[mike777]

luke warm, on Sep 16 2009, 05:30 PM, said:

my view, fwiw (which isn't very much), is that if there is to be universal health care the only way to do it properly is the 'public option', period, paid for through taxation... nothing else, nada... if that can't be done, forget about it... it would have to be actualized (if that's the right word) according to factors such as level of coverage (family, single, etc) and age... i see no easy answers for the pec problem... the analogy to mandatory car insurance should not have been made by obama

congress has become too corrupt for *any* plan to be appealing, or even workable, imo... whatever we get will not be loved

Jimmy I wonder why those in power just do not advocate medicare for all with auto enrollment, no forms to fill out.

It may not be the best plan but it seems the most passable and quickest.

I have no idea how to pay for it but that is another thread.

[Winstonm]

mike777, on Sep 16 2009, 11:03 AM, said:

One issue I have not seen discussed much in the media is if Mandatory Health Care is constitutional.


A few seem to suggest under the Commerce Clause it might be. I wonder if the ninth and tenth amendments would apply here.

I think you are confusing issues. Mandatory Health Care does not compute unless you are talking about Christian Scientists - everyone else I know would have no problem receiving health care if it were needed - or mandated.

I mean, really, what are you going to do, yell out, "Please don't save my life."
"I'm sorry, sir. I have to. It's a mandate."

I believe what you are asking about is Mandatory Health Insurance.

And thus there are two questions, really, to answer: first, does the Federal government have the right to require mandatory health insurance, and a second more important question that asks whether or not health care is an inalienable right.

If health care is a right, then the government should provide it at no charge; if it is not a right, then the government should not be allowed to force a mandated health insurance on the citizenry.

[hotShot]

How many people die because they can't afford the medical treatment necessary to help them?

How many people suffer pain, because they can't afford the pain killers they would need?

If the state should not protect you from a premature death and unnecessary pain caused by illness or age, why should he protect you from murder or assault.

In the first case you could get yourself some health insurance, for the second case you could hire private security or get a martial arts expert yourself.

I wonder if it is your constitutional duty to suffer from your inability to earn enough money to pay for a volunteered heath care or being to stupid to do it on time.

[Mbodell]

hotShot, on Sep 16 2009, 04:13 PM, said:

How many people die because they can't afford the medical treatment necessary to help them?

How many people suffer pain, because they can't afford the pain killers they would need?

If the state should not protect you from a premature death and unnecessary pain caused by illness or age, why should he protect you from murder or assault.

In the first case you could get yourself some health insurance, for the second case you could hire private security or get a martial arts expert yourself.

More than 26 000 people in 2006 between the ages of 25 and 64 dies each year in the US because they don't have health insurance. The estimates of the number who die who do have insurance but are denied necessary coverage go much higher than that (a number of people suggest >100K/year).

That is more people between the ages of 25 and 64 die due to lack of health care then the total number of Americans of all ages who are murder victims each year!

[kenrexford]

hotShot, on Sep 16 2009, 07:13 PM, said:

How many people die because they can't afford the medical treatment necessary to help them?

How many people suffer pain, because they can't afford the pain killers they would need?

If the state should not protect you from a premature death and unnecessary pain caused by illness or age, why should he protect you from murder or assault.

In the first case you could get yourself some health insurance, for the second case you could hire private security or get a martial arts expert yourself.

I wonder if it is your constitutional duty to suffer from your inability to earn enough money to pay for a volunteered heath care or being to stupid to do it on time.

I think you are missing a core principle of the theory of government for many people, even if that core principle is violated constantly.

TYhe core principle is that government exists for two main purposes -- defense and necessary cooperation.

Defense includes defense of the country from external attacks and defense of the individual from internal attacks. Internal attacks are anything defined as crimes by one against another, although "crimes against yourself" get improperly glumped in, IMO, like silly drug and prostitution laws.

