Repeal of Obamacare

[loosechickens]

maybe I'm dense, Alan....and I apologize if I am. But in this case, you'd definitely be giving the Federal government the power to override the various state governments, so even if all the Feds are doing is just handing total freedom to avoid any kind of regulations to the health insurance companies, it's still giving the Federal government the power to do that. AND at the expense of the states, which I thought most conservatives were always against doing. So, is it o.k. to give the Federal government powers as long as it uses them to "unfetter" business?

Maybe because it would allow the companies free, unfettered capitalism makes it worthwhile to you. That's the only thing I can think of. I'm not meaning to mischaracterize what you're saying. Maybe I just don't understand. Honestly.

Free.....my understanding would be that CA would no longer have the POWER to regulate how much an insurance company had in profit or overhead. Companies would be allowed to center themselves in states with little or no regulation, and be allowed to sell their policies all over the country. That's why the insurance company lobbyists have spent so much time and money trying to sell this concept.

Look, I'm no expert on health care. I look around at other developed countries, other democracies and I see citizens all having access to health care. I see no families going bankrupt from medical bills, or not having access to needed care. The U.S. is surely as wealthy as many of these other countries. What is WRONG with us that we are having such a hard time solving this problem that others have managed to solve, at lower cost and are providing care to all? I just think we can do better. And this bill was at least an attempt to try to address the situation, within the system that we have, and the opposition won't even let it get underway, and are spending all their time trying to destroy it. Yet, don't seem to have come up with any real solutions of their own. Or are unwilling to admit that much that is in this health care bill are things that they, themselves, advocated for not too long ago.

[SoSimple]

It may be getting off topic a little, but this article from Inc. magazine very nicely sums up the European attitude to taxes. In short "(w)hat we're doing when we are paying taxes is buying a product. So the question isn't how you pay for the product; it's the quality of the product." I agree.

I see no logic in the idea that a for-profit corporation is somehow more concerned about me getting the medications I need, at a price I can afford, in order to live a productive life, than the government would be. Or, for that matter, a well-regulated non-profit "insurance" system.

[loosechickens]

What an interesting article, SoSimple. Thank you for posting it. Who would have thought that there is a higher rate of entrepeneurs in Norway than here in the U.S.

Also interesting to see the levels of capitalism, business ownership, and other things in a country that we, here, see as that dreaded word "socialist", and somehow seem to believe that some socialism is an enemy of capitalism, as opposed to actually assisting it in many ways. I learned a lot in that article I didn't know, and it was well worth reading, even as long as it was.

Perhaps we'd be better off if, instead of constantly wanting taxes reduced, looked at it more as whether we are getting good value for them. Just as we should be asking whether we are getting "good value" for our health care expenditures.

Back onto the subject of health care reform....I found this in the article especially interesting (to get us back on topic a bit, hahaha)

"When I got back to the United States, I had a beer with Bjørn Holte, the CEO of bMenu, whom I'd first met in Oslo. It was early November—days after the congressional elections—and Holte had just arrived in New York City, where he is opening a new office. We talked about the commercial real estate market, the amazing cultural diversity in a city that has twice as many people as his entire country, and the current debate in the United States about the role of government. Holte was fascinated by this last topic, particularly the angry opposition to President Obama's health care reform package. "It makes me laugh," he says. "Americans don't understand that you can't have a functioning economy if people aren't healthy."

Holte's American subsidiary pays annual health care premiums that make his head spin—more than $23,000 per employee for a family plan—and that make the cost of employing a software developer in the United States substantially higher than it is in Norway, even after taxes. (For a full breakdown, see "Making Payroll.")"

[Gregg]

Perhaps we'd be better off if, instead of constantly wanting taxes reduced, looked at it more as whether we are getting good value for them.

Interesting for me LC because that is a statement that I can both agree with and at the same time it sends a little shiver down my spine. The shiver comes from the simple idea that people would probably be willing to hand more responsibility over to any level of government if that government suddenly started doing a good job managing money and providing services. While competence would be refreshing (and I'm really not that worried that we will see it any time soon), it's still an often debated slippery slope.

I absolutely agree that the government, on all levels, should be held accountable. Tax payers have a responsibility to monitor spending to make sure it is in line with their values. The problem with viewing government spending through the lens of a value investor comes when you start to look at the more subjective issues, and nothing is more subjective than healthcare. We all know that a healthy populace will ultimately generate more income (taxes) so it makes sense to keep citizens as healthy as possible, but in the US we can't mandate health. We can implement plans that pay for preventative screening or health club memberships or any other proactive measure, but most of the healthcare dollars spent will necessarily be for reactive procedures. The cost to provide a plan similar to the Norwegian company plan in the article would be $7 trillion, or about 1/2 of our GDP. I know not many people are suggesting we go quite that far, but even very basic universal coverage at a cost of $1500 per person/year still adds up to almost 1/2 a trillion dollars a year. Is it ethical to choose our option by simply calculating what the return on that investment would be?

[loosechickens]

I still keep coming back to the fact that every other western democracy has solved this problem in ways superior to the results we've been getting.

Perhaps health care access is something that should be separated from the need to profit profits to shareholders.......

I don't pretend to have answers, only wonder why we don't look more at all the other countries who have managed to make sure all their citizens have access to care, and who spend less per capita than we do, accomplishing that.

No family in Canada has to worry or lie awake nights, afraid that they will go bankrupt because of medical bills, yet hundreds of thousands of OUR families will find themselves in that position, this year alone. Yet Canada is certainly a free country with a capitalist economy. Why are they and others able to solve these problems and we can't? What is wrong with US?

We're doing something wrong, yet we are like someone with their fingers stuck in their ears, yelling lalalalalalalalalala, rather than look at systems that are working, how they provide that for their citizens (not all are single payer government run systems.....Germany, for example has a system based on private providers). I've heard that France has an excellent system.

