Fiscal Cliff

@georgeob1,

Georgeob, I'm not sure where you're trying to go with this, but almost all developed countries provides universal health care, and most US governments whether democrat or republican have supported social programs for its citizens. It's only a matter of degree; not if they will change these programs. Education for our children should be a given, but the republicans wants to cut the funding for it in support of defense spending. That's what I see. Prove me wrong.

0 Replies

For most of its history the United States has been distinguiushed from most of the nations of the developed world by several traditional values. Among these are a notable preference for local government, where government action is necessary, and unusually low levels of interference in the daily lives of its citizens by the central government. I believe those traditions have served us very well and seed no compelling need to change them.

The collection of "most of the nations of the developed world" against which you would compare our health care "system" involves nations facing rather serious financial and demographioc crises, and in many prominent cases the clear prospect that their well-established social welfare systems cannot be sustained both because of the inescapable demographic/financial imbalances, and because their populations increrasingly exhibit a reluctance to do what it takes to compete with their very real economic competitors ina still very real world.

In general I don't favor "systems" at all for our social and economic activity. I believe a moderately regulated free market will do far better than most such "systems" in the long run. The free choices of free people is itself a pretty good "system", though progressive power seekers generally don't nrecognize it as one, preferring, as they strangely do, the governance of some (imaginary) benign, all-wise and incorruptable authority.

0 Replies

Again, the per capita cost in single payer systems is HALF what we pay. The private system isn't working, and it's costing twice as much. That is real world fact, call it what you will. Which means, since roughly a sixth of GDP goes for health care, and the government and the private sector each pay about half, we could adopt a single payer system and cover everybody for what the government already spends in tax dollars, OR what is already spent on health care apart from glovernment spending and totally do away with any tax dollars. However you look at it, WE ARE PRESENTLY SPENDING TWICE AS MUCH AS THE REST OF THE WORLD, AND IT'S NOT DOING US A WHOLE LOT OF GOOD. As was made perfectly clear in congresional hearings, private providers have an incentive to ration health care, because the less they actually have to pay out of the premiums they collect, the more they pocket for themselves. And they do. And they have ridden herd on their employees to find ways to deny care. In general, that incentive doesn't exist with single-payer health care, rather the guiding principle is "medically necessary" (that's how Medicare works, incidentally). I would far rather have someone looking at what the doctor recommends when paying for the bills, rather than what their monthly bonus will be if they turn me down, rather than what the doctor recommends (which the Obama reforms went far to eliminate). Again, this is not fantasy. This is what the real world has shown.

Aarge part of the developede world chose the wrong model of recovery from the Bush-administration-induced worldwide recession. Cutting government spending in a recession doesn't work. It doesn't stimulate demand, it lessens it.
That was the model Europe chose, which is a large part of why they're floundering now. If they adopted our health care system, they'd be worse off because they'd be getting half as much for their money. That makes no sense, in a deep recession or when the economy is booming.

2 Replies

@Thomas,

Thomas wrote:

Neither does Obama or his treasury. If they did, they would have gone with the platinum coin, which is harmless and would have defused the Republican hostage crisis in an instant.

Well, sometimes even the best of us have to eat their words. Obama won the standoff against the House, and didn't end up needing the platinum coin or the threat thereof.

1 Reply

@MontereyJack,

Your priorities are very different from mine and you appear to believe that we could create a single-payer system in this country which would (1) be satisfactory to most citizens and (2) cost half as much as our aggregate spending today. I don't believe that is a possibility in this country, though you appear to accept it as an undeniable fact.

Our current spending on existing government payment health care programs (Medicare, Medicaid and Military) is already vastly higher than what was forecast just a few years ago, and there is no good reason to believe that extending its reach will correct that already existing problem. An additional dose of the same poision is generally not a good treatment. Moreover each of these programs is already highly politicized with well organized lobbying and self-interest groups already in place orchestrating the activities of politicians all too willing to play to their particular grandstands with public money, whenever it is to their advantage. One can readily see that analogous systems in the UK and Canada are fairly constant political issues in their own political discourse, and they, in my view, are far more likely, given their traditions, than are we to make such a public syatem work.

I am Medicare eligible, though I still work full time. One simply can't easily find a medical praticioner here in the San Francisco Area who will accept a Medicare patient. As a result Medicare is (theoretically at least) my secondary insurance. I pay about $7,800 annually in Medicare employment and part B taxes, and doubt that I have ever collected more than $1,000 in any year in benefits from it. Why should I welcome more of that?

