What if We Win the Healthcare Fight?

143 responses so far

• 1 Spartacus // Aug 7, 2009 at 4:27 pm

  “What if we win the healthcare fight?”

  If you want a serious discussion about this question, you’ll probably need to go over to http://www.theatlantic.com or http://www.thinkprogress.com.

• 2 Geoff C // Aug 7, 2009 at 4:56 pm

  Canadians such as myself have been hearing this debate for as long as we can remember. A lot of the rhetoric is coming off as a mirror image. The push in Canada is coming from the Cons to move to a more privatized system and the push in the US is from the Dems trying to move it to the left. There has to be a happy medium somewhere. The real dilemma with this issue is the scaremongering coming from both sides of the isle. Dems tell us that people are dying in the street because they can’t afford healthcare while Republicans put out videos like this one. Neither side is right and all that’s happening is polarizing the public into a return to stagnation. Republicans can’t block Obamacare so what they should really be doing is working to make it a system that, although its more to the left than they would like, doesn’t bankrupt the US or make the system worse. Get off your high horses and get to work, both sides.

• 3 jeffpeterson // Aug 7, 2009 at 5:16 pm

  You’re not suggesting that a conservative shouldn’t oppose nationalizing the health insurance industry, are you? If not, then it would seem helpful to offer some concrete proposals for Republicans to seize the initiative on healthcare reform. I’d think the aftermath of Obamacare’s defeat and the run-up to 2010 would be the ideal time for Republicans to unite around proposals along the line of Arthur Laffer’s (http://online.wsj.com/article/SB10001424052970204619004574324361508092006.html) — a Healthcare Contract with America.

• 4 barker13 // Aug 7, 2009 at 5:25 pm

  I’ve shared my views and proposals (yes, concrete proposals – catastrophic care insurance, changes in the tax code, etc.) and see no need to keep repeating myself.

  Instead… let me share a personal anecdote.

  My sister-in-law Vicki just had a total hysterectomy yesterday. (She’s recovering nicely.)

  Now I’m kinda paraphrasing here, so bare with me. Apparently she was having some stomach complaints (pains) back last year. She saw her GP in December and he determined that she had a tiny fibroid. He told her to come back in a few months and they’d revisit it to see if it was growing. It was.

  So, and here I may be getting the story slightly wrong, but my point will be made at the end anyway…

  Apparently the GP wasn’t taking my sister-in-law’s complaints of pain and discomfort seriously enough. So, she went to her gynecologist who hooked her up with the oncologist and they were able to get her in to see him. He’s supposedly a top NYC surgeon and once a month he comes up to Orange County to do surgeries. Well, after the latest MRI (or whatever… she had to drink this terrible tasting crap) scan showed the fibroid was a growing tumor that they suspected might be malignant they operated yesterday.

  Result. My sister-in-law had had stage one cancer – a fast growing tumor. If the surgery had been delayed even for a month… (*SHRUG*)

  Hey… I’m absolutely convinced that if we lived in Canada or Britain as middle class folks without the luxury of going outside the system this time frame would have been spread way out. Let’s say she made an appointment to see her Canadian or UK GP in the fall – would she have gotten a December appointment or would it have been January… February… March?

  Say the Canadian or UK GP had reacted the same as Vicki’s GP here – not been concerned enough… how long would it have been for Vicki to get a follow up appointment with him… let along an appointment with a specialist.

  Oh… and once she got an appointment with a specialist, do ANY of you have total or even near total confidence that from initial exam by the specialist to actual operation the timeline would have been anywhere NEAR as short as it was here…???

  In other words, folks, if my sister-in-law was a Brit in Britain or a Canadian in Canada… she’d be dying right now. She wouldn’t have had the surgery yesterday. Her cancer would still be growing inside her. In a month – perhaps less – it would have been stage two… how long to stage three… how long till stage four…?

  I’m sure each and every one of you have horrendous medical stories – either you personally or something that happened to a friend or family member. But I’m betting you’ve all also seen “miracles,” seen what happens when American doctors and American hospitals “handle the action” at the highest levels.

  Yep. Plenty to complain about… but I’m not willing to trade my insurance and the care it provides me and my wife. How’bout the rest of you? Anyone considering moving to Canada (or Cuba) for the “free” healthcare?

  BILL

• 5 ottovbvs // Aug 7, 2009 at 5:27 pm

  ………I wouldn’t worry about it, the President is going to get a bill that gives him 95% of what he wants and that includes a public option btw……He’ll almost certainly have to pass it under reconciliation but that’s been obvious from the start to anyone who isn’t fooled by the kabuki theater, the Republican charade of “negotiating,” and/or fixated on the latest bit of ringside reporting by the media.

• 6 ottovbvs // Aug 7, 2009 at 5:34 pm

  barker13 // Aug 7, 2009 at 5:25 pm
  “Hey… I’m absolutely convinced that if we lived in Canada or Britain as middle class folks without the luxury of going outside the system this time frame would have been spread way out. ”

  ………Another Baarking invention……he’s never lived in either place……quite a few people in Britain think everyone in America wears a ten gallon hat and has gunbelt around his waist…….Just as fantastic…….Of course Baarking never asks the far more realistic question about the situation of a woman in America with pains and discomfort but no health insurance who is frightened to go to the docs because of the potential expense…..much better to look the other way

• 7 sinz54 // Aug 7, 2009 at 5:37 pm

  One thing that all conservatives can support enthusiastically is tort reform.

• 8 sinz54 // Aug 7, 2009 at 5:49 pm

  ottovbvs sez: “He’ll almost certainly have to pass it under reconciliation ”

  Then it will be a political loser. And all that brave Obama talk about “post-partisanship” and “changing the tone in Washington” will have been revealed to be a smokescreen for naked power plays (which, BTW, is exactly what TMPCafe and DailyKOS always said it was for).

  The only reason why SS and Medicare proved durable, was that both passed with a substantial number of GOP votes. Moderate and liberal Republicans had bought into those programs.

  Whereas ObamaCare is medical welfare for the poor–the wet dream of liberals for decades.

  If ObamaCare hasn’t appealed to me, with my individual insurance policy and my chronic illness, it’s sure not going to appeal to the 70% of the nation who are satisfied with their group coverage (cf. RasmussenReports). Ramming this thru Congress over the objections of just about everybody outside Blue areas will be a political disaster for the Blue Dog Dems–nearly every one of them will lose in the next election. They won in Red States by pretending to not be puppets of Pelosi. Now they will lose.

• 9 sinz54 // Aug 7, 2009 at 5:56 pm

  ottovbs: Polls consistently show that the moral imperative–let’s help all those poor folks out–is NOT swaying the vast majority of the nation.

  How you got to be such a liberal on this issue, I’ll never understand. But just about everybody outside of LiberalLand cares much more about cost containment and preserving the health care and health insurance they already are satisfied with, then about accepting either worse care or fewer choices or higher taxes to help the poor. Virtually every poll shows that helping the uninsured get care is a LOW priority for non-liberals.

  Obama can’t square this circle. He and all his supporters are just like you: Let’s cover the poor, cost be damned, if those with good health care now have to sacrifice it, well that’s how an “enlightened” society is. And with all the window dressing and 1,000 page text can’t conceal the true purpose of ObamaCare: Medical welfare for the uninsured. That’s its main job, and everything else is window dressing.

  And it’s not selling.
  Welfare never does.

• 10 Spartacus // Aug 7, 2009 at 5:59 pm

  Barker,

  Your sister-in-law’s case points out the importance of getting the right care quickly, and you’ve suggested that in Canada or the UK she may have not received care quickly enough. Leaving aside for the moment whether there is any empirical evidence to support that conjecture, keep in mind that neither the president nor any Dems in Congress have proposed a Canadian or UK syle system for the U.S. All of the proposals on the table leave private insurers in place, they simply offer a government option, which is the equivalent of Medicare for everyone. Since no one on Medicare presently has to wait in order to receive treatment there is no apparent reason to fear that your sister-in-law would have been worse off under any of the proposed Dem healthcare reforms.

  Her case also indicates that she has a PPO plan and not an HMO. If she had had the typical HMO she would not have been able to see her gynecologist without a referral from her GP because her insurance company would have prohibited that. My point here is that, way more often than not, someone other than the patient or her doctor makes decisions affecting care under the current U.S. healthcare system. So, are we better off having those decisions made by a profit-motivated insurance executive or a Federal Reserve-type board that is comprised of representatives of patients, doctors, hospitals, insurers, pharma, etc.? For a variety of obvious reasons, I prefer the latter.

  Lastly, there is the issue of what comes next for your sister-in-law. I don’t know if her insurance is offered through her employer or if it’s an individual policy, but in either case she faces the continuous risk of losing coverage. If that were to happen, depending on the state in which she lives, she almost certainly would not be able to obtain any other coverage except through an employer because of her pre-existing conditions. Well, with medical costs skyrocketing, more and more employers are dropping coverage for their employees so that chances of finding replacement coverage are constantly diminishing.

• 11 Geoff C // Aug 7, 2009 at 5:59 pm

  Jeffpeterson – I wouldn’t go so far to say that cons should outright support it, but they have to get over their fear of discussing it just because it has the words ‘national’ in it. Both Canada and the US have a national K-12 education system (although they vary greatly). Would you say that basic education shouldn’t be guaranteed? Would the US be a better place if the push for Public Education had been stamped out in the 1850’s? I think that’s an important question because it lies at the heart support for public health plans. The bleeding hearts look at it and scream ‘they are dying in the streets!!’ while economists look at it and say ‘if we want individuals to succeed to their full potential we need to make sure that they have basic health services.’ Its the same premise behind education. If you want a successful economy then you need to have an educated workforce so ensuring kids get a basic education is a must. That isn’t to say that there isn’t a place for private health; there is a big one and barker13 nailed why.
  Barke13 – Your story is a common one and while I can’t predict what the outcome would have been in either country I would say that the patient probably would have been better off in the US. That being said, Canada does have various systems in place for situations where time is important.
  If you learn that you have stage one cancer then you will get surgery for it that week or as soon as necessary. There really isn’t a wait for stuff like that because the system expedites those individuals. The patients who really lose out are those who are taking a surgery that doesn’t have a time stamp on it. Hip and joint replacements are the worst offenders for problems like this. In Canada we need to allow private health to cover areas such as this because it would streamline everything.
  Your sister in law’s biggest challenge would have been getting to the MRI machine because that is seen as less of a rush. Once they saw the cancer the process would have been about as fast as in the US.

• 12 ottovbvs // Aug 7, 2009 at 6:06 pm

  sinz54 // Aug 7, 2009 at 5:49 pm
  ” And all that brave Obama talk about “post-partisanship” and “changing the tone in Washington”

  …….It’s a win win for him……..check all the polls and see who the public thinks is reaching out and who is being intransigent……..if he get Republican coop he gets the credit…..if he doesn’t he will be perceived as at least having made the effort and will have plenty of cover when the inevitable happens as I think it will and he himself hinted at the other day…….you’re totally consumed with hatred of him as your numerous posts attest so hardly objective I’m afraid…….It’s as irrational as your political predictions which have no foundation whatever apart from what you hope for

  “Whereas ObamaCare is medical welfare for the poor–the wet dream of liberals for decades.”

  ………I must say Sinz your racism and attitude to others is rather compelling proof that personal suffering doesn’t always produce nobility of character

• 13 Spartacus // Aug 7, 2009 at 6:09 pm

  sinz54 // Aug 7, 2009 at 5:49 pm wrote: “Whereas ObamaCare is medical welfare for the poor–the wet dream of liberals for decades.”

  Another blast of hot air from an ideologue who is immune to facts.

  If ObamaCare was nothing more than welfare for the poor, why would he spend so much time trying to address the issue of cost containment?

  Incidentally, Sinz, how much are your insurance premiums, who pays them and wouldn’t they be higher if the cost of treating the poor in MA wasn’t subsidized by the state? In effect, you are a welfare recipient.

• 14 ottovbvs // Aug 7, 2009 at 6:19 pm

  Spartacus // Aug 7, 2009 at 6:09 pm
  ” In effect, you are a welfare recipient.”

  ………Bingo

• 15 ottovbvs // Aug 7, 2009 at 6:20 pm

  Spartacus // Aug 7, 2009 at 6:09 pm

  ……Btw Spartacus do you agree with me on the politics?

• 16 Spartacus // Aug 7, 2009 at 6:23 pm

  geoff-c // Aug 7, 2009 at 5:59 pm.

  Your comparison to public ed is exactly on point.

  However, the reason many conservatives can’t engage constructively on the healthcare debate is that they believe the driving force behind reform is a bleeding heart concern for the uninsured. Since it is anathema to modern-day conservatism to use govt to assist the poor, most attempts at reform are viewed by many of them as a way of helping the poor, which is something govt should not do. Yet, if you listen to Obama’s arguments for reform, he never talks about reform just for the sake of covering the uninsured. He always talks about reform in the context of bringing down the cost of healthcare, which is a prerequsite for sustainable universal coverage.

• 17 ottovbvs // Aug 7, 2009 at 6:24 pm

  sinz54 // Aug 7, 2009 at 5:56 pm

  “ottovbs: Polls consistently show that the moral imperative–let’s help all those poor folks out–is NOT swaying the vast majority of the nation.”

  ………to be honest I don’t know whether the do or not what I do know is that anxiety about healthcare is at levels never seen before across all classes…….basically all the polls show somethng like 75% of the public want’s to reform the system…….issue polls on narrowly defined questions are worthless

• 18 ottovbvs // Aug 7, 2009 at 6:27 pm

  Spartacus // Aug 7, 2009 at 6:23 pm

  …….At a time when large tracts of the population are fearful of losing health insurance because it’s tied to their job you’d need to be truly brain dead not to realize that this is currently a huge isse……unfortunately the right are largely brain dead although large numbers of them would actually be beneficiaries of healthcare refomr.

• 19 Spartacus // Aug 7, 2009 at 6:37 pm

  ottovbvs // Aug 7, 2009 at 6:20 pm

  I absolutely agree with you on the politics of how Obama will be perceived by the public. There is no political upside for the GOP or for the country in killing reform.

  I am not, however, as optimistic as you are about the passage of reform. I do not believe the people have enough foresight to do what is best for the country. No one, not even the most conservative GOPers, will propose meaningful cuts to Medicare, yet no one is willing to pay the costs.

  Believe it or not, in many ways, I share Barker’s pessimism about this country in the long term.

• 20 ottovbvs // Aug 7, 2009 at 7:02 pm

  Spartacus // Aug 7, 2009 at 6:37 pm
  “I am not, however, as optimistic as you are about the passage of reform.”

