Health Care Reform - Universal/Public Option

[Klinglerware]

Originally Posted by molson

It also seems believable to me that more people's economic viewpoints are motivated by hatred and jelousy of the top 1% (because 99% of people are conceivably subject to such hate), than those who just feel bad for the top 1% and want them to have all their money because they deserve it (because only 1% of people are conceivably subject to that). And liberals always throw out the latter, that anyone who isn't with them is pro-rich, so it's not unreasonable for me to throw out that response.

On the other hand, the majority of voters who make $200,000 or more (roughly 5% of voters) voted for Obama. This effect of rich people voting for Obama and other liberals is especially pronounced in the Northeast and Pacific Coast.

The point here is that expressing liberal politics is not incompatible with making a lot of money. A lot of lefty Ivy types don't shed their liberal values when they graduate to jobs as investment bankers and management consultants. There have been theories put forth that the "super-rich" tend to be a lot more liberal than you would expect due to the fact that they make so much money that their tax burden is less meaningful to them and can vote without regard to pure economic interest. This seems to have played out in the 2008 election, where the exit polling suggests that Obama did not carry voters who made between $100,000-$200,000, i.e. the group of somewhat affluent voters below the $200k group, where presumably the tax burden takes more of a bite.

[lynchjm24]

Originally Posted by Klinglerware

On the other hand, the majority of voters who make $200,000 or more (roughly 5% of voters) voted for Obama. This effect of rich people voting for Obama and other liberals is especially pronounced in the Northeast and Pacific Coast.

The point here is that expressing liberal politics is not incompatible with making a lot of money. A lot of lefty Ivy types don't shed their liberal values when they graduate to jobs as investment bankers and management consultants. There have been theories put forth that the "super-rich" tend to be a lot more liberal than you would expect due to the fact that they make so much money that their tax burden is less meaningful to them and can vote without regard to pure economic interest. This seems to have played out in the 2008 election, where the exit polling suggests that Obama did not carry voters who made between $100,000-$200,000, i.e. the group of somewhat affluent voters below the $200k group, where presumably the tax burden takes more of a bite.

I fit your profile and favored Obama over McCain. Much of that was a lesser of two evils stance though. Palin was pure poison and I'd happily pay higher taxes to keep her from ever ascending to the Presidency.

Do take note though of how quickly people are fleeing high tax areas like New York and New Jersey for states with no income tax like Florida and Texas.

I think most people beyond just the liberals are fine with a progressive tax system. The struggle is over going further. I'm not looking for tax breaks or credits. I just don't need it getting any worse then it already is.

[Galaxy]

Originally Posted by cartman

Except that California has, compared to other states, a very low property tax rate. It is capped at 1% of the appraised value of the house, and the appraised value cannot increase by more than 2% per year from the purchase date. So even though the average value of a house in California is more than $500K, if these were bought 10 or more years ago, the taxable amount is only in the $200K to $250K range.

Plus, when you pay a state income tax or local property taxes, those are deductions you can claim on your Federal taxes.

Do you feel that this prop (can't remember what # it is) is what is killing California's budget?

[Galaxy]

Originally Posted by lynchjm24

I fit your profile and favored Obama over McCain. Much of that was a lesser of two evils stance though. Palin was pure poison and I'd happily pay higher taxes to keep her from ever ascending to the Presidency.

Do take note though of how quickly people are fleeing high tax areas like New York and New Jersey for states with no income tax like Florida and Texas.

I think most people beyond just the liberals are fine with a progressive tax system. The struggle is over going further. I'm not looking for tax breaks or credits. I just don't need it getting any worse then it already is.

That's how I feel it went (Obama over McCain).

[cartman]

Originally Posted by Galaxy

Do you feel that this prop (can't remember what # it is) is what is killing California's budget?

Prop. 13 was something that definitely affected the California budget process over the past 30 years, but I feel that the ability to decide spending with a simple majority vote, outside of the budget process, is just as big. In California, a spending measure can be put on the ballot, and a simple 50%+1 authorizes the measure. But for any kind of tax increase or bond measure, it has to get a supermajority in order to take effect.

[RainMaker]

Originally Posted by lynchjm24

I fit your profile and favored Obama over McCain. Much of that was a lesser of two evils stance though. Palin was pure poison and I'd happily pay higher taxes to keep her from ever ascending to the Presidency.

Do take note though of how quickly people are fleeing high tax areas like New York and New Jersey for states with no income tax like Florida and Texas.

I think most people beyond just the liberals are fine with a progressive tax system. The struggle is over going further. I'm not looking for tax breaks or credits. I just don't need it getting any worse then it already is.

The odd thing is that young adults and rich people used to vote Republican.

The rich liked the fiscal responsibility which would lead to lower taxes. Republicans stopped being small government and there wasn't as much of a reason to vote Republican for them. They killed one of their strongest issues with that voting block. It's why my compass has swung from slightly to the right to slightly to the left in recent elections. There is no difference in the two fiscally, so you have to judge it on social issues which Democrats win on in my book.

It's also funny to see that HW Bush beat Clinton amongst young adults in 1992. That has shifted dramatically now which is real bad long term. If you are a Democrat at 23, there is probably a stronger chance you remain one later in life. Republicans were able to get youth vote because they for the most part didn't want government fucking with us.

I contend that while Bush won in 2000 and 2004, those victories will hurt the Republican Party more than anything. Not necessarily his policies like Iraq, but the way he transformed the party. He created huge wedges and when society progressed passed those, the party was left with nothing. Now they sit in a situation where they have a rabid supportive base that is unwilling to budge on issues but is also not large enough to win an election.

[JPhillips]

Originally Posted by RainMaker

The odd thing is that young adults and rich people used to vote Republican.

The rich liked the fiscal responsibility which would lead to lower taxes. Republicans stopped being small government and there wasn't as much of a reason to vote Republican for them. They killed one of their strongest issues with that voting block. It's why my compass has swung from slightly to the right to slightly to the left in recent elections. There is no difference in the two fiscally, so you have to judge it on social issues which Democrats win on in my book.

It's also funny to see that HW Bush beat Clinton amongst young adults in 1992. That has shifted dramatically now which is real bad long term. If you are a Democrat at 23, there is probably a stronger chance you remain one later in life. Republicans were able to get youth vote because they for the most part didn't want government fucking with us.

I contend that while Bush won in 2000 and 2004, those victories will hurt the Republican Party more than anything. Not necessarily his policies like Iraq, but the way he transformed the party. He created huge wedges and when society progressed passed those, the party was left with nothing. Now they sit in a situation where they have a rabid supportive base that is unwilling to budge on issues but is also not large enough to win an election.

