Sunday, March 21, 2010

NOOOOOOOO!

Stupak Announces Deal With White House on Abortion Funding Ban

How can he and the other prolife Democrats be stupid enough to trust Obama to disappoint his pro-abortion backers?

Did Obama lobotomize these people? Threaten their kids if they voted "No"? Blackmail them? They can't honestly believe him.

32 comments:

Kathy said...

One of my f/b friends said the price of the unborn was $726,409 for grants for Michigan airports. :-( Close enough to 30 pieces of silver, I daresay.

Also, Stupak was videoed some time ago (I guess at a town hall mtg) saying that if it came down to voting for a health-care bill with abortion funding or letting it fail, he'd probably vote for it.

OperationCounterstrike said...

No surprise here!

Face it: to most politicians, right-to-lifism is a joke. They take your campaign contributions and laugh themselves silly at you in the cloakrooms.

The only true right-to-lifers are bona-fide loonies like Tom Coburn and Rick "Man-on-Dog" Santorum.

GrannyGrump said...

Robert A. Heinlein defined an honest politician as "one who stays bought." I think he was on to something.

L. said...

No public funding for abortion, explicitly spelled out....Pelosi, NOW, and PP are thoroughly pissed off.....

The health care bill has some hideous flaws, but you know, I'd have to say, I don't see much for pro-life people to get so riled up about. I'd say the abortion rights folks lost waaaaaaaaaaaaay more here.

SegaMon said...

The executive order cannot constitutionally change law. Thus, it will most likely be overturned in the courts (this has been done before). Furthermore, the president can choose to rescind his own executive order after he signs the health care bill into law. Also, the executive order only restates the senate language. Add another insult to injury is the allowance of federal funds to kill children conceived of by means of rape.

Pro-lifers lost a lot here, L.

OperationCounterstrike said...

Actually, it's more likely that pro-lifers gained a lot. More and more examples are showing that when you get universal care, abortion rates drop. Massachutsetts under Romneycare is the latest example, subject of a recent article in New England Journal of Medicine.

Of course, there's no way to say for sure because all we have are examples, not controlled experiments, but common sense supports the unversal-care-lowers-abortion-rates hypothesis. A rational person is more likely to grow a pregnancy if she knows who's gonna pay her birthing bills, and her baby's pediatric care bills.

So it's more likely true pro-lifers GAINED a lot today.

GrannyGrump said...

It's not about whether prolifers or prochoicers "won". It's about what direction we needed to go to fix the problems with the health care system. And we chose the direction that takes the bus off a cliff, and we won't be allowed to get off the bus. We're screwed. I'd suggest shopping for dental tools on eBay so you won't have to resort to Super Glue and pliers like a Brit.

L. said...

Hmmm, in my 20's, when I lacked health insurance, my primary provider was....Planned Parenthood. I never sought abortion services there -- just my contraception and basic checkups (including bloodwork that went way beyond reproductive healthcare). Back to the future!

army_wife said...

Re: Stupak's deal...

It's all about the Benjamins, Baby!

Chad Tonka said...

And we chose the direction that takes the bus off a cliff, and we won't be allowed to get off the bus. We're screwed.

Yeah, we’re really screwed:

30 million + uninsured will now get basic coverage.

Medical underwriting and rescission are now illegal.

Estimates of over a trillion dollars in savings over the long run.

Maybe you care to explain how exactly this screws us over?

Chad

Kathy said...

Here's a quick run-down, Chad.

Also, it's a point of contention whether those numbers of either uninsured, promise-to-be-insured, and estimated savings are accurate.

Chad Tonka said...

Kathy

While I agree with the author that the insurance mandate was a bad idea, many of the points listed are downright laughable. Some greatest hits:

2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status.

So we’ve really hit rock bottom and now long for the good old days of medical underwriting? Yes sir, there was so much “freedom” back when insurance companies could cherry pick and stratify risk according to their profit margins.

5. You are an employer and you would like to offer coverage that doesn’t allow your employers’ slacker children to stay on the policy until age 26? Tough.

This small change actually fixes many problems for middle-class families with multiple children. Framing it as “slacker” children completely misses that we’re going through a recession, and jobs are scarce.

11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians.

