Health Care Reform - Universal/Public Option

[Edward64]

Health Care reform was a key issue for me in voting for Obama. There was a lack of info a couple months ago but it seems to be coming together. The House version by August and hopefully something by end of year is pretty good for me.

Its amazing what Obama (through the House/Senate proxies?) has been able to accomplish so far with Health Care reform vs the Clintons. I don't know what the right solution/combination is but the GOP's tax credit was IMO more of the same useless rhetoric. What is being proposed seems to be a fundamental paradigm shift.

Here's to universal healthcare and a public option.

Dems look at taxing the rich for health care - Capitol Hill- msnbc.com

WASHINGTON - House Democrats working on President Barack Obama's goal of health legislation are narrowing in on an income tax surcharge on the highest-paid wage earners to help subsidize insurance for the 50 million people who lack it.

Pushing to complete a comprehensive health care overhaul plan by Friday and bring it up for committee votes next week, House Democrats abandoned earlier money-raising proposals, including a payroll tax. They met behind closed doors Thursday to fine-tune the details.

"I promised the president that we would have legislation out of the House before we went on an August break. That is still my goal," House Speaker Nancy Pelosi said Thursday.

As discussed in the tax-writing House Ways and Means Committee, the surtax would apply to individuals with adjusted gross income of more than $200,000 and couples over $250,000, according to officials involved in the discussion. Most spoke on condition of anonymity because the talks were private.

Rep. Shelley Berkley, D-Nev., a member of the panel, said the panel is looking at a surtax of around 3.5 percent on income above those amounts. Other members suggested it would be closer to 3 percent.

[revrew]

I couldn't disagree with you more - on universal health care, Obama's plan, or movement towards socialized medicine. I am equally surprised, however, at how effective Obama has been at moving his agenda forward. I just happen to disagree with his agenda.

[rowech]

I can't even rationally talk about this topic and my feelings.

[molson]

I haven't followed this too closely, but it just sounds like "where are we going to get the money to throw at this problem" rather than "reform".

Is there any consideration to reducing health care costs?

[Edward64]

Originally Posted by revrew

I couldn't disagree with you more - on universal health care, Obama's plan, or movement towards socialized medicine. I am equally surprised, however, at how effective Obama has been at moving his agenda forward. I just happen to disagree with his agenda.

Socialized public school education has worked for me so far.

My understanding is there will still be private option choices, albeit some of the more inefficient private option choices will be hurt severly with people going to the public option.

[lordscarlet]

I'm in the ignorance camp. I know there has to be a better way for the healthcare system to run, but I have no idea what it is. HMOs and outrages insurance costs don't seem to be the correct solution. Preventative medicine seems to be the answer to a lot of the problems,b ut people can't afford that. If we could somehow make that cheaper or government funded or something to get the people in the lowest incomes to a point where they can afford to take proper care of themselves (in an emergency "we" are paying for their care regardless), it has to be a win. Is nationalization of the health system the answer? Hell if I know. Is there some way to reign in the HMOs and pharmaceutical companies? See previous.

[Edward64]

Originally Posted by molson

I haven't followed this too closely, but it just sounds like "where are we going to get the money to throw at this problem" rather than "reform".

Is there any consideration to reducing health care costs?

I think the public option is real reform. It will change the dynamics and should (?) reduce health care costs. With that said, I know the MA model has not lived up to expectations and do not have an analysis of the differences and what went wrong in MA.

[Edward64]

Damn pork. Okay, I'm not for these riders. I can understand new public agencies setup to help educate, coordinate etc. but com'on, walking paths, public parks?

In health bill, billions for parks, paths - The Boston Globe

WASHINGTON - Sweeping healthcare legislation working its way through Congress is more than an effort to provide insurance to millions of Americans without coverage. Tucked within is a provision that could provide billions of dollars for walking paths, streetlights, jungle gyms, and even farmers’ markets.

The add-ons - characterized as part of a broad effort to improve the nation’s health “infrastructure’’ - appear in House and Senate versions of the bill.

