Reforms Conservatives Can Favor

53 responses so far

• 1 sinz54 // Aug 8, 2009 at 11:32 am

  Here’s a reform that we can support:

  Currently, our Congresspersons have a government program that gives them the choice of TEN–yes, TEN–different health care plans.

  It is unconscionable that our elected representatives should enjoy better health insurance than their constituents.

  If we’re going to create these health co-ops, then let’s move ALL our Senators and Representatives into those co-ops. Let them beta-test those co-ops THEMSELVES–by forming the “Congresspersons Co-operative”–and let them negotiate in the private market like everybody else.

• 2 midcon // Aug 8, 2009 at 11:40 am

  In the interest of providing correct information because I like to be absolutely correct, I thought I would provide the url for information on the health insurance plans that are available to Congress (and by the way, to myself since both they and I are covered un the Federal Employees Health Benefits program). You will note that you need to select a state in order to see the availalble plans because some plans are state specific. Also, some plans only be for a certain group, such as Foreign Service Officers, and not generally available to other federal employees.

  Enjoy! http://www.opm.gov/insure/health/planinfo/index.asp

• 3 sinz54 // Aug 8, 2009 at 12:16 pm

  Here is what is available to Federal Employees in my state of Massachusetts, for example:

  http://www.opm.gov/insure/health/planinfo/2009/states/ma.asp

  As I said, there are TEN plans open to everybody, and NINE more open to those with specific jobs and needs. That’s far better than even the employees of a large corporation like Raytheon get.

  That’s unconscionable.

  Let’s move all the Federal employees into the ObamaCare “public option.” They can “beta-test” it for a few years.

• 4 cubuff1 // Aug 8, 2009 at 1:37 pm

  Spot On. Give them tax free money not Government subsidized health options. Start at the top that is where leadership begins.

• 5 midcon // Aug 8, 2009 at 1:49 pm

  Actually, in a few years I will have a choice of the current public option – Medicare vs my current FEHB. I certainly will do an analysis to determine which is more financial favorable to me.

• 6 ottovbvs // Aug 8, 2009 at 4:29 pm

  ……..The average cost of a plan for a family of four purchased by the private sector from a private insurer is around $13,500…….the average cost of government plans is $17,000……..why is that I wonder

• 7 Spartacus // Aug 8, 2009 at 6:34 pm

  Frum says: “We should favor the creation of non-government health cooperatives – provided that they truly are non-government . . . Direct government provision ought to be the conservative red-line . . . ”

  Why?

  The positions Frum takes on these issues are purely ideological. Shouldn’t we evaluate ALL of the options and weigh the actual, real-world costs and benefits of each, choosing the best plan irrespective of which ideologies it might offend?

• 8 Spartacus // Aug 8, 2009 at 6:44 pm

  Frum is opposed to community rating but, combined with an individual mandate and subsidies, that’s what is largely responsible for very low uninsured rate in Massachusetts.

  Moreover, while tort reform is good, it is deceptive to suggest that tort litigation is a major driver of medical malpractice premiums. Many states have already enacted tort reform and med mal premiums have continued to rise. The continued rise is likely due to the fact the cost of medical treatment for a plaintiff in a medical malpractice case continues to rise which, in turn, is due to ever increasing costs of new technologies/therapies.

  Tort reform is a good thing, but you’re simply not going to bend the cost curve with it.

• 9 midcon // Aug 8, 2009 at 6:59 pm

  Otto, My guess is that the government plans include significant regulations that the plans have to meet. For information on just what they have to do to be a Federal Employees Health Benefits provider here is a url to the solicitation documentation.

  http://tinyurl.com/OPMFEBH

• 10 Spartacus // Aug 8, 2009 at 6:59 pm

  Frum says: “The practice of imposing a “lifetime cap” on health coverage is outrageous and should be banned. ”

  I agree this is bad, but you will destroy the private insurers if you require them to take on unlimited risk without doing anything to contain the costs of care.

  Healthcare reform is not just about expanding coverage it has to also contain the costs of care. It is impossible to expand coverage on a sustainable basis without also containing costs.

• 11 joemarier // Aug 8, 2009 at 9:49 pm

  A couple more: Let’s make sure to respect the Hyde Amendment, let’s let pharmacists prescribe some medications, let’s allow association group health plans, let’s allow plans with 4 million dollar deductibles as an alternative solution to banning any plan without a lifetime max, let’s allow federally chartered insurance companies, and can we do anything about breaking up county-wide hospital monopolies like in Maui and in Loudon County?

• 12 joemarier // Aug 8, 2009 at 9:52 pm

  Also, how about a cafeteria plan mandate? Part of the problem is people think they’re making 30k and paying 3,000 when in actual reality they’re making 39k and paying 12,000. There’s your problem right there.

• 13 Conservative David Frum on the healthcare fight - Politics and Other Controversies - City-Data Forum // Aug 8, 2009 at 9:57 pm

  [...] These are David Frum’s non-gov’t alternatives. They are an improvement on the current system but I still believe in a public option. Reforms Conservatives Can Favor [...]

• 14 Reasonable Conservatism « Droit Blog // Aug 8, 2009 at 11:04 pm

  [...] healthcare reform, in Reforms Conservatives Can Favor, Mr. Frum offers 8 reasonable principles to ground conservative healthcare reform proposals. These [...]

• 15 SFTor1 // Aug 9, 2009 at 2:40 am

  Let’s stop nibbling around the edges. There is no reason not to admit that health care is not a market. The Hippocratic Oath is diametrically opposed to the corporation’s fiduciary responsibility to its shareholders. Irreconcilable, period. Health care is not suitable as a business. Just as we have cops to keep us safe, we need a health care system to keep us healthy. No less. That means breaking the health care oligarchs once and for all, and putting in place a system that delivers to all Americans. If Republicans can’t see that this is the only durable solution, they should at least get out of the way. It is not an abdication of capitalist principles, just an admission that there a certain things that are too important for businesses to handle. Sort of like national defense.

• 16 Winning the Healthcare Fight | Outside the Beltway | Online Journal of Politics and Foreign Affairs // Aug 9, 2009 at 7:34 am

  [...] do? Well, nothing in that post.  Fortunately, he follows it up with this a rather detailed set of bullet points which he says is “non-exhaustive.”  Allowing the self-insured to buy insurance with [...]

• 17 barker13 // Aug 9, 2009 at 9:52 am

  One more time…

  Anything referred to as “insurance” must operate as… “insurance.” The actuarial realities must be acknowledged. Over the long haul the financial system must take in at least what it’s paying out and I’d argue more. (Yes… profit… I realize that’s a “bad word” to some of you.)