I think you are indulging your personal fantasies about a non-existent public health care system, supposing that it will have none of the already existing defects of existing ones in this country and will, at the same time cost far less and deliver better service - in the hands of Nancy Pelosi (whose Father bled the city of Baltimore MD white while his political machine ran the place) and other like-minded "progresseives" who are very sure that they alone know what is good for the rest of us. I don't agree.

6 Replies

@MontereyJack,

MJ, Excellent understanding of macro-economics.
Austerity programs (in Europe) will only succeed in reducing demand for all goods and services as they lay off more workers.

0 Replies

@georgeob1,

Your personal anecdotal experience is unique to only a few in this country; universal health care is somewhat similar to free education. One plan does not fulfill the needs of the majority. A single payer plus private insurance will meet the needs of the majority. Germany is a good example.

1 Reply

@cicerone imposter,

Yeah, but Germany is populated by Germans. That's why it is not like Greece. I don't give a damn about how the Germans run their lives as long as they are pleased with the results.

1 Reply

I'm not talking fantasy, George, but actuality. There are enough different kinds of systems, in enough different countries, in existence for several generations, to know it works and it's much cheaper. Medicare, for example, has administrative costs about a third of private insurers per capita. Also it serves the population most in need of expensive medical care and populations private insurers won't touch (like end -stage renal disease, which is horrendously expensive, and the private sector wouldn't touch people with it. Of course we COULD let them die, a good conservative principle--if they can't afford it, tough, why didn't they become investment bankers?--but a caring society doesn't think that way. And if it did, it's not a government I'd want for anyone I knew and cared about)

And I'm Medicare-eligible too. I get my care at a nationally-ranked nonprofit teaching hospital with over 500 doctors and over 5000 nurses, therapists, and other professionals. It covers most of Massachusetts and southern New Hampshire. And every single one of them accepts Medicare. It's a condition of employment there. They recently had a huge capital improvement program. As far as I know, they've been doing this since Medicare started. And they're thriving. Apparently San Francisco doctors aren't as creative. So sorry for you.

0 Replies

And anecdotal: hm, yes, Germany and the German system. Which costs around half as much percapita as the US does. My niece recently got married in Baden Baden, which has been a center for medicinal waters and volcanic mineral springs since the Romans. The XXV Legion was quartered there. Every five years the German health plan pays for a week at the spas there and their medicinal waters (and sitting and soaking in the hot springs, which is, let me tell you from personal experience, heavenly). And the costs are still half ours. Ain't gonna get that with our bottom-line-and-screw-the-patient private system.

0 Replies

@Thomas,

It's actually an interesting political move on their part.

Quote:

“In the fiscal cliff fight, the president had greater leverage because current law was on his side,” said the aide, noting that if nothing was done on the cliff taxes would have gone up on all Americans. By contrast, the aide added, “in the sequestration fight, we have greater leverage because current law is on our side” — meaning that if Congress fails to act the automatic spending cuts kick in.

It’s an interesting — and smart — gambit by House Republicans who have done very little interesting or smart in terms of political strategy of late.

The simple fact is that trying to go toe to toe with President Obama is a loser for the GOP at the moment. In a Washington Post-ABC News national poll released earlier this week, 55 percent of those tested approved of the job Obama was doing while just 24 percent said the same of House Republicans.

Add those numbers to the fact that Republicans have no obvious foil for Obama — House Speaker John Boehner, who had been playing that role, was knee-capped by his own conference during the fiscal cliff negotiations — and it’s clear that Republicans are simply in no position at the moment to win a political fight with the president.
By postponing a potential debt ceiling showdown and instead making their stand on the sequester (and, to a lesser extent the continuing resolution that must be passed to fund the federal government) the Republican-controlled House pits itself against a less popular political entity: the Senate.More at the Washington Post

Personally, I think the sequestration cuts are a good place to start.

1 Reply

@JPB,

The thing the current crop of legislators do best is to kick the can down the street. I suspect "kicking the can down the street" will be the major tactic used from this point on.

We, the citizens, are significantly a part of the problem. We refuse to see the difficult steps that must be taken in order to ease the problem...and will viciously turn on anyone who suggests anything that might have any chance of actually working.

0 Replies

@georgeob1,

georgeob1 wrote:

I am Medicare eligible, though I still work full time. One simply can't easily find a medical praticioner here in the San Francisco Area who will accept a Medicare patient. As a result Medicare is (theoretically at least) my secondary insurance. I pay about $7,800 annually in Medicare employment and part B taxes, and doubt that I have ever collected more than $1,000 in any year in benefits from it. Why should I welcome more of that?

