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Now that the Republicans control the House, they are working to repeal health care. Of course, this would seem to be a futile endeavor: the Democrats still control the senate and the White House. As such, attempts to repeal it would seem to be political theater or perhaps a matter of principle. Or something else.
The Republicans who want to repeal the law often claim that they have a mandate to repeal the law because they were elected to do so. This, of course, assumes that the voters who voted for them were motivated primarily by this factor rather than some other factor. Presumably, this justification is itself grounded in the idea that the congress should do the will of the people.
However, the will of the people is a difficult thing to determine. One obvious concern is that polls are subject to manipulation in terms of the sort of questions asked, how the data is interpreted (is, for example, being against a part of the law counted as being against the law as whole or not). As such, it is hardly surprising that while most polls show that more Americans are for keeping the law than are for repealing it, others are taken as showing that a majority is for repealing the law.
When sorting out such polls, it is important to consider the nature of the questions (the wording, the order, as well as the available answer choices). After all, these have a considerable impact on the results that a survey will yield. It is also important to examine how the data is being interpreted. After all, the same data can be interpreted in ways that support very different conclusions.
Based on the majority of what seem to be the most objective polls, those favoring keeping health care seem to outnumber those in favor of repealing it. If the people who favor changing it without a complete repeal are factored in, then the law seems to be favored by the will of the people. If this is the case, then the Republicans would be going against the will of the people by trying to repeal the law. Of course, they could argue that they are following the will of the majority of those who specifically voted for them rather than the will of most Americans. They could also argue that they know the true will of the people despite what the surveys seem to show. They could also argue that they are doing what they regard as being for the good of the country and hence that most Americans are wrong about this matter. Or they could just follow the will of the people.
I do agree that there are legitimate grounds to criticize the law and that it will, at the very least, need tweaks and probably some major overhauls. Sorting out what things need to be modified, which need to be jettisoned and which should be kept would require rational evaluation based on facts. Unfortunately, the Republicans have been engaged in what might be described as willful untruths regarding this matter. The most famous untruth was, of course, Palin’s Death Panel claim. Somewhat less famous but also inaccurate are claims that the law is “job killing.”
As I see it, if the health care law is actually bad enough to justify repealing, then there would be no need to misrepresent it or make claims about it that are not accurate. After all, if the facts suffice, why lie and distort? Naturally, the fact that certain Republicans are making such claims does not prove that the law is good or that it should remain. However, it is reasonable to challenge the Republicans to provide reasonable and fact-based criticisms. If it is as bad as they claim, they should have plenty of material to use. If they are forced to fabricate and exaggerate, one might suspect that they do not have a valid case at all.
I think the major problem with the new health care legislation is that it requires US citizens to buy insurance when the US government cannot require US citizens to buy anything, especially insurance.
Unlike choosing a home or an automobile I didn’t choose to be here, but here I am. Should I be required to insure the health of my body simply because I exist, especially if I am healthy?
This health care legislation is the proverbial camel’s nose under the tent. If it stands, what’s next? The insurance industry is huge, as is the health care industry, and now were supposed to bail these guys out too?
People are asking “where is all our tax money going?”
We don’t really know, do we? And this health care legislation will only make that worse.
Mike,
It’s true that people should not lie if the law is bad enough Prima facie, but if the law is really good, why do Democrats need to lie to make it look thus?
32 million additional people covered with health insurance and at no cost to the tax payer?
CBO projections are about the only info we can turn to. When those figures match up with the Republican pov, CBO is their darling. When CBO projections fit with Democratic claims, they’re the liberal favorite.
No excuses for any lies Dems may be putting out there. But– we all know that somewhere in our history, one party or the other initiated the lying. The initiator may have been an Anti-Federalist. Or a Federalist. And the games began.
You’ve heard the saying “Never get in a pissing contest with a skunk!” ? Well, it’s safe to say the parties/ideologies in the US have been pissing on each other for centuries. With the 20th/ 21st Century media explosion, the spray pattern is much, much broader– impossible for us to avoid. The media has weaponized something that is already well-weaponized by Mother Nature. Unfortunately, our only protection it would seem, is information provided by the very media that spreads the smell. And they get their information from. . .the skunks .
The only “real” defense is a healthy dose of skepticism (catsup). And that and french fries will make you an order of french fries.
Another thing. This idea that everyone is “owed” medical care. What about food? People need food just about everyday. Why don’t we all get free food. We need it more than medical care.
