OK, what did George W. Bush do right?

[Al68]

That is the argument being used right now by the insurance companies. Scare the public with even higher health care costs so they will shut up and take the status quo. The insurance companies are arguing that the situation can't be resolved, so it's either-or. Of course it can be resolved - by adopting a single-payer system that serves all citizens.

The insurance companies love to toss around the costs of medicare and other publicly funded programs while quite dishonestly ignoring the reason for the high costs - their own profit-taking and inefficiencies that they foist onto the system. Let's put this in the form that any physics newbie can understand.

To obtain a medical service for a person, a certain amount of money must change hands which we can equate to work.

To obtain a medical service for a person within a system that is larded with bureaucracy and administrative overhead and duplication a much larger amount of money must change hands.

Equating money with work, getting services for a person in an efficient system is equivalent to picking up a box and putting it on a table. Getting those same services for a person through an inefficient system is equivalent to picking up the box, climbing a flight of stairs, and putting the box on a table at that higher elevation. The greater the inefficiency, the more work has to be done to achieve the same result.

People who cite the costs of medicare without taking the price of administrative overhead, duplication, and other inefficiencies into account are uninformed in cost-analysis at best or disingenuous or even dishonest at worst.

If you really believe the problem is with the insurance companies, then you should blame Democrats for not just creating a company to compete with them. Democrats have been perfectly free to start a company to compete with private insurance companies for over 200 years. And they wouldn't need any Republican support.

It's funny that no Democrats have suggested competing with private companies. Why compete when they can take them over and control (own) them instead?

 

[turbo]

If you really believe the problem is with the insurance companies, then you should blame Democrats for not just creating a company to compete with them. Democrats have been perfectly free to start a company to compete with private insurance companies for over 200 years. And they wouldn't need any Republican support.

It's funny that no Democrats have suggested competing with private companies. Why compete when they can take them over and control (own) them instead?

Where do you get the idea that I am either a Democrat or a Republican? Both parties are complicit in the stranglehold that the insurance companies have on our health-care system. I have worked in the health-care industry, and have spent lots of time down in the bowels of the analysis/decision-making processes trying to keep a large private practice solvent and liquid. The insurance companies have leveraged their control over the health-care system to the point where they can ration access to care or deny it completely, which is pretty antithetical to the concept of "insurance".

 

[Al68]

Where do you get the idea that I am either a Democrat or a Republican? Both parties are complicit in the stranglehold that the insurance companies have on our health-care system. I have worked in the health-care industry, and have spent lots of time down in the bowels of the analysis/decision-making processes trying to keep a large private practice solvent and liquid. The insurance companies have leveraged their control over the health-care system to the point where they can ration access to care or deny it completely, which is pretty antithetical to the concept of "insurance".

I didn't say you were a Dem or Rep, I said you should blame Dems. It seems from your post that you would agree if only they started a company to compete with the private companies, it would take care of the problem. Do you?

It seems to me that an unwillingness to compete with private insurance companies is a tacit acknowledgment that they know they couldn't do better.

 

[wildman]

I have left leaning friends at EPA, and though they griped under Bush none of them would say the EPA was 'gutted'. How do you support that statement? Regards NCLB, do you blame him for not vetoing the version that emerged, or for what the Congress (including the Dem Senate) did to it?

You have to realize that a certain amount of the bashing you hear going on is just fund raising. As I stated in an earlier post, Bush did some fine things for the environment.

It is the same thing you are hearing now vis-a-vi Obama with gun control. Ohhhh HE IS GOING TO TAKE ALL YOUR GUNS AWAY. SEND MONEY! Well guess what, the first gun bill he signed is an expansion of gun rights (see http://news.yahoo.com/s/ap/20090520/ap_on_go_co/us_guns_national_parks ). NRA has made a lot of money in the last 6 months though. Just like the Sierra Club made a lot of money the last 8 years.

 

[Gokul43201]

I disagree. These are not stochastic processes.

I disagree. Do you imagine that the budget numbers/projections would look the same if Obama assumed office in a 2004 economy?

 

[mheslep]

I disagree. Do you imagine that the budget numbers/projections would look the same if Obama assumed office in a 2004 economy?

