelin: The problem is it’s easy to say that when you’re young and healthy. It’s not so easy when you’re dying. But I do think better palliative, end-of-life care would do a lot in keeping costs down. I think medicine for the elderly should focus on quality of life rather than treating all illnesses that come up.

  84. nedzeppelin says:

    @johnva: no, it really isn’t. especially if i’m in a coma or unresponsive. i’m pretty sure i wouldn’t care.

    i guess if i think it will be a problem, i should start saving now for those millions of dollars to keep me on life support for a couple extra weeks. then i won’t ask you to pay for it.

    although by then i’d rather just die and give the money away.

  85. nedzeppelin says:

    @johnva: tax and spend!! tax and spend!!!

  86. ironchef says:

    @HIV 2 Elway: Everybody runs ;)

    (different movie though)

  87. @johnva:” So no, individuals do not know how to spend their own money better than the government,

    By that logic, we should just do away with private property and money altogether and just give our money straight to the government for everything because hey- they sure know better than I do!

    The reality is that our (US) system of government was specifically set up to prevent the government from taking money from us to use for things we can do on our own.

    Taken from here-


    “When the Founding Fathers said that “WE THE PEOPLE” established the Constitution to “promote the general Welfare,” they did not mean the federal government would have the power to aid education, build roads, and subsidize business. Likewise, Article 1, Section 8 did not give Congress the right to use tax money for whatever social and economic programs Congress might think would be good for the “general welfare.”

    James Madison stated that the “general welfare” clause was not intended to give Congress an open hand “to exercise every power which may be alleged to be necessary for the common defense or general welfare.” If by the “general welfare,” the Founding Fathers had meant any and all social, economic, or educational programs Congress wanted to create, there would have been no reason to list specific powers of Congress such as establishing courts and maintaining the armed forces. Those powers would simply have been included in one all-encompassing phrase, to “promote the general welfare.”

    John Quincy Adams, sixth President of the United States, once observed: “Our Constitution professedly rests upon the good sense and attachment of the people. This basis, weak as it may appear, has not yet been found to fail.”

    It is NOT the government’s business (constitutionally) to “help” individuals in financial difficulty. Once they undertake to provide those kinds of services, they must do so with limited resources, meaning that some discriminating guidelines must be imposed. (so many who need that kind of help- so little resources to provide it.)

    Quoting the Tenth Amendment, Jefferson wrote: “I consider the foundation of the Constitution as laid on this ground: That ‘all powers not delegated to the United States, by the Constitution, nor prohibited by it to the States, are reserved to the States or to the people.’ To take a single step beyond the boundaries thus specially drawn around the powers of Congress is to take possession of a boundless field of power, no longer susceptible of any definition.”

    If you advocate for federal spending on social welfare programs, you are describing a redistribution of income (MY income) for the benefit of Specific individual citizens INSTEAD of (for example) a strong national defense. Which of those activities is the government LEGALLY REQUIRED to perform? (hint: Art. I, Sec. 8, U.S. Constitution.)

    If the Federal government MUST do certain things, and something is NOT EXPRESSLY STATED in the constitution as a duty of Federal Government, then HOW (or WHOM) should any other services be provided? (Hint: Tenth Amendment)

  88. Trai_Dep says:

    @IamNotToddDavis: “My argument is simply that the government will not be more efficient at spending MY MONEY than I am.”

    Well, actually, it is. Do you have any idea how expensive it would be for you to carve your own roads to work and back? Build a water supply system running from the mountains to your home? Do you have a primary care facility in your laundry room and an emergency care one in your garage?

    Go to your kitchen. Turn on your tap and fill a glass of water. Drink it. How much did it cost? Free, right? Too cheap to measure? It’s a miracle that we forget, it’s so common.

    There are many great things that a free market excels at. Others, not so much.

  89. Bladefist says:

    @IamNotToddDavis: You might as well talk to a wall. Liberals think the constitution is a living document and should be updated every other day. Makes me puke.

  90. johnva says:

    @IamNotToddDavis: I like how you guys just pulled that quote right out of context. You’re just blinded and infuriated by the idea that sometimes the government does a better job than individuals left to their own devices. I specifically qualified that statement, and I was making it only in a very narrow area (healthcare). And I frankly don’t care what J. Q. Adams’ opinion on this. The world and this country are much different now than they were then. I’m sure there were people at the time who disagreed with him, as well.