Critics argue the provision is a thinly disguised effort to insert pork-barrel spending into a bill that has been widely portrayed to the public as dealing with expanding health coverage and cutting medical costs. A leading critic, Senator Mike Enzi, a Wyoming Republican, ridicules the local projects, asking: “How can Democrats justify the wasteful spending in this bill?’’

But advocates, including Senator Edward M. Kennedy of Massachusetts, defend the proposed spending as a necessary way to promote healthier lives and, in the long run, cut medical costs. “These are not public works grants; they are community transformation grants,’’ said Anthony Coley, a spokesman for Kennedy, chairman of the Senate health committee whose healthcare bill includes the projects.

“If improving the lighting in a playground or clearing a walking path or a bike path or restoring a park are determined as needed by a community to create more opportunities for physical activity, we should not prohibit this from happening,’’ Coley said in a statement.

The Senate health panel’s bill does not specify how much would go to the community projects. A Senate staff member said the amount of spending will be left up to the Obama administration. A House version of the bill caps the projects at $1.6 billion per year and includes them in a section designed to save money in the long run by reducing obesity and other health problems.

[Galaxy]

I still don't see any reform at all. I just see lets tax one group of people to pay for the rest (I like how it went down from individuals who earn $250,000 to $200,000). I don’t see any changes that will improve the costs and encourage doctors/surgeons to enter or stay. It's a band-aid situation to one that requires major surgery.

[Galaxy]

Originally Posted by Edward64

I think the public option is real reform. It will change the dynamics and should (?) reduce health care costs. With that said, I know the MA model has not lived up to expectations and do not have an analysis of the differences and what went wrong in MA.

How exactly do we reduce costs? We all want the top doctors (who have a lot to pay for such as malpractice insurance, high student loans, and low government-funded payments through Medicaid/Medicare), the lastest drugs and technogoly, the state-of-the-art hospitals. People also seem unwilling to accept death (giving seniors heart transplants, ect.).

[Grammaticus]

Originally Posted by Edward64

Damn pork. Okay, I'm not for these riders. I can understand new public agencies setup to help educate, coordinate etc. but com'on, walking paths, public parks?

In health bill, billions for parks, paths - The Boston Globe

Why do you need new public angencies to help educate people? You have a complete public education system that has been educating people on diet, health and physical fitness for years. Is there actually anybody left that has not been given the opportunity to learn about how bad tobacco is for you or how laying up on the couch, eating crap food and not exercising will make you unhealthy?

[Edward64]

Originally Posted by Galaxy

How exactly do we reduce costs? We all want the top doctors (who have a lot to pay for such as malpractice insurance, high student loans, and low government-funded payments through Medicaid/Medicare), the lastest drugs and technogoly, the state-of-the-art hospitals. People also seem unwilling to accept death (giving seniors heart transplants, ect.).

Can't vouch for them but some discussion points. I don't think we can say definitively without first knowing all the details of the House/Senate plans.
Why a public health insurance option is key to saving costs

[Edward64]

Originally Posted by Grammaticus

Why do you need new public angencies to help educate people? You have a complete public education system that has been educating people on diet, health and physical fitness for years. Is there actually anybody left that has not been given the opportunity to learn about how bad tobacco is for you or how laying up on the couch, eating crap food and not exercising will make you unhealthy?

Elderly, the poor, new (and legal) immigrants? Public education system would not be educating the current HS generation on how the public option works, benefits, etc vs other options (or would they?).

[revrew]

Originally Posted by Edward64

Socialized public school education has worked for me so far.

I. cannot. believe. you said that. That is way, way too rich.

There is a significant difference between public school and public education; as your comments clearly demonstrate. Yes, people who are "schooled" quickly accept government as the solution to our problems, but an education on the subject clearly reveals that a socialist form of government does not, never has, and in fact cannot solve social or economic ills.

No, given your political opinions as expressed so far, I would argue that socialized public school has not worked out so well for you so far.

[Edward64]

Originally Posted by revrew

I. cannot. believe. you said that. That is way, way too rich.

There is a significant difference between public school and public education; as your comments clearly demonstrate. Yes, people who are "schooled" quickly accept government as the solution to our problems, but an education on the subject clearly reveals that a socialist form of government does not, never has, and in fact cannot solve social or economic ills.

