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Thursday

23

July 2009

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COMMENTS

Breaking the Code of Silence: Government Run Healthcare

Written by , Posted in General

We all watched the news conference last night and so I thought I’d carefully dip my toe into allowing the occasional non-sports stuff on the site. The key here is going to be kindness, open mindedness and self control. Just debate back and forth without tearing down the other person.

Question 1 – Should the Government be involved in health care?

Question 2 – Are you OK with Obama’s way of paying for the other “1/3” of the cost by reducing the amount of itemized deductions for families with over $1 mil household income?

I’ll put my thoughts into two quick answers. Nothing run by the government is very good or efficient. Why would health care be different? Taxing only the “rich” is socialism and it’s becoming more and more accepted in this country every day. Not good.

There ya go. Enjoy this spot while it lasts.

  • cap’n obvious

    I believe that those who pay nothing into the system should not be allowed to take anything out of it. The scale can slide, but everyone should have to have some skin in the game.

    Other than that, just assume I agree with everything Sherm and Doc Raker write in their upcoming manifestos below…

  • Oh boy… do we really want to get involved with this discussion here? Probably no, so I think I will stay out of this for now…

  • Okay… I lied.

    Nothing run by the government is very good or efficient.

    Not true.

    Why would health care be different? Taxing only the “rich” is socialism

    This is completely false. This is not socialism. At all. Having a progressive tax system (i.e. where higher incomes are taxes at higher percentages) is not socialism. Throwing out the “socialism” line is a really nice way to drum up fear, but that doesn’t mean it is true. It is amazing how little understanding there is of what socialism really is. Conservatives run to label any kind of progressive policy as socialism even though it rarely, if ever, even resembles socialist policy.

    As for your questions, yes, the government should be involved in health care. The health care system is this country is completely broken, and the industry itself sure is not going to “fix” it, as they have no incentive. And yes, I have no problem with a small tax of the rich to fund health care reform.

  • MJ

    The health care system is this country is completely broken, and the industry itself sure is not going to “fix” it, as they have no incentive.

    Exactly. There’s no checks and balances.

    As someone that works at a large P&C Insurance company (not named AIG), even I hate working with health care insurance companies.

  • cap’n obvious

    So in some people’s world, individuals who have worked hard and become successful and financially stable should be punished for that success by having to pay more for a system that is constantly abused by persons who choose mediocrity and are happier living on government handouts than actually earning something for themselves.

    Sorry, this plan is not progressive. It might not be exactly socialism, but its closer to socialism than progressive. It (once again)motivates those who choose to be lazy and unsuccessful to become even more so.

    The healthcare system is in the midst of fixing itself, and possible the entire welfare system. If the government would just let the failing fail, the country would come out the other side stronger. The governemt leeches would, at some point, be forced to carry their weight one way or another. An example of this is the closure of county hospitals all over the country. A business cannot be in business if no one who frequents it will pay for its services. GM and the banks can fall by this wayside as well.

  • constantly abused by persons who choose mediocrity and are happier living on government handouts than actually earning something for themselves.

    Do you know any poor people? Do you know any people who receive help from the government? Because this statement makes it pretty clear that you don’t. Are there people that abuse the system? Sure. But if you really think that all poor people, or even the majority of poor people, are in that situation because they “choose” mediocrity or because they are “happier living on government handouts than actually earning something for themselves,” I am not really sure this conversation is even worth continuing. You do realize that receiving help from the government is not an easy life, right? And that the help from the government is barely enough (and often not enough at all) to truly live on, right?

    Sorry, this plan is not progressive.

    First of all, the definition of a progressive tax system is one where higher income levels are taxed at higher levels. Sorry that you don’t know what the difference between a regressive and progressive tax system.

    It might not be exactly socialism, but its closer to socialism than progressive.

    Again… no, it isn’t. Not sure why you are trying to change definitions.

    The healthcare system is in the midst of fixing itself, and possible the entire welfare system.

    Huh? The health care system is
    going to fix the welfare system?

    If the government would just let the failing fail, the country would come out the other side stronger.

    This says a lot right here, and is, in large part, why I didn’t really want to jump into this conversation. You and I are coming from two very different perspectives. It is clear that you think that the government has no role in any kind of safety net, and that poor people are a) completely to blame for all of their problems, and b) deserve no help, and c) like to be dirt-poor.

    A business cannot be in business if no one who frequents it will pay for its services.

    No true… millions of not-for-profits and other similar social service providers stay in business every day without their clients paying for the services that they receive.

    It appears that not only do you believe that government has no role, you also believe that there is no place for charity either. You think that poor people, or the “failing,” should just fail.

    GM and the banks can fall by this wayside as well.

    Oh my… you really have no idea how that would have impacted out economy, do you?

  • By the way… these so-called “leeches” actually often pay a larger percentage of their income in taxes than the richest in this country.

  • Doug

    Certainly this topic can stir up some passionate responses.
    I live in Vancouver BC.
    We have Government run health care. I pay monthly premiums and a lot more taxes than you U.S. folks do that go to a lot of places including health care. Is it perfect? No. Does it work well? I’d say yes.