I’m sure Lenin and Trotsky thought the same way. Great intentions. Disastrous results.
Actually, a sufficiently rich and advanced society would be able to provide basic necessities to all its members. This is, of course, science fiction.
Yes, and who was it that said a sufficiently advanced technology looks like magic?
We can provide basic necessities to all of our societies members. But the members have responsibilities too. They have to show up, they have to try. And of course, if the meaning of “basic necessities” keeps changing, you’ll never get there.
There are two major problems with US health care:
1) lack of universal coverage
2) It costs too much
Obamacare addresses the coverage issue, but it does nothing to reduce the cost of medical care. This is the primary failing of the present health care reform law.
I say that if we treat health care like anything else, it will be forced to bring its prices into a reasonable range.
This will be just like upping the federal tuition grants for college. What happens? The colleges increase tuition costs everytime. It’s basic inflation.
I think the universal health care thing would work in the case of people that need medication to live, ie diabetics etc. For others, make it a high deductible, so the insurance covers catastrophic accidents and disease but isn’t bled off by people who go to emergency rooms for hangnails. And there’s plenty of those people believe me.
People need to be taught not to go to the doctor for every ache and pain. I’ve learned that most issues resolve themselves after 2 weeks. Too much TV has made us a nation of hypochondriacs.
Cost is a serious problem. For example, I had a 30 minute surgery and was in the hospital for only a few hours in total (most of which was waiting for the surgery and filling out forms). My total bill was about $12,000. Insurance took care of most of that. However, that seems to be an insane amount of money for a fairly straightforward operation (quadriceps tendon repair).
Agree. But what is missing from all of the discussion I have seen so far here is 1) the high cost of lawsuits, 2) malpractice insurance, and 3) the bureaucracy required by both for not just the doctor who performed the operation but also the anesthesiologist, the hospital, and any other doctor who may or may not have been needed for consultation due to the requirements of items 1 & 2.
I agree. Lawsuits do need reasonable caps. They should suffice to compensate for damages, but should not go beyond that. As you note, malpractice insurance (because of the lawsuits) is a major cost. Anecdotally, friends of mine who are doctors have noted that while their income is very good, a significant chunk gets devoured by the need to have such massive insurance. Having reasonable caps on law suits can help with this. Also, some simple things like using pre-surgery checklists and better sanitation could go a long way to reducing lawsuits and hence the cost of malpractice insurance.
Might I suggest that reducing the incidence of malpractice might go a long way to reducing lawsuits and the cost of malpractice insurance? Those of you who can avoid a knee jerk reaction to anything Public Citizen produces can read the following:
http://www.citizen.org/congress/article_redirect.cfm?ID=8308.
The same principle that the public rightfully expects to be applied to teachers –i.e. removing ineffective teachers from the classroom–could and should be applied more effectively and efficently to physicians.
In theory, if you rid the system of the bad apples, the good apples, performing to the appropriate professional level, will commit malpractice less often, and (again, in a perfect world–where insurance company bottom lines are less important than human physical well-being) malpractice insurance costs would likely drop.
To add some color to this discussion:
http://www.marylandmedicalmalpracticeattorneyblog.com/2010/11/good_doctors_sometimes_commit_1.html
First things that strike me? The doctor has operated on some very notable professionals, and there’s no malpractice in those cases. Was the 17-year old alluded to in the article a professional? As wealthy as the professionals? Did the doctor carry the same attitude into the operating room in this girl’s case as he does with the likes of Roderiguez,Norman, et al? And note the role of our molasses-like legal process in increasing the settlement. . .
Physicians are specialists performing very specialized tasks. Even minimally invasive surgery is something the average person cannot perform and would likely not wish to perform on himself . Physicians pay an educational premium for the right to cut into your knee. So (assuming the patient has done his homework). he hires a very well-trained professional. We’re not talking plumbers or electricians here. And he’ll pay a price that’s likely only minimally affected by malpractice insurance (and would be even less so if the observations in my above paragraphs would be considered and implemented). WTF mentions the bureaucracy but seems to omit any mention about the actual cost of the physician as a portion of your $12k overall bill (after the costs of “the anesthesiologist, the hospital, and any other doctor” and, don’t forget, the operating room nurses—who, in good hospitals, are also highly trained) have been subtracted.
http://freakonomics.blogs.nytimes.com/2011/01/25/busting-docs-who-dont-wash-their-hands/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+FreakonomicsBlog+%28Freakonomics+Blog%29
The comments are also interesting. . .