  91. nedzeppelin says:

    @Trai_Dep: i wouldn’t be building a road by myself. i’d be building it with my neighbors. and i’m pretty sure we wouldn’t have to put up with the substandard labor, backscratching, corruption, and waste that goes along with a 300 billion dollar annual highway bill.

    you seem to be the one who thinks it’s “free” if you pay the government to do it.

  92. johnva says:

    @Bladefist: I could say the same thing about conservatives. You guys think things should never change, or only extremely slowly. It’s like talking to a wall trying to get most conservatives to even acknowledge that things need to change sometimes and that the status quo isn’t always best.

  93. johnva says:

    @nedzeppelin: He never said it was “free”. He said that it was more efficient for the government to do it than for private individuals to collaborate to do it. And he’s right. We would have nowhere near the economy we have right now if the roads were all privately owned.

  94. nedzeppelin says:

    @johnva: where’s your proof?
    can you name me one thing the government does do efficiently?

    his example was roads.. roads?
    we spend 300 billion dollars on “roads” every year. more like on political kickbacks and pet projects and teamsters.

    do you really think it’s possible to spend an entire iraq war on roads every single year? or 3 international space stations? and still have bridges that fall down?

    you call that the model of efficiency?

    what else has the government done efficiently and solvent? social security? bzzz. medicare? bzzz.

  95. JeffDrummer says:

    Let me just say, Conservative are more “Liberal” on guns and the economy. Liberals are more “Conservative” the same way. That’s why we say Right-wing and Left-wing, it keeps things simpler.

  96. @Trai_Dep: Do you have any idea how expensive it would be for you to carve your own roads to work and back?

    Do you have any idea how inefficient and corrupt government road construction is? I’m from Boston, ever heard of the big dig? Not exactly a monument to efficient government-run services. Currently many countries are using more and more private sector businesses to build and maintain roads, and they are much more efficient than the government. For every government-run public works I could show you a more efficient private run system. Just because we don’t have it doesn’t mean it doesn’t exist.

    Oh and btw, privately run rural roads are making a comeback-Canada’s Highway 407 near Toronto, the U.K.’s M6 motorway are two examples.

    There are many great things that a free market excels at. Others, not so much.

    But none of them are run any better by a Government system. That they are government run systems now doesn’t mean they are some model of efficiency. Again, Medicaire and Medicaid are fiscal disasters. Social Security is almost as bad. How anyone can make the argument that they are MORE efficient is just asinine.

    @johnva: I specifically qualified that statement, and I was making it only in a very narrow area (healthcare)

    And I am disputing it in this area. In regards to healthcare, the government does not know how to spend my money better than I do, mainly because they will make me pay for things I neither have asked for nor want. The free market will not limit my options in the same way. If you want to make a statement like that, then be prepared to defend WHY.

  97. MrEvil says:

    @Bladefist: Or how about not letting the states with douchebag DMVs run healthcare? I’ve NEVER waited more than 15 minutes at the Department of Public Safety in Texas for any driver licence issues. Renewing vehicle registration takes even less of a wait, walk up to courthouse, present title, give money, receive plates and/or sticker. Last time I had to purchase registration it took 10 minutes and that included filing an application for a new title.

    I swear, I think Texas really hates bureaucracy or something.

  98. johnva says:

    @nedzeppelin: @IamNotToddDavis:

    Medicare and Medicaid are run more efficiently than most private insurers. They have lower administrative overhead, and get better results per dollar. They ARE NOT fiscal disasters, at least not in comparison to private insurance. They are just costing an increasing amount of money because healthcare costs are soaring. But it’s not because they’re badly run.

  99. ironchef says:

    the private sector isn’t all that great either.

    Government has a better chance of bargaining lower cost of drugs than the individual or the largest corporation. I found it strange that the GOP went out of their way to write the medicare drug benefit and specifically bar the government from negotiating the prices of prescriptions like it can with the VA. That’s why governments in Canada and UK can get the same drugs but at a fraction of the price America is paying.


  100. SadSam says:

    Of course UHC is going to cost buckets of money. Last night on 60 minutes there was a segment on how people from Denmark (who-hoo, I’m Danish) rate the highest on happiness. The Danes have free health care, subsidized day care, free elder care, college kids are paid to go to college, new moms and dads get a year off of work, workers get 6 weeks in vacation per year, etc. How much do they pay in taxes? 50% How much do I pay in taxes? 33% on income, plus real estate taxes, sales tax, etc. I would guess, I’m sure you’ll let me know if I’m wrong, that my total tax burden isn’t too far from 50%. Seems like us Americans might benefit from slightly higher taxes and much better benefits.

