United Liberty
Flatline ObamaCare
Sat, 07/18/2009 - 8:50am | posted by Brett Bittner
Interestingly, government intervention in the 1960s introduced a third party (insurance co/HMO/PPO, etc) into the one-on-one relationship between doctor and patient. Prior to that, people paid premiums for medical insurance policies designed to cover catastrophic medical events like cancer, serious accidents and the like, NOT for physicals, check ups or routine visits. Instead, the DOCTOR and the PATIENT negotiated a rate for services based on the patient’s ability to pay on an individual case by case basis. The introduction of a third party shorts the doctor AND raises the costs for the the patient, as the third party must also be paid. Yes, health costs have soared, but further government intervention - especially a government takeover of a free market healthcare system - is NOT the answer.
Rather than burden the American people with a “public option,” I prefer a return to the system before the government intervened last. The “public option” shifts decision-making to bureaucrats to decide treatment, trumping the decisions of doctors and patients. Are you aware that page 16 of the 1000+ page bill currently before the House “grandfathers in” private insurance plans, but ONLY until your employment status changes? At the time of that change, you no longer have the option to pursue private insurance on your own or through your new employer. You are REQUIRED to begin using the government plan, unless you are able to gain access to a plan wrought with new regulations , including a “community rating” or “guaranteed issue,” both of which will drive up the cost of private health insurance, exactly the opposite of what this bill is supposed to do. To me, that hardly sounds like a “public option,” but it is a great way to kill off private insurers in favor of government-provided health care.
It goes without saying that an entity as inefficient as the government simply cannot bring costs down without cutting the level of service. The “savings” we’re expected to see in Medicare and Medicaid spending are merely the result of the government dictating a lower price paid to doctors for services already rendered and invoices already submitted for reimbursement. Rather than seek efficiency in the administration of these programs, they are “saving” money by cutting the payments to doctors. As this occurs, doctors have two choices: either stop accepting Medicare and Medicaid or pad their invoices to an amount high enough to recoup their costs and maintain profitability.
Those issues aside, as President Barack Obama noted on Tuesday during the All Star Game that we, as a nation, are broke. With a trillion dollar deficit only nine months into the current fiscal year, we the tax payers, are expected to accept a burden that the Congressional Budget Office estimates to add over $1 trillion dollars in deficits over the next decade. To offset some of the additional deficits, taxes of $544 billion are to be levied on an already beleaguered tax base, though we are promised that the savings described above from Medicare and Medicaid will pay for the entirety of the health care bill. I find it interesting that a plan that is “already paid for” by “savings” from programs as described above needs half a trillion dollars in additional tax seizures from the American people to be implemented.
After all that gloom and doom the good news is that, regardless of Speaker Pelosi’s claims, the latest Zogby poll shows only a minority of those polled favor more government intervention. As we saw with the bailouts last year, politicians with an agenda supercede the will of the American people, so there is no indication that this legislation is lost until the session ends, so calls, faxes, and letters to our Congressional Representatives and Senators are still necessary to give this bill the flatline it deserves.
You truly are a fool.
You have no concept of how bad the American system of healthcare is and you have no real world model for how to fix it.
Knock off the personal attacks and calling people names.
umm… No.
I actually meant that to be very personal. People need to understand the weight and consequences of their beliefs and actions.
Even Jesus was quite harsh on those who were deserving of such scorn.
This article is abject foolishness. The worse because it represents a willful rejection of evidence and reality. It represents a callous disregard for human life and the value of individual people. And for what? “freedom” as defined by some utopian/libertarian fantasy.
But maybe you stand by your beliefs. Well, good for you. But in that case, you need to be strong enough to endure a little scorn.
If you want debate, then you need to take it down a notch. No one will have conversation with someone who is going to act like a four year-old.
I appreciate that you want to comment, but is it possible for you to provide something worthwhile to the conversation, rather than your broad generalizations about what I can or cannot conceptualize?