Necessary cooperation includes things like building roads. This "necessity" is always a fuzzy concept. Strictly speaking, roads could be built without government involvement, with road owners charging tolls to pay for their roads, but the result would be a mess for obvious reasons. Things like schools, parks, civic centers, football stadiums, and the like have varying degrees of extension of the principles. Some extreme examples, like seizing houses to build better shopping malls, infuriate many people who think the "too far" line has been crossed. However, in theory all of these are still community-oriented.

Government also ends up acting in some ways that are neither of these, instead being "protective" of the weakest among us. A helping hand to the downtrodden, if you will. A safety net sometimes, all of us cooperatively investing. This is where the greatest fights are, because there is a wild disagreement between how far government should go in this area, and some even disagree as to whether proposed ends are better than the status quo or better than some alternative proposed ends.

When you talk of uninsured people falling dead if we do nothing, you are talking about this third type of government work. Assuming for the sake of argument that the hyperbole is actually reality, the conclusions that X is needed to solve the dead people outside the hospital scenario might be easily countered by a claim that Y would work better or even that the status quo actually is better for everyone in the long run. This is not a call to a duty to die gracefully because the State won't protect you from illness or injury.

[kenrexford]

Mbodell, on Sep 16 2009, 08:10 PM, said:

hotShot, on Sep 16 2009, 04:13 PM, said:

How many people die because they can't afford the medical treatment necessary to help them?

How many people suffer pain, because they can't afford the pain killers they would need?

If the state should not protect you from a premature death and unnecessary pain caused by illness or age, why should he protect you from murder or assault.

In the first case you could get yourself some health insurance, for the second case you could hire private security or get a martial arts expert yourself.

More than 26 000 people in 2006 between the ages of 25 and 64 dies each year in the US because they don't have health insurance. The estimates of the number who die who do have insurance but are denied necessary coverage go much higher than that (a number of people suggest >100K/year).

That is more people between the ages of 25 and 64 die due to lack of health care then the total number of Americans of all ages who are murder victims each year!

What's the source for that info? I find that hard to believe. I bet a lot of these people actually died because of some medical condition.

[nigel_k]

Let's go back to basics here. There are two (non-violent) ways to apportion scare resources: pricing and rationing.

With pricing, the goods and services that cost the most to produce will have the highest prices. Each individual consumer decides what they do and do not wish to buy, essentially using a cost/benefit analysis. They can make choices that reflect their personal preferences - one consumer may choose to forgo health care and take a big overseas trip instead, and another may economise on just about everything in order to pay for a comprehensive health care package.

With rationing, a central decision maker, not the consumer, decides how much each person gets and how much they pay. The decision maker may be a politician or bureaucrat or a combination of employer and insurer as exists to some extent in the present system. If a politician is the decision maker, they will decide in a way that avoids negative media coverage that could hurt their chances of reelection. If a company decides, they will do so in a way calculated to maximise their profits.

I do not trust politicans or corporations anywhere near enough to support a rationing approach. If people object to the pricing approach on the grounds that some people are too poor to afford healthcare, then the solution is a direct cash transfer from rich to poor, not a government takeover of the health system.

But any successful solution must involve people receiving different levels of care depending on their individual choices and priorities. That is the only way to ensure that resources are put into providing services that people want, and not wasted on providing services that people would prefer to do without if the costs were taken into account.

[cherdanno]

So you are against any form of health insurance?

[Winstonm]

Quote

Let's go back to basics here. There are two (non-violent) ways to apportion scare resources: pricing and rationing.

Let's get back to reality here - health care isn't a corn crop. By itself it is not scarce. The very thing that makes it a scarce resource IS ITS pricing.

Quote

But any successful solution must involve people receiving different levels of care depending on their individual choices and priorities.

Let me give you a clue - poor people want to live, too.

What exactly is the choice of most Americans - not the 5% but the 95%? I can hope this chest pain goes away or I can kiss off any increase in my living standards for the next 10 years while I pay off the medical bills?

Poorer people don't have the luxury of prioritizing health care - it's a choice of either taking their kid to the doctor or paying the gas bill this month.