  • MJ

    So in some people’s world, individuals who have worked hard and become successful and financially stable should be punished for that success by having to pay more for a system that is constantly abused by persons who choose mediocrity and are happier living on government handouts than actually earning something for themselves.

    Yeah, because all of those financially stable people have worked hard. :rolling my eyes: There’s jsut as many lazy ones that get handouts in other ways too.

    This entire country is pretty much made up of lazy people. I’m surrounded by three of them right now in my own office.

    OK I’m done….I’ve gone off on a tangent.

  • I’ve gone off on a tangent.

    Not really. You actually bring up an important point in response to cap’n obvious.

    People like cap’n obvious prefer to think of poor people as lazy, and contrast them to “hard working” rich people.

    And the contrast breaks down very, very quickly. The truth is that there are a lazy people everywhere. And hard working people everywhere. There are lazy people who make a lot of money. There are hard working people who live in poverty.

    I work with a lot of poor people. And they all work hard. Really hard. And they still don’t make a lot of money. They do very important work such as taking care of children, taking care of seniors and people with disabilities, etc. Yet they still are making poverty wages. cap’n obvious thinks that these people don’t work as hard as anyone making over $500,000 a year. And he is wrong.

  • Doc Raker

    If you want to see government run health care you can look at Medicare, Medicaid (health care for the poor) and the Veterans Administration. No one looks at these systems as top notch medical care.

    Fact: Government intervention into markets make things more expensive. If the government artificially lowers cost the costs are made up elsewhere in the private sector. One of the reason healthcare costs has increased over the years is government artificially lowering provider reimbursemnent in the medicare and medicaid systems. The difference has been increased costs in the private sector.

    Fact: The 45 million uninsured is one of those slick stats that doesn’t really explain the true situation. Over 40% of those uninsured can afford health insurance but CHOOSE not to buy it. Misplaced priorities one could say. Many of the 45M could receive medicaid but haven’t applied for it. The real uninsured number is about 8M.

    Fact: Medical care in an HMO, managed care or government run system is and WILL BE RATIONED. Decisions on who gets what procedure will be decided by a bureaucrat, not between the patient and the doctor.

    Fact: Research and innovation will be stifled. If it cost 1 billion dollars to bring a new drug to market and those research and REGULATION costs are not lowered, yet reimbursement for the new drug is lowered motivation to bring new drugs to market will diminish. Same thing with medical services, if hospitals are not reimbursed fairly, see emergency room Free services, hospitals will close.

    The solution is to take government and third parties out of the equation as much as possible. Decisions on medical purchases inculding insurance should be done directly by the consumer. Corp HR departments buying insurance for employees is part of the problem. The more direct patient doctor transactions there are the lower the costs will be.

    Obama’s plan takes us in the wrong direction.

  • If you want to see government run health care you can look at Medicare, Medicaid (health care for the poor) and the Veterans Administration.

    Actually, the VA has a good reputation.

    Fact: Government intervention into markets make things more expensive.

    Fact? Prove it then.

    The real uninsured number is about 8M.

    No. The real uninsured number is still 45M. You can claim that only 8M don’t have access to insurance, but that is a different statement. Further, there is a very strong argument that when you have 45M uninsured, it increases the cost of care (and insurance), as the 45M who are uninsured still end up needing care and those that do self-select into insurance are those who need it more.

    Decisions on who gets what procedure will be decided by a bureaucrat, not between the patient and the doctor.

    Heh. The fact that you don’t think is already happens by the insurance companies is hilarious. Insurance companies decide all the time on what they will or will not cover. The difference between the insurance company deciding and the government deciding is that the insurance wants to make a profit. The government will not.

    Fact: Research and innovation will be stifled.

    I disagree that this is a fact. You seem to think that opinions that hold strongly must equate with facts.

    The solution is to take government and third parties out of the equation as much as possible.

    So no insurance companies? Basically you think that everyone should pay for their own health care costs, and there shouldn’t be any kind of insurance industry?

    What I am hearing is that you want a completely unregulated health care system. You believe that the health industry should just live within the so-called “free market” allowing supply and demand (and consumer choice) to dictate the cost and availability of services.

    Is this a fair assessment?

  • Lizzie

    I work for the largest consumer owned health insurance company in the country so I will put a disclaimer here: aside from the commenting physicians I probably have the most personally vested interest here and the one who will be the most immediately affected. As you can imagine I have fabulous insurance and I am paid well for what I do. And my company will cease to exist if the full-fledged government program takes affect, and I’ll be looking for a job with the government.

    Yet even people in my circles feel change is needed. I just don’t agree that a government funded option that competes with private insurance is the right answer. That will drive down choice, will put most physicians out of business (they will, in effect, be paid on the scale of social workers, elder caretakers … all those “working poor” people Dave mentioned …) and in a few years we’ll be in as big a mess as we’re in now. Perhaps a different mess, but a mess nonetheless.