Actually my intent was to insult and belittle. Let’s be very clear about that. The post was short because I wanted to spend more time donating money to groups that will support the Obama plan.
But in a sort of pearls before swine kind of effort I will “provide something worthwhile to the conversation.”
You’ve made an assumption that reforms of the 1960’s were made to a system that was working well. I’ve seen no evidence for this assertion. While it is true that costs were lower in those days, it is also true that people delayed care or were impoverished due to high healthcare costs. The push for a socialist healthcare system goes back at least to the 1930’s and the popularity of the idea is evidence that there were significant problems with the existing system.
You claim that a government takeover of a “free market” healthcare system is not the answer yet you provide no evidence of any country in the world that has switched from a socialist system to a free market system and consequently achieved better outcomes or lower costs or both.
On the contrary, the examples of both Switzerland and Taiwan are instructive.
Switzerland has seen massive increases in cost in the last 10 years (post socialization) and they now pay 11.6% of GDP. This is still substantially less than what the US spends and the Swiss cost increases have been on a lower trajectory.
(The Swiss system is the most “free market” of all socialist systems and has the highest costs outside the US. Can we draw a correlation? Possibly.)
Taiwan by contrast was able to decrease costs while adding 40 million people that were previously uninsured.
So now you have two, real world examples, of nations that have recently implemented a socialist system and achieved better (not perfect, but BETTER) outcomes than the United States.
It is telling that in your article you don’t cite ANY positive examples of a system that works. Okay, you do say you want to go back to the way things used to be, but you’ve made no actual argument that conditions were better than the conditions in modern socialist systems.
When it comes to private health insurance, the real world emphatically disagrees with you. Private health insurance companies continue to exist under socialist system. The rules and regulations simply set a level playing field. In socialist countries private insurance provides for all that “rationed” care that the government doesn’t pay for. It’s kind of like a free market that way. Private insurance companies offer a product at a price and then those who can afford buy it do so. The difference in a socialist system is that they don’t let people die while waiting 24 hours in the ER to see a doctor like Americans do.
Then there’s this little gem:
“It goes without saying that an entity as inefficient as the government simply cannot bring costs down without cutting the level of service.”
First, you assume that the government MUST be less efficient than a private company. That’s a conversation for another post but suffice it to say that I do not accept your premise.
Second, I’m not sure how you define cutting the level of service. Are you familiar with healthcare in America? 27% of American families put off getting needed care. 20% had a prescription that went un-filled due to cost. 15% cut pills in half or skipped doses. 1.2 Million Americans went to other countries like India for medical procedures last year.
These things generally don’t happen in socialist systems. They do ration care but by any measurable statistic things are on par or WORSE in the United States.
But what’s even more incongruous for your argument is that in socialist systems spend just about half of what we spend on healthcare. If our government were to do the same thing I would get back nearly $3000 for each member of my family. I could use that money to purchase the care that the government wasn’t paying for. Or I could go buy something. Maybe a new Mac Book.
You’ve made an assertion that rationing is bad without any reference to the facts or any sense that you truly understand the implications of what you’re saying.
Then you complain about Medicare and Medicaid dictating prices without any apparent realization that private insurance companies also set prices and pay lower “allowable” amounts than a given doctor may charge. This is a net zero change to the system, yet you imply that this is not currently happening.
When it comes to your budget analysis you seem to forget that we pay 17% of GDP for healthcare already. Maybe for you money spent on healthcare is somehow less spent than money paid in taxes. For me, both my insurance premiums and FICA are deducted from my paycheck. It is a matter of indifference to me weather I purchase services from the government or get taxed by a healthcare company, as long as I get good value for the money spent. Currently I do not get good value.
I find it interesting that if taxes went up by 10% and insurance premiums went away I would SAVE money. My employer would save money too.
