Knights & Knaves Alehouse

AxeMental wrote:http://online.wsj.com/article/SB123327719403931465.html

"Mr. Daschle ... offers his party two pieces of political advice: Move fast, before there can be a public debate, and write as vague a bill as possible."


Regardless of your stand on national socialized health care, it seems its part of the stimulas bill (snuck in) and will likely become law in the next few weeks (I haven't seen this on the news yet).
Just a heads up.

And about time, too. As long as the Republicans don't keep stonewalling the administration and instead get into the job of changing what they don't like to get a compromise package, we might get a good system. Keep up the stonewalling, and the necessary conservative side of the program gets lost. But it's time we reformed healthcare; the conditions we're accepting for the poorest members of our community are a national and moral disgrace.

AxeMental wrote:Joe, its the cost of medicine, not the quality thats the problem. Once again you side step those issues as if they don't exist (despite having first hand experiance with the insurance industry from the inside.)

I wasn't aware that I said US medicine was of poor quality nor was I aware of "once again?" sidestepping any issue. If you can afford health care in the US, it generally works well. We do have a pretty high rate of error when compared to some other systems, however, with a recent survey saying up to 1/3 of Americans experienced some sort of medical, medication, or test error in the past 2 years.

Cost of medicine is only a part of our many health care issues. There are many other costs besides only medicine costs.

joe b.

Mythmere wrote:But it's time we reformed healthcare; the conditions we're accepting for the poorest members of our community are a national and moral disgrace.

When you understand that the poor are only poor because they have no morals, you'll realize it's morally right to resist changes that help the poor.

I don't believe that, but hey, some people even think this financial crisis was caused by the dirty dirty poor people.

joe b.

AxeMental wrote:Medicine is highly competitive with many individual elements competing driving down costs and increasing quality.

Sorry, I just had to pull this out separately for a response because it's so egregious. I'm honestly surprised you could type that with a straight face.

From the USA today: "Patient payments for generic drugs rose 38% from 2000 to 2007, and some brand-name drugs rose 48%, the Kaiser data show. Inflation rose 21% during those years."

Competition isn't driving down prices. Nothing is driving down prices. You only have to look at pharmaceutical expense breakdowns (like more spent in marketing than for R&D), gross profit, and margins to get the main reason why.

Competition and free-market "solutions" are not solutions for everything. It's just a tool, and just like any tool, it doesn't work for everything. A hammer makes a poor screwdriver.

The profit motive seems to make for more expensive health care available to fewer and fewer people, not cheaper and cheaper health care available to more and more people.

joe b.

Joe: "Competition isn't driving down prices. Nothing is driving down prices. You only have to look at pharmaceutical expense breakdowns (like more spent in marketing than for R&D), gross profit, and margins to get the main reason why.

Competition and free-market "solutions" are not solutions for everything. It's just a tool, and just like any tool, it doesn't work for everything. A hammer makes a poor screwdriver."

Marketing is an essential element to any business (including your own). Often times the cost of advertising, labels and packaging costs more then whats inside (what your selling). Thats been going on since the dawn of civilization probably (if you don't know the product exists you can't buy it). This is true for medications. Do you think if the system is socialized (and caps are put on how much these companies can charge for new medications) that there will be the same level of drug development that we see today (basically gutting the profit but not removing the risks).


As for competition not working, I beg to differ. We have a few dozen orthopedics in town. Of those people that have severe breaks go to the best (from reputation) same with every other specialty. Thats called competition, same as exists with plumers, electritions or any other service industry. Want to get the same quality you get when you go to your local govt. office, knock yourself out and socialize it. Sure, everyone will get care for the little stuff, but for the big stuff forgeddaboutit.

Here's another example: 15 years ago we had I think 1 MRI in town (maybe 2) loud and enclosed, now we have around a dozen (in my little dirt bag town of Daytona), once again threw competition. There used to be a wait of weeks to get into that MRI 15 years ago, now you can get into one of the MRIs the same day (or perhapst the next). Think if we'd socialized medicine 15 years ago we'd have the same number and lack of wait...think again my friend. Competition has also resulted in the centers and staff improving (as I stated in an earlier post). Don't think Joe that Medicine isn't a growth industry it is (with stiff competition), and it can't be played with as if its a monopoly or a dwindling resource. Do that and you will lower the proliferation of those things that we most dearly need (cures for cancer, improved testing, better doctors etc.).