No, given your political opinions as expressed so far, I would argue that socialized public school has not worked out so well for you so far.

Feel free to participate in the below thread. I'd love to get your point of view on this and lets have other interested parties participate.
Education Reform........ - Page 2 - Front Office Football Central

[JPhillips]

Originally Posted by revrew

I. cannot. believe. you said that. That is way, way too rich.

There is a significant difference between public school and public education; as your comments clearly demonstrate. Yes, people who are "schooled" quickly accept government as the solution to our problems, but an education on the subject clearly reveals that a socialist form of government does not, never has, and in fact cannot solve social or economic ills.

No, given your political opinions as expressed so far, I would argue that socialized public school has not worked out so well for you so far.

The schools should stop trying to indoctrinate our kids and instead make sure everyone is a conservative.

[CU Tiger]

Originally Posted by Edward64

Socialized public school education has worked for me so far.

Aside from what was said above, you do realize the 2 can not be compared right?
Education needs vary person to person, on a magnitude of maybe 4 to 1. Medical expenses may vary 25,000,000 to 1....the fact that you even compare the two is laughable.

Originally Posted by Galaxy

I still don't see any reform at all. I just see lets tax one group of people to pay for the rest (I like how it went down from individuals who earn $250,000 to $200,000). I don’t see any changes that will improve the costs and encourage doctors/surgeons to enter or stay. It's a band-aid situation to one that requires major surgery.

Agreed...
By the way. Can anyone point to one government agency that has ever lowered cost or improved efficiency?

[revrew]

Originally Posted by JPhillips

The schools should stop trying to indoctrinate our kids.

Fixed.

I'd rather they were taught TO think, instead of WHAT to think. And, for the record, I completely reject the label of conservative. One needs not be a conservative to simply look at the historical fact and recognize that socialism does not work as a viable economic or governmental system.

[Edward64]

Originally Posted by CU Tiger

Aside from what was said above, you do realize the 2 can not be compared right?
Education needs vary person to person, on a magnitude of maybe 4 to 1. Medical expenses may vary 25,000,000 to 1....the fact that you even compare the two is laughable.

I'm not sure I understand? My response was to revrew who seem to believe that socialized medicine would not work. My counterpoint is there are some examples of socialism in the US that has worked.

[Edward64]

Originally Posted by revrew

Fixed.

I'd rather they were taught TO think, instead of WHAT to think. And, for the record, I completely reject the label of conservative. One needs not be a conservative to simply look at the historical fact and recognize that socialism does not work as a viable economic or governmental system.

Okay. So some clarity around the confusion. We are not talking about a socialized governmental system. We are talking about socialized health care.

[Mustang]

Originally Posted by CU Tiger

By the way. Can anyone point to one government agency that has ever lowered cost or improved efficiency?

This is what bugs me most about this reform. Health care is perhaps the single most important thing and we expect our inept government to reduce costs and improve this. Color me skeptical, I don't think either party is capable of this and just seems like they are trying to slap something together to get it in before they go on vacation. You need to get this right, not fast.

[Edward64]

Originally Posted by CU Tiger

By the way. Can anyone point to one government agency that has ever lowered cost or improved efficiency?

For improved efficiency - CIA, FBI, NSA? I know they have taken their lumps lately. Not sure how to compare to a baseline of (I assume) private intelligence agencies, but don't believe private would have the breadth, scale to do this - hence the argument for efficiency.

[Edward64]

Originally Posted by Mustang

This is what bugs me most about this reform. Health care is perhaps the single most important thing and we expect our inept government to reduce costs and improve this. Color me skeptical, I don't think either party is capable of this and just seems like they are trying to slap something together to get it in before they go on vacation. You need to get this right, not fast.

You know, I agree about getting it right vs fast. In this case:

1. Right is subjective. There will always be people saying it wasn't done right.
2. Letting this drag on is dangerous with elections next year. It will get bogged down. My preference is get it in and tweak later but yes, this can be a 2 edged sword.

[JPhillips]

Originally Posted by revrew

Fixed.

I'd rather they were taught TO think, instead of WHAT to think. And, for the record, I completely reject the label of conservative. One needs not be a conservative to simply look at the historical fact and recognize that socialism does not work as a viable economic or governmental system.