I fail to see how making basic data available to the public is some violation of freedom. The AMA has consistently opposed this idea, not out of some concern for patient safety, but for reasons of professional control. Doctors understandably want to set prices; however that ship has long since left the dock.

And my favorite:

20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough

I love the fact that you simultaneously hate Hollywood starlets who create a “culture of death,” yet will defend to the tea bag their right to have affordable boob jobs.

Chad

Kathy said...

Anything the private sector can do, the government can screw it up worse. There are a lot of changes that *could* have been implemented that would not have increased the size and scope of government, but would have improved prices and access.

If these changes are so great, why did Congress exempt themselves? Why is it only good for other people, but so bad that they refuse to be covered by it?

Kathy said...

Oh, and just in case you were confused, I didn't write the list, so don't have to agree with everything in the link. Do you have 100% agreement with everything you've ever posted or shared or linked to, here or elsewhere?

Chad Tonka said...

Kathy,

Anything the private sector can do, the government can screw it up worse. There are a lot of changes that *could* have been implemented that would not have increased the size and scope of government, but would have improved prices and access.

It’s answers like that which make me wonder if you’ve been paying attention in class at all. Unless you think one time premium increases of 39% are the best private sector ways of improving prices and access.

Heath care is complicated, and thus requires solutions that are hybrids of market and government reforms. To make simple-minded slogans sheds no light on this process.

Oh, and just in case you were confused, I didn't write the list, so don't have to agree with everything in the link.

You don’t have to get defensive. I wasn’t implying you agree with everything – however you yourself posted the link. Maybe you ought to find better support. Like this, from that noted Fifth Column of Socialism….Forbes:

http://www.forbes.com/2010/03/21/health-care-vote-business-beltway-congress.html?boxes=businesschannellighttop

Fairly balanced assessment of winners / losers.

Chad

Kathy said...

Not everything that is a complicated problem requires a complicated solution. Often difficult problems can be solved by a simple solution.

One of the biggest problems of health care insurance is that there are too many steps between purchaser and product. Often, the person's employer buys the insurance (getting a discount from the government for so doing, while individuals do not), and the employee does not know the cost. The employee pays a co-pay at the doctor, but doesn't know the true cost of the visit above his out-of-pocket expenses. Since it doesn't "cost" him anything, he doesn't shop around for the best price; since his insurance requires him to choose from in-network providers, he can't "shop around" for the best doctor. Both of these things squelch competition, although it is competition that drives people to do better and provide better services for cheaper.

In a recent post Christina had (one of the John Stossel health-care videos), there was a doctor who stopped taking insurance and was able to offer competitive rates (the same as many people's copays, and similar to or less than other doctors' rates) while still making a profit, because he didn't have to have a staff of medical/insurance billers to try to get paid -- he got paid when he saw patients, not three months down the road.

The pendulum was swinging to HSAs, but then government interfered, which will make a lot of stuff a whole lot worse, and is entrenching even more levels of bureaucracy and more layers of people and red tape between buyer, seller, provider, payer, etc.

Oh, and I used that link because it was something I had just read. I could have looked for something else, but didn't feel like it, when that was so handy.

Chad Tonka said...

Kathy,

Not everything that is a complicated problem requires a complicated solution. Often difficult problems can be solved by a simple solution.

Sure, except the organization and delivery of health care (and reform) really is complex. And there is no one simple solution to improving the health care system.

Since it doesn't "cost" him anything, he doesn't shop around for the best price; since his insurance requires him to choose from in-network providers, he can't "shop around" for the best doctor. Both of these things squelch competition, although it is competition that drives people to do better and provide better services for cheaper.

There is a fundamental flaw in your argument. If your point is that free market competition and “shopping around” will lower health care costs, you will need to explain why managed care, which was a free market innovation, did not lower costs. Essentially your claims have been refuted by empirical reality.

In a recent post Christina had (one of the John Stossel health-care videos), there was a doctor who stopped taking insurance and was able to offer competitive rates (the same as many people's copays, and similar to or less than other doctors' rates) while still making a profit, because he didn't have to have a staff of medical/insurance billers to try to get paid -- he got paid when he saw patients, not three months down the road.

That’s a great solution for those who can afford it. But of course it simply ignores the larger problem that is at the root of reform – those who can’t afford this mode of care delivery.