  101. @johnva:
    Medicare and Medicaid are run more efficiently than most private insurers

    Medicaid patients were statistically significantly less likely to receive short-term (less than 24 hours) medications and to undergo invasive cardiac procedures than patients covered by HMO and private insurance. They also had higher mortality rates (2.9% vs. 1.2%; adjusted odds ratio, 1.33; 95% CI, 1.08 to 1.63).

    They ARE NOT fiscal disasters, at least not in comparison to private insurance.

    Show me one private insurance company that is anywhere near as fiscally insolvent as Medicaire and I will show you a private insurance company that is no longer in business. If not for the federal subsidy, Medcair/Medcaid would be a bankrupt company.

    They are just costing an increasing amount of money because healthcare costs are soaring. But it’s not because they’re badly run.

    Bzzzzt again.
    “One estimate states that fraud and abuse cost Medicare and Medicaid about $33 billion each year. Worse, it’s ridiculously easy to cheat the federal government and taxpayers out of millions of Medicare and Medicaid dollars, according to three convicted felons appearing yesterday before a Senate panel.

  102. ironchef says:


    You won’t have CEO’s converting those insane premiums into a cushy payday.

  103. johnva says:

    @IamNotToddDavis: Your link shows that the main problem with Medicaid is that doctors won’t accept it due to low reimbursement rates. If the government were the only game in town, doctors wouldn’t have a choice.

    Also you need to compare apples to apples. Medicare and Medicaid have much more unhealthy patient populations than most private insurers, who don’t want those people. That’s the main reason Medicare exists. The reason private insurers don’t have as high costs, as I ALREADY SAID, is that they can dump expensive patients.

    And you don’t think a lot of fraud against private insurers exists???

  104. @johnva:”Your link shows that the main problem with Medicaid is that doctors won’t accept it due to low reimbursement rates. If the government were the only game in town, doctors wouldn’t have a choice. “

    That’s not at all what it shows. The report notes Doctors are not happy when they get a Medicare patient because they will not get paid the same amount as a privately insured for the same service, not that they refuse to accept it. But I am beginning to realize that this is a waste of time to attempt to explain. Your argument is that because there is a profit-motive for Doctors (SHOCK! HORRORS!) the government should step in and “level the playing field”.

    This is income redistribution, plain and simple. If the government were the only game in town we would all be medicare patients, and pardon the french but F*ck that noise.

    Medicare and Medicaid have much more unhealthy patient populations than most private insurers, who don’t want those people. That’s the main reason Medicare exists.

    And I’m all for subsidizing this and other social safety net programs for those who can’t afford it for precisely that reason. They can’t afford it. Great, wonderful, peace and love. It sucks that these programs are going broke at a breakneck pace, but at least it’s available for now.

    The reason private insurers don’t have as high costs, as I ALREADY SAID, is that they can dump expensive patients.

    Huh? So if a patient gets too expensive they can just dump them without any penalty?

    Really? Right out the door? Are you sure?

    And you don’t think a lot of fraud against private insurers exists???

    I do, but it’s a fraction of what Government programs endure.

  105. nedzeppelin says:

    @johnva: umm no they simply have bigger pools to make in the denominator
    if an insurance company had 10x as much volume of business, they’d appear to have lower overhead costs too.

    secondly, real world companies are bothered by this thing called solvency, which the govt is not concerned with. medicare is set to go belly up in 2017 i believe?


    i call “insolvency” a fiscal disaster. in which case every private insurer in existence today passes that test, and medicare does not.

  106. nedzeppelin says:

    @SadSam: wasn’t that the same 60 minutes piece that said danes score highly on these “happiness” surveys simply because they don’t know any better?

    the allegory of the cave

  107. ironchef says:


    [i]Huh? So if a patient gets too expensive they can just dump them without any penalty?

    Really? Right out the door? Are you sure?[/i]


  108. @ironchef: Tarsha Harris is currently suing the crap out of Blue Cross via The Quisenberry Law Firm. Blue Cross broke the law and should be held accountable. And most likely they will be. I am not defending Insurance companies that break the law, but no system is out there that will prevent this from happening. And most certainly not a government run system.

  109. johnva says:


    I’m not against income redistribution. In fact, I’m for it. That’s why I support what I support. Duh.