    That said, there is still that group of people living between the extremes of the folks who do nothing to help themselves, and the well paid (by skill or by luck). There needs to be some sort of solution for those people who choose to go to work every day and try to better themselves and their families’ lives and still can’t make ends meet. Private insurers have plans in place to help these people, and have had them for years. Prior administrations didn’t want to hear about it, and the current administration skipped right into government-owned. There IS a happy medium.

    P.S. Matt, you wouldn’t hate working with me. 🙂

  • cap’n obvious

    I work with a lot of poor people. And they all work hard. Really hard. And they still don’t make a lot of money. They do very important work such as taking care of children, taking care of seniors and people with disabilities, etc. Yet they still are making poverty wages.

    I am not arguing this point, but what these people and bleeding hearts like you fail to understand is that they have the CHOICE to find work that pays better. Literally thousands of programs are in place for low income people to better their standard of living through furthering their education and/or job skills. Millions of “poverty stricken” Americans choose not to. It is easier to take government handouts. As you pointed out, there are certainly going to be exceptions. I am sure you do know a great many hard working poor. So do I. They call my office every day looking for help and most of the time I advise them for free. I also know folks that came from nothing and have educated themselves and persevered and now earn a nice living. How is it fair that those folks should be continually penalized financially to subsidize health services for those who make a choice to live at or below poverty level? Certainly hard working folks that pay their taxes have my respect and admiration, no matter how much they earn. The problem is that a great many “Americans” want free healthcare and social services, and they are not “Free”.

    For the record, I do believe in charity, and those that know me well would say I am a charitable individual. I do not believe, as you do, that our government and tax dollars should be used for charity, especially when the budget shortfall is in the trillions. Something’s got to give.

    No true… millions of not-for-profits and other similar social service providers stay in business every day without their clients paying for the services that they receive.

    RIGHT…the ones that are privately funded are fantastic. The ones that rely mostly on handouts from the government are not so much.

  • And my company will cease to exist if the full-fledged government program takes affect, and I’ll be looking for a job with the government.

    Why?

    hey have the CHOICE to find work that pays better.

    Not necessarily. First of all, some of these people have limited educations and skill sets. Many cannot afford to pursue more education, as it takes both time and money – neither of which they have.

    Millions of “poverty stricken” Americans choose not to. It is easier to take government handouts.

    No, it really isn’t. It is not easy to take government handouts. Government handouts are minimal, and are often simply not enough.

    How is it fair that those folks should be continually penalized financially

    They are not “penalized.” They would simply be taxed a slightly higher rate.

    For the record, I do believe in charity

    Well, that completely goes against what you wrote in the previous comment. You didn’t only say that the government should not do charity. You basically said that poor (or “failing”) people deserve to fail, and we should all just let them.

    the ones that are privately funded are fantastic. The ones that rely mostly on handouts from the government are not so much.

    Really? Then who will fund foster care programs? Or home care programs that cost less than institutionalization? Or drug rehab programs that are cheaper than the alternative – more crime/imprisonment?

    Do you really think that there is no place for a government safety net? At all?

  • MJ

    P.S. Matt, you wouldn’t hate working with me.

    I’m amazed at how many here don’t do a lick, and then pass the blame when they’re called on it. I am literally surround by three people that spend most of their day making personal calls, and making up excuses on why they’re behind. And I know it’s not ust here, but it’s everywhere. I work hard, and it gets me no where.

    I’m just tired of being screwed by every system out there.

  • [The physicians] will, in effect, be paid on the scale of social workers, elder caretakers

    Huh? Where do you get this from?

    So a government-funded public option will mean that doctors will all of a sudden be making $20,000 a year? Come on. This is blatantly untrue. This hasn’t come true in other countries that have a much more expansive public health care system than the Dems are proposing. Why would it come true here?

  • Sour Bob

    No matter what side of this issue you came down on Joe, you might just as well have titled this post, “I Would Like to Ask Half of You to Leave.” Really a piss-poor idea to bring up something as divisive as politics on a baseball board.

    Pity there isn’t some other place where you could have discussed this matter online. Someone should start a site or something.

  • cap’n obvious

    Programs for children like foster care are a different animal. Of course they should be there. In California, the amount of fraud and corruption with regard to these home health programs is out of control. There is a place for a government safety net to help those that can’t help themselves. Right now, that safety net is being abused by a great many that WON’T. My comment about letting the failing fail was directed at the hospitals and big businesses, not individuals.

  • lizzie

    Bob, the conversation here is no different than when we talk about baseball. Everyone gives some logical opinions and thoughts that are well written and whether you agree or not really shouldn’t offend anyone, and Dave runs back and forth telling everyone why they are wrong. What’s the difference?

  • Sour Bob

    You’re right. I just made that up. Politics aren’t divisive. They’re a natural fit for a Cubs site.

    Let’s talk about religion, now!

  • cap’n obvious

    and Dave runs back and forth telling everyone why they are wrong. What’s the difference?

    hilariously true.

