RSS Feed MenuNot everything about the Democrats’ healthcare proposals is bad from a free-market, limited-government point of view. But enough is bad that if I were a member of the House of Representatives, I would determinedly vote “nay.” My reasons:
1) The House bill finances health insurance subsidies in part with a highly redistributive tax: a 5.4% surtax on individuals earning more than $500,000 per year and families earning more than $1 million. That tax won’t raise anything like enough money of course. It’s a wedge to open the way to further redistributive taxes, reaching someday down to the $200,000 mark, most likely.
Some measure of redistribution is inescapable in modern healthcare: Insurance has become so expensive that the less affluent half of the population cannot afford coverage unaided. But when dealing with something as costly as healthcare, it is super-dangerous to load costs on a few at the top of the income distribution. That creates malign incentives to spend, spend, spend – because only a very few voters pay the real cost.
2) The House bill imposes heavy new costs on small business at the beginning of what looks to be a weak and fragile job recovery. I thought the point of this exercise was to move AWAY from employer-provided healthcare? Instead employers with payrolls above $500,000 would be required to buy health coverage for their employees – and to pay the larger portion of the bill directly, without their employees’ feeling the cost.
3) Where are the cost controls? The excise tax on high-coverage plans is postponed into the wild blue yonder. The House bill also ends the antitrust exemption for the health insurance industry – when what is needed are STRONGER insurance companies that can impose price discipline on medical providers. The House bill envisions price discipline being imposed by government through regulation and direct buying power – not through competition.
4) Illegal aliens do not qualify for subsidies under the House plan, but they can buy into the health exchanges. We should be focusing on making the U.S. labor market less attractive to illegal labor, not more so.
5) Medicaid is perhaps the single most dysfunctional major social welfare program we have. The House bill makes it bigger. Bad idea.
6) It’s still not clear whether a so-called public option – that is, a government run insurance company – will emerge from the reconciliation process. I am assuming that the Senate will not allow it. But if it does somehow emerge, then that ought to be an absolute red line for any limited government person: NAY, NAY, NAY and again NAY.
franco 2 // Mar 21, 2010 at 3:33 pm
“……instead franco gives a lecture on the social and linguistic origins of chairs at picnics…….you split my sides franco you really do……and whose Jimmy Buffett?”
You get a lecture if you call people crazy using nonsensical references. Here you had a perfectly good (although somewhat hackneyed) expression “a few sandwiches short of a picnic” and you chose to change one word because you wanted to be less of a drone and a bit more creative.
If you don’t know the meaning of words and references, why should I debate politics with you? We have to go back to “picnic” and start there…that’s the joke. You don’t get it and there is a lot you don’t get, genius.
I think you know who Jimmy Buffet is. You can always google him if not, so I guess you were being cute with me. Hard to tell, with all the other lies and distortions in your posts. If your musical tastes were parallel to your political sensibilities, Jimmy Buffet would be about it. Shania Twain, and ABBA too – Oh and Steve Miller.
Going back outside to get my property tax moneys worth…
franco 2 // Mar 21, 2010 at 3:37 pm
Came in to charge my I-pod and download “Ricochet” a very fun podcast by Mark Steyn and others. I highly recommend it even for those who don’t like talk radio of Limbaugh etc. this is informative and entertaining.
Bye for now!
Independent // Mar 21, 2010 at 4:10 pm
B’fault: “Was Teabagged banned? How would we know? Granted, the name was considered offensive by many readers, so I could understand Frum banning it for optics purposes.”
Ah yes, the old saw about “optics (sic) purposes”… gosh, you are a funny one today!
“Mi-GOPer, master of projection”… um, that title only belongs to your Messiah, Barrie O and his loyal band of Obami worshipers, B’fault. I am hardly worthy.
But I do appreciate the fact that you’ve seemingly put away the other personae for the day –agent’P– and are using the more recognized, dominant name. It helps in tracking the echo chamber that’s soon to develop as the clock wears down –not winds down.
“
Independent // Mar 21, 2010 at 4:13 pm
ottoBS @ #74, I think you’ve been playing a little too long in the weeds, buddie. The last few comments have been rambling and incoherent by even farLeft troll-under-the-bridge standards.
Come into the light, get some fresh air and try again.