    As for “dumping patients”, one thing they do is raise your rates the next year to such a level that many people can’t afford it. They know that a lot of people will cancel if they do that. (I’m talking about the individual insurance market). Many insurers create new “plans” every year. If they decide you don’t qualify for the new plan, you’re stuck with the old one (which they have to keep offering by law in many states). But now the old one is a riskier pool, because all the people healthy enough to qualify have moved on to the “new” pool, and the old one just contains the people who didn’t qualify. So they raise everyone in the old pool’s rates. The intent is to “fire” expensive customers by making things unaffordable to them. Insurance companies are expert at negotiating state laws in order to legally get rid of people who are unprofitable.

    @nedzeppelin: I agree that the reason Medicare is more efficient is because it has a larger pool. That’s one of the biggest problems with private insurance…it divides up the pool and duplicates administrative overhead across many insurance companies.

    As for Medicare insolvency, I still think you’re not getting what I’m saying. The reason why private insurers are not going bankrupt despite constantly rising costs is because they are “innovative” in finding new and creative ways to get only profitable customers and get rid of the unprofitable ones. You can’t compare the two, because the goal of the government programs is to make sure that everyone has decent care. That is not the goal of insurance companies, being for-profit entities. They are just intended to turn a profit, and aren’t concerned with covering everyone. No one expects Medicare to be “profitable”. And if Medicare is insolvent, the solution is simple: cut benefits or raise taxes.

  110. johnva says:

    @IamNotToddDavis: Seriously your whole objection to something like single-payer seems entirely faith-based. There isn’t a huge difference between a government insurer and a private insurer, except in how they’re funded. You just object to government because you object to government, and that’s your ideology. The status quo is NOT more efficient. We pay more for medical care than any other country and get less for our money than 35 or so other places.

  111. cyclade says:

    For all the freshman econ 101 being thrown around in these comments, let’s take a deep breath and remember the concept of “market failure.” Healthcare is a classic.

    To paraphrase the old Pogo cartoon, we’ve met the enemy and it is us. Or rather, it’s our exaggerated expectations of the healthcare system and providers’ bad incentives to sell us all what we (or rather, our insurance companies, with the right diagnostic coding in the computer) are willing to buy. Got a twisted ankle or a sore knee? Nobody will accept a simple and cheap x-ray; we want an MRI. Feeling blue? Forget prescriptions for free lifestyle changes, or even some sessions of talk therapy; you can get a year’s worth of mood-enancers for just 5 bucks a co-pay. We have virtually inelastic demand when it comes to our health – and virtually zero information about medicine and the appropriate diagnoses and treatments we may need.

    We want a pill, a patch, an easy-breezy fix, the latest and greatest diagnostic tools. And we want it now, because our friend/aunt/co-worker got it, so we’re entitled to get it, too. Sadly, unless it’s going to do us more harm than good, our doctors are going to give it to us because they have every incentive in the world to do so. The more tests they do, the more scrips they write, the more procedures they perform, the more they get paid. Until we can readjust our demands, (or face the “true” cost of medicines, treatments, etc.) – and until doctors and drug co’s are fully transparent about pricing, and risk/benefit realtionships, there’s total market failure and virtually zero relationship between supply, demand, and price with healthcare.

    Which gets to my punch line: Single payer health care now. Seriously. The market is busted every bit as much as say, a private market for automobile and driver licensing (to borrow the DMV analogy) would be. Cut out the for-profit insurance bureaucrats and their mob-like “skim” – because, in reality, a “private” bureaucrat simply can’t be all that much better than old Patty and Selma at the DMV. Besides, the profit maximizing duties owed to private shareholders/investors is inherently in conflict with the “public” nature of much of health care. Put us all in the same pool (with reasonable copays to limit abuse) – more players means more shared risk and lower costs per participant. I’d imagine that whatever “tax increase” would be associated with this would wind up costing less than many people pay for private insurance now, given that making everyone participate in the system means those of us who currently pay for insurance wouldn’t be subsidizing the “uninsured” like we do now. Frankly, I’m amazed that companies like GM, Ford, or others with massive healthcare costs and retiree liabillity aren’t begging for this.

  112. cyclade says:

    @johnva: You said it much more concisely than long-winded me.

    /returns to munching dinner and procrastinating

  113. johnva says:

    @cyclade: “Concise” isn’t the word I would use to describe my posts! But good post.

    I actually remember reading about one of the automaker CEOs (or one of their big lobbyists) recently talking about how our lack of universal healthcare is hurting their competitiveness. They are starting to make noise about it. I expect that that’s when something will actually get done – when all the big corporations start screaming for it. Then the Republicans won’t see it as so much in their interest to torpedo it any longer. I don’t know if we’ll get true single-payer, but I’m hopeful we can do better than we are now.