We, in this country, are so afraid of the bogeyman of "socialism", despite our embrace of public libraries, public schools and Medicare, all of which are socialist to the core, that we won't even consider looking at how all these other countries have worked with this problem.

Somehow, we prefer to put our health access in the hands of profit making insurance companies whose conflict of interest is extreme. It makes no sense to me.

[bae]

Are there any significant demographic, cultural, or geographical differences between the USA and other Western democracies that might come into play? ...

[loosechickens]

I don't know, bae. That's a good question. I went on "The Google" and found some comparisons between Canada and the U.S., since we are near neighbors, both have a capitalist based free economy, and all the Canadian friends we have seem much like ourselves, and found some interesting statistics, see below, but not sure if they explain the difference.

http://www.unitednorthamerica.org/simdiff.htm

but nothing that would explain to me why no families in Canada go bankrupt from medical bills and hundreds of thousands of families go bankrupt from medical bills in the U.S. every year. I couldn't find anything that really explained why everyone in Canada is covered by health care, and we have nearly fifty million people with no coverage, and many others with inferior and patchy coverage.

We spend 1.5 times as much on health care as Canada does, yet Canadian citizens have 3. 8% higher life expectancy. And of course, a population where everyone is covered and has access to health care, while many, many millions of U.S. citizens have little or no access at all.

Canada seems to be a creditor nation and we are a debtor nation, but don't know what effect that might have.

Canada has a much higher rate of immigration. While the actual number of immigrants is higher in the U.S., as expressed as a per capita basis, Canada's rate is twice that of the U.S.

Honestly, to me, the clue seems to be that Canada doesn't seem to have served up its citizenry to the benefit of profit hungry corporations that seem to control our access to health care, and have the conflict of interest implied between profits to stockholders and coverage of patients. But, maybe that's just me.

What do you see as the reasons why Canadians do not have to fear bankruptcy from a major illness and so many millions of our citizens do? How are our two countries so very different?

To me, it seems more of a "social ethics" question. Canadians seem to believe that health care and access to it is a normal human right that should be available to all, regardless of whether they are rich or poor or anywhere in between. And we seem to feel that it's "every man for himself", and that's o.k.

If it were education, it would be like Canadians believe that everyone should have access to education, through public schools, rich, poor or in between, and the U. S. would believe that you either could afford to pay for school or fall by the wayside. Actually, even worse, that if you had any kind of "pre-existing" condition, you couldn't go to school, even if you had the tuition.

Why do we have such different ideas in this country regards access to education and access to health care, which admittedly, all need?

If you get info from those statistics that you think is relevant, please share it. Because, honestly, it is a mystery (and an embarassment to me that our wealthy country is so willing to allow so many to go without needed medical care, and that when nonprofit organizations stage "health fairs" in some of our cities, people come out of the woodwork with untreated diabetes, blood pressure problems, neglected teeth and other conditions that basic access to health care would have prevented or treated long before).

I don't even see significant differences between taxes as a reason. Canada collects about 6% more in taxes as a percentage of GNP, but personal disposable income is not that awfully different, especially given that the Canadian has full health care and need not worry about medical bills.

We spend 3.7 times more on our military as expressed as a percentage of GNP, and the fact that we spend more on our military than all the other countries in the world put together, may speak to our priorities as a country, or our level of fear, so perhaps that spending is soaking up a lot of money that would otherwise be available for more useful things. If that is it, the U.S. citizens are being sadly shortchanged IMHO.

Why are all these countries able to provide access to care to all their citizens, and we are not? How has Canada been able to do these things and we have not? That is my basic question, and no one has ever given me an answer with any degree of believable explanation.

[Wildflower]

I so agree with what you've said here, LC. And it just drives me crazy that we can't do something comparable to Canada and other countries.... What's it gonna take, how many people are going to go broke or bankrupt due to their healthcare costs! GRRR - it makes me very angry, especially when I think of the hell WJSimon has been through....

[flowerseverywhere]

Bae, I have been thinking about what you have posted and I have been trying to think of an answer.
We do spend more on defense but I think the difference is insurance overhead, advertising, attorneys and lobbying.
Insurance companies have big shiny buildings, paid staff, and the bonus structure for the CEO types could cover lots of people. Part of the new healthcare bill includes making companies pay x% towards actual medical care.
When you watch TV (which I don't think you do) you see lots of ads for the latest greatest magic pill. I am amazed at what is advertised during daytime and early evening. Do you really want preschoolers to hear about erectile dysfunction? High blood pressure and cholesterol meds are touted instead of diet and exercise. It is no secret as a society we are not the most healthy.
Attorneys advertise all the time, have you been hurt by x pill or have this diagnosis. They get a percentage of the winnings, they could care less about you. I have no idea if this goes on in other countries. When a physician or drug company are sued they aren't going to absorb the cost.
And lobbying. If you look at campaign donations it is not unusual to have health or insurance companies donating to candidates. Often, lobbying to include things like chiropractic care or autism care are done. In my state autistic kids are identified early and sent to school from about age 2, and some have in home speech or language therapy provided by the school district. Health insurance has to include chiro care. Well, someone has to pay for all this.
The companies that advertise on TV for new diabetic testers or scooters etc. have form letters they get MD's to sign and then go to the insurance companies to get things covered. It is not right because the MD is not making the decision, the people making and profiting from the equipment are.

what do you think Bae?

[heydude]

If it really is Obamacare than where the hex do I sign up! It certainly is not a new health insurance that is going to cover me. They make it sound like it is a new health insurance run by the government that everyone is going to have to have. Well, I would love to have the Obamacare. SIGN ME UP!

But of course, that isn't what it is.