This time with the goal of making some sense instead of the usual drive-by ramblings.
ottovbvs // Mar 21, 2010 at 4:47 pm
Independent // Mar 21, 2010 at 4:13 pm
……Indie honeychile…..earlier this afternoon I switched the telly on for five minutes and they had a clip of Pelosi (the drinker of the blood of children) leading a march of Dems brandishing a huge mallet that apparently Dingell’s father used when they passed Medicare…..she’s got the votes and probably has had for some days……someone just called and told me they’ve just seen Stupak has switched so I guess it’s over……good luck with convincing those that couldn’t get insurance for themselves or their children because of cost or pre existing conditions that this is bad news!!……nice to see you’ve used spell check for incoherent btw
sinz54 // Mar 21, 2010 at 5:34 pm
ottovbs: what bids up the price of healthcare is not the appearance of handful of overseas customers but the willingness of much of US business favored by tax breaks to continue footing ever more outrageous bills from the healthcare and insurance industries
I agree nationally–but here in MA where I live, the number of foreign patients coming to our world-class hospitals is disturbing.
Obviously if you don’t go to a hospital like Mass General or Cleveland Clinic or Johns Hopkins, you don’t see that factor at work. Most foreigners aren’t going to go to Joe’s Hospital in Dogpatch USA. If they come to the U.S. for treatment, they’re going to go to one of those world class hospitals.
Group health insurance as a tax-free fringe benefit has enabled employers to offer generous plans (my former employer included such bennies as subsidized membership in health clubs), while passing the cost on to the Federal Government–i.e.., the taxpayers.
But I despair of ever fixing that. We’ve gotten so accustomed to ‘free” group health insurance from large corporations that I see no way to change it.
Obama got as far as he did with ObamaCare by promising, over and over and over again, that “if you like your insurance from your employer, you can keep it.” Unfortunately, that’s about 78% of American households. I don’t see how we can control the cost of health care when 78% of it is ruled off limits to reform.
balconesfault // Mar 21, 2010 at 7:11 pm
But I do appreciate the fact that you’ve seemingly put away the other personae for the day –agent’P– and are using the more recognized, dominant name.
Actually, you are flat out lying when you make that charge. Not that the truth in such matters means anything to you, but I can assure you that AgentP and I am two wholly different people. I am not ashamed of my opinions, and unlike you have no need to name shift.
Furthermore, if you have no evidence that TeaBagged was banned, and not simply asked to change his name from one found offensive by some, I’d like to see evidence of that as well.
As far as I know, you are the only person here who adopts multiple aliases, and then lies about it when challenged.
Sinz: If they come to the U.S. for treatment, they’re going to go to one of those world class hospitals.
And I have no doubt that those world class hospitals provide foreign treatment because they make money doing so.
my former employer included such bennies as subsidized membership in health clubs
I would be curious to know if there is any evidence that subsidized health club membership – which makes excellent sense, btw, for a company interested both in attracting a certain type of worker and in promoting employee wellness – received the same tax benefits that group insurance provides. I doubt it, and would bet that those health club memberships were taxed as income on employee’s individual returns.
I don’t see how we can control the cost of health care when 78% of it is ruled off limits to reform.
Am I incorrect that 8 months ago, you were attacking the public option because you feared companies would drop their coverage, knowing that employees could buy into a public plan?
ottovbvs // Mar 21, 2010 at 7:52 pm
sinz54 // Mar 21, 2010 at 5:34 pm
ottovbs:
what bids up the price of healthcare is not the appearance of handful of overseas customers but the willingness of much of US business favored by tax breaks to continue footing ever more outrageous bills from the healthcare and insurance industries
I agree nationally–but here in MA where I live, the number of foreign patients coming to our world-class hospitals is disturbing.
……Sinz I actually don’t think you’re a fool although your obtuseness frequently tests my patience…..MA is not national……I can’t help but think disturbing number of “foreigners” show up in MN also because the Mayo clinic is there (I actually know a couple) and these foreigners who are paying a premium are actually a nice profit center but they are not “material” in the scheme of things…….Do you ever ask yourself why the entire developed world has universal, largely govt directed healthcare and spends half what we do…… could there be a connection do you think?
82 balconesfault // Mar 21, 2010 at 7:11 pm
“Sinz: I don’t see how we can control the cost of health care when 78% of it is ruled off limits to reform.”
“Am I incorrect that 8 months ago, you were attacking the public option because you feared companies would drop their coverage, knowing that employees could buy into a public plan?”