  I agree with the “Left” side of the isle on the question of universality. In a society where everyone is going to be treated to one extent or another, it’s only fair that everyone pays to one extent or another – and by that I don’t mean “pay what they can;” what I mean is that I acknowledge that at the low ends there are going to be subsidies.

  (Hey… if we had a society/government willing to let people face the consequences of irresponsible behavior I’d opposed mandatory insurance on libertarian principle, but since we don’t live in that type of society I’m gonna cut down on the leeches any way I can.)

  A few key points:

  We’ve got to do away with “employer provided” health insurance and make insurance (and health care) an individual/family responsibility – just as all other expenses are.

  Will this cost American more in the short term? Sure. But in a fair sense! I mean right now we have a situation where if you’re employed and receive employer paid/subsidized health insurance the government is basically picking up the tax bill yet if you’re not in that situation you’re on your own – no tax subsidy (except for being allowed to fund your premiums pre-tax).

  Again… just as you pay your rent/mortgage, grocery bills, vacations, car payments, clothing purchase, etc., out of your overall income, so you (we) should be paying for our health insurance out of our income. This puts everyone on an even playing field. And this makes everyone aware of exactly how much they’re paying – just as they are as concerns their other living expenses.

  Insurance should be based upon the individual. By this I mean a family of two adults and three children should be paying more for the same insurance as a “mirror” family of two adults and two children. By the same token, the “original” family should be paying less than a “mirror” family of two adults and four children. (BTW, obviously parents must be responsible for their minor children’s insurance. Once a “kid” hits 18 the burden will legally shift to him or her, but of course if the parents choose to keep paying the “child’s” insurance premiums for a period beyond this that’s up to them.)

  Now… what are we talking about in terms of insurance. Well, I’m talking catastrophic insurance. Something that kicks in after you’ve spent a certain portion of your individual/family income over a certain period of time. (I’ve outlined this proposal in the past here at NM.) Basically we need to place “normal” health care expenditures back in the category of “normal.” People need to understand that healthcare isn’t free and that in terms of “normal” health care expenses you’re expected to shoulder them just as you shoulder your other normal day to day, week to week, month to month, year to year expenses. Again, we return to the concept that “insurance” must be “insurance,” not simply income transfer or pre-payment.

  Now… I keep on coming back to the concept of “actuarial” calculation. In line with this there must be carrots and sticks. Now laying aside for the moment the whole pre-existing conditions debate, let’s talk “normal” people. It seems to me that certain exam mandates are totally appropriate and those who refuse to get yearly exams, get their colonoscopies at the appropriate life points (whatever the recommendations are, tailored to your family history of course), all the so called “preventive care” milestones should be nailed with higher premiums. After all, they’re putting themselves at greater risk! Same with smoking, obesity, other behaviors/choices which put one at risk…

  Hey. Obviously the insurance companies – and the government – could (and no doubt would try) to go way overboard, but I’m fleshing out a basic concept here. Heck… I spoke of carrots too; perhaps mandated “preventive care” would be incentivized. Bottom line, though… risks and costs must be balanced as best we can – otherwise the system capsizes.

  So… pre-existing conditions…

  Part of the cost of insurance will go towards pre-existing conditions. The question is, what’s appropriate for society as a whole to subsidize and what’s “fair” for the sufferer individually to bear?

  Hey… we can work that out! This is where we get all off-track in this whole health insurance/health car debate – we tend to gravitate towards the “what ifs” as opposed to taking care of the vast majority of “normalcy” first.

  If we create a system that first and foremost addresses the needs and economic reality of serving these needs of your average person leading an average life with average problems… THEN you can start worrying about the extreme ends – take account of those with pre-existing conditions.

  I don’t have all the answers, all the details, but I know enough to know you’ve got to start with designing a system that concentrates on the “many” vs. the “few.”

  Anyway… enough for one post. (*WINK*)

  BILL

• 18 Asteriodboy // Aug 9, 2009 at 11:23 am

  This post strikes me as a serious conservative view on health care. Im left of center and generally supportive of what the Obama administration wants to do in health care but I don’t see the public option as the litmus test of serious reform, so if jettisoning that would bring serious conservatives to the table with a list of proposals like the one here, there still may be a way to get substantive reform without alienating a sizeable segment of the population that is dead-set against greater government involvement in health care (despite the laudable track record of government-led programs in Europe, Japan, Taiwan and elsewhere). One objection, however: the community rating does not need to be so constrictive that it prevents insurers from offering discounts/incentives for healthier behaviors. I think Obama’s health care team would welcome discussion on tweaking a community rating approach so that it allows discounts for non-smokers, weight loss, or other lifestyle-related behaviors associated with better health. If we stick with a private-sector health insurance system, then measures must be put into place to counter the incentive for insurers to cherry pick the best risks–the young and healthy that do not need expensive medical care–and leave those with poor risk profiles–e.g., older people with weight issues/smokers, diabetics, asthmatics or other pre-existing conditions–with few options aside from very expensive coverage with high deductibles. Taken to an extreme, insurers would compete to identify the best risks and avoid the poor ones (government regs on company-sponsored health care plans that enforce a community-rating approach are one reason the US system is not at this extreme). The status-quo is not an optimal outcome for anyone but the insurers. From a broader social perspective, it seems absurd to set up a health care system where government insures the most expensive segment of the population (over 65 covered by Medicare) and the rest of the market is left to insurers to skim off a large portion of the nation’s premiums to cover administrative costs associated with cherry picking good risks and denying coverage. Yet competing to select the best risks is the current business model of insurers. It is what they know best and has been profitable for them for decades, so they will probably attempt to get around piecemeal regulation aimed at reigning in this incentive. Community ratings combined with an individual mandate gets around this problem by preventing insurers from pricing policies based on health risk profiles (pre-existing conditions etc.) and instead reorients competition to managing health care for populations since everyone would be charged the same rate for coverage, aside from small allowances for age and discounts for healthy behaviors. I understand concern about government intrusion in markets, especially given how much influence moneyed special interests have in the Senate/House and other federal institutions. Yet the problem of adverse selection is real and cannot be ignored (asymmetric information is also a concern in markets with high complexity but not really unique to insurance, and could be largely overcome with a well-run exchange).