Somewhere along the line I read a study that linked feelings toward the President before voting age to later voting patterns. So Reagan built a generation of Republican leaners while Clinton produced a lot of Dems. Carter and Bush1, not so much.

[RainMaker]

Originally Posted by JPhillips

Somewhere along the line I read a study that linked feelings toward the President before voting age to later voting patterns. So Reagan built a generation of Republican leaners while Clinton produced a lot of Dems. Carter and Bush1, not so much.

I think it was done by Nate Silver at Five Thirty Eight.

[SteveMax58]

Originally Posted by RainMaker

The odd thing is that young adults and rich people used to vote Republican.

The rich liked the fiscal responsibility which would lead to lower taxes. Republicans stopped being small government and there wasn't as much of a reason to vote Republican for them. They killed one of their strongest issues with that voting block. It's why my compass has swung from slightly to the right to slightly to the left in recent elections. There is no difference in the two fiscally, so you have to judge it on social issues which Democrats win on in my book.

I tend to agree that this is how the Repubs lost the center(if thats what you meant) in the last 2 elections (2006 & 2008). But I don't think it is anywhere near as dire as I keep hearing from various pundits. These things always go in waves and very similar to the way Repubs crapped away their "stock value" with center voters, the Dems are trotting down a similar path with the Stimulus and Health Care reform plans. Sprinkle in a major international issue that the center feels Obama handles wrong (or nets an undesirable result) and I think you'll see how quick that stock value swings back.

While I think Obama won on his own merits vs. McCain, I dont think Senate and Congressional Dems (generalizing here) won on anything but "not being Republicans". Reverse can very easily occur if they arent more mindful of public perception, IMHO.

In regards to the Republican part pandering to right wing loons...yes, I agree this is where they get their whole pitch wrong. Rather than being "pro" anything but states rights to decide moral/social issues, small government advocates (i.e. what the Repubs are supposed to be) should be "anti" federal government interference. They should be acknowledging that there are select issues that do make sense to run at the federal level (military, monetary policy, etc.) but stop advocating things like constitutional ammendments for abortion, gay marriage, etc. Doesnt matter what they "believe"...just matters what role the government should play in deciding this.

Or...we can keep giving the fedral government more and more authority so every 4-6 years we can see radical shifts in policy depending on who Americans are more "sick of".

[SteveMax58]

Dola,

I think my post probably belonged in the Obama thread...but these things keep confusing me.

[RainMaker]

Originally Posted by SteveMax58

I tend to agree that this is how the Repubs lost the center(if thats what you meant) in the last 2 elections (2006 & 2008). But I don't think it is anywhere near as dire as I keep hearing from various pundits. These things always go in waves and very similar to the way Repubs crapped away their "stock value" with center voters, the Dems are trotting down a similar path with the Stimulus and Health Care reform plans. Sprinkle in a major international issue that the center feels Obama handles wrong (or nets an undesirable result) and I think you'll see how quick that stock value swings back.

While I think Obama won on his own merits vs. McCain, I dont think Senate and Congressional Dems (generalizing here) won on anything but "not being Republicans". Reverse can very easily occur if they arent more mindful of public perception, IMHO.

In regards to the Republican part pandering to right wing loons...yes, I agree this is where they get their whole pitch wrong. Rather than being "pro" anything but states rights to decide moral/social issues, small government advocates (i.e. what the Repubs are supposed to be) should be "anti" federal government interference. They should be acknowledging that there are select issues that do make sense to run at the federal level (military, monetary policy, etc.) but stop advocating things like constitutional ammendments for abortion, gay marriage, etc. Doesnt matter what they "believe"...just matters what role the government should play in deciding this.

Or...we can keep giving the fedral government more and more authority so every 4-6 years we can see radical shifts in policy depending on who Americans are more "sick of".

But where do they make up ground? Look at the demographics.

Blacks and hispanics are the two fastest growing voting blocks in the country. Both side heavily with Democrats for a variety of reasons. Now as long as those demographics continue to grow faster every election cycle, Democrats will continue to gain votes. I don't see that changing with the veiled racism that goes on in the party right now.

You have a young generation who has decided their stance on social issues. They don't mind gay marriage. They aren't too keen of religion being pushed down their throats. They are pro-science and more environmentally friendly. Unless you see a dramatic shift in social issues on the Right, they can't get a lot of those voters. That's a generation they lose.

So with many of the base dying off and not many new voters in the pipeline mixed with the huge gaps in minorities that are growing faster, I don't see where the wave stops. Maybe they pick up a couple house seats in 2010 (they'll lose Senate seats), but I can't foresee a situation where they will be in power for a long time.

[lynchjm24]

Originally Posted by RainMaker

The odd thing is that young adults and rich people used to vote Republican.

The rich liked the fiscal responsibility which would lead to lower taxes. Republicans stopped being small government and there wasn't as much of a reason to vote Republican for them. They killed one of their strongest issues with that voting block. It's why my compass has swung from slightly to the right to slightly to the left in recent elections. There is no difference in the two fiscally, so you have to judge it on social issues which Democrats win on in my book.

It's also funny to see that HW Bush beat Clinton amongst young adults in 1992. That has shifted dramatically now which is real bad long term. If you are a Democrat at 23, there is probably a stronger chance you remain one later in life. Republicans were able to get youth vote because they for the most part didn't want government fucking with us.

I contend that while Bush won in 2000 and 2004, those victories will hurt the Republican Party more than anything. Not necessarily his policies like Iraq, but the way he transformed the party. He created huge wedges and when society progressed passed those, the party was left with nothing. Now they sit in a situation where they have a rabid supportive base that is unwilling to budge on issues but is also not large enough to win an election.

I agree with what's you've got here. I also think that the educated and wealthy on the coasts are scared of some of the religious zealots in the Republican Party. I know they scare the crap out of me. People in the Northeast don't really mind gay marriage and support stem cell research.

Since we all know neither party is fiscally responsible, might as well go with the one that appeals to your mindset on social issues.

[SteveMax58]

Originally Posted by RainMaker

But where do they make up ground? Look at the demographics.

Blacks and hispanics are the two fastest growing voting blocks in the country. Both side heavily with Democrats for a variety of reasons. Now as long as those demographics continue to grow faster every election cycle, Democrats will continue to gain votes. I don't see that changing with the veiled racism that goes on in the party right now.

