[kenrexford]

Just a thought.

People can have reasonable debates as to whether riding a horse to work or driving a car to work is better. One seems faster, but more expensive and more dangerous. One is slower, but less expensive and perhaps better for the environment. Great debate there.

But, if you end up unresolved about what to do, cutting a horse into pieces, and attaching the pieces to an engine block and a tire with duct tape seems like a really bad alternative.

[akhare]

Interesting metaphor, but how does it map to the health care bill (assuming that is what was being alluded to)?

[jonottawa]

Your Republican talking point fails. The debate isn't between two reasonable alternatives (as in your analogy,) it's between restoring sanity and cost containment to a broken system and insanely pursuing the unsustainable and immoral status quo while demonizing virtually all reasonable reform proposals.

[luke warm]

jonottawa, on Dec 16 2009, 04:24 PM, said:

Your Republican talking point fails. The debate isn't between two reasonable alternatives (as in your analogy,) it's between restoring sanity and cost containment to a broken system and insanely pursuing the unsustainable and immoral status quo while demonizing virtually all reasonable reform proposals.

why aren't the "reasonable reform proposals" being introduced as alternatives by the majority party? oh wait, it's the republicans fault.. there's something to be said for proposing principled bills regardless of the possible outcome, don't you think?

[kenberg]

I am not a great fan of the Dems, but I think that here the Republicans are in a really weak arguing position, at least when they try to present themselves as in favor of some sort of reform. Firstly, they had the White House and both houses fro six years. If they had some good ideas, they could have put them through. Secondly, when Obama started pushing for reform, the Republican reaction was to form Tea Parties and bring their rifles.

I deeply believe that the desire to do good must be balanced by the ability to pay for it. I am more than willing to allow that a serious Republican effort to help shape the reform effort would most likely have produced a better bill.

Unfortunately, very unfortunately in my view, what I have seen is a lot of crap and very little seriousness. Republicans now pronounce themselves to be shocked that the Dems are writing the bill in a way that Dems are apt to do. Well, the train at some point leaves the station.

If a Republican, or anyone, is simply opposed in principle to poor people getting help with health care then they can be opposed to this bill or any bill and they are being true to their beliefs. Many of them claim, however, that of course Republicans wish to help poor people obtain better health care, just not in this way. Why would anyone believe them?

[luke warm]

kenberg, on Dec 16 2009, 05:28 PM, said:

If a Republican, or anyone, is simply opposed in principle to poor people getting help with health care then they can be opposed to this bill or any bill and they are being true to their beliefs. Many of them claim, however, that of course Republicans wish to help poor people obtain better health care, just not in this way. Why would anyone believe them?

i think republicans nowadays, and for the past few decades, have rightly been criticized for putting the interests of big business ahead of what's necessarily the good of the country, not that the dems don't kowtow to the same constituency... if a person is truly philosophically conservative, that's one thing... but to be against, for example, allowing the purchase of drugs from outside the country for no reasons other than those given by the pharmaceutical industry is hard to swallow

the problem is, there are few really principled dems or reps (or so-called independents)... and when one does show up s/he is castigated by one or both of the major parties

[kenrexford]

jonottawa, on Dec 16 2009, 04:24 PM, said:

Your Republican talking point fails. The debate isn't between two reasonable alternatives (as in your analogy,) it's between restoring sanity and cost containment to a broken system and insanely pursuing the unsustainable and immoral status quo while demonizing virtually all reasonable reform proposals.

Um, actually I was inspired by a recent article at the Huffington Post. It seems like a lot of people objecting to this mess are from the left, not liking how catering to moderates is resulting in a possible disaster.

And, for that matter, how reasonable is the alternative of the freeways into LA being clogged with horses? I would have thought that you would have seen this as a metaphoric poking of fun at conservatives.

However, it seems that any comment possibly tending against anything that happens to come out as a result of discussions among Democrats must be Republican talking points? Wow. I'll try to send you a snorkle, so you can at least breath from down there.

[Winstonm]

I'm lost. How is having a rodeo on the L.A. freeway supposed to solve the healthcare problem - is it like Farm Aid - you know, Health Buck?

[jdonn]

Ken, compared to your analogies, your bidding system is starting to seem better by the day.