Adam Smith did not account for humans acting like humans when he spoke of his Invisible Hand. The part left out was that when a marketplace is left with no rules, no regulations, that the richer devour the poorer, and as they gain wealth they gain power.

And here's rub to free markets: Power corrupts; absolute power corrupts absolutely; and free markets consolidate wealth and power.


Have you seriously considered this problem outside your free-market ideology?

[nigel_k]

Winstonm, on Sep 17 2009, 03:10 PM, said:

Adam Smith did not account for humans acting like humans when he spoke of his Invisible Hand. The part left out was that when a marketplace is left with no rules, no regulations, that the richer devour the poorer, and as they gain wealth they gain power.

And here's rub to free markets: Power corrupts; absolute power corrupts absolutely; and free markets consolidate wealth and power.

Have you seriously considered this problem outside your free-market ideology?

Health care is a scarce resource. There is no country where people get all the health care they want, whether it is provided by the private sector or by a state monopoly. This is all about how we decide who gets care, how much they get, and who pays.

I never said anything about no rules and regulations. Political power corrupts more severely than money, and does not allow a choice as there is only one government at a time and it is funded by force. It is the socialists who fail to account for human nature as has been tragically seen all around the world.

As for ideology, it is a matter of sad reality for me as I live in a country with a state monopoly provider. If I need an operation I will wait months or even years for it. If my cat needs an operation she can have it next week since veterinarians are run privately.

[Mbodell]

kenrexford, on Sep 16 2009, 05:20 PM, said:

Mbodell, on Sep 16 2009, 08:10 PM, said:

hotShot, on Sep 16 2009, 04:13 PM, said:

How many people die because they can't afford the medical treatment necessary to help them?

How many people suffer pain, because they can't afford the pain killers they would need?

If the state should not protect you from a premature death and unnecessary pain caused by illness or age, why should he protect you from murder or assault.

In the first case you could get yourself some health insurance, for the second case you could hire private security or get a martial arts expert yourself.

More than 26 000 people in 2006 between the ages of 25 and 64 dies each year in the US because they don't have health insurance. The estimates of the number who die who do have insurance but are denied necessary coverage go much higher than that (a number of people suggest >100K/year).

That is more people between the ages of 25 and 64 die due to lack of health care then the total number of Americans of all ages who are murder victims each year!

What's the source for that info? I find that hard to believe. I bet a lot of these people actually died because of some medical condition.

I can't tell if you are being sarcastic or not. Of course the most proximate cause is the illness. But the lack of health care coverage is a strongly contributing cause. But look at the numbers from the british medical journal. Web searching will find many other such articles with estimates in this range. I tend to prefer medical journals and academic research to random fox news people.

[Mbodell]

nigel_k, on Sep 16 2009, 06:21 PM, said:

The decision maker may be a politician or bureaucrat or a combination of employer and insurer as exists to some extent in the present system.

Some extent is a huge underbid.

The top 6 private health insurers in California rejected more than 20% of medical claims made by California patients over the past 5 years. This includes a number of people who have insurance, and who the health insurance company later admitted should get the treatment, but who died because the treatment was not given fast enough. Again, this is people who have health insurance and whose doctor's wanted to pursue the treatment but who had private insurance companies forming "death panels" and denying them in todays system. See California's real death panels.

If someone has to decide if I qualify for a health treatment but me down as far, far preferring it being a gov't agent who is motivated by appealing to the public interest far above a private individual who is paid more and profits more when they reject my claim. Oh, and as a bonus, existing practice demonstrates that in the US the private system is far less efficient at providing health insurance than the public system so moving to a public system wouldn't just be beneficial from alleviating existing rationing problems, but it would also be more efficient.

[hrothgar]

nigel_k, on Sep 17 2009, 06:30 AM, said:

As for ideology, it is a matter of sad reality for me as I live in a country with a state monopoly provider. If I need an operation I will wait months or even years for it. If my cat needs an operation she can have it next week since veterinarians are run privately.