  ………..I must say from what I see Democrats are just as reactive to the latest newscycle as Republicans…..with every little bit of info that emerges they start panicking…….no need to in my opinion…….the way this works is that there are going to be three bills out of the house(they’re all out of committee and two have been floor voted) and two out of the senate (one senate bill is out of committee while the other is still tied up in Baucus’ committee) both will ultimately emerge and it is at this point where the white house and Dem leadership will have to decide on the voting protocol…….I just don’t think there are the senate votes for any kind of bill to be passed outside of recon but I could be wrong……anyway ultimately they end up with the five bills in conference where basically the leadership and white house are in the driving seat and will cherry pick from the five bills to create the final one……even if they got the senate committee bills out on a 60 vote there’s no doubt the final bill will have to pass on recon because there’s no way the Republicans are going to vote for the public option or how it’s all going to be funded…….For Obama, Emmanuel and co not to have realized that this was the ultimate likely scenario they’d have to been brain dead…..and they are not………So far Obama has not really turned his guns on the Republicans……I really think this is partly because that’s who he is, but I’m also sure a large part of it is tactical as I’ve seen the odd flash from him which suggests you don’t want to cross this guy…….People like Sinz and Barking have basically got their head up their asses because they don’t understand process and drinking the kool aid anyway……..As for the future it’s going to be fine……I promise you it looked much bleaker in the late sixties…….We’re going to undergo some relative decline over the next 50 years but the man in the street isn’t going to notice…….I’m also coming to the view Obama is a game changer( I used to be a sceptic)…….he is going to make huge changes in this country over the next seven years.

• 21 sinz54 // Aug 7, 2009 at 7:03 pm

  geoff-c: In America, public education was mostly paid by state taxes and local property taxes. And the content of what was taught was, and still is, controlled by local school boards. It was NEVER the primary responsibility of the Federal Government. And when public education started in America in the 19th century, it was started as a set of state initiatives.

  So there’s no comparison between public education and ObamaCare. A much closer analogy would be public education versus the various state health care experiments: RomneyCare in Massachusetts, TennCare in Tennessee, etc.

• 22 sinz54 // Aug 7, 2009 at 7:06 pm

  ottovbs sez: “I’m also coming to the view Obama is a game changer( I used to be a sceptic)”

  You certainly were. For two years, you were confidently predicting that Hillary was going to clean Obama’s clock in the Dem primaries.

  Your current set of predictions will prove to be just as worthless.

• 23 sinz54 // Aug 7, 2009 at 7:13 pm

  Spartacus sez: “There is no political upside for the GOP or for the country in killing reform.”

  Should ObamaCare fail, the upside for the GOP will be the exposure of Obama as a weak, milquetoast, cerebral intellectual, comparable to Adlai Stevenson; incapable of putting across even his top domestic priority.

  ObamaCare is floundering because Obama doesn’t have Hillary’s killer instinct, much less LBJ’s killer instinct. He’s all brain and no guts. And that’s becoming clearer every day.

  And Americans don’t want a weak cerebral intellectual as Commander-in-Chief. Whether his name is Adlai Stevenson, Eugene McCarthy–or Barack Obama.

  ottovbvs: You were right the first time. We should have elected Hillary instead.

• 24 Spartacus // Aug 7, 2009 at 7:20 pm

  Sinz says “So there’s no comparison between public education and ObamaCare. ”

  Really, no comparison? In each case government – not the private sector – is offering a service for the public that competes with services currently offered by the private sector. Yet, somehow, Sinz wants us to believe that all of the conservative arguments against ObamaCare would be invalid if it was simply a state government that was offering the reform. This is like a pro-lifer saying “I’m really opposed to killing a fetus, but if the state allows it, as opposed to the federal government, then I’m ok with it.

  This is a perfect example of being confronted with facts that debunk your belief system and then twisting illogically simply so you don’t have to admit to you’re dead wrong.

• 25 Spartacus // Aug 7, 2009 at 7:23 pm

  Sinz says “ObamaCare is floundering because Obama doesn’t have Hillary’s killer instinct, much less LBJ’s killer instinct. He’s all brain and no guts. And that’s becoming clearer every day.”

  I think Hillary and John McCain would strongly disagree on whether Obama has a killer instinct.

• 26 balconesfault // Aug 7, 2009 at 7:27 pm

  Barker – your sisters story goes the way it did because she had healthcare. Say she was one of the many many contract or minimum wage workers in America who don’t have healthcare insurance … or who have only “disaster” insurance that forces a very high co-pay for checkups.

  Short story … like millions of working Americans, she might have avoided going to the doctor … because the $100 visit fee may have not fit into her tight budget right away, when there is rent to be paid and car payments to make and car insurance payments to make and food to buy and a person making twice minimum wage makes all of $28K/year after FICA. So she might have put off seeing her primary care provider altogether, until the pain became really debilitating, in which case she’d have washed up in one of our Emergency Rooms that keep being talked about as a form of universal health care … and they’d have taken their biopsies and such and glumly informed her of how many months she probably had left to live at that point.

• 27 ottovbvs // Aug 7, 2009 at 7:28 pm

  sinz54 // Aug 7, 2009 at 7:06 pm

  “You certainly were. For two years, you were confidently predicting that Hillary was going to clean Obama’s clock in the Dem primaries.”

  ……….Really? For two years? How would you know that?

• 28 Geoff C // Aug 7, 2009 at 7:34 pm

  Thanks Spartacus,
  Sinz – I don’t claim to fully understand the US public education system. Canadian public schools are directed provincially as well, it isn’t a federal jurisdiction. The argument I made still stands: the end result of promoting a system like basic education or basic health services is to give some sort of safety net to individuals taking risks. Everyone likes to support small business so lets take an example like this. If I have to invest (and risk) a large amount of my personal income to start my own business, I’m more likely to do so if I don’t have to worry about my family not getting basic healthcare were my business to fail. Imagine taking a a legitimate risk (something we all support), losing your business and turning around to your kids and saying that they can’t go to school anymore. Your failure impacts their ability to succeed as individuals. I make the same argument for basic healthcare.
  I’m not talking about giving tummy tucks to every Joe the Plumber who can’t fit under the kitchen sink.

• 29 ottovbvs // Aug 7, 2009 at 7:41 pm

  sinz54 // Aug 7, 2009 at 7:13 pm
  “He’s all brain and no guts.”

  ………That’s how he made it from the South side of Chicago to the presidency…….I do think his style is conciliatory although you clearly want confrontation all the time……on the whole in my experience it tends to the conciliators that do rather better in the game of life……and I say this although I’m not one myself and it’s cost me sometimes but I have observed some really smooth operators and it’s clear Obama is one of them…….. a very smooth operator who never loses his cool…….as many have observed and Hillary found out this guy plays chess while others are playing checkers…..Unfortunately you are totally consumed with hatred of the guy(and hatred is not too strong a word)……judging by some of your earlier comments I assume its racial but whatever it is as this comment illustrates it visceral:

  “Should ObamaCare fail, the upside for the GOP will be the exposure of Obama as a weak, milquetoast, cerebral intellectual, comparable to Adlai Stevenson; incapable of putting across even his top domestic priority.”

  ………You’re a sad sack Sinz

• 30 anniemargret // Aug 7, 2009 at 8:24 pm

  Sarah Palin on healthcare reform: “The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.”

  And David Frum thinks he will start a ‘new majority” of more rational thinking, respectful Republicans? HA!

  Otto you are correct. Obama is at once ‘conciliatory,’ and happily the antithesis of the hate-fear-prejudice-mongers coming from the right wing of Republicanism. Thank God for him. There are real people suffering in America and we need real solutions from people who haven’t lost their souls or who have ice in their veins.

• 31 johnmarzan // Aug 7, 2009 at 8:25 pm

  i liked krauthammer’s latest proposal in his column.

• 32 Jewels // Aug 7, 2009 at 9:30 pm

  I get what you’re saying, David. But would allowing Obama’s plan really be a better choice?

  Show us a third option and we’ll consider it. Or help us to come up with a third option.

• 33 balconesfault // Aug 7, 2009 at 11:23 pm

  Jewels … the big problem here is that the Republicans have basically exempted themselves from the debate. They’ve already made it clear that any bill that could be viewed as some sort of win for Obama, they are set on voting against it almost unanimously … it will be a surprise if any bill gets any Republican votes in the House, and more than 2 or 3 in the Senate.

  And once they’ve made that as clear as they have, it’s going to be hard for any “third option” to come forward.

• 34 Spartacus // Aug 8, 2009 at 1:04 am

  Jewels // Aug 7, 2009 at 9:30 pm

  David is not intentionally witholding a third option. There simply is no possible way of addressing the primary goals of healthcare reform without offending the basic tenets of modern conservatism.

  Most people, irrespective of their ideology, agree that healthcare reform ought to (1) reduce the number of uninsured, (2) make insurance less costly for those who are already insured, and (3) reduce the amount of money spent on healthcare services that produce no actual benefit. There simply is no possible way to achieve these goals without (a) increasing the amount of regulations imposed on businesses (including insurance companies), (b) providing some kind of government subsidy for people who can’t afford insurance, and (c) creating some kind of competitor in the market who is large enough to put downward pressure on the prices of healthcare services. Each of these measures offends conservative/GOP opposition to regulation, government spending and government involvement in the marketplace.

  Conservatives and the GOP controlled Congress and the White House for 6 out of the last 8 years. They would have gladly proposed a plan to solve the healthcare problems I described above IF they could have done so without offending their core ideology. It’s simply not possible and NO CONSERVATIVE on this blog or anywhere else has offered any ideas that come close to plausibly solving the problem.

  For conservatives and the GOP, it’s simply a matter of preferring ideology over practical solutions.

• 35 SFTor1 // Aug 8, 2009 at 5:50 am

  Let me first take issue with the headline of this article: there is no winning by defeating reform. We all own this mess, and until it is cleaned up this country will continue to weaken.

  The truth is that public health care, as practiced in every other industrialized nation, basically works. Private health care as practiced in the U.S. basically does not work. There is an obvious reason for this: a public system gives you a measure of control over costs. The private system drives costs. There is not a single incentive in our current fee-for-service and private insurance system to contain costs.

  Why do I say that the private system does not work? 50 million without access to care. Over 50% of bankruptcies caused by health care expenses incurred by people who have coverage. Loss of insurance in many cases once you’ve had a serious condition. Rates climbing like a monkey with his tail on fire.

  For anyone to call this a health care “system” is a joke. It fails on every important benchmark: economy, outcomes, and peace of mind for working Americans. The idea that this is something that is being rigged to proffer handouts to the poor is preposterous. Not that they shouldn’t have access to care. They should. This is an economic and strategic issue.

• 36 anniemargret // Aug 8, 2009 at 8:52 am

  sftor1 nails it. But I would also add to your, “this is an economic and strategic issue” that it is also a moral issue. A country that ignores the suffering of its own citizens has not business calling itself a great country. Even Castro has a better healthcare system for his people than we do.

  Stroll down to Atlantic and Andrew Sullivan’s blog and read the posts entitled, “The View From Your Sickbed” – an eye-opener for anyone who still thinks we have the ‘best healthcare system in the world.” Horror story after another.

  When I worked years ago as a medical receptionist in a cardiologist’s office, a young woman called in to say she had lost her insurance due to a job change, and because she had a serious heart condition, she asked me to ask her cardiologist about what do and if he would see her again. His answer: “…tell her to go to the nearest ER. Tell her I can no longer keep her as a patient.” When I returned to the phone to tell her what the doctor said, she started crying. She told me she thought she was going to die because the ER where she was (she had moved out of the city) told her that they could not give her ongoing care, only emergency care. It troubled me deeply to listen to her crying and I had no words of comfort for her.

  This is playing out hundreds of times per day on the national scene. When I watch these Republican-oriented ‘town halls’ and see the stupidity on display and the distortions and outright lies perpetrated by the right wing machine to keep their constituents in a state of constant fear and ignorance, I am reminded once again why I despise what passes off for Republicanism these days. It is partisan politics at the expense of the good of the country.

  The status quo of rising healthcare costs and the loss of insurance coverage for millions of people, middle class and the poor, should be concern for all Americans who really care about America. Instead Republicanism has embraced the ‘what me care?” attitude. No one is pretending it will be an easy ride into change and reform and a healthcare system with more parity, but it is a reflection about our ‘values’ – Pretend you don’t see, don’t hear, better that way….no?

  The Republican party did not scream and hoot and holler when they voted for our invasion of Iraq, where financial resources were drained, not to mention the huge loss of life, where ‘billions were lost.’ Nor did they scream and holler when Bush pushed the deficits, both federal and trade, into the billions. They did not scream and holler when he bailed out Wall Street to a tune of $700 billion. But to listen to the egregious distortions coming out of the GOP these days, and the blatant encouragement of racism and fear-mongering, it will be a cold day in hell before I would ever venture toward Republicanism again.

• 37 sinz54 // Aug 8, 2009 at 8:59 am

  sftor1 sez: “Private health care as practiced in the U.S. basically does not work.”

  FYI, single-payer has been taken off the table by the DEMOCRATS.

  So your entire screed is irrelevant.

  Except for one thing:
  This “public option” the Dems are demanding, is a stealth move toward single-payer. Their plan is to FOIST single-payer on an unwilling public, by creating the public option and then sitting back and waiting for large corporations to dump their private plans and switch to the public option, over the objections of their employees.

  This is cynical, it’s insufferably arrogant, and it’s duplicitous. The very face of modern liberalism: We know what’s best for Americans, so we’re going to do it, whether they like it or not, and lie through our teeth about what our real goal is.

• 38 sinz54 // Aug 8, 2009 at 9:02 am

  anniemargaret: Poll after poll is showing that Americans do NOT want to spend a trillion dollars on medical welfare to help the poor. They would much rather have the deficit reduced and their own taxes lowered.

  Give it up. The electorate does NOT agree with you on this. The only ones who do, are the Blue State Birkenstock liberals of the coasts.

• 39 ottovbvs // Aug 8, 2009 at 9:25 am

  Spartacus // Aug 8, 2009 at 1:04 am
  “For conservatives and the GOP, it’s simply a matter of preferring ideology over practical solutions.”

  ……….This is the nub of the issue……during the fifties, sixties and until the early 90’s really pragmatism and a sense of reality was what defined the Republican party………..Since then they’ve made themselves the prisoners of a set of ideologies which either don’t work and/or are deeply unpopular……..they’ve brainwashed an entire group that these are wholly writ or absorbed from the group(it’s a two way process) and now they can’t deny them…….a bit like those 16/17th Century Cardinals had construct ever more elaborate theories to confirm the belief the sun revolved around the earth……..ultimately it can’t be sustained

  sftor1 // Aug 8, 2009 at 5:50 am
  “Private health care as practiced in the U.S. basically does not work.”

  …….While I agree with your basic premise that a single payer system is conceptually the most efficient I think you overstate the case when you say the US system doesn’t work. It does work just not very cost effectively but despite this produces some good outcomes, in some areas outstanding outcomes. Nor is really practical, even putting the politics on one side, to junk the existing system. Over the years a massive infrastructure has been created to manage the system as it exists and this can’t just be thrown overboard because the dislocation and employment implications would wreck the system. Neither despite the frantic emotionalism of the Sinz’s of this world does a public insurance option mean the demise of private insurance (the delivery system is in any case entirely unaffected by this remaining as it will largely in private hands). However, private insurance will become a lower margin business.