  114. ironchef says:

    @IamNotToddDavis: a single payer system would improve things dramatically.

    I’m not convinced the private system we have now is working, considering how hard it is for someone to get health insurance. And once you are denied coverage by one carrier, it is impossible to get picked up by another. That’s a fact.

  115. @johnva: So you are for income redistribution. It’s refreshing to hear someone admit that at least. I don’t agree with you in principle primarily because I don’t believe that income can ever be distributed from one group to the other in a fair and orderly fashion, not to mention the fact that income is not a limited number. Theoretically there is no ceiling to what one can earn, nor should there be. Ironically the part you listed about “dumping” already happened here in Tennessee, except it was the government program that did the dumping- Tenncare.

    You just object to government because you object to government, and that’s your ideology.

    No, I object to the idea that “the Gubmint” can be more efficient than the free market.

    @cyclade: “. I’d imagine that whatever “tax increase” would be associated with this would wind up costing less than many people pay for private insurance now, given that making everyone participate in the system means those of us who currently pay for insurance wouldn’t be subsidizing the “uninsured” like we do now.”

    Maybe I read that wrong, but how would making us all pay under the same umbrella make any difference to what we currently subsidize? The people who can’t afford health care now will be under the same system regardless if I am under a private or government run system. You are just changing who handles the money.

    It’s amazing the faith that everyone has in government when it comes to healthcare, despite all evidence to the contrary.

  116. johnva says:

    @IamNotToddDavis: One reason it would lower overall costs is that the people who are currently paying nothing and being “free riders” would be forced to pay something via taxes, even if their income is pretty low.

  117. magnoliasouth says:

    Oh my! The problem here is that the ones who scream the loudest haven’t a clue about how health care really works.

    There are a bunch of problems with health care costs and there is no good way to fix it. It’s this endless circle of stuff that causes these problems.

    Take Medicare and Medicaid. For Americans to believe that the government should pay is like believing in Santa Clause. It’s still NOT free. Taxpayers are paying and the only way to pay it is to raise taxes. It’s just a 2+2 problem.

    By using Medicare, health care providers are forced to accept a set amount of dollars for care and most of the time this doesn’t always cover the cost. They then are forced to charge more to insurance companies and other consumers.

    So why doesn’t it cover the cost? To begin with there are so many regulations that one can hardly keep track. You’ve got OSHA and JCAHO and Medicare and Medicaid and insurance companies and whatever else that I can’t name off the top of my head that have guidelines which must be followed. It takes a million sheets of paper for just one band-aid!

    Also, what isn’t mentioned most of the time is the infinite amount of manpower, time and effort to meet these ridiculous expectations. In case no one has noticed, there is a major nursing shortage out there and no wonder! Trying to keep up with this catastrophic situation causes serious burn out. Not to mention that frivolous lawsuits is just something else to add to the mound. No one wants to do it anymore and why I still do is a mystery even to myself.

    I’ve been a nurse for 19 years and have been in the health care field for 22 years and I’m here to tell you that the health care crisis is only going to get worse.

    In order to lure nurses providers have to fork over more money and where do they get that money? Someone has to pay for it. I’m not going to work for free, thanks, and believe me when I say, I EARN my paycheck. I do the job of 3-4 nurses because we are never fully staffed.

    This is just one area too. There are lab techs, surgical techs, people who clean instruments and the list is a mile long. All of this is just so you can be seen when you’re ill. It will never be cheap and if it ever becomes “free” then God help us because it’s going to be lousy. You’ll get the worst care, if you can even be seen because you’ll wait in lines like you’ve never waited before.

    Go down to your local health department to get a glimpse of what it will be like. It should be a real eye opener.

    It’s really funny because most of these comments are about regulations (government or otherwise) and clearly, more regulation IS the problem.


  118. Trai_Dep says:

    I find it droll that anti-gov’t people are venting their anti-gov’t bile on a medium invented, developed and implemented by the gov’t. Then handed over to quasi-public monopolies. Neither phones nor the internet would exist without your hated “interference”.

    Better start using post cards, guys, because you’re relying on Communistic technology. Otherwise, you have to admit that – yup – some things the free market doesn’t do well that society working together does.

    Oh. Wait. The post office is Socialistic as well.

    Err, signal flags?

  119. mannyv says:

    Well, there are a lot of really weird things in government-sponsored healthcare in the US. An old girlfriend of mine used to work in a treatment facility for troubled teens. It was one of the highest-level facilities, for the really “bad” kids. Cost per child: $580/day. They probably had around 60 kids in there.