The thing is, I wonder what the cost would have been if there was no such thing as insurance?
I see this sort of thing in Afghanistan where we’re building basic structures that should cost $20,000, but because they know we have very deep pockets, the contractor sets up several people who pose as contract cadidates. So the company bids against itself and jacks the price up to $200,000. No kidding.
That’s what happens with limitless insurance. It sets up a false market value. I don’t mean a real value, as I’m sure that not being a cripple is probably worth more than $12,000, but as far as comparing other things on the market, it’s way over-priced.
“I wonder what the cost would have been if there was no such thing as insurance?”
Interesting question. It’s almost impossible to imagine, since it’s been around in one form or another for so long. The following article might provide some insight for anyone who’d like to perform a thought experiment about a world without insurance:
http://www.investopedia.com/articles/08/history-of-insurance.asp
If insurance did not support high prices, doctors would either need to charge less or only minister to those wealthy enough to afford their services.
Yeah, not being crippled would be worth more than $12,000 to me. But, as you say, that is a lot for what it took to do the operation. I actually seriously thought about going to medical school after that. If I were a younger man, I would have.
Now THAT’s an interesting approach to health insurance. 🙂 Go to med school to develop the medical skills to provide medical care for yourself and your family free for life!
Scenario: You could hire Danny Boyle to film you performing your own knee surgery. Title: 1/2 Hour. You could find yourself in the running for an Oscar as Best Actor!
You already have your degree in philosophy, but assuming you didn’t, which would come first, med school or the area of study you really care about ?
Even if you did the med school gig first, you could always go back to college and get a degree in philosophy. Med school experiences might even enrich your view of your preferred subject.
Lots of factors to consider, but this might all cost more than the sum of your yearly health ins. premiums + $12000. . . Even with the profits from your movie. 🙂
Democrats at work:
Congressman Dennis Kucinich bought a sandwich from the Longworth House Office Building cafeteria in April 2008, and bit into it only to find an unpitted olive that cracked a tooth. This month, he sued the cafeteria for selling “dangerous” sandwiches.
http://webcache.googleusercontent.com/search?sclient=psy&hl=en&rls=com.microsoft%3Aen-us%3AIE-SearchBox&q=cache%3Agawker.com%2F5743909%2F&btnG=Search&aq=f&aqi=&aql=&oq=&pbx=1
Republicans at play:
en.wikipedia.org/wiki/Larry_Craig
As much as some of you out there may crave it, I can’t provide video. . . 🙁
From Forbes:” The suit says that Kucinich suffered “serious and permanent” dental and oral injuries requiring multiple surgical and dental procedures.”
So the case goes to court, or settles out of court. That’s all legal and constitutional, right? If Rep. Kucinich has documents verifying the procedures involved and the costs, it would not seem beyond reason to sue. The amount is a matter of question, but the story gives no detail (that I saw) indicating what the specific costs were, so I won’t judge that at this point. That’s not the American way. . .
The claim does include “future dental expenses”. One thing we think we know is that a Republican–which poor Dennis is not–at least the new-style, post-Bush Republican gives good lip service to such things as future expenses.
You know, Mike paid $12k for one 1/2 hour operation by a physician of unknown (to us) capabilities. “Multiple” visits to specialists and “”multiple . . .procedures” must certainly cost more, especially if Kucinich employed the services of the best dental specialists. I don’t know about you TJ, but I know I want my representative–he’s not mine btw–to have fine teeth. A winning smile is 90-95 % of any politician. 🙂
So who decides on how health care resources are rationed?
http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2011/01/22/the_reality_of_death_panels/
The reality of death panels
ObamaCare’s end-of-life planning comes down to economics
By Mike Stopa
January 22, 2011
SUPPORTERS OF President Obama’s health care reform law have relentlessly derided Sarah Palin’s notion of “death panels’’ as a vulgar rhetorical technique, with no basis in reality, devised merely to scare a gullible, uneducated citizenry into rallying to repeal the law. The death panel notion persists, however, because it denotes, in a pithy way, the economic realities of scarcity inherent in nationalizing a rapidly developing, high-technology industry on which people’s lives depend in a rather immediate way. G.K. Chesterton once wrote that vulgar notions (and jokes) invariably contain a “subtle and spiritual idea.’’ The subtle and spiritual idea behind “death panels’’ is that life-prolonging medical technology is an expensive, limited commodity and if the market doesn’t determine who gets it, someone else will.