Depends on what you define as socialism. Most of Europe is far more socialized than the U.S. and it isn't some third world hell hole.

Regardless, you can't read what you wrote and not see that you have a very clear political agenda you want taught whether you call it conservatism or ponyism or Fuck Yeah!

[JPhillips]

Originally Posted by CU Tiger

Aside from what was said above, you do realize the 2 can not be compared right?
Education needs vary person to person, on a magnitude of maybe 4 to 1. Medical expenses may vary 25,000,000 to 1....the fact that you even compare the two is laughable.




Agreed...
By the way. Can anyone point to one government agency that has ever lowered cost or improved efficiency?

According to surveys people are just as happy or happier with Medicare and the VA as with private insurance.

[sabotai]

I have to give Obama a bit of credit. At least he's trying to cut spending in some areas to pay for his reform.

Obama proposes budget cuts to pay for health care reform - Jun. 13, 2009

[Surtt]

Originally Posted by Edward64

Can't vouch for them but some discussion points. I don't think we can say definitively without first knowing all the details of the House/Senate plans.
Why a public health insurance option is key to saving costs

Then why is Obama ready to abandon it?
White House Open to Deal on Public Health Plan - WSJ.com

[Edward64]

Originally Posted by Surtt

Then why is Obama ready to abandon it?
White House Open to Deal on Public Health Plan - WSJ.com

Thanks for the info. Don't know. Hopefully, its just positioning and semantics to get the Senate vote?

Article - WSJ.com
WASHINGTON (Dow Jones)--Senate Democratic leaders Thursday claimed progress in talks on forming a public competitor to private health insurers, though senators appeared to make little headway on finding a way to pay for health-care legislation.

Senate Majority Leader Harry Reid, D-Nev., and Sen. Charles Schumer, D-N.Y., said they're amenable to making a non-government health cooperative part of health-care legislation, perhaps in lieu of a controversial proposal to form a government-run health insurance plan.

Schumer, who has led efforts to find a middle ground between opponents and supporters of a public plan, said it is most important for the public competitor "to keep the companies honest, to be available right at the beginning to everybody, and have the strength to borrow."

"If it can do those things in a co-op form, I think we're open to it," he said.

Reid told reporters that "we're going to have some type of public option - you can call it cooperative or whatever you want."

Finding a compromise on a public option could be a key to passing the bill. Senate Finance Chairman Max Baucus, D-Mont., suggested that Reid's and Schumer's statements represented an important step.

[BishopMVP]

Originally Posted by JPhillips

According to surveys people are just as happy or happier with Medicare and the VA as with private insurance.

According to surveys people in many 3rd-world countries are just as happy or happier than people in the United States. Doesn't mean they actually are happier or that we should strive to emulate their living conditions. People tend to adjust to a baseline of happiness about 1-2 months after any life-changing event. Lottery winners, people that went bankrupt, etc. In short, public opinion surveys are no way to measure the quality of any public good.

[JPhillips]

Originally Posted by BishopMVP

According to surveys people in many 3rd-world countries are just as happy or happier than people in the United States. Doesn't mean they actually are happier or that we should strive to emulate their living conditions. People tend to adjust to a baseline of happiness about 1-2 months after any life-changing event. Lottery winners, people that went bankrupt, etc. In short, public opinion surveys are no way to measure the quality of any public good.

Okay, they also cost less per capita largely due to a lower cost for overhead. If satisfaction and cost don't count, how should we judge the effectiveness of government programs?

[Greyroofoo]

Originally Posted by Edward64

Health Care reform was a key issue for me in voting for Obama. There was a lack of info a couple months ago but it seems to be coming together. The House version by August and hopefully something by end of year is pretty good for me.

Its amazing what Obama (through the House/Senate proxies?) has been able to accomplish so far with Health Care reform vs the Clintons. I don't know what the right solution/combination is but the GOP's tax credit was IMO more of the same useless rhetoric. What is being proposed seems to be a fundamental paradigm shift.

What has he accomplished?

[panerd]

Originally Posted by Edward64

Socialized public school education has worked for me so far.