The pendulum was swinging to HSAs, but then government interfered, which will make a lot of stuff a whole lot worse, and is entrenching even more levels of bureaucracy and more layers of people and red tape between buyer, seller, provider, payer, etc.

To claim that HSAs have no bureaucracy or overhead costs is simply wrong. Again, HSAa may benefit higher income individuals and families, but there is cost-shifting that impacts lower income families disproportionately. For example:

http://www.kff.org/uninsured/7568.cfm

Chad

Kathy said...

There is a fundamental flaw in your argument. If your point is that free market competition and “shopping around” will lower health care costs, you will need to explain why managed care, which was a free market innovation, did not lower costs.
I answered this in the paragraph you quoted! When people don't pay out-of-pocket because a third party (the insurance company) is footing the bill, there is a disconnect that happens between their health-care usage and health-care costs.

Here's an analogy -- imagine if groceries were purchased like insurance. You'd go into the store, and there wouldn't be any prices listed. Instead, every month, you write a check for $300 (for a single person policy) or have it directly debited and paid to the grocery insurance company. You'd load up your cart every week, and at check-out, regardless of how much you bought, you paid $20; perhaps if you got steak or other "luxury" or high-ticket items you might pay an extra $10 at check-out. You go home and eat, and still don't really know how much that gallon of milk or dozen eggs actually cost. However, the "grocery insurance company" does know how much it costs. It has figured up that the average single adult eats about $350 per month worth of food, so if you shop every week you pay $380 altogether per month; the extra $30 is for overhead and profit for the groc. ins. company. However, since you pay the same whether you get rice 'n' beans or whether you get meat, there is no reason for you to eat even moderately frugally. Without that "ouchie" at the checkout counter to keep your individual food costs down, you as an individual may spend well over what the insurance company has estimated. While others may spend less, most people will eat a lot more and spend a lot more money than they would if they were paying for everything out-of-pocket. If at the end of the month or the end of the year the grocery insurance company realizes that the average single adult has purchased $400 per month in groceries, they're going to have to raise rates. However, when they do, people may start buying even more expensive groceries so that they "get their money's worth" since the "evil insurance company" raised rates on them. They simply do not make the connection between steak every weekend and higher grocery insurance bills every year. Or they think it's "other people" who are spending so much. Plus, with more people now able to afford steak (since it's little or no more out-of-pocket than cheap hamburger or just vegetables), demand pushes costs up, which further increase the average cost of groceries.

It's a simple concept, but it's harder to make the connection when payments are so far removed from services rendered -- particularly when there is a third party handling the fees.

Kathy said...

That’s a great solution for those who can afford it. But of course it simply ignores the larger problem that is at the root of reform – those who can’t afford this mode of care delivery.
Most people who are uninsured are either uninsured by choice (they're young and healthy and insurance seems either a luxury or not a necessity), or don't have $400 every month (or whatever the cost of an individual policy might be, for the average individual in average health). However, they may have $100 every six months or every year that they could spend on an annual checkup. You seemed to have overlooked that the doctor who didn't take insurance had similar rates as the out-of-pocket copays of other doctors.

To claim that HSAs have no bureaucracy or overhead costs is simply wrong.
I didn't.

Again, HSAa may benefit higher income individuals and families, but there is cost-shifting that impacts lower income families disproportionately.
The article quoted a family of 4 making $20,000 and also $25,000. That would qualify the children and possibly the entire family for government assistance in most if not every state. My kids qualify for my state's CHIPs program, and our income is higher than $25,000. It also said, "If the family were to save $2,100..." Yes, this would be a significant percent of $25,000 or even $35,000; however, would an average healthy family need that much in reserve? Most likely, they would not, unless a major illness or catastrophe befell them. Because they would be paying their health-care expenses entirely out of pocket until they got to $2,100, they would be choosy about when to go to the doctor and especially an emergency room. Lower usage would lower costs. And if they saved the difference in premiums to fund their deductible, and didn't use the money they saved this year, it would roll over to next year, so they would be even further ahead next year.

HSA premiums averaged $3324 for non-group market; and are "about 30% lower" than "all group health plans" (I presume that this would exclude HSAs, because if they average them in, then they've distorted the numbers), which puts traditional insurance premiums at $4748. If the family saved the difference in premiums, then they could save $1400 per year inside an HSA, and within 2 years would save more than enough to cover a full $2100 deductible, even if they spent some of that on doctor's bills.