  • Programs for children like foster care are a different animal. Of course they should be there. … There is a place for a government safety net to help those that can’t help themselves.

    So you think that there should be safety net, but only in select situations that you agree with. I see.

    You have made it very clear that any entity that takes (or at least depends on) government money are not good. Yet then you flip that and say some of it is okay.

    Right now, that safety net is being abused by a great many that WON’T.

    How many? How many people “abuse” the system? What percentage of these people do you think are “lazy” “leeches?”

  • Sour Bob, you’re living up to your name my man.

  • Sour Bob

    There’s a time and place, man. That’s all I’m saying.

    This is a baseball site, man. Just let it be that.

  • cap’n obvious

    How many people “abuse” the system? What percentage of these people do you think are “lazy” “leeches?”

    too many. More than half I’d bet. At least in California. The current system is rife with abuse, it is well documented. Welfare fraud exists, and there is a lot of it. Whether you choose to believe it or not.

  • The current system is rife with abuse, it is well documented.

    Lets see some of this documentation that shows “more than half” of the people in the system abuse it. I really want to see this. If it is really well-documented, you should be able to very easily point out said documentation.

    Welfare fraud exists, and there is a lot of it. Whether you choose to believe it or not.

    I am sorry… can you point out where I said that it didn’t exist? Welfare fraud absolutely exists, just not at the levels that you claim it does. It is funny that not one person who claims that such fraud is so prevalent can every give any supporting evidence.

  • Sour Bob

    Yeah, this is gonna end well.

  • lizzie

    Huh? Where do you get this from? So a government-funded public option will mean that doctors will all of a sudden be making $20,000 a year? Come on. This is blatantly untrue. This hasn’t come true in other countries that have a much more expansive public health care system than the Dems are proposing. Why would it come true here?

    Here’s where I get it from. This is well-researched, Dave, and even if I don’t get it EXACTLY correct per your specifications it’s not “blatantly untrue” so please refrain from calling me a liar.

    Let’s say that you and I both get a good health insurance plan paid for by our employers. As the cost of that increases over the years more of that cost is passed on to the employees. So let’s say we are contributing 20% of a $10,000/year plan, so that amounts to $2,000/year.

    Now let’s say that the government funded program that competes with private insurance comes along and only charges $1,000/year. And let’s even say it’s a lesser plan. Many people are going to choose to switch to that because for many people, $1,000/year is preferable to $2,000/year even if the care is not as good. The majority of these people who switch to such a plan would be the “generally healthy” because they feel less mortal and are less inclined to pay for care they may never need to use.

    How health insurance works (or any insurance for that matter) is that the people who don’t file claims end up covering for the people who do. In general.

    So, now the “generally healthy” have transferred to the less expensive government-run program, leaving the private insurers with the expensive folks. So the private insurers are forced to raise their rates to account for the fact that they are left with the sickest population.

    Yes, I know, I haven’t touched on the physicians’ salaries yet.

    While this is all happening, the government is setting the rates that they pay the physicians. Let’s say a private insurer would have given the physician $500 for a $750 billed procedure. These are negotiated rates which are driven by the bargaining power of the private insurers. The government may say “ok, I’ll give you $200 instead”. Well, the physician in essence HAS to agree to accept that coverage because so many people are flocking to it as the private insurers continue to raise their rates.

    Eventually the governmental programs will have more subscribers than the private programs since the private programs will have to continue to raise their rates to exist. As the governmental programs obtain more subscribers they also obtain more bargaining power with physicians and can then say “hey, we’ve got 90% of the market share, you HAVE to accept our rates or you are out of business” and the physicians either a.) accept the rates or b.) go out of business. When they accept the rates which will continue to be driven down, they will, indeed, eventually make $20,000/year. Those that continue to stay. They can only see so many patients during the course of a day, and they’ll still have their overhead and expenses like they always had.

    Those that take their talents elsewhere will be in the majority and that’s what causes the lack of availability of care etc. etc. etc.

    And yes, this is an extreme example which is intentionally generalized because really, no one other than you is out to prove me wrong so I don’t feel the need to be ultra-precise. And yes, it isn’t this extreme in other countries. But remember that other countries didn’t start out in the situation that we are currently in. They never had it as “good” as we have it, so the “bad” never looks as bad.

    Take a cancerous tumor over to England and attempt to get care and see how you make out. It won’t be good. Yet my friend’s mom thought 4 months was a GOOD wait time for hers. Because that’s what she knows.

    Have at it.

  • Sour Bob

    You know I like tilapia and I like chocolate fondue. But I don’t put fish in my fondue.

    Is anybody following what I’m saying here? You know… fish: politics, fondue: baseball… No? I’ll just banging my head against the wall then.

  • sherm

    Dave runs back and forth telling everyone why they are wrong. What’s the difference?

    Lizzie — that one had better make it to your “best lines of the week” column.

  • This is well-researched, Dave, and even if I don’t get it EXACTLY correct per your specifications it’s not “blatantly untrue” so please refrain from calling me a liar.

