Obamacare: Nay

March 20th, 2010 at 12:30 pm David Frum | 93 Comments |

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Not 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.

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93 Comments so far ↓

  • ottovbvs

    49 franco 2 // Mar 21, 2010 at 12:09 pm

    “I don’t care if I get banned from this pathetic site……..Then this site, lacking any recognition desperately tries to sex things up with gossip, all the while pretending to be a serious site. too pathetic for words.”

    ……I hope you don’t get banned either franco, you and indie are such a source of entertainment all the while taking yourself so seriously

  • franco 2

    Quoting Shakespeare eh? You must be a smaaart un!

    What I kinda meant was more this:

    “In peace there’s nothing so becomes a man
    As modest stillness and humility:
    But when the blast of war blows in our ears,
    Then imitate the action of the tiger;
    Stiffen the sinews, summon up the blood,
    Disguise fair nature with hard-favour’d rage;
    Then lend the eye a terrible aspect;
    Let pry through the portage of the head
    Like the brass cannon; let the brow o’erwhelm it
    As fearfully as doth a galled rock
    O’erhang and jutty his confounded base,
    Swill’d with the wild and wasteful ocean.
    Now set the teeth and stretch the nostril wide,
    Hold hard the breath and bend up every spirit
    To his full height. …”

  • balconesfault

    Sinz: But once these illegals are brought into the system, they’re going to demand the same generous care for their chronic conditions that the rest of us get. And that’s going to bid up the cost of that care enormously–supply and demand.

    So your contention is that any action we take to increase the number of people who have access to healthcare is bad for society, because it will drive up the price for everyone due to supply and demand?

    This would seem to be an excellent reason for favoring a government takeover of the healthcare system, if you really believe that the free market is that absolutely dysfunctional.

  • franco 2

    No I enjoy the absurdity. Not so much from you left wingNUT trolls, you’ll notice I swat you away or ignore you, but from the wimpy Republican policy wonks who don’t understand that you “progressives” want to progress all the way to totalitarianism. Anti-freedom and one-party (yours) Sate control that’s what you want. You have no principle, scruples or moral compass. You lie distort and deceive at every turn. I care not what you think of me, because I have about the lowest opinion of you – in the political sense – that’s possible. You guys are Cartman, except Cartman has some likability factor because he’s honest.

  • franco 2

    I use you trolls as examples. I think you guys have done some good work here exposing yourselves as craven partisans while posing as reasonable quasi-centrists. You have opened up some eyes of some of the wimpy Republicans here who are understanding that policy debates with Democrats are really lip-service. Democrats want power not good policy, and they will use good policy, the illusion of good policy, the propagandizing of bad policy the demonization of opponents good policy, whatever to advance their power agenda. It becomes more and more obvious. The problem for you guys is that the move into open leftism was premature and there will be a backlash. Prepare for it!

    Obamas poll numbers are already in the tank.

    Well it’s a nice day, I’m going outside. You can discuss quietly amongst yourselves your plans to retake Congress in 2012 and whether to primary Obama or to double down again.

    Ta-ta!

  • balconesfault

    from the wimpy Republican policy wonks who don’t understand that you “progressives” want to progress all the way to totalitarianism.

    I’m glad that you use a “small t” totalitarianism here, because what we progressives want is so far removed from true totalitarianism that it’s farcical to use that term. Then again, you probably consider it a step towards totalitarianism to pass laws to regulate how much of a toxic substance a company can discharge into a body or water or into the air.

  • ottovbvs

    franco:
    “Well it’s a nice day, I’m going outside.”

    …..to look for some chairs for your picnic?

  • sinz54

    balconesfault: So your contention is that any action we take to increase the number of people who have access to healthcare is bad for society, because it will drive up the price for everyone due to supply and demand?
    No.

    My contention is that illegal aliens should not be buying into the health care system. It should be for citizens only. As citizens, these formerly illegal aliens will be working to make America more prosperous, not taking the money and going back to their home countries to spend it there.

    It’s exactly consistent with my earlier point, which I will repeat here:
    At Mass General, they have interpreters ready to speak to foreign patients in 30 different languages.

    If it was up to me, I would ban foreigners. No more Canadians or Africans traveling to Massachusetts General for care, even if they’re affluent and can afford it, or even if their governments will pay for it. All such excess demand ends up doing is bidding up the price of health care for the rest of us. Since Canadians and Europeans are so proud of their health care systems, they should be banned from coming to American hospitals.

  • franco 2

    As in, “Otto is a few sandwiches short of a picnic”, but he brought his chair anyway.