I agree with that statement completely. Lets not kid ourselves the richer people are in better public school districts than the poor. The same will definitely be true even if health care were to go completely government run. The rich will have the best doctors and facilities and the poor won't. Some people will want to opt out for an even better plan but for the most part rich people will like it. And so will the people who never had insurance.

Name one government "socialized" program that isn't like this.

-The best public schools are in the richest areas
-More efficient and responsible mail carriers are in lower crime (i.e. richer) areas
-While this may be debated: richer poilice departments and fire departments hire the most qualified. (You can argue that some city cops are there for the challenge. I agree but most are there because they aren't as qualified)
-The DMV in the rich part of St. Louis has really nice couches, highly efficient and personable and even hot counterpeople, and the service is in and out in 10 minutes no questions asked. They are also extremely overstaffed. I can't imagine this would be true in North St. Louis
-Amtrak services the major cities and then other more well to-do cities (this may be a bit of a stretch)


Why do we think the rich are still not to going to reap the benefits and the less fortunate not as much under any plan? Is Obama going to change human nature?

[panerd]

Another point about government health care. As a teacher in a rich district I get really good health coverage. Teachers in poorer districts don't. We both in a round about way basically have government health insurance.

I bet the members of Congress don't have the same coverage as the clerk at the Omaha Federal Building.

Why does everyone think health insurance is going to be everyone being equal? This country is not the least bit socialist. Canada and the European countries are in many more aspects than health care. Look at their tax systems!!!!!

[Young Drachma]

I'm no socialist, but I sure do find people who say socialism doesn't work who ignore Nordic Capitalism are just sorely misinformed. You might not like that it exists, but save for the whole lack of a "richer than rich class" these countries are prosperous and people don't suffer like they do here.

And again, I'm no socialist, nor an advocate of it. But...the curious logic between this thread and the one that talks about the minimum wage proves how little people in this country know about economics and about the way the world really works these days.

[JeffNights]

Originally Posted by revrew

I. cannot. believe. you said that. That is way, way too rich.

There is a significant difference between public school and public education; as your comments clearly demonstrate. Yes, people who are "schooled" quickly accept government as the solution to our problems, but an education on the subject clearly reveals that a socialist form of government does not, never has, and in fact cannot solve social or economic ills.

No, given your political opinions as expressed so far, I would argue that socialized public school has not worked out so well for you so far.

Hey way to be a screaming asshole while disagreeing with his point of view.

Apparently whatever education you received has not worked out that well for you eithier, jerk.

[fpres]

I'm going to reserve judgment until I see specifics. That's the real problem I have with Obama's plan at this point. There aren't enough specifics. Where are you going to make cuts? Where is each healthcare dollar going to go? If you really have a plan, just put it out there (at least in general terms).

Does universal healthcare equal quality healthcare?

What I do see is a complete lack of attention to reforming the nation's healthcare infrastructure. The nation is littered with "medically-underserved areas"...from rural areas to the most populous cities. It's not merely a matter of poor distribution of resources (doctors, nurses, medications, equipment, etc.) but also the result of inadequate resources. Providing universal healthcare is great, but where are all of the new patients going to go and how long is too long when it comes to getting an appointment, starting on chemo/radiation, or going under the knife for a not-so-elective surgery?

Call me jaded, but my idea of "quality healthcare" goes a little beyond what seems to be proposed thus far. I hope I'm proven wrong.

[CU Tiger]

Originally Posted by Edward64

I'm not sure I understand? My response was to revrew who seem to believe that socialized medicine would not work. My counterpoint is there are some examples of socialism in the US that has worked.

And I would counter that socialized education is at best a push. My point was that with education (aside from medical disabilities) people start from a fairly common ground and grow towards a common end goal. Extremely intelligent and extremely challenged will be removed but the remaining 90% fall pretty well within a nice standard distribution.

I'm not sure the same can be said of healthcare. I think the last statistic I read was that 10% of patients account for 85% of all costs (both financial and resource impact)

With healthcare there is no common end game, short of death, and costs run the gamut from non existent to asinine. And a shitty fact of life is that, statistically speaking more affluent individuals tend to be in better health.