• 19 ottovbvs // Aug 9, 2009 at 11:25 am

  midcon // Aug 8, 2009 at 6:59 pm

  “Otto, My guess is that the government plans include significant regulations that the plans have to meet. ”

  ……..Call me stupid but I’d say it’s much more likely to be greater benefits, lower deductibles and lower co-pays…….greater regulation hardly accounts for a 26% premium

• 20 mymy // Aug 9, 2009 at 11:26 am

  AH Mr. Frum looking for TV time? “next we have Conservative David Frum”and Mr.Frum will be more than happy to bash those who don’t want more Gov. control over their health care.I do hope Mr. Frum doesn’t call us crazy,but I wouldn’t bet on it

• 21 midcon // Aug 9, 2009 at 11:37 am

  barker,

  Well said. As a broad concept, we forget that the debate should be about insurance, not health care. We generally have the best health care in the world and we have equal access to that the health care. What we do not have is equal resources to access the health care. Those with better insurance have more resources. Although you (and I) are not attempting to equate health care insurance with auto insurance, there are differing levels of auto insurance that are available to each of us depending on need and resources. Everyone should be required to have a minimum level of insurance just as each state requires a minimum level of insurance for vehicles. After that you buy insurance based on what you can afford and need. However, I am not equating a vehicle with a human being so the minimum level of insurance must be driven by basic societal values. Things like pre-existing conditions need to be covered, but just as in a vehicle, if I reach a certain stage in life where I choose not have collision coverage because the age of my vehicle results in a disporportionate cost vs benefit ratio that should be my choice. The same concept could be applied to health insurance. Additionally, lifestyle choices could be taken into account, just as your driving record and the Claims Loss Underwriting Exchange (CLUE) reports are used by the insurance industry to influence your rate for vehicle insurance.

  The problem we face is that everyone wants to fix/correct/design/ the whole enchilada at once, which as everyone knows is much more difficult than if you break it down and tackle it a bite at a time. The plan needs to address everything but trying to put it all in place at once is silly.

• 22 In This Corner, Scrappy Kid From Chi-Town, Barry Obama! And In The Other Corner, The Elephant From “Real America,” The Republican Party! Let’s Get Ready To Rumble! « Around The Sphere // Aug 9, 2009 at 12:23 pm

  [...] do? Well, nothing in that post.  Fortunately, he follows it up with this a rather detailed set of bullet points which he says is “non-exhaustive.”  Allowing the self-insured to buy insurance with untaxed [...]

• 23 Cforchange // Aug 9, 2009 at 1:11 pm

  sftor1 #15, I’m with you. Certainly it is the insured GOP membership that is protesting. Are they a majority, I don’t think so.

• 24 mymy // Aug 9, 2009 at 1:28 pm

  Since 82% of the American public is satisfied with their own Health Care there could be a few non Republicans in these crowds

• 25 ottovbvs // Aug 9, 2009 at 1:35 pm

  midcon // Aug 9, 2009 at 11:37 am
  ” The problem we face is that everyone wants to fix/correct/design/ the whole enchilada at once, which as everyone knows is much more difficult than if you break it down and tackle it a bite at a time. The plan needs to address everything but trying to put it all in place at once is silly.”

  …………You’re correct this is principally about how the healthcare is funded and providing access but an attempt to fix the whole thing is NOT being made at the moment…….what’s
  happened and what always happens is the right attempt to muddy up this basic issue with all kinds unrelated issues related to the delivery of healthcare so were murdering granny, the govt is conscripting all doctors etc etc. The people at fault here are the Republican party who use obfuscation as a tactic to confuse people…..I would have thought that fairly obvious.

• 26 barker13 // Aug 9, 2009 at 1:37 pm

  Re: Midcon // Aug 9, 2009 at 11:37 am –

  “Barker, well said.”

  Well, thanks, Mid, but to throw out a cliche, common sense just ain’t that common. The reaction of most of our fellow posters to a post like mine is to simply ignore it and go back to their “same old, same old” circular arguments disconnected from reality and often hinging on ideology.

  (*SHRUG*)

  Hey… they’d rather fight about it than strive for concrete solutions.

  (*SHRUG*)

  “Although you (and I) are not attempting to equate health care insurance with auto insurance…”

  Nope. We’re simply trying to make the math work within our parameters of fairness and reasonableness. This puts us squarely in the minority. (*WINK*)

  Hey… although I threw the wink in… it’s really nothing to smile about or wink about. Bottom line, Mid, you and I are dragged down by the mob. Oh, sure… sometimes “the mob” is on OUR side (as with this debate) and instinctively recoils at the possibility of government making things worse, but still… how many of “our” like-minded voters are willing to face the bitter medicine I propose such as losing their “free” or subsidized employer “provided” health insurance as part of the price for true reform?

  It’s so damned depressing, Mid.

  (*SIGH*)

  HEY… perhaps I’m wrong, Mid! Perhaps following this post they’ll be a flurry of posts from all points on the ideological spectrum applauding my post and your post!

  (I’m not going to be holding my breath though…)

  (*CHUCKLE*)

  BILL

• 27 ottovbvs // Aug 9, 2009 at 1:40 pm

  mymy // Aug 9, 2009 at 1:28 pm

  “Since 82% of the American public is satisfied with their own Health Care there could be a few non Republicans in these crowds”

  …….Are you guys stupid or do you think we are…………satisfaction is a different issue as you well know or at least I hope you do…….in fact people may be satisfied with their own healthcare but there’s anxiety about what it’s costing them and whether they’ll be able to keep it which is why 75%+ of the country wants reform…..why do these right wing types always produce non sequiturs

• 28 SFTor1 // Aug 9, 2009 at 2:15 pm

  When I read many of these posts, what strikes me is the sheer complexity and involvement required of ordinary people in their health insurance and health care issues while they are healthy. What coverage will you have for yourself? For your kids? Will we allow adult children to stay on their parents’ policies? Which hospital to enroll with? Which GP to choose? Which plan? On and on.

  I grew up in Norway. The population is 100% covered. There is a Health Council that works on social medicine, that is preventive education (smoking, obesity, you get the picture.) You then have private physicians being paid by the government. When you are healthy you spend zero time thinking about health insurance and health care. When you are sick, you go to the doctor. If you are really sick, the doctor sends you to the hospital, and you get treated.

  The Byzantine mind twirls we are going through on this thread: only in America.

  Maybe this country is just plain wrong for once. Ever thought about that?

• 29 ottovbvs // Aug 9, 2009 at 2:25 pm

  sftor1 // Aug 9, 2009 at 2:15 pm
  “The Byzantine mind twirls we are going through on this thread: only in America.”