……….Sinz, old man, remember this?
sinz54 // Mar 21, 2010 at 8:38 pm
ottovbs: I actually don’t think you’re a fool
Coming from you,
that’s quite a warm and valued compliment indeed. AFAIK, you’ve never bestowed it on any other right-wing posters here.
Do you ever ask yourself why the entire developed world has universal, largely govt directed healthcare and spends half what we do
Frequently.
And I’ve come up with two answers:
1. Because we subsidize them; and
2. Because they ration care and medical supply tightly, in ways that would be anathema to the individualistic, free-wheeling American people.
The “entire developed world” has price controls on pharmaceuticals that are developed by American pharma companies, often with research funds from the NIH, paid by American taxpayers. Those pharma companies are forced to cost-shift the cost of those drugs from foreign countries onto American consumers. That’s how they stay in business–by charging us that much more for what they can’t squeeze from foreign countries. But if America placed the same draconian price controls on drugs that foreign countries do, these pharma companies would end up like insurers in MA: They would become money losers. And the development of new life-saving drugs would suffer.
And as for rationing:
The British NHS has a flat rule: They won’t pay for any treatment that costs more than $40,000 to extend your lifespan less than 6 months. Instead you’re offered treatment in a hospice.
That is entirely logical–the biggest cost driver is the final year of life, when one fights that final losing battle to stay alive–but will never sell in America. We have a deeply religious population that won’t accept any government policy that sounds biased toward euthanasia.
But at least if you’re wealthy enough, you can pay for extra or better care from private clinics, which do exist in Britain.
In Canada, with their single-payer system, private clinics are illegal. I once asked the advocates of an American single-payer system if those of us with some means could obtain extra care out of pocket, if we weren’t satisfied with what the single-payer system provided us. Their answer was NO. In their model, Bill Gates wouldn’t be entitled to anymore care than some impoverished welfare recipient in the slums; anything else would be against the law. And that, kiddies, is one more reason why single-payer flopped in America. We don’t believe in universalist leveling.
And I’ll believe you will find that the French have huge co-payments–20% to 30% for virtually everything, including major surgeries. That’s actually worse for a patient than what you can get here in America from an HMO. On the other hand, the French expand the supply of providers, by giving each medical student “free” medical education (paid by the government).
Personally, if I had to pick just ONE foreign medical system as worth emulating here in the U.S., I would pick the French model.
But I would use every diplomatic and other leverage at our disposal, to end this practice by our “allies” of putting price controls on drugs created by American scientists, in American laboratories.
And it is important to realize that the health care system a nation has is a function of its values. Unlike Europe or Canada (which was till fairly recently a part of a European empire), America was founded on a creed of wild freedom and fierce individualism. Our ancestors came here to get away from European collectivism. The Left doesn’t get that. They are always asking why America can’t have the same types of health care that they have in Europe.
The answer is that Americans have always been proud of not being anything like Europe.
Hope this helps.
sinz54 // Mar 21, 2010 at 8:41 pm
ottovbs:
One more thing.
The French model is superior to both the Canadian, British, and Canadian models, precisely because it forces all French citizens to have “skin in the game.” Heavy co-payments are a disincentive to frivolous visits to doctors by hypochondriacs.
The French model is the only one that makes some kind of sense–though again, I wonder how solvent it would be without price controls subsidized by Uncle Sap.
ottovbvs // Mar 21, 2010 at 8:50 pm
85 sinz54 // Mar 21, 2010 at 8:41 pm
I’ve lived in France and Britain and been treated under both systems and I’d agree the French systme is better but if you think it’s less tightly controlled than the British you’re in dreamland…..the French are much more dirigiste than the Brits……and French waiting rooms seemed as full of hypochondriacs as British ones to me
………As for the drug companies I agree they are cleaning up at our expense……the rest of the world seems to have heard of the “price break” but here the politicians on their payroll make sure there’s radio silence…..you think this is a good thing…..it isn’t for American taxpayers or patients……and I say this as someone who has invested in pharma stocks for years and made lots of money…..I’ll be looking for signs that it’s time to jump ship but that’s at least a couple of years away in my judgement.
ottovbvs // Mar 21, 2010 at 8:56 pm
“And it is important to realize that the health care system a nation has is a function of its values. Unlike Europe or Canada (which was till fairly recently a part of a European empire), America was founded on a creed of wild freedom and fierce individualism. Our ancestors came here to get away from European collectivism. The Left doesn’t get that. They are always asking why America can’t have the same types of health care that they have in Europe.”