• 40 ottovbvs // Aug 8, 2009 at 9:29 am

  sinz54 // Aug 8, 2009 at 9:02 am
  ” anniemargaret: Poll after poll is showing that Americans do NOT want to spend a trillion dollars on medical welfare to help the poor. They would much rather have the deficit reduced and their own taxes lowered”

  ……….What are these polls you keep referring to……..can yu provide some links…….I think narrow issue polls are fairly worthless but I’d be interested to see them……..As against that we do have plenty of polls showing that 75% of the electorate want the system reformed.

  ” The only ones who do, are the Blue State Birkenstock liberals of the coasts.”

  ………..The self parody never ends

• 41 balconesfault // Aug 8, 2009 at 9:42 am

  “The self parody never ends”

  Yeah. I’m wondering why all those states in the middle of the country are turning blue … Birkenstock must be making a ton.

• 42 anniemargret // Aug 8, 2009 at 9:49 am

  sinz54: I’m a left of center Democrat and I live on the coast. I do not wear Birkenstocks, but mocs, and prefer my coffee plain, not lattes, and if I wrote a ’screed’, then what can we call yours? Looked like screeds to me.

  Why don’t you just admit you don’t care about the poor and be done with it?

  Americans are woefully ignorant about this issue. After all, we got people yelling at these town halls that they don’t want ’socialized medicine’ and then in the same sentence stating they don’t want anyone taking away their Medicare. Are these the poll- takers you are talking about?

  The American people, by far, are eminently fair minded. I am a public servant and talk to all manner of people everday, from all socio-economic strata. Many are those that rejected the 8 years of Bush Republicanism, and put President Obama in place and if you remember, one of the primary issues was healthcare cost reduction and seeking some solution for the uninsured, which is rising steadily as we speak.

  More and more people are being forced to go to ER’s for simple solutions to their medical problems because they have no primary care physicians. A third of costs go into bureaucratic paperwork, CEO salaries, profits and a universal system would reduce these costs. People with common diseases such as diabetes and HBP would be treated before they become full-fledged major illnesses. The uninsured right now are forced to delay medical attention because of the lack of care, and then end up getting far worse because of it. Bankruptcies are rising due to loss of insurance.

  What is your solution to these problems?

  I believe in the betterment of society at large. The status quo is not clearly not working.

• 43 barker13 // Aug 8, 2009 at 9:54 am

  Re: Spartacus // Aug 7, 2009 at 5:59 pm –

  “…you’ve suggested that in Canada or the UK she may have not received care quickly enough. Leaving aside for the moment whether there is any empirical evidence to support that conjecture…”

  Com’on, Spart, you know it’s not conjecture. Sure, I’m with you in the sense of saving time, space, and wasted effort not reinventing the wheel every time we have these discussions, but even most of those on the Left don’t deny the reality of longer waiting times – longer “lines” – in the UK and Canada.

  “…keep in mind that neither the president nor any Dems in Congress have proposed a Canadian or UK syle system for the U.S.”

  Again, Spart, no need to go over the same debates again and again. (You and Sinz had a great exchange awhile back.) (*SMILE*) In short… yes, you’re right… where the foot in the door would lead… if you truly believe it wouldn’t lead over time to single payer (the system President Obama and many Democrats are on record over the years as supporting as the ultimate “reform”) then that’s your position. Me? I have a crystal ball. (*GRIN*) I see where government interference has led and my crystal ball allows me to see where more government control will lead.

  “Her case also indicates that she has a PPO plan and not an HMO. If she had had the typical HMO she would not have been able to see her gynecologist without a referral from her GP because her insurance company would have prohibited that.”

  I’m not sure if she has a PPO or HMO, but either way your logic is faulty. First of all, women have both a GP and a GYN. Typically women get yearly exams with the GYN as a matter of course, no referral. For all I know this was Vicki’s “yearly” GYN exam.

  Regardless, if she needed a referral obviously she got one when she asked. (*SHRUG*) I don’t know about you, Spart, but I’ve had all sorts of plans – plans where I’ve needed GP referrals, plans where I haven’t. When I’ve needed a referral my doctor has never blinked an eye, he’s just given it to me. Perhaps you simply have always gone to shitty doctors…??? (*LOL*)

  “My point here is that, way more often than not, someone other than the patient or her doctor makes decisions affecting care under the current U.S. healthcare system.”

  Yeah. So you say. Sorry… that hasn’t been my experience. Oh, sure, I’ve run into my share of dimwitted bureaucratic snafu situations, but a few phone calls and if necessary a registered letter or two clears that sort of stuff up.

  Hey… your perception (apparently) is that government bureaucracy is easier to navigate and less rigid and less petty and less incompetent than the private sector while at the same time being more “fair.” I don’t buy it. I reject it. Bottom line…. we don’t share the same perception.

  “…she faces the continuous risk of losing coverage.”

  Actually… (*SHRUG*)… no. Wrong again. (*SMILE*) Her husband – my brother-in-law – is retired NYPD. I’m pretty sure he and his spouse are covered for life.

  But, hey… in any case… I get your general point. I simply don’t care all that much about it. I’m not talking the exception, I’m talking the rule. And the rule is… middle class insured Americans have access to arguably the most advanced most effective health care system in the world when that health care is needed.

  ANYWAY… take out of my personal anecdote what you will. (*SHRUG*) I through it up on the board because it’s real life.

  BILL

• 44 midcon // Aug 8, 2009 at 10:08 am

  From what the polls indicate, most people who are covered by insurance are pretty safisfied with that insurance. If that is the case, then this debate is about the margins – which are the ones who are not covered and the elderly who are covered by a government plan (Medicare). Since Medicare is already a “public option,” why not extend Medicare coverage to those who are not covered and spend effort on making it more cost effective and efficient? Arguing about a public option when one already exists and does not appear to be going away is counter productive. Instead we should be discussing how to make Medicare the best public option it could be. One way to do this is to take the reimbursement level authority out of the hands of Congress and into the hands of an independent commission in a manner similar to the BRAC where Congress is only permitted a thumbs up or down vote.

• 45 barker13 // Aug 8, 2009 at 10:11 am

  Re: Geoff-c // Aug 7, 2009 at 5:59 pm –

  “Barker13 – Your story is a common one and while I can’t predict what the outcome would have been in either country I would say that the patient probably would have been better off in the US.”

  “Probably,” huh? (*CHUCKLE*) OK. I’ll take it. (*THUMBS UP*)

  On a serious note, when “the patient” is oneself or a loved one, that “probably” thing has a huge impact upon your thinking. So… for those of you who NEVER expect to get really, really sick and who also NEVER expect friends, relatives, and other loved ones to get very, very sick… a system such as the UK or Canadian system might be just what you’re looking for. As for the rest of you… “out of the frying pan into the fire” isn’t a risk I’d advocate taking. (*SHRUG*) Hey… that’s just me…

  “If you learn that you have stage one cancer then you will get surgery for it that week or as soon as necessary. There really isn’t a wait for stuff like that because the system expedites those individuals.”

  So you say. Sorry, but I don’t buy it – not on a consistent basis. Heck… just in one sentence you hedge with the whole “that week OR as soon as necessary” bit. And if their idea of “as soon as necessary” turns out to be not soon enough…???

  Hey… we can debate whether the U.S. has “too many” high tech bells and whistles (MRI’s being standard equipment in the 2010 Ford Focus) (*GRIN*) or too many hospitals (too many empty beds) or even too many doctors and nurses (even while there’s also the argument that we don’t have enough doctors and nurses), but “perceptions” aside, the numbers are the numbers and we’ve just got more and better “stuff” than the UK and Canada when it comes to treating the average insured middle class American quickly and competently.

  “Your sister in law’s biggest challenge would have been getting to the MRI machine…”

  But, Geoff… in many cases that’s the whole ballgame! In my sister-in-law’s it certainly was. With fast moving cancer and other deadly diseases speed is of the essence. What you blithely refer to as a “challenge” I call a potential death sentence.

  BILL

• 46 ottovbvs // Aug 8, 2009 at 10:16 am

  ………The reality of how the insurance industry bureacracy functions and why it’s consuming 18-40% of ever dollar (depending on whose numbers you believe)….from the atlantic

  07 Aug 2009 04:36 pm

  The View From Your Sickbed
  A reader writes:

  I was horrified at the stories your reader’s sent you yesterday about their health care cost nightmares, and thought I’d share the view from the other side.

  I work for a national insurance company and it’s my job to pay hospitals and clinics for services performed. Now when I say pay, you should think of that in air-quotes. Assume it takes a week for the bill to be routed to the right person in the right department at my company. Once the bill reaches the right desk it heads back out. Because before we pay a bill we send it to a 3rd party company who reviews it to see how much we “really have to pay” for the services. This is because every state has different guidelines about what services should cost. This takes a week. Then the bill comes back to us, and if there are no issues with the hospital’s records in our systems we pay the bill then.

  However, if there are any issues it comes to me.

  It’s my job to call the hospital for updated tax forms (because it’s not enough that we know their tax id, we have to have a government form showing the number). Then I send the records to another company who updates our database with the information. This takes another week, or longer if I have trouble getting a hold of the right person at the hospital.

  Finally, we pay the bill. During this time the hospital has been waiting to get paid X number of dollars. Only instead we’ll be paying them Y because that’s what the state says is the minimum we have to pay.

  So while your readers are being charged $50 for asprin; my company employs an entire department just to shuffle bills around while they decide what they will pay the hospital for that asprin.

  I like my job, but I would gladly give it up if it meant that this insanity could stop.

• 47 MFarmer // Aug 8, 2009 at 10:18 am

  “More and more people are being forced to go to ER’s for simple solutions to their medical problems because they have no primary care physicians. A third of costs go into bureaucratic paperwork, CEO salaries, profits and a universal system would reduce these costs. People with common diseases such as diabetes and HBP would be treated before they become full-fledged major illnesses. The uninsured right now are forced to delay medical attention because of the lack of care, and then end up getting far worse because of it. Bankruptcies are rising due to loss of insurance.

  What is your solution to these problems?”

  Get the government out of healthcare. Government created the healthcare problems and cannot “fix” healthcare. In a free market, healthcare is a service offering between provider and patient, not a system to be engineered by technocrats. You are thinking in collective terms while the proper healthcare relationships are individual — your healthcare needs have nothing to do with mine, or my employer, for that matter. Without the costly, convoluted involvement of government, individuals will work out contractual arrangements for healthcare services, whether directly or through insurance arrangements. Poverty is different issue which requires different solutions, but conflating poverty with healthcare issues confuses the whole effort to remove the problems and allow the market to work. When we talk about both problems together, healthcare and poverty, we are misled. Without government intervention, insurance policies could be sold across state lines and menu options could be offered, tax breaks for individuals would allow more money for policies, competition would force providers to develop creative strategies to stay in business by offering affordable services, on and on — there is no “plan” — it’s just allowing the market to work. We DO NOT have a free market in healthcare now — that’s the problem.

• 48 ottovbvs // Aug 8, 2009 at 10:23 am

  midcon // Aug 8, 2009 at 10:08 am

  ‘From what the polls indicate, most people who are covered by insurance are pretty safisfied with that insurance. ”

  ……..But that hardly means they are happy with how the entire system functions does it?…….In fact all the polls show massive majorities for reform of the system even if the how and why is somewhat inchoate as it always is with these narrowly focussed issue polls where most people either aren’t interested or have only a shaky grasp of the issues……have you ever participated in one of these telephone polls on issues……even when there’s a real person asking the questions it’s a bit of a joke and when it’s pre recorded questions it’s almost an entire joke.

• 49 ottovbvs // Aug 8, 2009 at 10:28 am

  MFarmer // Aug 8, 2009 at 10:18 am
  “We DO NOT have a free market in healthcare now — that’s the problem”

  ………Actually to a large extent we do and THAT is the problem…….I love this vision of every individual buying his own health insurance in an entirely unregulated market…….After all we have such wonderful examples of how it might work……like the mortgage market

• 50 barker13 // Aug 8, 2009 at 10:32 am

  Re: Spartacus // Aug 8, 2009 at 1:04 am –

  “NO CONSERVATIVE on this blog or anywhere else has offered any ideas that come close to plausibly solving the problem.”

  Liar, liar, pants on fire! (*GRIN*)

  Hey… I’ve laid plenty of proposals out there. So has Mike K. Heck… even Sinz has dealt with specifics off and on for as long as I’ve “known” him as a poster here. Midcon… Franco… yep.

  Heck… YOU’VE even thrown some ideas out! (*GRIN*)

  Re: Sftor1 // Aug 8, 2009 at 5:50 am –

  “The truth is that public health care, as practiced in every other industrialized nation, basically works. Private health care as practiced in the U.S. basically does not work.”

  So put Sftor1 down For single payer, Against private health care… right? (*SMILE*) I mean that’s the logic of your statement… right?

  * Spart – See what I mean…??? At least we need to be honest – as Sftor1 is being. As I previously noted, the Dem plan is definitely a step towards single payer and ultimately single payer is the goal of the Obama/Pelosi/Left Dems. (*SHRUG*)

  Re: Anniemargret // Aug 7, 2009 at 8:24 pm –

  “Sarah Palin…”

  Oh, jeez… not Anniemargret again! (*LAUGHING TILL IT HURTS*) (*DISMISSIVE SNORT*)

  BILL

• 51 anniemargret // Aug 8, 2009 at 10:41 am

  As I am not an expert, I will forego to the experts on how to solve this problem. But there are those who feel there isn’t a problem, and there are millions who do. To me, THIS is the actual problem – those who are satisfied with the status quo, and those who recognize we have a burgeoning complex problem that will only worsen if ignored. Fer cryin’ out loud…this is not a ‘liberal’ issue! This should be an American issue that will affect all of us eventually even if we enjoy adequate affordable healthcare for ourselves and our families.

  Most Americans recognize there is a need to reform, even if they are ‘happy with their healthcare.’

  If you dip a little deeper into that phrase, you will also see them petrified that they will lose it due to job loss or not being able to continue to afford the premiums which are rising steadily with each passing month.

  If the Republican party expects to achieve some measure of respect in the coming years, then they have to step up to the plate. I would prefer a bi-partisan approach. But the hateful atmosphere surrounding this issue is precluding that, as politicians on both sides are lining up in attack-mode instead of intelligent debate on the complex difficulties of resolving this problem.

• 52 anniemargret // Aug 8, 2009 at 11:06 am

  Hey Barker….. best wishes!

• 53 MFarmer // Aug 8, 2009 at 11:18 am

  Ottovbvs — with the mortgage industry what you actually have is more proof of government interference through Fannie and Freddie and government regulation. Thanks for helping make my point.