Chad Tonka said...

Kathy,

The analogy you proposed does not make much sense, and it’s difficult to decipher what you are getting at. You state: You'd go into the store, and there wouldn't be any prices listed. Instead, every month, you write a check for $300 (for a single person policy) or have it directly debited and paid to the grocery insurance company. You'd load up your cart every week, and at check-out, regardless of how much you bought, you paid $20; perhaps if you got steak or other "luxury" or high-ticket items you might pay an extra $10 at check-out.

So then what would stop me from paying my $300 monthly fee and my $20 weekly fee, then walking out with everything in the store? I’d clearly be able to profit from this arrangement, and clearly the store would lose. Therefore the store would need to put a limit on what I walk out with. So you’ll need to rethink the analogy.

There are other problems with your scenario – what are you describing is closer to a “subscription” model rather than insurance. You are talking about the direct exchange of commodities (groceries for currency). Insurance does not work like that; it is more like a futures contract than direct exchange. In other words, with insurance you pay a set amount in case of a future event of unknown severity. So again your analogy is not clear.

Most people who are uninsured are either uninsured by choice (they're young and healthy and insurance seems either a luxury or not a necessity), or don't have $400 every month (or whatever the cost of an individual policy might be, for the average individual in average health). However, they may have $100 every six months or every year that they could spend on an annual checkup.

Yeah, and this would be fine if medical care was nothing more than a series of $100 checkups. But what about when you need the $20,000 surgery? What do you do then?

Yes, this would be a significant percent of $25,000 or even $35,000; however, would an average healthy family need that much in reserve? Most likely, they would not, unless a major illness or catastrophe befell them.

But “major illness and catastrophe” are the entire point!! How would a HSA help then??

Chad

Kathy said...

So then what would stop me from paying my $300 monthly fee and my $20 weekly fee, then walking out with everything in the store? I’d clearly be able to profit from this arrangement, and clearly the store would lose. Therefore the store would need to put a limit on what I walk out with.
I'll revise my analogy by saying "per cart," so it's not taken to extremes. However, it's not the store that would lose -- it's the insurance company. You see, in this little "grocery insurance company" scheme, it's the insurance company that foots the bills, not the grocery stores. Of course, the ins. co. has to turn around and raise premiums so they don't go out of business, so it's really the consumers that ultimately pay the bill for the food they eat. However, with so many steps in between the money and the product, it doesn't "feel" like that.

Every analogy breaks down at some point; however, I think it's pretty dang good for the point I'm trying to make, which your comments show you understand, if you don't take it too far. However, I can extend the analogy further, and say that the insurance company (not the grocery store) would have to exert control over and set limits on what foods their customers could buy. Just as many insurance companies today don't cover certain elective procedures, or require authorization for medications, etc.

Insurance does not work like that; it is more like a futures contract than direct exchange. In other words, with insurance you pay a set amount in case of a future event of unknown severity.
Well, yes and no. Most forms of insurance are for catastrophic or "unknown severity" things -- your house burns down, your car is totaled, etc. Health care insurance is partly futures (potential for cancer), but partly a direct commodity (prescriptions, doctor's visits). And it is this mixing of the two which causes some problems. If people paid for the small stuff out-of-pocket, and only had insurance cover big stuff (like what happens with cars and houses and such), then premiums would be smaller -- as HSAs show.

Yeah, and this would be fine if medical care was nothing more than a series of $100 checkups. But what about when you need the $20,000 surgery? What do you do then?
Then you pay what you can out-of-pocket and make payments on the rest of the deductible; the HSA picks up most of the tab. What happens if you need a $20,000 surgery and you have to pay 20%? That's a pretty common insurance scenario. It would be $4000, which is higher than the hypothetical deductible of the HSA. The person would have a better chance of being able to save to cover this surgery with the lower premiums of the HSA.

But “major illness and catastrophe” are the entire point!! How would a HSA help then??
By having a known and set cap on the total out-of-pocket expenses a person/family would have every year -- just as a deductible works if your house burns down or you total your car. And they'll be in a better financial position to cover this deductible if they save the difference between an HSA and traditional insurance. HSAs work best if you're basically healthy -- I've never said they didn't, although perhaps I didn't spell it out. If you end up meeting your deductible every year, traditional insurance might end up being a better deal. Although, depending on the details of a particular insurance plan (such as having to pay 20% of everything), some people who regularly have high-cost medical care may end up better off. The devil is in the details.

