Comments on: Healthcare: What Liberals Really Want

By: Mike K

Mike K — Thu, 23 Apr 2009 23:17:00 +0000

""Many liberals believe our entire health-care system should be scrapped in favor a government-run single-payer plan along Canadian or British lines."

This, I fear, is Obama's mistake. Canada and England share our language, and for a president who speaks only English (in spite of his preening about monolingual Americans), this is attractive. He understands it. He thinks it will be easier to explain to an English speaking public. That's why this will be a disaster for the future of good healthcare. This is buying an Edsel 25 years after it has been shown to be a poor model.

The French have one great virtue that Democrats (and Republicans) lack; they may say anything but they don't believe their own bullshit. France gets 85% of electric power from nuclear. They have made no effort to meet Kyoto guidelines. Hypocrisy is the homage that vice pays to virtue. There actually is a good model for what we could do. Will we learn ? Of course not. It is about politics, not healthcare.

By: sinz54

sinz54 — Thu, 23 Apr 2009 21:46:23 +0000

And if Obama has his heart set on a public option, then the Republicans should insist on constraints to ensure that the public plan can never compete unfairly against the private sector, merely by drawing on Uncle Sam's near-infinite bankroll (as Medicare competed unfairly against private old-age insurance).

The best way to do that is to means-test the public plan. That was Governor Romney's approach in Massachusetts, with his public plan, MassHealth. It's available only as a last-ditch plan to those who are too poor to afford any private plan. Hence it can never compete with private plans for the health care of the affluent.

If Democrats squawk at that, the next best option is to set scales for fees and premiums for the public plan, which are comparable to the average prevailing fees and premiums for private insurers. This would ensure that the public plan can compete with private insurers only on quality and availability of service, NOT on price. As long as the prices remain comparable, all could remain in business, just like UPS and FedEx continue to compete effectively with the U.S. Postal Service for package delivery business. (That would not be possible if Congress had decided to subsidize the Postal Service to such an extent that it could deliver packages for only one-fifth or one-tenth the cost of UPS and FedEx. That would soon force UPS and FedEx out of business.)

By: sinz54

sinz54 — Thu, 23 Apr 2009 21:38:35 +0000

Mike K: In his column today, the liberal columnist E. J. Dionne said what liberals really want: To put America on an inexorable path to a single-payer health care system, with the Obama plan as the jump-start to move us in that direction:

"Many liberals believe our entire health-care system should be scrapped in favor a government-run single-payer plan along Canadian or British lines. The problem is that single-payer is not only politically impossible; it would also cause significant disruptions in the existing system. The public-option idea is a clever halfway house. It would allow the United States to move gradually toward a government-run system if -- and only if -- a substantial number of consumers freely chose to join such a plan. The market would test the idea's strength."

Mr. Dionne is being deliberately obtuse.

The public plan, able to draw on unbounded resources to drive down its fees and premiums, could always undercut the private plans, driven them out of business, after which it could jack up its prices and again and be free to stagnate without competition. This is exactly how an aggressive monopoly can develop in the private sector. That's how Microsoft drove many of its competitors out of business. Such monopolistic practices are hated by liberals when they are practiced by private companies--but not, evidently, when they are practiced by government programs.

By: Mike K

Mike K — Thu, 23 Apr 2009 16:19:16 +0000

"Remember, under the current set up, impoverished Cuba has better infant mortality rates than the US."

This old chestnut may get you some traction in those Trotskyist meetings but it hasn't even a grain of truth in it. It's more in keeping with the drunk under the lamp post reasoning.

"There are a lot of votes in improving affordable health coverage, so the GOP needs some better ideas than laissez faire."

I agree although we are a long way from Laissez Faire. The reason I studied the French system is because it is so much like ours. It uses private insurance, fee-for-service and free choice all the way down. The big differences are two: free medical school and a fee schedule plus evidence based guidelines on what the system will pay for. The money comes from payroll deductions or other contributions and only a fraction from tax revenues alone.

We could do that from the place we are right now but it will not happen. It will not happen for the same reason that nuclear power is off the table and France gets 85% of its electric power from nuclear. They are hard realists and we have moonshine politics currently in power. If we had kept going with nuclear power at the time we shut it down, we wouldn't need Cap and Trade.

Right now most people get health care but it isn't a stable system. When I began in practice, I agreed to accept Medicaid. My office filled up with women who wanted varicose vein injections, for which the state paid $6. That included equipment. I quit the Medicaid list and, like everyone else, saw Medicaid patients on referral only. Many primary care docs didn't even submit the bill as the paperwork was more costly than the payment a year later.

We need a better system but it won't come from Obama or Pelosi.

By: barker13

barker13 — Thu, 23 Apr 2009 14:51:48 +0000

Re: Cmhmd; 7:49 PM --

Ducking the question, huh, Cmhmd?

(*SNORT*)

(*CHUCKLING KNOWING THAT THE SNORTS GET TO YOU*)

(*GUFFAW*)

Anyway... where was I? Oh... yes...

You won't even defend free expression! And you expect to be looked upon as someone whose "approval" is worth seeking...??? You must be either delusional or joking.

Here... perhaps this will strike a chord:

"I may not approve of what you say but I will defend to the death your right to say it."

Nope. Class "Big L" Liberal values give way to expediency and personal interest every time with folks like you and "the censors" at this site, Cmhmd.

I truly wish it weren't so.

Beyond this thread... going to the heart of the divide between "Frum" Republicans and folks like Franco, Cherokee, Mike K and myself is that folks like us put basic "character" above and beyond mere policy disagreement.

All too often "your" side seems to have lost your way when it comes to basic concepts such as defending civil self-expression on a blog supposedly dedicated to building a MORE INCLUSIVE conservatism that can win elections.

(*SIGH*)

BILL

By: cmhmd

cmhmd — Thu, 23 Apr 2009 13:34:31 +0000

Sinz, you caught me in hyperbole, sorry!

You are correct on the theology thing though, I looked it up and, indeed, the central message of Christianity was indeed, "Every man for himself," not "Whatsoever you do for the least of my brothers, that you do unto me."

My bad.

By: sinz54

sinz54 — Thu, 23 Apr 2009 11:31:14 +0000

cmhmd: Your knowledge of history is as faulty as your knowledge of Christian theology. Jesus did not live in the Bronze Age. I guess you never saw any of those movies which (accurately) depicted the Romans with iron implements and weapons.

By: cmhmd

cmhmd — Wed, 22 Apr 2009 23:49:21 +0000

"So please don't quote Jesus out of context anymore."

You make extrapolations about how jesus would view this argument and so do I. Why am I at fault? He lived in the Bronze Age for goodness sake!

And Barker, quit with the snort and chortles, you're making an a** out of yourself. Just post your comments.

By: barker13

barker13 — Wed, 22 Apr 2009 23:29:31 +0000

Re: Cmhmd; 11:56 AM --

Ironic that the "free thinkers" running this site REMOVED my post that you referred to.

(*LAUGHING OUT LOUD*)

What do you think about that, Cmhmd?

So much for free exchange of views and perspective, huh?

What do you think they're afraid of...???

Anyway... "cheers" right back at ya!

(*WINK*)

BILL

By: sinz54

sinz54 — Wed, 22 Apr 2009 18:14:42 +0000

I live in Massachusetts, and I’m very satisfied with the bipartisan health care reforms enacted here by then governor Mitt Romney working with the Dem legislature.Our health care system covers 95% of Massachusetts residents, working mostly through the private sector.