• 54 midcon // Aug 8, 2009 at 11:32 am

  Otto, You are correct – it does not mean they are hapyy. At best it means that they do not want any solutions that hurt them. Yes, polls are inexact at best and invalid at worse. So we glean what information we can from them and consider the source. As you know I personalize everything in how it affects me, my friends, neighbors, family and acquaintances, etc. And speaking for those whom I have talked to (most but not all of whom have insurance), they want first for the government to do no harm – the devil you know is better than the devil you don’t. Secondly, they want their health care costs to be reduced, without reducing the quality and access to health care. Finally, they believe that everyone should have insurance, but are conflicted in how that should happen and the cost to themselves. I take that to mean they want everyone to have insurance but no on their dime. Obviously this is a logical conflict because the cost has to be borne by someone. Anyway, that’s my the result of my informal conversations with people.

  anniemargret, The people I know are not petrified about losing their jobs (and susequently their health insurance). And personally speaking, if I was petrified about losing my job, I would go find some work where I did not have to be petrified. What kind of way is that to live? Getting up every morning thinking “Is today the day” Sheesh! That’s just plain silly. And the first thing someone will say is “Well supposing that’s all they know is what they now do” my response – go learn something new. Anyone who has a job that is tenuous and is not thinking/planning/doing something to change that does not accept personal responsibility for themselves and their family. Sitting and waiting for the axe to fall? Why would someone do that? And premiums do not rise every month. They rise once per year during open season when you can make your choice. While there may be other plans where the premiums are adjusted monthly, those plans are not the norm. Exaggerated sound bites do not facilitate intelligent debate.

• 55 anniemargret // Aug 8, 2009 at 12:03 pm

  Midcon: I come from a hard-working, personal responsibility family. I believe in the work ethic and I believe in planning ahead. But I also know that life throws punches and that not everyone has the good fortune that I had. If if were just a simple matter of just going out a finding a job that offers excellent affordable healthcare, or earn enough to pay for it, we wouldn’t be discussing this at all, would we?

  You don’t know anyone who is not petrified of losing their job and/or healthcare, or worried that they cannot afford to continue paying the cost of their healthcare? Wow. That sounds like a comfortable position to be in. God Bless.

  I have two members of my family right now who have lost their jobs within the past year – one on a professional level, and one a blue collar worker (who has no healthcare benefits). It’s personal for me- although I see the nation’s problems through a different prism than yours obviously.

• 56 sinz54 // Aug 8, 2009 at 12:23 pm

  anniemargaret sez: “If the Republican party expects to achieve some measure of respect in the coming years, then they have to step up to the plate.”

  They DID.
  They offered alternatives to the so-called “public option with teeth.” Each and every one of the GOP’s proposals was shot down.

  Because liberals know that the “public option” is the first step to what they REALLY want–a single-payer system comparable to Canada. (They LOVE Canada, they think Canada is a better country than the U.S.)

  So the public option became non-negotiable. And the GOP walked out.

  That’s what happened.

  Right now, there are still some moderate Republicans like Collins who are trying to negotiate SOME semblance of a bipartisan bill. But a public option designed to destroy the private insurance market is unacceptable to the GOP. Period.

• 57 ottovbvs // Aug 8, 2009 at 12:35 pm

  MFarmer // Aug 8, 2009 at 11:18 am
  ” interference through Fannie and Freddie and government regulation”

  ………..I think you must have been asleep during the entire mortgage meltdown……most of the problems arose from inadequate regulation!

• 58 ottovbvs // Aug 8, 2009 at 12:46 pm

  midcon // Aug 8, 2009 at 11:32 am

  “Otto, You are correct – it does not mean they are hapyy. At best it means that they do not want any solutions that hurt them.”

  ……..I’d broadly agree with your take but then the “public” usually has little sense of the nitty gritty of policy or process…….there is however a generalized angst about the whole issue that was not present in 1994……the is the product of years of companies shuffling costs onto employees or cutting benefits and widespread fear of losing insurance because of the state of the job market…….the partisans from the right believe all this renta mob stuff, hectoring from Beck or someone, and the latest scene from a 12 act play means something……it doesn’t mean a thing in practical terms of producing bills getting them voted on and then finally conferencing the final bill and getting it past……..the bottom line is that this is the signature issue after righting the economy of the Obama admin…….therefore failing to pass it is unthinkable…..they have the votes to pass it on recon if they have to and if they have they will

• 59 barker13 // Aug 8, 2009 at 1:16 pm

  Re: Anniemargret // Aug 8, 2009 at 11:06 am –

  “Hey Barker….. best wishes!”

  (*CHUCKLE*)

  You too, hon!

  (*WINK*)

  BILL

• 60 balconesfault // Aug 8, 2009 at 1:28 pm

  “They LOVE Canada, they think Canada is a better country than the U.S”

  Sinz, don’t be an idiot.

• 61 midcon // Aug 8, 2009 at 1:46 pm

  anniemarget, actually the difference is you look at things through a prism and I look at them through clear glass with no distortion. Reality is easier to deal with when the light waves are not distorted by prisms regardless of what kind of prism one is using. I examine cost vs benefit, goals and objectives, and coldly evaluate methods, processes, and systems that faciltate meeting those objectives.

  Consequently, when you said in part “you will also see them petrified that they will lose it due to job loss” I said, that if I was petrified I would get up and do something about it rather than live in fear. You see, the government has never created a program for me. Nor do I expect them to. My situation, for good or ill, is the result of decisions I have made over the years. I was in the military when the pay was so low I qualified for food stamps. So I went I got an additional job and when that wasn’t enough, I got 3rd job (until I got fired for sleeping that is). My point is not that I am more capable than other people, it was just that I was petrified that I wouldn’t have enough money to buy food or pay my rent. So rather than being petrified, I did something about it.

  I accept that you have taken charge of your life and have accepted personal responsibility for yourself and my comment was not about you, it was about those you know or know of who wake up everyday wondering if this is their last day on the job. In Elkhart,IA the RV Capital of the World. Unemployment there was 4.7% a year ago. Today, it’s the highest in the nation at 15.3%. Imagine if you will that it’s January 2008 and that you are employed painting RVs. You see the economy tanking and you know that people will not have the money to buy RVs, so what do you do? Continue painting RVs and whatever happens happens? Or do you get online and start looking at what areas of the country and what kinds of jobs they have that are recession proof and that you might learn how to d?. Do you go back to school at night to learn IT or some other skill? Or do you get off work everyday knock back a few with the guys and head for home and TV to see how bad things are and get up the next morning and do it all over again?

  I am symphathetic to those who are out of work and I do believe this nation needs to step up and provide basic health insurance to everyone BUT I also believe that individuals need to step up and be in charge of themselves and their lives. We cannot expect the government to everything for everyone because the nation cannot afford it AND because it contributes to the loss of that pioneering, can-do, American ingenuity that made us what we are today. By having government do everything for us, we risk becoming American’ts instead of Americans.

• 62 cubuff1 // Aug 8, 2009 at 1:49 pm

  Three step approach.

  1. Get lawyers out of health care – “No Fault” comes to mind.
  2. Allow national healthcare plans and co-op. I’m sure USAA would start offering plans if they could.
  3. Tax free money so everyone has a choice of at least catastrophic care insurance offered by private insurance companies.

• 63 MFarmer // Aug 8, 2009 at 2:00 pm

  “………..I think you must have been asleep during the entire mortgage meltdown……most of the problems arose from inadequate regulation!”

  No, I actually was running my real estate business during the meltdown. Yes, inadequate regulation — that’s it. If only the government had interfered more, everything would be fine. Even when they regulate, it’s guided by politics, cronyism, protection and the inability to centrally plan complexity, but you hold on to that — we have the right technocrats, now, I hear.

• 64 anniemargret // Aug 8, 2009 at 2:06 pm

  midcon: I agree with you. I truly do. I truly believe people are in charge of their lives….to a point. LIFE happens to people, Midcon. Surely you do not think that just because you worked hard that this simplistic philosophy would solve everyone’s problems? I am not disputing that there are people who are lazy and non-goal oriented, but the vast majority of people right now having monumental problems with healthcare don’t fall into that category.

  People are not born with the same DNA, family backgrounds (good vs bad), environmental circumstances or psyches. It is why life is full of complexity and why this issue is such a thorny debate. If you think I am a ideologue, you would be deadly wrong. I’m a pragmatist. And it is for this reason, that I see more problems on the horizon in this issue, than not. It is NOT simply a matter of someone going back to school (do they get someone to pay for childcare while they do this? get a federal loan like I did? do they drop off the kids at grandma’s while they go to school? ) or work two or three jobs to make ends meet? Many people are already doing this.

  I’m not talking about those people like you, or even me, who did the above. I am talking about those people who are less fortunate, in spite of their efforts. Read the book, Outliers by Malcolm Gladwell. We are a great country not only because we have a powerful military, or free market, or a representative democracy. We are considered a great country because we are an ethical one. We must care and we must find a way.

• 65 Spartacus // Aug 8, 2009 at 3:31 pm

  Barker,

  Thre quick points:

  1. You’re right that we differ on where a public option will actually lead in the long-term, but why do you believe it will lead to a Canadian or UK style system as opposed to a Singaporean, Dutch or French system for which there are no anecdotes about long lines? The current Dem proposals are more similar to the systems in the Netherlands or Singapore than they are to the ones in Canada or the UK.

  2. I’ve never questioned the quality of healthcare that’s provided in this country. Whenever I talk about the goals of reform I never mention improving the quality. The problem is the cost and whether or not we can achieve similar quality for less cost. On that score, it’s very hard to argue that the U.S. model is not a failure – particularly when compared to France, Singapore and the Netherlands.

  3. To be clear, I’m not saying that no recommendation by a GP can go forward without first gettting insurance approval, I’m saying that the boundaries of what an insurer will pay for are pre-set by the contract between the insurance company and the doctor. Most of the time there is no problem b/c most ailments call for procedures that are covered. Similarly, most procedures would also be covered under a public option. My point on this topic was not to point out the flaws in the private insurance market, but to demonstrate that, on this issue, a public option is no worse, which seems to be a main fear among opponents of a public option.

• 66 Spartacus // Aug 8, 2009 at 3:38 pm

  Barker – “even most of those on the Left don’t deny the reality of longer waiting times – longer “lines” – in the UK and Canada.”

  A 4th quick point: I truly don’t know if the lines are the same as here and I did not argue they were. I know that there is an impression or reputation that longer lines exist in Canada and the UK, but I haven’t seen any studies or evidence of it. Consequently, I don’t know if it is fact or if it is just an impression. If we’re going to allege (or deny) that longer lines exist we ought to be able to demonstrate it with a link to a source.

• 67 ottovbvs // Aug 8, 2009 at 3:55 pm

  MFarmer // Aug 8, 2009 at 2:00 pm
  “No, I actually was running my real estate business during the meltdown. Yes, inadequate regulation — that’s it. If only the government had interfered more, everything would be fine. ”

  ………So you were complicit in the whole mess?……Just kidding…..but give me a break the whole history of how an unsupervised mortgage industry peddled sub prime and Alt A mortgages without due regard to the creditworthiness of borrowers is the subject of several books and articles without number(leaving aside the fact many of them are under indictment or civil prosecution)……they then securitized them themselves or passed them over to people like Lehmann Brothers who again were inadequately regulated who securitized them and sold them to insufficiently regulated and overleveraged banks and hedge funds…….you can entrust your financial fate to the likes of Angelo Mozilo or Richard Fuld if you like but I’d rather stick with good old boring Sheila Bair or Tim Geithner.

• 68 ottovbvs // Aug 8, 2009 at 4:02 pm

  cubuff1 // Aug 8, 2009 at 1:49 pm

  Three step approach.

  1. Get lawyers out of health care – “No Fault” comes to mind.

  …….What’s the relevance of lawyers to the healthcare issue except as another urban myth, that you clearly believe, that has been peddled by the Republican party as big cause of the cost problem….It isn’t…….In reality malpractice insurance and settlements amount to less than 1% of the annual cost of US healthcare……it’s simply not material except in the minds of people who don’t know too much about the subject.

• 69 anniemargret // Aug 8, 2009 at 4:25 pm

  No, it’s not malpractice that the bulk of the rising costs are originating from:

  http://www.nchc.org/facts/cost.shtml

• 70 greg_barton // Aug 8, 2009 at 4:47 pm

  Incredible, Frum. Pragmatic insight. I’m flabbergasted.

• 71 Matthew Yglesias » After Victory // Aug 8, 2009 at 5:24 pm

  [...] Frum contemplates conservative victory in the health care fight and doesn’t like what he sees: The problem is that if we do that… we’ll still have the present healthcare system. Meaning [...]

• 72 » What If Republicans Win The Healthcare Fight? Liberal Values // Aug 8, 2009 at 6:38 pm

  [...] David Frum has done something which few other conservatives have–question what it would mean if they actually won on healthcare: What would it mean to “win” the healthcare fight? [...]

• 73 Below The Beltway » Blog Archive » Beating ObamaCare Could Be A Pyrrhic Victory // Aug 8, 2009 at 7:09 pm

  [...] Frum contemplates the political landscape if the current campaign against the President’s health care reform pla… What would it mean to “win” the healthcare [...]

• 74 Conservative David Frum on Healthcare - Politics and Other Controversies - City-Data Forum // Aug 8, 2009 at 7:25 pm

  [...] Frum on Healthcare David Frum is a conservative jourmalist and former Bush speech writer. What if We Win the Healthcare Fight? [...]

• 75 SFTor1 // Aug 8, 2009 at 8:28 pm

  MFarmer: “In a free market, healthcare is a service offering between provider and patient, not a system to be engineered by technocrats.”

  We are back to the old argument that healthcare is a market. I will lay out my case why it is not, one more time.

  When you walk past a row of vegetable stands, you have greengrocers competing for your veggie budget. You can squeeze the yams and knock on the cantaloupes. You make an informed decision based on quality and price. Your five dollar bill carries real market power, bringing positive outcomes for all involved.

  Now let’s fast forward to the doctor’s office. The tests are back and the news are not so good. You have cancer. It is an aggressive type, and this is going to get very expensive in a hurry.

  You have private insurance. With 100% certainty your insurance company now will do the following: try to rescind your contract, or deny the claim, or limit your coverage.

  Provided your insurance carrier does not find a way to shake your claim you are facing a system where experts dominate the process completely. You have no idea what you need, nor how much of it. The experts do. If you have gold-plated coverage the hospital can make an extra buck by providing you with more care and procedures than you really need. You will never be the wiser for it. (The procedure is euphemistically known as “defensive treatment.”)

  Does this still look like an atomistic market model to you? Who has the market power? You certainly do not—none whatsoever. At the time you buy your coverage, you have literally no information about what you need. By the time you need your coverage, it doesn’t matter anymore: you will pay what it takes to get well, covered or not. You don’t have a choice.

  Health care is not a market, Farmer. Health care is a cost center, and the risk pool is the entire population. Anything else is bad husbandry.

• 76 sinz54 // Aug 8, 2009 at 8:53 pm

  sftor1 sez: “Provided your insurance carrier does not find a way to shake your claim you are facing a system where experts dominate the process completely. You have no idea what you need, nor how much of it. The experts do.”

  That’s absurd.

  Do you actually KNOW anyone with a serious illness?

  You do now. I’m one.
  My doctors ALWAYS involved me in my health care decisions. Over and over, they presented alternatives and let me make my decisions. That’s also true with cancer, where a patient chooses between different modalities (surgery, chemo, radiation, even more exotic things), chooses what hospital he trusts to treat him, etc. For prostate cancer, for example, there are a dizzying array of different options and combination of options. No cancer patient tells their doctor “Just do whatever you think is best”–are you serious?