I’m getting a little off track. The point is that healthcare is already a massive drain on our economy and transferring that drain to the government instead of a for-profit company will make little difference in the state of our economy. In fact, the experience of other socialist healthcare systems is that costs are lower and businesses more free to compete under a socialist system.
In all of this, you’ve completely ignored the moral considerations of not providing healthcare. Every year between 12 and 20 thousand people die in America for no other reason than they lack adequate access to health services. That’s the equivalent of a 9/11 attack every 3 months, every year, year after year. You seem to be okay with that.
Even if we went back to the old system without insurance, the poor would STILL die for no other reason than they are poor.
You’ve written this article to condemn a national healthcare plan without any real reference to the facts of healthcare in this or any other country. You’re attempting to mobilize people to your cause based on your own self indulgent fantasy.
That is honestly and truly offensive and is deserving of the appropriate level of scorn and derision. Not debate.
Rather than insult and belittle you, I have a few questions:
1. Have you read the entirety of both bills before the houses of Congress?
2. Are you aware that there is a penalty written into both bills for those that choose not to carry some form of health insurance (public or private) of 2.5% of their annual income? Who can afford that 2.5% more? The family struggling to make ends meet on $20,000 a year ($500) or the family whose income is $1,000,000 ($25,000)? When it comes to taxation, the argument is that the lower income family is hardest hit by the slightest percentage increase in the government bite of their pie.
3. Have you ever paid cash for services rendered by a doctor? If so, did you bring a commission of bureaucrats and insurance executives into the room to determine what the price should be? If so, how big of a piece of the pie did they take for their consultation?
4. Can you tell me where I once called the system currently in place a “free market” system? Can you tell me once where I stated that I want to continue with the status quo?
5. If Taiwan was able to add “40 million people that were previously uninsured,” how many were insured prior to their efforts? Since the 2009 estimated population of that small island nation is only 23 million people in total, so do the other 17 million people you claim they added to a public insurance plan reside?
6. How can private companies compete to provide the “extra” care that the government doesn’t provide when their plans are regulated to offer the exact same plan as the government by 2013 in the bill?
I will stop there to allow you a chance to answer, before going further into your claims about government efficiency, GDP, and death stats.
1. In their Entirety? No. But I have read good portions of them and reviewed the key points. (I do have an actual job and family to deal with)
2. There SHOULD be a penalty for not carrying insurance. Remember that this IS a tax and people are normally penalized for not paying a tax. Even more to the point, making sure everyone is enrolled is key to keeping costs down. It’s a matter of making sure that the risk pool is as wide as possible.
So that person making $20,000 per year will HAVE to buy insurance to avoid paying the fine. Since the bill includes subsidies for those earning between 133% and 400% of federal poverty level (on a sliding scale of course, for a family of 4 that range would be $29,326 - $88,200), there should be no reason why that person couldn’t purchase insurance and avoid your 2.5% penalty.
Of course with the system we have NOW, they would have to pay 15% of their income for individual coverage and 60% if we’re talking about a family of 4. (see below **)
So in the new system, your $20,000/year worker will have healthcare that they don’t currently have, and when they get TB, they’ll go to the doctor instead of coughing on my burger and giving it to me too.
3. There are a lot of hidden assumptions behind your question. The short answer is, yes I have paid cash for services rendered and no, I did not consult with anyone else.
Beyond that, you’re assuming that on my own I would be able to negotiate the optimal price for a service. Have you ever bought a car? Have you ever convinced a grocery store to take 30% off that carton of milk? As an individual consumer your ability to negotiate price is very limited. By contrast, large companies such as WalMart that employ buyers and agents and lawyers have incredible power to set prices because they have leverage.
Maybe another way to look at this is to look at legal services. There is no bureaucracy to get between me an my lawyer, and yet my last legal consultation (which fell outside of the easily defined parameters of a simple transaction like a will) cost $300 / hour.
It is an observable fact that a single payer system has the ability to reduce costs more effectively than our system does. What about the poor doctor? Well if they don’t like it, they are welcome to do something else.