Originally Posted by Edward64

For improved efficiency - CIA, FBI, NSA? I know they have taken their lumps lately. Not sure how to compare to a baseline of (I assume) private intelligence agencies, but don't believe private would have the breadth, scale to do this - hence the argument for efficiency.

So you really think the CIA is more efficient than private personal security companies?

Really?
Ever seen the budget for that?

Now most private security is not allowed the blatant disregard for basic constitutional rights that those mentioned agencies are afforded..so they do have that going for them.

Originally Posted by JPhillips

According to surveys people are just as happy or happier with Medicare and the VA as with private insurance.

So happy = good?
Or, I bet I would be happy if I had free insurance...that is not what is being proposed here. Even if you "opt out" o a national plan you will still be paying to support it.

BTW I wonder what the happiness is of people who pay for medicare but are not on it? I bet its pretty low.

Originally Posted by BishopMVP

According to surveys people in many 3rd-world countries are just as happy or happier than people in the United States. Doesn't mean they actually are happier or that we should strive to emulate their living conditions. People tend to adjust to a baseline of happiness about 1-2 months after any life-changing event. Lottery winners, people that went bankrupt, etc. In short, public opinion surveys are no way to measure the quality of any public good.

+1

[Logan]

the surtax would apply to individuals with adjusted gross income of more than $200,000 and couples over $250,000

It's not really relevant to this discussion, but can anyone explain to me why cost of living is never taken into account when we determine who pays certain taxes and who doesn't?

[Grammaticus]

Originally Posted by panerd

Another point about government health care. As a teacher in a rich district I get really good health coverage. Teachers in poorer districts don't. We both in a round about way basically have government health insurance.

I bet the members of Congress don't have the same coverage as the clerk at the Omaha Federal Building.
Why does everyone think health insurance is going to be everyone being equal? This country is not the least bit socialist. Canada and the European countries are in many more aspects than health care. Look at their tax systems!!!!!

Sure they don't and you do realize that congress will not be subject to the universal health care program they are pushing, right? They will continue to have a separate program, just for themselves.

If the public program they are pushing is better, cheaper and more efficient, then why don't they (congress) fall under the same plan?

[Edward64]

Originally Posted by Greyroofoo

What has he accomplished?

Just having a health care reform proposal by end of year is amazing to me. Nothing has been passed but to do this in under 12 months and not having it gone down in flames already is a feat IMO unto itself. Same cannot be said for the Clinton example in early 90s.

[Galaxy]

Originally Posted by Edward64

Can't vouch for them but some discussion points. I don't think we can say definitively without first knowing all the details of the House/Senate plans.
Why a public health insurance option is key to saving costs

You still got pay for all the expenses (resources) that we demand. It doesn't matter who is paying them.

I just don't see people giving up junk food, alcohol and start working out. I think you might be able to bring costs down very slightly with some front-office measures, but you still got to pay $1 million for that MRI machine and $100,000's for the resources to fight cancer.

[Swaggs]

Like most, I am pretty skeptical of universal healthcare being run by the government, but I am pretty solidly in favor of Obama giving it a shot for a few reasons:

-the system now is pretty much made up now by regional monopolies who can cherrypick their customers (btw, this is why comparing universal healthcare to medicare is poor comparison because of the age/health medicare's users, who are "uninsurable" to most companies). Nate Silver recently blogged about the topic in a much more articulate way than I am capable of, but he essentially pointed out that the industry isn't truly capitialistic because the nearly impossible entry barriers for startups prevents the need to have competitive pricing.
-I think health insurance being "for profit" is pretty questionable ethically. Even though I know the government is completely full of waste, just thinking about how much multiple executives in multiple companies currently "earn," makes me curious to see if eliminating all the redundant executives under a single government agency wouldn't go a long way towards lowering health care costs.
-I think a lot of potential entrepreneurs are unwilling to open small businesses because it is difficult to leave the safety of a job that provides healthcare coverage. My father has been a pretty successful small business owner for over 35-years, but as he and my mother get older his out of pocket expenses for private insurance (that is essentially just major medical that does nothing for him unless he hits a $10K threshhold) are increasing at an almost unsustainable level from year-to-year.