  That’s not the issue.

  The issue, as I have pointed out over and over, is that we patients almost never make our decisions on treatment based on PRICE. What any cancer patient cares about is: Which hospital and which treatment modality offers him the best chance of cure? Not which one is cheaper.

  Because you don’t negotiate on price unless you’re prepared to walk away if you don’t get the bargain you’re looking for.

  When dickering with an auto dealer, if he doesn’t offer you a decent price on the car, you’ll walk out of the showroom. That doesn’t happen at hospitals. Almost nobody, even someone with a family to support, is going to tell a doctor “Sorry, doc, it’s not worth that much money to keep me alive,” and walk out of the hospital–unless they’re suicidal.

  Multiple studies have shown that a big driver of health care costs is advancing technology. Because as soon as the latest whiz-bang treatment for metastatic cancer comes along, desperate patients will demand it. They don’t want to die!

• 77 SFTor1 // Aug 8, 2009 at 9:17 pm

  Sinz,

  so you agree with me completely. You are being informed by experts at the relevant time of what the available options are and the likely outcomes, and you are being involved because an involved patient has a better prognosis. Without the expert advice you’d be eating sharkskin jelly and silver powder off an internet site.

  And the vast majority of cancer patients absolutely tell their doctors, implicitly or explicitly, “do what you think is best.” That you can take to the bank, Sinz.

  My best friend in the world lives in Houston, and recently had his second stroke at the age of 52. It turns out that he also has had a hidden heart attack. Part of his heart muscle is dead. He is now getting an IED. When asked about whether this would help for his condition he was told no, but it would restart his heart if it stopped. It is nothing but a defensive measure, and a pretty pricey one at that. He is taking the IED, no questions asked. He is also eating the entire bag of beta blockers and blood pressure medications and all the rest, because he is being told to. I have pointed out to him that several of his drugs do not seem to change outcomes for his condition, and he has told me in so many words that he will take the word of his doctor over mine. I would too.

  I’m not even sure what you are getting at, Sinz. Are you saying that you expect that people should consider the price issue? You even say so yourself: price is at the bottom of the list for the patient.

  So what is your point, exactly? A wish for more suicidal patients?

• 78 SFTor1 // Aug 8, 2009 at 9:38 pm

  BTW, my friend is an executive at a major oil industry company and has a VIP health plan. He’s lucky.

• 79 What if We Win the Healthcare Fight? | receptionists // Aug 8, 2009 at 9:41 pm

  [...] Here is the original post: What if We Win the Healthcare Fight? [...]

• 80 The American Spectator : AmSpecBlog : David Frum's Counsel of Despair // Aug 8, 2009 at 10:01 pm

  [...] anyone suggest a good purpose in Frum’s writing this: What would it mean to “win” the healthcare fight? For some, the answer is obvious: beat back the [...]

• 81 Hindsight Isn’t Always 20/20 « A Hard Left Hook // Aug 8, 2009 at 10:58 pm

  [...] same ones that Senate Democrats are trying to woo on health care reform. Conservative David Frum recognizes the risks of leaving the health care system the way it is, and he can’t be the only [...]

• 82 Health Care Reform (Part IV): The Solutions « The Western Experience // Aug 9, 2009 at 1:05 am

  [...] Frum of the New Majority asks the question, “What if We [Conservatives] Win the Healthcare Fight?” Uh, David, it’s called [...]

• 83 jhh112 // Aug 9, 2009 at 1:56 am

  Most of the people expressing strong opinions on US health care reform have zero first-hand experience with the systems in other countries that they tout or condemn. David Frum (from Canada, now living in US) is an exception, and it is clear that actually having some real knowledge helps him raise sound points. I am another exception—I am American, but my family and I have spent 14 of the last 30 years living in other countries, in order: Russia, Japan, France, and Australia. We were younger and childless and didn’t get sick in the first two , but we had extensive experience with France and Australia. In both these countries, we had real, ambulance-sirens-blowing, potentially life-threatening emergencies with our kids, surgeries with multiple day hospital stays, and close friends with suddenly discovered cancer requiring rapid action. The French and Australian systems both feature a base Medicare system with essentially universal coverage as well as additional private insurance that is NOT keyed to employment (a key difference is that people are not excluded because of pre existing conditions, but covered as in US employer group insurance. The Aussie term for this is “community risk”).

  The outcomes in the cases we have first hand knowledge of are comparable (and perhaps in some cases better, though it is hard to really know) than they would have been in the US. I would add that the nightmare stories popping up (most recently on Andrew Sullivan’s blog) of people without insurance going to or being taken to the ER and emerging a day later alive but with $10K bills (often for MRIs and CAT scans that look at best defensive and at worst like scamming) simply do not occur in either France or Australia because Medicare covers all emergencies and there is a careful triage system in place to make sure the most urgent patients are handled first and get proper care.

  Just to give you the flavor, here are a few real life stories. One day, our village school in France called to say our son was found unconscious on the playground and they had not been able to bring him around. We raced over, and found our son in the arms of a fireman who was trying to revive him gently while administering oxygen. The mayor of the village was already there, on his mobile to the hospital in the city (about 10 miles away), who were already revving up the medevac helicopter just in case. Suddenly, our son opened his eyes and stirred, at which pt he was loaded into an ambulance which I followed as it roared at 80 mph with police escort down the wrong side of the road to the hospital. They did all sorts of scans and exams, could find nothing wrong, but kept him for three days of observation in the neurological service because that was their protocol for ensuring that no “hidden” head injury would appear. We were not in the French Medicare system formally but on our US insurance, which the hospital billed for a nominal few hundred dollars. Note that as long term residents and French speakers, we were not treated any differently than anyone else. In another case, a friend in her late twenties, France complained of sudden flank pain, and was sent to hospital for an immediate appendectomy. Her appendix had burst, and there was also a substantial colon tumor, unusual in a young person. So she became a regular patient at the regional cancer hospital, with specialized chemotherapy (some of it intra-abdominal), all customized because she had inherited sickle cell anemia (!). Fifteen years later she is still OK, and her daughter has grown up. One more thing–the woman in question, is a permanent resident of France, but she holds a UK passport, pays French taxes and is part of the French Medicare system. Moving on to Australia—two days after we arrived, our son fell from a pool slide and broke both sides of his jaw. Ambulance time again. So we spent our first weekend in Australia jet lagged and in the emergency room, with visits to a dental surgeon as well because of broken teeth. All covered by Medicare—as permanent residents, we were part of the system the day we arrived, and my wife made sure to get our cards within hours of our plane touching down “just in case.” And in our years there, our family and friends had experience with abdominal surgery, acquired hemophilia due to overactive immune systems, emergency hospitalization for a collapsed lung, specialized cancer surgeries, kidney transplants, compartment syndrome, depression, anxiety, etc. My wife subsequently became an education officer in a newly established medical school, and helped formulate and administer the curriculum, and got to know a lot more about the Australia medical system, and her experiences support the picture I am painting here.

  The hysteria being hyped up about waiting lists in countries with universal Medicare just does not correspond to reality—-when immediate intervention is needed, the medical system is OBLIGED to act, and does so. Doctors and other medical professionals (who are for the most part independent practitioners and not civil servants, just as in the US) make a good living relative to other professions in both France and Australia; perhaps not the millions some doctor-businessmen-hospital owners in the US make, but then again, doctors in France and Australia do not have to borrow hundreds of thousands of dollars to go to medical school because the government supports most of the cost—-in Australia, training doctors is seen as similar to training military jet pilots—a national priority. What is true in both France and Australia is that medical care is seen as part of the glue that holds society together.

  Here in the US, the government administers about half (47% to be exact) of the taxpayer-paid financing for medical care. This covers Medicare for seniors, Medicaid for the really poor, and programs for children (SCHIP etc). If for the sake of argument we take this as covering the half of the population that does not work, that means that the half that works has to get their insurance from their employer or privately. Now, it is well known that about 50M of these people have no insurance, and an additional 25 M are under insured—meaning they are one medical catastrophe away from bankruptcy. So, what we have is nearly one half of our WORKING population of ~150-200M very vulnerable to financial ruin because of medical bills. So under our present system of employer-provided insurance for some, and go it alone for the rest, we are leaving a large fraction of the able WORKERS in a precarious state. These are the people who do the work that makes our country run, and earn the money that pays the bills of those who are too young or too old to work. And this is the system the right wing GOPers are so keen to protect? Some even to the point of making threats of violence (”using the Second Amendment”) against those who seek to discuss the proposed reform program with their elected representatives?

  Something is terribly wrong here. Country first? Not bloody likely. The whole nasty business smells of people being bought and paid for, or deliberately undermining a president who garnered more votes than any previous candidate for the office.

  So I find that David Frum’s points ring true, and urge everyone to wake up and listen.

• 84 jhh112 // Aug 9, 2009 at 2:05 am

  I forgot one more stubborn fact about the Australian and French medical systems. They give comparable overall results to the US system for less money. Australia spends about 9% of its GPD on health care, France spends a bit more, about 10%. The US spends far more, between 16 and 17%. Costs are going up in all these countries as populations age and new technology is introduced, of course, but the US continues to outspend nearly all of them (I believe Norway spends more). One more thing—life expectancies in both France and Australia exceed those in the US. Surely these hard numbers ought to make Americans—who pride themselves on being oriented to the true cost of things— think hard.

• 85 SFTor1 // Aug 9, 2009 at 2:20 am

  jhh112,

  Thank you for a very instructive post. Regarding health care spending in Norway: about half of the U.S. figures.

• 86 SFTor1 // Aug 9, 2009 at 2:27 am

  I should also mention that I grew up in Norway, and as anyone else I went to the doctor when I had to, and otherwise went about my business. The Norwegian system works well, with the typical cost increases as in other comparable nations. The biggest complaint from Norwegians is occasionally crowded hospital wards. This is usually a problem around Christmas, for whatever reason.

  My mother is 84, and is having a hip replacement operation on the 23rd. It is paid for, down to the cab ride to the hospital and back. She has waited about a month and a half for the procedure. I don’t think that’s outrageous.

• 87 Spartacus // Aug 9, 2009 at 2:34 am

  jhh112 // Aug 9, 2009 at 1:56 am

  jhh112, this was extremely informative. Unfortunately, most posters on this site who oppose the current reforms do so mainly for ideological reasons and are largely impervious to facts.

• 88 hhr // Aug 9, 2009 at 5:43 am

  jhh112, this was extremely informative. Unfortunately, most posters on this site who “SUPPORT” radically changing the current reforms do so mainly for ideological reasons and are largely impervious to facts…Two can play that game!

• 89 hhr // Aug 9, 2009 at 5:45 am

  this was extremely informative. Unfortunately, most posters on this site who “SUPPORT” radically changing the system do so mainly for ideological reasons and are largely impervious to facts…Two can play that game!

• 90 Winning the Healthcare Fight | Outside the Beltway | Online Journal of Politics and Foreign Affairs // Aug 9, 2009 at 7:24 am

  [...] David Frum frets that conservatives might be in for a Pyrrhic victory in the health care debate if they define winning as “beat back the president’s proposals, defeat the House bill, stand back and wait for 1994 to repeat itself.” [W]e’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments. [...]

• 91 anniemargret // Aug 9, 2009 at 8:57 am

  jhh112: Masterful rebuttal!

  Now can you kindly find some time to go out and educate some of these nutters out there at these town hall meetings where they shout down any semblance of rational discourse, (preventing others who want to listen their First Amendments rights) while they scream about ‘government interference’ and grasping their Medicare cards firmly in hand.

  I would suspect very few of them are even listening with any attention but are extremely susceptible to fear-mongering (”I want my country back”) and excoriating President Obama as a ‘Nazi” “Communist” “Socialist” “Marxist” “anti-Christ” (picking up the Limbaughisms and Beckisms, etc…) and maybe what’s surely coming next…”Klingon!”

  As I said elsewhere on this blog, my own personal experience in England with a life/death situation of my former husband and myself (he almost died from a virulent form of food poisoning), was stunning in its simplicity. He got the best of care, in the ER, and then in hospital, and we paid nary a penny for it. Whereas if that same situation had occurred here in the U.S. we would have been sacked with huge costs for months afterward. And we had insurance…I shudder to think if we had not.

• 92 sinz54 // Aug 9, 2009 at 9:05 am

  jhh112: In America, a single-payer system is off the table.

  Give it up.
  That’s not even under serious consideration.

  Your entire post is worthless and irrelevant to this discussion.

  The big debate we’re having in America is whether ObamaCare could someday move us to single-payer.

  Since we conservatives are unalterably opposed to that, for us that’s non-negotiable.

  BTW: My ancestors came to America to get away from Europe. They were never sorry, and they taught me to be glad that America isn’t like Europe.

• 93 Bits & Pieces » Be careful what you wish for // Aug 9, 2009 at 9:09 am

  [...] David Frum, himself a Republican, asks an interesting question: What if the Republicans successfully block healthcare reform? The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments. [...]

• 94 sinz54 // Aug 9, 2009 at 9:41 am

  Here, from an Obama-loving columnist on HuffPo, is the liberal grand scheme, which they don’t have the guts to tell non-liberals:

  “The most logical correction to the costly inefficiencies of the American private health insurance system would be a single-payer system — such as Medicare, a popular and successful single-payer system. But single-payer has proven to be too radical a change for Congress even to consider this time around, so we are left with the possibility of a “public option,” which would allow individuals and employer plans to buy into a public system modeled on Medicare. While this “public option” may not be the perfect solution, the perfect should not be the enemy of the good. Moreover, if the public option is robust, over time it would out-compete the costly, inefficient private health insurance system and you would find not only individuals choosing the public option, but also employer health plans concerned about costs.”

  http://www.huffingtonpost.com/guy-t-saperstein/the-only-good-option-for_b_253339.html

  THAT is the liberal scheme: “We know Americans won’t tolerate the government forcing single-payer down their throats. So we’ll put in place this robust public option, and then we’ll sit back and let employers force their employees into it instead.” So America’s corporations do Obama’s dirty work for him, forcing American workers into a government program at the threat of losing their jobs.

  How DARE liberals foist single-payer by a craven, duplicitous, diabolical scheme?

  WE GOT THEIR NUMBER.
  WE KNOW WHAT THEY’RE DOING.

  And we’re going to stop them cold.

• 95 Let Freedom Ring » Blog Archive » David Frum: Twentieth Century Conservative // Aug 9, 2009 at 10:32 am

  [...] 9th, 2009 • 8:32 amDavid Frum: Twentieth Century Conservative David Frum’s latest post at the New Majority is one of the most moronic posts I’ve read, recently or otherwise. He [...]

• 96 ottovbvs // Aug 9, 2009 at 10:43 am

  jhh112 // Aug 9, 2009 at 1:56 am

  ……I can only endorse what you say about the healthcare systems in these other countries based on my personal experience of both the British and French systems where I was treated for respectively kidney stones and an emergency appendectomy. I also had a child born in Britain and have in laws resident in Britain who have been treated in a timely and efficient way for numerous ailments from hip replacements to a very serious case of Guillame Barre syndrome all at zero, as in nada, cost to the patients. All this scaremongering by the Republicans is basically bs but that’s what Republicans do isn’t it these days just bs.