Someone might consider a compromise between two sides to be like agreeing to ride a bike, which is (let's just pretend) faster than a horse but less expensive than a car.

Someone else might consider that some number (let's say 1 in 10,000) of people who ride horses will die on the way to work every day, but that the people telling them they should choose a horse over a car are people who have fancy horses that are as safe as cars.

Someone else might consider your mutant horse-car hybrid a better alternative than the current system of riding cows to work.

You are trying to take something very complicated, and explain it in very simple terms. But it didn't work.

[Winstonm]

Digby explains so well:

Quote

Obama can say that you're getting a lot, but also saying that it "covers everyone," as if there's a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don't get it from their employer. I guess you can call that progressive, but that doesn't make it so. In fact, mandating that all people pay money to a private interest isn't even conservative, free market or otherwise. It's some kind of weird corporatism that's very hard to square with the common good philosophy that Democrats supposedly espouse.

Nobody's "getting covered" here. After all, people are already "free" to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won't make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn't or didn't want to write. Indeed, it actually looks like the worst caricature of liberals: taking people's money against their will, saying it's for their own good --- and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don't miss the money as much when they never see it

I have to take exception to one sentence: "Nobody's 'getting covered' here." Sure they are - the Democratic Party is covering itself head to toe in lobbyist excrement to make certain it continues to get health insurance and Pharma money for campaigning.

Obama got exactly what he wanted - more money for Democrats.

[jdonn]

I don't know who or what Digby is but I don't think that was well explained at all. It's a big whiny rant.

Btw has he considered that the reasons people have for not buying private insurance may often be very similar to the reasons some people would drive 125 miles per hour if it were legal? No one wants to make Joe Shmo buy insurance for his own good (well I don't). I want him to buy insurance for everyone's good, because if he doesn't buy his own insurance we all may have to pay for his even-more-expensive medical treatment a bit later.

I mean in a sense Ken is right that there are two extremes and the middle may not be good. One is everyone must get insurance, and that insurance is used on everyone. The other is that there is no insurance at all, and the government pays for everyone with tax money. Personally I don't much care whether you call the money I send away to pay for the health of society "tax" or "insurance", or some combination of the two (actually I have a preference between the two but it's a smaller issue.) What I really have a big problem with is people who want to pay neither. The moment they become sick they rip off everyone else. I am very happy if the government decides to stop them.

[blackshoe]

My father was a cardiologist. If someone got sick, and he could help them, he generally did. If he didn't get paid, well, he didn't get paid. That is not to say he would have been happy to provide health care to everybody for free.

Most people want to pay their debts. In many cases they pay something, even if it's insignificant. One of Dad's patients brought him several baskets of apples every fall. That man never paid the money he owed Dad, but he paid something. It's the deadbeats who think society "owes" them healthcare that are the problem.

[Rain]

In many states, if you had a preexisting condition (and this is extremely loosely defined by the insurers), and can't get insurance through job, the next best option is the state high risk health insurance.

http://www.cobraheal...hriskpools.html

However, I don't think all states have these? I counted 30 something in this list, and then there are a few more where insurers can't deny coverage. Not sure what the remaining 15 states do.

http://www.chip.state.il.us/
This is for illinois. I looked it up when I couldn't get insurance. The premium is ~3X private health insurance + much worse benefits. It's also for legal permanent residents or citizens only. It didn't make sense for me then.

Anyways, under the current system, I think one problem was insurers were able to deny coverage too easily, and push many people into the high risk group (if their state has one, leaving the cream for themselves only. This group deemed high risk, + the group of people who'll receive some subsidy on their premiums (couldn't pay for normal health insurance otherwise) will benefit from this.

Are Canadian drugs subsidised or something for Canadians? It'll make sense if non Canadians can't get cheaper drugs if their govt had paid for it for their own people.

I also think a reason health care cost is crazy high here is because Americans subsidise poorer countries a lot. I'm not even talking about "legalised" patent breaking generic drugs. The same drug is unlikely to be sold at the same price in USA and in Malaysia.

Add legal costs (which also results in extraneous and needless tests and procedures) , labour cost, and fixed (instead of % based + high deductible) and the costs will skyrocket so fast no reasonable premiums/taxes will be able to keep up.