You have a young generation who has decided their stance on social issues. They don't mind gay marriage. They aren't too keen of religion being pushed down their throats. They are pro-science and more environmentally friendly. Unless you see a dramatic shift in social issues on the Right, they can't get a lot of those voters. That's a generation theylose.

So with many of the base dying off and not many new voters in the pipeline mixed with the huge gaps in minorities that are growing faster, I don't see where the wave stops. Maybe they pick up a couple house seats in 2010 (they'll lose Senate seats), but I can't foresee a situation where they will be in power for a long time.

This is their problem at the moment...but they have plenty of arguments that they just have not brought forth that can sway black and hispanic voters. And even if a few Repubs have in small doses...they get drowned out because Repub leadership has felt it better to advocate for social issues that nobody that wouldnt vote for them cares about.

Instead of pointing out ways that big federal government coupled with big business winds up creating more poor people with less of a lobbying voice...they opt for gay marriage. I dont care if a majority of blacks in California DID vote gay marriage down...it should serve as an example of states' rights doing the will of the people, and why you should vote Repub, not some percieved support for a new ammendment. Not to mention it just isnt the side of the issue Repubs should be on in the first place...they should not be for ANY side, just the process of determining (which decreases big government). This resonates more with people of all races. Better to be "for" fairness than to be "anti" people that everybody knows.

Unfortunately...this would be a titanic shift for them at the moment. But it's a shift that they have to make IMO. Basically, be more like libertarians.

[CamEdwards]

People unfortunately rarely vote for the party that says, "Not our problem!" I'm not saying it's right, but it's how modern politics works.

[RainMaker]

Originally Posted by SteveMax58

This is their problem at the moment...but they have plenty of arguments that they just have not brought forth that can sway black and hispanic voters. And even if a few Repubs have in small doses...they get drowned out because Repub leadership has felt it better to advocate for social issues that nobody that wouldnt vote for them cares about.

Instead of pointing out ways that big federal government coupled with big business winds up creating more poor people with less of a lobbying voice...they opt for gay marriage. I dont care if a majority of blacks in California DID vote gay marriage down...it should serve as an example of states' rights doing the will of the people, and why you should vote Repub, not some percieved support for a new ammendment. Not to mention it just isnt the side of the issue Repubs should be on in the first place...they should not be for ANY side, just the process of determining (which decreases big government). This resonates more with people of all races. Better to be "for" fairness than to be "anti" people that everybody knows.

Unfortunately...this would be a titanic shift for them at the moment. But it's a shift that they have to make IMO. Basically, be more like libertarians.

You really think they are going to be able to sway black and hispanic voters back in big numbers? There's a lot of veiled racism on that end and I just don't see it happening without a major overhaul.

I agree with you 100% on the libertarian argument. They should stand back and say "listen, gay marriage is not up to us, it's up to the state". Everything should be about States rights and less federal power. It allows them to somewhat stay on the side of the argument their supporters are on without actually coming across as socially regressive.

The problem is that the religious side is anything but libertarian. They want to tell people how they have to live their life and I don't know how the party can persuade those people otherwise.

[SteveMax58]

Originally Posted by CamEdwards

People unfortunately rarely vote for the party that says, "Not our problem!" I'm not saying it's right, but it's how modern politics works.

But it's more about pushing "the people's" agenda. Meaning...newer Republican political figures should be for the people's will vs. being for any of the results. In my mind...this is what small government advocacy should be "for". Not that I'm in any way confused that this is what the Repubs have stood for recently...but still.

It's akin to "it's the economy stupid".

[SteveMax58]

Originally Posted by RainMaker

You really think they are going to be able to sway black and hispanic voters back in big numbers? There's a lot of veiled racism on that end and I just don't see it happening without a major overhaul.

No, I don't think they "will"...but I think they "could".

[Edward64]

Wanted to bring this thread back to life focusing on healthcare.

It looks as if the rubber is going to hit the road now and it should be an interesting 2-4 weeks as the proposed bills are reconciled.

Still hoping for a public option to keep the insurance companies honest. Appreciated Olympia voting for the Senate version, shows her maturity (?) and puts the republicans, imo, in a bad light.

[gstelmack]

The Labor Unions have come out against the plan that came out of committee, so I am now officially all for giving it a whirl.

[Mizzou B-ball fan]

Originally Posted by Edward64

Appreciated Olympia voting for the Senate version, shows her maturity (?) and puts the republicans, imo, in a bad light.

One vote by a RINO in a committee vote did all this? Who knew?

[albionmoonlight]

I don't know if it is even on the table, but I like the idea someone floated of having a robust public option but letting states choose to opt their residents out of it.

[JPhillips]

Originally Posted by albionmoonlight

I don't know if it is even on the table, but I like the idea someone floated of having a robust public option but letting states choose to opt their residents out of it.

I'm intrigued by that too, but apparently Snowe prefers a trigger and Conrad and Lieberman are up in the air about the whole package.

[Mizzou B-ball fan]

Originally Posted by JPhillips

I'm intrigued by that too, but apparently Snowe prefers a trigger and Conrad and Lieberman are up in the air about the whole package.

From what I heard last night, it sounds like the Snowe vote wasn't exactly a ringing endorsement from her as much as she just wanted to get a bill out of committee so it could move closer to an up/down vote in the full Senate. It sounds like she still doesn't fully support the wording of the bill. If so, I support that move. No need to hang up a bill in committee just for the sake of holding it up. Get it out where we can get a final bill and actually know what will and won't be in it.

[Young Drachma]

Story in today's NY Times about Hawaii and its health care law:

In Hawaii’s Health System, Lessons for Lawmakers - NYTimes.com

In Hawaii’s Health System, Lessons for Lawmakers
By GARDINER HARRIS

HONOLULU — Imee Gallardo, 24, has been scooping ice cream at a Häagen-Dazs shop at Waikiki Beach for five years, and during that time the shop has done something its counterparts on the mainland rarely do: it has paid for her health care.

Ms. Gallardo cannot imagine any other system.

“I wouldn’t get coverage on the mainland? Even if I worked? Why?” Ms. Gallardo asked in an interview.

Since 1974, Hawaii has required all employers to provide relatively generous health care benefits to any employee who works more than 20 hours a week. If health care legislation passes in Congress, the rest of the country may barely catch up.

Lawmakers working on a national health care fix have much to learn from the past 35 years in Hawaii, President Obama’s native state. Among the most important lessons is that even small steps to change the system can have lasting effects on health. Another is that, once benefits are entrenched, taking them away becomes almost impossible. There have not been any serious efforts in Hawaii to repeal the law, although cheating by employers may be on the rise.

