Big Gulp, Meet Big Brother

[peggy]

Well peggy, maybe my response has become typical because there are so many people out there repeating it. I'm one of what I think is a pretty large group of people who chose to not associate with either political party. Healthcare is one of many examples of why. Speaking for myself, not for all independents, I actually like the compassion on the Democratic side as far as wanting to provide access to good quality care for everyone. I'm not naive enough to think that is the only motivation within that party, but nonetheless would love to see that situation come about. One obstacle in trying to account for everyone individually is that it naturally leads to crazy amounts of legislation being written (like 2700 pages) because the authors are trying to include every single possibility. That is very compassionate, but from a legislative standpoint it just doesn't make sense.

The other down side is that a lot of people with this vision don't seem to take a realistic look at what it really costs to accomplish. While I'm all for caring for anyone who needs it, I don't want to bankrupt the country to do it. People lose sight of the possibility that exponentially increased debt could ultimately cause more pain and suffering in different, but possibly much broader, ways than a lack of universal healthcare. It's a risk I see as very real and one I'm not comfortable taking.

The current Republican stance appears to be just slam anything the Dems come up with. They haven't really proposed anything of value and I don't expect they will in the next 153 days. I agree with you that they're basically a bumper sticker factory right now. The "anybody but XXX" is not the kind of platform that appeals to me.

The question for this fiscally conservative, compassionate voter is how do we care for everyone without breaking the bank. It's about that simple. I do not want to become a country with 60% or 70% base tax rates and a government that "provides" all the necessities for us. That apparently works pretty well for a whole lot of people in this world, it just wouldn't for me so I use my vote to head in a different direction. I think our ever increasing debt is close to reaching an unsustainable level and that if we do not manage it in a very astute fashion it could trigger a time when healthcare seems like a pretty low priority. If a candidate comes up with a solution I like believe me it will get posted here. In the mean time healthcare remains less of a priority for me than other issues I believe have a more significant and immediate impact on our country.

OK gregg, I hear you. Yes, your response is common, but that doesn't make it right, or helpful. But we have something here. let's keep going.

It IS expensive, yes, we agree. And everyone should have basic health care, again we agree.
Does that basic health care include care when a man, say in his 50's, has a heart attack? Does it include car accidents? Both very expensive and happening to fairly young people, in the case of the car accident, all ages. Not 'end of life' people (i.e. in their 80's with multiple health problems) but people who can live many decades in good health. Does your basic care include them? Falling off a ladder, breaking an arm, hip, whatever? Meningitis? Whooping cough? And all the expensive things that happen randomly to otherwise healthy, youngish people? I'm just trying to set the ground rules here. What does basic health care look like and, where do we cut it off. (see very small list above) I mean, do we tell the young mother, we'll check your kids ears, but we won't set his bones, or treat him for asthma. To me basic health care includes everything we can reasonably do with modern medicine to get oneself from cradle to grave. I'm not including extraordinary measures, because those are, well , extraordinary.(no heart transplant for everyone)
so, we have established it's expensive. Now here's the good part. See, this whole mandate thing that the right keeps pushing on and trying to use as a weapon is the very thing that makes this all possible. Of course the republicans know this which is why they keep trying to nullify it because, well, job #1 and all, but it really is the beauty of Obamacare, (and Romneycare too, but we aren't supposed to talk about that!) See, everyone will need health care, cradle to grave, so everyone pays. Granted, insurance companies are still in the mix, which I hate, but if Obama has a fault it's that he tried to hard to please the right, who really only want to defeat him and don't give a squat about the country or health care or you or I. He should have gone for universal health care, but we know how far that would have gotten!
Anyway, everybody pays and strict restrictions are placed on insurance companies (because we still have to deal with them) so everyone can be covered.

So, it's expensive, we agree.
Everyone should have basic health coverage, whatever that looks like, we agree.
Who pays for it? If you don't want to buy insurance, who pays for it? Who pays for your heart attack? Who pays for your motorcycle accident?

[Gregg]

Everyone makes a very good living, but the 'investment' element is removed.

It's my experience that people with nothing invested typically do not operate with the same sense of resolution as those who are invested in an enterprise. And we should not expect that because they just don't have the same incentive. The preeminent example given is usually government employees although there may be no one more qualified to "oversee".

And I'm not trying to dodge the debate of how we achieve healthcare for all. The simple truth is that I'm drawn to certain candidates because of their stance on issues that I feel are most critical. At this point in our history I just don't feel that healthcare is one of those. You, of course, have every right to assign different priorities to issues.