    And that was back in the mid 90s.

    The Federal Government is incapable of doing a cost-benefit analysis because in government health care the answer is political not practical. Would any sane human being pay $580/day to treat a teenager? How would you ever be able to justify spending $211,700/year on what basically is a teenager with extreme behavior problems.

    And that’s just a ridiculous cost that I know about. Given the size of Medicare/Medicaid, there has to be more things like this.

  120. Trai_Dep says:

    @mannyv: Are you sure this wasn’t a facility for insured kids? Because it sounds a LOT like the ones that would pack kids in until their the last dime of their (private) insurance was maxed out, then magically declare that they were cured. Err, “cured”.

    In any event, anecdotes don’t change the hard facts: single-payor systems spend a fraction compared to us. Medicare spends 1/10 compared to private, FOR-PROFIT* insurance companies.

    It’s hard for some to wrap their heads around, and simple truth sometimes are the hardest to accept, I realize. But try.

    * “For-Profit” – THINK about it: would their role be inflationary or deflationary to providing health care? Yeesh!

  121. ironchef says:

    @Trai_Dep: the anti government crowd has been DORMANT for the last 7 years, giving Bush a blank check to grow that government an extra 30%.

    So I find much of their rant a bit hypocritical and selectively prosecutorial.

    Just wait until they get a democrat in the white house…then they will whine like they did during the clinton years.

  122. Bender says:

    Maybe this has already been said, but I’m not going through 120 comments to check first.

    You want to know one of the big reasons healthcare costs are rising? Prescription drugs.

    I work for a (non-profit) insurance company, and our biggest expense is prescription drugs. The name brand drugs are so ridiculously expensive, that we conducted a 6 month trial where we would pay 100% of the cost of any generic drug prescriptions. It was cheaper for us to pay 100% of a generic, vs even 40% of a name brand.

    Before we jump into universal health care, I think a lot could be fixed just by implementing government price controls on prescription drugs.

    If you bring down drug costs, you make health care more affordable to everyone.

  123. Bladefist says:

    @ironchef: As a conservative talk show listener, pretty much daily, I can tell you that we (conservatives/republicans) are fully aware of Bush and his spending and increasing the Government. And we are not happy about it. Nobody is out there thinking Bush is a true conservative. I like Bush on some policies, but it’s obvious that he is not truly a social conservative. He is just barely more conservative then John McCain.

  124. Bladefist says:

    @ironchef: If a democrat wins the white house, I would be sleep easy. Unfortunately, there are no democrats in the general election. A moderate and a socialist are running.

  125. johnva says:

    @Bladefist: The fact that you listen to conservative talk shows daily explains a lot about why you have so many misconceptions.

  126. Trai_Dep says:

    @johnva: Well that’s not completely fair. He also watches Saturday Night Live skits to learn about what’s really happening in the world. And Drudge. See: a totally balanced media diet!

    @Bender: Also worth mentioning the GOP give-away to Big Pharma: making it illegal for the Federal gov’t to use its size to negotiate cheaper prices. Note it wasn’t “just” Bush that did it, but the wide swath of the Republican Party. So the “Oh noes, Bush led us astray” meme is as patently false as the “Oh noes, we really want small gov’t, honest!” meme. Or the “Oh noes, we hate deficits” meme, or… Well you get the idea. :)

    Hmm, add those two paras together and you get wildly misinformed and wildly destructive to our nation! Oh, and hypocritical. But we knew that.

  127. ironchef says:

    @Bladefist: talk shows are just talk. no action.

    I watched the whole GOP go along with Bush in lock step. We all came to the conclusion that the small government talk is just a platform to get elected and once you get into power, all that stuff you promised gets flushed down the toilet.

    Let me remind you the contract with America…

    FIRST, require all laws that apply to the rest of the country also apply equally to the Congress;
    SECOND, select a major, independent auditing firm to conduct a comprehensive audit of Congress for waste, fraud or abuse;
    THIRD, cut the number of House committees, and cut committee staff by one-third;
    FOURTH, limit the terms of all committee chairs;
    FIFTH, ban the casting of proxy votes in committee;
    SIXTH, require committee meetings to be open to the public;
    SEVENTH, require a three-fifths majority vote to pass a tax increase;
    EIGHTH, guarantee an honest accounting of our Federal Budget by implementing zero base-line budgeting.