But perhaps the most intriguing lesson from Hawaii has to do with costs. This is a state where regular milk sells for $8 a gallon, gasoline costs $3.60 a gallon and the median price of a home in 2008 was $624,000 — the second-highest in the nation. Despite this, Hawaii’s health insurance premiums are nearly tied with North Dakota for the lowest in the country, and Medicare costs per beneficiary are the nation’s lowest.

Hawaiians live longer than people in the rest of the country, recent surveys have shown, and the state’s health care system may be one reason. In one example, Hawaii has the nation’s highest incidence of breast cancer but the lowest death rate from the disease.

Why is Hawaiian care so efficient? No one really knows. In dozens of interviews, Hawaiian doctors and hospital and insurance executives offered many theories, including an active population that is culturally disinclined to hospitals, a significant military presence and a health care market dominated by a few not-for-profit organizations. But there was another answer: With nearly 90 percent of the populace given relatively generous benefits, patients stay healthy and health providers have the money and motivation to innovate.

If true, it’s a crucial lesson. Health care overhaul efforts at the state and national levels have so far been largely confined to providing bare-bones insurance coverage to those in need. But changing the way care is provided has been given short shrift, and medical experts warn that costs could soar if overhaul legislation passes. After expanding coverage in 2006, Massachusetts is only now tackling the cost problem as expenses continue their inexorable rise.

But the Hawaii experience suggests that overhauling health insurance before changing the way care is provided could work, eventually. With more people given access to care, Hawaiian hospital and insurance executives say they have been able to innovate efficiencies. For instance, the state’s top three medical providers are adopting electronic medical records — years ahead of most of their mainland counterparts.

The Hawaii Medical Service Association, the state’s largest insurer and a Blue Cross Blue Shield member, recently offered the nation’s only statewide system whereby anyone for a nominal fee can talk by phone or e-mail, day or night, to doctors of their choosing. Kaiser Permanente Hawaii, which covers about 20 percent of the state’s population, screens 85 percent of its female members ages 42 to 69 for breast cancer, among the highest screening rates in the country.

One result of Hawaii’s employer mandate and the relatively high number of people with health insurance is that hospital emergency rooms in the state are islands of relative calm. In 2007, the state had 264 out-patient visits to emergency rooms per 1,000 people — 34 percent lower than the national average of 401.

Dr. Ray Sebastian splits his time between the emergency room at Kapi’olani Medical Center at Pali Momi and a hospital in Los Angeles. Nearly all of his poorest patients in Hawaii have routine access to family doctors who can provide follow-up care, while fewer than half of those in Los Angeles do, he estimated. So he said the emergency room in Hawaii is not clogged with patients suffering minor problems like medication adjustments and cold symptoms, and patient waiting times are a small fraction of those in Los Angeles: “It’s like greased lightning here,” he said.

Other states tried employer-mandated care only to repeal the efforts after employers threatened to move across state lines. Hawaii’s isolation forestalled such threats, and its paternalistic plantation history made employer-provided care an easy fit. In interviews, Hawaiian leaders and employers referred with surprising earnestness to an “aloha spirit” and a sense of familial obligation known as “ohana” to justify providing care to nearly everyone.

Hospital executives said they never overbuilt their facilities because the Pacific Ocean meant they could not delude themselves into thinking, as their mainland counterparts sometimes do, that they would be able to attract patients from afar. Since supply tends to drive demand in health care, this may be one reason Hawaiians use fewer health care services — they get a third fewer magnetic resonance imaging tests and are admitted to the hospital 26 percent less than the United States average.

There are clear problems with Hawaii’s system. Hospitals on the outer islands are small and losing money. With unemployment rising, so, too, are the ranks of the uninsured — which is now 10.7 percent of nonelderly adults. Only Massachusetts has a lower share of uninsured adults, and the national share is 20.4 percent. And there is growing evidence that as the economy has slowed and premiums have risen, employers have hired more part-time workers who are ineligible for benefits.

Barbara Zacchini, owner of Pizzeria Zacchini on the island of Hawaii, said she makes sure that her 17 part-timers work less than 20 hours a week so she does not have to pay for their care.

“I’m for universal health care,” Ms. Zacchini said, “but it’s tough to run a business in this state and in this economy.”

Some employers are ducking the law altogether. A 61-year-old travel agent in Honolulu said her boss refused to provide health insurance although he is required by law to do so. She cannot find another job, so she asked that her name not be used.

She has not been to a primary-care doctor or a gynecologist in years and goes to the emergency room when she needs care. “I could have an alien called cancer growing inside me, but who knows?” she said. “It worries me.”

Hawaii law requires employers to offer standardized health plans with low co-pays, no deductibles and few out-of-pocket costs. Cliff Cisco, senior vice president at the Hawaii Medical Service Association, said that having a standardized and popular benefit has helped keep administrative costs to just 7 percent of revenue, among the lowest in the nation.

Indeed, many in Hawaii are worried that legislation moving through Congress could, if it supersedes Hawaii law, allow employers to reduce the quality of care provided. So Hawaiian legislators have pushed for provisions exempting the state.

Chad Buck, owner of Hawaii Food Service Alliance, a grocery distribution company with 140 employees, said he feared national health care legislation might allow his competitors to provide low-cost, high-deductible plans in place of the generous benefits now required by the state.

“I don’t want to compete against low-quality health care, and I don’t want my employees to have a cheap second,” Mr. Buck said.

Richard Caldarazzo, 25, a manager at Lulu’s Waikiki Surf Club, said he had worked at restaurants in Ann Arbor, Mich., and Chicago and never got health insurance. After he moved to Hawaii and got a job at Lulu’s, “I was really surprised when they told me I’d get insurance,” Mr. Caldarazzo said. “My parents couldn’t believe it.”

[Galaxy]

Originally Posted by albionmoonlight

I don't know if it is even on the table, but I like the idea someone floated of having a robust public option but letting states choose to opt their residents out of it.

Would the federal government have to pay regardless for those states who do opt out?

Why are the labor unions against it?

[Grammaticus]

Didn't Hawaii have to drop its universal child health care last year and within a year of starting it? If I recall they were not able to fund it.

[Young Drachma]

Originally Posted by Grammaticus

Didn't Hawaii have to drop its universal child health care last year and within a year of starting it? If I recall they were not able to fund it.

Hawaii Ending Universal Child Health Care - CBS News

Yeah, because of a free-rider problem.

A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."

[albionmoonlight]

Originally Posted by Galaxy

Would the federal government have to pay regardless for those states who do opt out?