Why can’t everyone who needs “life-prolonging medical technology” get it? Granted, you’ll still need criteria for what conditions qualify for what care, but is that a ‘death panel’?
The reason “death panel” is disingenuous is that no one is or will be sitting around and saying, “You live, and, hmm, you over there with the blue cravat — you die.” Rather, it will be handled just like it is now, with policy. Let me emphasize that: Just like it is now. Are there death panels now? The ‘market’ isn’t some nebulous entity, it’s the aggregate of current providers — and they set their own policy. Are these death panels?
However you look at it, ‘Obamacare’ isn’t introducing death panels — it can’t be, because it’s using the same set of tools to deal with these decisions that are being used now by the ‘market’.
“The death panel notion persists, however, because it denotes, in a pithy way, the economic realities of scarcity inherent in nationalizing a rapidly developing, high-technology industry on which people’s lives depend in a rather immediate way.” (emphasis added)
See, this is just slight of hand; it implies that nationalizing something is generating these “economic realities of scarcity”, but those economic realities of scarcity are the same ones the current market is shaped by — it has nothing to do with nationalizing anything.
“See, this is just slight of hand; it implies that nationalizing something is generating these “economic realities of scarcity”, but those economic realities of scarcity are the same ones the current market is shaped by — it has nothing to do with nationalizing anything.”
While it is true that there is and will always be some level of scarcity, this is true for anything. Food, clothing, etc. Yes, due to the complexity, it is far more relevant to medical care. But the “slight of hand” that this argument employs is that these resources are, and will continue to be, constant. That they cannot grow or recede. This is typical dead-end Malthusian reasoning.
The difference, as I stated in other words on the prior thread where we discussed HC, is choice. With the government making the decision, you have no say in the matter as to how these decisions will be made, short of a change in government. But why must the entire government change just to get a change in health care? OTOH, if you choose your insurance coverage and/or your health care, you have control over how much you spend vs. what kind of coverage, and to what degree your end-of-life scenario will play out. Granted, your control over these specifics are very limited, however if the government is the sole entity making the decisions, better ideas are far less likely to see the light of day. Plus, you don’t have to accept the kind of health care either Democrats or Republicans think you should have.
Choice is fine, until you don’t have it any more. People with pre-existing conditions don’t have a choice. They get health insurance from an employer or from the community health clinic. They can’t buy insurance for themselves, because even if it were affordable, the insurance companies won’t sell it to them.
The argument here needs to take into account that health care is an essential for modern living. Yes, so are food and housing, but in this country, those two needs are supplied by the market for the vast majority of us at prices that we can afford. Health care has not followed that pattern. It’s more like transportation or national security, something that we need the whole of society to create.
“They can’t buy insurance for themselves, because even if it were affordable, the insurance companies won’t sell it to them.” Well, I somehow managed to do it. And I didn’t pay anywhere near what most people pay for COBRA. Catastrophic health insurance is not all that expensive. I payed something like $600 for 3 months for me and the wife. People can and do buy it.
Yes, full care is highly expensive. Part of that is due to things I stated on the “Civility” thread. As for pre-existing conditions, many and possibly most who oppose government health care acknowledge that this needs to be addressed. However handing the financial responsibility, for lack of a better word, of the entire health care system to the government is a bad idea.
You state “health care is an essential for modern living”, well no it’s not. Food is essential and we don’t provide that for free, at least not to everyone. Housing is less necessary (note, not essential) than food but more so than health care, yet that is not free to all. While you might find what I just said uncomfortable, it is not, in fact, wrong. Life is full of uncomfortable facts.
Health care should, I think, be considered part of the national defense. It does, after all, help protect citizens. 🙂
Supposedly almost every government project does, too.
But should I be forced to buy healthcare for myself?
That’s where we’ve come to, and it’s both a symptom and cause of our decline.
No, provided that you are willing to be chipped so that you will be denied any medical service that you cannot pay for yourself. I’m fine with competent adults opting out-but they must opt out completely. No use of any public money for their medical care.
“But should I be forced to buy healthcare for myself?”
Similar–in reverse– to the arguments heard during the Bush Social Security Reform period.
Those who supported the idea of privatization, it seemed, were enamored of the possibility of controlling “their money”. They couldn’t wait to be permitted to remove all or a portion of “their money” (SS wage tax) from the SS pool and invest it as they wished without regard for the national “pool” of insureds ( the elderly, disabled, and survivorsor) and with no understanding of the soon-to-become-painfully- obvious problems associated with trusting any part of Social Security to the vagaries of the stock market. The only difference now is that those who don’t want to be forced to buy healthcare, as we are forced to pay SS payroll tax for SS, are in a position to dig their heels in to refuse being included rather than screaming and shouting to be allowed to opt out.