I am focusing here as Russ did above on spending, and for spending, yes I expect it would have been just as large, perhaps even more so. Clearly there would not have been a bill labeled 'stimulus', but all his policy statements point to a huge general budget. I expect he would have already raised taxes as he called for in the campaign instead of delaying the increase until next year because of the recession. Thus the deficit might not have been so large, but the spending -rebuilding infrastructure, public health care, energy - is all inline with his campaign policies, and the general pork give-aways by a newly arriving party was expected if not pre-announced.

 

[turbo]

It seems to me that an unwillingness to compete with private insurance companies is a tacit acknowledgment that they know they couldn't do better.

Wrong! There are both Democrats and Republicans "on the take" from health insurance companies, and their "unwillingness" to fix the system comes from greed for money and power. The vast majority of Americans want a public health insurance program, but our Congressional representatives would lose millions from the insurance companies if that happened. Thus we have the GOP railing against "socialist health-care" and "moderate" Democrats urging for tinkering the status quo.

As for the argument that our government could not do better than the private insurers: you only have to look at any other modern, industrialized country. They have public insurance and spend less per-capita and less as a % of GDP than the US does, with better results, overall. Are Americans somehow less-capable of reforming a health-care system and making it accessible to all citizens than people of other nationalities? That does not even deserve consideration, though it is implicit in your post.

 

[Al68]

Wrong! There are both Democrats and Republicans "on the take" from health insurance companies, and their "unwillingness" to fix the system comes from greed for money and power. The vast majority of Americans want a public health insurance program, but our Congressional representatives would lose millions from the insurance companies if that happened. Thus we have the GOP railing against "socialist health-care" and "moderate" Democrats urging for tinkering the status quo.

As for the argument that our government could not do better than the private insurers: you only have to look at any other modern, industrialized country. They have public insurance and spend less per-capita and less as a % of GDP than the US does, with better results, overall. Are Americans somehow less-capable of reforming a health-care system and making it accessible to all citizens than people of other nationalities? That does not even deserve consideration, though it is implicit in your post.

Nice sidestep. I was referring to competing with private insurers, not controlling them.

It's taking control of private companies with force to avoid having to compete with them that is referred to as "socialist".

I suppose my question will remain unanswered: Why have Dems not started an insurance company to compete, like the USPS competes with private companies?

 

[turbo]

You are free to propose your own fix. The government has not proposed taking over private insurance companies by force. If you have support for this neo-con idea, I would like to see it. If you want to bandy the word "socialist" as a negative to denigrate any publicly-finance health insurance, you are free to do so, as are Rush Limbaugh and all the hacks bought by the insurance companies. I ask that you provide some cost-benefit studies to support your assertions, though. Our country needs a publicly-finance health insurance plan that ensures ALL our citizens, not just the ones wealthy enough to afford coverage or those with no pre-existing conditions. Currently, private insurance companies can reject anybody (Rationing Care! - a big neo-con rallying-cry) because they have a pre-existing condition or cannot afford coverage. Taking care of these people on a too-little, too-late basis costs our health system billions ever year and ensures poor outcomes for too many. Preventative care, regular exams, and decent follow-up can avoid the most expensive emergency procedures and the (entirely expected) failure to provide favorable outcomes. Care delayed is care denied, and we ALL pay for it.

 

[Al68]

You are free to propose your own fix. The government has not proposed taking over private insurance companies by force. If you have support for this neo-con idea, I would like to see it. If you want to bandy the word "socialist" as a negative to denigrate any publicly-finance health insurance, you are free to do so, as are Rush Limbaugh and all the hacks bought by the insurance companies.

So no one could possible take the libertarian position unless they were "bought off"? This is the same hateful rhetoric we've heard for decades. And a classic logical fallacy (ad hominem).
And neo-con means economic liberalism now? And I shouldn't use the word socialist to describe government economic control?

I ask that you provide some cost-benefit studies to support your assertions, though.

What assertions?

Our country needs a publicly-finance health insurance plan that ensures ALL our citizens, not just the ones wealthy enough to afford coverage or those with no pre-existing conditions.

That's two different subjects. Deciding whether to have government controlling all insurance companies (which they already do to some extent, yes, by force, and isn't that what the word socialism means?) is one issue, deciding whether to use theft to help poor people is another.