• 97 ottovbvs // Aug 9, 2009 at 10:45 am

  sinz54 // Aug 9, 2009 at 9:41 am

  “Here, from an Obama-loving columnist on HuffPo, is the liberal grand scheme, which they don’t have the guts to tell non-liberals:”

  ……….Since when is Huffington Post deciding Democratic party policy?……it’s a blog for godsake…….is NM deciding Republican party policy because it’s a blog too!

• 98 ottovbvs // Aug 9, 2009 at 10:48 am

  Spartacus // Aug 9, 2009 at 2:34 am

  “jhh112 // Aug 9, 2009 at 1:56 am

  jhh112, this was extremely informative. Unfortunately, most posters on this site who oppose the current reforms do so mainly for ideological reasons and are largely impervious to facts.”

  ……..Unfortunately, imperviousness to facts has become one of the defining characteristics of Republicans today on everything from birth certificates to economic management.

• 99 barker13 // Aug 9, 2009 at 10:48 am

  Re: Midcon // Aug 8, 2009 at 1:46 pm (#61)

  (*CLAP-CLAP-CLAP*)

  Bravo, Mid!

  Re: Spartacus // Aug 8, 2009 at 3:31 pm (#65)

  Well, I don’t know anything about Singapore’s health insurance system, but if memory serves they flog litterbugs and graffi “artists,” don’t they? (I like that…!!!) Anyway… feel free to share your knowledge of Singapore’s system. I’m always up for gaining new info and insights!

  (And you know I’m serious… that’s not a wiseass response. The more you post the more I read, Spart!)

  As to the Dutch system… well… I recall reading a NYT article on it and I’m guessing you’re the one who posted the link – am I right? As I recall, the article was (as you’d expect) fairly glowing. Hey… and that’s fine! I recall nodding to myself quite a bit while reading the article. I don’t recall saying to myself, “hey, we should adopt the Dutch system.” (*SHRUG*)

  The French system…? Well, that’s the one we ALL seem to point to as a potential model to focus on. Me… you… Mike K… the French model seems to get a lot of positive attention across the board. Still… it’s far from a perfect system and one of the main reasons it’s cheaper than ours because their doctors are paid perhaps a third of what ours are paid. Now that alone doesn’t “sink” the model in my eyes, but I’m just pointing to that one specific as an example of the complexities of comparing systems apple to apple.

  But, Spart… think about this and react to what I’m about to write:

  Have you noted President Obama championing the French system or Dutch system or Singaporan system? Pelosi? Reid? The politicians when they appear on TV roundtable news shows?

  Would you guess the average Member of the House knows as much about the French system (or the Dutch system) as you and I do…??? (*SNORT*) Or would you share my guess that when your average Member of Congress thinks “universal health insurance/care” they’re thinking UK/Canada?

  Hey… I WISH that the politicians (and the MSM) were focusing on specifics – focusing on SPECIFIC strengths and weakness of a number of foreign models. They’re not, though. I see no evidence whatsoever to point towards a trend among our “pro universal coverage/care” politicians and MSM to be actually dealing with this whole issue in a logical manner along the lines of how you and I would go about “negotiating” if you and I were powerful politicians.

  Anyway…. sorry for the ramble… but the short answer to you question of “why UK/Canadian” comes down to believing the folks who will ultimately steer the “reforms” are one part stupid, one part lazy, one part ideologically focused, and one part looking to cash in somehow of the “reform” process.”

  BILL

• 100 sinz54 // Aug 9, 2009 at 11:19 am

  ottovbs: I’ve shown you videos from YouTube, where Barney Frank and Jan Schiakowsky said exactly the same thing: The public option is our way to entice employers to force their workers into government-run care. I’ve shown you a video of the Berkeley professor who DESIGNED single-payer, explaining that it’s the way to “nudge” Americans toward single-payer.

  You keep ignoring it, you don’t even bother to look at it.

  STOP LYING.
  You know perfectly well that’s what it is.

  If by any chance you don’t, I suggest you go back to your Dem and liberal friends and ask THEM.

  The Dems are lying through their teeth.
  And so are you.

• 101 sinz54 // Aug 9, 2009 at 11:20 am

  ottovbs: I’ve shown you videos from YouTube, where Barney Frank and Jan Schiakowsky said exactly the same thing: The public option is our way to entice employers to force their workers into government-run care. I’ve shown you a video of the Berkeley professor who DESIGNED single-payer, explaining that it’s the way to “nudge” Americans toward single-payer.

  You keep ignoring it, you don’t even bother to look at it.

  You know perfectly well that’s what it is. But you won’t say so because the moment you open your mouth and admit it, ObamaCare is dead.

  The Dems are lying through their teeth.
  And so are you.

• 102 The American Spectator : AmSpecBlog : Defending Frum // Aug 9, 2009 at 11:28 am

  [...] Stacy McCain took issue with David Frum’s blog post arguing that defeating Obamacare may prove a pyrrhic victory for conservatives, but I actually [...]

• 103 sinz54 // Aug 9, 2009 at 11:29 am

  barker13 asks: “Have you noted President Obama championing the French system or Dutch system or Singaporan system? ”

  Obama is too smart to go before the American people and say anything positive about France–you know, those “cheese-eating surrender monkeys.”

  Remember that John Kerry lost a lot of votes because Americans thought he “talked French.”

• 104 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 12:22 pm

  [...] David Frum at The New Majority: [...]

• 105 John Dingell's Town hall on healthcare in Romulus - Page 2 - MotownSports.com Message Board // Aug 9, 2009 at 12:26 pm

  [...] sure where to put this but it raises some good points from David Frum What if We Win the Healthcare Fight? [...]

• 106 Five Key Freedom's You'll Lose under the proposed health care reform - Page 2 - MotownSports.com Message Board // Aug 9, 2009 at 12:27 pm

  [...] sure where to put this but it raises some good points from David Frum What if We Win the Healthcare Fight? [...]

• 107 jhh112 // Aug 9, 2009 at 1:16 pm

  To Sinz24 who said”
  jhh112: In America, a single-payer system is off the table.”

  If you bothered to actually READ my post, you would see that both Australia and France have both Medicare (emergency and catastrophic coverage) AND private insurance.

  I will add some more info on this, specific to Australia (where we lived for 9 years): (1) there is a 30% tax credit for the private insurance premiums you pay; (2) the younger you are when you start private insurance, the lower your premiums are for your whole life. This measure was set up to encourage people to sign up for private insurance from when they are young (as opposed to waiting until they are old). Immigrants joining the system, by the way, are grandfathered into this system when they show evidence of private medical cover in the country from which they came (this was our situation). The net result of all this is that 70% of surgeries are actually done under private insurance (in both publicly and privately owned hospitals), which allows more flexibility as to dates and so on.

  So Australia is NOT a single payer system, but features a mix of competition and collaboration between public and private insurance and provider entities.

  Australia and the US have remarkably parallel histories as British colonies which are peopled by immigrants from many different societies around the world–both are big melting pots. The US would do very well to adopt a medical system along Australian lines.

  [Parenthetically, the newly--and rationally--- reformed Australian tax system, which combines a national sales (aka "goods and services") tax of 10% on everything but food and medical care---and whose revenues go entirely to the six Australian states/territories---with a three rate income tax system with many fewer twists, turns, loopholes, and deductions than our IRS system, is also worth a look, too. Oh yes, and this new tax system was introduced by the conservative coalition govt of John Howard, whose political philosophy is basically similar to that of the GOP before it was taken over by the present group, whose approach is that of the Confederate States of America. ]

  Even France, which along with Malta (!!) is ranked at or near the top by the World Health Organization, has only a quasi-single payer system. When you go to the doctor, you pay what he charges right then and there. You then send in forms to the national insurance organization (think US Medicare) who reimburses you for a stated proportion of the cost. The doctors are independent professionals. To help pay for things not covered by the French national insurance system, French people can take out additional coverage from a variety of “mutuels”, ie, shared-risk health funds, which are in the cases I know about connected to employee pools of companies, industries, or the membership of trade unions.

  So, once again, actually knowing something about how other countries address problems is instructive. The fact is, of the nearly 5 billion people on the planet, only 300M or so inhabit the US. And yet, many of these other countries manage to deliver medical care comparable to that of the US in outcome, to larger fractions of their populations, at lower cost.

  I will conclude with a family update showing that the US system has its own horror stories of delays. My daughter, who went to university in Australia is now traveling around the world after graduation (we can afford that because going to Australian university is so much cheaper than it is in the US, and so young Aussie graduates often manage to see how other countries work through travel—there is an interesting story there). We arranged for private medical insurance for her travel thru a US firm specializing in insurance for ex patriates like students, missionaries, international professionals etc. This gives access to major US preferred provider networks and good coverage (including emergency repatriation) around the world. While in the US, she had a routine exam which turned up some abnormalities (cancer related) that need immediate follow up with a specialist. She is now in a major US city renowned for its many world class medical centres and doctors. None of the list of more than 100 relevant specialists close to her location could/would give her an appointment until January!. She finally was able to get in to see someone by working thru the office of the primary physician of a relative with the same last name.

  It is de rigueur for those opposed to any change in the our obviously superior. world-leading US medical system to point to alleged horrid delays in the Canadian medical system. A bit of reading around the web shows that these are exaggerated, but never mind for the moment. As everyone who has had experience in the US knows, getting timely appointments with a specialist when something has just been discovered is sometimes difficult to the point of being scary. These things are generally resolved by some sort of personal connection, as in the case of my daughter, which cuts thru the bureaucratic maze. But that is not so very different than in countries like, gasp, the old USSR–where I have seen similar dramas play out. (I even once provided hard currency for, er, a bribe to get someone injured in an accident into the “right” hospital. Sadly, this story did not end happily).

  My bottom line–and that of David Frum, the multi-national guy who started this thread— is that the US medical provider and insurance system is in need of some re-engineering. There are many ways to do this, and reasonable people can disagree and debate, but we have to do something if we are to remain a competitive society. Pretending that absolutely nothing needs to be changed in this “best of all possible countries” is irrational, dishonest, or both.

  The emanations from extreme elements in the GOP on reform of the health system, including most recently, the Queen of the Wingnuts, Sarah Palin, border on insanity. And yet the Republican leadership does nothing to distance themselves from these irresponsible ravings. That has to change.

• 108 David Frum wonders what’ll happen if there is no health reform : Galt Gone Wild // Aug 9, 2009 at 1:23 pm

  [...] health care reform. Actions need to follow words, David: David Frum, himself a conservative, ponders the consequences of the right “winning” the fight. The problem is that if we do that … we’ll [...]

• 109 ottovbvs // Aug 9, 2009 at 2:18 pm

  sinz54 // Aug 9, 2009 at 11:19 am

  ……..There Republican congressmen who want to start a war with Iran tomorrow but it’s not Republican party policy any more than a single payer system is Democratic party policy…….ranting and pulling odd statements from people on the fringes doesn’t amount to a hill of beans

• 110 ottovbvs // Aug 9, 2009 at 2:19 pm

  …….The Sinz brain in action

  “sinz54 // Aug 9, 2009 at 11:29 am

  barker13 asks: “Have you noted President Obama championing the French system or Dutch system or Singaporan system? ”

  Obama is too smart to go before the American people and say anything positive about France–you know, those “cheese-eating surrender monkeys.”

  Remember that John Kerry lost a lot of votes because Americans thought he “talked French.”

• 111 barker13 // Aug 9, 2009 at 3:19 pm

  Re: Jhh112 // Aug 9, 2009 at 1:16 pm (#107) –

  “…specific to Australia (where we lived for 9 years): (1) there is a 30% tax credit for the private insurance premiums you pay; (2) the younger you are when you start private insurance, the lower your premiums are…”

  As to (1) — Again, both philosophically and practically, I’m a “flat tax” kinda guy. To my way of thinking you don’t get more transparent and “fair” (in the sense of equal treatment) than a flat tax with no loopholes, no governmental picking of “winners” and “losers” with regard to how people want to live their lives. Of course as a pragmatic matter I’m willing to accept the reality that “The Barker Way” ain’t gonna be the law of the land anytime soon. (*WINK*) Therefore, rather than get hung up on flat tax, let’s just put the whole “30% tax credit” deal aside and assume good faith negotiation and compromise would be possible were this a key part of the national debate. Fair enough?

  As to (2) –Hey… I’m with you… insurance should start at birth – and perhaps even upon conception! Exactly right… in order to make the numbers work in an actuarial sense we need to have the ENTIRE population (as as close to it as feasible) part of the payee pool just as the entire population is part of the treatment pool when and as necessary to one extent or another.

  “…new tax system…”

  Hey… while we may disagree on VAT vs. income tax vs. “whatever tax,” one thing we agree on is that the U.S. federal tax code (and this goes for most state tax codes as well to one degree or another) is a disaster and as it now exists is far more a cause of dysfunction than a viable hope for being part of the “solution.”

  What we need to do is make the math work on TAXES in relation to government EXPENDITURES.

  Hey… we can argue till hell freezes over (apologies to the global warming contingent) about who is taxed too little vs. who is taxed too much, but what we must all acknowledge is that when “income” is less than “outflow” on a consistent basis with countless underfunded/unfunded liabilities facing our nation in the future, we need to keep our eyes on the basis… on the ball… on figuring out how to balance the books!

  “The fact is, of the nearly 5 billion people on the planet, only 300M or so inhabit the US. And yet, many of these other countries manage to deliver medical care comparable to that of the US in outcome, to larger fractions of their populations, at lower cost.”

  And you live in WHICH country now…??? (You lived – past tense – in Australia, right?) (I get the feeling you’re back “home” in the States now, but please confirm.)

  In any case… I’ll take my chances here in the U.S. if (God forbid) one of these days after a routine exam my doctor calls me to say, “Mr. Barker, I’m afraid that I’ve got some bad news…”

  “While in the US, she had a routine exam which turned up some abnormalities (cancer related) that need immediate follow up with a specialist. She is now in a major US city renowned for its many world class medical centres and doctors. None of the list of more than 100 relevant specialists close to her location could/would give her an appointment until January!. She finally was able to get in to see someone by working thru the office of the primary physician of a relative with the same last name.”

  Should we assume she’ll be returning to Australia for treatment? Should we assume she’ll be utilizing the medical services of some other foreign country for her care, treatment, and follow-ups? OR… should we assume she’ll be receiving treatment and follow-ups HERE in the States…???

  Hey… I’m not gonna call you a liar, but I’m telling you flat out, neither I nor anyone I know has EVER been faced with a situation even remotely resembling what you describe. You’re telling us your kid HAS a cancer related illness diagnosed but was told no specialist would see her earlier than five months from now (even longer depending upon what your actual timeline is – I’m starting now thru January)? Sorry… sounds highly… er… irregular to me and doesn’t jibe with my personal experience at all.

  But, hey… in any case… all this is irrelevant now since she DOES now have an appointment with a specialist – right…???