Anyway, I'm under not illusion that a government run agency will be perfect, but I think the industry is in poor enough shape that I would rather see a big shake up and make tweaks as neccessary from it, rather than continuing on with the BS that is going on now.

[Edward64]

Originally Posted by panerd

I agree with that statement completely. Lets not kid ourselves the richer people are in better public school districts than the poor. The same will definitely be true even if health care were to go completely government run. The rich will have the best doctors and facilities and the poor won't. Some people will want to opt out for an even better plan but for the most part rich people will like it. And so will the people who never had insurance.

Name one government "socialized" program that isn't like this.

-The best public schools are in the richest areas
-More efficient and responsible mail carriers are in lower crime (i.e. richer) areas
-While this may be debated: richer poilice departments and fire departments hire the most qualified. (You can argue that some city cops are there for the challenge. I agree but most are there because they aren't as qualified)
-The DMV in the rich part of St. Louis has really nice couches, highly efficient and personable and even hot counterpeople, and the service is in and out in 10 minutes no questions asked. They are also extremely overstaffed. I can't imagine this would be true in North St. Louis
-Amtrak services the major cities and then other more well to-do cities (this may be a bit of a stretch)


Why do we think the rich are still not to going to reap the benefits and the less fortunate not as much under any plan? Is Obama going to change human nature?

You are right. In general, richer people live in richer areas and by default get better services ... even if its a socialized healthcare system.

Can't argue with it.

My counterpoint is without socialized public schools or healthcare system, the poorer people will be much worse off. So, socialized healthcare/public school is not necessarily equal healthcare/public school in reality but it is better than what poor people would have if it did not exist.

[Edward64]

Originally Posted by fpres

I'm going to reserve judgment until I see specifics. That's the real problem I have with Obama's plan at this point. There aren't enough specifics. Where are you going to make cuts? Where is each healthcare dollar going to go? If you really have a plan, just put it out there (at least in general terms)..

You are right, nothing too specific yet and we don't have the full context to do a proper assessment. But hey, its only been 6 months or so, still quite a feat to get it to where it is, the details will come.

Originally Posted by fpres

Does universal healthcare equal quality healthcare?

What I do see is a complete lack of attention to reforming the nation's healthcare infrastructure. The nation is littered with "medically-underserved areas"...from rural areas to the most populous cities. It's not merely a matter of poor distribution of resources (doctors, nurses, medications, equipment, etc.) but also the result of inadequate resources. Providing universal healthcare is great, but where are all of the new patients going to go and how long is too long when it comes to getting an appointment, starting on chemo/radiation, or going under the knife for a not-so-elective surgery?

Call me jaded, but my idea of "quality healthcare" goes a little beyond what seems to be proposed thus far. I hope I'm proven wrong.

No, universal healthcare does not mean equal healthcare. I know there is debate whether as to how many are un(der) insured, but there is no doubt there is a segment of our population that is. The reform will benefit those 40M+ the most. Its something, Obama is trying to address it ... better than the $4-$5K tax credit alternative.

[Edward64]

Originally Posted by CU Tiger

I'm not sure the same can be said of healthcare. I think the last statistic I read was that 10% of patients account for 85% of all costs (both financial and resource impact)

I read something similar but it was related to those near death. The amount of $ spent to prolong life for those x months is very disporportionate.

Another healthy issue for discussion. What is the limit to universal healthcare. Should those on it expect extraordinary care in the final months? I'm not sure but would lean towards no.

[Edward64]

Originally Posted by CU Tiger

So you really think the CIA is more efficient than private personal security companies?

Really?
Ever seen the budget for that?

Now most private security is not allowed the blatant disregard for basic constitutional rights that those mentioned agencies are afforded..so they do have that going for them.

Without a baseline to compare to (and I don't know how to get one) our discussion will be somewhat subjective.

I think you are alluding to: all $ things held equal, would a private security company be more efficient than a public one?

To answer your question, yes, I do think the CIA, FBI, NSA is more efficient than private personal security companies. Private security companies will have a profit motive which does not necessarily serve the public good. Therefore, although I will concede a private company will be more efficient in $, I do not believe a private company will be more efficient in intelligence gathering and serving the public good.