Chad Tonka said...

Kathy,

Every analogy breaks down at some point; however, I think it's pretty dang good for the point I'm trying to make, which your comments show you understand

I certainly understand your point – and I disagree with it. I think your point here is to say that health care cost inflation is driven by overutilization of services by patients who don’t know the true costs of their care. While there are certainly individuals who overuse the system, no serious analyst of health care reform considers it to be a major driver of health care cost inflation. In other words, there are much bigger (and costlier) fish to fry.

What happens if you need a $20,000 surgery and you have to pay 20%? That's a pretty common insurance scenario. It would be $4000, which is higher than the hypothetical deductible of the HSA. The person would have a better chance of being able to save to cover this surgery with the lower premiums of the HSA.

Not a chance. If you look at HSAs for families without employer-based insurance who make between $20,000 and 30,000 (average is $24,767), HSAs are not a viable option. Here’s the answer (quote):

"In contrast, for a family without employer-based coverage who is purchasing an HSA-qualified [health plan] in the nongroup market, the premium alone would consume 13 % of the [household] budget. After putting aside $2100 in savings to cover health care costs under the minimum deductable, such a family would be left with about $500 for the remainder of their household expenses in a year."

source: http://www.kff.org/uninsured/7568.cfm

Clearly not a solution. Unless you think $500 is enough to get you through 12 months.

HSAs work best if you're basically healthy -- I've never said they didn't, although perhaps I didn't spell it out.

Correct! But this is the basic flaw in your position. I’m “basically healthy” right now, but I could step out side and get hit by a drunk driver and face $100,000 is charges? How does a HSA help in that case? They don’t help at all, unless I’m independently wealthy, or have a job with employer-based insurance. So we’re talking around 50 million people here, likely more.

You’re correct that HSAs primarily benefit affluent, basically healthy people. So what about the rest of us??

Chad

Kathy said...

While there are certainly individuals who overuse the system, no serious analyst of health care reform considers it to be a major driver of health care cost inflation.
There may be costlier fish to fry, but overuse certainly adds up. Dr. Atul Gawande's article "The Cost Conundrum" explores just this reality.

This may not fall into the "common use" of health care (such as prescriptions and annual physicals), but it's not exactly the catastrophic expenses associated with cancer, that are analogous to car/house insurance. Take ultrasounds during pregnancy as an example. My sister got one during each prenatal visit (at least 10 in all, but perhaps as many as 13). Let's low-ball what her insurance likely paid at $100 apiece. They were unnecessary, but my sister agreed to them because they were "free" so why not? That was at least $1000 in unnecessary expense, and possibly $2500+. Certainly, not everybody gets u/s every time, but many women are getting at least 2 per pregnancy (of questionable medical "necessity"), and many women get many more unnecessary u/s. Multiply $100 per unnecessary u/s times 4 million births per year, and you get quite a chunk of change. That's just one aspect that runs into the billions, and there are literally dozens of examples like this that I could cite just using the realm of pregnancy, birth, and postpartum.

Clearly not a solution. Unless you think $500 is enough to get you through 12 months.
The cost of "traditional" health insurance is $1400 more per year than HSAs, so if they had "traditional" insurance and didn't have to save $2100 for the deductible, they'd end up with only $700 extra per year, bringing them to a total of $1200 to get them through for 12 months. However, most if not all insurance plans I'm aware of have deductibles and/or copays which would probably eat up at least that $700, unless the family did not go to doctors at all -- does that sound much better?

Best-case scenario - no insurance, and no need of it either - any expenses are mild and cheaper than the cost of insurance.
Worst-case scenario - no insurance but some health catastrophe strikes.
Then there are various actuarial "middle grounds". HSAs are cheaper if you have little or no need of health care or if you're generally healthy but occasionally have catastrophe strike. Traditional health ins. may be cheaper if you end up maxing out what would be your HSA deductible year after year.

but I could step out side and get hit by a drunk driver and face $100,000 is charges?
First, the driver's insurance would have to cover most if not all of your expenses. Second, the HSA would cover everything after your deductible. You would have to pay that part, of course, but doctors and hospitals take payment plans, and generally work with you on that. So, instead of having to pay $100,000, you'd have to pay whatever the deductible is, which in this case is $2100. I'd consider that them picking up over $95,000 of expenses as quite a bit more than "no help at all." And, again, most of the uninsured are not going to spend $2100 per year on health care, so would not max out their deductible any given year, thus allowing them to save up over the years for when they do end up using the deductible.