…….Sinz…..at times you descend into self parody……I’ve got news for you…..when most American immigrants came here pre 1914 there was no European collectivism outside of Germany(as Bismark’s bulwark against the left) and some feeble stirrings in Britain……the great Irish immigration of 1845-75 was not because of collectivism in Ireland…..quite the contrary.
wht // Mar 22, 2010 at 12:09 am
There is one optimal actuarial algorithm that will work for all health insurance policies for everyone in the USA. There is no reason to have more than one insurance company as the insurers can’t differentiate their product based on this one insurance algorithm. All updates to the algorithm work by simple Bayesian updates that the US government can just as easily maintain as your garden-variety Aetna can.
Here is an example, based on working on taxes recently, there is a simple algorithm that specifies how much of an IRA distribution to take out based on your age. It looks at actuarial tables and estimates the minimum payout based on expected life expectancy from you current age. This is basic probability and no one could do any better job than the government based on the data at hand. It actually makes you feel good, because when you get to 75, you realize that you won’t automatically keel over. Well that is probability at work (thank goodness). Most health insurance algorithms are no different. In other words, differentiation of actuarial algorithms between insurance companies does not exist, and they can not figure out life expectancies or health rate payouts any better than the government can with a small stable of actuarians. In this sense, commercial insurance policies are an archaic relic of a cutthroat industry. They exist solely to skim profits off the margin and via monetary exchanges.
RK0 // Mar 22, 2010 at 12:35 am
Instead employers with payrolls above $500,000 would be required to buy health coverage for their employees – and to pay the larger portion of the bill directly, without their employees’ feeling the cost.
My understanding was that this provision was in the initial House bill, but under the Senate bill and the reconciliation bill, the penalty applies to businesses with 50 or more employees (click on “Employer Mandates”).
sinz54 // Mar 22, 2010 at 9:16 am
ottovbs: American immigrants came here pre 1914 there was no European collectivism outside of Germany(as Bismark’s bulwark against the left) and some feeble stirrings in Britain
Correct.
And the British Health Service didn’t exist then either.
But in the 20th century, Europe chose collectivism, in one form or another. Not till the late 1970s was there any move away from that (and that move proved only partial). The mindset that a European is entitled to cradle-to-grave social security is now unshakable.
America never chose collectivism. We Americans simply don’t believe in welfare states.
FDR could never have sold Social Security if he hadn’t constructed it as a plan with the illusory but popular notion that you pay into the system to receive “your” benefits at retirement. He knew that Americans hate welfare programs.
America just ain’t like Europe. We’re more individualistic, more libertarian (with 150 nationalities represented here, we have to be), and proud of the fact that our ancestors came here to get away from Europe and yet we were generous enough to save Europe’s ass four times at least.
That’s why the Left’s argument about “why can’t America have what Europe has” falls like a lead balloon, every time it’s been tried.
WE AMERICANS DO NOT ADMIRE EUROPE.
We’ve seen enough of Europe’s history. Especially its ghastly 20th century history.
Europe is still on probation, as far as I’m concerned.
Let’s see if they can handle the influx of Muslim immigrants without going Fascist.
Either way, this time, we’re not going to bail them out.
ottovbvs // Mar 22, 2010 at 9:43 am
Sinz;
“But in the 20th century, Europe chose collectivism, in one form or another. Not till the late 1970s was there any move away from that (and that move proved only partial). The mindset that a European is entitled to cradle-to-grave social security is now unshakable.”
……But that’s not when most of the immigrants to the US who were developing all that self reliance and general wonderfulness in your purple prose came here……Actually European collectivism is largly a postwar phenomenon passed in the main by right wing govts to prevent a repeat of the events of the thirties when extreme poverty drove people into political extremism with results we all know about.
” Europe is still on probation, as far as I’m concerned.
Let’s see if they can handle the influx of Muslim immigrants without going Fascist.
Either way, this time, we’re not going to bail them out.”
……..It’s xenophobic statements like this that are so asinine that they shade off into the humorous that makes a reasonbly intelligent man look rather silly
sinz54 // Mar 22, 2010 at 9:49 am
THIS IS A TEST MESSAGE
testing an apparent bug in FF
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