[jonottawa]

Lame and misleading introductory analogy aside, here's my take on health care:

Americans tend to be fat, unhealthy, litigious, prone to substance abuse and prescription drug abuse, prone to violence, unaccountable, narcissistic, gullible, demanding and irresponsible.

Doctors tend to charge exorbitant amounts for what they do. They all too often abuse their monopoly to reap windfall profits.

People who sell insurance expect to make a profit and charge some people more for health insurance if their costs are reasonably expected to exceed the health costs incurred by other people. In many cases, the profits they reap are excessive given the relatively small risks they incur.

That makes any health care reform a huge challenge that requires both parties to step up and give Joe 6-pack, Dr. Joe, and Joe Insurance guy some straight talk.

And yes, I'd kill the current bill as per Howard Dean and others. That doesn't mean the Republicans are 'right.' It just means that the Republicans have demonized all the good out of the bill and what's left would do more harm than good.

[Trinidad]

blackshoe, on Dec 17 2009, 03:38 AM, said:

My father was a cardiologist. If someone got sick, and he could help them, he generally did. If he didn't get paid, well, he didn't get paid. That is not to say he would have been happy to provide health care to everybody for free.

Most people want to pay their debts. In many cases they pay something, even if it's insignificant. One of Dad's patients brought him several baskets of apples every fall. That man never paid the money he owed Dad, but he paid something. It's the deadbeats who think society "owes" them healthcare that are the problem.

Are you proposing a health care system with mandatory health insurance for all and premiums depending on income/wealth of the insured? In that way, everyone gets health care, the doctors get paid and everyone is paying something that they can afford.

Rik

[blackshoe]

I'm not proposing anything, merely suggesting that not all doctors are evil, greedy, and the cause of the problem, and not all (but too many) patients are useless deadbeats who think the world owes them something.

[kenrexford]

jonottawa, on Dec 16 2009, 11:03 PM, said:

Lame and misleading introductory analogy aside, here's my take on health care:

Americans tend to be fat, unhealthy, litigious, prone to substance abuse and prescription drug abuse, prone to violence, unaccountable, narcissistic, gullible, demanding and irresponsible.

Doctors tend to charge exorbitant amounts for what they do. They all too often abuse their monopoly to reap windfall profits.

People who sell insurance expect to make a profit and charge some people more for health insurance if their costs are reasonably expected to exceed the health costs incurred by other people. In many cases, the profits they reap are excessive given the relatively small risks they incur.

That makes any health care reform a huge challenge that requires both parties to step up and give Joe 6-pack, Dr. Joe, and Joe Insurance guy some straight talk.

And yes, I'd kill the current bill as per Howard Dean and others. That doesn't mean the Republicans are 'right.' It just means that the Republicans have demonized all the good out of the bill and what's left would do more harm than good.

Typical Republican talking points.

You have to support the President and support what Congress is tryiong to do, as a moment in history, or you are a Palinite. Obviously.

Hmmmm.

Let's see. We have a good idea, as a whole plan. However, we take all the good out of it, leaving just things that will harm people. The gaps are apparently filled by the residue of the old system, but the changes do more harm than good because the changes also negatively affect the old system.

So much different from the analogy, I see.

[Trinidad]

I don't know what the current sentiments in the USA are, but my idea was never that the doctors or the patients were the main problem.

My view is that the problem lies with the insurance system.

Rik

[kenberg]

About the analogy: At first reading I assumed it was the horse that was expensive and dangerous. S probably I won't dwell on the analogy. Well except for this:

A guy buys a horse from a farmer. He gives the farmer the money, takes the horse out of the barn and leads him down a trail. A hundred yards down the trail the horse drops dead. The guy goes back to the farmer and says "The horse that you sold me just dropped dead." "Hmmm. He never did that before."

[kenrexford]

kenberg, on Dec 17 2009, 09:13 AM, said:

About the analogy: At first reading I assumed it was the horse that was expensive and dangerous. S probably I won't dwell on the analogy. Well except for this:

A guy buys a horse from a farmer. He gives the farmer the money, takes the horse out of the barn and leads him down a trail. A hundred yards down the trail the horse drops dead. The guy goes back to the farmer and says "The horse that you sold me just dropped dead." "Hmmm. He never did that before."

The sad thing is that this horse seems to have dropped dead many times before. Or, maybe the car's engine is dead. Now, I'm losing the analogy.