  Oh… and btw… back to the issue of how long one might have to wait to see a doctor/specialist… don’t you believe there “might be” some link between supply and demand in terms of too many patients, not enough doctors?

  Stratospheric medical costs (and thus loan repayments) added to a litigious civil justice system in desperate need of tort reform coupled with the expenses of the American culture of “the best of everything” in terms of equipment and pharmaceutical availability/use coupled with downward pressure on doctor’s incomes coupled with artificial price fixing (low balling) by government (medicare/medicaid) coupled with early retirements…

  I’m just saying… government can’t simply mandate “creation” of tens of thousand of additional doctors – particularly specialists. Let’s for the moment go with the 47 million uninsured number. Let’s say Obama and Congress wave a magic wand and suddenly… they’re all “insured” too – just like me, just like you. Well if doctors are already backed up treating you and me (and your daughter)… what’s going to be the effect of “dumping” 47 million more patients on the system? Well…??? (*SHRUG*)

  “…alleged horrid delays in the Canadian medical system.”

  Nothing “alleged” about it.

  http://www.youtube.com/watch?v=sXJgkvF19QA

  Seriously. We could go back and forth for days… weeks….! Bottom line… again… nothing “alleged” about it.

  “As everyone who has had experience in the US knows, getting timely appointments with a specialist when something has just been discovered is sometimes difficult to the point of being scary. These things are generally resolved by some sort of personal connection, as in the case of my daughter, which cuts thru the bureaucratic maze. But that is not so very different than in countries like, gasp, the old USSR…”

  Yeah. Actually it’s a whole lot different. (*SNORT*)

  Get real, Jhh112. Everything’s relative. I’m aware of NO stats showing waiting times for a specialist to be longer in the States than in other first world nations – just the opposite in fact. But, hey… if you’ve got something to show us… I’m willing to be convinced.

  “…we have to do something…”

  Well THAT certainly clears things up! (*LAUGHING OUT LOUD*)

  Fine. I believe we’re ALL in agreement there. (*WINK*)

  “The emanations from extreme elements in the GOP…”

  Way to use your “word power” there, Jh! And yeah… by all means… let’s watch those “extreme elements” in the GOP.

  Yep. That damn GOP. Why can’t they simply avoid “extremism” like… er… the Democratic Party does… like the Green Party does… like ALL “other Parties” do. (*SMIRK*)

  “…the Queen of the Wingnuts, Sarah Palin, border on insanity.”

  Let it out, Jh… let it all out. (*WINK*)

  “…irresponsible ravings.”

  Good boy! (Or girl…???) Way to let it out! Feel better now…???

  (*SOLICITOUS INQUIRING GAZE*)

  BILL

• 112 ottovbvs // Aug 9, 2009 at 4:21 pm

  111 barker13 // Aug 9, 2009 at 3:19 pm

  ” Hey… I’m not gonna call you a liar, but I’m telling you flat out, neither I nor anyone I know has EVER been faced with a situation even remotely resembling what you describe.

  Let it out, Jh… let it all out. (*WINK*)

  “…irresponsible ravings.”

  Good boy! (Or girl…???) Way to let it out! Feel better now…???

  (*SOLICITOUS INQUIRING GAZE*)

  BILL”

  Jhh112 // Aug 9, 2009 at 1:16 pm (#107) –

  ……………..Unfortunately a lot of private health insurance doesn’t cover psychiatric conditions which is why many people remain untreated

• 113 sinz54 // Aug 9, 2009 at 5:34 pm

  John Dingell, who ain’t no conservative, said recently about health care that “we’re not conducting this debate on a vital national issue with the intelligence and dignity it deserves.”

  On health care, there’s been hardly any debate at all between liberals and non-liberals.

  Long ago, liberals had fallen in love with all things Canadian, and so they expected Obama’s victory would bring America a Canadian-style single-payer system. With the only “debate” being about how many years it would take to complete the roadmap to full single-payer.

  On the left-wing blogs, I’m now seeing an awful lot of comments like “We were made to believe that Obama would fight for single-payer.”

  Where was Dingell for the last two years? Oh, he wanted single-payer too.

  And now Obama and Dingell are surprised that a lot of Americans don’t want single-payer plus a $1 trillion medical welfare program for the poor. So they’re put in the position of claiming the public option is an alternative to single-payer, when it was always planned to be the roadmap to single-payer. And they’re getting pinned daily on this lie.

  Obama could have gone about this a different way. He could have organized “Health Care Summits” in which MANY different health care models would be proposed and discussed by their advocates, everything from a British NHS-style system to a Heritage Foundation-style free market system. Televised on C-SPAN, the public could follow the debates and understand all that was at stake. Then, a bipartisan commission could have made recommendations about the way forward in health care reform.

  Instead, Obama chose to “not let a crisis go to waste” and worked with Pelosi to try to ram through a pure doctrinaire left-wing bill, the fever dream of all San Francisco and Vermont liberals.

  It’s pretty obvious by now that Obama’s election victory was a repudation of Bush. It sure didn’t signal a new American love affair with Canada.

  Except among liberals.

• 114 balconesfault // Aug 9, 2009 at 7:03 pm

  Sinz … forgive me if I’m wrong … but haven’t you been advocating that defeat of Obama’s health care initiatives would be a first step to eliminating Obama’s political power to move any of his agenda?

  If this is the take of conservatives … and it certainly is the take of many conservatives … why should anyone expect them to be honest brokers on working towards a health care reform bill, no matter what the format used to reach a bill?

• 115 So, what if healthcare is defeated? - MotownSports.com Message Board // Aug 9, 2009 at 8:03 pm

  [...] what if healthcare is defeated? David Frumm has an idea, and it makes sense to me… What if We Win the Healthcare Fight? [...]

• 116 jhh112 // Aug 9, 2009 at 9:03 pm

  To the guy up there calling me a liar:
  –I was born in the US and live in the US now. I have, however, lived in other countries for 14 of the last 30 yrs in connection with my work. I speak three languages fluently and several others badly, and so have generally been aware of what was going on around me. As a result, I have been able make absolutely direct comparisons of living costs, commercial conditions, everyday legal and banking affairs, income, sales, and property taxes, home and car repairs, and all sorts of insurance, and medical care from generalists to specialists to scheduled and emergency hospitalization. In some cases, these comparisons have been simultaneous—ie in one yr I paid income taxes to three different countries (each tax depended on the other two, which was fun). I still file both US and Australian tax forms every year, and can tell you all about the twists and turns in the evolution of tax law in both countries (The bottom line, BTW, is that Americans are lucky to be simultaneously well paid and moderately taxed.) I have had family members undergoing medical treatment in two different systems at the same time (by virtue of going back and forth), sometimes the same person for the same condition, so care had to be coordinated. I have lots of hard data, and being an engineer, I am happy working with numbers.

  –I never said that specialist wait times are longer in the US than elsewhere. Merely that I have direct experience of them being potentially as long as in any other horror story you hear. My daughter’s adventures in getting in to see a specialist are absolutely contemporaneous. As in, two days ago, an ongoing drama. I’d offer her phone number to the unbelievers, but I doubt she’d like the intrusion.

  Anecdotal information from family experience in two very different states (one Northeast, one Southeast) suggests there is more gatekeeping going on in medical practices, who seem to be limiting the number of new patients they take on. To be sure, this is time and place dependent, and your mileage may differ, but my point was to counter posters who voice fears that other medical systems which have universal coverage with substantial govt insurance components are guaranteed to be utter horrors in terms of waiting. My family has simply found that that is not the case, and we are not alone.

  —Finally, about Sarah Palin. I myself am basically a frugal New England Yankee who doesn’t waste money or have much tolerance for those who waste other people’s money. And having lived in Russia, I know about how communism works in practice (Russian is one of the languages I speak well). The state of Alaska is in fact the closest thing to a socialist state there is in the US. Why do I say this? Because Alaska taxes access to its petroleum reserves and pays some of the proceeds to its residents— Sarah Palin raised the payout to something like $3000 per yr per resident, yielding nearly $20K for a family of six. The state thus acts as an owner of the means of production. Which is, of course, what socialism is all about. Now that seems OK at first glance given the historical context–Alaska was a tough place to live for a long time, etc. But Alaska under Sarah Palin also managed to cop a cool $2 from the Federal govt for every $1 they paid in in Federal taxes, which Alaska uses to fund necessary things like roads and (famously) bridges. But wait a minute. They use taxes on petroleum, which raise prices paid by the rest of us, to give handouts to every Alaskan. And then they hit us AGAIN to pay for their infrastructure. So we are paying for their direct, non-means tested, public payoff (ie, vote buying) system. And then Sarah Palin is all over the Obama administration for spending money to stimulate the economy during the worst recession since the Great Depression? Seems pretty wingnut to me.

  (Most of the Red states that voted GOP in 2008 are in the same boat, taking in more aid from the Feds than they pay in taxes. Texas and Utah are the key exceptions to this. In contrast, all but a few of the Blue states consistently pay more to the Feds than they get back in aid etc, the leading payer being New Jersey. )

  And then last Friday Sarah outdid herself with claims that her Down’s syndrome kid like her famous Trig would be euthanized by the Obama health care plan. For starters, that is not true, it takes a whacko imagination to find that interpretation in a provision added–I gather— by one of the GOP senators from Maine to encourage better end-of-life care and counseling. And, even better, it turns out that at present, kids with birth defects like Down’s born to parents with private (ie, not employer guaranteed) insurance are often denied coverage because—and get this—their condition is deemed to be “pre-existing” by insurance companies. ( didn’t know this until this week, and I was gobsmacked to learn it thru a bit of Googling. Boy, am I glad I have employer coverage. (There is also the slightly off-topic factoid that Trig is something like 1/16th Yupik native Alaskan, which apparently may qualify him for coverage under federal programs for native Americans. )

  For a former VP candidate to be this off-the-wall on a major national issue is prima facie evidence of wingnut syndrome in my book. And truly, this from Sarah was a counterfactual “extreme emanation,” ranking right up there with that from the person who told his congressperson to “keep the govt’s hands off my Medicare.”

  That makes me wonder if the right tactic is to simply extend Medicare coverage downward in age. It is apparently no longer considered a govt program by those opposing other reform schemes.

• 117 Spartacus // Aug 9, 2009 at 9:16 pm

  barker13 // Aug 9, 2009 at 10:48 am – This was not a ramble at all. I wanted to hear her views.

  Sorry for the delay in responding; I had passed out from reading your post on a different thread in which you came out in favor of universal coverage and the abolotion of pre-existing conditions

  “Hey… I WISH that the politicians (and the MSM) were focusing on specifics – focusing on SPECIFIC strengths and weakness of a number of foreign models. They’re not, though. I see no evidence whatsoever to point towards a trend among our “pro universal coverage/care” politicians and MSM to be actually dealing with this whole issue in a logical manner along the lines of how you and I would go about “negotiating” if you and I were powerful politicians.”

  I could not agree more strongly.

  “Have you noted President Obama championing the French system or Dutch system or Singaporan system? ”

  I suspect he doesn’t do this because of the extreme prejudice (not racial, but cultural prejudice) that so many Americans have against foreign societies – particularly of Europe, as well as the demagoguery that many on the Right would immediately engage in. If a U.S. Congressman were willing to take the time to push for a change in the name of “French Fries” merely because France, a long-time ally who happened to be right, refused to support our misadventure in Iraq, what chance is there of getting a fair hearing when stating that there are elements of the French system that are worth evaluating and considering for implementation here?

  Just look at these threads. You and I are on opposite ends of the ideological spectrum, but based on your posts above and on your post on a different thread today, I suspect we could probably come to some kind of compromise that results in real reform if we were the decision-makers. But look how long it’s taken for us to look past each other’s ideology, admit neither of us has a monopoly on all the facts and become willing to judge proposals on their merits. Now, compare that to Sinz, who after reading two of JHH112’s, still won’t concede that the French system is not a single-payer system despite the fact that JHH lived there and sounds to have way more knowledge about the French system than Sinz.

  Now, if Sinz, who owns a computer, has very good reading and writing skills, has more familiarity with the U.S. healthcare system than most Americans, possesses a well-above average knowledge of history and still ends up being DEAD WRONG and unwilling to concede his error about an indisputable fact, what hope would Obama have in trying to present a comparative evaluation to your average American? I mean when an under-employed plumber making $40k/year and believes he’s going to pay more taxes under Obama’s tax cut plan can become the officially appointed figurehead of the presidential candidate of a major political party, then I’m not very optimistic about this country’s ability to take the time to understand the facts and evaluate the issues on the merits. And, it’s not just conservatives or GOPers who don’t inspire my confidence; I think this transcends politics. It just so happens that on the issue of healthcare, it is the Right whose opposition seems less fact-based and more ideological.

  Incidentally, those of us who point out some of the comparative advantages in these other healthcare systems are not arguing that the U.S. should adopt those systems wholesale. Instead, we’re saying that there are other countries – Western countries – who are dealing with this issue in a much more cost-effective way without compromising outcomes and that we should consider replicating some of those features here. Again, let’s evaluate the pros/cons of all the options and choose those that work best irrespective of which ideologies might be offended.

• 118 Etl World News | Assorted links // Aug 9, 2009 at 9:16 pm

  [...] 2. Can the health care fight be won? [...]

• 119 akindependent // Aug 9, 2009 at 10:24 pm

  Barker 13:
  So your sister goes into remission, but she loses her job. Finally, she finds another one, but because she has a preexisting condition, she cannot be insured. She spends the rest of her life, until she is old enough to qualify for medicare, anxious about not only a possible recurrance of the cancer, but the knowledge that the lack of coverage would financially devastate her family.

  Or, she once had chest pain and went to the hospital and was relieved that it was only heartburn or stress. But she forgot to put it on her insurance application because it happened 10 years ago and it wasn’t anything significant. She sees the doctors you talked about, but the insurance company refuses to pay for her treatment because she “lied” on her application. Rescission.

• 120 akindependent // Aug 9, 2009 at 10:45 pm

  Sinz 54 said: They offered alternatives to the so-called “public option with teeth.” Each and every one of the GOP’s proposals was shot down.

  Actually, more that 100 of their suggestions are in the house bill, including the living will consultations that inspired Sarah Palin to claim that Obama wants a death panel to encourage euthanasia. Newly reincarnated Republican leader Newt Gingrich today defended her distortion of this Republican proposal.

• 121 akindependent // Aug 9, 2009 at 11:05 pm

  jhh112:
  I wish you would combine your posts, edit a bit, and publish in a mainstream venue. Your posts are so well documented and articulated I have no doubt they would gain a broad audience. Thank you for taking the time to give such thoughtful responses. Expect to find me cribbing from you on my hometown–Anchorage, AK–news sites.

• 122 Let's Brainstorm on Healthcare. - Page 11 // Aug 9, 2009 at 11:10 pm

  [...] Sullivan’s blog: Conservatism And Healthcare, which is in reply to a posting from David Frum’s What if We Win the Healthcare Fight? I think the more people are having the discussion, the more that although they have disagreements [...]