  ………There’s money in confusion…..large parts of American business, well business everywhere really, function by arbitraging confusion and inefficiencies in systems……the US healthcare system because it is so huge is a goldmine in this respect……that’s why so many people are invested in perpetuating the confusion……part of the process is propagandizing those who don’t understand what’s going on

• 30 mymy // Aug 9, 2009 at 4:55 pm

  OTTO Why thank you once again showing all us rude rednecks how to be civil.I sure you are correct about the 82% feeling anxiety about their insurance.I bet the idea of the government taking it over made a lot of them very anxious

• 31 ottovbvs // Aug 9, 2009 at 5:31 pm

  mymy // Aug 9, 2009 at 4:55 pm

  ……I did provide for you to opt out of either being stupid or assuming we were as in:

  “satisfaction is a different issue as you well know or at least I hope you do”

  …….People are anxious for the hard reasons I suggested not the one you invented……….and the govt aren’t “taking it over” btw

• 32 mymy // Aug 9, 2009 at 5:45 pm

  OTTO so there are 1000 page bills floating around to not increase Govt. power.I guess there is a first for everything

• 33 roninjoey // Aug 9, 2009 at 11:45 pm

  Barker, why the fatuous stage directions? Your condescension drips from every letter typed. (*CHUCKLE*)

  Unless there’s been a surprise development, as far as I know there is no one bill being championed by the President, who has asked the Congress to deliver. I understand they would like a public option as a means to create competition with the private insurers, who would then have impetus to keep the cost of private insurance reasonable. Most people would probably prefer private insurance to public insurance and would probably opt for private insurance if it were affordable. The person who was comparing our system to the Australian system had some good ideas about creating incentives to avoid going on a public option. Even so, it’s not looking good for the public option. Ah well. (*TEAR*)

  Public option aside, I believe the original plan was to include a provision that said that companies making over a certain amount of money per year would be required to provide health care to their employees. I can see some conservatives would be outraged by the government telling a company it had to act ethically, but if a company is already that big I think this is a pretty sure way to help control costs. But that’s gone too, thanks to Republicans who fought against it and then went on television bitching that it wasn’t included in any bill. (*DISAPPOINTED GRIN*)

  If we all agree that something needs to be done to reform the health care system in this country I can’t see the point of fear mongering. (*LAUGH OUT LOUD*). I’m glad Barker and his like have such awesome luck with health care and see no point in feeling empathy for people in more precarious situations though. (*WINK*)

• 34 roninjoey // Aug 9, 2009 at 11:50 pm

  Oh shit. I used the word empathy. (*OH NO!*)

• 35 ottovbvs // Aug 10, 2009 at 8:03 am

  mymy // Aug 9, 2009 at 5:45 pm

  “OTTO so there are 1000 page bills floating around to not increase Govt. power.I guess there is a first for everything’

  …….It’s not unusual for the spec for a fairly mundane piece of military equipment to run to 1000 pages…..Just another one those non sequiturs that you right wingers love so much……the fact is the govt is NOT taking over health insurance however much you want to believe this myth that’s basically been invented to frighten the gullible.

• 36 barker13 // Aug 10, 2009 at 8:19 am

  Re: Roninjoey // Aug 9, 2009 at 11:45 pm (#33) –

  “Barker, why the fatuous stage directions?”

  Wow… EXCELLENT use of the word “fatuous!”

  Just my own inimitable blogging style. If you stick around you’ll get used to it. Heck… you even incorporated it into your own post! See how much fun it can be?! (*GRIN*)

  “Unless there’s been a surprise development, as far as I know there is no one bill being championed by the President…”

  No. There are a number of bills (the main proposal most folks seem to be focusing on is of course HR 3200) and the President hasn’t claimed one particular bill as “his” one and only vision of perfection.

  What’s your point…??? (I mean, what’s your point in relation to anything I’ve written…???)

  “Public option aside, I believe the original plan was to include a provision that said that companies making over a certain amount of money per year would be required to provide health *care to their employees.”

  Correct. And of course I’m opposed to requiring businesses to provide health insurance (btw, “insurance,” not “*care” – there’s a difference – a HUGE difference) on a number of levels. Frankly, I don’t believe such a requirement would pass constitutional muster (but we’ll leave that discussion for another day), but beyond that, as I’ve outlined time and again, that would be moving in exactly the WRONG direction. We need insurance to be a PERSONAL responsibility, not a governmental or business responsibility.

  “…if a company is already that big I think this is a pretty sure way to help control costs.”

  Actually, group discounts kinda conflict with the very notion and goal of universal coverage. Shouldn’t we ALL be “the group?” Costs should be costs. (I’ve written about this before… I’m kinda pressed for time at the moment.) (*SMILE*)

  “I’m glad Barker and his like have such awesome luck with health care and see no point in feeling empathy…”

  Ahh… at least a fairly subtle personal jab. (*GRIN*)

  Gotta run! Chat with you later!

  BILL

• 37 sinz54 // Aug 10, 2009 at 9:24 am

  ottovbs sez: “the fact is the govt is NOT taking over health insurance however much you want to believe this myth that’s basically been invented to frighten the gullible.”

  That’s a lie.

  Schiakowsky, Barney Frank, the inventor of the public option, and 99% of the liberals I have corresponded with on the Internet, see a robust public option as the steppingstone to a Canadian-style single-payer system.

  I’m sick and tired of your moby lies. Your purpose here is to lie your head off for Obama.

• 38 Morning Report, August 10th « Evangelical Gateway // Aug 10, 2009 at 10:56 am

  [...] David Frum on health care reforms that Conservatives can [...]

• 39 Stewardship // Aug 10, 2009 at 11:05 am

  Tales from Real Life
  My wife, family, and I have a high deductible policy…$5,000 must be spent out of our own pockets before insurance kicks in. A year ago, one of my sons was rough housing and claimed he broke his wrist. I dismissed it as a sprain, in part, because it was the weekend and I didn’t want to pay $500 for an ER visit. A week later, on a holiday, he complained that it was really hurring, so I took him to the ER. Both bones in his forearm were broken. Fortunately, there were no complications caused by my skinflintness.

  We need to convert our medical system into a more retail-oriented delivery system. If my doctor’s office was open 24/7, like the local Walgreens or Wal-Mart, the visit would have only cost $75.

  Although I am very conservative in most areas, I struggle with the immigration issue. Part of me wants to be lenient. Another part sees the several million dollars of ER care delivered to immigrants at our community hospital–care that would be more appropriately handled in a doctor’s office, and care that they cannot or do not pay for–that is then spread among the paying customers and taxpayers and puckers my skin.

  I turn 50 this year. The benchmark year to have a colonoscopy performed for colon cancer screening. In our area, it costs $2,200. The opportunity cost of spending that money is weighing heavily on my mind. And I’m sure there is some income level and below (say, $50,000) where people simply will not or cannot afford it.

  Any plan that is built upon the idea that everyone must buy insurance needs first to consider that, although auto insurance is mandatory in every state, up to 25% of motorists are driving without coverage (25% in the highest state (California), 8% in the lowest state (Maine). How do you make someone buy more expensive health insurance, if we can’t get them to buy car insurance with the threat of loss of driving priviliges hanging over their heads?