Could a private company scale to the level of intelligence gathering provided by the CIA, FBI and NSA? I don't think so, nor would I trust them because of the profit motive.

[molson]

Originally Posted by Dark Cloud

I'm no socialist, but I sure do find people who say socialism doesn't work who ignore Nordic Capitalism are just sorely misinformed. You might not like that it exists, but save for the whole lack of a "richer than rich class" these countries are prosperous and people don't suffer like they do here.

And again, I'm no socialist, nor an advocate of it. But...the curious logic between this thread and the one that talks about the minimum wage proves how little people in this country know about economics and about the way the world really works these days.

The issue is what might work in the US. It's not as simple as adopting European health care or Nordic Capitalism tomorrow and have everything be good.

And I don't think economics, especially American economics, is something where any particular open can show how little "about the way the world really works". There's clearly not one consensus, there's a lot of moving parts, and there's certainly intelligent people all over the spectrum of opinions.

[Edward64]

Originally Posted by Swaggs

Like most, I am pretty skeptical of universal healthcare being run by the government, but I am pretty solidly in favor of Obama giving it a shot for a few reasons:

-the system now is pretty much made up now by regional monopolies who can cherrypick their customers (btw, this is why comparing universal healthcare to medicare is poor comparison because of the age/health medicare's users, who are "uninsurable" to most companies). Nate Silver recently blogged about the topic in a much more articulate way than I am capable of, but he essentially pointed out that the industry isn't truly capitialistic because the nearly impossible entry barriers for startups prevents the need to have competitive pricing.
-I think health insurance being "for profit" is pretty questionable ethically. Even though I know the government is completely full of waste, just thinking about how much multiple executives in multiple companies currently "earn," makes me curious to see if eliminating all the redundant executives under a single government agency wouldn't go a long way towards lowering health care costs.
-I think a lot of potential entrepreneurs are unwilling to open small businesses because it is difficult to leave the safety of a job that provides healthcare coverage. My father has been a pretty successful small business owner for over 35-years, but as he and my mother get older his out of pocket expenses for private insurance (that is essentially just major medical that does nothing for him unless he hits a $10K threshhold) are increasing at an almost unsustainable level from year-to-year.

Anyway, I'm under not illusion that a government run agency will be perfect, but I think the industry is in poor enough shape that I would rather see a big shake up and make tweaks as neccessary from it, rather than continuing on with the BS that is going on now.

Don't disagree. I think something needs to be done. Not sure what the right solution/combination is but at least Obama is trying to do something about it.

[molson]

Originally Posted by Edward64

Therefore, although I will concede a private company will be more efficient in $, I do not believe a private company will be more efficient in intelligence gathering and serving the public good.

Aren't those the same thing? To be efficient in $, or intelligence gathering means you're efficient relative to each other, cost and results.

[JPhillips]

Originally Posted by CU Tiger

And I would counter that socialized education is at best a push. My point was that with education (aside from medical disabilities) people start from a fairly common ground and grow towards a common end goal. Extremely intelligent and extremely challenged will be removed but the remaining 90% fall pretty well within a nice standard distribution.

I'm not sure the same can be said of healthcare. I think the last statistic I read was that 10% of patients account for 85% of all costs (both financial and resource impact)

With healthcare there is no common end game, short of death, and costs run the gamut from non existent to asinine. And a shitty fact of life is that, statistically speaking more affluent individuals tend to be in better health.



So you really think the CIA is more efficient than private personal security companies?

Really?
Ever seen the budget for that?

Now most private security is not allowed the blatant disregard for basic constitutional rights that those mentioned agencies are afforded..so they do have that going for them.



So happy = good?
Or, I bet I would be happy if I had free insurance...that is not what is being proposed here. Even if you "opt out" o a national plan you will still be paying to support it.

BTW I wonder what the happiness is of people who pay for medicare but are not on it? I bet its pretty low.



+1

So the fact that Medicare and VA are cheaper and the people with those plans are more satisfied doesn't matter. Again, how do you measure an effective program? Is it just assumed that because it's a government program it must be worse than a similar private program?