And don't forget, what percent of this money thats collected will go to medicine and what percent will go to paying for this gigantic proposed new agency (probably run by MBAs and attorneys payed far more then the doctors they manage, just as we see in HMOs today)? If its like any other federal system, be prepared for a ballooning in costs.

As for drugs being expensive. Deal with the FDA and lawsuites. Thats were you want to start.

TRP: "Unlike Axe, I'm not so much concerned about a moneypit, healthcare is a moneypit already, so that wouldn't be much of a change. My concern is giving over my autonomy to lobbyists. I have absolutely no trust that Mommy Sam could put together a system that works at least as well (let alone better) than what I have right now. "

No thats my main concern as well (loss of the ability to see who I want when I want, loss of teh ability to get tested quickly, and the loss of autonomy of my doctor. My arguements concerning cost relate to the arguement that socializing medicine will drive down costs, it will do just the opposite, while at the same time lead to what your worried about and rationing. It has to. Also, I'd rather see the present problems that make our health care system addressed before we talk about moving toward socialism.

P&P you are correct. When the poor need healthcare they can walk into most any doctors office or hospital and get it. They are billed but are not expected to pay (unless they are on medicaid or medicare, in which case that is socialized medicine basically). When your in that situation your not paying does not effect your credit score, so most just pay what they can.

Alot of it is charity as well (doctors and hospitals just seeing patients regardless).

Myth, the Republicans are in chaos right now. They had their chance with the Contract with America and blew it big time (basically not delivering even when they could).

The economic Moderates have seezed control (I don't even know who the economic conservatives are anymore). I think thats probably whats stopping a unifide front and counter proposal. But your right, they need to come up with something fast and hit the AMerican people hard with it. When it fails (and it will of course) they can at least point to having offered a fix in the private sector in the next election cycle (better then nothing right?).

Honestly, I think the Republicans may loose ground in two years if they don't act with a focused plan now. A supermajority may be a lock, and we may be seeing our worst nightmares about to take shape.
Of course, those who like California style leftist liberalism will love it.

Re modern American notions of socialism:

(The short form: E Pluribus Unum is the Devil's work, while Social Darwinism is the true Gospel.)

I can easily wax long on this subject. There is, far short of the anarchic extreme, a louder than large segment of the population essentially opposed to "charity." This routinely (and bizarrely, to my ears) gets bruited along with proclamations of Christian piety (with which the dog-eat-dog approach to polity is equated).

Who is for charity and against Christianity? Why, Communists, of course! Ergo, anyone not in agreement with the ideology must be a Red.

(Roman Catholics can be admitted to the "Christian" fold long enough to join attempts to have the state regulate people's sex lives -- but they're back to being Reds as soon as they raise any other element of their doctrine of the sanctity of life.)

Bombs, prisons and gas chambers are wonderful, but public schools are not. Public subsidies for private schooling could be okay -- but only if the scheme screws the poor. Toll roads are good, public trains and omnibuses bad. "Binding arbitration" is good, while recourse to public courts is bad. Keeping lots of guns is good, but providing preschool or prenatal care is bad.

And so on. The rule is really quite simple!

Talk of cost is a smoke screen. If memory serves, only the Chinese beat us (or maybe not any more) in incarceration per capita. The cost per prisoner is such that one cannot help but wonder whether simply handing it out in return for good behavior might be a more effective deterrent to crime. How much would it cost to replace slums with decent housing, education (right through university or trade school) and employment? Why spend so much effectively propping up the prices of cocaine and opiates instead of dealing with the reasons demand for such escapes from reality is so much greater in our reality than elsewhere (including, apparently, the very sources of those imported drugs)?

It's no surprise that health care gets the same treatment.

Sooooooo .. I've got to give up what I've earned through conscious decisions and hard work so that the poor can have a better level of care. And, since we're now getting into the inevitable class warfare, I suppose somehow I must have cheated my way into a secure job with good benefits. And, no, I wasn't born with a silver spoon in my mouth. My parents were what today would be referred to as the working poor.

Yes, I spend a lot on insurance. Right now it's optional, but I pay it anyway, so enforced insurance wouldn't be any different for me.

This thread is helping me make up my mind about something I hadn't though about much before. That is, what I have to lose so others can benefit.

Yeah, I'll fight any system (private or public) that attempts to take away my right to choose my doctor and what medicines and procedures I may, or may not, have. That's why on the private-side, I refuse to join an HMO.

Thanks ya'll for giving me some clarity on this. I owes ya.

In a proximate sense, it's obvious that compulsory rather than voluntary participation is the sine qua non of state undertakings. I can imagine other approaches, but the rationale then for making them governmental seems obscure.