    Touchy, touchy. I didn’t call you a liar, I said what you said was untrue. And I still think it is untrue.

    You still have to show where this happened in other places. Because it hasn’t happened like this. At all.

    Your theoretical examples make sense. In theory. But that is not how it is going to happen. And it is not how it is happened elsewhere.

    By the way – is GM’s management now going to make poverty wages? Do state workers? Do industries (such as road building) that heavily rely on government funding make poverty wages?

    No, not at all.

    BTW – those that take Medicaid/Medicare patients are not making poverty wages. Those who work at country hospitals as doctors or nurses are not making poverty wages. Those who take Medicaid/Medicare consumers are not making poverty wages.

    So you can claim that salaries are going to plummet to “the scale of social workers, elder caretakers” based on an extreme theoretical argument, but it simply does not hold up when compared to any other similar system either in the US or in other countries with a more expansive public health care system.

  • sherm

    I was typing a comment, but when it got to seventy five thousand words, I decided to scrap it. Hey, look everyone…Joe posted a minor league report.

    Note to Lizzie — (just Lizzie, the rest of you avert your eyes) Nice going. That was awesome. That “model” you describe threatens a lot more than just the health care system in this country.

    Note to Sour Bob — (just Bob, dammit, what’s wrong with you people?) Funny stuff, but in some countries they would kill to have fondue chocolate fish to eat.

  • And lizzie… FWIW, just because the government plan may cheaper does not mean that it would be lesser care.

    As I have already pointed out, private insurance has a profit incentive that government does not have. In turn, private insurance HAS to charge more for the same level of care, because they have to make a profit in order to overpay their CEO’s and reward their stock holders (if it is a publicly held company).

    Cheaper does not mean better or worse. And you cannot assume that only the healthy would move to the government plan.

  • MJ

    Fishy, fishy. Where is the fishy?

  • lizzie

    You still have to show where this happened in other places.

    No, I don’t. It didn’t happen in other places. I stated that it didn’t happen in other places. Lots of things that don’t happen elsewhere can still happen here.

    I also didn’t state that doctors who take medicare/medicaid patients are making poverty wages. Nor did I imply such a thing. Medicare and Medicaid can stay exactly where they are and that would not affect any of us, physicians or not. I’m talking about a governmental program that competes with private insurance, which I stated ad nauseum.

    It’s ok, Dave, we’re allowed to disagree. And I have no doubt that you will get the last word because you are simply too exhausting for people to continue. So yippee you win!!!

    I hope and do think that people other than you took this discussion for what it was worth and maybe even learned some things. I sure did.

  • MJ

    As I have already pointed out, private insurance has a profit incentive that government does not have. In turn, private insurance HAS to charge more for the same level of care, because they have to make a profit in order to overpay their CEO’s and reward their stock holders (if it is a publicly held company).

    Nice generalization. Where’s YOUR proof they all do this. There must be some sort of evidence of this, if you said it.

  • cap’n obvious

    insurance has a profit incentive that government does not have.

    right. It’s the government’s job to lose money. The worlds biggest and most corrupt charity.

  • Where’s YOUR proof they all do this.

    Do you want me to prove that health insurance companies make large profits?

    Lets start with Blue Cross, which in 2008 made $186M. Just in North Carolina.

    I don’t think I need to prove that for-profit corporations have a profit incentive that the government doesn’t have.

  • It’s the government’s job to lose money.

    Huh? You don’t have to lose money just because you are not seeking a profit. Do you think that all non-profits lose money?

  • I’m talking about a governmental program that competes with private insurance, which I stated ad nauseum.

    Fair enough, but again, the VA doesn’t even compete with anyone. Based on your logic, their doctors, nurses, and other staff should be making poverty wages, right?

    I also didn’t state that doctors who take medicare/medicaid patients are making poverty wages.

    I didn’t say that you said so. I asked if they were.

    There are thousands of industries were private entities compete with government entities. And those private entities have not been driven into poverty or closure.

    And I have no doubt that you will get the last word because you are simply too exhausting for people to continue.

    So basically it is okay for you to share your perspectives, and disagree with mine, but it isn’t okay for me to do the same?

    I love how I continually get attacked for having an opinion, but the crew of you who all agree with each other can continue to disagree with me and that is perfectly acceptable.

  • MJ

    So basically it is okay for you to share your perspectives, and disagree with mine, but it isn’t okay for me to do the same?

    I love how I continually get attacked for having an opinion, but the crew of you who all agree with each other can continue to disagree with me and that is perfectly acceptable.

    You miss the point everytime. It’s not your message. It’s how you present it.

  • You miss the point everytime. It’s not your message. It’s how you present it.

    No… I get that. And my point is that it goes both ways.

  • lizzie

    Dave, I would love it if just once you shared an original opinion. But you never do. You just pick everyone else’s apart instead. Write a paragraph with no gray boxes and no “huh?” and no rhetorical questions just to imply someone is wrong and I’ll be the first to jump on your bandwagon. Say “hey you have some great points but I think of it this way instead” and then state your views. You’d be surprised at the number of people who would love to have that conversation with you. But instead you take one-sentence pot shots to try to make yourself look good and everyone else look like an idiot. All it really does, is force everyone else out of the conversation because you’re so intent on beating us over the head. There’s something to be proud of!!!