Currently, private insurance companies can reject anybody (Rationing Care! - a big neo-con rallying-cry) because they have a pre-existing condition or cannot afford coverage.

Again, neo-con means economic liberalism? Gee, anyone selling anything can refuse to sell it to someone unable to buy it. That's what "for sale" means. Insurance companies sell insurance coverage. Believing that a private company should be free to sell insurance free of government control is "neo-con"? Are we completely losing the English language now?

Taking care of these people on a too-little, too-late basis costs our health system billions ever year and ensures poor outcomes for too many. Preventative care, regular exams, and decent follow-up can avoid the most expensive emergency procedures and the (entirely expected) failure to provide favorable outcomes. Care delayed is care denied, and we ALL pay for it.

Gee, that must be the disagreement (not!).

The issue I was referring to, and the question I asked, is:

Whatever plan you favor for the source of insurance coverage, would it be good enough to compete with private companies?

Notice that for my question, the worse you think insurance companies are, the easier they should be to out perform, so the less justification one would have to avoid competition by controlling or regulating them.

 

[WheelsRCool]

You are free to propose your own fix. The government has not proposed taking over private insurance companies by force. If you have support for this neo-con idea, I would like to see it.

They don't need to. A universal healthcare program will drive private insurers out of business, and thus move all of America onto the government system, which is the idea, to move us to single-payer. The Democrats are fully aware of this, and so is the insurance industry.

When President Obama says that you will be able to keep your own private insurance, he is lying, because eventually everyone will be forced onto the government program.

The government program will be cheaper, although not any better, and thus many people will make the choice to switch to the government program.

The other big lie is when President Obama says, "If the free-market healthcare is so good, then it will be able to compete fine with the government option." Yeah, if it was free-market, that would be true perhaps, but it is not free-market. Not anywhere ever close.

50% of healthcare is already government essentially, Medicare and Medicaid. The other 50% is privatized but it is so heavily regulated that it is not anywhere even close to being a free-market. Insurance companies control it.

People with Medicare and Medicaid can only been charged up to a certain amount of money by hospitals and so forth. Because of this, hospitals and insurance companies have to make up that lost money by yanking up costs on people with private plans.

However, then there are laws that restrict insurance companies from yanking up prices on this and that. This results in direct rationing, as the health insurance companies essentially flat-out deny care to people.

There are other enormous problems with universal healthcare:

1) The cost will be astronomical, this is according to the CBO. And that is assuming the program would be within its projected cost range, which government health programs never are. There are trillions in unfunded liabilities for Medicare, Medicaid, and Social Security alone. The only government healthcare program to actually cost less than initially projected is the Medicare prescription drug program that was enacted by the Bush administration, and that is because it employed free-market principles (increased competition between drug manufacturers which has driven down costs).

And since the country is short of $$$ right now, the only way to pay for it will be to borrow most of the money, which will skyrocket interest rates, which will drive us into an all-new recession (or depression if we are not out of this current recession).

Although one way they are talking about helping pay for it is also to tax people's health benefits, which was McCain's plan during the campaign which then Senator Obama criticized highly at the time.

The neat thing about this is that if they decide to tax only the health benefits of non-unionized workers, it would result in people scrambling to get into unions and make it far easier for anyone to form a union. It would be one of the biggest pay-offs to organized labor in history.

And it would be a nice way to get the effect that the Orwellian-named "Employee Free Choice Act" (which takes away a worker's right to a secret ballot vote) seeks, only without actually enacting that legislation.

2) Quality in a government-run healthcare system sucks. Even in France, where they are far more socialist than in the United States, they have a separate privatized healthcare system for the bureaucrats.

3) If the country moves to single-payer, the government gets an enormous degree of control over the economy. Healthcare is 16% of our economy as is.

When the "government is paying" for your healthcare, then they can do things like say levy a tax on this, or levy a tax on that, or regulate this, regulate that, make a law restricting this, make a law restricting that, because otherwise "it will increase healthcare costs."

If you want to bandy the word "socialist" as a negative to denigrate any publicly-finance health insurance, you are free to do so, as are Rush Limbaugh and all the hacks bought by the insurance companies.

Rush Limbaugh is no hack. He is one of the few who actually bothers to talk about real issues.

President Obama is bought and paid for by the unions and the trial lawyers, however.