Why are the labor unions against it?

1.) No. Though it would not have to pay for a public option with no opt-out either. The public option would be self-sustaining based on premiums. The idea is that it will be able to bring down costs b/c it will be able to put all of the premiums back into coverage and not have to keep a certain percentage out as profit. This will force private insurance, the argument goes, to lower rates to remain competitive.

See also: FiveThirtyEight: Politics Done Right: George F. Will Admits Public Option Will Cut Costs

George Will's latest:

The puzzle is: Why does the president, who says that were America "starting from scratch" he would favor a "single-payer" -- government-run -- system, insist that health care reform include a government insurance plan that competes with private insurers? [...]

Assurances that the government plan would play by the rules that private insurers play by are implausible. Government is incapable of behaving like market-disciplined private insurers. Competition from the public option must be unfair because government does not need to make a profit and has enormous pricing and negotiating powers. Besides, unless the point of a government plan is to be cheaper, it is pointless: If the public option conforms to the imperatives that regulations and competition impose on private insurers, there is no reason for it.

Emphasis in original. Will's argument is apparently this: The government does not need to make a profit and will have greater leverage with providers; therefore it will deliver the same service for less money. That's unfair!

Is this really the best argument that one of the most prominent intellectual conservatives can mount against the public option?

I'm a big believer in the profit motive in 99 percent of all cases. If the government decided to open a non-profit hamburger stand, I doubt that it would compete successfully against Five Guys. If it tried to open a non-profit airline, I doubt that it could offer the same value as JetBlue. Insert joke about General Motors and/or the Post Office here. The point is, I think the profit motive is generally well worth it in terms of the incentives it creates to cut costs, develop new products, improve customer service, and so forth.

But health insurance is not like those things.

Insurance exists because of the decreasing marginal utility of income: most people would rather have a 100% chance of paying $300 a month than a 1% chance of paying $30,000 a month. In fact, our hypothetical customer -- let's call him Frederick, after George F. Will's middle name -- might very well accept a 100% chance of paying $400 a month rather than take 1% chance of having to pay $30,000, which he might not be able to afford. This is true even though Frederick will lose $100 on this deal in an average month.

There's nothing wrong with this arrangement -- the customer has improved his marginal utility and the insurance company has made $100. It's a win-win.

The thing is, though, that the insurer hasn't had to work particularly hard for his $100. He hasn't had to figure out how to cook up tastier fries or save you a few bucks off the cost of your next flight to Orlando. All he has to do is to have a bunch of money pooled together, such that he has a different marginal utility curve than you do. He has the luxury to accept the risk of unlikely outcomes, particularly if he can hedge his position by making the same deal with other customers, most of whom won't wind up requiring an angioplasty or cataract surgery, even if Frederick does.

Now, what's supposed to happen in the free market is that another company will come in and offer Frederick a better deal: they'll offer him the same coverage for $350 a month, accepting a smaller profit, and Frederick will happily take the deal. There are at least a couple of reasons, however, why this may not be happening in the insurance industry. The first is that Frederick might not realize he's paying $400 every month for insurance. That's because if he's like the majority of Americans, he's getting his insurance through his work, and except when the HR lady gave him a shiny brochure on his first day at the office, he's probably never thought very much about what this insurance is costing him in terms of foregone salary. This is particularly so because health insurance benefits, unlike other types of income, aren't taxed, and so Fredrick is less cognizant of them if show up on his paycheck at all. Not only, then, is the free market maxim of perfect information violated, but it's violated in such a way that creates artificial profits for the insurance industry: the government is effectively subsidizing every dollar that Frederick's company is willing to spend on his insurance benefit.

The profits the insurance industry is making, of course -- profits artificially boosted by an enormous backdoor tax subsidy -- don't seem to be buying the customer much of anything in terms of improved service or cost savings. On the contrary, health care costs are rising by as much as 9-10 percent per year, without any concomitant increase in the level of service. If JetBlue were raising the cost of its fares by 10 percent per year, they'd be out of business.

The reason the insurers are staying in business, though, is because barriers to entry in the health insurance industry are in practice quite high. Insurers benefit from pooling risk. The larger the pool, the better in terms of the insurer's ability to hedge its risk and build negotiating leverage with its providers. That makes it very difficult for a Five Guys or a JetBlue type of start-up to compete: they'll have trouble getting together enough customers to pool their risk adequately, and even if they do, they won't have as much negotiating leverage as the big guys. Health care providers may demand a better deal or refuse to accept them. As such, they'll never get off the ground.

Insurance, in other words, is a volume business, the main requirements for which are that (1) you have a lot of money pooled together and that (2) you've been around for awhile.

CIGNA and Aetna have a lot of money pooled together and they've been around for awhile -- but they don't have as much money, nor have they been around as long, as the federal government. It's possible, certainly, that the profit motive in the insurance industry has driven more innovation than we're giving it credit for. But that isn't my bet, and it isn't George Will's: There's no obvious reason that the government couldn't provide more for less. And if we are wrong, we would find out soon enough: if the public option can't deliver more bang for the buck than private insurers, it wouldn't gain much market share from them, and Will will have nothing to worry about.

What Will's position reflects instead is ideology: who cares that the federal government could build a better mousetrap? They're the government and that's bad. His argument is really no more sophisticated than that. If a libertarian conservative wants to make this argument, more power to them, but they absolutely should not be turning around and suggesting that a public option would raise health care costs. They're saying, rather, that they're morally opposed to the cost savings that would ensue.

If you've been reading me for a while, you'll know that, as compared with most self-described liberals, I'm unusually sympathetic toward the notion of the profit motive and private industry; I've defended Wall Street bankers and the AIG bonuses at various points during the financial crisis, among other things. It's my belief that private industry is usually able to deliver more efficient outcomes to the consumer than the government could.

But usually isn't always. And health insurance, as Will seems to admit, is one of those exceptions.

The cost of health care reform will come from covering the currently uninsured, and that is going to happen with health care reform whether or not there is a public option.

The two debates--cost and public option--are different.

2.) Unions are against health care reform because unions have been able to negotiate great health plans for their members. When that becomes less of a big deal (because there will be another option for people) unions lose some of their reason for existing. In addition, union plans, by virtue of being so good, tend to be the kinds of "gold plated" plans that some people want to tax to pay to cover the uninsured. FWIW, the unions are being short-sighted here. The reasons GM started shedding jobs like they were fleas was b/c of the "gold plated" plans for retirees that it could not afford.