I do think we have the basics here for a good discussion. We've been working on it as a group for quite a while now. I wish I had a wise and workable answer that could just be injected in to the current system to fix all the problems, but I don't and I doubt anyone else does either. It's an extremely complex issue that at some point is going to affect every one of us so I do agree that it is critical to get it right. I just don't know what that is.

The truth is that I feel more qualified to discuss something like national energy policy or, to a lesser degree, housing policy. I'm only 6 feet wide, but a mile deep. Healthcare is one of those issues that, in the real world, I will probably remain reactionary to by simply voting for the least evil option on the table. Not proud of that, but I don't have the time or energy or desire to become an expert in that field. I do, however, have rather strong, generally negative opinions when healthcare spills over into the nanny state mentality that began this thread.

[bae]

It's my experience that people with nothing invested typically do not operate with the same sense of resolution as those who are invested in an enterprise.

I'm also curious where the capital to fund development and production of cool new medical technologies will be coming from, if we eliminate the "investment element"?

I myself don't invest in the medical/health care field much - profit margins and ROI are usually not very good/predictable, compared to other sectors. Under the "remove the investment element" approach, I suspect capital access would dry up even more.

Of course, you could just tax people and take their money to provide the capital.

[JaneV2.0]

I'm also curious where the capital to fund development and production of cool new medical technologies will be coming from, if we eliminate the "investment element"?

I myself don't invest in the medical/health care field much - profit margins and ROI are usually not very good/predictable, compared to other sectors. Under the "remove the investment element" approach, I suspect capital access would dry up even more.

Of course, you could just tax people and take their money to provide the capital.

The government is already heavily subsidizing Pharma research, enabling them to crank out oodles of redundant, dangerous, and ill-tested drugs (and a few useful ones) with reduced financial risk to themselves.

Medical technologies are a gray area, in my mind. I have less problem with investors there. My main beef is with all the layers of middlemen shuffling papers and not adding value.

[peggy]

It's my experience that people with nothing invested typically do not operate with the same sense of resolution as those who are invested in an enterprise. And we should not expect that because they just don't have the same incentive. The preeminent example given is usually government employees although there may be no one more qualified to "oversee".

And I'm not trying to dodge the debate of how we achieve healthcare for all. The simple truth is that I'm drawn to certain candidates because of their stance on issues that I feel are most critical. At this point in our history I just don't feel that healthcare is one of those. You, of course, have every right to assign different priorities to issues.

I do think we have the basics here for a good discussion. We've been working on it as a group for quite a while now. I wish I had a wise and workable answer that could just be injected in to the current system to fix all the problems, but I don't and I doubt anyone else does either. It's an extremely complex issue that at some point is going to affect every one of us so I do agree that it is critical to get it right. I just don't know what that is.

The truth is that I feel more qualified to discuss something like national energy policy or, to a lesser degree, housing policy. I'm only 6 feet wide, but a mile deep. Healthcare is one of those issues that, in the real world, I will probably remain reactionary to by simply voting for the least evil option on the table. Not proud of that, but I don't have the time or energy or desire to become an expert in that field. I do, however, have rather strong, generally negative opinions when healthcare spills over into the nanny state mentality that began this thread.

Oh Gregg...are you really saying government employees don't' do as good or thorough a job as, you? Or someone who works at a for profit company? Really? They don't have the same dedication? Wow, I'm sure that's news to all the military out there who are being, you know, shot at for their jobs. How much dedication do you want dude? I guess i should inform my husband that he should dial back and, you know, eat bon bons and watch Oprah, like all those other government employees instead of dedicating himself to the veterans at the VA. And my daughter, who only has a student position, should probably stop giving blood as often as she can cause, you know, she ONLY works for a non profit. What a bunch of slackers! If they had any self respect, or motivation apparently, they'd quit their jobs now and go work for an insurance company. Now there is a purpose!
Those evil evil government employees!

[Yossarian]

My main beef is with all the layers of middlemen shuffling papers and not adding value.

So you want to let the government run it?

At least those evil capitalists have an incentive to cut out the costs that don't add value.

[peggy]

I don't misunderstand that at all.

But I'm curious where the line between acceptable and unacceptable "profit" is.

In your reply, you seem to indicate it is to be found around here:

"but a corporation doesn't own the police force with the expectation of making a profit."
"But the hospital isn't owned by a big corporation who expects a huge return on investment "

"the 'investment' element is removed".