  I live in a small city with a nice hospital. Unfortunately, the hospital tries to replicate all of the services and specialties offered at the much larger regional hospitals located an hour in any direction. The massive overhead drives up the cost of local healthcare. I choose to live in a rural area. I know that really good healthcare, with specialties and state of the art equipment, is an hour away by car. I made the decision to live here, and I should live with the consequence that, in an emergency, I might be in trouble. Do I or my insurance company really want to pay for the $24,000 helicopter ride from here to there? Do we taxpayers really need to pay for Medicare or Medicaid to fly patients from here to there? Again, those folks made the same decision to live an hour away from top notch facilities. Heck, it is as common here to drive to Mayo in Minnesota, a 9 hour drive, as it is to drive to one of the regional facilities. We simply need to be smarter about utilization of assets.

  One major issue regarding insurance companies is that they have to deal with 50 different sets of rules, regulations, and laws. Each state adopts its own insurance laws. Often, insurance companies have to set up entirely separate corporations in states to comply with the laws. The investment in backroom operations and to have a different set of dancers dancing to each state’s tune wratchets up the overhead cost our premiums need to cover. We need to adopt one uniform insurance code to allow all insurance companies to compete across the country. (In my opinion, smart state legislatures would begin pairing up with surrounding states and doing this on a regional basis–it could dramatically drive down costs and make the region a preferred place to locate one’s business).

• 40 midcon // Aug 10, 2009 at 11:10 am

  While Barker’s blogging style is not conducive to skimming (you have to read carefully), there is nothing wrong it. I tend towards treatises and verbosity which can be a big turn off for folks. We all have our style and quirks.

  Barker has a shorter more emotive style. I’m a believer in a big tent and welcome both Barker’s ideas (except for the military coup one) and his style.

  I’m a fan of everyone here who regularly contributes thoughts, ideas, and potential solutions regardless of the label (liberal/conservative) they assign themselves or that which others assign to them.

• 41 barker13 // Aug 10, 2009 at 1:30 pm

  Re: Midcon // Aug 10, 2009 at 11:10 am –

  (*GRIN*)

  Wow, Mid… I just happened to start at the BOTTOM of the thread this time around and I can hardly wait to scroll up to see what it was you were responding to in defending me.

  (*HUGE FRIGG’N GRIN*)

  * O00hhh… I see… you were just getting around to RJ’s post. (*CHUCKLE*)

  No sweat… he’ll get used to my style; everyone does eventually! (*GRIN*)

  Re: Stewardship // Aug 10, 2009 at 11:05 am (#39) –

  “My wife, family, and I have a high deductible policy…$5,000 must be spent out of our own pockets before insurance kicks in.”

  QUESTION: How much are your monthly premiums?

  “A year ago, one of my sons was rough housing and claimed he broke his wrist. I dismissed it as a sprain, in part, because it was the weekend and I didn’t want to pay $500 for an ER visit. A week later, on a holiday, he complained that it was really hurring, so I took him to the ER. Both bones in his forearm were broken.”

  OK. A few points: First of all, you’ve already taken responsibility failing to take your child to the ER initially. Question, though: Was the kid complaining all along – from day one till a week later? If so, why didn’t you schedule a doctor’s appointment – a regular office visit? Why the ER – don’t you have a GP or a pediatrician or even a “Quick Med” type place within a reasonable distance that you could have taken your son to as opposed to an ER visit…???

  “We need to convert our medical system into a more retail-oriented delivery system.”

  “We…???” (Go on… I’m listening…)

  “If my doctor’s office was open 24/7, like the local Walgreens or Wal-Mart, the visit would have only cost $75.”

  Hmm… so you think your doctor is going to offer 24/7 office hours? Is he in private practice, group practice? Who exactly is going be be manning the third shift…??? (*GRIN*)

  (As you correctly note, we HAVE 24/7 emergency care availability – it’s called the local ER.

  Also… along the original line of my “third shift” question… are you under the false impression that we already have more doctors and nurses than we know what to do with so that we can provide the omnipresent 24/7 local doctors’ offices care that you’re apparently calling for…???

  (*SCRATCHING MY HEAD*)

  “…the visit would have only cost $75.”

  How do you figure…??? I mean, obviously you just grabbed a number out of a hat, right? (Hmm… have y0u considered running for Congress?) (*GOOD-NATURED CHUCKLE*)

  No… seriously… where’s you cost metric? What do you think… your doctor and his staff and his nurse are going to be sitting around an empty office at 3:00 a.m. waiting for you to amble in and then they’re going to charge you $75 for examination, X-Rays, treatment, casting the kid’s arm…

  (*LAUGHING OUT LOUD*) What’s your auto mechanic charge per hour – per DAYTIME hour…?!?!

  (Are you getting my point here…???)

  “…the several million dollars of ER care delivered to immigrants at our community hospital…”

  Hey. (*WINK*) I’ve dealt with that. Here’s what we do: When an “undocumented” person shows up at the ER you treat him, right.? So far so good. But then as the medical needs are being taken care of it also becomes a police/immigration control matter so that identity is verified for billing purposes. (Just as you and I verify OUR identities when we utilize an ER – right?) So… let’s say it’s Paddy the illegal alien from Ireland or Jose the illegal alien from Mexico or Viktor the illegal alien from Russia. It doesn’t matter. Once the individual is officially identified as a foreign national who is illegally here we not only institute deportation procedures (after emergency treatment) but we – the Federal Government as the “agent” of the hospital and later the detention facility – start tallying up a bill… a list of charges… for this illegal alien and we (again, the Federal Government) submits this bill to the illegal alien’s home country/government.

  Now… will we necessarily get paid? No. But we’re making a point. And, hey… actually… there are ways (liens, etc.) to seize foreign assets.

  At the very least such a policy would no doubt lead to foreign nations (Mexico primarily) working VERY hard to assist us with our border security because now THEY are the ones being billed for services provided to THEIR citizens here illegally in the U.S.

  “I turn 50 this year.”

  Happy Birthday! Did you go a “guy’s trip” or something special? When I hit 50 we’re either gonna do a “guy’s trip” to Scotland (distillery touring!) or Germany/Eastern Europe (brewery hopping).

  (We went to New Orleans for my 40th!)

  (*WINK*)

  Hey… I’ve gotta run… expecting company any minute. Let me get back to you and continue this later, ok?

  BILL

• 42 Stewardship // Aug 10, 2009 at 4:32 pm

  barker-
  Our premium is just under $4,000 per year, and it’s purchased through an employer. We are in one of the highest cost markets in the nation because of the duplication of services between hospitals.