  • sinz54

    balconesfault: we progressives want is so far removed from true totalitarianism that it’s farcical to use that term.
    What concerns conservatives like me,
    is that I rarely, if ever, see “progressives” finding legitimate uses for the free market.

    They can think of a thousand reasons and ways that government should intervene more and more in the economy–but they can’t draw a bright red line around that and say “Here is what the free market should always be doing and the government should never be doing.”

    Hence over time, this becomes a steady accretion of government control over the economy and ever stricter constraints on markets.

    As a conservative, I’m willing to say what I believe the proper role of government is.

    How about you progressives being willing to say what you believe the proper role of markets is?

  • sinz54

    COProgressive: Where was the outrage then?
    Over Medicare Part D?

    The GOP base never liked Medicare Part D. But they had committed to backing Bush on the War on Terror, and didn’t want to weaken him further at a time when the attacks on Bush and Cheney from the Left over the Iraq War had reached a point of actual hysteria. The GOP base wanted to see Bush re-elected to see the Iraq War through. So they circled the wagons around Bush, reacting reflexively to any dissent from Bush policies, and they kept their mouths shut themselves.

    And that was a mistake.

    To your credit, you Lefties haven’t done that. You haven’t said “Let’s not criticize Obama from the Left because we don’t want to make it harder for the Dems to win in 2010.”

    I think it’s because you Lefties are more comfortable with dissent and demonstrating against the status quo than we conservatives are. In this country, you’ve been marching, demonstrating, protesting, for a lot longer than we have. So dissent comes a lot easier to you. It’s in your blood.

  • ottovbvs

    60 franco 2 // Mar 21, 2010 at 12:52 pm

    …….I thought you were leaving us because we weren’t worth talking to or had been swatted away……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?

  • ottovbvs

    sinz54 // Mar 21, 2010 at 1:05 pm

    “The GOP base never liked Medicare Part D. But they had committed to backing Bush on the War on Terror, and didn’t want to weaken him further at a time when the attacks on Bush and Cheney from the Left over the Iraq War had reached a point of actual hysteria. The GOP base wanted to see Bush re-elected to see the Iraq War through. So they circled the wagons around Bush, reacting reflexively to any dissent from Bush policies, and they kept their mouths shut themselves.”

    …….ohhh it was all the democrats fault the Republicans didn’t express outrage….but of course

  • balconesfault

    Sinz – would you ban the export of goods manufactured or extracted in the US because allowing the export raises the cost of those goods domestically?

    I’m really unsure of what your principle is.

    Particularly since what you’re talking about in #24 – banning people from legally entering the US to purchase treatment in legal private transactions – seems to represent another step in “a steady accretion of government control over the economy and ever stricter constraints on markets”.

  • ottovbvs

    It’s exactly consistent with my earlier point, which I will repeat here:

    “If it was up to me, I would ban foreigners. No more Canadians or Africans traveling to Massachusetts General for care, even if they’re affluent and can afford it, or even if their governments will pay for it. All such excess demand ends up doing is bidding up the price of health care for the rest of us. Since Canadians and Europeans are so proud of their health care systems, they should be banned from coming to American hospitals.”

    ……er…. but that wasn’t your original point was it, the qualifiers crept in when I pointed out these foreigners who are actually relatively few in number (and not the hordes you implied) were paying full tariff and thereby actually defraying the total cost of healthcare provision…….I’d love you to explain the economic mechanism whereby this “bids up” the price of healthcare for the rest of us…….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……the fact they are less willing to do this and have effectively reached the limit of what they can shift to employees is what lies at the core of the developing healthcare crisis

  • ottovbvs

    balconesfault // Mar 21, 2010 at 1:20 pm

    Sinz – would you ban the export of goods manufactured or extracted in the US because allowing the export raises the cost of those goods domestically?

    I’m really unsure of what your principle is.

    Particularly since what you’re talking about in #24 – banning people from legally entering the US to purchase treatment in legal private transactions – seems to represent another step in “a steady accretion of government control over the economy and ever stricter constraints on markets”.

    ……Sinz, bless his heart, is not exactly the most intellectually consistent of folks

  • agentprovocateur

    “But hey, it’s a good diversion for your team –you got us off the thread’s topic once again… onto anything but Obama’s greatest gift to the GOP: Obama sCare [sic] passage.”

    Hey, wait a minute. I thought there was no way this thing was going to pass? At least that is what the strategic genius from Michigan with the multiple aliases was telling us earlier this week. Now we are told that it’s passage will be a “gift” to the GOP? Whirling dervish, indeed.

    re: franco 2 // Mar 21, 2010 at 12:09 pm

    If this site is that bad, why do you keep hanging around?