The cry against "compulsory charity" generally depends on more than moral postulates, though; it depends on a myopic view of one's self-interest.

There are people who want you to believe as an article of faith, against all evidence, that any profit to "the poor" must be a loss to you. You must somehow cleave to this even though the principle of mutual profit is the very foundation of the "free trade" concept!

Dw, in case you don't remember, charity is when someone volunteerily gives to another. When you are forced to pay taxes for this, this is not volunteering, its called legal theft (liberals call it moral obligation or whatever code they can think of). Thats not to say I'm against forcing society to take care of the poor, I totally am (thats why I'm not a hardcore libertarian but rather a Republican). However, I can at least admit thats what it is (and not charity). My concern is to make that amount required to be as little as possible while keeping people alive so eventually they can be self dependent, hell even prosper (which should be everyones goal, but sadly is not). Last fall I did about 450 inspections in Houston for FEMA. Most of those were among the nonworking poor. Believe it or not most had running cars that were in good shape, and about half owned at least one Plasma TV (that would put to shame my 2 10 year old Sonys). Many of these people didn't scam the government and needed help. But there is a large population that milk the system for every damned dime they can get. And who can blame them when there are liberals handing it out for votes.

WRONG, Axe, except perhaps in some sort of Orwellian "Newspeak."

"Volunteering" is not definitive of charity. If it is The Lord God's Commandment to give a tithe, that makes the alms-giving no less charitable.

What is definitive is that one expects nothing in return -- which is precisely why it pleases foes of this or that to call it "charity."

Dwayanu wrote:In a proximate sense, it's obvious that compulsory rather than voluntary participation is the sine qua non of state undertakings. I can imagine other approaches, but the rationale then for making them governmental seems obscure.

The cry against "compulsory charity" generally depends on more than moral postulates, though; it depends on a myopic view of one's self-interest.

There are people who want you to believe as an article of faith, against all evidence, that any profit to "the poor" must be a loss to you. You must somehow cleave to this even though the principle of mutual profit is the very foundation of the "free trade" concept!

Well, then. Please spell out these benefits to me (and others who are already insured and have decent healthcare) if we go to nationalized medicine.

Dwayanu wrote:WRONG, Axe, except perhaps in some sort of Orwellian "Newspeak."

"Volunteering" is not definitive of charity. If it is The Lord God's Commandment to give a tithe, that makes the alms-giving no less charitable.

What is definitive is that one expects nothing in return -- which is precisely why it pleases foes of this or that to call it "charity."

You've totally lost me here. An atheist can give charity.

TheRedPriest wrote:This thread is helping me make up my mind about something I hadn't though about much before. That is, what I have to lose so others can benefit.

I think this is the basic question of politics.

Everyone wants to protect the people that do the work. The left wing wants to protect the workers from the "evil" rich (because to left wing ideology, you can't get rich without exploiting people), and the right wing wants to protect the workers from the "idle" poor (because to right wing ideology, if you don't have any money it's because you're an idle sponge on the system).

But I think healthcare that's free at the point of delivery is about fairness.

First, it's about fairness to the doctors and nurses who've worked hard to earn their qualifications and put in long hours in difficult jobs. They deserve to get paid for what they do, even if the person they're helping happens to be poor.

Second, it's about protecting the workers from infectious diseases that'll spread among the poor if they're denied access to treatment.

Third, it's about giving a decent level of preventive healthcare -- advising people on a healthy lifestyle, rather than incentivising doctors to let people get sick and then sell them expensive treatments. (That's one of the big reasons Europeans live longer than Americans, by the way.)

Fourth, it's about retaining the skilled workers; in a global marketplace the US has to be as attractive as France or Germany to workers who can go where they like. I mean, in Europe workers get free healthcare and their employer's legally obliged to pay them even if they're sick.

Fifth, it's about basic justice. After the amount of money we've just poured down the gullets of ailing banks that accepted government handouts with one hand as they dished out fat bonuses to their staff with the other, to then argue that the taxpayer can't afford healthcare looks like lunacy. What we can't afford is banks.

Mythmere wrote:But it's time we reformed healthcare; the conditions we're accepting for the poorest members of our community are a national and moral disgrace.

Like a legally mandated access to top-of-the-line healthcare at any medical institution regardless of ability to pay???

I'm not a big fan of our current healthcare system, but I refuse to feel guilty about it when most "poor" people in America have access to better healthcare than middle-class people do in a large portion of the world.