Hmm. Just found the following:

http://www.dfat.gov....healthcare.html

Quote

Non-government health sector financing

Private hospitals provide about one-third of all hospital beds in Australia. Private medical practitioners provide most out-of-hospital medical services and, along with salaried doctors, perform a large proportion of hospital services. Private practitioners provide most dental services and allied health services such as physiotherapy.

About half of all Australians have private health insurance. Forty-three per cent of the population (or nine million people) are covered by hospital insurance for treatment as private patients in both public and private hospitals. Forty-three per cent of the population (or nine million people) have ancillary cover for non-medical services provided out of hospital, such as physiotherapy, dental treatment and the purchase of spectacles.

The Australian Government is seeking to achieve a better balance between public and private sector involvement in health care by encouraging people to take out private health insurance, while it also preserves Medicare as the universal safety net. The Australian Government helps to make private health insurance more affordable by offering a 30 per cent rebate (and higher rebates for older Australians) for the cost of private health insurance premiums. Safety nets for medical services and pharmaceuticals assist people facing high annual out-of-pocket health costs. An Extended Medicare Safety Net, introduced in 2004, provides further assistance by meeting 80 per cent of the out-of-pocket cost of medical services provided out of hospital once an annual threshold is reached.

Private sector expenditure on health accounts for about one-third of total health expenditure. The majority (around 60 per cent) of this is individuals’ out-of-pocket expenses and the remainder is expenditure by private health and other insurers such as workers’ compensation and third-party motor vehicle insurers.

[luke warm]

mike777, on Sep 16 2009, 06:39 PM, said:

luke warm, on Sep 16 2009, 05:30 PM, said:

my view, fwiw (which isn't very much), is that if there is to be universal health care the only way to do it properly is the 'public option', period, paid for through taxation... nothing else, nada... if that can't be done, forget about it... it would have to be actualized (if that's the right word) according to factors such as level of coverage (family, single, etc) and age... i see no easy answers for the pec problem... the analogy to mandatory car insurance should not have been made by obama

congress has become too corrupt for *any* plan to be appealing, or even workable, imo... whatever we get will not be loved

Jimmy I wonder why those in power just do not advocate medicare for all with auto enrollment, no forms to fill out.

It may not be the best plan but it seems the most passable and quickest.

I have no idea how to pay for it but that is another thread.

i don't know why they don't do something like that... i read the blurb richard provided, and that seems to me to be unworkable... for everyone to have the (relatively) same quality of coverage, there can be only one plan, it should be a gov't run plan, providers should receive medicare-like compensation, and patients should be protected from onerous balance billing

[hrothgar]

luke warm, on Sep 17 2009, 01:20 PM, said:

mike777, on Sep 16 2009, 06:39 PM, said:

luke warm, on Sep 16 2009, 05:30 PM, said:

my view, fwiw (which isn't very much), is that if there is to be universal health care the only way to do it properly is the 'public option', period, paid for through taxation... nothing else, nada... if that can't be done, forget about it... it would have to be actualized (if that's the right word) according to factors such as level of coverage (family, single, etc) and age... i see no easy answers for the pec problem... the analogy to mandatory car insurance should not have been made by obama

congress has become too corrupt for *any* plan to be appealing, or even workable, imo... whatever we get will not be loved

Jimmy I wonder why those in power just do not advocate medicare for all with auto enrollment, no forms to fill out.

It may not be the best plan but it seems the most passable and quickest.

I have no idea how to pay for it but that is another thread.

i don't know why they don't do something like that... i read the blurb richard provided, and that seems to me to be unworkable... for everyone to have the (relatively) same quality of coverage, there can be only one plan, it should be a gov't run plan, providers should receive medicare-like compensation, and patients should be protected from onerous balance billing

Comment 1: From the sounds of things you are confusing "Public Option" and "Single Payer". The plan that you are describing here is single payer.

Comment 2: Please show me where anyone is arguing in favor of complete (or even relative) equality in health care. A lot of people, myself included, argue that there should be a right to receive a certain minimum standard of care. I haven't seen anyone argue that people shouldn't be allowed to pay for their own private health care if they have the means to afford it.