  • balconesfault

    If this is a question of supply and demand, we should simply consider the following.

    Each year, we graduate about 40,000 law school students.

    Each year, we graduate about 16,000 medical school students. Our medical school population, thanks to various restraints, has remained constant since 1980 despite our growth in population – as a result an ever increasing number of our physicians are trained abroad.

    Increase the number of med schools in the US. Subsidize them so someone can graduate without 200K in debt.

  • ottovbvs

    From C span(expletives deleted but these folks really are brain dead to the point it’s humorous)

    “The first opponent I heard was a woman from Delaware who said both she and her husband were disabled and on Medicare yet were absolutely opposed. The neutral guy with the host kept saying he couldn’t understand how this would affect her and the host was saying “but you’re already on a govt. healthcare plan.” The lady was muttering something about a $1000 deductible, um WHAT DO YOU THINK WOULD HAPPEN IF YOU HAD PRIVATE INSURANCE?

    The next lady was undecided, said her premiums were as much as her rent, yet she wasn’t sure how much this bill would help. Here’s my question to her: HOW COULD IT GET ANY WORSE FOR YOU?

    The last guy was the best. The apex of wingnut. Said he was opposed to the bill and govt. involvement in healthcare. That, unfortunately, healthcare was a privilege, not a right. And most gloriously, that neither he nor his wife had health insurance because they couldn’t afford it. They hoped to have it one day, but not from the government.”

  • Independent

    agent’P or B’fault or whatever name you’re going by this thread: “Hey, wait a minute. I thought there was no way this thing was going to pass? At least that is what the strategic genius from Michigan with the multiple aliases was telling us earlier this week. Now we are told that it’s passage will be a “gift” to the GOP? Whirling dervish, indeed.”

    I pointed out to you repeatedly that if it passes, the Obami will have given the GOP yet another nail to drive into the Democrat coffin and we lower ya’ down… no Last Post & Chorus, this time though.

    The title Whirling Dervish fits only you and your alternate personae, agent’P. I just tell the truth.

  • balconesfault

    agent’P or B’fault or whatever name you’re going by this thread

    Sorry – you’re the multiple name guy.

    the Obami

    Idiot.

  • balconesfault

    Well, from the most famously banned troll on FF site, you would know TeaBagged.

    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.

    Mi-GOPer, master of projection.

  • Carney

    blowtorch_bob @ 1, what are you talking about? Liberating Iraq was thoroughly discussed at exhaustive handwringing length, for 18 interminable months, in every democratic country, before the long-overdue effort was finally and at long last launched. And that was after ten years of dithering while Saddam blatantly violated the 1991 ceasefire terms.

    Can you name me a single war in history that was more fully debated before it began?

  • ottovbvs

    Independant:
    “I pointed out to you repeatedly that if it passes”

    ……Except when you were repeatedly pointing out it hadn’t got a snowball in hell’s chance of passing…….apart from the vicarious pleasure of making dogs bark I do wonder why we bother playing with you Indie in that you don’t really have any contact with political reality, you don’t even pretend to have despite the ho ho “Independant” label…..there’s a slight chance this won’t pass but a receding one and ultimately it’s a deal based on recon as I personally have always believed it would be…..it took about three months longer than I expected and the Democrats won’t get the PO which was always a 50/50 chance but it was always an outside chance it would fail completely…..now the rhetoric is changing to “we’ll repeal it” which is really an admission it’s going to pass and which is never going to happen because as Kristol pointed out years ago and Sinz and co know only too well it’s going to be very popular……you’re living in an alternate reality up there in MI I guess.

  • ottovbvs

    Carney // Mar 21, 2010 at 3:01 pm

    ” Can you name me a single war in history that was more fully debated before it began?”

    …..American civil war(in south), Austro Hungarian declaration of war on Serbia (the assassination was just the Causus Belli, they’d been planning it for years), German declarations of war on France in 1914 and Russia (Germany had been debating a pre-emptive wars against these countries for years)…..just a couple of examples that spring to mind……the problem with the Iraq war was that the Causus Belli was largely a fiction (two fictions actually…..WMD and a 9/11 connection)…..that’s one of the reason the whole enterprise is regarded as a disaster (by about 75% of the country anyway)

  • franco 2

    “……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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    “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

    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

    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

    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

    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

    THIS IS A TEST MESSAGE
    testing an apparent bug in FF