Now, as I see it, opponents of PPACA essentially don’t want to be forced to pay for insurance which they, somewhat foolishly, think they may not need. Just as they oppose SS because they think they can do a better job with their money. They’re pushing it as an issue of individual rights when PPACA is not an “individual” issue, but a national issue just as is Social Security.
But in reality it’s a matter of pocketbook rights. The fight is right here. “If we can repeal PPACA, then we move on to rolling back and repeaing SS and Medicaare and PartD.”
If PPACA had been funded by a payroll tax as are SS and Medicare, the issue would be different and the same. The state’s rights issue would be gone, but the old argument about “the general welfare” would be central to the argument once again.
And we haven’t really touched on the issue of adding one more layer to the bureaucracy.
Go the the DMV and see how you get treated. This is a symptom of the bureaucracy upon a human being. I really believe this. Read Kafka’s, The Castle.
It’s really bad in the Army, too. This month, The Atlantic has an article about why officers are leaving the Army in droves. They polled a group of officers who left early and yoiu know what the number 1 reason for them leaving is? Frustration with the bureaucracy.
http://www.theatlantic.com/magazine/archive/2011/01/why-our-best-officers-are-leaving/8346/
I’ve experienced it. It’s horrible. You spend whole days and parts of weeks simply trying to get a small piece of information changed on a piece of paper. It takes half a year to get money you’re owed even though it should only take a week. You go to one person or office to handle a problem and are told to go somewhere else. When you get there, you’re told to go back to the first person again.
The bigger the system is, the greater the possibilities for fraud and mismanagement, and thus the greater the bureaucracy. This is just as true of business. The problem with government is it touches a far greater and diverse population, thus its bureaucracy exceeds even that of the largest corporations. Having worked for government contractors and businesses that have varying degrees of government contact, I’ve found that the closer you get to the government, the less efficient things become. And also, the more accepting the workers become of the inefficiencies.
BTW, didn’t get through the whole article (reading through it during the gaps of time I have available whilst I wait on our corporate bureaucracy), but I found this quote most informative:
” The business guru Warren Bennis reflected in his recent memoirs, “I never heard anything at MIT or Harvard that topped the best lectures I heard at [Fort] Benning.” ”
Not only does that tell you something about the business world, but I wish such positive aspects of the military were more prominent when I was younger…or even today. Hopefully the military still has its fundamentals (philosophy) in place, it’s its execution that is the problem.
“The bigger the system is, the greater the possibilities for fraud and mismanagement, and thus the greater the bureaucracy. This is just as true of business. The problem with government is it touches a far greater and diverse population, thus its bureaucracy exceeds even that of the largest corporations.”
How does the simple reality of a much larger nation (nearly 80x larger than the US of 1789) come up against the need to keep government small? So small that, as Nordquist has said, it could be “drowned in a bathtub”? Liberals and conservatives both have to come to grips with reality. On the one hand, bureaucracy is obviously too large. On the other hand, how large is too large?
We’re tackling a huge task here. If you look at the three largest countries (combined population and landmass), only the US is in the top three in both areas–China missing out by a tad to the US in land mass.If Russia were still the USSR it would probably be in the top three in both. Eliminate the likes of Qatar, Luxembourg, Singapore,and Norway –which are not large countries, and the United States is number one in a prime indicator of wealth (GDP)
The only one legitimate “constitutional republic based on a representative democracy” or anything like it in the top three is the USA. The others are taking the easy/wrong way out. So our task is much more difficult. We’ve got to figure out how we can take a huge “system” and make it work with only the necessary regulation and with as little “fraud and mismanagement” as possible.
Assuming that every problem can be solved with a regulation is foolish. Assuming that any new layer of regulation is bad is a ridiculous approach. New developments frequently call for additional government regulation. Automobiles weren’t regulated in 1789. Assuming that regulations can be eliminated without regard for consequences is inane.
The real, best, most sensible approach (and I can’t see it coming any time soon) is for our government representatives–and not just an appointed panel– to sit down, all politics aside, and begin poring over regulations, determining what’s important and what’s not and relentlessly cutting where necessary. The other approaches,of course, could be anarchy or communism. But, then, there goes American exceptionalism right out the window.