    And no, it does NOT go both ways. No one does to you what you do to everyone else.

    Done. You win.

  • I would love it if just once you shared an original opinion. But you never do.

    First, just because I respond to someone else’s comment doesn’t mean it isn’t an “original opinion.”

    Second, I have definitely given more than my share of original opinion around here.

    But instead you take one-sentence pot shots to try to make yourself look good and everyone else look like an idiot.

    No. This is not what I do, or at least why I do it. I respond to posts sentence by sentence in order to make it clear what I am referring to. The funny thing is now that most people have figured out how to do it, they do the same thing.

    And no, it does NOT go both ways. No one does to you what you do to everyone else.

    I never said that people act in the exact same way that I do. But to pretend that I am the only one who gets snarky around here is just silly. I have constantly dealt with personal attacks from numerous people here. While I know that the presentation of my message is not always in the best ways, I have refrained from personal attacks. The same cannot be said about others, yet not only are they not called out on it, they are encouraged.

    So basically it appears that personal attacks are much more acceptable than not disagreeing well.

    I will say this again. I know that there are many times where I need to work on my “presentation.” I admit that. And conversations such as this (health care policy) can often stir up emotion and passion on both sides. I’ll continue to work on my tone.

  • Seymour Butts

    Morning (on the west coast) all, nice cup of worms Joe.
    First as a matter of disclosure, and I’m sure to some, shock, I don’t go to VFTB first thing in the morning, I do it after I go make rounds at the hospital across the street. Seymour is a practicing Interventional Cardiologist, Surprise.

    So, Socialism, perhaps not strictly, but the idea of “from those who can, to those who need” is maybe better labeled as Communism than socialism, but at the least it says not everybody pays their own way. To some degree taking care of those less fortunate is a very good thing as well as a good idea. From a practical stand point, failure to do so leads to insurrection and those who worked for what they have can get it taken away from them by brute force. But I appreciate people like Dave who make it their work to care for the poor, because we all don’t have the stomach for it. Are HALF of welfare recipients lazy schemers? probably not, but damn near half of my welfare patients are very obviously “entitled” to free care. At least the working poor appreciate that you are giving them a break on the bill, the welfare crowd, as a whole, do not.

    About 20% of my patients have no insurance, and another 15% have crappy insurance. That does not count medicare. Medicare pays so poorly that you can’t even keep the office open if all your patients have it, so almost all primary care Doc’s cap the number of their medicare patients. In effect the patients with good insurance allow the doctor to stay in business to see those without it. Several of my referring physicians chose early retirement in the last 5 years rather than continue the paper work nightmare that is medicare (conventional insurers also have onerous paperwork that I beileve(sorry Lizzie) is designed to delay or altogether avoid payment) . An entirely government run payer system would exacerbate that situation, and lessen access to physicians.

    The VA. I spent parts of 6 years rotating in and out of a VA hospital. They deliver rotten quality medical care. A classmate of mine said it best “this isn’t a hospital, it’s a nursing rest haven”. It may not surprise you to learn that I once was called to the principle’s office at the VA to explain why I had written an order to transfer a patient to a real hospital. (I had a good reason).

    Before getting all excited about what the current health care reform hubub will do to you and your care, examine history. I have strong faith in the ability of our government to not accomplish anything they set out to do. What I expect is that some watered down bill that affects, and helps, very few people will get passed. There will be much trumpeting by politicians of all stripes about how they personally saved America, and we all go back to a system that should be better than it is.
    Now, if only we could get Milton Bradley solved.

  • Sour Bob

    Hey Sherm–my handle on this thing is “Sour Bob” because that was a mighty fine taffy flavor I liked as a kid. My name is Jeff, but the first board I was a regular on had four Jeffs, so I went a different way. At this point, it’s just something I use habitually online.

  • MJ

    Now, if only we could get Milton Bradley solved.

    I’d prefer that nonsensical debate over this one, anytime of day of the week.

  • MGAD

    This topic has made for some interesting reading today, Joe. In contrast to sour bob, I have enjoyed a little change of pace on an off day for the Cubs…..

    I read this site every day but only give the occasional comment. I thought for a while about throwing in my two cents, but, in the end, decided that it would take too much of my day to type it up and in the end, I would probably be “gray boxed”. So, to keep it short and to get back to the questions asked by Joe:

    1. No, the government should not be involved in health care.

    2. No, I am not OK with Obama’s way of paying for the costs by reducing the amount of itemized deductions for families with over $1 million household income. If, ultimately, his plan is going to go through, it would be better financed (along with reducing our national debt) by cutting needless, excessive government spending in MANY other areas (i.e. pork barrell spending)…..when will our politicians learn to live within a budget like the rest of us…..but that is a topic for another day, if Joe so chooses!