  My assumption about deliverying health care via more modern retailing assumes supply and demand. An enterprise couldn’t launch 24/7 until the supply of physicians catches up. In my state, 4 universities have announced plans to start med schools (granted, might be a revenue stream in the minds of the chancellors). $75 is what my doc charges for an office visit. And, yes, my son continued to complain about it hurting…but being the tough old jock I am…I thought the ouch would go away after a week. “Dad of the Year” was not a phrase in which you would see my name connected last year!

  I served my community (which owns the hospital) as Mayor–and delivered a symbolic invoice to my congressman for care of illegal immigrants. I told him that immigration law was the domain of the federal government–because it hadn’t done its job, we were left holding the tab. If he wanted to pass it on to the country of origin, feel free.

• 43 barker13 // Aug 10, 2009 at 6:13 pm

  Re: Stewardship // Aug 10, 2009 at 4:32 pm (#43) –

  “Our premium is just under $4,000 per year…”

  For a family, right?

  My wife and I pay approximately $10K out of pocket to ensure ourselves and that’s for Empire Blue Cross/Blue Shield HMO coverage with $500/pppv hospitalization deductibles.

  Do the math: $4K (your premiums for an entire family) + $5K (your family healthcare deductible) < $10K.

  (*SHRUG*)

  You’re not doing too bad; if I could trade with you I would, but here in NY there’s no real “catastrophic care” insurance available. In theory we could get something “called” catastrophic care insurance but due to NY insurance regulations and mandates it’s really NOT true catastrophic insurance (as you have); what they “call” catastrophic insurance here is almost as expensive as “regular” insurance.

  So… to recap… if I had your deal I’d be able to bank THOUSANDS of dollars each year that I presently am forced to piss away on premiums. (Or go without insurance.) Worse case scenario, say I had to spend $5K out of pocket on care in addition to $4K in premiums… I’d STILL be better off under than scenario than I am under a “not sick a single day all year” scenario here in NY.

  “My assumption about deliverying health care via more modern retailing…”

  Is simply off base.

  “$75 is what my doc charges for an office visit.”

  Including X-Rays and treatment – casting in this case…??? (Hey… if you say so…) (*SHRUG*)

  In any case, next time you see your doc ask him how much he’d charge to give you an exam at 3:00 am. (*SMILE*)

  “In my state, 4 universities have announced plans to start med schools…”

  And WHO or what is paying for that…??? (*SNORT*) You’ve just ADDED to overall medical system costs. (*CHUCKLE*) Oh… and then we’re back to the original question of exactly who it is you believe is going to spend hundreds of thousands of dollars on schooling (years and years of schooling) and then spend a career doing what amounts to “shift work” at low enough compensation to make $75 pppv for a 3:00 am visit economically viable while repaying loans and living in the style a doctor deserves after putting in all those years of study in a field where only a small percentage of the population has both the intellectual and physical abilities necessary to shine.

  “I served my community (which owns the hospital) as Mayor–and delivered a symbolic invoice to my congressman for care of illegal immigrants. I told him that immigration law was the domain of the federal government–because it hadn’t done its job, we were left holding the tab. If he wanted to pass it on to the country of origin, feel free.”

  You should have ordered your police to process each illegal and then once this was on the record, the next step would be for your officers to physically deliver each illegal alien to the congressman’s office.

  BILL

• 44 midcon // Aug 10, 2009 at 6:36 pm

  I pay $4279.08 per year for Blue Cross/Blue Shield PPO family (or FFS as it really is called)(Federal Employees Health Benefit). I am generally satisfied with the cost, copay, etc. Although the perscription cost is bit higher than I would like. I could get it cheaper if I went to an HMO or accepted some higher personal cost for services. Sounds like Stewardship is getting a pretty good deal.

• 45 Jim Pier // Aug 11, 2009 at 10:09 am

  sftor1:

  “sftor1 // Aug 9, 2009 at 2:40 am

  Let’s stop nibbling around the edges. There is no reason not to admit that health care is not a market. The Hippocratic Oath is diametrically opposed to the corporation’s fiduciary responsibility to its shareholders. Irreconcilable, period. Health care is not suitable as a business. Just as we have cops to keep us safe, we need a health care system to keep us healthy. No less. That means breaking the health care oligarchs once and for all, and putting in place a system that delivers to all Americans. If Republicans can’t see that this is the only durable solution, they should at least get out of the way. It is not an abdication of capitalist principles, just an admission that there a certain things that are too important for businesses to handle. Sort of like national defense.”

  I am puzzled as to why Hippocratic medicine is necessarily excluded from a market economy. I wonder if you could elaborate? This question is one that I pose to every proponent of socialized medicine with whom I attempt to exchange ideas; thus far, I have received no cogent arguments in support of that position. This is naturally my humble opinion, and would be disputed by the few who have actually given a response – one of whom is Spartacus – but, as in his case, it typically comes down to something like ‘our society has made a value judgment that we are not going to allow the elderly to die for lack of health insurance.’ See if you can spot the weakness of that argument. That’s right, it has nothing to do with economics, nothing to do with whether or not the solution actually effectively solves the problem, in the long term, and without unacceptable compromises to other important values.

  I think it is great that you are proud of Norway’s system. I am not familiar with it, so I will not attempt to use it for comparison, although when I get a chance I will familiarize myself with it, as I am willing to entertain alternative solutions with an open mind. When it comes to other state solutions, however, such as Canada, Great Britain, Sweden, France — there are fundamental and serious flaws in the argument for socialized care, and while the systems are viable for the time being, they are all on trajectories that appear to me to be unsustainable fiscally and as a consequence morally.

  The so-called conservatives or New Majoritarians on this site, for the most part, appear to be willing to settle for half-measures in addressing this issue. I believe what we need to be doing is forcefully and persistently making the case that the reason the US health ’system’ is on an unsustainable path is NOT because of the little bit of free enterprise that has survived thus far, but because of the massive distortions that have been introduced and have metastasized through government interventions beginning with WWII employer-provided health insurance incentives, then accelerating with Medicare/Medicaid, and perhaps most significantly the pervasive regulation of the health insurance market which grossly inflates the cost of coverage and so bastardizes the market the the product cannot accurately be called insurance. Any solution that fails to eliminate these interventions, and particularly one that introduces even more, can do no more than prolong the long, painful decline of the quality of US health care products and services, and the long, painful increase in the relative costs of the ’system.’