[Arles]

Originally Posted by Dark Cloud

Hawaii Ending Universal Child Health Care - CBS News

Yeah, because of a free-rider problem.

So, some people decided to take advantage of a "free" program and stop paying for their current plan? Shocking - no one could have predicted that...

[Galaxy]

Originally Posted by albionmoonlight

1.) No. Though it would not have to pay for a public option with no opt-out either. The public option would be self-sustaining based on premiums. The idea is that it will be able to bring down costs b/c it will be able to put all of the premiums back into coverage and not have to keep a certain percentage out as profit. This will force private insurance, the argument goes, to lower rates to remain competitive.

See also: FiveThirtyEight: Politics Done Right: George F. Will Admits Public Option Will Cut Costs



The cost of health care reform will come from covering the currently uninsured, and that is going to happen with health care reform whether or not there is a public option.

The two debates--cost and public option--are different.

2.) Unions are against health care reform because unions have been able to negotiate great health plans for their members. When that becomes less of a big deal (because there will be another option for people) unions lose some of their reason for existing. In addition, union plans, by virtue of being so good, tend to be the kinds of "gold plated" plans that some people want to tax to pay to cover the uninsured. FWIW, the unions are being short-sighted here. The reasons GM started shedding jobs like they were fleas was b/c of the "gold plated" plans for retirees that it could not afford.

The thing that still drives me nuts is do not see any reform in the actual cost control. You're still going to pay the cost for those cancer treatments and obesity problems (would I be accurate to say the cost to treat those who qualify for the public option are more likely to have more health problems?).

So the unions want their cake and eat it too? I hate the idea of taxing those who DO have insurance plans.

[Edward64]

Should be an exciting weekend vote, lets see if the Dems can keep all 60 together. Disappointed about the LA bribe though.

Heard on NPR yesterday about plastic surgeons not happy with it, paraphrasing "should these women be penalize, I don't think so". Have to find the full script but was not sympathetic to the Drs or the patients.

Moderate Dems wooed in crucial health vote - Health care reform- msnbc.com

WASHINGTON - Suitably opaque, Section 2006 takes up only a few dozen lines in a sweeping health care bill that runs to 2,074 pages and mentions neither Sen. Mary Landrieu nor her state of Louisiana.

But the section's purpose is indisputable: to deliver $100 million or more in federal funds to the state. And in the process it could clear the way for one of three moderate Democratic fence-sitters — Ben Nelson of Nebraska and Blanche Lincoln of Arkansas are the others — to help propel the legislation past its initial hurdle in a crucial Saturday vote.

Nelson, Landrieu and Lincoln emerged several days ago as the last public holdouts among 58 Democrats and two independents whose votes Majority Leader Harry Reid and the White House must have to overcome the Republicans' attempt to strangle the bill before serious debate can begin.
:
:
According to the Congressional Budget Office, it will send an additional $100 million to Louisiana to help it cover costs for Medicaid, the federal-state health care program for the poor.

Should Landrieu decide to side with Republicans this weekend, she would also be voting to deny her state those funds

[lynchjm24]

The mistake that Unions make is not that they have great plans. The mistake that they make is that they fight for the same plans in retirement.

[lynchjm24]

About 6 pages back on this thread we talked about the cost of this legislation and that the estimates coming from the pro-reform lobby are embarrassingly low:

By KEVIN SACK
The New York Times


While Congress searches for ways to slow the growth of health care spending, a new study suggests that its efforts may be overwhelmed by the surging prevalence of obesity.

The report, issued Tuesday, projects that if current trends continue, 103 million American adults will be considered obese by 2018. That would be 43 percent of adults, compared with 31 percent in 2008, according to the research by Kenneth E. Thorpe, a professor of public health at Emory University and an authority on the cost of treating chronic disease.

Mr. Thorpe concluded that the prevalence of obesity is growing faster than that of any other public health condition in the country's history. Health care costs related to obesity, which is associated with conditions like hypertension and diabetes, would total $344 billion in 2018, or more than one in five dollars spent on health care, if the trends continue.

Mr. Thorpe said in an interview that the health care bills in Congress limited their attack on obesity to a few community-centered pilot programs with insufficient financing. Congress has steered clear of measures that might have a more direct impact, like taxing sugary sodas and fat-laden snacks.

''If we're interested in bending the cost curve, we've got to go back to the source of what's driving spending,'' Mr. Thorpe said. ''And if you go back 5 or 10 years, it's not technology at all. It's the explosion of chronic disease.''

[lynchjm24]

Hawaii has the sort of laws that would blow up the entire system within 3 years. The benefits offered in Hawaii need to be so rich it's ridiculous. Plans in Hawaii would make the UAW blush.

The idea that the biggest reason for good health in Hawaii is their insurance system is hilarious. It's a completely different gene pool then what exists in the contiguous United States. They have a totally different diet, different weather and a more active lifestyle.

Having richer benefits doesn't change the net payment to health care providers. It's just an issue of how the costs are shared between plan and member. If the people are healthier then the average provider would have less revenue - unless there were that many fewer providers per capita. Whoever dreamed up they have rich benefits therefore the providers have more money and therefore innovate is just plain moronic. If they were innovating cost saving techniques it would take exactly 2 seconds to get to the mainland since the Medicare and the private insurers would force those best practices stateside.

[JPhillips]

Originally Posted by Edward64

Should be an exciting weekend vote, lets see if the Dems can keep all 60 together. Disappointed about the LA bribe though.

Heard on NPR yesterday about plastic surgeons not happy with it, paraphrasing "should these women be penalize, I don't think so". Have to find the full script but was not sympathetic to the Drs or the patients.

Moderate Dems wooed in crucial health vote - Health care reform- msnbc.com

Another principled moderate. She'll threaten to deny the opportunity for debate because the bill is too expensive, but throw in another 100 mil to LA and suddenly it's important to give the bill a hearing.

[lynchjm24]

The thing that really is entertaining about health care reform is the complete lack of awareness of how competitive the market is. Cigna and Aetna and United work just as hard to bring value to their products and take market share from each other as Silver's french fry example. It is quite frankly idiotic to pretend that just because you have reserves that it's easy to make money selling health insurance.

I mean seriously Nate, if you don't get how hard employers negotiate their health insurance on behalf of their employees because most of them pay the majority of the cost then you should really stop blogging about the subject.

Since someone as smart as Silver doesn't get huge parts of the debate, it's not a shock that average people have no idea what they are talking about.