Plus, you're forgetting that most people in that income bracket would end up being covered already by some government program; and most people who are uninsured could afford insurance, but choose not to spend their money that way.

Oh, and I haven't had health insurance since I was about 5 years old, and my household income is less than $40,000, so I'm one of those who will supposedly benefit from Obamacare, but I'm still against it. So, I'm one of "the rest of us."

Chad Tonka said...

Kathy

There may be costlier fish to fry, but overuse certainly adds up.

You’re missing the entire point of the Gawande article: it is about controlling provider behavior, not patient behavior. The overuse Gawande’s talking about is by doctors doing too many tests.

However, most if not all insurance plans I'm aware of have deductibles and/or copays which would probably eat up at least that $700, unless the family did not go to doctors at all -- does that sound much better?

Of course not! That’s why we needed health insurance reform.

First, the driver's insurance would have to cover most if not all of your expenses.

Sure, but what if the driver does NOT have insurance? This is the whole point. You keep basing your arguments on wildly idealistic or optimistic claims. The key point of health care reform is not the best case scenario, but worst case.

Plus, you're forgetting that most people in that income bracket would end up being covered already by some government program

No, your whole point is that these government programs are “bad socialist government-run health care.” You can’t appeal to them now. Your whole point is that everyone should have HSAs, or have no insurance at all.

most people who are uninsured could afford insurance, but choose not to spend their money that way.

Completely wrong.

Oh, and I haven't had health insurance since I was about 5 years old,

Congratulations, then you are extremely lucky that you have not been bankrupted. Yet.

Chad

Kathy said...

The overuse Gawande’s talking about is by doctors doing too many tests.
And they can do these tests because insurance pays for them. How many people would submit to repeated testing if it cost thousands of dollars out of their own pocket? But, eh, the government or their insurance pays it, so what's the big deal?

Sure, but what if the driver does NOT have insurance? This is the whole point. You keep basing your arguments on wildly idealistic or optimistic claims.
It's not wildly idealistic to say that when car insurance is mandatory that most drivers will have it. And I already noted that if the driver didn't have it, the person covered by the HSA would be out only the deductible, not the entire amount of the bill.

No, your whole point is that these government programs are “bad socialist government-run health care.”
That's not my whole point, although it is true that government programs are poorly run and expensive. However, if the government would stop spending so much, they could take in less taxes; if they took in less taxes, we would have a bigger and better economy, and more people would be able to look after themselves and their families (including purchasing health insurance) without needing the govt to provide for them.

Your whole point is that everyone should have HSAs, or have no insurance at all.
Not at all. In fact, I've said at least twice that sometimes traditional health insurance may be most cost-effective. And I don't think that everyone "should have no insurance at all." Just that it's cheapest as long as catastrophe doesn't strike. I'd have insurance if I could afford it, but I'm one of those who can't, and my husband's job doesn't provide family benefits.

Congratulations, then you are extremely lucky that you have not been bankrupted. Yet.
I know.

Chad Tonka said...

Kathy,

You are making assertions that are completely divorced from reality. For example:

That's not my whole point, although it is true that government programs are poorly run and expensive.

Completely untrue. Medicare has less than half the overhead of private insurance. You know what health care program has the lowest overhead? The VA. Yes, that “socialist” program for veterans.

However, if the government would stop spending so much, they could take in less taxes; if they took in less taxes, we would have a bigger and better economy, and more people would be able to look after themselves and their families

This is totally wrong. The federal government must spend more every year for relatively simple reasons: price inflation and demographic change among others. You seem to have no grasp of history – government spending has increased under every president, including such “big government opponents” like Reagan and Bush.

In fact, I've said at least twice that sometimes traditional health insurance may be most cost-effective.

Yes, they are very cost-effective for the wealthy. Again you have no good ideas how to help low income people, other than to say they don’t need insurance because they are healthy.

I'd have insurance if I could afford it, but I'm one of those who can't, and my husband's job doesn't provide family benefits.