Another issue that comes up here is the notion of state interference in my healthcare. My care is currently rationed by my ability to pay and what some insurance company hack decides they will cover so the notion of “someone coming between me and my doctor” doesn’t scare me. They will have to get in line.
But one wonders what the experience of those in socialist countries is? From those that I have personally talked to, and the mounting evidence available in various reports (NPR has some very good if anecdotal articles on the experience of healthcare in other countries) the experience of people in socialist systems is that they get excellent care based on what their doctor thinks is necessary.
Contrast this with our current system where my doctor says I need X and I look at him and say, “I can’t pay for that now, how about next year?”
Of course for every anecdote of good care there’s another horror story, so we should go back to the objective data which is all on the side of socialism. Feeling sick today? Want to call your doctor and get it looked at? You’ll get in faster if you live in a socialist country. Here’s a link to a BusinessWeek article to back up that claim.
http://www.businessweek.com/magazine/content/07_28/b4042072.htm
4. I think I was clear that you didn’t want the status quo or believed that what we have is a “free market” system. What I said was that you have no better alternative to propose. You’ve offered no real world examples of a free market system that does work or examples of where free market principles have made the system perform better.
You did express a preference for going back to the days before employer sponsored health insurance but you’ve yet to offer anything like evidence, much less convincing evidence, that that system worked well or was actually preferred by those who lived with it.
5. You caught me on this. That should have read 40 percent, not 40 Million. I got confused. The data comes from Frontline
(http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/).
Still the larger point remains. Taiwan switched from a free market system to a socialist system and things are better (not perfect but BETTER).
Again, where is your example of the failed socialist system that got so much better when they switched to a free market?
6. I can’t say that I read the bill the same way you do on this. In my reading of it as long as a plan offered minimum standards, extra features (say laser eye surgery or a face lift) could be added to the plan. As long as the basics conform to the plan rules then there is no problem. Insurance companies in Switzerland and France appear to be doing just fine following a similar model.
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So any more data? or do you keep your theories in the abstract away from pesky things like facts? Are you going to argue that statistics in the U.S. are invalid because we are a stinking hellhole where we shoot everyone who’s not loading up on heroine?
Bottom line: socialist systems provide better service for less cost than ours does. You’ve offered no alternate system that does and no proof that our system is actually better. I pray I get to sell you a car someday. You’ll pay $40K over it’s value and bring it back to me every week for repairs.
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** Clarification from above:
The average cost of insurance for a family of 4 is $12,000 / year. I’m making the assumption that for a single person the cost would be 1/4, but it is probably more as children are typically less expensive to insure. Regardless, $12,000 to insure a family is 60% of a $20,000/year income.
Since My insurance for a family of 4 last year cost more than $12,000, I’m inclined to believe the $12,000 figure which has been cited in many media stories on healthcare.
Rock it Griefer667! I hear nothing but crickets chirping. I do enjoy the articles on this site, but many times it is nothing but government bashing without providing any realistic alternatives. Thank you for calling that out.
There are some issues I have with the current bill - particularly the grandfathering clause stated in this article. Now is the time to debate those details, and get a bill that is good for Americans (not health insurance companies). The Republicans don’t want that, they want the shitty status quo, so they can blame Obama in future years for “not fixing healthcare”. The politics needs to take a back seat on this issue. Obama has put the issue before Americans, and let’s have rational and realistic discussions on the future of healthcare in America.
I’m sorry, that’s simply not true and I cannot believe someone would so naive to believe that politics isn’t being played on both sides of the aisle, including the president himself. If you really believe that, I have a bridge to sell you in Brooklyn.
Other proposals have been talked about, but no one seems to want to listen. I will admit that the Republicans haven’t really offered that much, but no one can tell me with a straight face that Obama has offered anything substantive.
No one is going to respond to someone who cannot debate with insulting the other party.
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