You realize that insurance isn't like a bank account, don't you? You don't get to take a dollar in benefits for every dollar you pay in premiums -- that's not how any insurance system works. If you're like most people, I imagine that you've had a similar experience with your home and auto insurance policies -- you've paid more in premiums than you've received in benefits. Does that mean that home and auto insurance are rip-offs too?

1 Reply

@georgeob1,

George, no disrespect intended, but I really have to ask:

You wrote:

Quote:

One simply can't easily find a medical praticioner here in the San Francisco Area who will accept a Medicare patient.

Is that actually true...or were you using hyperbole to make a point.

Here in New Jersey I know dozen upon dozens of people using Medicare...and none of us seem to have a problem finding practitioners who accept it. Even the specialists do. I...and most of my friends...do have supplemental insurance.

I cannot understand why things are so different here from there.

1 Reply

@georgeob1,

Quote:

I pay about $7,800 annually in Medicare employment and part B taxes, and doubt that I have ever collected more than $1,000 in any year in benefits from it. Why should I welcome more of that?

Because you're a good Christian who is not only thankful to be well paid and healthy but also willing to contribute to the welfare of those less fortunate than yourself.

0 Replies

@georgeob1,

Germany is not a one race country; as part of the European Union, citizens of all member states can work and settle in Germany.

0 Replies

@Frank Apisa,

Frank Apisa wrote:

You wrote:

Quote:
One simply can't easily find a medical praticioner here in the San Francisco Area who will accept a Medicare patient.

Is that actually true...or were you using hyperbole to make a point.

Yes it is increasingly true here, and I suspect it's true to a degree in New Jersey as well. There are practiconers here who who simply won't limit themselves to medicare payment rates and refuse to process the associated claims. Others categorically refuse to accept Medicare only patients, and a greater number who simply say when asked something like "Dr. Jones has a full component of Medicare Patients and isn't taking any more now. A small, but increasing number, refuse to deal with insurance claims at all. I recently had to find a new regulat internist, as mine had retired, and I encountered a lot of this stuff in my search for a replacement. I expect the incidence of these approaches will increase if The Administration attempts to reduce payment rates to, as the great prophet says, "bend the cost curve" by administrative fiat.

Concierge care is becoming more frequent here as well with groups of doctors requiring annual fees in return for continuous regular service by the group.

I'll concede I could have simply joined an organized plan such as Kaiser Permanente, which some say they like. I just want to be responsible for my self and in control of my dealings with those who provide me any kind of service, so I don't.

It is interesting to note that the advocates of government health care "reform" are advocating a huge increase in the demand for medical services; arbitrarily imposed limits on the prices charged for them and soon the organization of the services provided, while at the same time doing nothing to increase the number of practicioners or the facilities they require. Does it appear to you that something may be out of balance in all this?

1 Reply

You might start by looking into why the medical profession, medical associations, medical schools, and licensing boards act in a cartel-like fashion to restrict numbers trained to well below the demand from potential students and public demand for more physicians, and set the cost of it absurdly high. You might also reflect on the fact that single-payer systems have better doctor-patient ratios than we do--which shouldn't exist under your scenario. Doctors should be bailing worldwide, but they're not, as the ratios show.

0 Replies

@georgeob1,

Quote:

Does it appear to you that something may be out of balance in all this?

First of all, thanks for the detailed response, George.

I have NEVER heard of anyone having a problem here in New Jersey finding a doctor...and most of the people I know are of Medicare age. Not a one…nor have I ever read a letter to the editor (I read every one in several papers here) indicating any sort of problem in that respect whatever. So I can only assume there is no pressing problem of that sort here.

Not sure why things are so different on the west coast, but I accept that they are.

Unlike you, I think the best way for our healthcare system to head is in the direction of much greater government involvement...and I think that conservative suggestions that private enterprise can handle our healthcare situation better and cheaper than government is way off base. I suspect that has to do with ideological pressures. We know this: Our general health and life expectancy is far from the best in the world; this is not, as many conservatives suggest, due to racial or ethnic considerations…and the overall cost of health care in America is greater by far than in the rest of the world.

They handle things through government; they have better care; they have higher life expectancy; and the cost for them is appreciably lower than it is here.

It seems to me that moving in the direction that seems to be working better than what we have...makes more sense than moving further away.

2 Replies

@Frank Apisa,

Excellent post, Frank. The countries with universal healthcare do have longer lifespans -and are happier to boot. Denmark has one of the highest income tax rates, but the majority are healthy and happy.

0 Replies

Related Topics

Quick Links

My Account

able2know