This is what is the most baffling. You of all people should support health insurance reform, since you and your family will benefit directly. Yet you continue to hold up you signs of Obama with a Hitler mustache, and make bizarre assertions like those above that have no connection to reality.

Chad

Kathy said...

Medicare has less than half the overhead of private insurance.
Not true -- plus they have estimated fraud of $68,000,000,000 every year.

The federal government must spend more every year for relatively simple reasons: price inflation and demographic change among others.
Partly true; however, there is an awful lot of fraud and waste and abuse that goes on; not to mention poor return on investment -- e.g., D.C. spends $26,000 per student with horrendous results, while charter schools do a better job for 1/4 of the cost. And $146B for Head Start which doesn't work. [Not to mention all the money that goes to the NEA to pay for garbage that pretends to be "art," and many other programs.]

You seem to have no grasp of history – government spending has increased under every president, including such “big government opponents” like Reagan and Bush.
Just because they have an "R" after their names doesn't mean I agree with everything they did, nor everything that happened during their tenure.

Again you have no good ideas how to help low income people, other than to say they don’t need insurance because they are healthy.
Sure I do, but you wouldn't listen to them anyway.

You of all people should support health insurance reform, since you and your family will benefit directly.
Yes, because it is unconstitutional. Every time someone gets something he didn't pay for, someone else pays for something he didn't get. I don't like that.

Yet you continue to hold up you signs of Obama with a Hitler mustache...
Nope, never did that. Did you liken Bush to Hitler?

Kathy said...

This is what is the most baffling. You of all people should support health insurance reform, since you and your family will benefit directly.
Also want to add -- I'd also benefit if someone else paid my mortgage and bought my groceries, but I'm not going to ask anybody to do that.

I think it is said that most democracies last around 200 years -- then the citizens realize that they can vote to give themselves more and more benefits, and finally bankrupt the country. Our government is not a democracy, but a republic. There are limits on the government that were placed there by the Founders who understood both history and human tendencies and frailties. Far too many politicians in the past century (both Democrat and Republican, and possibly Independent or other 3rd-party) have forgotten their restrictions and have overstepped the bounds of the Constitution. Unfortunately, each side tends to look the other way when one of "their guys" does the overstepping. I hope that this trend stops, although it is far too easy to let it continue.

I just found out that my conservative Senator is #1 in the Senate for earmarks. I wrote him and told him that he has 4 years to mend his fiscal ways, or else I will not vote for him, and will campaign against him. Unfortunately, he will probably not have a serious challenger, or his Democrat opponent will be far worse; but perhaps there will be a change.

Chad Tonka said...

Kathy,

No, you are quite wrong. As I often tell my students, public blogs are not appropriate forms of evidence. First, you have no idea whether or not anything written there is true. You’re much better off sticking with legitimate sources of information. For example this is from a researcher at UC Berkeley:

http://institute.ourfuture.org/files/Jacob_Hacker_Public_Plan_Choice.pdf?#

Look especially at pp. 5-13. Your claims about Medicare fraud are likely right – however the unspoken assumption of your claim is that there is less fraud in private insurance. This is a grave error. As you can see, fraud happens in all health care, private and public (again from a university):

http://www.gwumc.edu/sphhs/departments/healthpolicy/dhp_publications/pub_uploads/dhpPublication_EFDAD1BC-5056-9D20-3D3D36632A4F2163.pdf

To simply claim that private markets are less fraudulent is clearly wrong.

Every time someone gets something he didn't pay for, someone else pays for something he didn't get. I don't like that.

Then logic dictates that you must oppose all insurance, since it works by cross-subsidizing. You must also oppose all public relief for the poor, including aid to poor children like SCHIP.

Nope, never did that. Did you liken Bush to Hitler?

Now you’re just being disingenuous. Multiple times in this blog you have compared Obama to Hitler. Nice try - I have never compared Bush to Hitler.


Chad

Chad Tonka said...

Kathy,

Our government is not a democracy, but a republic. There are limits on the government that were placed there by the Founders who understood both history and human tendencies and frailties.

Since I’m not sure if you went to college, I’ll give you the benefit of the doubt regarding your claims about the Founders. One of the things college students learn is basic fallacies in historical reasoning. One of the most important is that there is no direct, unmediated access to the past; that is, every claim about what some past figure “really understood” is always an interpretation.