    Finally, I would like to commend lizzy and seymour butts for very well written, thought provoking posts. I enjoyed your opinions. And in the end, I believe that the last paragraph of seymour’s post will prove to be very true.

    Now, back to my FD job…..got a 911 call for an ambulance to pick up one of our citizens with a runny nose……….hmmmmmmmmm

  • Since this subject has been broached I would like to point out something very important:

    No part of this discussion (or related discussion) should ever appear in any other VFTB thread. It should never be referred to in any other thread. Even Lizzie’s comment that “Dave runs back and forth telling everyone why they are wrong. What’s the difference?” should not make it into the best of the week.

    Keep it isolated here. We will all benefit.

    And for the record, I pretty much agree with Dave.

  • MJ- me too but these are important debates.

    Why should private insurance companies, like Lizzies, have to compete with a public insurance option that has no need for profit. The public option simply takes from tax payers to cover any losses, see government run Amtrak for an example of that. How can a private company that needs profits to exist compete with a company that doesn’t need profit to exist. The result of a public insurance option will be the government bringing artificially low insurance prices to the market undercutting and eliminating private companies with tax payers footing the unpaid bill.

  • rob

    I think dave brings up a really good point about 50 comments back. Socialism is a word that is thrown out to scare people and end discussion that seeks answers to difficult questions. It is a simple way to answer a complex issue.

    It also seems oblivious to the shortcomings of capitalism. Capitalism falls apart when it is driven by greed (and that is a very easy line to cross). When people think they deserve things they cannot afford, and people or organizations enable them by giving them things they cannot afford in the hopes of making more and more money…it all hits the fan at some point. Welcome to our current situation.

  • cubbiedude

    Okay, I just can’t resist.

    1. I missed the TV presentation last night. I chose to enjoy the Tour de France coverage instead. But I’m somewhat familiar with the script.

    2. There is an engineering principle in play here: You can have good, you can have fast, you can have cheap. Pick any two.

    3. The government run, socialistic health care delivery system I experienced in the military was wonderful. Not everyone will agree, but I’ve seen a lot and that was pretty good.

    4. Now I’ll answer Joe’s specific questions:
    – Should the government be involved in health care? Sure. Who else can afford to fund the research?
    – Am I OK with funding this program by changing the itemized deductions for some people? Sure. Won’t cost me a penny, and might be the incentive needed to do away with itemized deductions altogether and go to a flat/fair tax system.

    5. As an added benefit, maybe Mr. Obama’s government run health care system can diagnose what’s wrong with the Cubs’ offense.

    6. Lizzie, that line goes straight to the highlights reel.

  • CubbieDude- most research is done by private firms hoping to profit from the benefit they provide society. Additionally, private firms invest in avenues of research that show the most promise vs politicians that would fund research based on politics. See State of California Bonds to fund Stem Cell Research. Because of politics the State of California took on $3B in debt to fund some of the least promising avenues of stem cell research, basically waisting $3B dollars. Private firms continue to research more promising avenues of stem cell research.

    Also, taxing health benefits will cost you plenty, and others. I included a link to a Washington Post Opinion piece from Monday July 20 explaining how this will cost us all titled ‘The Cost of Taxing Benefits’ by James Klein and John Sweeney

    Isn’t, ‘sure, screw the other guy it won’t cost me a penny’ a pretty poor way to vote and govern even it was true?

    Shortcut to: http://www.washingtonpost.com/wp-dyn/content/article/2009/07/19/AR2009071901761.html

  • Rob Bukowski

    I absolutely love that sour bob is a candy flavor and not a chosen name to define a personality. It makes me like Jeff a lot more. Not that I didn’t like him before. That makes all of this more than well worth it.

  • cubbiedude

    Doc Raker,

    1. Thanks for reading and thanks for thinking and thanks for commenting.

    2. I know nothing about State of California Bonds to fund Stem Cell Research. But I believe that Joe and I were talking about the Federal government. (If I admit I know that the last sentence will cause a spike in your blood pressure, does that constitute a violation of the Hippocratic Oath?)

    3. Thanks for the link. I read the article, but I don’t remember mentioning the taxing of health care benefits. The question involved reducing the amount of itemized deductions allowed. Forgive me, but I’m missing the connection.

    4. I didn’t say anything about screwing anybody. Only that my miniscule itemized deductions wouldn’t be affected.

    5. I’ve treated many patients who could never in a million years afford high buck coverage. Most would feel that they, themselves, were on the receiving end of a “screw the other guy” system. I guess perspective is everything.

  • Mastrick

    I have one of the best health insurance plans that is available in the private sector. That having been said I also feel that the current system is broken and corrupt – we spend nearly twice as much as most Europeans per capita and yet we are in the high forties in both average life span and infant mortality rates. And nearly 50 million people have no insurance! Anybody that feels that the rest of us aren’t footing the bill when the uninsured go to an emergency room should kindly pass me the bong.