  What is needed is the very same thing that works everywhere else – food, housing, clothing, transportation, communications, etc. – and that of course is the free market. The all-encompassing interventions currently in place are what is responsible for the extraordinary growth in HC costs. Employer provided insurance contributed to the elderly being priced out of health insurance, which then created the hue and cry for Medicare/Medicaid, which then accelerated the inflation in the health care and insurance markets, bringing us to the unfortunate pass at which we find ourselves: serious contemplation of measures we know to have failed everywhere else. It bears noting that the US has generated by far the greatest number of advances in treatments, procedures and medications for decades, advances possible only because of free enterprise — a fantastic gift to the socialized-medicine world that cannot generate similar innovation but happily adopts it once the US has paid for its development. These advances have contributed immensely to the improved quality of life enjoyed thanks to Western medicine over the last 60 years or so. It is highly unlikely that this leadership would survive a significant shift further toward socialization. The whole world will pay for that.

  The health care ‘crisis’ in the US is a manufactured one, with liberals exaggerating the problems in the current market in order to justify draconian measures that otherwise would be untenable. Overstating the number of bankruptcies, for instance, is one tactic. Exaggerating the true number who can’t afford insurance but are not eligible for current programs is another – one they browbeat us with incessantly, “47 million uninsured!” when the number in question ought to be closer to 12 million.

  We conservatives need to get away from the concession that health insurance is something that by rights ought to be provided by fellow citizens through taxes. We ought to call Medicare what it is, a welfare program. And we ought to challenge the notion that somehow it is the free market that is responsible for the high and accelerating cost of health care in the US. This notion is the opposite of the truth, and we are doing the nation and the world a disservice to permit the left to get away with that characterization.

• 46 sinz54 // Aug 11, 2009 at 11:01 am

  Jim Pier asks: “I am puzzled as to why Hippocratic medicine is necessarily excluded from a market economy. I wonder if you could elaborate?”

  Can I, a conservative, answer that?

  The law of supply and demand assumes that beyond a certain price, a buyer will refuse to pay. Therefore, the demand curve intersects the supply curve at some reasonable price.

  But that almost never happens with health care for serious illnesses like cancer, heart disease, kidney failure, etc. Because nobody wants to die just because their health care is expensive. Hence a patient with stage III cancer is going to demand whatever health care it costs to save his life, cost be damned. IOW, in health care, we price a patient’s life as if it’s INFINITE. Hence the supply-demand curve won’t intersect at a price that’s reasonable–it intersects at a price that is limited only by supply.

  And sure enough, surveys have shown that one of the biggest, if not the biggest, driver of health care costs is advancing technology. As soon as that stage III cancer patient hears that some hospital has the brand-new whiz-bang Neutrino-Beam machine to treat stage III cancer, he’ll demand it, cost be damned.

  Society is forced to ration care. I have kidney failure. Back in the 1960s, there just weren’t anywhere near enough dialysis machines to go around. And committees went to work, reviewing the backgrounds of kidney patients, deciding who would get dialysis and who would be left to die. It was a literal death lottery, and most kidney patients didn’t win.

  Left to its devices, the free market will ration based on ability to pay. A gazillionaire will get the state-of-the-art Neutrino-Beam machine; a poor person will get a pain-killer till cancer kills him. That inevitably leads you to Social Darwinism–a society based on survival of the fittest, where “fittest” equates to “richest.”

  Most of us don’t want to live in a society where the poor and unemployed have to die of diseases that the rich can afford to treat. And doctors don’t want to cure rich patients while leaving poor patients to die. There’s no way to alleviate that except by government intervention, or by sending those poor patients to go begging to various private charities.

• 47 Jim Pier // Aug 11, 2009 at 12:27 pm

  sinz54 said:

  “I am puzzled as to why Hippocratic medicine is necessarily excluded from a market economy. I wonder if you could elaborate?”
  “Can I, a conservative, answer that?”

  I very much credit and appreciate your effort, but again in my opinion it falls short. I explain:

  “As soon as that stage III cancer patient hears that some hospital has the brand-new whiz-bang Neutrino-Beam machine to treat stage III cancer, he’ll demand it, cost be damned.”
  –First, I grant the point that ever-improving medical technology is a major driver in the cost of care. But far from the only one. The only way he can ‘demand’ it, is if he is covered under a government program. Private insurance either covers it or doesn’t.

  “Most of us don’t want to live in a society where the poor and unemployed have to die of diseases that the rich can afford to treat.”
  –No doubt we all want to live in a world where nobody has to die from any treatable condition. That world does not and cannot exist. Health care goods and services are just that — goods and services. They are economic goods. Socialized medicine does not eliminate inequities between rich and poor consumers of medical care, even in Great Britain, the most socialized of all. The only reason such disparities are such a bedrock issue for advocates of socialized medicine is their political framework – egalitarianism raised to paramount importance. Rousseau. Marx. No matter how the US finances care, most of the rest of the world’s human population does not have access to the care we do. Does that make it unjust? No, it makes it a scarce resource. Period. Should we be expected to provide top-notch food, clothing, and housing for everyone in America because we don’t want to see somebody have to eat Kraft mac n cheese, wear the same pants every day, or deal with a basement that floods every time it rains? What makes these goods morally different than health care? I wouldn’t want to see people starve, but I would address that with voluntary charity. The same goes for basic health care. Socialized medicine will only take us in the direction of Canada and Britain, where not only do the poor not have access to the best medical technology and medications, but NOBODY has access.

  We ought to provide — voluntarily — the best care we can to the poor in America. We should not be coerced into providing as much as can be extracted from us for those of our fellow citizens who are most favored by the federal government. Attempts to do so will only exacerbate the misallocation of resources and bastardize the provider-insurer-consumer relationship in such a way that inflation in health care continues apace. I am fairly certain you cannot refute this point: costs cannot be controlled by external price controls. That mechanism has never worked in history – because it can’t. It is contrary to the laws of economics. Simply not wanting to accept the implications of scarcity does not eliminate scarcity. The question is what is the most effective, economical, productive, just solution to that problem. As always, despite its bad name (as you say, “Social Darwinism”) free enterprise is not Darwinian – it benefits everybody. What does control costs are improvements in productivity and efficiency which cannot be imposed. Free enterprise and its profit motive and competitive structure are the only proven principles for producing goods and services that consumers want at the best price. Centralization limits the experimentation with solutions, so very few innovations come out of it. Free enterprise radically expands those experiments, and the ones that prove to be most effective win out, and they benefit everyone. Socialism does nothing more than shift the costs, it destroys incentives and leads to misallocation of resources and inefficiencies. (Obama’s claim that the Public Option is competition is fraudulent, and his claim that government is going to make the ’system’ more efficient is a joke.)

  “There’s no way to alleviate that except by government intervention, or by sending those poor patients to go begging to various private charities.”
  – Government intervention is the worst way to alleviate it (centralization’s impact, above). That is what has exacerbated health care inflation for the last 60 years. There’s no way to alleviate discrepancies in the availability of care entirely, but we have progressively provided more and better care to the poor and elderly by way of advances in medical care delivery, medicines, treatments and procedures – most of which are available thanks to the incentives and capital provided by the free market. Destruction of free enterprise in medicine, which is what we are contemplating here, will doom us all to the same fate enjoyed by all previous victims of socialism: we will all be equally miserable (with the exception of the politically powerful and their favored groups).