In several past threads you (and others) have appealed to the Founders as the basis of your arguments without acknowledging this. Therefore it is a fallacious argument. In other words, if you’re going to invoke the Founders, you have to deal with the following:

1. They held very different ideas than we do now. Prime example is slavery – many of them held slaves and had plantations. While the brightest among them (Franklin) eventually changed his views, the point still holds.
2. They lived in a very different world than we do now. The Founders did not have the internet. They did not have nuclear weapons. They did not have the technological, economic, or cultural structures that we now have.

That this is the case does not mean that the Founders were racist. People who argue that commit the same fallacy you do. We have to put the Founders in their proper context, and evaluate the validity of their thoughts to our present situation. They were not omniscient gods who could see the future – they were human, and made some great advancements, as well as some tragic errors.

Chad

Kathy said...

As you can see, fraud happens in all health care, private and public
Yes, but these are different types of fraud; and it does not necessarily follow that if the govt cracked down on fraudulent claims that consumers would be defrauded by private insurance. That is one flaw of the paper you linked to -- equating providers' bilking the government out of money to insurance companies' bilking consumers out of money, and acting as if it's either one or the other. It doesn't have to be that way -- the govt could crack down on fraud, without affecting private industry.

"Every time someone gets something he didn't pay for, someone else pays for something he didn't get. I don't like that."

Then logic dictates that you must oppose all insurance, since it works by cross-subsidizing. You must also oppose all public relief for the poor, including aid to poor children like SCHIP.

You forgot Christmas presents, birthday gifts, and charitable donations as well. Or did you exclude those because you understood that the context was clearly that of money being taken from someone (as opposed to being freely given) to be given to someone else? If you understood that, then you would also logically exclude insurance, which is a bargain in which money is freely given in exchange for a promise that if certain things happen (death, house burns down, car gets crashed), more money will be given to the insured (or his heirs) to compensate for the loss; but if not, then no money will be given back.

I favor charitable giving, not forced wealth redistribution.

One of the most important is that there is no direct, unmediated access to the past; that is, every claim about what some past figure “really understood” is always an interpretation.
Fortunately, we have lots of their writings, plus their citations of what they read and who influenced them, and we can read *their* writings as well.

I was referring to the Constitution, which set up a system of checks and balances, designed to keep power from residing too heavily in any single branch of government; and also specifically kept certain degrees of power away from the federal government, which makes perfect sense considering they had just fought a difficult war against a government which had too much power over them. In fact, they erred in the first national government, making it far too weak, as a reaction to the overly-strong government of the King and Parliament.

Unfortunately, this Constitution has been far too often ignored and even attacked, particularly by those who have sworn to uphold and defend it.

Chad Tonka said...

That is one flaw of the paper you linked to -- equating providers' bilking the government out of money to insurance companies' bilking consumers out of money, and acting as if it's either one or the other.

If you could give me a page number of where in the paper you derived that interpretation, I would be better able to respond.

You forgot Christmas presents, birthday gifts, and charitable donations as well. Or did you exclude those because you understood that the context was clearly that of money being taken from someone (as opposed to being freely given) to be given to someone else?

I excluded gifts and charity because we’re not talking about that! We are talking about insurance. Since insurance is a formal contract, it is not at all like gifts.

If you understood that, then you would also logically exclude insurance, which is a bargain in which money is freely given in exchange for a promise that if certain things happen (death, house burns down, car gets crashed), more money will be given to the insured (or his heirs) to compensate for the loss; but if not, then no money will be given back.

Insurance is neither a “bargain” nor a “promise;” it is a contract. As such it is regulated by contract law. Insurance is not like a gift – gifts are regulated by social norms, not laws.

I was referring to the Constitution, which set up a system of checks and balances, designed to keep power from residing too heavily in any single branch of government…Unfortunately, this Constitution has been far too often ignored and even attacked, particularly by those who have sworn to uphold and defend it.

You must be referring to the Bush administration, whose adherence to the unitary executive theory stands in stark contrast to your beliefs.

Our government is not a democracy, but a republic.

This does not make any sense. A republic is a nation with elected leaders, as opposed to a monarchy or hereditary dynasty. Democracy is a method or process by which leaders or officials are chosen. I don’t see how they are oppositional??

Chad