    1. THE FISCAL RESPONSIBILITY ACT: A balanced budget/tax limitation amendment and a legislative line-item veto to restore fiscal responsibility to an out- of-control Congress, requiring them to live under the same budget constraints as families and businesses.

    2. THE TAKING BACK OUR STREETS ACT: An anti-crime package including stronger truth-in- sentencing, “good faith” exclusionary rule exemptions, effective death penalty provisions, and cuts in social spending from this summer’s “crime” bill to fund prison construction and additional law enforcement to keep people secure in their neighborhoods and kids safe in their schools.

    3. THE PERSONAL RESPONSIBILITY ACT: Discourage illegitimacy and teen pregnancy by prohibiting welfare to minor mothers and denying increased AFDC for additional children while on welfare, cut spending for welfare programs, and enact a tough two-years-and-out provision with work requirements to promote individual responsibility.

    4. THE FAMILY REINFORCEMENT ACT: Child support enforcement, tax incentives for adoption, strengthening rights of parents in their children’s education, stronger child pornography laws, and an elderly dependent care tax credit to reinforce the central role of families in American society.

    5. THE AMERICAN DREAM RESTORATION ACT: A S500 per child tax credit, begin repeal of the marriage tax penalty, and creation of American Dream Savings Accounts to provide middle class tax relief.

    6. THE NATIONAL SECURITY RESTORATION ACT: No U.S. troops under U.N. command and restoration of the essential parts of our national security funding to strengthen our national defense and maintain our credibility around the world.

    7. THE SENIOR CITIZENS FAIRNESS ACT: Raise the Social Security earnings limit which currently forces seniors out of the work force, repeal the 1993 tax hikes on Social Security benefits and provide tax incentives for private long-term care insurance to let Older Americans keep more of what they have earned over the years.

    8. THE JOB CREATION AND WAGE ENHANCEMENT ACT: Small business incentives, capital gains cut and indexation, neutral cost recovery, risk assessment/cost-benefit analysis, strengthening the Regulatory Flexibility Act and unfunded mandate reform to create jobs and raise worker wages.

    9. THE COMMON SENSE LEGAL REFORM ACT: “Loser pays” laws, reasonable limits on punitive damages and reform of product liability laws to stem the endless tide of litigation.

    10. THE CITIZEN LEGISLATURE ACT: A first-ever vote on term limits to replace career politicians with citizen legislators.

    So how did you do?

    Term limits LOL
    Fiscal responsibility LOL
    Fixing Social Security LOL
    Taking back our streets LOL
    Reducing the size of govt? LOL.
    Honest Accounting? LOL

    None of it actually materialized. Well maybe the part about UN command of American forces. Instead you replaced it with the Iraqi government dictating the schedule of American troops staying in Iraq.

  128. sirellyn says:

    You only have a finite amount of money before you start either printing money (inflation) or have to borrow money (thanks China). Considering only ONE year when Clinton was president the US actually managed to have a zero sum deficit that year, and the debt is now so high it will only be a few more years until all taxes actually go to paying the interest on foreign loans, how much do you REALLY think you have to spend on a national health care plan???

  129. Bladefist says:

    @johnva: Now you’re starting to piss me off. You’re spoon fed BS from CNN, CBS, NBC, NPR, etc all day and night. I listen to someone on the other side, now I am the crazy one? Oh excuse me for wanting to hear the other side of the argument. I guess I’ll sit there like a zealot and watch Larry King and Keith Olberman explain it to me.

    You keep getting your politics spoon fed, and I’ll listen to people who actually do a little bit of research. I don’t have any misconceptions about jack shit. You are the socialist. Not me. I respect the Constitution, and the original Government job description. Not you. Smart people listen to both sides. You wouldn’t believe the number of democrats/liberals that call into Rush Limbaugh and debate with him. Those are the democrats who are listening, learning, and have the balls to call him up and debate an issue, while you hide in the background and speak down about that which you do not know.

  130. Bladefist says:

    @ironchef: I’m a conservative before a republican. Also my part affiliation is based on principals. If the GOP continue down this road, I’ll have to change my icon. But I think it’s just a momentary lapse of reason.

  131. johnva says:

    @Bladefist: The problem is not “listening to someone on the other side”. The problem is avidly listening to people who are known propagandists. I’ve listened to Limbaugh before, and I know that he’s not a reliable source of information. Usually because I’m already informed about what he’s talking about, and know where the errors are. Don’t assume that I just believe what I hear in some other media that you imagine is “liberal”. I think virtually all of the mainsteam media is full of liars, and I’ve gotten to the point where I don’t believe a word any of them say unless they point me to a primary source where I can research an issue myself and independently confirm it. No one should believe anything that any media source says without doing their own research.