    I am for a single payer healthcare system similar to what French and Japanese citizens enjoy. That ain’t gonna happen overnight and quite frankly the American people aren’t hurting enough yet to insist on better healthcare. So in the short term I will be satisfied with major insurance reform that sets up state insurance pools which companies can either participate in or not – with nobody excluded due to pre-existing conditions.

    We are the most technologically advanced country to ever exist, basic healthcare should be our right as citizens.

  • Doc Raker

    cubbiedude- part of the plan to fund this 1 Trillion dollar behemouth is to tax health benefits and to raise taxes on the incomes over a certain amount. Raising taxes on itemized deductions is all part of the same.

    Mastrick- do you mean to say the life expectancy in the US is under 50 years of age? What do you mean by ‘high forties in both life span and infant mortality’? I am confused, life expectancy is in the 70 + years of age range in the US.

    Medical care is and will be rationed in a managed care system, whether it is an privately run HMO or a government run plan. Don’t we deserve choices and liberty within our medical system? Shouldn’t treatment plans be made by doctors and patients together, not bean counters or bureaucrats?

  • part of the plan to fund this 1 Trillion dollar behemouth is to tax health benefits and to raise taxes on the incomes over a certain amount.

    This isn’t true. There are a few different plans out there, but most of the different plans would do one or the other – tax health benefits or raise taxes on high level incomes.

    What do you mean by ‘high forties in both life span and infant mortality’?

    That would be the US’s ranking.

    Medical care is and will be rationed in a managed care system, whether it is an privately run HMO or a government run plan.

    First, this is not true. Care will not be rationed. What is covered by insurance will be rationed, but not actual care. Second, again, this already happens. How is it any different when a government does this than when an insurance company does it? And, by the way, this doesn’t just happen in a managed care system, but it also happens in PPO plans. Insurance plans only cover certain things, up to a certain level, etc.

    Again, I ask the same question: are you saying that you want to get rid of the insurance industry?

  • mastrick (at work)

    The last I read the US was 48th-ranked in one of those indices and 50th in the other, that was according to the CIA Fact Book. Americans deserve to be better than 48th best especially when the per capita spending on healthcare is around $6000

  • Care will not be rationed. What is covered by insurance will be rationed, but not actual care.

    What’s the difference? Sorry, but rationing is part of the formula. I see it done all the time with the HMO medicare patients. I have had patients in need of cataract surgey who have to wait years for what they would have had immediately if they were in open Medicare and had a say in their own treatment.

    To answer your question Dave. It is unrealistic to eliminate insurance companies but to lower costs you have to eliminate or minimize the middle man. Direct purchase decisions between patients and doctors would lower costs. A world with no insurance companies will never happen so the next best thing is to increase employees choice in choosing health benefits and increasing direct patient payment with higher deductibles coupled with tax free FSA accounts. At least the money spent within the deductibles would be the patients direct choice. “Should I spend $1000 on my cataract surgey now or wait a little longer” vs “Is it covered, OK do it.”

    Looks like Dr Seymour was correct according to Charles Krauthammer, I have included the link to the 7/24/09 Washington Post piece WHY OBAMACARE IS SINKING

    Our healthcare system is not in crisis. Can it be improved, sure. Can the government improve it no.

    Shortcut to: http://www.washingtonpost.com/wp-dyn/content/article/2009/07/23/AR2009072302723.html?wpisrc=newsletter&wpisrc=newsletter&wpisrc=newsletter

  • cubbiedude

    Doc Raker,

    So are you in favor of Direct Reimbursement? I believe that cuts out the middle man.

  • Terrelle Pryor 2

    62 comments, I’m not going to read through them all, so I will say what I think: I’m not too sure about the government running health care, but I think for certain, the current system needs to be heavily regulated, as it is full of fraud and lies. Being healthy is not a privilege, it is a right, and I believe if we have healthy workers, our economy will do better. So what if the insurance companies lose money? Things have happened in the past where economic growth occurred but some industry lost out. Like the railroad industry. It was king until cars, planes, and trucks came.

  • Doc Raker

    Cubbiedude- direct reimbursement from whom? The patient? Yes, I think I offered some direction on reform above. You don’t agree, so be it.
    You would rather trust goverment and give away more of your liberties, so be it.

    Terrelle- Being healthy is not a right. Receiving health care isn’t a right. The word health care is misused. Health care is what an individual does for oneself. You eat right and excercise for good health. Medical care is what doctors provide to you when you are ill or injured. Medical care is a service another individual must provide. You can’t have a right that makes someone else provide you a service. I have the right to free lunch so cook me some lunch. Free lunch isn’t a right. The government can choose to pay someone to make you lunch, that doesn’t make it a right, it makes it an entitlement paid for by the government. Also, the system is already heavily regulated and regulation adds cost to the system.

    I always wonder why so many are distrustful of the private sector yet have a blind trust in government.

  • MJ

    The public option simply takes from tax payers to cover any losses, see government run Amtrak for an example of that.

    There more to Amtrak’s problems than being government run. Perhaps that should August 6’s discussion! 😆