JetBlue isn't a ridiculous comparison. JetBlue at times WILL raise their fares quickly based on what fuel costs them. The difference in why it isn't usually so sharp is that, A: Fuel doesn't always go up and B: You can use purchasing strategies to hedge your future costs. Cigna can't hedge against future medical costs with a futures market. It's not jet fuel where there is speculation. The only thing Cigna can do is try to negotiate the best deal they can get with providers and then try to build value added services that keep people from getting sick in the first place.

Also, it's nice to use JetBlue... what about the other airlines that are in complete shambles and have used bankruptcy and government bailouts and loans to even survive. Almost every airline in this country wouldn't exist if not for the grace of the federal government.

[Edward64]

Originally Posted by lynchjm24

The thing that really is entertaining about health care reform is the complete lack of awareness of how competitive the market is. Cigna and Aetna and United work just as hard to bring value to their products and take market share from each other as Silver's french fry example. It is quite frankly idiotic to pretend that just because you have reserves that it's easy to make money selling health insurance.

Health Care insurance may be competitive with employers (not the unemployed) but it continues to rise. It continues to rise because there is not enough competitiveness or transparency in the cost/quality of care provided (from pharmas to drs to lack of available comparison of how much each procedure cost etc.)

Health care will only get worse unless something is done about it. It needs a transformational change. Not saying either House plans is perfect or is the solution, but at least they are trying to do something about it, above and beyond the $5K tax credit that McCain and the Reps were trying to sell me.

[lynchjm24]

Originally Posted by Edward64

Health Care insurance may be competitive with employers (not the unemployed) but it continues to rise. It continues to rise because there is not enough competitiveness or transparency in the cost/quality of care provided (from pharmas to drs to lack of available comparison of how much each procedure cost etc.)

Health care will only get worse unless something is done about it. It needs a transformational change. Not saying either House plans is perfect or is the solution, but at least they are trying to do something about it, above and beyond the $5K tax credit that McCain and the Reps were trying to sell me.

That's not why the cost goes up 3 and 4 times faster then general inflation. Sure, they are doing something... it will have the same impact as if they replaced the water that comes out of fire hydrants with gasoline. That is also making a transformational change.

There isn't one provision in any government option that would lower costs.

[Edward64]

Originally Posted by lynchjm24

That's not why the cost goes up 3 and 4 times faster then general inflation. Sure, they are doing something... it will have the same impact as if they replaced the water that comes out of fire hydrants with gasoline. That is also making a transformational change.

There isn't one provision in any government option that would lower costs.

Add back a public option and the indusry (drs, insurance companies, pharmas etc) will lower cost to compete.

Sorry if I missed your answer in previous posts, why are costs going up 3 to 4 times faster than general inflation?

[Buccaneer]

For the first time in years, our 2000-staff company will not see an increase in premiums next year (and only a tiny increase in what the company pays out). The reason is that we have been very pro-active in a personal wellness program (and in educating about emergi-care and generics), so much that we have won a national wellness initiative award or something like that. For 2009, with the same number of people, our claims and out-of-expenses actually went down compared to 2008. Therefore, we keep the same level of coverage for 2010 without having to pay more. Healthcare costs don't always automatically go up, there is some personal responsibility in keeping costs lower.

[Edward64]

Originally Posted by Buccaneer

For the first time in years, our 2000-staff company will not see an increase in premiums next year (and only a tiny increase in what the company pays out). The reason is that we have been very pro-active in a personal wellness program (and in educating about emergi-care and generics), so much that we have won a national wellness initiative award or something like that. For 2009, with the same number of people, our claims and out-of-expenses actually went down compared to 2008. Therefore, we keep the same level of coverage for 2010 without having to pay more. Healthcare costs don't always automatically go up, there is some personal responsibility in keeping costs lower.

Not sure where to get the info (transparency issue?) but am willing to state that although your premiums from you employer is the same (mine also stayed the same, of course they tried to sell it as a bonus since we would not have to pay more), on average health care costs increased. This means that the 20% (as an example) that you do pay for treatment/drugs will be greater in flat dollar amounts.

[Galaxy]

I'm curious as to what's going to happen when we start seeing the next-generation of medicine come on-board down the line. The cost to research and develop these products and technologies will be even more insane. Who's going to pay for it? I believe a MRI machine costs around $1 million alone. A proton therapy center costs between $140 million to $200 million for a multi-room facility.

[JPhillips]

I don't think either bill goes far enough to contain costs. At some point we have to realize there's no way to sustain the huge year to year increases in costs. Either providers or services or both will have to see a significant reduction in the growth of expenses.

[SteveMax58]

Originally Posted by lynchjm24

That's not why the cost goes up 3 and 4 times faster then general inflation. Sure, they are doing something... it will have the same impact as if they replaced the water that comes out of fire hydrants with gasoline. That is also making a transformational change.

There isn't one provision in any government option that would lower costs.

I'd be curious of your take on this...since I know you are in the insurance business...but others who I know will disagree strongly as well.

I can't help but to think that one significant way to lower costs is to do away with the $0 co-pays & "everything is covered because I have insurance" mindset. IMO, it isnt much different than the mindset of 0% down homeloans, easy credit, etc. It is all intended to help "some" while dragging down the rest. Taxing, or confiscating profit, of others in order to fund something is not making it "free"...it's why you see massive inflation of costs.

I recall a time when "good" insurance meant you paid 10-20% of the actual bill (up to a max deductible)...at whatever medical facility you went to...up to a maximum benefit per year. You had a vested interest in not overdoing how often you went to the doctor, or the amount of tests you allowed them to run...but obviously not underdoing it either if you had some value for your own life. This was all left up to individuals to decide for themselves...nobody forced them. This allowed your monthly premium to be cheap...maybe 2x/3x your dental.

So...if you maintained a healthy lifestyle and only needed to go to regular checkups, get minor things done, etc...you were easily able to afford your health coverage. If you had more serious chronic issues, or just a really bad year (i.e. accident)...it was a bit more difficult to afford so you were more inclined to avoid the things you could control (obviously not talking about every chronic illness...but most of it being preventable by behavior).

Have we (as a country) just gotten to the point where we no longer care that those with bad behaviors are screwing those with good behaviors...because there might be a "some" persons who's illness was not their "fault"? We don't have a single idea for how to just solve those situations as opposed to every situation?

We really have no better solution than to create an extension of government...which will employ people with no reason to create efficiency (you think insurance companies have no benefit to create efficiency?)...because we feel we are entitled to be fat, lazy, and not have to own up to our own problems and stop burdening our neighbors? Or do we just think our neighbor needs more help than they actually should be expecting?