That is, the ownership of the capital required for the enterprise is the issue. You seem OK with profit for labor.

So, you want a for profit police force? For profit fire protection? Why don't you just move to south America! And what incentives do we give the police to bring in that profit? And what would that board of directors meeting look like?

See, when our health and very lives are at stake, like with police, fire, and open heart surgery, the bottom line shouldn't be the top priority. It's crass, and dehumanizing that we demand money before we give life saving medical treatment. We may call ourselves a compassionate nation, but it means nothing if medical treatment is denied because someone can't pay.
I guess you've never been in a first class military medical facility. No slackers, plenty of dedication, and first rate care. All without a profit motive. Doesn't mean it's free. The costs cover a well paid staff, facility upkeep and equipment use and replacement, but there isn't a line of 'investors' standing with their hand out expecting a huge return.

Now we aren't stupid, even though you seem to think we are. Everyone knows the difference between profit for your labor and profit from investment. You keep trying to insinuate that non profit is free. Let's see if i can put it another way.
President Obama, who makes a decent wage and is a government employee, works to 'profit' everyone in the country, rich, poor, democrat, republican, worker, elderly, everyone. Mitt Romney, who likes to fire people (although his favorite people are corporations) worked ONLY to 'gain profit' for the investor class, raking them in lots of money. See, that's the difference. Obama is non profit and Romney is ONLY for the profiteers.

[creaker]

So you want to let the government run it?

At least those evil capitalists have an incentive to cut out the costs that don't add value.

Actually the evil capitalists are the ones running the government. At at least have a huge input on how it's being run.

[bae]

Peggy, really now, be civil. It is impossible to even attempt to engage in conversation with you when you insist on erecting straw man positions, placing words into the mouths of others, and attributing base motives to them.

It is dishonest, and not conducive to any rational discussion.

[loosechickens]

What makes me CRAZY about this whole "Obamacare" individual mandate business is that it was originally, completely a conservative, Republican idea......that all these "freeloaders" who should be getting coverage, weren't, and then were showing up at emergency rooms on the taxpayers' dime. The whole idea was to force individual responsibility, and Mitt Romney, the Heritage Foundation, Newt Gingrich and a host of others were all for that individual mandate that would ensure people had to purchase health insurance, so we wouldn't be giving that proverbial "free ride" to so many people.

THEN, as soon as President Obama tried to incorporate their ideas into the health care reform plan, their desire to obstruct and be against anything at all he wanted to do, even if it was THEIR idea in the first place, kicked in, because their desire to see him lose was greater than their desire to find solutions.

How did all those "freeloaders" all of a sudden turn into "freedom loving patriots" being forced by a big bad government to buy something, as opposed to folks not taking responsibility for getting healthcare insurance, and thereby being layabouts just expecting the taxpapers to save them when they showed up in emergency rooms needing lifesaving care? Which is how the Republican/conservatives were portraying them when THEY were pushing an individual mandate.

And, why is something that is designed to ensure that coverage is available to all, while utilizing our private enterprise system, but trying to make it more effective, such a bad thing? Do we somehow think that by bleating about repealing "Obamacare", that we can make the problems of fifty million people not having health insurance, insurance companies cherry picking who they will ensure in an effort to have as few people who might NEED care on their rolls as they can manage, ensuring higher profits for their shareholders, just go away?

At least this President has TRIED to address the problems. I am sick to death of all the people determined to tear the plan down, but with no coherent idea as to how to get people with pre-existing conditions covered, try to bend costs, or get us out of this morass of paying massively more money than other countries with effective systems pay, yet having results so poor in comparison. It's hard not to believe that the game at hand is simply "make sure that Obama can't succeed, even if we drag the country down in the process". They've shown their willingness to bring us to the brink of defaulting on debt for the first time in our history to make political points.

Maybe we ARE headed toward another civil war, because polarity seems to be so complete that if Obama somehow came up with something (like the individual mandate) that every rightwinger wanted, they would immediately switch sides, swear up and down they never wanted any such thing (as they are doing on the individual mandate), and we'd be off to the races again.


Why, why, why are we practically the only developed democracy in the world, especially among the several dozen richest countries, who haven't solved this problem, who have many millions of our citizens without healthcare coverage, and that we pay more than twice as much as other countries for results that often don't even put us in the top several dozen countries in various measures of effectiveness of health care?