• 123 barker13 // Aug 9, 2009 at 11:59 pm

  Re: Jhh112 // Aug 9, 2009 at 9:03 pm –

  “To the guy up there calling me a liar:”

  Moi…??? Bill…??? Barker13…??? (*GRIN*)

  To recap…

  —–Hey… I’m not gonna call you a liar, but I’m telling you flat out, neither I nor anyone I know has EVER been faced with a situation even remotely resembling what you describe. You’re telling us your kid HAS a cancer related illness diagnosed but was told no specialist would see her earlier than five months from now (even longer depending upon what your actual timeline is – I’m starting now thru January)? Sorry… sounds highly… er… irregular to me and doesn’t jibe with my personal experience at all.—–

  I just call ‘em as I see ‘em, Jhh. (*SHRUG*) Heck… I thought I was being EXCEEDINGLY polite and – for me – diplomatic. (*WINK*)

  * Sparky! Tell him! Tell him THAT was ME being on my best behavior! (*LAUGHING OUT LOUD*)

  “The bottom line, BTW, is that Americans are lucky to be simultaneously well paid and moderately taxed.”

  I hear ya! (I wouldn’t use the word “lucky,” a lot of people over a lot of years worked their asses off and suffered to build the foundation of what we’ve got, but yeah, the American middle class has long enjoyed a living standards the world did and should indeed have envied.) (Of course there were and are negatives as well, but short answer… I we’re in agreement on the above quoted point.)

  Oh… and btw… I certainly don’t disdain your experience. In fact I salute you! (*SMILE*) No shit. Don’t let critiques and comments related to one (or even several) parts of your post blind you to those areas where we share common ground. (*SHRUG*)

  “I never said that specialist wait times are longer in the US than elsewhere.”

  (*SNORT*) (*CHUCKLE*)

  Ahh… com’on… engineers are supposed to be honest and trustworthy! (Hmm… or perhaps that Boy Scouts… or maybe West Point Cadets…) (In any case…)

  Listen. (*SMILE*) Jhh. I’m not gonna argue perceptions and inferences with you… you wrote what you wrote – I wrote what I wrote. I felt your “inference” (via your daughter’s tale of initially not being given a timely appointment with any one of 100 specialists) was… umm… off the mark – not a fair picture of what happens in the real world.

  “Merely that I have direct experience of them being potentially as long as in any other horror story you hear.”

  As I wrote originally, Jhh… I wasn’t calling you a liar; I was simply pointing out that your… er… direct experience is like nothing I’ve ever experienced. (*SHRUG*)

  “Anecdotal information from family experience in two very different states (one Northeast, one Southeast) …”

  Your anecdotal experience. (*SHRUG*) Not mine. Not that of anyone I know. You’re being honest with me… I’m being honest with you.

  “…my point was to counter posters who voice fears that other medical systems which have universal coverage with substantial govt insurance components are guaranteed to be utter horrors in terms of waiting.”

  Not guaranteed. Just more likely. (*SMILE*) And of course that varies nation to nation, class to class.

  “My family has simply found that that is not the case…”

  Sounds to me that the “class” thing is kicking in. AKA the “color thing”: green that is. (*WINK*)

  Com’on… again, Jhh, be honest… you’re the American upper middle class. In fact you’re the sophisticated world traveling representative of corporate America upper middle class American (occasional) ex-pat. People like you, people who send their daughters on world travels as college graduation presents aren’t exactly some poor lower middle class schmuck in Canada or the UK (or wherever) dealing with government bureaucracy. Guys like you (and yeah, like me) have resources and connections that come into play when the $hit hits the fan (as in the case of your daughter’s illness).

  “Finally, about Sarah Palin…”

  You mean… er… the Queen of the Wingnuts? (*RELATIVELY GOOD-NATURED SMIRK*)

  Listen. I could respond to your attacks on Palin and we could go on and on. Been there. Done that. (*SMILE*) In relative – and I mean compared to all other state governors, not just to her predecessors as Alaska governor – terms, Palin was a cost cutter and fiscal conservative and there’s just no way around that. Here earmark/federal funding requests were a downward line and doing stuff like selling the Governor’s jet is exactly the tone I want set by Republican governors. Again… we can go on and on… but Palin is as close to a true fiscal conservative in a relative (comparative) real world sense as you’re gonna see. Again… no way around that. (*SHRUG*)

  Hey… you wanna try and portray Palin as some sort of socialist… (*CHUCKLE*)… good luck with that.

  “…last Friday Sarah outdid herself…”

  Yeah, yeah… throwing red meat to the base… something NO politician EVER does.

  (*ROLLING MY EYES*)

  Hey… personally… that’s not my style. If you stick around and pay attention to my posts you’ll notice that I’m VERY specific and VERY fact-based and literal. I tend to fact check anything that sounds “too good to be true” or “too bad to be true” rather than risk getting caught up in passing along “bad” info.

  Still… slapping Palin on the wrist for a Facebook entry she made… (*CHUCKLE*) Are you AWARE of some of the stuff that comes out of Nancy Pelosi’s mouth or Harry Reid’s – or Obama’s… or Biden’s…??? Now I’m not justifying “bad behavior” by pointing to other “bad behavior, ” but what I am noting is that there’s a HUGE double standard in play here. (As Ireign has often pointed out.)

  Anyway, Jhh… hope all turns out well with your daughter!

  BILL

• 124 jhh112 // Aug 10, 2009 at 2:11 am

  From Washington Monthly, today

  <>

  And guys, Palin’s Alaska, like most of the Red States depends on handouts from the Feds to keep their taxes low. It is easy to be ” fiscally conservative” when Federal tax payments from states like NJ, Mass, Calif. that put in more than they get back are funding nice Federal programs and jobs in your state. I live in the South, I speak fluent redneck, I get my electricity at great rates from the TVA, and I know how the game is played.

  And here is a link to the blog of Michael Kelly, a well-traveled, politically conservative surgeon, and his take on the French medical system (which is, as he explains, fee for service, avoids the problem of moral hazard , and is effective at delivery— all things I noted earlier, but laid out by him in professionally informed detail)—and which he suggests as a model the US should look at for ideas. He is not keen on the Canadian or British models and worries in other posts on his website that the proposed US reform leans too far in that direction. He has lots of other things to say on medical care and related issues.

  http://abriefhistory.org/?p=400

  And especially for Barker13—we can send our daughter around the world ONLY because five years of tuition for two degrees in Australia’s leading university cost a grand total of $US 15K, and she managed a half time job that paid her living costs for 3 of the five years. For the 9 yrs we lived in Australia, my wife and I made Australian salaries, and our maximum after tax annual income from two good jobs was something around $US70K (taxes in Australia until recently were twice what they are in the US for the same income, by the way. In 1997, for example, the 48% top bracket kicked in at a salary level of US$35k. And mortgage interest is not tax deductible). Since fuel, food and manufactured goods in Australia have become generally more expensive than they are on average in the US (think urban San Francisco or NYC), and sometimes much more expensive, our living standard was hardly at patrician levels even in our best years down under. So we know very well how ordinary people live. We work at going native wherever we are—-and native is generally cheap. And that is why we are well traveled.

  And now I am done here. Good bye and good luck to all the defenders of the status quo. As David Frum says, you might want to think about to do if you get your way and keep things just as they are while more and more people lose their employer-paid health care. I reckon there is no better way to turn the US into Argentina than to keep widening the gap between rich and poor in everything from money and education to health care. Thanks to the two Bushes and Reagan, who together are responsible for 70% of the accumulated debt of the US since Washington, we are well on our way to financial default—just like Argentina. Thanks to W, Cheney, Arrington and Gonzo, the government now has all sorts of enhanced executive powers, and can now tap phones and email with near abandon, and can even disappear inconvenient people —just like Argentina. It is possible to turn things around, but that requires more creative interaction than I see just now.

• 125 Right-wing Tactics Boost the Importance of Health Care Reform | Rants & Reasons // Aug 10, 2009 at 2:12 am

  [...] that through sheer deception and force a minority of loudmouths can defeat reform that everyone, including conservatives, agrees we [...]

• 126 Winning Nothing Much « Just Above Sunset // Aug 10, 2009 at 2:30 am

  [...] Oddly, that may be the real problem, as Bush’s former speechwriter, and the man who came up with the words Axis of Evil, David Frum, agues in one of the most discussed column of August – the consequences of the conservative activists actually winning, and this not changing, are not nice at all: [...]

• 127 Spartacus // Aug 10, 2009 at 4:15 am

  jhh112 // Aug 10, 2009 at 2:11 am

  I completely understand your frustration here. On many public policy issues, conservatives have become the intellectual descendants of “flat earthers.” Nevertheless, I hope you stick around because your posts are quite informative.

• 128 Conservative vs. Conservative : Delaware Liberal // Aug 10, 2009 at 8:02 am

  [...] guess it’s a tie 2-2. Any other conservatives care to weigh in? What about you, former Bush speechwriter David “Axis of Evil” Frum? The problem is that if we do that… we’ll still have the present healthcare system. Meaning that [...]

• 129 Koso // Aug 10, 2009 at 8:36 am

  Any Repulican/Conservative should be very ashamed at the horrible lies we are telling to derail healthcare reform. Why? Just because we lost an election!

• 130 sinz54 // Aug 10, 2009 at 11:04 am

  balconesfault: “why should anyone expect them to be honest brokers on working towards a health care reform bill, no matter what the format used to reach a bill?”

  Because that was their Grand Plan before Obama even got the Dem nomination.

  We conservatives are responding to the Dems’ calculated lies and duplicity.

  They chose to play dirty. Jan Schiakowsky said, long ago, to a cheering crowd of supporters:

  “A public option will put the private insurance industry out of business and lead to single-payer. This is not a principled fight. This is a fight about strategy for getting there, and I believe we will.”

  http://www.youtube.com/watch?v=zZ-6ebku3_E

  “This is not a principled fight.” That’s what you said.

  You liberals CHOSE to make this a fight based on lies and duplicity. You wanna play dirty?

  We’ll play dirty.

  They started it.
  We’ll finish it.

  Any Blue Dog Dem who votes for this piece of San Francisco/Vermont liberal garbage will be gone in November 2010. His political career will be over.

• 131 balconesfault // Aug 10, 2009 at 12:44 pm

  The private insurance industry could … well … compete. Something that they’re increasingly not having to do, as more and more insurance markets in America are dominated by a very small number of providers. I too believe that creating of a public option will lead not to a single payer system … because we’ve seen functional models around the world where it does not … but to some form of nationalized universal coverage, which we seriously need.

  Sinz, you’ve steadfastly avoided all the points that various people have made that a nationalized system would lead to a business boom – increasing entrepreneurism and global competitiveness. In fact, except for your sympathy for the insurance industry, you’ve shown a certain antipathy for American business, talking derisively about how business would shed their employer-paid healthcare plans if a public option could take care of their workers.

  Why is it that the rest of the country must work extra hard, and take on extra debt, to ensure the economic viability of the health insurance companies?

• 132 linus bern // Aug 10, 2009 at 1:44 pm

  Barker,

  Your fears about the Canadian health care system are completely unfounded. It does not take 3 months to get an appointment with a GP, it takes 1 – 2 weeks. You are not restricted to your GP’s opinion, you can consult other doctors and specialists. Your views are likely based upon misinformation disseminated by people who are getting rich fleecing the current system.

  The US would be extremely fortunate to actually adopt a Canadian style system of Universal Healthcare. It is clear though that any system you could come up with that moved you closer to Universal Healthcare will be designed deliberately to fail so as not to undermine the arguments of the freemarketeers.

• 133 Spartacus // Aug 10, 2009 at 1:54 pm

  balconesfault // Aug 10, 2009 at 12:44 pm wrote: “Sinz, you’ve steadfastly avoided all the points that various people have made that a nationalized system would lead to a business boom . . . ”

  He steadfastly avoids the issues because he’s intellectually impotent in these matters. It’s exactly as Ottovbvs said – he’s like a squid who squirts ink into the water and then disappears.

• 134 ottovbvs // Aug 10, 2009 at 5:18 pm

  …..Actually this is a very astute piece by Frum……it’s subtext is that if this situation is left unattended it’s going to start spiralling out of control as more and more companies cut benefits or increase employees share of costs and this could turn into a much more aggressive program of reform…..I’ve seen it suggested that this is the attitude of the insurance and pharma industries in the main….better to make a deal now and remain in the game rather than let the whole system breakdown and god knows what would come out of it…..the current system is sclerotic……it will be fixed by Obama or another at some point because it’s unsustainable……..this is what Obama and a lot of people see but not the far right and the foot soldiers they’v indoctrinated.

• 135 Of Sarah Palin, Death Panels, Obamacare, and liberal bloggers - Blogs - NewsSpotz // Aug 11, 2009 at 2:54 am

  [...] Frum made a valid point last week. In defeating Obamacare we may end up creating an even more untenable situation. Playing [...]

• 136 David Frum: how stupid can conservatives be, trying to win the health care fight? « The TrogloPundit // Aug 11, 2009 at 6:31 pm

  [...] David Frum: how stupid can conservatives be, trying to win the health care fight? David Frum asks the question: What if we win the healthcare fight? [...]

• 137 4 Points on Health Care - 2parse // Aug 12, 2009 at 11:07 am

  [...] if the right “wins”? David Frum asks what it would mean for conservatives and right-wingers to “win” the health care fight. This Republican’s answer: We’ll have entrenched and perpetuated some of the most [...]

• 138 Brian Lilley » Blog Archive » The Great Debate – Health Care Roundup // Aug 13, 2009 at 12:04 am

  [...] to sway policy inside the Republican Party asks what his side should offer voters should they beat back Obama’s plan. “The problem is that if we do that… we’ll still have the present healthcare system. Meaning [...]

• 139 The Crossed Pond » Just Frustration // Aug 13, 2009 at 1:29 pm

  [...] commentators who are beginning to dip their toes into this sort of self-critique. For one, David Frum has a great post that ranks as the best movement navel-gazing I’ve read this [...]

• 140 Serious Times … « Democratic Way // Aug 16, 2009 at 9:31 am

  [...] Times … Posted on August 16, 2009 by Ben In a recent post at newmajority.com David Frum, resident fellow at the American Enterprise Institute, questions the [...]

• 141 Assorted links « See the Invisible Hand // Aug 18, 2009 at 2:44 pm

  [...] Greg Clark fears the machines. 2. Can the health care fight be won? 3. The cover for SuperFreakonomics. 4. Waffle House weirdness (via Craig Newmark). 5. History of [...]

• 142 ShortsandPants - Taser of Wisdom: “Learning Frum Experience” Edition // Aug 18, 2009 at 10:25 pm

  [...] To wit: What would it mean to “win” the healthcare fight? [...]

• 143 LittleDEM // Jan 23, 2010 at 4:54 pm

  Belatedly, a Thank You nonetheless for acknowledging that the status quo when it comes to healthcare is totally and utterly unacceptable. I don’t quite get why people still fail to see that fact. It’s like a train wreck in slow motion . . . It’s still a train wreck in the end.

  We need to solve this by deploying Healthcare Reform, ideally, in a bipartisan fashion. But if need be, Democrats need to do the best they can without Republican support.

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