[sabotai]

Originally Posted by Galaxy

I believe a MRI machine costs around $1 million alone.

I talked to someone not too long ago that had a sister that worked for a place that specializes in CT Scans, MRIs, etc. We were waiting for our LASIK appointments and were speculating on how much the machines for LASIK must cost (started out as "I wonder who is getting the biggest piece of the bill we paid."). I said something like "I think an MRI machine costs around $1 million, so I can't imagine how much these new LASIK machines must cost."

Anyway, he told me that not only are MRI machines really expensive, it's also the cost to run the machines. He said that it costs $20,000 just to turn an MRI machine on, so places that have them leave them run all day and try to schedule as many MRI appointments as they can on the same day.

I forget the specific reasons he told me on why it costs $20,000 to turn an MRI machine on. And the guy (or his sister) may have just been full of shit, I don't know. I never bothered to look up what he said.

[JPhillips]

Originally Posted by SteveMax58

I'd be curious of your take on this...since I know you are in the insurance business...but others who I know will disagree strongly as well.

I can't help but to think that one significant way to lower costs is to do away with the $0 co-pays & "everything is covered because I have insurance" mindset. IMO, it isnt much different than the mindset of 0% down homeloans, easy credit, etc. It is all intended to help "some" while dragging down the rest. Taxing, or confiscating profit, of others in order to fund something is not making it "free"...it's why you see massive inflation of costs.

I recall a time when "good" insurance meant you paid 10-20% of the actual bill (up to a max deductible)...at whatever medical facility you went to...up to a maximum benefit per year. You had a vested interest in not overdoing how often you went to the doctor, or the amount of tests you allowed them to run...but obviously not underdoing it either if you had some value for your own life. This was all left up to individuals to decide for themselves...nobody forced them. This allowed your monthly premium to be cheap...maybe 2x/3x your dental.

So...if you maintained a healthy lifestyle and only needed to go to regular checkups, get minor things done, etc...you were easily able to afford your health coverage. If you had more serious chronic issues, or just a really bad year (i.e. accident)...it was a bit more difficult to afford so you were more inclined to avoid the things you could control (obviously not talking about every chronic illness...but most of it being preventable by behavior).

Have we (as a country) just gotten to the point where we no longer care that those with bad behaviors are screwing those with good behaviors...because there might be a "some" persons who's illness was not their "fault"? We don't have a single idea for how to just solve those situations as opposed to every situation?

We really have no better solution than to create an extension of government...which will employ people with no reason to create efficiency (you think insurance companies have no benefit to create efficiency?)...because we feel we are entitled to be fat, lazy, and not have to own up to our own problems and stop burdening our neighbors? Or do we just think our neighbor needs more help than they actually should be expecting?

Do you have any data to back up these claims? What percentage of people have 0 co-pay? Are people with those plans less healthy than people with less/no coverage? Can you connect inflation of medical costs to more comprehensive plans?

You may have something here, but a lot of your assumptions need data to back them up.

[SteveMax58]

Originally Posted by JPhillips

Do you have any data to back up these claims? What percentage of people have 0 co-pay? Are people with those plans less healthy than people with less/no coverage? Can you connect inflation of medical costs to more comprehensive plans?

You may have something here, but a lot of your assumptions need data to back them up.

I don't know if you'd see a correlation between health and the plans themselves unless you're talking over time as a whole...since policies are run through employers and employers want to compete for top employees...which 0 co-pays tend to be more attractive. Not being an insurance expert, personally, that's something I was curious if lynchjim might have a grasp of.

Some of it I can probably dig up myself (i.e. avg monthly premiums over time, certainly my own anecdotal monthly premiums anyway)...some of it is just from my understanding of how businesses transfer "finance" (which is what 0 co-pays are in my mind).

Maybe I can try to find some data on the relative costs of healthcare, automobiles, & housing to "avg income" or "median income" over time. Pretty sure its common knowledge of the relative "finance" cost inflation in regards to housing...but interesting to contrast that to things like automobiles & healthcare. Difficulty I see is that "healthcare costs" have to include insurance, direct cost, etc. over time which may be difficult to determine (if not publicly available) the ratio of each. So it may end up being a real gray "sliding" bar which you could debate on how fast it went from minimal financing (i.e. you paid a healthy portion out of pocket when you used services) to near 100% financing today (or whatever that real number is...of course not 100% is paid by insurance companies).

Maybe I can dig something up worth looking at by tomorrow.

[lynchjm24]

I'm away from home for the weekend and typing on a Netbook so I don't have time to get into medical trend until I get home.

I did just teach a class that was eligible for continuing education credit that brokers need to keep their licences and I did 4 hours on what drives medical trend.

I'll put together some of the material and post it. It doesn't take someone being very expert in the subject to see that the legislation being kicked around doesn't do anywhere near enough to lower costs.

Short answer on benefits like 0 copays is that they are almost obsolete except for labor unions and the public sector. The vast majority of private business has been shifting costs their employees very quickly over the last 10 years.

[Edward64]

Woo hoo. Finally. The real work begins.
Senate Democrats assured of 60 votes to debate health bill - CNN.com

NEW: Arkansas Sen. Blanche Lincoln says she will vote to bring debate to the floor
NEW: Louisiana Democrat ends suspense over her position on debate
NEW: Only Arkansas' Blanche Lincoln stands in way of health care bill
After hours of debate, 60 votes are needed to move health care bill to debate
Washington (CNN) -- Senate Democrat Blanche Lincoln of Arkansas said Saturday she will support bringing the Senate health care reform bill to the floor for debate, giving Democrats the 60 votes they need to prevent a Republican filibuster.

[Galaxy]

Originally Posted by sabotai

I talked to someone not too long ago that had a sister that worked for a place that specializes in CT Scans, MRIs, etc. We were waiting for our LASIK appointments and were speculating on how much the machines for LASIK must cost (started out as "I wonder who is getting the biggest piece of the bill we paid."). I said something like "I think an MRI machine costs around $1 million, so I can't imagine how much these new LASIK machines must cost."

Anyway, he told me that not only are MRI machines really expensive, it's also the cost to run the machines. He said that it costs $20,000 just to turn an MRI machine on, so places that have them leave them run all day and try to schedule as many MRI appointments as they can on the same day.

I forget the specific reasons he told me on why it costs $20,000 to turn an MRI machine on. And the guy (or his sister) may have just been full of shit, I don't know. I never bothered to look up what he said.

$20,000 to turn it on? I wonder why it costs that much. I think the $1 million number might be higher, btw. That doesn't include creating the space for it either and the people to run it.