    And the GOP has been on a bad road where their stated principles diverge from their actions for at least 25 years. St. Ronnie really kicked that trend into high gear.

  132. DallasPath says:


    “”I think you’ve raised a very good point. Subsidize medical education to lower the burden on students. Also reign in malpractice insurance, better hours for residence (so they’re not working 36 hour shifts).

    As it stands now, most doctors graduating come from wealthy backgrounds. I’m in a medical school and there are barely a dozen students out of a class of 160 that come from lower income families; hence, most have no clue what it is like to live without adequate health care””

    I think you’d be suprised at how some of the people you think you are wealthy are paying for their medical education. I knew a lot of people who were struggling to get by but still kept up the appearance of being well off due to parental subsidies. Most people do not talk about their education debt and accept it is a given.

    The average medical graduate is 160,000 in debt. That is reality. I know people who are a quarter of a million dollars and up in debt. That is absolutely insane. When you consider the ridiculous sacrifices that doctors make to get to where they are, and still they face increasing cuts from medicaid/medicare as well as censure, criticism, and belittling from everyone they know-(Trust me, I’ve read enough malicious doctor bashing comments on this site, which I consider to composed of ‘informed’ consumers)

    Currently, doctors have their hands tied by insurance companies, lawyers, and the government. Bureaucracy and greed are crippling our nation’s healthcare system.

    I’ve had the socialized medicine debate multiple times and I’ll say it again…it won’t happen because there is too much money being made in this country by lawyers, pharmaceutical companies, insurance companies, and a host of others. You think United Health Care is just going to roll over and play dead? You think all the pharma CEOs are going to watch trillions of dollars slip out of their grasp? You think the med mal lawyers are going to give up their bentleys without a fight? Dream on.

    Finally, please someone, name me a government program that has, on a nationwide scale, been run efficiently, cost effectively, all while providing satisfactory comprehensive service. Medicine is not like McDonald’s. If they mess up your order, no one dies.

  133. Bladefist says:

    @johnva: Disagree he is propagandist.

    And I never used the word Avid. If listening to Rush on my way to Sonic is avid, then I guess I’m a Rush Zealot.

  134. ironchef says:


    There’s a better term for Rush listeners:

  135. Bladefist says:

    @ironchef: I wish consumerist would write a program to comment for you.

    After each article posted, it automatically generates an idiotic statement. I could help w/ the programming.

    For Trai_dep I would do something similar, but have BabelFish convert it to Chinese, then take the results, port it back to English, then Post it again.

  136. Trai_Dep says:


    So how did you do?

    Term limits LOL
    Fiscal responsibility LOL
    Fixing Social Security LOL
    Taking back our streets LOL
    Reducing the size of govt? LOL.
    Honest Accounting? LOL

    Notice how he skipped the facts you laid out, then ignored the question, then launched an ad homonym, unrelated attack?

    That’s the Conservative ‘bot script in a nutshell.

    …Wait, something’s missing. Lemme debug for a few secs.

    Don’tYouLoveAmerica? SmallerGovernmentLessspendingNoTaxesLapelPin! LiberalMedia! LiberalMedia! LiberalMedia!

    There: GOPBot v1.01. Fixed! :D

  137. Mr. Gunn says:

    Another libtard vs. libertardian argument. Great.

    Anyone manage to respond to ironchef‘s clear explanation of why the free market can’t fix healthcare, or did we all just fall back on complaining about governmental inefficiency and complaining about the nanny state?

  138. Trai_Dep says:

    Well, the thing is, health care isn’t something handled well by classical economic rules. That’s where it breaks.
    Most people are cognizant that some things, the market’s the optimal mechanism, and others, not. It’s a reasonable position to take. This is why there’s little argument from our side about Ironchef’s point that you raised.

    Why the other side skipped the excellent points that he raised, see the steps involved in my Conservo-Bot 1.01, above. I’m confident it explains much in that regard. :)

  139. Bladefist says:

    @Mr. Gunn: I hope you aren’t referring to me as the libertardian. I am not.

    I’ve responded to Ironchef probably over 100 times. I’m tired of it. I don’t owe it to anyone. This comment thread is well over 100 comments and dead, so very few will see my hard work of explaining.

    If you see my lack of interest in responding as a loss in the debate, or that I am speechless, thats fine. I don’t feel compelled to educate you either.

    I don’t live in my parents basement like some of these people, I have bigger fish to fry.