I ask that you provide some cost-benefit studies to support your assertions, though. Our country needs a publicly-finance health insurance plan that ensures ALL our citizens, not just the ones wealthy enough to afford coverage or those with no pre-existing conditions.

Yeah, it would be nice if we could actually discuss these things, wouldn't it, instead of our President working furiously to ram his healthcare agenda down our throats with no real debate.

The truth is that we CAN'T cover everyone the way you want, because there are simply not enough doctors and nurses nor enough money to finance such a program. Rationing will occur. When they say they will "control costs" (never heard of a government program that does that), they are talking about rationing.

Currently, private insurance companies can reject anybody (Rationing Care! - a big neo-con rallying-cry) because they have a pre-existing condition or cannot afford coverage.

And you think the government program will not? Furthermore, what makes you think the GOP supports health insurance companies? Health insurance companies controlling healthcare and government healthcare are two evils, one lesser than the other. With the insurance companies, at least you have competition and multiple choices.

But you are still at the mercy of bureaucrats, just corporate bureaucrats. Corporate bureaucrats do everything at a profit, which in general is good but with healthcare it depends. I do not want corporate bureaucrats or government bureaucrats in charge of healthcare.

With government healthcare, you're at the mercy of government bureaucrats, and they tend to spend far too much money, wasting it. Medicare and Medicaid are monuments to waste, fraud, corruption, etc...this leads to massive inefficiency and wait times.

Insurance companies only dominate because of already massive government interference into the economy. Areas of healthcare that are truly free-market see costs going down, not up. Medicare and Medicaid are two prime drivers of increasing costs in private healthcare.

One thing we could do to really bring down some healthcare costs is tort reform. But that means going against the trial lawyers, which the Democrats will NEVER do.

Taking care of these people on a too-little, too-late basis costs our health system billions ever year and ensures poor outcomes for too many. Preventative care, regular exams, and decent follow-up can avoid the most expensive emergency procedures and the (entirely expected) failure to provide favorable outcomes. Care delayed is care denied, and we ALL pay for it.

True, but I have never seen a government program do these things better. It is like a religion to the Left that government can do healthcare better when they cannot even run AMTRAK or the postal service properly.

 

[mheslep]

You are free to propose your own fix. The government has not proposed taking over private insurance companies by force...

Single payer as proposed by some legislators like B. Sanders would indeed put them all out of business. Is that force?

 

[Al68]

The other 50% is privatized but it is so heavily regulated that it is not anywhere even close to being a free-market. Insurance companies control it.

Insurance companies only dominate because of already massive government interference into the economy.

This is a good point. It's really silly to say that insurance companies have control over themselves because they lobby to minimize government's control.

That's like saying I have control over how often I use the bathroom because I have bribed (helped the campaign of) government officials to "give" me that control (not oppress me).

Gee, greed is the reason for my bathroom habits, since they are due to politicians receiving "bribes".

Do people not realize how absurd it is to attribute libertarianism to greed or bribery?

 

[WheelsRCool]

Regarding Bush Sr. and Bill Clinton, I think one thing that caused the recession under Bush Sr. was his tax increase (although I might be wrong). He wanted to balance the budget, but the tax increase was overall more negative than positive.

Under Clinton, I think there were about five things that contributed to the economy and budget deficit shrinking under him:

1) Military spending was cut back significantly because of the Soviet Union being no more (under Reagan I believe defense spending consisted of a large portion of the Reagan deficit (the other factors being the tax cuts and the fixing of inflation which drove up the deficit).

2) Welfare reform

3) Completion of NAFTA

4) Dot Com bubble

5) Signing a capital gains tax cut, which increased revenues (initially at least anyhow, enough to help contribute to a surplus).

 

[mheslep]

...
Under Clinton, I think there were about five things that contributed to the economy and budget deficit shrinking under him:

1) Military spending was cut back significantly because of the Soviet Union being no more (under Reagan I believe defense spending consisted of a large portion of the Reagan deficit (the other factors being the tax cuts and the fixing of inflation which drove up the deficit).

2) Welfare reform

3) Completion of NAFTA

4) Dot Com bubble

5) Signing a capital gains tax cut, which increased revenues (initially at least anyhow, enough to help contribute to a surplus).

Exactly right, with #4 being the largest figure on either side of the spending/revenue ledger