Personally, I think that a parallel private health care system would have a great deal of value, if only to measure the relative efficiency of the single payer system.

[kenrexford]

Mbodell, on Sep 17 2009, 01:21 AM, said:

kenrexford, on Sep 16 2009, 05:20 PM, said:

Mbodell, on Sep 16 2009, 08:10 PM, said:

hotShot, on Sep 16 2009, 04:13 PM, said:

How many people die because they can't afford the medical treatment necessary to help them?

How many people suffer pain, because they can't afford the pain killers they would need?

If the state should not protect you from a premature death and unnecessary pain caused by illness or age, why should he protect you from murder or assault.

In the first case you could get yourself some health insurance, for the second case you could hire private security or get a martial arts expert yourself.

More than 26 000 people in 2006 between the ages of 25 and 64 dies each year in the US because they don't have health insurance. The estimates of the number who die who do have insurance but are denied necessary coverage go much higher than that (a number of people suggest >100K/year).

That is more people between the ages of 25 and 64 die due to lack of health care then the total number of Americans of all ages who are murder victims each year!

What's the source for that info? I find that hard to believe. I bet a lot of these people actually died because of some medical condition.

I can't tell if you are being sarcastic or not. Of course the most proximate cause is the illness. But the lack of health care coverage is a strongly contributing cause. But look at the numbers from the british medical journal. Web searching will find many other such articles with estimates in this range. I tend to prefer medical journals and academic research to random fox news people.

If you like to quote medical journals, read what the medical journal is saying.

This link takes me to an article that states what another agency is claiming. That other agency is a political action committee seeking universal health care in the USA. So, the medical journal cites a political action committee?

I then looked on the Families USA website (the advocacy group -- not a medical journal) for their report. What I found was a bunch of reports where they quote themselves and their "estimate." I did not look that long, but I could not find any actual explanation for their conclusions. Rather, as a political group advocating universal health care, they claim that 26,000 people die each year for no insurance, on their own estimations.

Wow. That's pretty good.

I also checked another journal and found out that 145,000 people die each year because they don't hire a criminal defense attorney from Lima, Ohio, whose initials are KJR.

[kenberg]

KJR spent more time checking on the numbers than I did. The statement itself was suspect enough. An alcoholic drinks himself to death. Maybe health insurance would have provided counseling, or a stay at a clinic, or a new liver, or maybe it wouldn't. Maybe he would have gone to the counseling or maybe he wouldn't. Chalk up one more in the died from lack of health insurance column. Or maybe they don't count this one. I seriously doubt that it is possible to devise a methodology that would place a reliable number on the number of deaths due to lack of health insurance. I don't watch FoxNews, I can assure you that FoxNews is not the basis for my skepticism about the numbers.

Data can be useful, but numbers compiled by advocacy groups are best ignored.

[cherdanno]

Do you really find this number so hard to believe? There are 45 million without health insurance. Is it so hard to believe that not having health insurance increase your risk of dying by 0.05% per year? That would roughly correlate to health insurance increasing your life expectancy by 1 year.
Sounds like a pretty reasonable estimate to me.

[kenberg]

I find it hard to believe that the number has any reliable meaning. It seems likely to me that a significant number of people have their lives very significantly impacted by the current set up. But. I am not willing to sign on to any particular number being meaningful, especially if the source is an advocacy group. I find this skepticism to be very reliable. We went through it on another thread where the issue was the percentage of bankruptcies caused by medical bills and lack of insurance. The often cited figure of 50% turned out to be, if anything at all, perhaps the number of bankruptcies caused by medical problems including such things as loss of a paycheck from inability to continue working.

It's not a matter of lack of concern for the unfortunate victims of these many problems, it's a matter of respect for argument by data. If people claim to have data then they should have data, and it should show what they claim it shows. Data from advocacy groups, of any persuasion, rarely meets that standard.

[helene_t]

hrothgar, on Sep 17 2009, 11:38 AM, said:

Comment 2: Please show me where anyone is arguing in favor of complete (or even relative) equality in health care.

What does "relative equality" mean?