• 48 Jim Pier // Aug 11, 2009 at 12:35 pm

  P.S. Re ‘rationing’ — the word is based on the Latin ‘ratio’ – meaning the same for everybody. That can only be done by arbitrary force. When the market is the basis for the allocation of goods and services, they are not rationed. Each participant has incentives to maximize his own benefit. Thus, there are positive exceptions to the sad stories in the US, such as Safeway and their self-insured medical benefits, where the company saved a lot of money, employees saved money, and employees improved their own health because the company introduced incentives for doing so.

  The market does not ration – the government does.

• 49 Jim Pier // Aug 11, 2009 at 12:38 pm

  Recommended reading: George Reisman – Mises Institute: “The Real Right to Medical Care versus Socialized Medicine”

• 50 Jim Pier // Aug 11, 2009 at 12:41 pm

  sinz54
  one last point – re that supply/demand analysis: the meaningful term is appropriately ‘effective demand’ — which cannot be infinite, because it is limited by the consumer’s ability to pay. It is attempts to wish away this limitation that make the problem thornier than need be.

• 51 barker13 // Aug 11, 2009 at 2:29 pm

  Re: Jim Pier // Aug 11, 2009 at 10:09 am (#45) –

  “Just as we have cops to keep us safe, we need a health care system to keep us healthy.”

  OK…

  So my village has X cops on the payroll making anywhere from ABC to XYZ per year plus benefits, retirement, etc.

  Town cops… we have Xa number making… (blah, blah, blah…)

  State Troopers…

  County Sheriff’s Deputies…

  …and so on and so forth across the board.

  Here – quick and easy as an example:

  http://wiki.answers.com/Q/How_many_police_officers_are_employed_in_the_United_states

  So let’s say 800,000 cops. (*SHRUG*)

  (Then of course we have as “back-up” the national guard… ultimately the military… we have Homeland Security, the FBI, U.S. Marshall’s Service, Secret Service…

  In other words we have quite a few (*SMILE*) folks directly employed by local/state/federal government who have either a badge and a gun or a patch and a gun. Right…??? We’re all on the same page?

  So… what’s gonna be STARTING SALARY for a “government doctor” – employed by the government just as a cop is?

  Hmm… and are we gonna have ONLY “federal doctors” or are we going to have “village doctors, town doctors, county doctors, state doctors” and if so which governmental body is responsible for paying each of these (plus benefits and retirement)?

  A brand new cop can start as low as the “teens” (under $20K) in some small poor localities in poor states… what are we gonna start his doctor “employee peer” at?

  At the other end of the scale with overtime a cop/detective can make a couple hundred grand a year in Suffolk County (Long Island, NY) if memory serves.

  So… what are we gonna pay a senior surgeon working for “the government” in the same local?

  How many doctors will be employed by the federal government when we change the healthcare system so it looks more like the policing system?

  I’m pretty sure we have something like two and a half million doctors practicing in the United States. What’s it gonna cost to put ‘em all on “the payroll?”

  Nurses too…??? (I mean… makes sense, right…???)

  In fact, I suppose if all doctors are going to work directly for the government everyone in the medical field should become a government employee… right…???

  I don’t know, Jim; I’ll go back to reading your posts, but this whole comparing the provision of healthcare to the provision of policing seems a bit… er… problematic.

  (*WINK*)

  BILL

• 52 barker13 // Aug 11, 2009 at 2:57 pm

  Re: Jim Pier // Aug 11, 2009 at 10:09 am (#45) –

  “I believe what we need to be doing is forcefully and persistently making the case that the reason the US health ’system’ is on an unsustainable path is NOT because of the little bit of free enterprise that has survived thus far, but because of the massive distortions that have been introduced and have metastasized through government interventions beginning with WWII employer-provided health insurance incentives, then accelerating with Medicare/Medicaid, and perhaps most significantly the pervasive regulation of the health insurance market which grossly inflates the cost of coverage and so bastardizes the market the the product cannot accurately be called insurance. Any solution that fails to eliminate these interventions, and particularly one that introduces even more, can do no more than prolong the long, painful decline of the quality of US health care products and services, and the long, painful increase in the relative costs of the ’system.’”

  OK. So you ARE on the right side of the debate!

  (I gotta admit… you had me all confused, Jim! I must have misread your RESPONSES to something Sftor1 or someone else wrote to be what YOU believed. That was the context of my #51 comment.)

  “What is needed is the very same thing that works everywhere else – food, housing, clothing, transportation, communications, etc. – and that of course is the free market.”

  Exactly the point I keep making on all these health insurance/health care threads! Yes… a social safety net must be provided… but the MAJORITY of health insurance/health care provision simply CAN’T be nor SHOULD it be “provided” as a sort of social welfare program – either directly or through tax code subsidization.

  “It bears noting that the US has generated by far the greatest number of advances in treatments, procedures and medications for decades, advances possible only because of free enterprise — a fantastic gift to the socialized-medicine world that cannot generate similar innovation but happily adopts it once the US has paid for its development. These advances have contributed immensely to the improved quality of life enjoyed thanks to Western medicine over the last 60 years or so. It is highly unlikely that this leadership would survive a significant shift further toward socialization.”

  Yes.

  YES! YES! YES!

  Jim… thank GOD you’re here…!!! (*GRIN*)

  “…“47 million uninsured!” when the number in question ought to be closer to 12 million.”

  (*THUMBS UP*)

  “We conservatives need to get away from the concession that health insurance is something that by rights ought to be provided by fellow citizens through taxes. We ought to call Medicare what it is, a welfare program. And we ought to challenge the notion that somehow it is the free market that is responsible for the high and accelerating cost of health care in the US. This notion is the opposite of the truth, and we are doing the nation and the world a disservice to permit the left to get away with that characterization.”

  http://www.youtube.com/watch?v=-yWCzhhpZ2c&feature=PlayList&p=2360F9634CA6D85D&playnext=1&playnext_from=PL&index=53

  God bless Jim… GOD BLESS FRANK!

  Thank GOD… someone besides me finally GETS it!

  BILL

• 53 Brian Lilley » Blog Archive » The Great Debate – Health Care Roundup // Aug 13, 2009 at 12:08 am

  [...] to have answers on health care in his 2008 book Comeback: Conservatism That Can Win Again. Luckily he sums up some proposals he says Republicans should support on the blog, but I still recommend the [...]

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